The importance of the mask to avoid the clinical complications of the COVVI-19

Faced with a virus as contagious as the current coronavirus, the mask remains the best way to reduce the number of viral particles absorbed to allow immunity to neutralize the infection.

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The race for covid-19 drugs should not make us forget that prevention represents an essential aspect in our fight against this disease.In addition to basic hygiene measures like wash your hands regularly, it is increasingly obvious that wearing the mask can play a very important role in alleviating the transmission of the virus and avoiding exponential growth in the number of infected people.

Air transmission

The coronavirus is mainly transmitted by the droplets secreted by an infected person, whether symptomatic or not.These particles, which are quite bulky, quickly fall to the ground and generally do not cross a distance greater than 2 meters (hence the recommendation to maintain this distance between people).

On the other hand, several observations made since the beginning of the pandemic suggest that the virus can also spread in the form of much smaller particles: these aerosols are lighter, remain suspended in the air longer and can therefore spread overImportant distances in a closed room (in a way similar to a puff of cigarettes).

Le port du masque demeure alors la seule façon de diminuer l’entrée de ces particules virales en suspension au niveau du nez et de la bouche⁽¹⁾.

Decrease

The primary function of the mask is to act as a physical barrier which prevents the vast majority of viral particles from being expelled (in the case of infected people) or being captured by those present nearby.

Un point intéressant, souvent négligé, est que le masque n’a pas besoin d’être efficace à 100 % pour avoir un rôle positif : plusieurs études indiquent que la sévérité des virus respiratoires, comme celui de la COVID-19, est en général proportionnelle à la quantité de virus (l’inoculum) absorbée lors de l’infection⁽²⁾.

When it is present in too many, the virus overloads our immune system and causes uncontrolled inflammation which compromises the function of several vital organs. En diminuant le nombre de particules virales qui pénètrent à l’intérieur du corps, le masque permet donc au système immunitaire de neutraliser plus efficacement le virus, de réduire la charge virale et d’empêcher l’évolution de la maladie vers des stades plus avancés⁽³⁾.

The data obtained with animal models infected with the SARS-COV-2 coronavirus strongly suggest that this reduction in the number of viruses can effectively reduce the severity of the COVID-19.

Par exemple, une étude a montré que des modèles infectés avec une dose élevée de virus ont été plus malades que ceux auxquels on avait administré une petite quantité de particules virales⁽⁴⁾.

Une autre étude a quant à elle observé que ceux qui portaient un masque étaient moins susceptibles de développer la COVID-19 ou, lorsqu’ils étaient infectés, présentaient des formes beaucoup moins sévères de la maladie⁽⁵⁾.

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Variolization

According to a commentary recently published in the famousNOTewEngineandJournal ofMedicine (2), this protective effect of the mask is similar to variolization.Before the discovery of a vaccine against smallpox, a very small amount of the virus was inocuated to well -promising people to create a slight infection that stimulated their immunity and allowed them to become resistant to the virus.

The authors propose to consider the mask as a form of variolization, a way of exposing the body to a minimum of viral particles so as to allow immunity to develop a response that will neutralize the virus and prevent the disease from evolvingtowards severe forms that put the life of the infected person in danger, because of a too high viral load.

In other words, the mask does not completely prevent the transmission of the virus, but infected people remain asymptomatic or develop lighter forms of COVVI-19.

This reduction in damage is extremely important, not only because it saves many lives, but also because it decreases the risk of seeing the paralyzed health system and becoming unable to treat people affected by othersserious diseases (surgeries, anti -cancer treatments).

We mention more and more often that we must learn to adapt to the presence of the coronavirus if we want to find an almost normal life.

By limiting the damage caused by the virus, the mask is an essential tool for this adaptation, while waiting for the rate of transmission of the virus to be significantly reduced using an effective, safe and administered vaccine to large segments ofpopulation.

References

⁽¹⁾van der Sande M et coll.Professional and Home-Made Face Masks Reduce Exposure To RespiratoryInfectiveions Among The General Population.PLOS ONE 2008;3 (7): E2618.

⁽²⁾Gandhi M et GW Rutherford.Facial masking for covid-19: potential for "variolation" as we await a vaccine.NOT.Engine.J.Med., published on September 8, 2020.

⁽³⁾Gandhi M, Beyrer C, Goosby E.Masks do More Than Protect Others During Covid-19: Reducing the Inoculum of Sars-Cov-2 to Protect the Weare.J Gen InternMed 2020July 31 (Epub ahead of print).

⁽⁴⁾Imai M et coll.Syrian Hamsters AS A Small Animal Model for Sars-Cov-2Infectiveion and Countermeasure Development.Proc.NOTatl Acad.SCI.USA 2020;117: 16 587-16 595.

⁽⁵⁾ChanJFK et coll.Surgical Mask Partition Reduces The Risk of Non Contact Transmission in A Golden Syrian Hamster Model for CoronAvirusSayease 2019 (COVVI-19).Wink.Infective.Say., published on May 30, 2020.