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Experts Call For N95s Over Surgical Masks As Flu, Covid Viruses Spread
By Dr. Judy Stone, Senior Contributor, Forbes
"Nationally, we are seeing very high levels of influenza and, again, a growing wave of COVID-19 infections. A new variant of influenza A H3N2 called subclade K is driving some of this epidemic. Subclade K has already appeared in Japan and Europe and is more severe, especially in the elderly and very young.
"Last week, the Center for Infectious Disease Research and Policy reported 39,945 hospital admissions, up from 33,301 admissions the week before. While numbers have varied some week to week, they have been relatively high. There have been 19 pediatric deaths so far this season. The CDC estimates that there have been at least 15,000,000 illnesses, 180,000 hospitalizations, and 7,400 deaths from flu so far this season.
"COVID-19 levels are increasing, and Respiratory Syncytial Virus and Pertussis are also circulating, causing considerable illness. On January 10, Mike Hoerger, Ph.D., a health analytics expert who runs the Pandemic Mitigation Collaborative, posted, “There is now a 1 in 4 chance of exposure in a room of 15 people. Risk varies considerably by state. We are approaching an average of 5 infections per person since pandemic onset.” This level of exposure has significant implications, given the millions of people infected, the toll of long Covid, and the quickly growing knowledge of long-term damage from infection. Note, too, that there is no curative treatment for long Covid and that 80% of long Covid clinics have closed as of April 2025. At the same time, there are increasing work requirements for Medical Assistance, which many of these patients will simply not be able to meet.
"We have learned a lot about how COVID-19 spreads— the World Health Organization, which was initially resistant to the idea, agrees that transmission is largely airborne. Even the US Environmental Protection Agency begins by saying, “Spread of COVID-19 occurs via airborne particles and droplets.
How can we best protect ourselves?
"It comes down to improving ventilation. The more air exchanges you have in a room, the safer you are. Unfortunately, most businesses, schools, and hospitals don’t publish any data that might indicate how risky a space is. CO2 monitors are a surrogate for how much fresh air is cirulating in your space. The World Health Network has tried to crowdsource this CO2 data. You can get a rough idea yourself by buying (or sharing) a CO2 monitor, which can be pricey (~$200.) Several commercially available CO2 monitors are available to estimate ventilation levels. Aranet is a popular, well-regarded brand; multiple brands are reviewed.
"You can also improve your indoor ventilation with HEPA units or Corsi-Rosenthal boxes. Outside the home, most of us rely on masks or respirators.
"For everyday use, medical masks, aka procedural or surgical masks, are commonly used. They are disparagingly known as “baggy blues” because they are loosely fitting and allow significant leakage.
"Respirators are more protective and include the Filtering Face Piece, N95, KN95 (Chinese), and KF94 (Korean). They protect the wearer from inhaling dangerous organisms.
"Previously, both NIOSH and OSHA determined that surgical masks provide inadequate protection and “are not designed or certified to prevent the inhalation of small airborne contaminants."
"Despite that, the Healthcare Infection Control Advisory Committee concluded that they were equivalent in November 2024.
"Last week, the WHN sent a letter to the WHO urging them to declare respirators as the default protection for healthcare workers, rather than surgical masks. They said that FFP2/3 respirators or N95s should be the standard.
"This letter was endorsed by 50 experts—including Trisha Greenhalgh, professor of primary care health sciences at the University of Oxford, and Gregg Gonsalves, epidemiology professor at Yale and cofounder of the Defend Public Health advocacy group.
"It concluded that continuing to recommend surgical masks is “scientifically indefensible” and “dangerous,” as it “exposes patients to preventable and potentially even lethal risk.”
"Adam Finkel, ScD, MPP, is a professor of environmental and occupational health and formerly Director of Health Standards Programs at the Occupational Safety and Health Administration, and a WHN spokesman. Finkel stresses the seriousness of Covid infections. Opponents of respirators say there is no good clinical trial showing that they are better than masks. To this, promoted by the Cochrane collaborative, Finkel argues that randomized trials are neither ethical nor necessary. “There are no studies, and I don’t think there could ever be studies that really segregated the respirator-wearing from the non-wearing group.” He added, “It’s like no one has shown a benefit from parachutes or lead aprons. We don’t have to prove that parachutes are a good idea if you fall out of a plane.” Finkel concluded, “It's very clear that "It's very clear that N95s are (roughly) 90% effective, and why wouldn't you want 90% less viruses getting into you?”
"Vaccine (and mask-) preventable illnesses are enormously expensive, exceeding $10 billion per year in direct and indirect costs for flu alone. How many masks and improved ventila*tion systems might that buy?
"Finkel noted today’s news that the “EPA is baldly saying they're not going to count death as a as a harm or benefit of regulation.”
"Robert F. Kennedy and his team have drastically cut back on the vaccines recommended for children in general and Covid in particular. Kennedy told CBS News that it may be a "better thing" if fewer children receive the flu vaccine.” He said that even though 289 kids died in the 2024-25 flu season, 90% of whom were not vaccinated. Public health experts warn this likely increase in preventable illness and death will not be a consideration except for any economic impact.
"Even so, the costs of infections, as noted above, and the toll of acute and chronic illness, burnout, and staffing shortages on HCWs, are significant. From an economic perspective alone, the WHN makes a compelling case for respirators as the standard of care for healthcare workers."
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