| More than three years after Covid-19 emerged, and despite influenza outbreaks that kill thousands of people annually, there's still not definitive proof on how much — or whether — wearing masks slows the transmission of respiratory viruses. That's the takeaway message from a 2023 Cochrane Review, the gold standard analysis of medical research that's intended to help shape future health care decisions. More than a dozen experts reviewed 78 studies, some dating back years, involving more than half-a-million people from across the world to figure out if physical interventions can help control these highly contagious pathogens. The initial conclusion for masks? Not so much. Wearing a medical or surgical mask "probably makes little or no difference" to infections from viruses like influenza or Covid, the researchers concluded. Even restricting the results to health care workers, or examining more sophisticated masks like N95s, turned up no clear differences for respiratory pathogens overall. Almost everywhere in the world has stopped demanding universal mask-wearing to control Covid, though the mouth-and-nose coverings are required in some areas like public transportation and health-care facilities. A notable exception is Hong Kong, where they must be worn at all times in public – even outdoors – with a few concessions (such as when you are eating). A spot fine of HK$5,000 ($637) awaits those who break the law. The policy is wearing thin on residents. It is miserable to be wearing a mask, and glasses, especially in Hong Kong's long, humid summers. When even light clothing causes discomfort, foggy glasses that make it hard to see can really compound one's misery.  Shoppers at the Brands and Products Expo in Hong Kong, China, on Thursday, Dec. 22, 2022. Photographer: Lam Yik/Bloomberg But the research conclusions aren't totally cut and dried. Some studies included in the review were done before Covid, when transmission and circulation of the viruses weren't as intense. Many people didn't wear their masks faithfully. Other research shows masks can significantly reduce Covid transmission rates, especially in tight indoor environments, making them a critical tool. Health experts continue to advise people, particularly those at high-risk, to wear masks to protect themselves. If there is a significant benefit, having other people also take steps to limit the spread would likely help those who are most vulnerable. I would willingly endure discomfort if it meant some people were more likely to dodge, or survive, a viral infection. But the lack of proof one way or another, three years into Covid, makes Hong Kong's outlier status frustrating. Covid continues to circulate here, just as it does in the rest of the world, and officials have said residents will likely be wearing them at least through winter. Hopefully someone's collecting data and eventually we'll know exactly how helpful masks are. I'm not holding my breath, but I am fanning my (masked) face. — Michelle Fay Cortez | 
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