The highlight of the horrendous SARS outbreak for me a few years back was undoubtedly my first glimpse at a Hello Kitty Facemask worn by an Asian woman as she was exiting Logan airport. Clearly this was a serious epidemic if health prevention efforts had also become fashionable.

Minutes after the first chatter emerged earlier this year over the spread of the H1N1 virus (aka Swine Flu) the facemasks were back in full force. I flew that weekend to Detroit, MI and was surrounded by scores of facemask clad, nervous travelers who distanced themselves from anyone who even cleared their throat in public. In addition, Purell sales shot through the roof. There were reports of stock outs of the product coast to coast. Bottles popped up nearly everywhere. People, it seemed, were willing to try anything – even things for which there was little or no evidence that they provide any protection – to avoid catching this flu.

A new study, published today in the Annals of Internal Medicine, has more or less confirmed that such interventions provide only limited protection. A study of patients presenting with the flu at Hong Kong hospitals who were randomized to receive no intervention, were instructed to wear a facemask, or were instructed to practice proper hand washing techniques found no significant reductions in the number of family members who subsequently tested positive for the virus. However, there was some evidence that those patients who adopted the practices sooner after the onset of symptoms may have been less infectious, but only under some conditions. Lots of caveats, as there always are, these were patients who were already sick enough to decide to go to the hospital and adherence rates were abysmally low, but on the whole the evidence was far from a slam dunk for the value of facemasks and hand washing.

So breath freely, and forget reaching for a squirt the next time you are in the elevator, because it seems the flu is going to get us anyway.

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