Health & Fitness

The question of whether we should wear face masks or not to prevent the spread of COVID-19 is a hotly contested issue. Part of the confusion may be related to the difference between viral particles spread via respiratory droplets, and viral particles spread via the air itself.

I believe it's important to realize the difference between these two modes of transmission, and to not overestimate the protection you can get or give others by wearing a mask.

The science^1,2 clearly shows face coverings of various kinds do little if anything to prevent respiratory illnesses caused by aerosolized viruses. Many health authorities still insist that something is better than nothing, though, since they do inhibit the dissemination of viral-laden respiratory droplets.

But influenza viruses — coronaviruses that cause the common cold and SARS-CoV-2 — all spread via the air, not just via droplets or touching contaminated surfaces, and it's important to realize that preventing droplet contamination does not mean you also prevent the transmission of the aerosolized virus. (The aerosol part of transmission is regrettably overlooked in the video above, which reviews a number of problems with mandatory mask recommendations.) 

Size Matters

SARS-CoV-2 is an aerosolized virus, meaning it floats in the air. One of the issues at hand is the size of the virus. If the gaps in the mask are larger than the virus, it stands to reason it cannot block the virus from entering or escaping the mask.

SARS-CoV-2 is a beta-coronavirus with a diameter between 60 nanometers (nm) and 140 nm, or 0.06 to 0.14 microns (micrometers).³ This is about half the size of most viruses, which tend to measure between 0.02 microns to 0.3 microns.⁴

Virus-laden saliva or respiratory droplets expelled when talking or coughing, however, measure between 5 and 10 microns.⁵ N95 masks can filter particles as small as 0.3 microns,⁶ so they may prevent a majority of respiratory droplets from escaping, but not aerosolized viruses.

Lab testing⁷ has shown 3M surgical masks can block up to 75% of particles measuring between 0.02 microns and 1 micron, while cloth masks block between 30% and 60% of respiratory particles of this size. For cloth masks, cotton-chiffon, cotton-silk hybrids, and high thread count cotton materials provide the best droplet filtration. As reported by the Emergency Medicine News journal:⁸

"Mueller, et al.,⁹ placed a particle counter inside various masks worn by a volunteer to sense 0.04 micron NaCl particles aerosolized in ambient air, and found that adding a nylon stocking overlayer to the mask improved virus blockade for all types, including surgical masks. This simple addition improved many of the homemade cloth masks to the baseline level of a surgical mask."

So, in summary, if you are a carrier of the virus, by wearing a surgical mask, you theoretically lower the amount of viral-laden respiratory droplets that you deposit into your environment by about 75%.

As such, you could argue that surgical masks lower the overall contamination risk to others if you are a carrier of the virus. If you are infected and wear a surgical mask, others in close proximity will be protected to some degree from getting hit by your contaminated respiratory droplets.

That said, the force by which you expel the droplets also matters. Back in April 2020, a small South Korean study¹⁰ found that surgical and cloth masks were unable to block SARS-CoV-2 from the coughs of COVID-19 patients. The journal retracted the paper several weeks later.^11,12

Masks Cannot Block Aerosolized Viruses

The virus is not restricted to respiratory droplets, though. It's also in the air itself, and these aerosolized particles are far tinier. To block these, you'd need a mask that prevents all air flow, and that, of course, wouldn't work, since you need air flow to survive.

Now, the U.S. Centers for Disease Control and Prevention is actually recommending people wear cloth masks — not surgical masks or N95, which they recommend for health care workers only. The problem with this is that not only do cloth masks fail to provide any protection against aerosolized viruses, as noted above, they also provide very little protection in terms of blocking respiratory droplets.

As reported by The National Academies of Sciences in its Rapid Expert Consultation on the Effectiveness of Fabric Masks for the COVID-19 Pandemic report, published April 8, 2020:¹³

"The evidence from … laboratory filtration studies suggest that … fabric masks may reduce the transmission of larger respiratory droplets. There is little evidence regarding the transmission of small aerosolized particulates of the size potentially exhaled by asymptomatic or presymptomatic individuals with COVID-19."

So, regardless of the mask, it will not prevent you from exhaling or inhaling the aerosolized virus, but cloth masks are clearly the least preferable option if you actually want to reduce the spread of infection, as their ability to block respiratory droplets is also limited.

In particular, masks with airflow valves on the front should be avoided, as the valve lets out unfiltered air, thus negating the small benefit you might expect from a mask.¹⁴

What We Learned From the Mask for Flu Policy

To put the mask controversy into some perspective, let's compare it to what we learned from the masking for influenza controversy a couple of years back. In September 2018, the Ontario Nurses Association (ONA) won its second of two grievances filed against the Toronto Academic Health Science Network's (TAHSN) "vaccinate or mask" (VOM) policy. As reported by the ONA:¹⁵

"These policies force nurses and other health-care workers to wear an unfitted surgical mask for the entirety of their shift if they choose not to receive the influenza vaccine.

After reviewing extensive expert evidence submitted by both ONA and St. Michael's Hospital, which was the lead case for the TAHSN group, Arbitrator William Kaplan, in his September 6 decision,¹⁶ found that St. Michael's VOM policy is 'illogical and makes no sense' and 'is the exact opposite of being reasonable.' In reaching this conclusion, Arbitrator Kaplan rejected the hospital's evidence.

This is the second such win for ONA. In 2015, Arbitrator James Hayes struck down the same type of policy in an arbitration that included other Ontario hospitals across the province … Hayes found there was 'scant evidence' that forcing nurses to use masks reduced the transmission of influenza to patients.

Despite this clear ruling, the majority of TAHSN hospitals refused to follow the Hayes award and maintained their respective VOM policies. As a result, ONA was forced to litigate this matter again at St. Michael's Hospital …

ONA's well-regarded expert witnesses, including Toronto infection control expert Dr. Michael Gardam, Quebec epidemiologist Dr. Gaston De Serres, and Dr. Lisa Brosseau, an American expert on masks, testified that there was insufficient evidence to support the St. Michael's policy and no evidence that forcing healthy nurses to wear masks during the influenza season did anything to prevent transmission of influenza in hospitals.

They further testified that nurses who have no symptoms are unlikely to be a real source of transmission and that it was not logical to force healthy unvaccinated nurses to mask."

No Direct Evidence Masks Prevent Spread of Influenza

In summary, the ONA argued, and Kaplan agreed, that the rule forcing unvaccinated nurses to wear a surgical mask during flu season to protect patients from influenza was not supported by science and was most likely an attempt to drive up vaccination rates among staff.

TAHSN argued that "The wearing of face masks can serve as a method of source control of infected HCWs [health care workers] who may or may not have symptoms. Masks may also prevent unvaccinated HCWs from as yet unrecognized infected patients or visitors."¹⁷ Like the previous arbitrator, Kaplan disagreed.

"I … find that the weight of scientific evidence said to support the VOM Policy on patient safety grounds is insufficient to warrant the imposition of a mask-wearing requirement for up to six months every year.

Absent adequate support for the freestanding patient safety purpose alleged, I conclude that the Policy operates to coerce influenza immunization and, thereby, undermines the collective agreement right of employees to refuse vaccination," Kaplan wrote,¹⁸ adding that the TAHSN's mask rule:

"… was made in the admitted absence of direct evidence that mask- wearing HCWs protected patients from influenza; but on the basis of 'indirect evidence [that] suggests it does.'

The only fair words to describe the evidence advanced in support of the masking component of the VOM policy in the THASN report, and in this proceeding, are insufficient, inadequate, and completely unpersuasive."

CDC Now Promotes Mask Wearing for Flu

Despite the lack of supporting science, in its current guidance¹⁹ on mask use to prevent the spread of influenza, the CDC calls for health care personnel to wear a surgical mask or fit-tested respirator whenever they're within 6 feet of an influenza patient.

They also now recommend that anyone suspected of having influenza who enters a medical facility should wear a mask "at all times until they are isolated in a private room."

The CDC does point out that "Masks are not usually recommended in non-healthcare settings," and that "No recommendation can be made at this time for mask use in the community by asymptomatic persons, including those at high risk for complications, to prevent exposure to influenza viruses." Still, they add that:

"If unvaccinated high-risk persons decide to wear masks during periods of increased respiratory illness activity in the community, it is likely they will need to wear them any time they are in a public place and when they are around other household members."

When was the last time you wore a mask during influenza season? Never? Me either. Have you ever even heard the CDC recommend mask wearing to prevent the spread of influenza in previous years?

What has changed is that the CDC is now suggesting mask wearing, both at home and in public during influenza season, might be a good idea. Where's the evidence showing masks help prevent the spread of influenza?

Are masks an effective way to reduce the spread of respiratory illnesses, or are these mask recommendations just another strategy to make the public surrender to irrational medical tyranny that is likely to radically increase implementation of mandatory vaccination? Of course, these vaccinations would not just be for the flu but also COVID-19 once a vaccine becomes available.

Cloth Masks Offer False Sense of Security

April 1, 2020, the Center for Infectious Disease Research and Policy (CIDRAP) published a commentary²⁰ by retired professor Lisa Brosseau, ScD, and Margaret Sietsema, Ph.D., assistant professor at the University of Illinois, arguing that mandates calling for the wearing of cloth masks or face coverings in public are "not based on sound data." Both are experts on respiratory protection and infectious diseases. July 16, the following editor's note was added to the article:

"The authors and CIDRAP have received requests in recent weeks to remove this article from the CIDRAP website. Reasons have included: (1) we don't truly know that cloth masks (face coverings) are not effective, since the data are so limited, (2) wearing a cloth mask or face covering is better than doing nothing.

(3) the article is being used by individuals and groups to support non-mask wearing where mandated and (4) there are now many modeling studies suggesting that cloth masks or face coverings could be effective at flattening the curve and preventing many cases of infection."

The addition of that editor's note is more proof that this issue is politically driven. Kudos to CIDRAP for not succumbing to censorship pressure to remove the article entirely, as it makes some excellent points. Among them:

Worse, while cloth masks, at best, can help protect others if you're infected, the CDC and others are now implying cloth masks can also protect the wearer, even though there's no evidence for this at all.

"We are concerned that many people do not understand the very limited degree of protection a cloth mask or face covering likely offers as source control for people located nearby … Cloth masks and face coverings likely do not offer the same degree of protection as physical distancing, isolation, or limiting personal contact time," Brosseau and Sietsema write.

Surgical Masks Cannot Protect Against Influenza

Articles published before the COVID-19 outbreak also offer evidence that the mask rules are not driven by science but rather by politics. For example, in October 2019, Medical Xpress reported that not only is the influenza vaccine only 15% effective, on average, but wearing a surgical mask is equally ineffective:²¹

"A study that is often cited as evidence that surgical masks work is a randomized trial from 2009 that compared surgical masks with a specialist mask called an N95 respirator — a mask that fits snugly and filters at least 95% of very small (0.3 micron) particles. 

The study,²² published in JAMA, found that surgical masks were as effective as N95 respirators at preventing the flu, which is to say, not all that effective because, of the 446 nurses who took part in this study, nearly one in four (24%) in the surgical mask group still got the flu as did 23% of those who wore the N95 respirator.

And, because both groups wore masks, it's impossible to say how they would have fared compared with not wearing a mask at all. Basically, there is no strong evidence to support well people wearing surgical masks in public."

In 2019, a review of interventions for flu epidemics published by the World Health Organization also concluded the evidence leaned against using face masks, with the exception of one study that suggested N95 masks may offer some protection:²³

"Ten relevant RCTs were identified for this review and meta-analysis to quantify the efficacy of community-based use of face masks, including more than 6000 participants in total. Most trials combined face masks with improved hand hygiene, and examined the use of face masks in infected individuals (source control) and in susceptible individuals.

In the pooled analysis, although the point estimates suggested a relative risk reduction in laboratory-confirmed influenza of 22% in the face mask group, and a reduction of 8% in the face mask group regardless of whether or not hand hygiene was also enhanced, the evidence was insufficient to exclude chance as an explanation for the reduced risk of transmission.

A study suggested that surgical and N95 (respirator) masks were effective in preventing the spread of influenza … There is a moderate overall quality of evidence that face masks do not have a substantial effect on transmission of influenza …

Reusable cloth face masks are not recommended. Medical face masks are generally not reusable, and an adequate supply would be essential if the use of face masks was recommended. If worn by a symptomatic case, that person might require multiple masks per day for multiple days of illness."

We can also look at countries where people routinely wear face masks to protect themselves against air pollution, such as Japan. Despite widespread routine mask wearing out in public, they still suffer major influenza outbreaks.²⁴

Last but not least, face masks must be put on, removed and disposed of properly in order for you to benefit from them. Readers Digest recently published "11 Mistakes You're Probably Making with Face Masks,"²⁵ reviewing all the ways in which you might nullify the mask's benefit.

Where's the Evidence to Support Shift in Mask Guidance?

What are we to make of health mandates that aren't based on compelling scientific evidence? You may recall Dr. Anthony Fauci has flip-flopped on this issue over the past few months, in mid-February telling us:²⁶

"If you look at the masks that you buy in a drug store, the leakage around that doesn't really do much to protect you. People start saying, 'Should I start wearing a mask?' Now, in the United States, there is absolutely no reason whatsoever to wear a mask."

March 8, he told 60 Minutes:²⁷

"Right now, in the United States, people should not be walking around with masks. There's no reason to be walking around with a mask. When you're in the middle of an outbreak, wearing a mask may make people feel a little bit better, and it might even stop a droplet, but it's not providing the perfect protection that people think that it is."

By mid-June, he’d reversed course, and was urging everyone to wear a mask. But where is the data supporting this 180-degree shift in position?

Contrary to what you’d assume, even some of the most recently published research claims masks provide little to no benefit. Case in point is a policy review paper²⁸ published in Emerging Infectious Diseases in May 2020 — the CDC’s own journal — which reviews “the evidence base on the effectiveness of nonpharmaceutical personal protective measures … in non-healthcare settings.” According to this policy review:²⁹

“Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza. We similarly found limited evidence on the effectiveness of improved hygiene and environmental cleaning.”

Pages 970 to 972 of the review include the following quotes:

“In our systematic review, we identified 10 RCTs [randomized controlled trials] that reported estimates of the effectiveness of face masks in reducing laboratory-confirmed influenza virus infections in the community from literature published during 1946–July 27, 2018. In pooled analysis, we found no significant reduction in influenza transmission with the use of face masks …

Disposable medical masks (also known as surgical masks) are loose-fitting devices that were designed to be worn by medical personnel to protect accidental contamination of patient wounds, and to protect the wearer against splashes or sprays of bodily fluids …

There is limited evidence for their effectiveness in preventing influenza virus transmission either when worn by the infected person for source control or when worn by uninfected persons to reduce exposure.

Our systematic review found no significant effect of face masks on transmission of laboratory-confirmed influenza … In this review, we did not find evidence to support a protective effect of personal protective measures or environmental measures in reducing influenza transmission.”

When confronted with his previous statements, Fauci tried to justify his earlier statements saying they’d feared panic buying might trigger PPE shortages in hospitals.³⁰

A problem with that rationalization is that the two supply chains are separate. Retail customers typically cannot buy personal protective equipment from the same medical distributors that hospitals do. Another problem is that lying to the public is unacceptable, even if you think you have a good reason.

Does Empirical Evidence Matter Anymore?

I guess the question is, does anyone actually care about the science?^31,32,33 In a July 12, 2020, Twitter post, Ivor Cummins³⁴ asks whether empirical evidence matters anymore, and presents statistical evidence showing that mask mandates have not had any impact, positive or negative, on infection rates.

Empirical evidence refers to "observation and documentation of patterns and behavior through experimentation." In other words, can you show, after the fact, that an intervention led to the desired result you were after? In the case of mask wearing, the empirical evidence suggests it's a useless intervention, as it has not lowered, let alone eliminated, infections in countries after the mandate was implemented.

Fall of the Republic, Rise of Corporations in US

If mask wearing does not actually reduce infection rates, why are we doing it? Conversely, if SARS-CoV-2 is sensitive to ultraviolet rays and heat and is inactivated at temperatures at or above 80.6 degrees Fahrenheit or 27 Celsius,³⁵ why aren't we being told to spend more time outdoors this summer rather than closing parks and beaches and telling us to stay at home?

As noted in Jeremy Elliott's video monologue above, pandemic responses appear to have little to do with protecting public health, and everything to do with the promotion of a political agenda that aims to strip us of our personal freedoms and groom us to accept a radical loss of our civil liberties.

He proposes mask mandates may actually be a test run to see how well artificial intelligence-based facial recognition systems work. Whether that's true or not, we're certainly seeing a rapid roll-out of draconian tracking and tracing systems that, when combined with banking and other systems will eliminate any trace of freedom.

I believe there is a time and a place for wearing a mask. If you're visiting a hospital or nursing home, wearing a mask, ideally an N95 or surgical mask, makes sense for both patient and visitor. If you suspect you have COVID-19 and must go out, wearing a medical-grade mask would be wise.

But to mandate masks for all, everywhere, at all times — Broward County, Florida has even issued an emergency order³⁶ mandating masks to be worn inside your own residence! — makes little sense from a health standpoint.

Let's face it: SARS-CoV-2 is likely to be with us going forward, just like other pandemic influenza viruses that have emerged in the past. So, just how long are we expected to wear masks everywhere we go? Will we be forced to choose between vaccinations or permanent mask wearing?

As you ponder these questions, remember that we will never be able to prevent all death, be it from influenza, COVID-19, tuberculosis or any other viral infection, no matter what we do, and no matter how many of our freedoms we give up.

Consider Peaceful Civil Disobedience

Most objections to mask wearing requirements are not to the masks themselves, but to the mandate, and well-documented consequences such as oxygen deprivation which should give pause when considering a legal requirement of wearing masks in public. We already see that most will wear makes in public regardless of mandates. But, it seems entirely irresponsible and unethical for governments to mandate such a practice for everyone.

It is clear nearly everyone is being regularly exposed to the propaganda of the mainstream media that is seeking to convince you that masks will help. So, it is beyond understandable that you would want everyone to wear masks because you believe that they will prevent the spread of this virus and save lives.

I get it, but if you carefully evaluate the evidence independent of the mainstream narrative, it is likely you will conclude that this recommendation has nothing to do with decreasing the spread of the virus, but more to indoctrinate you into submission.

In my recent interview with Patrick Wood, he provides compelling evidence that this has been a carefully crafted technocratic strategy that has been in place for the last 50 years or so. By submitting to these orders, it is likely you are setting the stage for the inevitable mandatory vaccinations coming soon that I am planning a number of future articles on. So, watch the recent video from Wood above, and consider not complying with their recommendations.

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For centuries, people have been searching for the Fountain of Youth. Many thought it was a real fountain where a person could bathe or drink to slow the aging process. While that fountain doesn’t exist, there are several strategies you may use to affect a change internally with external results.

Several factors affect aging, including chronic inflammation that leads to chronic disease. Although inflammation plays an essential role in repairing injury, chronic inflammation may result in health conditions like bowel diseases, arthritis, diabetes and heart disease.¹

Although many times you won’t notice early visible signs of chronic inflammation, there is mounting evidence that it is an underlying factor in chronic disease.² There is also evidence that natural remedies are effective in reducing inflammation and thus reducing the potential for chronic disease.³

Underlying or baseline inflammation can exacerbate the aging process and raise the risk of severe infectious disease, as has been demonstrated by the numbers of people 65 and older who have died from COVID-19. The Centers for Disease Control and Prevention reports that 8 of every 10 deaths from COVID-19 are people age 65 and older.⁴

Inflammaging Associated With Frailty and Increased Death

Inflammaging is the “chronic low-grade inflammation occurring in the absence of overt infection.”⁵ This type of damaging inflammation negatively impacts immunity. Researchers hope that by preventing baseline inflammation, they can improve the immune response.

This is a significant pathway to help reduce the severity of disease in older individuals infected with SARS-CoV-2.⁶ This novel coronavirus brings about a serious condition in the elderly, increasing morbidity and mortality.

Severe disease often presents with excessive inflammation in the pulmonary system, especially in older individuals with high baseline C-reactive protein, indicating a heightened inflammatory response. Data show that inflammation biomarkers like this are relatively accurate predictors of mortality in the elderly, increasing their susceptibility to all sorts of maladies.⁷

In a paper published in Science Mag, the authors discuss some of the cellular and systemic challenges faced by older adults in their fight against infectious diseases, including COVID-19.⁸

They hypothesize that a low-grade inflammatory response may be the result of several mechanisms, including a compromised gut microbiome and obesity. As the body ages, it also slowly loses the ability to clear dead and dying cells, which subsequently increases inflammatory activity.

These senescent cells are no longer able to divide, and they accumulate throughout the body. However, they are not “silent” but rather can secrete inflammatory cytokines and other inflammatory molecules that can trigger inflammation and dysfunction.

Reducing Baseline Inflammation May Lower Disease Severity

If you have a baseline inflammatory response, the flu vaccine may not be as effective for you as expected.⁹ Researchers have improved the body’s response to an antigen by administering an inhibitor,¹⁰ which suggests that baseline inflammation has a significant effect on the immune system.

The authors also theorize this may be relevant to older individuals with severe respiratory tract disease. As we age, the number of senescent cells and the level of baseline inflammation rises. Another way to improve immunity and reduce inflammation, then, may be to eliminate them.

This has prompted the development of senolytic therapies to do just that. The relationship between baseline inflammation and severe disease in older individuals with COVID-19 has not yet been defined, but one hypothesis is that the senescent cells and pre-existing inflammatory cells amplify the effects of COVID-19 in the respiratory tract.

Another theory is that the baseline inflammation in the body is not damaging on its own, but it may start a cellular cascade, which heightens inflammation with an infection. In addition to this, senescent cells can bring about more inflammation. Their buildup in the pulmonary tract may contribute to an increase in severe disease.

While the authors of the perspective published in Science Mag promote vaccination against SARS-CoV-2, they also point out that any effective treatment for the elderly may require a combination of antiviral and anti-inflammatory treatments.

Clearing Senescent Cells With Senolytics

Senolytic therapies were initially developed with the aim of reducing the severity of disease in the elderly and making an impact on the meteoric rise in chronic diseases, including Type 2 diabetes, heart disease and idiopathic pulmonary fibrosis (IPF).¹¹

However, it’s not a big leap to predict that the beauty industry may use the science to develop a new line of products to slow the aging process. According to Mayo Clinic researchers, preclinical data have demonstrated the potential for drugs to selectively encourage apoptosis in dying cells and have a positive effect on:¹²

Cardiac dysfunction	Type 2 diabetes
Liver steatosis	Vertebral disk degeneration
Pulmonary fibrosis	Vascular hyporeactivity and calcification
Osteoporosis	Radiation-induced damage

The possibility of impacting multiple diseases and functional deficits at the same time excites the scientific community because it can move geriatric medicine from largely reacting to disease to preventing it and thus slowing the aging process.

The potential to extend life and reduce disease has prompted some scientists to investigate the use of antibiotics as senolytics, despite the dangerously high level of antibiotic-resistant bacteria.¹³ In 2018, a team from the University of Salford in the U.K. published a study with "the goal of identifying and repurposing FDA-approved antibiotics, for the targeting of the senescent cell population."¹⁴

The lab-based study involved human fibroblasts, and the team identified Azithromycin and Roxithromycin as drugs that showed senolytic activity. Another drug in the same family, Erythromycin, did not have the same effect.

In an interview with Health Europa, one member of the research team, Michael Lisanti, said he believes the next steps are clinical trials. He acknowledges they haven't examined the relationship to antimicrobial resistance and that azithromycin is not an ideal antibiotic in this "context." He went on to say:¹⁵

"Potentially in the future, once researchers identify what it is about the azithromycin that is causing the senescent cells to die, they could develop future drugs — azithromycin is a stepping stone in this context …"

You May Have a Senolytic in Your Vitamins — Quercetin

Although not all scientists agree,¹⁶ many argue that quercetin demonstrates senolytic properties. Early laboratory trials using human fibroblast cells showed quercetin “influence(s) cellular life span, survival and viability of HFL-1 primary human fibroblasts.”¹⁷

Early results from a clinical trial with chemotherapy agent Dasatinib and quercetin showed the combination of the two may lower the number of senescent cells in people with diabetic kidney disease.¹⁸

While encouraging, as one writer points out, "synergy with other compounds is a very different story from unilateral effects."¹⁹ Yet, in other studies using only quercetin, its effect on lung fibrosis was found to diminish inflammation in the lab and to reduce pulmonary collagen deposits in an animal model after induced damage.²⁰

The researchers went on to test the singular use of quercetin in an animal model with induced lung fibrosis and found:²¹

"Quercetin inhibited the progression of lung fibrosis, reduced the expression of senescent cell markers and SASP, and promoted overall health benefit in an experimental fibrosis model in aged mice. Last, we conclude that the data provided in our study are very promising and may add to current therapeutic strategies for IPF and other fibrotic disorders."

Metabolic Therapies on the Horizon

Metabolic therapies are another strategy that may be used to halt the progression of viral disease. In the new field of immunometabolism research, scientists have discovered that metabolism has an influence on altering viral replication and affecting the body's response to a pathogen.

One of the strategies showing promise is ketosis. In a paper published in the journal Cell, scientists said they believe the principal ketone body beta-hydroxybutyrate (BHB) is highly effective, and is:²²

“… a highly efficient oxidative fuel and signaling metabolite. BHB has been shown to have diverse molecular effects, including metabolic regulation; increased cellular resistance to oxidative stress; inhibition of nuclear factor κB (NF-κB) signaling via HCAR2 receptor binding; decreased activity of components of the innate immune system, such as the nonobese diabetic (NOD)-, leucine-rich repeat (LRR)-, and pyrin domain-containing protein 3 (NLRP3) inflammasome;decreased systemic inflammatory burden; modifying gene expression; and acting as a fuel in the context of energetic stress.”

Clinical trials are currently underway to investigate the use of a ketogenic diet to reduce the signs of aging, prevent heart failure and neurodegeneration and manage diabetes. Researchers hope that using a ketogenic diet on intubated patients who are confirmed positive for COVID-19 may help reverse the progression of the disease.²³

The authors of the paper warn it's important to distinguish between ketoacidosis, which is a metabolic dysfunction leading to uncontrolled ketone accumulation, and adaptive physiological levels of ketosis in response to eating a low carbohydrate diet.

In intubated patients in the ICU, they believe using an exogenous source of ketones rather than inducing ketosis through prolonged fasting will have a greater positive effect.

For those who are not intubated, the authors write of potential immunological advantages when a ketogenic metabolic state is initiated. Researchers have also found medications that mimic caloric restriction, such as metformin, can reduce the inflammatory response because they get rid of senescent cells in much the same way that senolytic agents work.²⁴

Fasting and Cyclical Ketogenic Diet Raise Ketone Levels

In addition to quercetin, you may have a significant impact on your health and immune system by practicing a cyclical ketogenic eating plan. There are several other benefits including losing weight, fighting inflammation, reducing appetite and lowering insulin levels.

As I've written in the past, limiting carbs and decreasing your eating window to 6-8 hours may help protect you against influenza. A team from Yale School of Medicine tested a theory in a small animal model study and found “… that the consumption of a low-carbohydrate, high-fat ketogenic diet (KD) protects mice from lethal IAV infection and disease.”²⁵

By integrating a cyclical approach to the ketogenic diet, you can increase the health benefits and have greater flexibility in your meal planning. I describe an approach to this in “Will Eating Keto Help Prevent Flu?” In another article I discussed my KetoFast protocol to help reduce metabolic dysfunction.

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Data from FDA-funded research published in the Journal of the American Medical Association (JAMA)¹ in 2019 and 2020² have shown that certain ingredients in sunscreen products may build up in the body at unhealthy levels. The chemicals studied were avobenzone, oxybenzone, octocrylene, homosalate, octisalate and octinoxate.

Some of these ingredients may accumulate at levels greater than what would be considered safe, according to the lead researcher and team that conducted both studies. This begs the question of whether the FDA should reconsider whether the products are safe.³ As Consumer Affairs explained:⁴

"The FDA gets concerned if ingredients are found in the bloodstream at a level of 0.5 nanograms per milliliter or higher. At that level, the FDA says chemicals need to undergo a rigorous analysis to make sure they don't have harmful health risks … [the] six chemicals found in sunscreen products were found at levels ranging from 3.3 to 258.1 per milliliter, depending on the product and how it was applied."

This is worrisome because the study showed that all of the sunscreen chemicals were still above safety levels seven days after application, with two of them still above the threshold on Day 21, according to The Wall Street Journal:⁵

"… if active ingredients are found in the blood at a level of 0.5 nanograms per milliliter or higher, they should be analyzed to determine whether they increase the risk of cancer, birth defects or other adverse effects … Previous studies have indicated a possible association between some of the chemicals and health risks such as endocrine disruption and reproductive harm, but no comprehensive safety data are available."

The studies serve as yet another warning as the fear of the sun and the infatuation with sunscreens continues. In 2010, environmental groups warned that nearly two-thirds of sunscreens provide inadequate UVA protection compared to their UVB ray protection.⁶ UVA rays are linked to skin aging and UVB rays are linked to skin burning.⁷

In 2010, Sen. Chuck Schumer, D-N.Y., asked the FDA to require warnings on sunscreen labels of products containing retinyl palmitate, because a lab study showed that the chemical caused the growth of tumors in animals.⁸ While some dermatologists vociferously claimed retinyl palmitate is safe because there was no definitive study on it yet,⁹ Schumer insisted the studies need to be done because consumers "have a right to know."¹⁰

Oxybenzone, a hormone-disrupting chemical that is often added to sunscreens, was also of concern. Astoundingly, despite this evidence and the fact that only 7% of products studied in the report he cited were determined to be both safe and effective, the FDA had not put forth any guidelines at that time.¹¹

Data Show Sunscreen Ingredients Enter the Bloodstream

Several years ago, researchers found that almost everyone — 96.8% — who took part in the 2003-2004 National Health and Nutrition Examination Survey had detectable levels of benzophenone-3, another name for oxybenzone.¹² That same ingredient is also used in cosmetics and food packaging materials.

In the 2019 JAMA study, the authors also found a host of sunscreen ingredients in the blood of participants who'd used the products. At least one (oxybenzone) can show up in breast milk and amniotic fluid, in addition to making its way to the blood and urine, as told by the researchers.

They also wrote that the ingredients were absorbed after only one day's exposure, and some persisted in the body after use. Results from their 2020 study corroborated their work from 2019 and its implications for safety. What did the second study add to what was learned from the first one? According to the researchers:¹³

"In the prior study of 24 healthy volunteers, systemic absorption of sunscreen active ingredients was demonstrated. This follow-up study expanded the sample size, tested additional sunscreen active ingredients and formulations, and confirmed the finding that sunscreen active ingredients are systemically absorbed.

This included 6 of the 12 active ingredients in the sunscreen over-the-counter monograph for which the FDA has requested additional data to make a determination as to whether these ingredients are generally recognized as safe and effective (GRASE)."

The FDA Is Continuing to Analyze Ingredients' Safety

In February 2019, just three months prior to publication of the JAMA study, the FDA proposed a list of updates to regulations for most sunscreen products sold in the U.S.¹⁴ However, the new rules have not been finalized as the FDA continues to analyze information after the second study.¹⁵ According to Good Housekeeping:¹⁶

"The FDA believes that the outcomes of these two studies are in line with their proposal [pending] and support their ask for additional safety data on those 12 chemical sunscreen actives. Given the recognized health benefits of sunscreen use, the FDA continues to advise the public to use sunscreen in conjunction with other sun safety measures …"

The Environmental Working Group (EWG), "a nonprofit, nonpartisan organization dedicated to protecting human health and the environment,"¹⁷ has weighed in on the effects of oxybenzone:¹⁸

"'For a decade, EWG has worked to raise concerns about sunscreens with oxybenzone, which is found in nearly all Americans, detected in breast milk, and potentially causing endocrine disruption,' David Andrews, Ph.D., senior scientist at EWG, said in a statement."

Sunscreens Are a Scourge on Coral Reefs

The effect of sunscreens on the world's coral is devastating. As reported by The Guardian,¹⁹ researchers found in 2015 that up to 14,000 tons of it wash into coral reefs every year.²⁰ Coral bleaching, caused by oxybenzone, causes "baby coral to encase itself in its own skeleton and die," The Guardian said.

In addition to the accumulation washing off from swimmers and boaters, sunscreen chemicals also reach waterways through wastewater treatment plants, which do not always filter out such pollutants.²¹

The situation is so serious that in 2019 a Florida state senator proposed legislation to require a prescription for any sunscreen containing oxybenzone and octinoxate.²² The proposal was based on restrictions that Key West and Hawaii put into place, which will become effective in January 2021.²³

Vitamin D Deficiency Is Also a Concern

Strong warnings from medical associations and the media to avoid sun exposure or to apply sunscreens have resulted in many people being deprived of sunshine's multiple benefits. One of these is vitamin D production, and avoiding the sun may be the reason why so many people are deficient in vitamin D.

While it's important to avoid getting sunburned, you need to take care in determining the best way to do that. Obviously, if they have chemicals in them that may not be safe, sunscreens come with their own set of dangers. But, avoiding the sun altogether also isn't good, since that can cause vitamin D deficiencies. This is particularly concerning because a deficiency in vitamin D can put you at risk of other health problems.

For example, the authors of research in the International Journal of Environmental Research and Public Health suggested that low sun exposure may be correlated with the development of "specific cancers (more on that later), multiple sclerosis, diabetes, cardiovascular disease, autism, Alzheimer's disease and age-related macular degeneration."²⁴

How To Be Sunscreen Safe

As the researchers noted in the 2019 JAMA article, zinc oxide and titanium dioxide have been found by the FDA to be generally recognized as safe (GRASE), as opposed to the sunscreen chemicals whose safety is still under investigation.²⁵ Both protect against UVA and UVB rays.

In addition to avoiding dangerous sunscreen chemicals I caution against using sunscreens and other personal care products that contain synthetic preservatives and fragrances. Some common synthetic chemicals with health-altering properties include:^26,27

• Parabens — Synthetic preservatives known to interfere with hormone production and release.
• Phthalates — Another synthetic preservative that's carcinogenic and linked to reproductive effects (decreased sperm counts, early breast development, and birth defects) and liver and kidney damage.
• Synthetic musks — These are linked to hormone disruption and are thought to persist and accumulate in breast milk, body fat, umbilical cord blood and the environment.

Also, remember that if you apply sunscreen every time you're out in the sun, you'll block your body's ability to produce vitamin D. And, optimizing your vitamin D levels may reduce your risk of as many as 16 different types of cancer, including pancreatic, lung, ovarian, breast, prostate and skin cancers. According to research published in the journal Medical Hypotheses:²⁸

"Since it was discovered that UV radiation was the main environmental cause of skin cancer, primary prevention programs have been started. These programs advise to avoid exposure to sunlight. However, the question arises whether sun-shunning behavior might have an effect on general health.

During the last decades new favorable associations between sunlight and disease have been discovered. There is growing observational and experimental evidence that regular exposure to sunlight contributes to the prevention of colon-, breast-, prostate cancer, non-Hodgkin lymphoma, multiple sclerosis, hypertension and diabetes.

Initially, these beneficial effects were ascribed to vitamin D. Recently it became evident that immunomodulation, the formation of nitric oxide, melatonin, serotonin, and the effect of (sun)light on circadian clocks, are involved as well … Considering these data we hypothesize that regular sun exposure benefits health."

In summary, if you do use a sunscreen, your safest choice is a lotion or cream with non-nanoscale zinc oxide,²⁹ as it is stable in sunlight and provides the best protection from UVA rays. Your next best option is non-nanoscale titanium dioxide.

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By now, we all know the drill: Maintain physical distance. Wear a mask. Wash your hands. Avoid people who are sick and stay away from others if you are sick. While these measures may seem simple enough, they are not easy to keep up month after month. Yet they are likely to be with us for a while.

But what about those who cannot comply? Certain conditions can make the standard measures to stay safe during the pandemic seem impossible. At the same time, some of those likely to have the most trouble following the guidelines — such as older people with dementia — are at higher risk for illness and death if they do become ill. And the risk for spreading infection to others by not wearing face coverings, washing hands regularly, and observing physical distancing remains very real.

Mitigation efforts are harder for some than others

People who may have the most trouble complying with pandemic-related restrictions include those with

• Dementia. Without constant supervision and reminders, people with cognitive problems may take off their masks or wear them incorrectly, and fail to maintain distance from others.
• Breathing problems. Although for healthy people there is no evidence that commonly worn cloth masks lower your oxygen levels or raise your carbon dioxide levels, those who have lung disease (such as asthma, emphysema, or cystic fibrosis) may find it particularly uncomfortable trying to breathe through a mask.
• Claustrophobia. Wearing a mask may make people with claustrophobia feel panicky or smothered. And this not a rare problem: claustrophobia is the most common phobia, affecting 5% to 10% of the population.
• Depression and anxiety. For people who struggle with mood or excessive worry, concerns about one’s health and the health of loved ones, and the limitations placed on social interactions, may make these conditions worse. According to recent National Center for Health Statistics data, symptoms of anxiety or depression have more than tripled since this time last year.
• Autism spectrum disorder. Difficulties with social skills, a need for routine, and a reliance on support services such as behavior or speech therapy are everyday challenges for many people with autism spectrum disorder. The pandemic has made these challenges even greater. A heightened sensitivity to touch and difficulty with nonverbal communication can make wearing a mask especially problematic.

Even the experts urging us all to wear face coverings to lower rates of illness and deaths recognize that some cannot comply. Still, there are steps that folks in these situations can take to reduce the risk of becoming infected with the virus that causes COVID-19 and spreading it to others.

What can be done?

There are no easy answers here. I know of at least one memory care center that has largely given up on requiring mask wearing for some of its residents (though staff are still required to wear them). While not ideal, it’s the most practical option. And other measures are still followed: every resident is surveyed about symptoms and has temperature checks daily, chairs and activities are set up to encourage physical distancing, and the number of people in a room is limited. Gentle and frequent reminders and redirection to prevent crowding, increase handwashing, and encourage mask wearing (if possible) are now part of the routine in most nursing homes and long-term care facilities.

The Alzheimer’s Association also recommends extra reminders to wear a mask and wash hands for people living at home with dementia. Visual cues around the home can help. Try tacking up images of people in masks — including their favorite actors or even superheroes — and written reminders in several spots explaining the rationale for all the handwashing and face masks. If possible, try to increase social support (while maintaining physical distance) for those with dementia living at home. For example, if someone living in a memory care center usually talks to family members on the phone once or twice a week, perhaps three or four times a week would be a good idea while social distancing restrictions are in place.

Those with breathing problems may be able to tolerate wearing a mask for short periods. If a particular mask seems too uncomfortable or restrictive, try another type. There are masks of many shapes, sizes, and fabrics out there, and it’s worth trying more than one type of mask before giving up on them. If wearing a mask still seems impossible, conscientious physical distancing and frequent handwashing may make face coverings less necessary. For anyone whose respiratory condition is so severe that wearing a mask is impossible, experts suggest that the safest course of action is to avoid public places rather than relying on “mask exemptions.”

People with depression or anxiety may need to consult more often with their mental health providers during the pandemic. Adjustments in behavioral therapies or medications may help. Claustrophobic people may find that wearing a mask at home for short periods, and gradually increasing the amount of time, may make it easier to consistently wear one in public.

Experts working with people who have autism spectrum disorder recommend a number of ways to help with mask wearing, including education about the rationale for wearing them, demonstrating the use of a mask on a favorite object or person, allowing the person to choose among different types of masks, and wearing the mask for only short periods of time to start. Transparent face masks that make the mouth or face of the speaker visible may be a good option.

The bottom line

While we should not have an expectation that people with certain medical or psychological conditions will be able to follow the guidelines perfectly, that’s one more reason we should maintain high expectations for everyone else.

For more information about coronavirus and COVID-19, see the Harvard Health Coronavirus Resource Center.

Follow me on Twitter @RobShmerling

The post Avoiding COVID-19 when following the guidelines seems impossible appeared first on Harvard Health Blog.

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