Bailey Anne Vincent is a dancer, a business owner, and a mother of two. She’s also immuno-compromised, suffering from a form of Cystic Fibrosis. Her condition has made 2020 particularly scary, because she knows that if she were to contract the COVID-19 virus, she would have a much lower likelihood of survival.

For this reason, she is asking everyone: if you don’t want to wear a mask for yourself, please do it for her.

“The inability to wear a mask to protect someone like me (so that I can survive 2020) is a privilege most unfathomable. If I sound dramatic, well, I feel a little bit dramatic” [1].

Compromised Immunity and COVID-19 Risk

As we approach the six-month mark of the COVID-19 pandemic, one thing has become abundantly clear: people with underlying medical conditions are at a greater risk for developing a severe COVID-19 infection that is more likely to result in death [2].

According to the Centers for Disease Control and Prevention (CDC), people of any age with the following underlying conditions are at an increased risk for the novel coronavirus:

• Chronic kidney disease – your kidneys are unable to filter your blood as well as they should, putting you at greater risk for infections [3].
• COPD (chronic obstructive pulmonary disease)- this includes emphysema and chronic bronchitis, all of which are chronic lung diseases. This causes airflow blockage and breathing-related problems, which exacerbates symptoms of COVD-19 [4].
• Immunocompromised state (weakened immune system)- this could be from a solid organ transplant, a blood, bone, or marrow transplant, immunodeficiencies, HIV, or prolonged use of corticosteroids, among other factors [2]. 
• Obesity (body mass index [BMI] of 30 or higher)- obesity puts you at greater risk for other conditions such as heart disease and diabetes, which put you at greater risk for developing a severe case of COVID-19 [2].
• Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies 
• Sickle cell disease – this includes all blood disorders that affect your hemoglobin, which is a molecule in red blood cells that deliver oxygen to the rest of the cells in your body [5].
• Type 2 diabetes mellitus – this can put you at risk for other risk-factors including heart disease, kidney disease, and many more [6].

The CDC also includes Cystic Fibrosis in its list of conditions that might increase the risk for severe COVID-19. This is because of what health experts call the “cytokine storm”. A cytokine storm is a severe immune reaction that occurs when the body releases too many cytokines into the blood too quickly [7]. 

This can lead to multiple organ failure, which is being reported by doctors and health officials as the most dangerous and potentially life-threatening event related to COVID-19 [8].

Cystic Fibrosis patients can also experience a cytokine dysfunction similar to what is being reported in COVID-19 patients, which may put them at a high risk for severe infection [9].

Other conditions that may increase the risk for severe COVID-19 include: 

• Asthma (moderate-to-severe)
• Cerebrovascular disease (affects blood vessels and blood supply to the brain)
• Hypertension or high blood pressure
• Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
• Neurologic conditions, such as dementia
• Liver disease
• Pregnancy
• Pulmonary fibrosis (having damaged or scarred lung tissues)
• Smoking
• Thalassemia (a type of blood disorder)
• Type 1 diabetes mellitus [2]

Read: Opinion: Why Telling People They Don’t Need Masks Backfired

Masks and COVID-19 Risk-Reduction

The most effective type of face-covering to prevent the spread of any virus is a respirator mask, such as an N-95 mask. These, however, are critical supplies that must be reserved for healthcare workers. They also require the user to wear them properly, something that has a higher margin of error when compared to non-medical masks. For these reasons, the CDC is now recommending that anyone aged two years and older should wear a cloth face mask when in a public setting [10].

At the beginning of the pandemic, there was significant debate as to whether or not clothe masks were effective at reducing the spread of germs that are carried on respiratory droplets. Since then, however, more and more research has come to light demonstrating how much even a cloth mask can reduce the amount of droplets released when a person breathes, talks, coughs, or sneezes.

One study, for example, found that hundreds of droplets that ranged in size from twenty to five hundred micrometers were released when saying a simple phrase, but almost all of them were blocked when the mouth was covered with a damp cloth [11].

While there are many others that have gotten similar results, UC San Francisco epidemiologist George Rutherford, MD, says the most important indicator for the efficacy of masks is the epidemiological data, which has come from so-called “experiments of nature” [12].

There have been several studies that have shown that infection rates slowed down after mask mandates were put in place, and that there was a lower death rate  in countries where mask-wearing was more of a cultural norm [12].

Essentially, masks are a method of “source control”, since they prevent larger expelled droplets from evaporating into smaller droplets that can travel further and spread infection. This does not mean that everyone will be one hundred percent protected, but it can reduce the risk significantly.

“What you want is 100 percent of people to wear masks, but you’ll settle for 80 percent,” said Rutherford, noting that in one simulation, when eighty percent of the population wore masks it did more to prevent the spread of COVID-19 than a strict lockdown [12].

Infectious disease specialist Peter Chin-Hong, MD, says that the best type of mask to wear is the one you can wear consistently and comfortably. N95 respirators are only necessary in medical situations, and surgical masks tend to be more protective than cloth masks. Many people also find them lighter and more comfortable.

“The concept is risk reduction rather than absolute prevention,” he says. “You don’t throw up your hands if you think a mask is not 100 percent effective. That’s silly. Nobody’s taking a cholesterol medicine because they’re going to prevent a heart attack 100 percent of the time, but you’re reducing your risk substantially” [12].

Both doctors, however, do not recommend using the valved masks that are often worn at construction sites. These masks prevent the inhalation of dust, but do not prevent the exhalation of droplets that could carry the virus.

Read: Study Finds Vitamin D Is Linked To Low Virus Death Rate

Bailey Vincent: What Does it Mean to be Human?

For her part, Bailey Anne Vincent is frustrated by the number of people who are resisting wearing a mask.

“For those frustrated because it encroaches on “human rights,” I have to ask: What does it mean to you to be human?” she asks. “Is being human having the right to knowingly cause harm? Is being human thinking about the individual and never the collective?” [1].

She is imploring the public to wear a mask, if not for themselves, then for people like her, who want to be around for her children as long as possible.

“You cannot say you love me and my family but want differently for mine than yours. That is not love,” she says. “You can love me or you can love your opinions. But you can’t do both” [1].

Keep Reading: Fabric Masks Need 3 Specific Layers to Effectively Block Coronavirus, WHO Says

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