Why Mask Mandates Should be Repealed Immediately

November 15, 2021

During the past 18 months, masks have been mandated worldwide as a major tool to prevent the transmission of the SARS-CoV-2 virus. Sweden is one of the few countries that wisely did not introduce the wearing of masks in a broader sense. At the start of the pandemic when there was not yet much information on the virus available, Sweden asked community members to wear masks during rush hours in public transport. This was a temporary solution and removed at the time a large proportion of vulnerable people was vaccinated.

The statement of Swedish policy advisor professor Anders Tegnell was clear: the wearing of non-medical masks to prevent viral transmission has never been used successfully and science has not yet proved the opposite. The wearing of masks by healthy people in public surroundings might even backfire. The viral spread could become worse. Effectiveness and safe use of non-medical masks in both indoor and outdoor settings is debated by many scientists. 


A false sense of security could be a major risk. During the pandemic Dr Fauci and WHO experts changed their policies frequently from no beneficial effect for wearing masks by the general public (interim report WHO 5 June 2020, to a mandate, wearing two masks, wearing masks for children from the age of five or even two years and even wearing masks outdoors. 

Politicians argue that wearing masks will help to respect other measures like 1.5 meter distancing, frequent hand washing, working from home and adjusting to a stay-at-home policy. However, positive effects of the behavioral aim of masks are flawed and have not been published in a peer-reviewed scientific journal. 


Politicians still push mask mandates. A frequently used political statement is “although there is no profit it will not harm.” Unfortunately when masks are frequently used and for long periods, there is a tremendous risk to people’s health and the environment. Effects may turn out to be irreversible and negatively affect the health of future generations.


During this pandemic wearing of non-medical masks is the most twisted symbol in the war against a virus to reach the ultimate aim of most politicians: a zero Covid policy. Masks reached the highest level of the medical and political agenda, as a comfort blanket for feeling safe and a mechanism of control to circumvent the fear of becoming infected. 


Dr Rochelle Walensky from CDC is claiming in advertisements, without evidence, that wearing a mask could reduce the risk of infection by 80%. However, a Cochrane study by Jefferson et al. and a report of the European Center of Disease Control concluded there is no high-quality evidence in favor of facemasks. No association was observed between mask mandates or use and reduced Covid-19 spread in US states. Up to now there are no results available of randomized clinical trials that could demonstrate beyond any doubt that wearing masks prevent people from viral infection and could slow the spread of the virus. 


Randomized controlled trials during this pandemic on the effects of wearing medical masks in Denmark by the general population could not alter the conclusions of previous trials with (medical) masks on the spread of influenza virus in a hospital setting or in non healthcare settings: there is no substantial effect. 


In September, results of a randomized clinical trial in Bangladesh were published. This study, which is not peer reviewed yet, concluded that the wearing of medical masks could reduce asymptomatic seroprevalence with 9% when mask wearing among villagers improved 29% as compared to members of other villages that did not improve in mask wearing (controlgroup). However this small difference could not be observed when villagers used cloth masks. 


The question remains: if the methods of analysis used in this study is evidence that wearing medical masks by the general population is able to prevent viral infections and transmission, should it be promoted to other regions?

Another recent study by the Max Planck Institute claiming a clear protective effect on preventing viral infections and slowing down the spread of the virus by wearing non medical masks by the general population was based on modelling studies based on assumptions and data from an observational study and a small study in two hospitals in Wuhan. 


Moreover, wearing masks by children and students on the effects of slowing down the spread of the virus in schools has never been studied in a randomized controlled trial. In general children younger than 18 years of age are not at risk of a severe disease. It is presumed children are protected by natural immunity as a result of cross reactivity with other coronaviruses and/or the presence of lower levels of ACE2 receptors which are required for the virus to replicate. 


Moreover, studies of Karolinska Institute and Institute Pasteur concluded that children are not the main drivers of spreading the SARS-CoV-2 virus. A study of the Swedish Institute of Public Health did not observe a difference of infections in children and teachers in Sweden where schools were open without wearing masks as compared to children and teachers in Finland where schools were closed. 


Meanwhile political mandates are forcing children and adults to wear masks many hours a day. An ethical and careful risk benefit evaluation for the wearing of masks on slowing the spread of SARS-CoV-2 virus has never been made while existing and scientific papers on harmful effects for people and environment have been neglected.


The exponential use of masks and other personal protective equipment (PPE) during the pandemic is polarizing the natural immune system and biodiversity with a devastating loss of plasticity resulting in an advanced risk for new virus variants, multiresistant bacteria, infectious diseases and severe chronic diseases. 


Although the environment might have made some gains in terms of the reduction of the carbon footprint and improved air and surface water quality during the pandemic there is a pending threat to our collective existence and the survival of marine organisms. 

The worldwide estimate is that disposable masks or face shields are discarded at a rate of 3.4 million per day. The presence of a diversity of plastics, toxic and cancerous compounds like perfluorocarbon, aniline, phthalate, formaldehyde, bisfenol A as well as heavy metals, biocides (zinc oxide, graphene oxide) and nanoparticles are found. An increasing number of environmental experts worry about the long-term effects. Most (85%) of the masks used worldwide are made in China where no environmental qualification is needed. 


A total breakdown of these dangerous compounds is expected to last 450 years. Problems corresponding to the various sizes of plastics of PPE in the environment and the ecosystems could serve as potential vectors of pathogens and could lead to injuries and death. The use of plastic bottles began in 1950. We consume about a credit card a week of plastic(s) as reported in “Assessing Plastic Ingestion’ from Nature to People.” 


Plastics and non-biodegradable PPE made from plastics in the environment can influence human and animal fertility. Professor Schwan writes in her book Countdown that without changing our attitude to nature it might be that in 2045 fertilization will only be possible via artificial insemination. In April 2020 researchers from Harvard and Worldbank showed a statistical link of air pollution and mortality numbers of Covid-19. 


The influence of harmful compounds, nanoparticles and biocides in masks on children, adults, animals, plants and the environment have not been intensively investigated so far. However based on the available peer-reviewed scientific articles the possible harmful effects on health of healthcare workers is known and an increase in infections and chronic diseases could have been expected.

A recent meta-analysis of 65 peer-reviewed scientific articles concluded a serious danger for developing MIES Mask Induced Exhaustion Syndrome. Symptoms vary from low O2, high CO2, dizziness, exhausted breathing and heartbeat, toxicity, inflammation, increased levels of stress hormone, anxiety, anger, headache, slow thinking and drowsiness. 


For children the possible risks for psychosocial, biological and immunological effects make long-term wearing of face masks difficult to maintain. In history medical masks have only been used by doctors and nurses during specific conditions. Infected wounds were found to be similar or could be increased during the wearing of masks as compared to non wearing masks. 

Masks were meant to wear for short-term use only to protect for blood or saliva squashes in operation rooms. Every two hours a new mask is recommended as well as alternating with a period of not wearing masks.


There is no doubt why many have started challenging the mask mandates for healthy people. US Senator Rand Paul has spoken out against mask mandates. He argues that they don’t work and cases can actually increase. In a tribunal in the German District Court in Weinheim in April 2021 expert professor Christof Kuhbander explained the dangers of wearing masks by children. It is a significant threat for their physical and emotional well-being and their general development by disturbing their nonverbal communication. 

Furthermore there is a serious risk for a change in the bacterial flora in the mouth resulting in bad breath, tooth decay and inflammation. In the long term the change in the microbial flora might increase the risk for skin problems, heart problems, digestive problems and a waning innate immune system. 


Professor Dr Ines Kappstein explained during the same court meeting there is no evidence that wearing masks can significantly decrease the risk for an infection with the SARS-CoV-2 virus. Improper use of masks may increase infections. The court judged that wearing masks is useless and unconstitutional. More judges should follow this decision. 


In August 2008, the NIH published a paper that during the flu pandemic in 1918 most people died due to bacterial pneumonia. Scientists debate that wearing masks lengthened the duration of the pandemic. During the current SARS-CoV-2 pandemic bacterial co-infection have been observed as well. Nowadays young adults with pneumonia caused by Staphylococcus aureus, which seldom occurred before, can land in ICU’s. Another remarkable phenomenon recently observed in hospitals is the enormous increase in up to 25% of Covid patients co-infected with black fungus. 


An infection that may end in death normally occurs in people with a compromised immune system. A possible explanation for this could be the use of dexamethasone. Similarly a rise in more RSV infections in young children is being seen. The role of the long-term use of dirty, humid masks and the presence of toxic compounds in masks resulting in a waning immune system needs further attention. Presence of respiratory viruses on the outer surface of medical masks used by hospital healthcare workers is demonstrated and may result in self-contamination. 


A possible link to neurological damage and an increasing risk for lung cancer due to decreased availability of oxygen and as a result dysbiosis of the lower respiratory tract has been published. Wearing masks at higher temperatures and high humidity e.g summer or places like hairdressers may lead to dehydration, increased heartbeat and other heat-related health problems. 

There are possible effects from the wrong use of masks that could damage human health. People might use the microwave to disinfect their mask, or sprays to disinfect or ethereal oils for a nice smell, which may be harmful. In Canada, Belgium, Germany, and The Netherlands nonmedical and medical masks financed by the governments had to be withdrawn from the market due to the amount of toxic and harmful substances found. Unfortunately most batches of masks used by the general public are not subjected to such analysis.


It is time to stop mask mandates for healthy people. It is no longer possible to justify a behavioral experiment with such far-reaching harmful consequences. Many scientific studies and analysis all arrive at the same conclusion: the wearing of masks by healthy people cannot stop the spread of a virus. 


People without any symptoms tested and a positive PCR test (due to the presence of a nonviable piece of RNA) rarely spread a virus. The most important magic rule is from ancestral wisdom: rest and go to bed when experiencing Covid or flu-like symptoms. Strengthening the immune system with a healthy food and lifestyle will decrease the risk for infections and chronic diseases

Governments and politicians should act with a moral compass. They should repeal all mask mandates immediately. Any action on Covid-19 policy will gain more impact if matched with a focus on restoring public health, the environment, and trust. In high-trust societies like Sweden, the result is a low number of Covid infections and mortality rates without restriction, mask mandates, or vaccine passports.


Also published at the Brownstone Institute, NOVEMBER 15, 2021


The (Lack of) Health in Young Women

By Carla Peeters • March 13, 2025
Many countries now face a growing problem with an aging population and declining childbirths. Too many infants still die unnecessarily before the age of five years. Countries increasingly struggle to keep their economies stable. While Public Health experts communicate to focus on healthier future generations, declining health in young females is ignored. The healthiest generation with a flourishing economy is achieved by a holistic strategy addressing Young Women’s Health as a Public Health priority. The Healthiest Generation of the World in 2040 A Federation of Organizations involved in Public Health in the Netherlands has the ambition to reach the healthiest generation of the world in 2040 . Health is aimed at all levels; mental, social, and physical. To achieve this goal, the Netherlands needs the healthiest young females of the world. In contrast, data analysis from the Netherlands shows the opposite; the health of young women is declining fast. In other Western countries, it won’t be much better. The health of young women has worsened worldwide; it is time to face reality. Women’s bodily functioning and metabolism differ from men and need specific female-adapted health support. While many health problems in a population could be prevented when young females are supported for optimal health prior to pregnancy, this is not a priority of Public Health Agencies. Good health for the next generation starts with a strong and resilient immune system before pregnancy and during the first 1,000 days around pregnancy, birth, and postpartum breastfeeding. Childbirth and children’s health are declining; the number of women dying during pregnancy (within 42 days after labor) is increasing, as well as the number of abortions. Without change, these conflicting trends may develop into a disaster touching all levels of society. The Public Health Future Outlook of the Netherlands predicts that close to 12 million people will have a chronic condition by 2050. Young Women’s Health Is Declining Around half of the young people aged 6-25 years in the Netherlands experience mental health problems. Moreover, 47% of the people aged 15-44 years are diagnosed with at least one chronic disease, with young women more often diagnosed than men. When diagnosed with a chronic disease, people work less, experience more sick leaves, and are less productive. Unfortunately, not being able to work contributes to poorer health and income. An even larger percentage of young people (79%) still suffer from a negative impact of the pandemic, with women and lower-educated individuals hit hardest and experiencing mental problems like emotional exhaustion, stress, and hyperactivity. A recent study published in PNAS showed a faster aging of the brains of young females as compared to young males, which might be related to chronic stress exposure. Students experience more stress than before due to worries about inflation and the high costs of living. Within the EU, the Netherlands has grown into the most expensive country to live in. Unfortunately, there is much more that is troubling the health of young females. Increased Drug Use and a Dangerous Beauty Myth During the pandemic, the use of antidepressants increased by 16% for those aged 16-24 years and for children. Women are prescribed antidepressants earlier and take them twice as much as men. While the positive effects of SSRI have been criticized repeatedly and women report more side effects than men, these medicines are still frequently prescribed by medical doctors. One in four young people in the Netherlands use Ritalin or Concerta ( methylphenidate ) without a medical prescription to improve concentration and study results. Most people are unaware of the potential risks, like sudden death, that are well-known as a potential side effect. Research has shown that 5.5-22.5% of the young have used ADHD medication without a doctor’s prescription. Furthermore, in mid-2023, a worrisome increase in NSAID like paracetamol (Tylenol or Acetaminophen) and ibuprofen use was observed, especially in young girls, increasing the risk for poisoning. The use of antibiotics like amoxicillin increased for children 0-10 years (55%) and for those aged 11-20 years with 50%. As 2023 was the first year after the pandemic with all festivals open to the public, an increased use of party drugs (like ecstasy ) among those aged 16-35 years was noticed with regularly registered symptoms of poisoning. The online and interconnected world exposes the risk of cyberbullying among young people. Ironically, many are feeling lonelier than ever before and are struggling with their weight and self-confidence, setting them up for poor health as adults. The beauty myth is another danger. During the years 2019-2022, the use of fillers increased by 80%, and the use of Botox doubled among young women. Exposure to microplastics, nanoplastics, and nanoparticles has increased. Furthermore, the concentration of PFAS/PFOA in Dutch drinking water is found to be above the norm and may decrease the fertility of both women and men. On the other hand, the use of oral hormonal contraceptives by young girls diminished in the Netherlands, with only a slight increase in the use of an intrauterine hormonal device. Recent studies showed that there is an increased risk, although small, of myocardial infarction or stroke when using hormonal contraceptives. The use of an intrauterine device with levonorgestrel did not show the risk. Given the extensive and ongoing reliance of millions of young women on these drugs, ensuring their safety remains a critical responsibility of the medical community. As well as medical doctors informing young women of potential harm based on the latest scientific literature by informed consent. Over the past 4 years, girls and young women have been exposed to repeated HPV vaccinations and Covid-19 mRNA vaccines within a short period of time, for both of which side effects in women have been reported to be more frequent and severe. Possible interactions and/or interference with these vaccines and long-term effects on the immune system and microbiome have not been investigated beforehand. Neither was knowledge available when it started in 2021 on the possible risks and short- and long-term effects when four vaccines before 22 weeks of pregnancy were introduced. Nutritious Food Not Affordable for Many The importance of daily consumption, as recommended by the WHO, of 400 grams of fresh fruit and vegetables, meat, milk products, and eggs for a healthy life and joyful social and working life is unknown by many young people. For most of them, it has become unaffordable . (Ultra)processed foods are the cheapest satisfying foods with a well-designed composition of low-cost ingredients, sugar, fat, and salt that change the microbiome. Home, school, commercials, social media, influencers, mobile phones, and retail environments are driving obesity and being overweight in children and adolescents, often concurrent with undernutrition and anemia. A growing body of evidence shows that the billions of microorganisms present in our body are intimately involved in weight gain and loss and immune training and modulation, as well as overall host homeostasis. Around 33% of the population in the Netherlands does not consume fruit and vegetables daily. As of 2024, 7.1% of Dutch children live in poverty, and this number is still growing . More children might be undernourished, which is associated with impaired growth, neurodevelopment, and increased infectious morbidity and mortality. To reverse the problem of malnutrition, the delivery of free meals has recently started at primary schools. Unfortunately, this does not make a difference for the children at secondary schools. While sending funding to developing countries to prevent malnutrition, a similar problem appears in front of our eyes in the Netherlands. The young generation predominantly eats more plant-based foods, as it would improve climate change. Almost 30% of young women prefer to shop for vegetarian food, and 0.7% of the Dutch population is vegan. In addition, the EU introduced novel food products such as insects and worms, lab-grown meat, and Bovaer for cows to reduce methane production, which might affect the human immune system. Almost one in five adolescents vape. Long-term effects are yet unknown. In the Netherlands, vapes with synthetic liquids that taste like cola, vanilla, apricot, etc., have now been forbidden . Although smoking is declining in adults, young women more frequently smoke than boys but drink less alcohol. All internal and external environmental factors may contribute to weakening or strengthening the resilience of the immune system and may therefore influence the period of pregnancy, labor, nursing, and the health of mother and child for future generations. Pregnancy Is Regulated by a Unique Complexity of the Immune System Pregnancy is a unique immunological state. The changes of the immune system in the three stages of pregnancy (very early, mid, and late stage) are meticulously timed. In the very early stage, the immune system adjusts to prevent her body from rejecting the fetus while at the same time still being strong enough to keep out foreign pathogens. In the late stage, the body is preparing for labor, which is driven by an inflammatory response. A full-term pregnancy will follow an immunological clock . Changes in this immune profile could help to predict and possibly prevent preterm labor. Studies show that pathologically-driven inflammation might trigger pre-term birth (before 37 weeks). In the Netherlands, 14.8% of the children born are preterm with 9.7% low birth weight for the duration of the pregnancy (Big2). Interestingly, in the case of a preterm child labor, the inflammatory reaction is more heated as compared to a full-term child labor. Preterm birth is an important indicator of a risk for early death, chronic and infectious diseases, sepsis, stunting, and delayed neurological and brain development. This may manifest throughout one’s lifespan. Very early birth and extreme early birth occur in only 1.5% of the Dutch baby population and are responsible for 50% of the deaths of newborn babies. The number of abortions jumped in two years in 2023 to 39,000, with most by women aged 25-34 years of age. Abortion in the Netherlands is allowed until 24 weeks of pregnancy. The number of childbirths has declined dramatically to 167,504 in 2022. That is 1.49 children per woman, with a mean age of 30.3 years. The number of women breast-feeding is also decreasing. At 6 months, women feeding breast milk lowered from 60% to hardly 30% of the young mothers. Each year, around 661 babies in the Netherlands die. Mothers dying within 42 days after labor are around 11 persons a year with an additional 5 women dying by suicide each year, and not counting women who died from cancer. Over the past years, mothers’ deaths have been increasing worldwide, with the leading cause being heart diseases and blood clots. Pregnant women with stress , depression , or anxiety , as well as obese women with gut inflammation and chronic disease, have altered immune systems and, as a consequence of malnutrition, have an altered microbiome. A weakened immune system suggests an increased risk for preeclampsia, high blood pressure, HELLP syndrome, gestational diabetes, preterm labor, and/or low birth weight. ‘Gut Feeling’ a Turmoil for Healthy Future Generations The gut presents 70-80% of the immune cells in the human body. In the mucosal layer of the intestine, neuronal cells, endocrine cells, and immune cells cooperate to manage its metabolism and bodily functioning. Recent studies in mice showed villi of the mucosal layer expanding twice its volume during pregnancy and breastfeeding, slowing food passage, improving digestion for an optimal use of available nutrition. The intestinal mucosal layer is strongly connected to various stages of pregnancy with altered gut microbiota, metabolites, and cytokines. These bioactive metabolites modulate and change the ‘innate’ and ‘adaptive’ immune system. Together, the microbial composition and the mucosal layer of the intestine determine long-term health. Mothers’ intestines influence the biodiversity of the microbiome and the resilience of the immune system, which is transmitted to the baby during pregnancy, labor, and nursing. Earlier periods in life facing hunger, extreme stress, or severe diseases may influence health during pregnancy and may transmit to the baby throughout one’s lifespan and even with intergenerational effects. Specific nutrients may have positive effects during pregnancy, labor, and nursing. Sufficient vitamin D , present in sunlight, nutrition (fish, milk products), or supplements, is a prerequisite during this precious time in life for both mother and child. For young women who wish to become pregnant, it is important to learn how to balance the immune system and the microbiome. The immune system of young women could be the most important regulator of the healthiest generations and a population’s workability and income. Author: dr. Carla Peeters First published at Brownstone Institute

The Alarming Increase in Female Healthcare Worker Suicide

By Carla Peeters • March 13, 2025
The increasing number of suicides and fatal overdoses of women healthcare workers has accompanied rising sickness, disability, and women leaving the sector. The total social and economic costs of a workforce in despair are yet unknown. A shortfall of 10 million healthcare workforce (of whom 80-90% is female) is projected by the WHO for 2030 and is of critical concern. When the health of those who look out for people’s health is at risk, the whole population and economy are at risk. This is an emergency of unprecedented scale that needs attention at the highest Public Health level. Humanity and nutrition instead of medicalization as a coping strategy urgently needs to return in the healthcare sector. Alarming Warnings by Healthcare Workers in Despair Recent studies noticed death by suicide and the risk for fatal drug overdose among women in healthcare is much higher as compared with the general population (1-10). It is not only female physicians, but the risk is even higher for nurses and other healthcare workers, especially for those with the lowest-paid jobs and heaviest mental and physical workload who have been most stretched to the limits (7). Worldwide over the last several years thousands of healthcare workers have died by suicide or fatal overdose leaving family, friends, and the workplace in shock and grief. Suicide and self-harm have substantial social and economic costs (12). One death by suicide was calculated in the UK to cost the economy an average of 1.46 million pounds (13). In 2022 more than 360 nurses attempted suicide, and 72 medical professionals took their own lives in 2020 in the UK as data from the Office of National Statistics indicate. Analysis of mortality data from the US Centers for Disease Control and Prevention from 2007 to 2018 identified 2,374 suicides among nurses, 857 among doctors, and 156,141 in the general population. However, the number of death by suicide or fatal overdose is grossly underreported. The WHO reports that over 50% of suicides happen under the age of 50 years (14). To address this avoidable burden, a better understanding of effective and non-effective strategies is paramount. Even before the Covid pandemic started women in healthcare reported substantial workplace stressors (9-11, 15-16). The past four years have put additional strain on women’s health. This is especially true for those women working as front-liners and first responders in highly demanding stressful situations. Increased complexity of care, understaffing, long working hours, additional bureaucratic tasks, moral injury, diminished autonomy, lack of decision-making ability, and low-paid jobs take a burden on their health. Moreover, women routinely face tougher challenges at work and at home such as institutionalized barriers to career advancement as well as additional pressure for domestic labor by frequently being a caregiver for children and/or parents (9). In all parts of the world healthcare workers are at high risk for violence with 8-38% suffering some sort of violence form in their careers. In 2023 for the first time in history, 75,000 healthcare workers in the US went on strike (17). Women are more frequently diagnosed with burnout, major depression, Post Traumatic Stress Syndrome, ME/CFS, and Long Covid. Long Covid is more prevalent in healthcare workers (11,18-20). These diagnoses of chronic illnesses have many symptoms in common that are known to exacerbate the risk for suicidal thoughts, suicide attempts, and suicidal completion beyond occupation and established risk factors such as socioeconomic status and education (7-8,20-24). An Epidemic of Emotional Trauma and Distress Healthcare workers are trying to hide their symptoms by pushing themselves to work despite extreme pain, fatigue, memory inconsistency, exhaustion, and grief of not being able to deliver the quality of care patients need. Being overstressed and with long-term understaffing, healthcare workers hardly take time to eat a nutritious meal. Many have become undernourished, and sleep-deprived. Potential disparities in help-seeking and healthcare access might manifest in non-medical use of prescription drugs among some healthcare workers, which has implications for workers’ safety and well-being (25). Many of the medicines used by healthcare workers might be unprescribed and unnoticed (1-8, 23). Toxic Cocktails: A Danger for Women’s Health Suicides among the healthcare workforce often take place at work. The most frequently used method of suicide is overdose or poisoning (1-8). New studies suggest that most overdoses are caused by psychiatric drugs and multiple medications in their system. Co-administration of antidepressants and opioids deliberate or unplanned is common. Women are more likely to be prescribed and take medication like antidepressants and birth control pills and seem to be more sensitive and experience drug side effects than men. Pharmacokinetic interactions may increase the concentrations and severity of side effects of antidepressants (27-28). Studies demonstrate potential side effects of psychiatric drugs and opioids as insomnia, burnout, fatigue, anxiety, pain, and suicidal thoughts (21-25). The risk of opioid-involved overdose death was nearly twice as high experienced by healthcare support workers such as nursing home workers and home health aides as compared to other healthcare workers in the sector (7). The interaction and side effects of the use of multiple medicines and concentrations are mostly unknown. This is especially true for women as most drugs have been poorly studied in women. Some medicine might even have more disastrous side effects than any benefit as seems to be the case for psychotropic medicine (26). Moreover, interactions of psychotropic drugs with immunosuppressive capabilities and Covid-19 mRNA vaccines have been reported (17). Furthermore, pandemic measures that have been mandated for healthcare workers including long-term wearing of medical facemasks (with potential inhalation of toxins) and repeated Covid-19 vaccinations with women reporting more side effects than men (30-31) might have exacerbated potential risks. Recent publications repeatedly reported a global burden of absenteeism related to Covid-19 vaccine side effects which could negatively impact the strained healthcare system and jeopardize patient care (32-33). Medicalization as a Coping Strategy During the pandemic, prescription of antidepressants and use of other over-the-counter medication like acetaminophen (paracetamol) which is often advised to temper vaccine side effects, has grown substantially. Although harmless in low doses, acetaminophen has direct hepatotoxic effects when taken in overdose or a wrong combination and may cause acute liver failure. Accidental or unintentional overdose usually occurs in patients who have been fasting, or are critically ill with a concurrent illness, alcoholism, malnutrition, or have preexisting chronic liver disease (34). Acetominophen (single or combination products) is one of the most used medications in the United States with 25 billion tablets sold in 2016. It is expected that treatment of trauma ailments and increase in chronic illness will fuel the market sales from $9.8 billion in 2022 to $15.2 billion in 2033. However, after a report showed 8,700 poisonings with high rates of hospitalization and liver injury in 2019-2020 with a sharp rise among females, the Australian medicine regulator is considering restrictions on who can buy paracetamol (35). In Sweden, the sale of acetaminophen in supermarkets was banned in 2015 after they experienced an overdose hike. Increased use of over-the-counter and controlled drugs may fuel a rise in acute liver failure. Awareness of potential unintentional irreversible harm is highly needed among healthcare workers and the public, as many new drugs and vaccines have been introduced since the pandemic. Drug Theft and Diversion Job stress and occupational burnout have been associated with increased risk for opioid use disorder which in turn can increase risk for overdose. Those who prescribe or administer medication have ready access to opioids and other controlled prescription drugs. Drug theft and diversion of controlled drugs in hospitals and nursing homes appear to have accelerated worldwide, bringing healthcare workers and patients at risk (36-38). Taking prescription medicine at work, almost 100 healthcare workers have been fired in The Netherlands. Moreover, the problems with understaffing in the Dutch healthcare sector have introduced the use of falsified certificates with people from illegal drug networks entering healthcare organizations pushing the system to more errors and deficits (39). Increasing stress at work and too many night shifts in a row have contributed to a 70% increase in medicine thefts. Almost 50% of calming and sleeping pills were not delivered to patients putting them at risk for suboptimal treatment or contaminations and errors (40). Drug use may gradually become an attractive and convenient coping mechanism. Although professionals often think knowledge of the medicine may control their use, dependence may slowly develop. Many impaired healthcare workers feel guilt and despair and suffer from physical and mental problems and may be indifferent to the risk of overdose (38) A Return to Humanity in Healthcare The problem of the rise in sudden (un)intended death of healthcare workers comes against the background of increasing long-term sick leaves, permanent disabilities, and hundreds of thousands of healthcare workers leaving the sector, choosing for less stressful and better-paid jobs. This is an unprecedented sign by dedicated women for no longer willing to work in a toxic and overstressed environment with underpaid complex tasks for often severely ill patients. The healthcare system is facing increased clinical error rates and liability exposures while adversely impacting patient satisfaction and organizational reputation. This may develop into a catastrophe when Public Health Officials do not take responsibility for a highly needed change ensuring that the workforce has the tools and resources needed to turn the wheel. Hard times may turn positive when CEOs and insurance companies start to embrace the idea that quality of care and reputation starts with a healthy, fair-paid workforce, gender equity, and a working environment choosing for humanity and good nutrition. A vital well-nourished empowered healthcare workforce that is occupied to guide people to health and work will be a win for all.
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