Facial Masking for Covid-19 — Potential for “Variolation” as
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A commentary in the New England Journal of Medicine published on 8 September posits wearing a facial mask may allow the wearer to be exposed to just enough of the coronavirus to provoke an immune response, serving as a crude vaccine.

The commentary by Drs. Monica Gandhi and George W. Rutherford of the University of California said the exposure could blunt the severity of the disease, ensuring a larger number of infections could remain asymptomatic.

“If this hypothesis is borne out, universal masking could become a form of ‘variolation’ that would generate immunity and thereby slow the spread of the virus in the United States and elsewhere, as we await a vaccine,” the authors wrote.

Authors also note there’s a strong correlation between universal mask-wearing and disease containment, and between the amount of virus received and severity of the disease.

Some 40% of coronavirus cases are asymptomatic, but experts say the rate could be as high as 80% if widespread masking is adopted.

“In an outbreak on a closed Argentinian cruise ship, for example, where passengers were provided with surgical masks and staff with N95 masks, the rate of asymptomatic infection was 81% [as compared with 20% in earlier cruise ship outbreaks without universal masking],” they said.

The authors also noted vaccine trials have indicated a lessening in the severity of the virus if it was not completely prevented.

Gandhi and Rutherford called for further studies to test their theory. Arizona epidemiologist Saskia Popescu told the New York Times, "we don’t have a lot to support it, it could lead to a false sense of complacency, putting people at even higher risk."

1. https://www.nejm.org/doi/full/10.1056/NEJMp2026913
2. https://www.nytimes.com/2020/09/08/health/covid-masks-immunity.html
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