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Who should not wear a mask

 

CDC recognizes there are specific instances when wearing a mask may not be feasible. In these instances, consider adaptations and alternatives.

 

The following categories of people are exempt from the requirement to wear a mask:

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Mask Etiquette

We did not find evidence that surgical-type face masks are effective in reducing laboratory-confirmed influenza transmission, either when worn by infected persons (source control) or by persons in the general community to reduce their susceptibility (Figure 2). However, as with hand hygiene, face masks might be able to reduce the transmission of other infections and therefore have value in an influenza pandemic when healthcare resources are stretched.

https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article?fbclid=IwAR2xTkEHyQfDgvwjJSyQRe3v7rhSldQYgka-sm7g4L1HgqGtdAr2uF3kdJ8

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World Health Organization (WHO)

 

   World Health Organization (WHO), June 2020

  • https://apps.who.int/iris/bitstream/handle/10665/332293/WHO-2019-nCov-IPC_Masks-2020.4-eng.pdf?sequence=1&isAllowed=y

  • “The likely disadvantages of the use of mask by healthy people in the general public include:

    • potential increased risk of self-contamination due to the manipulation of a face mask and subsequently touching eyes with contaminated hands;

    • potential self-contamination that can occur if non- medical masks are not changed when wet or soiled. This can create favourable conditions for microorganism to amplify;

    • potential headache and/or breathing difficulties, depending on type of mask used;

    • potential development of facial skin lesions, irritant dermatitis or worsening acne, when used frequently for long hours;

    • difficulty with communicating clearly;

    • potential discomfort;

    • a false sense of security, leading to potentially lower adherence to other critical preventive measures such as physical distancing and hand hygiene;

    • poor compliance with mask wearing, in particular by young children;

    • waste management issues; improper mask disposal leading to increased litter in public places, risk of contamination to street cleaners and environment hazard;

    • difficulty communicating for deaf persons who rely on lip reading;

    • disadvantages for or difficulty wearing them, especially for children, developmentally challenged persons, those with mental illness, elderly persons with cognitive impairment, those with asthma or chronic respiratory or breathing problems, those who have had facial trauma or recent oral maxillofacial surgery, and those living in hot and humid environments.

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Resources

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Every Organization has guiding principles, and uses resources to complete their Mission.

Here's some of ours:

Association of American Physicians and Surgeons

 

https://aapsonline.org/mask-facts/?fbclid=IwAR0it1ucddDKDqM-ME3hNWy6d_nGCQUF2AUxHPQC6PhlcFdM2JZP-WQjWFo

 

Final Thoughts

  • Surgical masks are loose fitting. They are designed to protect the patient from the doctors’ respiratory droplets.  There wearer is not protected from others’ airborne particles.

  • People do not wear masks properly. Many people have the mask under the nose. The wearer does not have glasses on and the eyes are a portal of entry.  If the virus lands on the conjunctiva, tears will wash it into the nasopharynx.

  • Most studies cannot separate out hand hygiene.

  • The designer masks and scarves offer minimal protection. They give a false sense of security to both the wearer and those around the wearer.
    **Not to mention they add a perverse lightheartedness to the situation.

  • If you are walking alone, no need for a mask. Avoid other folks; use common sense.

  • Remember: children under 2 years should not wear masks because of accidental suffocation and difficulty breathing in some.

  • Even if a universal mask mandate were imposed, several studies noted that folks do not use the mask properly and over-report their wearing.  Additionally, how would the mandate be enforced??

  • The positive studies are models that assume universality and full compliance.

  • If wearing a mask makes people go out and get Vitamin D – go for it. In the 1918 flu pandemic people who went outside did better.  Early reports are showing people with COVID-19 with low Vitamin D do worse than those with normal levels. Perhaps that is why shut-ins do so poorly. https://www.medrxiv.org/content/10.1101/2020.04.08.20058578v4

Americans with Disabilities Act

 

Subpart B – General Requirements: http://ada.gov/

 

§ 36.201 General.

  • (a) Prohibition of discrimination. No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any private entity who owns, leases (or leases to), or operates a place of public accommodation. 

  • (b) Landlord and tenant responsibilities. Both the landlord who owns the building that houses a place of public accommodation and the tenant who owns or operates the place of public accommodation are public accommodations subject to the requirements of this part. As between the parties, allocation of responsibility for complying with the obligations of this part may be determined by lease or other contract. 

  • (c) Claims of no disability.  Nothing in this part shall provide the basis for a claim that an individual without a disability was subject to discrimination because of a lack of disability, including a claim that an individual with a disability was granted a reasonable modification that was denied to an individual without a disability.  

 

§ 36.202 Activities.

  • (a) Denial of participation. A public accommodation shall not subject an individual or class of individuals on the basis of a disability or disabilities of such individual or class, directly, or through contractual, licensing, or other arrangements, to a denial of the opportunity of the individual or class to participate in or benefit from the goods, services, facilities, privileges, advantages, or accommodations of a place of public accommodation. 

  • (b) Participation in unequal benefit. A public accommodation shall not afford an individual or class of individuals, on the basis of a disability or disabilities of such individual or class, directly, or through contractual, licensing, or other arrangements, with the opportunity to participate in or benefit from a good, service, facility, privilege, advantage, or accommodation that is not equal to that afforded to other individuals. 

  • (c) Separate benefit. A public accommodation shall not provide an individual or class of individuals, on the basis of a disability or disabilities of such individual or class, directly, or through contractual, licensing, or other arrangements with a good, service, facility, privilege, advantage, or accommodation that is different or separate from that provided to other individuals, unless such action is necessary to provide the individual or class of individuals with a good, service, facility, privilege, advantage, or accommodation, or other opportunity that is as effective as that provided to others. 

  • (d) Individual or class of individuals. For purposes of paragraphs (a) through (c) of this section, the term "individual or class of individuals" refers to the clients or customers of the public accommodation that enters into the contractual, licensing, or other arrangement. 

§ 36.203 Integrated settings.

  • (a) General. A public accommodation shall afford goods, services, facilities, privileges, advantages, and accommodations to an individual with a disability in the most integrated setting appropriate to the needs of the individual. 

  • (b) Opportunity to participate. Notwithstanding the existence of separate or different programs or activities provided in accordance with this subpart, a public accommodation shall not deny an individual with a disability an opportunity to participate in such programs or activities that are not separate or different. 

  • (c) Accommodations and services.

    • (1) Nothing in this part shall be construed to require an individual with a disability to accept an accommodation, aid, service, opportunity, or benefit available under this part that such individual chooses not to accept. 

    • (2) Nothing in the Act or this part authorizes the representative or guardian of an individual with a disability to decline food, water, medical treatment, or medical services for that individual. 

 

§ 36.206 Retaliation or coercion.

  • (a) No private or public entity shall discriminate against any individual because that individual has opposed any act or practice made unlawful by this part, or because that individual made a charge, testified, assisted, or participated in any manner in an investigation, proceeding, or hearing under the Act or this part. 

  • (b) No private or public entity shall coerce, intimidate, threaten, or interfere with any individual in the exercise or enjoyment of, or on account of his or her having exercised or enjoyed, or on account of his or her having aided or encouraged any other individual in the exercise or enjoyment of, any right granted or protected by the Act or this part. 

  • (c) Illustrations of conduct prohibited by this section include, but are not limited to:

    • (1) Coercing an individual to deny or limit the benefits, services, or advantages to which he or she is entitled under the Act or this part; 

    • (2) Threatening, intimidating, or interfering with an individual with a disability who is seeking to obtain or use the goods, services, facilities, privileges, advantages, or accommodations of a public accommodation; 

    • (3) Intimidating or threatening any person because that person is assisting or encouraging an individual or group entitled to claim the rights granted or protected by the Act or this part to exercise those rights; or 

    • (4) Retaliating against any person because that person has participated in any investigation or action to enforce the Act or this part. 

 

     

§ 36.208 Direct threat.

  • (a) This part does not require a public accommodation to permit an individual to participate in or benefit from the goods, services, facilities, privileges, advantages and accommodations of that public accommodation when that individual poses a direct threat to the health or safety of others. 

  • (b) In determining whether an individual poses a direct threat to the health or safety of others, a public accommodation must make an individualized assessment, based on reasonable judgment that relies on current medical knowledge or on the best available objective evidence, to ascertain: The nature, duration, and severity of the risk; the probability that the potential injury will actually occur; and whether reasonable modifications of policies, practices, or procedures or the provision of auxiliary aids or services will mitigate the risk.