11 ms·
From the paper: > If the neuroinvasion of SARS-CoV-2 does take a part in the development of respiratory failure in COVID-19 patients, the precaution with masks
by aazaa 7y ago
From the paper:
> If the neuroinvasion of SARS-CoV-2 does take a part in the development of respiratory failure in COVID-19 patients, the precaution with masks will absolutely be the most effective measure to protect against the possible entry of the virus into the CNS. It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally. The possible neuroinvasion of SARS-CoV-2 may also partially explain why some patients developed respiratory failure, while others not. It is very possible that most of the persons in Wuhan, who were the first exposed to this previously unknown virus, did not have any protective measure, so that the critical patients is much more in Wuhan than in other cities in China.
This is a good example of why writing off COVID-19 as no more dangerous than the flu is itself so dangerous.
I should also point out that most people in the US face similar conditions to those in Wuhan. The extent of infection is not known, and therefore protective measures are not in place. We have been actively discouraged from "buying masks" and told that they are ineffective.
- 99_00 7y ago>I should also point out that most people in the US face similar conditions to those in Wuhan. I don't think that's true.
- morpheuskafka 7y agoYes, only a N95 or better mask would protect you from incoming, as opposed to outgoing, viruses, and these masks are both impractical for everyday wear and need to be conserved for public health users.
- bluGill 7y agoI have a small box of N95 masks in my shop - bought last summer for dust protection. When is the right time for me to put them on my family. Part of this is how long will they last before I must replace them. Or should I put them on eBay for a million dollars and hope I life to enjoy my new found wealth?
- mongol 7y agoFor a million dollars - no doubt.
- dx7tnt 7y agoYou could give them to health care workers and be even wealthier.
- deleted 7y ago[deleted]
- tdstein 7y agoOr you could donate them to your local hospital since there is a shortage. I’m not sure they would take them, but it’s worth considering.
- ceejayoz 7y agoLocal hospitals are not going to be able to take masks from some random person off the street.
- OJFord 7y agoThere isn't a shortage if you're a hospital. There's a run on the retail supply, and retail restocking will be very limited, if at all. But your local hospital is fine. And it would have to be apocalyptic for them to accept a box of medical equipment from some guy wandering in.
- Leary 7y agoSave them right now and have them as an insurance against if things go really bad and you have to go to a crowded place.
- deleted 7y ago[deleted]
- drcode 7y agoSurely you have elderly friends and relatives, give each one one of your masks (once things are dire enough that people will actually learn to use masks properly and not waste it.)
- SpicyLemonZest 7y agoI think there's a legitimate question here. Intuitively, if a non-N95 mask only stops 25% or 50% of incoming viruses, that still seems helpful? It's worth noting that in countries where wearing masks is normalized, making sure the general public can get some is a top priority.
- erentz 7y agoOn top of providing some limited protection of the wearer, it also works like herd immunity in that if everyone wears them, then those that don’t yet know they’re sick are reducing their spread. At the moment because of the misinformation people wearing masks are being mocked and chided in public and its really unhelpful. Especially since there are immune compromised individuals and individuals with other conditions that really need to take every precaution they can, including that 10% reduction a surgical mask may give them.
- jrandm 7y agoMy layman's understanding is that any barrier will stop some percent of most things. In the case of small, airborne particles, this stopped percentage of already-dry, floating material is very small. That means inhaling through them is relatively ineffective at stopping you from inhaling the particles. When you exhale it is more wet and the moisture causes the barrier to catch more of the airborne particles. The barrier also catches any more-solid material that would otherwise land elsewhere, providing a mechanism for the particle to spread. This means the net gain for wearing them to keep from catching the disease is relatively small compared to the gain by wearing them to prevent the spread if you may have been exposed.
- katmannthree 7y agoI've used them a fair bit at work, you get used to them. Proper fit is important though, and many people with facial hair will need to remove it before the mask will be effective. It's almost a moot point right now though because they're sold out pretty much everywhere.
- jcims 7y agoI see this a lot but there obviously have to be some kind of effectiveness curve for masks below N95.
- zapita 7y agoRegular surgical masks won't protect your from inhaling the virus, but they will protect you from rubbing your face and nose 100 times a day with contaminated hands, without even noticing it. I wouldn't dismiss their efficacy.
- lisper 7y agoIf that's your goal (and it is not an unreasonable one) you can achieve that with a bandanna. You don't need a surgical mask.
- giancarlostoro 7y agoI'm enjoying the thought of software engineers everywhere coming into work with bandanas covering their faces.
- propogandist 7y agodon't worry the facial recognition technology has been perfected to track through face masks / bandanas https://www.thetimes.co.uk/article/coronavirus-china-tech-firms-develop-software-to-recognise-mask-wearing-faces-x6w2bgwvq https://www.thetimes.co.uk/article/coronavirus-china-tech-fi...
- koolba 7y agoWhy would they not remote work?
- derivagral 7y agoMany places small and large put a large value on butts in seats. For a less cynical take, there's a lot of conversations that do happen more efficiently in-person, particularly at a lot of places that aren't set up for "full remote".
- jcadam 7y agoBecause boss says no.
- Leary 7y agoSurgical masks are effective against droplets from coughing and sneezing.
- kaylynb 7y agoI'm not sure I would call them impractical for everyday wear. I wear N95 masks when commuting during active wildfires. The news always says not to wear them because you won't put them on properly, but it's really not that hard to ensure the fitment is correct. It's not like the construction workers that wear them occupationally are rocket scientists. My partner is more vulnerable to respiratory problems and has always worn N95 masks when in public during flu season. What's changed now is she gets all kinds of shit from people because they think she somehow hoarded masks away from healthcare workers. We've had boxes N95 masks for years, but now we're assholes for hoarding...
- mirthflat83 7y agoMask fit testing isn’t really about whether you feel like it’s fitting or not but if you have the money I don’t see a reason not to wear the N95
- op00to 7y agoThe reason is that we need the N95 to keep our healthcare workers from getting infected and letting the rest of us die.
- drcode 7y agoTelling people they should wear masks because they don't put them on properly is like telling people they shouldn't drive cars because some people drive them into trees.
- allendoerfer 7y agoI am bookmarking this comment for the time after self-driving cars have become universally available.
- geggam 7y agogiven the longevity of webservices online I bet HN is gone before that day happens
- drcode 7y agoI will argue this is wrong: Only N95 or better masks have studies proving their effectiveness. I don't think we have good data on weaker masks or even "home made" masks- It's totally possible they are also effective, with proper technique. Please somebody show me data that proves otherwise, I'm totally open to it. (Note: I'm not saying I want you to post opinions from people in authority, I'm saying I want to see data)
- ceejayoz 7y agohttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373043/?fbclid=IwAR39J4bEKNngfQ7rwkOmthUouIPV2Rb7BMuZQsyGhbOlr2R4Xv2Ft6EzsXE https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373043/?fbclid... > Quality commercial masks are not always accessible, but anecdotal evidence has showed that handmade masks of cotton gauze were protective in military barracks and in healthcare workers during the Manchurian epidemic. > The prototype mask achieved a fit factor of 67 for 1 author with a Los Alamos National Laboratory (LANL) panel face size of 4, a common size. Although insufficient for the workplace, this mask offered substantial protection from the challenge aerosol and showed good fit with minimal leakage.
- drcode 7y agoGreat link!
- doublekill 7y agoNo, there is a 2009 study which compares N95 mask efficiency with surgical masks, because they predict that during a pandemic N95 masks will be in shorter supply. (1) They don't find significantly more efficiency for N95 masks, but other studies do find N95 masks slightly better. (2) (1) https://jamanetwork.com/journals/jama/fullarticle/184819 https://jamanetwork.com/journals/jama/fullarticle/184819 (2) https://onlinelibrary.wiley.com/doi/full/10.1111/j.1750-2659.2011.00198.x https://onlinelibrary.wiley.com/doi/full/10.1111/j.1750-2659... Do a search on Google Scholar for "N95" in combination with "virus" or "sars" for more studies. Really a shame that authorities, including the Surgeon General, claim that masks are not protective, despite medical science to the contrary.
- StanislavPetrov 7y ago>need to be conserved for public health users. I think we should all ask ourselves why we take it for granted that we should simply have to ration masks. Why aren't there enough masks available for everyone for inevitable outbreaks like this? Why don't we have the industrial capacity to manufacture masks in the US, leaving us reliant on foreign imports? We spend ~$80 billion dollars a month on our endless war, military and spy agencies in the name of "national security", but I'd argue that having ample medical supplies (and the ability to manufacture them) are just as, if not more important, to our "national security" as the vast majority of our military activities. Hopefully this crisis will not become to severe and will serve as a wakeup call for us to rethink our national priorities before the next inevitable crisis.
- pbhjpbhj 7y agoBecause capitalism doesn't work like that? Planning to care for people who don't have enough money for you to make a profit from. Are you a commie!? /s
- StanislavPetrov 7y agoIt comes down a question of priorities - the money is being spent right now. Is the average American better off if we spend $25 billion dollars next week arming Turkish Jihadists and sending missiles to Ukraine, or spending that money to build up our own country and respond properly to this outbreak before it gets out of control?
- jklhjklhtoeiru 7y agoThere was an article recently about an US mask manufacturer (small one, not 3M), which for years warned that this will happen: a pandemic will hit and there will be a severe lack of masks anywhere. He also recounted how after the 2009 flu scare everyone was telling him how after it ends they will now stockpile masks to be ready for the next one, he increased production, but then was stuck with it because people stopped taking his calls the moment the flu faded.
- vonmoltke 7y ago
- SkyMarshal 7y agoEven N95 masks are not fully sufficient. They typically block particles at 0.3 microns or larger, but coronaviruses tend to be smaller, around 0.1 - 0.3 microns. You need an ASTM Level 2 or higher surgical mask to block coronavirus from completely penetrating the mask. That said, any mask is better than no mask, first because it prevents you touching your mouth and nose with potentially infected hands, and second because coronavirus travels in water droplets which can be stopped by the mask from going straight into your mouth or nose.
- UncleOxidant 7y agoYes, the virus itself is small enough to get through, but typically the virus comes in a water droplet (as in being coughed or sneezed out) and those will be mostly stopped by an N95 mask.
- jeffmcmahan 7y agoHmm. Based on what I read, particles smaller than 0.3 microns have a widely "wandering" path of travel through the mask fibers on account of Brownian motion. My understanding was that 0.3 micron particles are the size that the N95 mask is least effective at blocking. Smaller particles are blocked more effectively, not less, until you get down to a scale so small that you pretty well exclude live biological material. Not my original source, but discusses the same thing: https://multimedia.3m.com/mws/media/376179O/nanotechnology-and-respirator-use.pdf https://multimedia.3m.com/mws/media/376179O/nanotechnology-a... This is to say, 95% filtration is the worst the mask will perform, with particles of any size, as it relates to coronavirus.
- hurrdurr2 7y agoThis is correct. Particles smaller in size than 0.3 microns will have HIGHER capture efficiency. This is similar for HEPA filtration as well.
- agumonkey 7y agocan't sub .3 microns particles get stuck in the fibers along the way even if they can pass the first (due to turbulent flow)?
- wintorez 7y agoAlso, you need to wear eye protection as well.
- headsupftw 7y agoWhich nobody does if she's not a healthcare worker.
- Symmetry 7y agoI think that different sources are using different definitions of "effective" here. If a simple surgical mask cuts down transmission rates by 50% that isn't anywhere near good enough for health workers working with sick patients every day. But it might still make a significant improvement in your chances of getting infected and, combined with social distancing, might drop the R0 below 1. Hence why Chinese and Korean authorities are encouraging everyone to wear surgical masks but the CDC saying they're ineffective.
- sagebird 7y agoI completely agree. Even having a mask that only results in a 20% reduction of transmission could be the difference between a growth factor that is less than 1, vs a growth factor of greater than one. It could be the difference between taking off or halting. I suspect that even a spare cotton t-shirt material affixed over the face would stop a significant amount of droplets from transmitting. It would be worth researching the effectiveness improvised masks, at the very least.
- deleted 7y ago[deleted]
- TeMPOraL 7y agoThe problem is that a mask that isn't regularly replaced and handled very carefully actually increases your chances of catching the virus, via a mask->hand->face transmission.
- whatshisface 7y agoWait, how? If it's on the mask wouldn't it be on the face if the mask wasn't there? What process puts viruses on masks but not faces?
- TeMPOraL 7y agoGreater surface area, more hand-face contact, and risk compensation.
- 7y ago
- wbl 7y agoMeanwhile in South Korea everyone has masks. In WWII we built one bomber an hour at one plant, and now we can't figure out how to build millions or billions of masks.
- irrational 7y agoThat's because that bomber was built by the "greatest" generation. By definition, we aren't the greatest generation.
- hellofunk 7y agoNow that made me laugh!
- thu2111 7y agoBe fair. Nobody was building one bomber an hour two months after the very first sign of trouble.
- adrianN 7y agoYou'd think that we have improved our ability to mass manufacture things since 1940.
- gamblor956 7y agoMultiple companies in the US, China, and Europe have announced that they will be producing millions or more masks a month with availability beginning as soon as next week, just 2 months after the virus went global... It took most of the war for that plant to get to the point of building a bomber an hour.
- headsupftw 7y agoOne of my coworkers, who is a staunch supporter for wearing face masks to protect against coronavirus, wears an N95 the entire time he's in the office. Yesterday he claimed he's having chest discomfort (which is what some people will feel when they wear N95 24x7 awake) and went to a hospital to demand a test for coronavirus infection. Needless to say his request got declined and he's doing just fine but I am simply speechless at the irony.
- bitxbit 7y agoThis is NOT true. N95 is needed for health professionals in an active care environment. THIS DOES NOT IMPLY MASKS in general ARE NOT EFFECTIVE for individuals in public spaces who may run into someone who’s infected.
- droithomme 7y ago> only a N95 or better mask would protect you from incoming That is not only completely false but is extremely dangerous misinformation. https://www.sciencedaily.com/releases/2019/09/190903134732.htm https://www.sciencedaily.com/releases/2019/09/190903134732.h... > The study reported 'no significant difference in the effectiveness' of medical masks vs. N95 respirators for prevention of influenza or other viral respiratory illness.
- chaostheory 7y agoGiven the size of the viruses, N100 is the minimum
- adrianN 7y agoThe virus is not airborne, it spreads via droplets. Those are typically MUCH larger than a virus.
- mirekrusin 7y agoProtection from outgoing is the same as protection from incoming if you don’t look at it only from your own perspective, right?
- mc32 7y agoHow often would people have to replace their N95s to be of help?
- sndean 7y agoIt looks like CDC recommends to use them for ≤ 8 hours (continuous or intermittent) [0]. [0] https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguid...
- pbhjpbhj 7y agoPresumably their effectiveness is reduced then, rather than negated. Aren't they just close bound fibres that form a filter?
- rolph 7y agothey may become fomitic , actually carrying aggregations of virions nestled in expectorated particles of mucous
- sndean 7y agoYeah probably reduced, but it may be more to do with them becoming contaminated. The link points to a study saying > One study found that nurses averaged 25 touches per shift to their face, eyes, or N95 respirator during extended use. How problematic that touching is probably scales with how problematic your environment is. They're pretty sponge-like. Wearing a surgical mask over an N95 would help a lot. In a controlled biosafety level 3 lab, "single use" things are definitely the most common, where everything exposed to the outside world is destroyed after you're done. What's worn underneath is washed and you're forced to take a shower. So that's what you do if you know you're in a contaminated environment – not sure what I'd do in a public place.
- sebazzz 7y ago> Yeah probably reduced, but it may be more to do with them becoming contaminated. How effective is the virus after the mask has been unused for a while (so "cold", like a doorknob or a desk)? If it is not, the mask should be good to go then, doesn't it?
- fiter 7y agoThis suggests an advantage to purposeful infection by oral/eye rather than accidental by intranasal. It'll be interesting to see what the case fatality rate is when segmented by infection route.
- newsbinator 7y agoIt's been suggested to me, in addition to hand washing, to use soap to rinse a bit of my nostrils. Not sure if it makes any difference at all, but I've been doing it on the off-chance.
- MistahKoala 7y agoPresumably in anticipation of upper respiratory tract infection. COVID-19 is a lower respiratory tract infection. I haven't heard of nasal irrigation using soap; hypertonic saline solution is usually recommended. http://www.elvisstudy.com/ http://www.elvisstudy.com/
- UncleOxidant 7y agoI would think this would actually increase the odds of infection via that route since it would tend to dry out the skin in your nostrils and remove some of the natural defenses we have there.
- bryanrasmussen 7y agoHow do you know what infection route it came in by, and how certain is the method for determining the route?
- tjt 7y agoThis is super scary. Before I read this I was happily thinking hey it's no worse than flu. Now... I'm wishing I didn't live in a huge city riding the subway daily.
- airstrike 7y agoI keep trying to not look up Coronavirus news online, but I can't help it... and after reading this I'm genuinely terrified. The word "potential" on the title is entirely invisible to me.
- drcode 7y agoOddly enough, I was on the "pandemic" bandwagon early enough that my period of anxiety and insomnia has now passed already. People get used to new states of affair pretty quickly.
- airstrike 7y agoI hardly ever have to deal with anxiety, but now I have a headcold and my coworker sitting 6-feet to my right has a mask on...
- lagilogi 7y agoYou should be the one wearing the mall though no?
- airstrike 7y agoStill waiting for mine to be delivered... They're hard to come by! But I'm sure my coworker is wearing a mask for their own set of reasons...
- davidw 7y agoIf you have a cold or anything else infectious, please work from home if at all possible.
- jessriedel 7y agoWhy is it easier to get to the brain from the nose compares to the mouth or eyes?
- rolph 7y agohttps://en.wikipedia.org/wiki/Olfactory_bulb https://en.wikipedia.org/wiki/Olfactory_bulb. however: Yan-Chao Li [etal.] ABSTRACT Swine hemagglutinating encephalomyelitis virus (HEV) has been shown to have a capability to propagate via neural circuits to the central nervous system after pe- ripheral inoculation, resulting in acute deadly encepha- lomyelitis in natural host piglets as well as in experimental younger rodents. This study has system- atically examined the assembly and dissemination of HEV 67N in the primary motor cortex of infected rats and provides additional evidence indicating that mem- branous-coating-mediated endo-/exocytosis can be used by HEV for its transsynaptic transfer. In addition, our results suggested that this transsynaptic pathway could adapted for larger granular materials, such as viruses. These findings should help in understanding the mechanisms underlying coronavirus infections as well as the intercellular exchanges occurring at the syn- aptic junctions. J. Comp. Neurol. 521:203–212, 2013. https://doi.org/10.1002/cne.23171 https://doi.org/10.1002/cne.23171 it seems if you are not a swine or a rat you have little to worry about.
- jessriedel 7y agoI don't understand what the Wikipedia link is supposed to show. Your eyes are tightly linked to your brain too.
- epmaybe 7y agoyes, but there isn't a direct route from the outside to your brain. Your eye socket is relatively well insulated from the outside by skin, connective tissue, conjunctiva.
- rolph 7y agothe neuronal terminals leading to a lobe of the brain innervate the nasal mucosa. the optic nerve is hidden behind the eye with a substantial barrier of non nervous tissue in front of it. https://upload.wikimedia.org/wikipedia/commons/thumb/1/1e/Schematic_diagram_of_the_human_eye_en.svg/250px-Schematic_diagram_of_the_human_eye_en.svg.png https://upload.wikimedia.org/wikipedia/commons/thumb/1/1e/Sc...
- stelfer 7y agoIt's not clear that it spreads via aerosols, in fact it's more likely that it spreads via droplet and contact. Thus the virtue of the mask is that it keeps the individual's fingers away from their faces. From the perspective of the theory in the article, masks keep people's fingers out of their noses. Of course, there are other ways to do that.
- airstrike 7y ago> It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally. Where can I buy noseplugs?
- velosol 7y agoFoam earplugs work but look a little funny.
- Allower 7y agoObviously buying masks is discouraged because there is a shortage and hospitals have a much greater need for them than an uninfected person living in location as of yet untouched by the virus. Its about priorities.
- spyckie2 7y agoWuhan was infected at the worst possible time (CNY) where the entire population underwent a systematic distribution of the virus (visiting relatives) and also likely bodily fluid exchange (via sharing food - Chinese people don't use communal utensils with family).
- odyssey7 7y agoWhy not use a cheap noseclip for swimming? Perfectly leak-free. The paper suggests intranasal transmission is what you most want to avoid. > It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally.
- nopinsight 7y agoSelf-infection is very plausible. Once someone has it in their body, some minor action can transfer it from one organ to another. No one can stay vigilant of their own body 24-7.
- _rrnv 7y agoThis! It really boggles the mind that officials would discourage wearing masks (even surgical masks). You see, the best way to stop COVID-19 is to thwart its infectious potential. And this is done by two things: everybody wears masks (since nobody knows they are contagious until it's too late) and everybody washes hands constantly. But nooo, no need to panic, this is not Asia, this is The West... Freedom!... x_x
- hoten 7y agoThe issue is a mask shortage.
- SubiculumCode 7y agoI think that the fear was of a mask shortage. Infected quarantined > Potentially Infected COVID-19 contacts wearing masks > Uninfected wearing masks.
- luckylion 7y agoCan someone shed some light on the difficulties of producing the "simple" surgical masks? I'm not talking about something that filters the incoming air, but the lame kind that just reduces the amount of liquids you disperse when breathing, coughing, sneezing etc. Are they so high tech you can't just ramp up production? And how many months in advance would you need to ramp it up? We're about 3 months in and nobody got the idea to increase production of masks until about a week ago (similar for hand sanitizer, soaps etc)? What am I missing, why is that a thing?
- OJFord 7y agoDemand is probably relatively (to other products) stable, why would you have been running a factory with unused capacity available to ramp up into for years ? I read about a hand sanitiser manufacturer ramping up in the UK; by increasing hours, not throughput. And obviously to increase hours you need more staff, training, and maybe to review some policies, local bylaws, and other procedural stuff.
- 7y ago
- Seenso 7y ago> I should also point out that most people in the US face similar conditions to those in Wuhan. The extent of infection is not known, and therefore protective measures are not in place. We have been actively discouraged from "buying masks" and told that they are ineffective. Not exactly. I'm hopeful that differences between the typical American lifestyle and the typical Chinese lifestyle will help make the epidemic less severe in the US. Americans are more "spread out" than Chinese: we often drive personal cars instead of taking public transit; our homes are freestanding with more private space per person; our public spaces are often less crowded, etc. I think open offices are even more common in China. Hopefully that extra distance will help.