The Masks Have It During the Coronavirus Pandemic: Wearing a Face Mask May Protect Wearer By Reducing Severity of Infection by Dr. John S. Rinehart

Recently there has been proposed a theory about further benefits of wearing a mask. The theory proposed that using a mask increases the number of asymptomatic patients while increasing the number of people with antibody immunity. So why would more people with asymptomatic COVID-19 be a good thing?

First, asymptomatic patients require far less intervention and hopefully will suffer far fewer long-term sequalae from COVID-19. But this is not necessarily beneficial as it has been thought that the asymptomatic patient does not develop immunity from their infection. Recent evidence, however, suggests that in fact asymptomatic infections stimulate the innate immune system (T-cell immunity) and thus confers immunity.

So how does wearing a face mask help? It goes to the concept that if a person is expose to a lower amount of the virus, they are more likely to experience asymptomatic COVID-19. There is some evidence for this in that the estimated asymptomatic infection rate is 40 percent, but where strict facial covering is mandated, the asymptomatic rate is 80 percent.

Other examples exist supporting the theory that the use of facial coverings increases the rate of asymptomatic infection. The authors cite the example from an Argentinian cruise ship where N95 face masks were provided. The rate of asymptomatic infection was 81 percent compared to an earlier cruise without masks and the rate was 20 percent. Using the masks quadrupled the asymptomatic rate. Another example was from the food processing industry where over 500 people became infected but had worn N95 masks. The asymptomatic infection rate for those who became infected was 95 percent.

The process whereby immunity is induced by introducing a pathogen to induce a mild infection is not new. The process, called variolation, was the process used by Jenner in 1796 to protect against smallpox by injecting a small amount of substance from people infected with cow pox – a much less virulent disease. Thus, while one argument for wearing the mask is to protect other people, in fact, it may also protect the wearer by reducing the severity of the infection.

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