by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

According to the reputed truth-gods of Fb, Gates and WHO and the other Event 201 attendees spewed Rona conspiracies in a video they made in October last year, which implies pre-science and vindicates the people calling covid a “plandem1c”


Many revere and admire the elites for their grandiose plan to enslave the whole humanity, but in fact all their plan is dumb AF from its fundamentals down to its executives, and this is just one of the many evidences.
I mean you want to control the world but you can’t even automate censorship on Internet and you end up shooting yourself in the both knees relentlessly? Imagine a fanfare of clowns with megalomaniac delusions, applauded by a congregation of geese. Covidiocracy is destined to cannibalise itself, starting with its propaganda machine, see the SJW/cancel culture.

I made this post very visual and simple so fact-checkers can understand it:
They targeted us but it’s their people’s video and it’s made last year. We work mainly with their sources precisely because they’re dumb and predictable and we knew we’ll have to deflect back these BS attacks when they occur. And they fell right into it as soon as they could. They’re a buncha morons with too much money and too many toys.

Basically, Facebook and a host of its “fact-checkers” such as USA Today, Factcheck.org and more, have claimed that one of our latest video uploads “repeats information identified by independent fact-checkers [themselves] as false”.

Thing is we’re not the authors of the content, we just mirrored (reuploaded) a video from Johns Hopkins, untouched, we’re just platforming these people, Facebook told us they’re good credible people :D.

Original source, pls watch all their videos, preferably the mirrors on our channel so we can benefit, not these conspiracy theorists! 😉



So the authors of the missinformation in the video are, among others:
WHO
Bill & Melinda Gates Foundation
World Bank
World Economic Forum
Johns Hopkins
Lufthansa
and many more

Bonus: the video has actually NOTHING, ZERO, 0 to do with the BS fact-checkers are munching there, it’s not about the man-made origins of the virus or anything like that.
Remember:

It doesn’t matter what Facebook says

Silviu “Silview” Costinescu
I think Facebook’s combat style is called Fact-Fu


I don’t know it but I bet factcheck.org took money from Gates to label him as a conspiracy head.

Please watch and share our Facebook upload, if not to raise awareness, at least just to piss off these douchebags!

First hour of the simulation is already on our Bitchute, Youtube, we have a BrandNewTube channel too now. All full of “conspiracies”.

At least good thing Facebook and its “independent fact-checkers” are not mere narrative-enforcers and smear-machines 😀

And if you got to here, you also need to read:

DIY: HOW TO EASILY PROVE FACEBOOK STEALS MONEY BY FAKING REPORTS

JOIN THE PEOPLE FOR FAUCI FASHION NOW! [UPDATED]

[EXCLUSIVE] FINAL EVIDENCE COVID-19 IS A ‘SIMEX’ – PLANNED SIMULATION EXERCISE BY WHO AND WORLD BANK

Our current Facebook cover

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! Articles can always be subject of later editing as a way of perfecting them

by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

It all comes round now…
World leaders dealt above our heads, played their games and kept the plebs in the dark using smoke-screens of technocratic lingo. The elites are resetting our lives. All about The Great Reset.

TIMELINE

  • 2005 WHO member countries sign the new International Health Regulations (IHR) which is basically the implementation of the Health Management chapter in The Great Reset, the tactical manual for the New World Order aka New Normal. The document envisions using drills to perfect the new system.
    Download IHR in PDF
  • 2014 – The creation of The Global Health Security Agenda (GHSA), “a group of 69 countries, international organizations and non-government organizations, and private sector companies that have come together to achieve the vision of a world safe and secure from global health threats posed by infectious diseases”.
    It was launched by a group of 44 countries and organizations including WHO, as a five-year multilateral effort with the purpose to accelerate the implementation of IHR, particularly in developing countries. In 2017, GHSA was expanded to include non-state actors. It was also extended through 2024 with the release of the Global Health Security Agenda (GHSA) 2024 Framework (called “GHSA 2024”). The latter has the purpose to reach a standardized level of capacity to combat infectious diseases.
    All financed through the World Bank, of course.
  • 2017-2018 – World Bank’s website reports massive shipments of COVID-19 medical devices (tests, mainly). See our previous reports.
  • 2019 In its first annual report, WHO and WB’s Global Preparedness Monitoring Board identifies the most urgent actions required to accelerate preparedness for health emergencies. This first report focuses on epidemics and pandemics.
    The document is “co-convened by the World Health Organization and the World Bank Group”.
    Under “Progress indicator(s) by September 2020“, the report states:

The United Nations (including WHO) conducts at least two system-wide training and simulation exercises, including one for covering the deliberate release of a lethal respiratory pathogen.
WHO develops intermediate triggers to mobilize national, international and multilateral action early in outbreaks, to complement existing mechanisms for later and more advanced stages of an outbreak under the IHR (2005).


Global Preparedness Monitoring Board

To quote page 8,

Countries, donors and multilateral institutions must be prepared for the worst.

A rapidly spreading pandemic due to a lethal respiratory pathogen (whether naturally emergent or accidentally or deliberately released) poses additional preparedness requirements. Donors and multilateral institutions must ensure adequate investment in developing innovative vaccines and therapeutics, surge manufacturing capacity, broad-spectrum antivirals and appropriate non-pharmaceutical interventions. All countries must develop a system for immediately sharing genome sequences of any new pathogen for public health purposes along with the means to share limited medical countermeasures across countries.

To quote page 10,

The United Nations must strengthen coordination mechanisms.


The Secretary General of the United Nations, with WHO and United Nations Office for the Coordination of Humanitarian Affairs (OCHA), must strengthen coordination in different country, health and humanitarian emergency contexts, by ensuring clear United Nations systemwide roles and responsibilities; rapidly resetting preparedness and response strategies during health emergencies; and, enhancing United Nations system leadership for preparedness, including through routine simulation exercises. WHO should introduce an approach to mobilize the wider national, regional and international community at earlier stages of an outbreak, prior to a declaration of an IHR (2005) Public Health Emergency of International Concern.


Progress indicator(s) by September 2020


• The Secretary-General of the United Nations, with the Director-General of WHO and Under-Secretary-General for Humanitarian Affairs strengthens coordination and identifies clear roles and responsibilities and timely triggers for a coordinated United Nations systemwide response for health emergencies in different countries and different health and humanitarian emergency contexts.
• The United Nations (including WHO) conducts at least two system-wide training and simulation exercises, including one for covering the deliberate release of a lethal respiratory pathogen.
• WHO develops intermediate triggers to mobilize national, international and multilateral action early in outbreaks, to complement existing mechanisms for later and more advanced stages of an outbreak under the IHR (2005).
• The Secretary General of the United Nations convenes a high-level dialogue with health, security and foreign affairs officials to determine how the world can address the threat of a lethal respiratory pathogen pandemic, as well as for managing preparedness for disease outbreaks in complex, insecure contexts.

To quote page 15,

The chances of a global pandemic are growing. While scientific and technological developments provide new tools that advance public health (including safely assessing medical countermeasures), they also allow for disease-causing microorganisms to be engineered or recreated in laboratories. A deliberate release would complicate outbreak response; in addition to the need to decide how to counter the pathogen, security measures would come into play limiting information-sharing and fomenting social divisions. Taken together, naturally occurring, accidental, or deliberate events caused by high-impact respiratory pathogens pose “global catastrophic biological risks.” (15)


The world is not prepared for a fast-moving, virulent respiratory pathogen pandemic. The 1918 global influenza pandemic sickened one third of the world population and killed as many as 50 million people – 2.8% of the total population (16,17). If a similar contagion occurred today with a population four times larger and travel times anywhere in the world less than 36 hours, 50 – 80 million people could perish (18,19). In addition to tragic levels of mortality, such a pandemic could cause panic, destabilize national security and seriously impact the global economy and trade.


Trust in institutions is eroding. Governments, scientists, the media, public health, health systems and health workers in many countries are facing a breakdown in public trust that is threatening their ability to function effectively. The situation is exacerbated by misinformation that can hinder disease control communicated quickly and widely via social media.

No they are not worried about misinformation. They are worried about their agenda being countered by truths leaking out on social media.

In the “Progress to Date” section, we find the following snippet (page 19):

In 2017 Germany, India, Japan, Norway, the Bill & Melinda Gates Foundation, the Wellcome Trust and the World Economic Forum founded the Coalition for Epidemic Preparedness Innovations (CEPI) to facilitate focused support for vaccine development to combat major health epidemic/pandemic threats.

On page 25, they are worried about armed resistance to their imposition of vaccines. To quote,

Challenges to poliomyelitis (polio) eradication efforts in Afghanistan and Pakistan and those experienced while containing the tenth Ebola outbreak in the DRC vividly demonstrate the impact that a breakdown in citizens’ trust and social cohesion can have on health emergency response. Consequences include attacks on both national and international health-care workers and delays or stoppages in response efforts. In some countries, waning trust in public health and government officials together with cultural and religious beliefs lead to is decreasing vaccination rates and leading to the re-emergence of measles and other vaccine-preventable diseases, a phenomenon found in communities at all economic and educational levels.

Page 34 proposes making ’emergency preparedness” a precondition for receiving loans and financial support from the IMF and the World Bank. To quote,

To mitigate the severe economic impacts of a national, regional epidemic and/or a global pandemic, the IMF and the World Bank must urgently renew their efforts to integrate preparedness into economic risk and institutional assessments, such as the IMF’s next cycle of Article IV consultations with countries, and the World Bank’s next Systematic Country Diagnostics for IDA credits and grants. The funding replenishments of the IDA, Global Fund to Fight AIDS, TB and Malaria, the and Gavi Alliance should include explicit commitments regarding preparedness.

Now here are the wonderful people who are members of the Global Preparedness Monitoring Board. Remember Fauci? Remember the Bill Gates Foundation? Other notables include a member of the Communist Party of China.

SOURCE: WHO

more info and resources:

WHO elaborates on what a SimEx is in October 2019

“Simulation exercises have been identified as a key voluntary instrument in the validation of core capacities under the “Implementation of the International Health Regulations: Draft 5-year draft global strategic plan to improve public health preparedness and response”, which was adopted by the seventy first World Health Assembly. Simulation exercises, along with After Action Reviews, represent the functional assessment of capacities and complement States Parties annual reporting, independent reviews, and joint external evaluations. They play a key role in identifying the strengths and gaps in the development and implementation of IHR capacities and to support countries to assess the operational capability of their national capacity for public health preparedness and response.” – WHO

Full-scale/field exercises (FSX):
“A full-scale exercise simulates a real event as closely as possible and is designed to evaluate the operational capability of emergency management systems in a highly stressful environment, simulating actual response conditions. This includes the mobilization and movement of emergency personnel, equipment and resources. Ideally, the full-scale exercise should test and evaluate most functions of the emergency management plan or operational plan. Differing from the FX, a full-scale exercise typically involves multiple agencies and participants physically deployed in an exercise field location.” – WHO


Field exercises:
“See full-scale exercise. A field exercise is one form of full-scale exercise, focusing on more specific capacities or series of capacities, such as procedures for Rapid Response Teams (RRT), laboratory analysis or other sample collection and transport.”- WHO

Exercises are not one-time events, but should be undertaken as part of a carefully designed exercise program which ensures a common strategic objective is addressed. A comprehensive exercise program is made up of progressively complex exercises, which build upon the previous, until they are as close to reality as possible. This ‘building-block approach’ should start with basic exercises that test specific aspects of preparedness and response, followed by progressively complex exercises requiring additional preparation time and resources.

WHO

The figure below provides an illustration of the level of preparation and capacity needed for each exercise type.

Situation map as of September 10, 2020. US, Brasil, Australia, Scandinavia and other countries seem to conduct their own drills following a different agenda, and that matches the actual field situation
So what is WHO planning out for Ukraine?
Ukraine is certainly being “groomed” for a 2nd wave of Covidiocracy. Source

WHO has been laying out the plans to control mass gatherings since 2019

Read more
Read more

Ever heard of “event 201”, the “crimson contagion”, “Clade X“, “Dark Winter“, or “Atlantic Storm“?

While Covid-19 is the largest so far, these simulations have a long history.

DOWNLOAD PDF

The photo above represents “The Department of Health and Human Services’ Covid-19 operations center in Washington. The department ran an extensive exercise last year simulating a pandemic” – NY Times

“The exercise played out in four separate stages, starting in January 2019.

The events were supposedly unspooling in real time — with the worst-case scenario underway as of Aug. 13, 2019 — when, according to the script, 12,100 cases had already been reported in the United States, with the largest number in Chicago, which had 1,400.

The fictional outbreak involved a pandemic flu, which the Department of Health and Human Services says was “very different than the novel coronavirus.” The staged outbreak had started when a group of 35 tourists visiting China were infected and then flew home to Australia, Kuwait, Malaysia, Thailand, Britain and Spain, as well as to the United States, with some developing respiratory symptoms and fevers en route.

A 52-year-old man from Chicago, who was on the tour, had “low energy and a dry cough” upon his return home. His 17-year-old son on that same day went out to a large public event in Chicago, and the chain of illnesses in the United States started.

Many of the moments during the tabletop exercise are now chillingly familiar.

In the fictional pandemic, as the virus spread quickly across the United States, the C.D.C. issued guidelines for social distancing, and many employees were told to work from home.” – NY Times

About the Event 201 exercise

According to their own website, “Event 201 was a 3.5-hour pandemic tabletop exercise that simulated a series of dramatic, scenario-based facilitated discussions, confronting difficult, true-to-life dilemmas associated with response to a hypothetical, but scientifically plausible, pandemic. 15 global business, government, and public health leaders were players in the simulation exercise that highlighted unresolved real-world policy and economic issues that could be solved with sufficient political will, financial investment, and attention now and in the future.

The exercise consisted of pre-recorded news broadcasts, live “staff” briefings, and moderated discussions on specific topics. These issues were carefully designed in a compelling narrative that educated the participants and the audience.

The Johns Hopkins Center for Health Security, World Economic Forum, and Bill & Melinda Gates Foundation jointly propose these recommendations.”

Purpose

In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes “Event 201,” would require reliable cooperation among several industries, national governments, and key international institutions.

Recent economic studies show that pandemics will be the cause of an average annual economic loss of 0.7% of global GDP—or $570 billion. The players’ responses to the scenario illuminated the need for cooperation among industry, national governments, key international institutions, and civil society, to avoid the catastrophic consequences that could arise from a large-scale pandemic.

Similar to the Center’s 3 previous exercises—Clade XDark Winter, and Atlantic Storm—Event 201 aimed to educate senior leaders at the highest level of US and international governments and leaders in global industries.

It is also a tool to inform members of the policy and preparedness communities and the general public. This is distinct from many other forms of simulation exercises that test protocols or technical policies of a specific organization. Exercises similar to Event 201 are a particularly effective way to help policymakers gain a fuller understanding of the urgent challenges they could face in a dynamic, real-world crisis.

Scenario

Details about the scenario are available here.

Recommendations

“The next severe pandemic will not only cause great illness and loss of life but could also trigger major cascading economic and societal consequences that could contribute greatly to global impact and suffering. The Event 201 pandemic exercise, conducted on October 18, 2019, vividly demonstrated a number of these important gaps in pandemic preparedness as well as some of the elements of the solutions between the public and private sectors that will be needed to fill them. The Johns Hopkins Center for Health Security, World Economic Forum, and Bill & Melinda Gates Foundation jointly propose these recommendations.”

Audience

An invitation-only audience of nearly 130 people attended the exercises, and a livestream of the event was available to everyone. Video coverage is available here.

Exercise team

Eric Toner, MD, is the exercise team lead from the Johns Hopkins Center for Health Security. Crystal Watson, DrPH, MPH and Tara Kirk Sell, PhD, MA are co-leads from the Johns Hopkins Center for Health Security. Ryan Morhard, JD, is the exercise lead from the World Economic Forum, and Jeffrey French is the exercise lead for the Bill and Melinda Gates Foundation.”

Main organisers:
The Johns Hopkins Center for Health Security, World Economic Forum, and Bill & Melinda Gates.
World Economic Forum as in the ideologists that redacted The Great Reset.

In order to create momentum for the Great Reset, UK royal Prince Charles said the imagination and will of humanity “will need to be captured” so that they can set the world on a new trajectory.
This is taken from his historical but largely ignored speech at the official launch event for The Great Reset.

He further suggested that longstanding incentive structures that have adverse effects on the environments must be reorientated, and that systems and pathways will need to be redesigned to advance net zero emissions globally.

“This reset moment is an opportunity to accelerate and align our efforts to create truly global momentum. Countries, industries and businesses moving together can create efficiencies and economies of scale that will allow us to leapfrog our collective progress and accelerate our transition,” the Prince said.

Also read about the spectacular Clade XDark Winter, and Atlantic Storm.

More very soon, come back later!

If you want to get the larger picture later, also read:

HENRY KISSINGER: “I USED TO ASSIGN MAO’S WRITINGS TO MY CLASSES AT HARVARD”

ABOVE BILL GATES: THE ROCKEFELLERS. FROM OPERATION PAPERCLIP TO CHINA AND WHO (PART. 1)


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! Articles can always be subject of later editing as a way of perfecting them

by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

Do what something like we did:

  1. Make a blog post on WordPress or anywhere you can get good live traffic reports. Set it private so that no one can find the link unless you give it to them.
  2. Make a Facebook post with that link and boost it. Make sure there’s no other links included so the audience can’t go anywhere else
  3. Compare the Facebook link click reports with the other traffic reports you have available for your website.

On the last test we did, Facebook reported 326 link clicks, WordPress 20, for the same timeline.
This costed us almost $30 from your donations but I think it’s the best spent money on Facebook from all we ever did.

These are the people who “fact-check” us. Any number or claim ever presented by Facebook is worthless. Facebook is nothing but a Narrative Enforcement & Smear machine literally stealing money, health and life from people by faking everything it touches. 

Ever felt fringe, overwhelmed by drones, marginalised? You’re just being gas-lighted by Facebook, Google and an army of trolls whose very own existence proves our reality is fabricated and rigged.

In the figure above we have Dork Suckerborg, Lord of the Echo-chambers, trying to tell us we made 7,000+ views without a single reaction or comment. As if that’s even possible. If I showed 7,000 people a blank page, at least 100 would react (mostly angrily I guess).

Get involved, share this as wide as you can, let’s crash this monster and its stock market value by outing its schemes!

Our worldwide readership is told to its face they are not going to show our link in comments
Sometimes it feels like Fakebook is holding meetings in which they debate how to help us further expose them. The main problem remains the public’s functional illiteracy which disables their cognitive abilities when facing evidences of wrongdoing
This called for a new Facebook cover, feel free to download and use 😉

In a coming episode we hope to teach you similar tricks for Google, who hides it better, but it’s just as rigged. Way more complicated to prove.

We are funded solely by our most generous readers and we want to keep this way. Help SILVIEW.media deliver more, better, faster, please donate here, anything helps. Thank you!

! Articles can always be subject of later editing as a way of perfecting them

by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

SOURCE: WORLD BANK WEBSITE

These links from their website are all I have for now, but it’s sufficient evidence.
I found it important to let it all out ASAP, while I dig for more relevant info.

I find very interesting who the main traders are:
Switzerland ($23,684,716.51K , 2,538,500 Kg), Germany ($17,464,406.19K , 7,242,210 Kg), European Union ($16,940,789.16K , 8,953,990 Kg), United States ($8,283,146.64K , 7,020,260 Kg), Ireland ($6,356,054.92K , 590,259 Kg).

China has been shipping Rona tests like there’s no tomorrow since 2018:

SOURCE: WORLD BANK WEBSITE

Brb, I hope.


UPDATE SEPT 9, 2020
I think you will find this WB document very interesting. Download PDF

“This document describes a programmatic framework responding to the global coronavirus (COVID-19) pandemic, the ‘COVID-19 Strategic Preparedness and Response Program (SPRP)’, which utilizes the Multiphase Programmatic Approach (MPA), to be supported under the FTCF.
The proposed Program, by visibly committing substantial resources (IBRD/IDA financing for SPRP is US$6 billion), and complementing funding by countries and activities supported by other partners, would help ensure adequate resources to fund a rapid emergency response to COVID-19.
In parallel, it is being submitted for approval the financing of Phase 1 of the Program for 25 Investment Project Financing operations under the SPRP for countries across the world.
The 25 countries are: Afghanistan, Argentina, Cabo Verde, Cambodia, Congo Democratic Republic of, Djibouti, Ecuador, Ethiopia, Gambia, Ghana, Haiti, India, Kenya, Kyrgyz Republic, Maldives, Mauritania, Mongolia, Pakistan, Paraguay, San Tome & Principe, Senegal, Sierra Leone, Sri Lanka, Tajikistan, and Yemen (the list of country operations is in Annex I of this document and the country operations are described in their respective Project Appraisal Documents (PADs)). The PADs for the 25 country projects included in this Phase 1 package are available online.”

The Covid Circus is supposed to be about health, but it’s ran by financiers and royalties, fronted by a computer dork and a communist terrorist.


MAJOR UPDATE!

So one thing led to another and eventually we struck oil.
We put in a separate article titled

FINAL EVIDENCE COVID-19 IS A ‘SIMEX’ – PLANNED SIMULATION EXERCISE BY WHO AND WORLD BANK

We are funded solely by our most generous readers and we want to keep this way. Help SILVIEW.media deliver more, better, faster, please donate here, anything helps. Thank you!

! Articles can always be subject of later editing as a way of perfecting them

by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

Experts say it acts like a booster for mental strength and self confidence.
For me.

Just finished it today, looks like this:

If really don’t like it, maybe this one is for you, on the modern tip:

Did anyone just say “This man bad, don’t listen to him”?

by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

Don’t want your posts reported or your profile flagged because you’re critical of Pharmafia, the establishment and their fake news? Block these profiles.
Permanently updated, there’s thousands of them.
The secret agents of the narrative enforcement, the real Covidiocracy army.

Funnier than the meme is the fact that this used to be a profile pic for a troll

individuals

(newer additions on top)

https://www.facebook.com/travhull

https://www.facebook.com/profile.php?id=100000170405179

https://www.facebook.com/profile.php?id=100016729500634

https://www.facebook.com/ChuckVersus

https://www.facebook.com/mary.shive.5

https://www.facebook.com/jess.mcdonald.9

https://www.facebook.com/tlnickel

https://www.facebook.com/harry.scottmoncrieff

https://www.facebook.com/arianna.calenda

https://www.facebook.com/profile.php?id=100015167653525

https://www.facebook.com/phil.newnam

https://www.facebook.com/jessicajkinter

https://www.facebook.com/john.mccormick.75470

https://www.facebook.com/iris.tibbitts

https://www.facebook.com/profile.php?id=100009877361808

https://www.facebook.com/MrMattyBlades

https://www.facebook.com/massifveeyni.tomaas.5

groups

Click on members and block everyone inside, but most importantly the admins and mods

https://www.facebook.com/groups/169384897058080/

https://www.facebook.com/groups/563727867132262/

https://www.facebook.com/groups/4647632349/

https://www.facebook.com/groups/237547303254654/

https://www.facebook.com/groups/1847079168685056/

pages

https://www.facebook.com/Weareross/

https://www.facebook.com/therealtruther/

https://www.facebook.com/StopAVMisinformation/

https://www.facebook.com/pg/MassifVT

https://www.facebook.com/JillysSecret/

More to come, just started to get things organised


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! Articles can always be subject of later editing as a way of perfecting them

by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

(We can’t type the headline correctly because search engines would sink the article and flag the website. Enjoy Covidiocracy)

Maskne is one of 2020’s most widespread skincare problems.

Tokyo Weekender

“Even having mild, minimal acne can have profound effects on interpersonal relationships, how we socialize, job performance, depression and anxiety.”

Board-certified Dr. Seemal Desai, spokesperson for the American Academy of Dermatologists.


‘Maskne’s existence has been reported by most mainstream media out there, so it’s “official”, but no one really talks about it, I’ve met very few people semi-aware of it and its consequences. Unsurprisingly.


Let’s break that silence. We start with none other than CNN, for fact-checkers’ delight, here’s what info they’ve gathered from US physicians on the maskne issue:

“I have patients calling in despair saying ‘What is going on? I’ve never had a breakout before and now my face looks like a teenager’s!'”

Board-certified dermatologist Dr. Whitney Bowe, clinical assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai Medical Center

Breakouts that occur after wearing a mask have become so common that mask acne’s been dubbed “maskne” on social media.”We think that wearing these masks, combined with stress from the pandemic, is causing an increased moisture-rich environment for bacteria and organisms to proliferate,” Desai said, “causing a breakdown of the skin and flaring of some of these conditions.”
Nurses and other health care professionals on the front line of the battle against Covid-19 are hardest hit, Desai said, due to the seal needed from personal protective equipment in order to keep the virus at bay.
“I’m seeing lots more skin disease in health care workers because they’re wearing PPE and N95 respirator masks that are causing ulcers, breakdown and bleeding of the skin,” said Desai, who is a spokesperson for the American Academy of Dermatologists.
Compared to the bruised and bleeding faces of doctors and nurses, a few pimples may seem inconsequential. But it’s an important issue that shouldn’t be trivialized, said Bowe, also a spokesperson for the American Academy of Dermatologists.
“Acne is significantly associated with self esteem, even if it’s just one or two pimples,” she explained.


“We’re seeing lots of flares of acne, especially a type called perioral dermatitis, which tends to happen typically around the mouth and in the areas around the nose”

Board-certified Dr. Seemal Desai, an assistant professor at the University of Texas Southwestern Medical

Here’s what Health.com has to say about it:

It’s not just the added anxiety of coronavirus that might be making you break out a little more than usual right now, though. If you’ve been diligently wearing your face mask whenever you leave the house (only for essentials, we hope!) and you’ve noticed a few extra pimples in those specific areas (the bridge of your nose, your cheeks, and your chin) you may be experiencing what dermatologists are calling “maskne.”

What exactly is maskne and why does it happen?

As the name suggests, maskne is a type of breakout that results from wearing a face mask. “Maskne is acne formed in areas due to friction, pressure, stretching, rubbing or occlusion,” Nazanin Saedi, MD, a board-certified dermatologist at Thomas Jefferson University, explains to Health. “You can see it in the areas covered by the mask and also the areas where the mask and face shields touch the skin.”

Kathleen C. Suozzi, MD, director of Yale Medicine’s Aesthetic Dermatology Program and an assistant professor of dermatology, explains that maskne is technically referred to as acne mechanica.

Prior to the pandemic, this form of facial irritation was primarily experienced by athletes, “commonly due to the sweat, heat, and friction in their helmets and straps,” Dr. Saedi explains. “We are seeing it more now with people wearing masks for an extended period of time.” Dr Suozzi adds that you also get acne mechanica in your armpits from using crutches. 

Overall, Dr. Saedi explains that maskne—and often, acne mechanica in general—is triggered by pores being blocked by sweat, oil, and makeup. For masks in particular, “while breathing for hours with the mask on, it creates humidity to [form] a breeding ground for acne,” she explains. The friction of the mask can also block and clog pores, leading to the formation of comedones or blackheads, says Dr. Suozzi.

How can you prevent and treat maskne?

Prevention is always your best bet. If you are wearing a cloth mask, wash it daily, urges Dr. Saedi. If you are wearing a disposable mask, try to replace it as often as possible or allow it to air out in between uses. And for tight-fitting N95 respirators—which should be reserved for essential workers right now—Dr. Suozzi suggests applying silicone gel strips to sit under the pressure points of the mask. “This will help prevent against skin irritation,” she explains. 

If you start developing maskne, first and foremost, be gentle—that means going easy on at-home spa days. “People might be overdoing it at home with face masks, scrubs, washes, and toners,” says Dr. Suozzi, who adds overdoing skincare right now can compromise your skin’s protective barrier. Instead, wash your face with a gentle cleanser, says Dr. Saedi. “I would avoid products that are too drying because they will cause the skin barrier to become more compromised.” She suggests a face wash with salicylic acid, to help unclog the pores.

As far as treatment options go for acne breakouts, “over the counter products that help resolve the clogged pores are beneficial,” says Dr. Suozzi.

And while wearing your mask out in public right now is essential–especially in social settings where physical distancing is difficult to maintain—remember you can (and should!) take the mask off and give your face a necessary breather when you’re away from other people, like in your own home (provided you’re not caring for anyone ill) and while driving your car.

Harry Dao, MD, FAAD, a dermatologist for Loma Linda University Health, says acne, isn’t the only skin condition reported by mask wearers. Other common face mask skin problems include:

  • Allergic contact dermatitis – Some manufactured masks may contain a chemical that causes an allergic reaction. Formaldehyde and bronopol can be found in polypropylene surgical masks.
  • Rosacea – Classically worsened by heat and stress, mask wearing can increase flares.
  • Seborrheic dermatitis – It causes scaly plaques, inflamed skin and stubborn dandruff.
  • Folliculitis – When yeast or bacteria infect hair follicles.


“The mask can also cause skin conditions like miliaria (heat rash) and rosacea to flare up,” she said, adding the mask rubbing on your face made it was the “perfect storm of grossness”.

Emily Doig from Micro Glow, Melbourne-based natural skincare brand

How to prevent these conditions

Dao offers six skin care tips to protect your face from mask irritation.

  1. Wash your face first – Use a gentle cleanser that is free of fragrance and oil and rinse with lukewarm water. “This prevents dirt and oil from being trapped on the skin surface, which cause breakouts,” Dao says. “Your face should always be clean before you put on your mask.”
  2. Apply a moisturizer – Not only will this keep your skin hydrated, it will also act as a barrier between your face and your mask, reducing friction. Apply onto a cleansed face before and after wearing a mask. Dao says to look for moisturizers that contain ceramides, hyaluronic acid, or dimethicone, which will provide extra protection. Take care to avoid fragrances amongst other common contact allergens. This may take trial and error to find the right formulation for your skin type. 
  3. Ditch the makeup – Wearing skin makeup under a mask causes clogged pores and breakouts, according to the American Academy of Dermatology. Makeup residue will also soil your mask.
  4. Wash your mask – If wearing a cotton mask wash it after each use as its surface contains dirt and oil and can become a breeding ground for bacteria from your nose and mouth. 
  5. Choose a fragrance-free laundry soap – Fragrances can irritate your skin — skip the fabric softener, too.
  6. Stay away from harsh products – Medicated skin care products that contain benzoyl peroxide, retinols and salicylic acid will be more irritating to the skin under a mask — be careful about how much and what you use. 

How to treat common skin issues

This is what you can do at home to help treat some of the most common mask-related skin issues, Dao says.

  1. Acne or breakouts – Add a glycolic acid wash and a light “non-comedogenic” moisturizer to your pre-mask regimen. Move the application of leave-on skin care products to times not wearing mask at home. If breakouts, redness or swelling still persist, seek medical care with your physician. 
  2. Dry skin – Always apply a good moisturizer to the skin before you put on a mask. After you take it off, cleanse the skin and apply a bland emollient. Commonly, natural or botanical substances can contain allergenic products, so beware. 

“It’s definitely been something that I’ve had to get used to,” says Jordan Dwyer, Director of Inpatient Transplant Services at Presbyterian/St. Luke’s Medical Center (PSL).

“You know around my chin, up my cheek bones, even a few like underneath my eyes where the mask touches,” she explained pointing to her face.

The facial plastic surgeon at PSL said any mask can cause irritation from the friction. The material and straps may cause a rash. Best are masks that fit comfortably around the nose and mouth.

(credit: CBS)

natvral r3medies TO DEAL WITH MASKNE

Indian skin expert Nirmala Shetty says for Times of India, that “preferably masks made with cotton material should be used. Wash them daily with soap and a few drops of tea tree oil.” She also shares a few tips to treat skin issues at home…

Acne buster

pic

Few coriander and mint leaves
Cucumber: ½
Organic coconut oil: 2 tsp
Blend together and store in a glass container. Use twice daily

For irritation around the nose and mouth

pic

Carrot juice: 2tsp
Cucumber juice: 2tsp
Coconut oil: 2tsp
Mix and apply three to four times


Queensland-based beauty brand Rawkanvas is among those who have seen demand for skincare items soar, netting £18,000 ($33,000 AUD) overnight yesterday with the launch of its Clarifying Red Wine Mask.

The Clarifying Red Wine Mask was launched this weekend, and beauty fans have been stocking up
The Clarifying Red Wine Mask was launched this weekend, and beauty fans have been stocking upCredit: Instagram/@rawkanvas

“We launched last night at 6pm and sold a product every 20 seconds totalling £8,000 ($15k AUD) in just 30 minutes,” the brand’s co-founder Simona Valev told news.com.au.

“Since then in the last 12 hours, we have totalled £18,000 ($33k AUS) across NZ and AUS customer base – it was definitely unexpected.”

Simona, who created the vegan-friendly and all-natural skincare brand with Shannon Lacey in 2018, said the clay mask helps to draw out congestion, refine pores and overall gives your complexion a boost.

The mask is made with pinot noir and sauvignon blanc grapes, which “commands next-level skin detoxification and polishing”. It also gives the product a unique mulled wine scent.

The mask is thought to alleviate the symptoms of 'maskne' or the acne caused by wearing a face covering
The mask is thought to alleviate the symptoms of ‘maskne’ or the acne caused by wearing a face coveringCredit: Instagram/@rawkanvas

While the face mask wasn’t created with coronavirus side effects in mind, Simona said during trials clients had mentioned it helped with their “maskne”.

“Since COVID-19 and the increase of wearing masks we have noticed so many customers reaching out and asking us what they should be using due to their skin concerns,” she said.

Simona, who created the vegan-friendly and all-natural skincare brand with Shannon, said the clay mask helps to draw out congestion, refine pores and overall gives your complexion a boost
Simona, who created the vegan-friendly and all-natural skincare brand with Shannon, said the clay mask helps to draw out congestion, refine pores and overall gives your complexion a boostCredit: Instagram/@rawkanvas

She adds that anyone using it may experience redness for a short time after as the process causes blood vessels to dilate and boosts blood circulation.

“This opens pores for a deeper clean and allows other active ingredients to be absorbed faster,” she explained.

“Maskne” was first reported in the US where several states have made it mandatory to cover your mouth and nose in public – similar to the conditions in Melbourne where masks are now compulsory when out in public. – news.com.au.

We are funded solely by our most generous readers and we want to keep this way. Help SILVIEW.media deliver more, better, faster, please donate here, anything helps. Thank you!

! Articles can always be subject of later editing as a way of perfecting them

by Silviu “Silview” Costinescu_ Buy Me a Coffee at ko-fi.com

Among other things, I have a 25years-long career in music. Electronic, mainly.
And one thing led to anoher…
If you think this is a joke, you are correct. If you think this is damn serious, you are sharp.

Hello World! We’re here to take over all screens with a message of love and acceptance for the Fauci Fashion phenomenon.
Too many people still prioritise brain oxygenation and freedom over Fauci Fashion and that is wrong. (We have established that oxygen fits all definitions for “drug”).
Youtube is stealing our views and we were helplessly watching our counter going backwards. That is very wrong! (good thing they don’t count Rona cases with the same accuracy and intentions)
Our muse and guiding lighthouse in Covidiocracy, Dr. Tony Fauci, gets diminished and that’s unacceptable!!! (almost used caps…)
So enough of that!
We’re asking your help to get Fauci Fashion (as seen below) into all music charts, and send out a message to everyone that we can’t be silenced. (it’s actually very doable)
Fauci Fashion is here to stay and give you Maskne! (it’s like acne, but from the mask, we’ll post links later if you need)
If you want to join the movement, read all our posts and follow your conscience. A developed conscience will know what to make of this, the rest won’t and they won’t matter 

The People for Fauci Fashion
Fauci IS Fashion

This is the introductory word to the work of an enthusiastic supporter, with all the help I and other supporters can provide. Can’t put it in words how grateful I am!
Yes, with your support, we want to attack official charts with this tune, as a way to get our voice where only Eminems and Cardi Bs can. The track is officially registered and every official stream and download counts, just use these sources.

As a music industry insider, I have the data and the method to mathematically calculate that it’s doable. We planned this carefully and we can mobilise a few thousand involved supporters that can move millions more, that can move billions. If we put together a few of your clicks with our products, know-how and strategy, we have a good shot at it.

Media is already starting to show interest, but it’s way too early to brag, we’ve just launched the initiative.

The music track (and many more)is available for free download from our Bandcamp page, this is not a business or about sales, this is about breaking a blockade. It’s “name your price” release, feel free to insert 0 if that’s the case, I still want you to have them all when you need them, even if you can’t contribute now.
We contribute what we can, when we can, IF we WANT.

And we devised a few simple and effortless ways you can get involved in our fake grassroots movement with a secret dark agenda to sabotage Covidiocracy. Because this can’t work without people like you, but can move things in the right direction with you aboard.

The short help course reads like this:
 It’s all about attention, we live in an attention economy now, we need a bit of yours to join ours and kickstart until this provides for itself. You can basically help us get more attention two main ways:
– By streaming, sharing and downloading the F out of Fauci Fashion from these official links: https://fanlink.to/cc1
– By using the Donate button on our shadow organisation’s webpage, which is right here, see the main menu on top 🙂
These funds are meant to buy ads, hire promoters and bribe media. Of course we will use most of it like Gates and Bono’s charities: in personal interest; but the rest will achieve our goals and everyone will be happy.
If you really need serious money talk: all money in the world are worthless when you have no future, like humanity under Covidiocracy. So I’m already putting everything in this work, with or without help, but it might not be enough without you. Either way, sponsoring change is the only way I can make money worth anything now.

The true Faucy Style

If you want to achieve maximum impact with your resources, here’s the details you need to know:
most efficient tools you have are
* official downloads from sites like Amazon or Juno, one track download equals 100 free streams. And one stream from a paid/premium account = about 5-6 free streams. They are also better reported and accounted too, there’s less accounts of fraud, while Youtube robbed us blind to our faces, turning back the counter;
Bundle purchases help less than individual track purchases, for some reasons related to how the charts are calculated.
* direct donations; because we have the data on how and where funds can make the best impact at a certain moment and its technically impossible to share all that knowledge and know-how.
For Paypal, use the button on this website, for cards hit the Bandcamp page, download what you like and pay what you like.
Unfortunately no crypto wallets available.
* website embeds and social shares. All platforms love that and google favors it a lot. However, Facebook hates external links, so if it’s not a paid post, it’s best to share the Facebook page itself.
Here’s a win-win trick you can do if you have a Facebook page, let’s say:
Instead of donating to us, make a dope post with the video or the Spotify player and use the money to buy promotion for it. This way you drive attention to both your page and our initiative, double win!

Soon we will devise more ways to grow this.

https://www.facebook.com/FauciFashion/

And if you really don’t like Fauci Fashion, we understand, feel free to purchase Covidiocracy T-shirts and hats from our shop. But most of those money won’t go to us, our percentage is tiny.
We don’t make any blood money on the masks, that’s manufacturer’s price.

updates:

This will most probably become like a running thread because we have interesting developments almost daily. Here are some of them

August 3rd 2020:
This happened. And even more interesting than the video is what happened when we uploaded it on Facebook, see below!

We uploaded this video on our Facebook page too and guess what happened to two people (me and a friend, in fact) the second we started to share it in private messages, verbatim copy incidents: We get locked out by Facebook who was claiming the accounts got hacked and they need to re-secure them. So we went through password changing and a whole f-ing test to regain access.
The hacking never actually happened, it was basically a false flag by Facebook, who have been long time shilling for China and Fauci.
Most of you users must have got the news that Fakebook’s just launched the new official private message censorship policy, which is basically an AI set to ban keywords and links. Much more complicated than that, but basically that. And the new toaster wasn’t set yet to the right temperature when we started to share inconvenient content.
Facebook’s pretense that two of our accounts were attacked, coincidentally and precisely when they were sharing the same video in PM’s – that’s dumb af, Suckerborg!

In other news, EDM Nations mag is with us more vigorously than China 🙂

The Swag is strong with this one

September 13th:
This escalated faster the we anticipated and we had to re-title our video to better reflect the developments:

Ever watched a heist live online? Hit the video and watch the counters.

Long story short:
Our target with The People for Fauci Fashion was 10,000 Youtube views and about as many streams on Spotify first half of September. Spotify went well since Day#1, no worries there.
First days we got the video some bumps in traffic, a solid few hundred views went away, we hardly documented it because we couldn’t believe our eyes we’re watching the counter going backwards.
We went over the shock, took it as an accident, got some more press, tricked the Facebook robots to approve our clips and literally paid Suckerborg to distribute out video across Facebook, mobilised some supporters and got things going, with a few ups and downs.
By Friday 11th we were at about 8,500 Youtube views and imaginary Champagne bottles went to the freezer before I went to bed.
Saturday morning I woke up to only about 8,900 views, I raised an eyebrow, but OK.
Before I finished my coffee we were down to around 7,300. Took me a while to process and react, mobilise some people etc, so first screenshot is from the afternoon at around 6,300 views.
Made noise, tons more people watched the video, Sunday afternoon we’re down 100 views and about 10 likes.
Regardless of what you think of our initiative, from Youtubers’ household budgets to entire industries, we all are hugely influenced by Youtube, Facebook and Twitter numbers and reports. And they are arbitrary. They insert there whatever figures they damn please. If you have doubts about that, read here how you yourself can prove Facebook is pick-pocketing users and advertisers, we learned it the hard way, and a lot more while promoting this project.

Meanwhile, reality has become even harder to distinguish from memes and parodies.


Is it a meme, is it “fake news”, is it “real news”?

By Sunday afternoon everything turned again…
#LMAO @ #Youtube: I Did a little roll call, pushed back, outed them everywhere and whatcha guess, the power is back. Not the views, though.
Did everyone just die this week-end?!
Youtube almost brags and rubs in our face the thick chunk of views they took from our video. Globalist scum, basically.

Monday: Same story reloaded, this time we kinda streamed it live on Facebook and other socials.

Before
Now



“Fauci Fashion” is part of a larger music release that has just been made available on most quality digital platforms that support electronic dance music.

Imagine a fist with five middle fingers up. Even 6 on Bandcamp or Youtube.
This is the official description of Alien Pimp’s newest EP.
Straight from the depths of the deepest Coronavirus mental and emotional depression, with one hand swinging the sword of comedy and with the other – the hammer of tragedy, here comes the sound of the “New Normal”. It’s angry, pissed, acid, deep, dark, ironic, silly, it’s everything punk aspired to be, but with computers and true care for the sound engineering. It doesn’t even matter if you like it, this EP is here to take a snap of history and set a stone. Alien Pimp did that before a few times, he pushed the bass music hybridization 10 years ago, and precisely 20 years ago he got featured on CNN for the pioneering internet as a medium for audio-visual collaborations. And now a new age awaits a new turn, especially in arts, you can be part of it or part of the past. And it’s pointless to even try stopping it, berating and belittling it, as it is pointless to ignore it. It is, it happened and it won’t go away, more so than the times that lead to its creation.
Every track comes ‘equipped” with visual support created by the musician himself. He practices something he calls “new media” or “Silview media” (from his own name and website), it’s a fusion of formats and aesthetics shaped by the current times and technology. It blends a bit of everything, from retro-futurism to memes and tiktok. Some tracks have vertical videos designed for phones, other resemble animated gifs and so forth.
In short: this is the sound o’ the times.
“Don’t like it? Imagine how much I love living the times that inspired it! Like it? You know what to do…”, says Alien Pimp.

Alien-Pimp.com

Enough blah now, this will be updated, it’s action time, thank you for everything!

So how do you go…

…from this (2016)

… to this…

… in less than four years? Must be some breakthrough science again, maybe viruses are getting fat like Brits, or maybe they invented invisible masks now, right?
No. Politics and media narratives changed. Nature works the same, masks are as lame as they ever were when it comes to virus protection.
See for yourself and you will understand why this article is not up anymore.

When did they embraced dogma, yesterday or today? Why?

Below is the full, unedited article, in all its beauty.
Probably the most valuable part is the references collection, as well as this little announcement hanged by the Oral Health collective at the end of the piece, just to trash it a bit later for no actual reason:

Oral Health welcomes this original article.

Why Face Masks Don’t Work: A Revealing Review

October 18, 2016
by John Hardie, BDS, MSc, PhD, FRCDC

Yesterday’s Scientific Dogma is Today’s Discarded Fable

Introduction
The above quotation is ascribed to Justice Archie Campbell author of Canada’s SARS Commission Final Report. 1 It is a stark reminder that scientific knowledge is constantly changing as new discoveries contradict established beliefs. For at least three decades a face mask has been deemed an essential component of the personal protective equipment worn by dental personnel. A current article, “Face Mask Performance: Are You Protected” gives the impression that masks are capable of providing an acceptable level of protection from airborne pathogens. 2 Studies of recent diseases such as Severe Acute Respiratory Syndrome (SARS), Middle Eastern Respiratory Syndrome (MERS) and the Ebola Crisis combined with those of seasonal influenza and drug resistant tuberculosis have promoted a better understanding of how respiratory diseases are transmitted. Concurrently, with this appreciation, there have been a number of clinical investigations into the efficacy of protective devices such as face masks. This article will describe how the findings of such studies lead to a rethinking of the benefits of wearing a mask during the practice of dentistry. It will begin by describing new concepts relating to infection control especially personal protective equipment (PPE).

Trends in Infection Control
For the past three decades there has been minimal opposition to what have become seemingly established and accepted infection control recommendations. In 2009, infection control specialist Dr. D. Diekema questioned the validity of these by asking what actual, front-line hospital-based infection control experiences were available to such authoritative organization as the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Association (OSHA) and the National Institute for Occupational Safety and Health (NIOSH). 3 In the same year, while commenting on guidelines for face masks, Dr. M. Rupp of the Society for Healthcare Epidemiology of America noted that some of the practices relating to infection control that have been in place for decades, ”haven’t been subjected to the same strenuous investigation that, for instance, a new medicine might be subjected.” 4 He opined that perhaps it is the relative cheapness and apparent safety of face masks that has prevented them from undergoing the extensive studies that should be required for any quality improvement device. 4 More recently, Dr. R. MacIntyre, a prolific investigator of face masks, has forcefully stated that the historical reliance on theoretical assumptions for recommending PPEs should be replaced by rigorously acquired clinical data. 5 She noted that most studies on face masks have been based on laboratory simulated tests which quite simply have limited clinical applicability as they cannot account for such human factors as compliance, coughing and talking. 5

Covering the nose and mouth for infection control started in the early 1900s when the German physician Carl Flugge discovered that exhaled droplets could transmit tuberculosis. 4 The science regarding the aerosol transmission of infectious diseases has, for years, been based on what is now appreciated to be “very outmoded research and an overly simplistic interpretation of the data.” 6 Modern studies are employing sensitive instruments and interpretative techniques to better understand the size and distribution of potentially infectious aerosol particles. 6 Such knowledge is paramount to appreciating the limitations of face masks. Nevertheless, it is the historical understanding of droplet and airborne transmission that has driven the longstanding and continuing tradition of mask wearing among health professionals. In 2014, the nursing profession was implored to “stop using practice interventions that are based on tradition” but instead adopt protocols that are based on critical evaluations of the available evidence. 7

A December 2015 article in the National Post seems to ascribe to Dr. Gardam, Director of Infection Prevention and Control, Toronto University Health Network the quote, “I need to choose which stupid, arbitrary infection control rules I’m going to push.” 8 In a communication with the author, Dr. Gardam explained that this was not a personal belief but that it did reflect the views of some infection control practitioners. In her 2014 article, “Germs and the Pseudoscience of Quality Improvement”, Dr. K Sibert, an anaesthetist with an interest in infection control, is of the opinion that many infection control rules are indeed arbitrary, not justified by the available evidence or subjected to controlled follow-up studies, but are devised, often under pressure, to give the appearance of doing something. 9

The above illustrate the developing concerns that many infection control measures have been adopted with minimal supporting evidence. To address this fault, the authors of a 2007 New England Journal of Medicine (NEJM) article eloquently argue that all safety and quality improvement recommendations must be subjected to the same rigorous testing as would any new clinical intervention. 10 Dr. R. MacIntyre, a proponent of this trend in infection control, has used her research findings to boldly state that, “it would not seem justifiable to ask healthcare workers to wear surgical masks.” 4 To understand this conclusion it is necessary to appreciate the current concepts relating to airborne transmissions.

Airborne Transmissions
Early studies of airborne transmissions were hampered by the fact that the investigators were not able to detect small particles (less than 5 microns) near an infectious person. 6 Thus, they assumed that it was the exposure of the face, eyes and nose to large particles (greater than 5 microns) or “droplets” that transmitted the respiratory condition to a person in close proximity to the host. 6 This became known as “droplet infection”, and 5 microns or greater became established as the size of large particles and the traditional belief that such particles could, in theory, be trapped by a face mask. 5 The early researchers concluded that since only large particles were detected near an infectious person any small particles would be transmitted via air currents, dispersed over long distances, remain infective over time and might be inhaled by persons who never had any close contact with the host. 11 This became known as “airborne transmission” against which a face mask would be of little use. 5

Through the use of highly sensitive instruments it is now appreciated that the aerosols transmitted from the respiratory tract due to coughing, sneezing, talking, exhalation and certain medical and dental procedures produce respiratory particles that range from the very small (less than 5 microns) to the very large (greater than a 100 microns) and that all of these particles are capable of being inhaled by persons close to the source. 6, 11 This means that respiratory aerosols potentially contain bacteria averaging in size from 1-10 microns and viruses ranging in size from 0.004 to 0.1 microns. 12 It is also acknowledged that upon their emission large “droplets” will undergo evaporation producing a concentration of readily inhalable small particles surrounding the aerosol source. 6

The historical terms “droplet infection” and “airborne transmission” defined the routes of infection based on particle size. Current knowledge suggests that these are redundant descriptions since aerosols contain a wide distribution of particle sizes and that they ought to be replaced by the term, “aerosol transmissible.” 4, 5 Aerosol transmission has been defined as “person –to – person transmission of pathogens through air by means of inhalation of infectious particles.” 26 In addition, it is appreciated that the physics associated with the production of the aerosols imparts energy to microbial suspensions facilitating their inhalation. 11

Traditionally face masks have been recommended to protect the mouth and nose from the “droplet” route of infection, presumably because they will prevent the inhalation of relatively large particles. 11 Their efficacy must be re-examined in light of the fact that aerosols contain particles many times smaller than 5 microns. Prior to this examination, it is pertinent to review the defence mechanism of the respiratory tract.

Respiratory System Defences
Comprehensive details on the defence mechanisms of the respiratory tract will not be discussed. Instead readers are reminded that; coughing, sneezing, nasal hairs, respiratory tract cilia, mucous producing lining cells and the phagocytic activity of alveolar macrophages provide protection against inhaled foreign bodies including fungi, bacteria and viruses. 13 Indeed, the pathogen laden aerosols produced by everyday talking and eating would have the potential to cause significant disease if it were not for these effective respiratory tract defences.

These defences contradict the recently published belief that dentally produced aerosols, “enter unprotected bronchioles and alveoli.” 2 A pertinent demonstration of the respiratory tract’s ability to resist disease is the finding that- compared to controls- dentists had significantly elevated levels of antibodies to influenza A and B and the respiratory syncytial virus. 14 Thus, while dentists had greater than normal exposure to these aerosol transmissible pathogens, their potential to cause disease was resisted by respiratory immunologic responses. Interestingly, the wearing of masks and eye glasses did not lessen the production of antibodies, thus reducing their significance as personal protective barriers. 14 Another example of the effectiveness of respiratory defences is that although exposed to more aerosol transmissible pathogens than the general population, Tokyo dentists have a significantly lower risk of dying from pneumonia and bronchitis. 15 The ability of a face mask to prevent the infectious risk potentially inherent in sprays of blood and saliva reaching the wearers mouth and nose is questionable since, before the advent of mask use, dentists were no more likely to die of infectious diseases than the general population. 16

The respiratory tract has efficient defence mechanisms. Unless face masks have the ability to either enhance or lessen the need for such natural defences, their use as protection against airborne pathogens must be questioned.

Face Masks
History: Cloth or cotton gauze masks have been used since the late 19th century to protect sterile fields from spit and mucous generated by the wearer. 5,17,18 A secondary function was to protect the mouth and nose of the wearer from the sprays and splashes of blood and body fluids created during surgery. 17 As noted above, in the early 20th century masks were used to trap infectious “droplets” expelled by the wearer thus possibly reducing disease transmission to others. 18 Since the mid-20th century until to-day, face masks have been increasingly used for entirely the opposite function: that is to prevent the wearer from inhaling respiratory pathogens. 5,20,21 Indeed, most current dental infection control recommendations insist that a face mask be worn, “as a key component of personal protection against airborne pathogens”. 2

Literature reviews have confirmed that wearing a mask during surgery has no impact whatsoever on wound infection rates during clean surgery. 22,23,24,25,26 A recent 2014 report states categorically that no clinical trials have ever shown that wearing a mask prevents contamination of surgical sites. 26 With their original purpose being highly questionable it should be no surprise that the ability of face masks to act as respiratory protective devices is now the subject of intense scrutiny. 27 Appreciating the reasons for this, requires an understanding of the structure, fit and filtering capacity of face masks.

Structure and Fit: Disposable face masks usually consist of three to four layers of flat non-woven mats of fine fibres separated by one or two polypropylene barrier layers which act as filters capable of trapping material greater than 1 micron in diameter. 18,24,28 Masks are placed over the nose and mouth and secured by straps usually placed behind the head and neck. 21 No matter how well a mask conforms to the shape of a person’s face, it is not designed to create an air tight seal around the face. Masks will always fit fairly loosely with considerable gaps along the cheeks, around the bridge of the nose and along the bottom edge of the mask below the chin. 21 These gaps do not provide adequate protection as they permit the passage of air and aerosols when the wearer inhales. 11,17 It is important to appreciate that if masks contained filters capable of trapping viruses, the peripheral gaps around the masks would continue to permit the inhalation of unfiltered air and aerosols. 11

Filtering Capacity: The filters in masks do not act as sieves by trapping particles greater than a specific size while allowing smaller particles to pass through. 18 Instead the dynamics of aerosolized particles and their molecular attraction to filter fibres are such that at a certain range of sizes both large and small particles will penetrate through a face mask. 18 Accordingly, it should be no surprise that a study of eight brands of face masks found that they did not filter out 20-100% of particles varying in size from 0.1 to 4.0 microns. 21 Another investigation showed penetration ranges from 5-100% when masks were challenged with relatively large 1.0 micron particles. 29 A further study found that masks were incapable of filtering out 80-85% of particles varying in size from 0.3 to 2.0 microns. 30 A 2008 investigation identified the poor filtering performance of dental masks. 27 It should be concluded from these and similar studies that the filter material of face masks does not retain or filter out viruses or other submicron particles. 11,31 When this understanding is combined with the poor fit of masks, it is readily appreciated that neither the filter performance nor the facial fit characteristics of face masks qualify them as being devices which protect against respiratory infections. 27 Despite this determination the performance of masks against certain criteria has been used to justify their effectiveness.2 Accordingly, it is appropriate to review the limitations of these performance standards.

Performance Standards: Face masks are not subject to any regulations. 11 The USA Federal Food and Drug Administration (FDA) classifies face masks as Class II devices. To obtain the necessary approval to sell masks all that a manufacturer need do is satisfy the FDA that any new device is substantially the same as any mask currently available for sale. 21 As ironically noted by the Occupational Health and Safety Agency for Healthcare in BC, “There is no specific requirement to prove that the existing masks are effective and there is no standard test or set of data required supporting the assertion of equivalence. Nor does the FDA conduct or sponsor testing of surgical masks.” 21 Although the FDA recommends two filter efficiency tests; particulate filtration efficiency (PFE) and bacterial filtration efficiency (BFE) it does not stipulate a minimum level of filter performance for these tests. 27 The PFE test is a basis for comparing the efficiency of face masks when exposed to aerosol particle sizes between 0.1 and 5.0 microns. The test does not assess the effectiveness of a mask in preventing the ingress of potentially harmful particles nor can it be used to characterize the protective nature of a mask. 32 The BFE test is a measure of a mask’s ability to provide protection from large particles expelled by the wearer. It does not provide an assessment of a mask’s ability to protect the wearer. 17 Although these tests are conducted under the auspices of the American Society of Testing and Materials (ASTM) and often produce filtration efficiencies in the range of 95-98 %, they are not a measure of a masks ability to protect against respiratory pathogens. Failure to appreciate the limitations of these tests combined with a reliance on the high filtration efficiencies reported by the manufacturers has, according to Healthcare in BC, “created an environment in which health care workers think they are more protected than they actually are.” 21 For dental personnel the protection sought is mainly from treatment induced aerosols.

Dental Aerosols
For approximately 40 years it has been known that dental restorative and especially ultrasonic scaling procedures produce aerosols containing not only blood and saliva but potentially pathogenic organisms. 33 The source of these organisms could be the oral cavities of patients and/or dental unit water lines. 34 Assessing the source and pathogenicity of these organisms has proven elusive as it is extremely difficult to culture bacteria especially anaerobes and viruses from dental aerosols. 34 Although there is no substantiated proof that dental aerosols are an infection control risk, it is a reasonable assumption that if pathogenic microbes are present at the treatment site they will become aerosolized and prone to inhalation by the clinician which a face mask will not prevent. As shown by the study of UK dentists, the inhalation resulted in the formation of appropriate antibodies to respiratory pathogens without overt signs and symptoms of respiratory distress. 14 This occurred whether masks were or were not worn. In a 2008 article, Dr. S. Harrel, of the Baylor College of Dentistry, is of the opinion that because there is a lack of epidemiologically detectable disease from the use of ultrasonic scalers, dental aerosols appear to have a low potential for transmitting disease but should not be ignored as a risk for disease transmission. 34 The most effective measures for reducing disease transmission from dental aerosols are pre-procedural rinses with mouthwashes such as chlorhexidine, large diameter high volume evacuators, and rubber dam whenever possible. 33 Face masks are not useful for this purpose, and Dr. Harrel believes that dental personnel have placed too great a reliance on their efficacy. 34 Perhaps this has occurred because dental regulatory agencies have failed to appreciate the increasing evidence on face mask inadequacies.

The Inadequacies
Between 2004 and 2016 at least a dozen research or review articles have been published on the inadequacies of face masks. 5,6,11,17,19,20,21,25,26,27,28,31 All agree that the poor facial fit and limited filtration characteristics of face masks make them unable to prevent the wearer inhaling airborne particles. In their well-referenced 2011 article on respiratory protection for healthcare workers, Drs. Harriman and Brosseau conclude that, “facemasks will not protect against the inhalation of aerosols.” 11 Following their 2015 literature review, Dr. Zhou and colleagues stated, “There is a lack of substantiated evidence to support claims that facemasks protect either patient or surgeon from infectious contamination.” 25 In the same year Dr. R. MacIntyre noted that randomized controlled trials of facemasks failed to prove their efficacy. 5 In August 2016 responding to a question on the protection from facemasks the Canadian Centre for Occupational Health and Safety replied:

  • The filter material of surgical masks does not retain or filter out submicron particles;
  • Surgical masks are not designed to eliminate air leakage around the edges;
  • Surgical masks do not protect the wearer from inhaling small particles that can remain airborne for long periods of time. 31

In 2015, Dr. Leonie Walker, Principal Researcher of the New Zealand Nurses Organization succinctly described- within a historical context – the inadequacies of facemasks, “Health care workers have long relied heavily on surgical masks to provide protection against influenza and other infections. Yet there are no convincing scientific data that support the effectiveness of masks for respiratory protection. The masks we use are not designed for such purposes, and when tested, they have proved to vary widely in filtration capability, allowing penetration of aerosol particles ranging from four to 90%.” 35

Face masks do not satisfy the criteria for effectiveness as described by Drs. Landefeld and Shojania in their NEJM article, “The Tension between Needing to Improve Care and Knowing How to Do It. 10 The authors declare that, “…recommending or mandating the widespread adoption of interventions to improve quality or safety requires rigorous testing to determine whether, how, and where the intervention is effective…” They stress the critical nature of this concept because, “…a number of widely promulgated interventions are likely to be wholly ineffective, even if they do not harm patients.” 10 A significant inadequacy of face masks is that they were mandated as an intervention based on an assumption rather than on appropriate testing.

Conclusions
The primary reason for mandating the wearing of face masks is to protect dental personnel from airborne pathogens. This review has established that face masks are incapable of providing such a level of protection. Unless the Centers for Disease Control and Prevention, national and provincial dental associations and regulatory agencies publically admit this fact, they will be guilty of perpetuating a myth which will be a disservice to the dental profession and its patients. It would be beneficial if, as a consequence of the review, all present infection control recommendations were subjected to the same rigorous testing as any new clinical intervention. Professional associations and governing bodies must ensure the clinical efficacy of quality improvement procedures prior to them being mandated. It is heartening to know that such a trend is gaining a momentum which might reveal the inadequacies of other long held dental infection control assumptions. Surely, the hallmark of a mature profession is one which permits new evidence to trump established beliefs. In 1910, Dr. C. Chapin, a public health pioneer, summarized this idea by stating, “We should not be ashamed to change our methods; rather, we should be ashamed not to do so.” 36 Until this occurs, as this review has revealed, dentists have nothing to fear by unmasking. OH


Oral Health welcomes this original article.

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