Another Post-Purgatorium Perambulation

One might have hoped that "Nurse Claire" might have made some protest at us posting her naked ass pics online, or attempted some lame defense of them, but so far, not a peep. Oh well. Ignorance is bliss.

14) Dubious effect of surgical masks during surgery

Abstract: 

This article clarifies the use of surgical masks during surgery and the evidence for this. A search performed in PubMed found four studies based on 6.006 patients. The studies described the use of surgical masks in surgery with post-operative infections as endpoint, and the studies had to include a control group. None of the four studies found a difference in the number of post-operative infections whether you used a surgical mask or not. However, the limited numbers of studies make it unsafe to conclude whether or not surgical face masks reduce post-operative infections.

Aesop summary: This article looked at all the other relevant articles, and can't reach any conclusion about anything.

 Yet another non-study of other people's work, showing nothing, and a complete waste of time from every aspect. Go, Team Claire! Another nothingburger!

 15) Surgical attire and the operating room: role in infection prevention

Abstract: 

Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection. The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection. Operating-room ventilation plays an unclear role in the prevention of surgical site infection. Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.

Aesop summary: Another review, i.e. bullshit session summarizing other people's work, conducting zero original research, yet getting paid for reading journal articles to tell you what you already knew, and finding three new areas that also haven't been adequately researched regarding their role in infection and prevention, which we didn't research either.

Jesus Christ on a cross! Medical professionals get paid to sit around and spin this kind of bullshit, and gain professional prestige thereby?!? What a fucking racket!!

Evidence found to support Team Claire's bloviations: Nil

16) Unmasking the surgeons: the evidence behind the use of facemasks in surgery

Abstract:

The use of surgical facemasks is ubiquitous in surgical practice. Facemasks have long been thought to confer protection to the patient from wound infection and contamination from the operating surgeon and other members of the surgical staff. More recently, protection of the theatre staff from patient-derived blood/bodily fluid splashes has also been offered as a reason for their continued use. In light of current NHS budget constraints and cost-cutting strategies, we examined the evidence base behind the use of surgical facemasks.

Examination of the literature revealed much of the published work on the matter to be quite dated and often studies had poorly elucidated methodologies. As a result, we recommend caution in extrapolating their findings to contemporary surgical practice. However, overall there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination. More rigorous contemporary research is needed to make a definitive comment on the effectiveness of surgical facemasks.

Excerpt:

The facemask has been used in surgical settings for over a hundred years;2 first described in 1897, at its inception, it consisted merely of a single layer of gauze to cover the mouth,3 and its primary function was to protect the patient from contamination and surgical site infection. This practice was substantiated, at the time, by a recent discovery which demonstrated that bacteria could be disseminated from the nose and mouth during normal conversation as observed by bacterial colony growth on strategically placed agar plates in theatres. In the 1940s and 1950s, antibiotics and aseptic technique came to the forefront of infection control strategies within the surgical setting. Until recently, it has remained unclear as to whether bacterial colony growth on an agar plate was a direct correlate of surgical site infections and also whether the purpose of the surgical mask has been superseded by more modern strategies of infection control.

Aesop summary: 

First, this is another not-a-study, masquerading as research, being yet another review of other people's work, and hoping it sort-of applies.

In a notably rare display of intelligence above the level found in baboons, the authors note that using antibiotics for 80 years may have had some wee effect on bacterial growth and post-operative infections. Almost as if Lister, Pasteur, and Semmelweiss may have been onto something with Germ Theory.

Third, the driving force behind this UK study appears to be the continual penny-pinching of the National Health Service, rather than best practice and patient outcomes (color me shocked again), and then casting about for means to justify a new means of parsimony with dubious scientific support. Already famous for time-clock surgeons punching out for lunch mid-procedure with patients laid open, and coming back to the surgery half-in-the-bag with strong drink, we can't say finding NHS shilling for savings over safety much surprises us.

Applicability of any of this to masks and the spread of aerosolized viral infections: Nil.

We had a number of previous unreadable forfeits in the shitstack, but think we have cracked the problem: PubMed's header fornicates up our browser. So instead of leaving a couple of forfeits, we returned above, and found all the nothing right where we expected it. We nonetheless continue the hunt for anything noteworthy, so far totally in vain.

17) Is a mask necessary in the operating theatre?

Abstract:

No masks were worn in one operating theatre for 6 months. There was no increase in the incidence of wound infection. 

Aesop summary: In this study from 44 years ago, after a sample of 432 surgeries where an open wound was involved and no masks were worn, only 8 infections occurred, none of them resulting from bacteria issuing from the oro-pharynx of the surgical team. 

"The 8 infections which did occur bore no relation to the throat or nose cultures from the the theatre team."

(Callou! Calay! At least one surgeon - from 1981! - knows what he should have been looking for, in contrast to every sonofabitch previously and subsequently writing on the subject!) Sadly for Nurse Claire, no viral pathology was looked for, described, nor pursued. So even granting masks don't benefit the patient, we still haven't disproven their utility in surgery for other reasons, nor advanced the knowledge of whether any not this applies in any way to prevention of aerosolized viral infections in general. As to the author, he was writing years before anyone had ever heard of AIDS or HIV, so he may be forgiven the ignorance of blood-born pathogens as a serious problem, and a risk to be mitigated by the most expedient means available.

Which still doesn't help out Team Claire's case a whit.

18) Possible toxicity of chronic carbon dioxide exposure associated with face mask use blah blah blah

Abstract:

Introduction: During the SARS-CoV-2-pandemic, face masks have become one of the most important ubiquitous factors affecting human breathing. It increases the resistance and dead space volume leading to a re-breathing of CO2. So far, this phenomenon and possible implications on early life has not been evaluated in depth.

Method: As part of a scoping review, literature was systematically reviewed regarding CO2 exposure and facemask use.

Aesop summary: We were so concerned with the potential grave health risks of prolonged wearing of masks, despite 127 years of surgeons and nurses wearing them uninterrupted for hours each day, days each week, weeks each year, for decades and decades, in every civilized country on the planet, we didn't do a single actual study of brain damage or any other injury associated with the imaginary phenomenon, despite literally millions of intensely interested parties - all with advanced degrees! - being available for study for the asking; we just went to the medical library and pored through old journals which don't cover anything about this at all. 

Plain English translation:

This is simply horseshit with legs. And they're running around in circles, with no head attached.

Applicability to mask safety, or the utility of masks in preventing the spread of aerosolized virus infections: Nil.

We have now concluded our review of 18 of the 51 referenced studies, which is over 1/3rd of the total.

We have, to date, found exactly no support whatsoever for any conclusions drawn by Nurse Claire, regarding masking, mask safety, neither the utility nor alleged lack thereof, of simple masks for stopping the spread of aerosolized viral infections, such as COVID. The referenced links have been a universal and total waste of anyone's time, and internet bandwidth. (And they were probably, every single one, peer-reviewed by the medical intelligentsia. Let that sink in for a minute.)

Her conclusions based thereon rest completely on "I pulled this out of my underwear", and nothing more.

We can and will examine the other 34 links at the source, but even if they prove the point, or any fragment of it, she's already down to a score of 64% on this exam.

FOR THOSE KEEPING SCORE AT HOME, A SCORE OF 64% IS A SOLID "D" GRADE.

That's now the highest grade that can be achieved, at this point. Nine more whiffs, and it slips to an irretrievable F. And with a solid D now, we amend this post to note: we are officially Arguing With Retards On the Internet.

But wait! There's More!