Why Face Masks Should not be Imposed on the Public Again: A Review Article

Abstract

Viral epidemics of acute respiratory infections pose a global threat. Influenza outbreaks occur almost every year. Specifically, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), emerged in late 2019. This unprecedented event resulted in many countries requiring masks in public spaces to contain the spread of SARS-CoV-2. However, the early and previous systematic reviews of randomized controlled trials (RCTs) found that medical/surgical masks did not appear to reduce respiratory viral infections. Also, N95 respirators did not provide superior protection over surgical masks against viral infections or influenza-like infections among healthcare workers (HCWs), although N95 respirators theoretically provide better protection. This led to the recommendation not to wear facemasks as potential benefits are limited, and there is a risk of self-contamination if misused. However, with the ongoing spread of SARS-CoV-2, several health authorities suddenly shifted their recommendations and advised the general public to wear masks, with some governments even mandating it. By July 2023, the health-protective benefits of wearing facemasks are still conflicting, and debate over the idea of a mask mandate is ongoing. Therefore, this review aims to discuss ten reasons why face masks should not be imposed on the public again, which include the functional weaknesses of facemasks, lack of justification for the sudden change in the recommendations during the COVID-19 pandemic, the effectiveness of facemasks in the community and among HCWs based on the systematic reviews of the RCTs, their effectiveness based on the RCTs, the effectiveness of N95 respirators versus surgical masks in protecting from acute respiratory infection based on the systematic reviews, their potential harms, the poor quality of most masks used by the public, their misuse, the trajectory of the COVID-19 pandemic despite masking, and the importance of acknowledgment of the rights of people in wearing masks or not.