12 ms·

The shameful lies about masks not working for civilians will kill thousands. Evidence based medicine (over the modern Bayesian Science-based medicine) has paral

The shameful lies about masks not working for civilians will kill thousands. Evidence based medicine (over the modern Bayesian Science-based medicine) has paralyzed our health officials from making common sense calls off priors. Homemade masks appear to be reasonably effective. The official response should be to make some form of improvised mask required when out of home, and ration regular mask for health care workers. Even a scarf made of a t-shirt over the nose and mouth will likely reduce RO when used at scale on the population. The best way to protect healthcare workers is to reduce the R0 below 1. Nothing else will help. Widespread use of homemade masks, though not tested in a double blind trial, is low risk enough and seemingly effective enough to encourage. Countries enforcing widespread mask use have lower ROs.

brigandish 7y ago
How widespread is widespread? Japan, South Korea, China, Hong Kong, Taiwan… these are countries in which people wear masks in large numbers on a normal day. They all still have an R0 above 1.
- harikb 7y ago
  Those countries also have higher population densities and public transport usage than some of the western countries. How can you say the mask isn’t helping?
  - brigandish 7y ago
    > How can you say the mask isn’t helping? I didn't but I also didn't make the claim that they would help so I suggest we start by getting claimants to back up their claims before we get anyone checking claims to prove negatives.
    - fspeech 7y ago
      We need universal mask wearing AND unlimited testing. South Korea showed it works. In Japan, even without widespread testing the spreading is still slower than the west. It's true Singapore does not mandate mask use, but they have thorough contact tracing and draconian quarantine laws.
      - octbash 7y ago
        Excuse me - what "draconian quarantine laws"?
        fspeech 7y ago
        You could lose your residency right for violating quarantine. https://www.channelnewsasia.com/news/singapore/covid19-coronavirus-pr-stay-home-notice-barred-12471954 https://www.channelnewsasia.com/news/singapore/covid19-coron... https://www.wsj.com/articles/asian-countries-wield-fines-jail-terms-to-stop-coronavirus-quarantine-violations-11582824849 https://www.wsj.com/articles/asian-countries-wield-fines-jai...
        octbash 7y ago
        How is that draconian? If you're issued a stay-home notice, STAY AT HOME.
        fspeech 7y ago
        "Draconian" as in I don't see it practicable in my country. Not a moral judgment.
- svara 7y ago
  They also happen to be the countries that have the most control over the epidemic. https://studylib.net/coronavirus-growth https://studylib.net/coronavirus-growth
- taeric 7y ago
  Does Japan? Last I saw, they had an inexplicably low curve. Despite not really testing or doing other measures.
  - sacred_numbers 7y ago
    I think the reason it's inexplicably low is that they haven't really been testing.
    - javagram 7y ago
      Considering the physical proximity of Japan and China (30% of tourists to Japan are Chinese) the fact that Japanese hospitals haven’t been overwhelmed like Italy suggests the virus is not spreading as rapidly there. (Testing may also be a concern but lack of testing cannot hide overwhelmed hospitals).
      - taeric 7y ago
        But why? I have pushed my air quality hypothesis. What other reasons are there. And you can't just claim social distancing. Unless they have shut down their trains, where people are literally packed in, that just doesn't fly. (So, have they?)
        MikeAmelung 7y ago
        Couple of possibilities I've been thinking about: The virus has been in Italy for a lot longer than they think, and they get close to each other/have actual contact a lot (I don't know if that's actually true, I've never been to Italy) Maybe they mostly have a particular mutation that is more deadly/infectious
        brigandish 7y ago
        Don't discount the possibility that figures are being massaged in various ways. One is the obvious lack of widespread testing. Another is the reports of people with symptoms being turned away. Then there are the kodokushi[0] numbers which are a clue to how the government already deals with uncomfortable mortality figures - let alone those kudokushi who may die because of the virus - and a over a million deaths a year (I don't know the monthly totals) in which to hide a few hundred (initially) deaths, especially while still in flu season. In short, I trust the figures here about one step more than ones coming out of China. [0] https://slate.com/news-and-politics/2015/06/kodokushi-in-aging-japan-thousands-die-alone-and-unnoticed-every-year-their-bodies-often-go-unnoticed-for-weeks.html https://slate.com/news-and-politics/2015/06/kodokushi-in-agi...
- Der_Einzige 7y ago
  Uhh, show me evidence that China's official numbers and South Korea have r0 above 1 please. It looks like it's finally under 1 right now...
GordonS 7y ago
I think if you're going to make a post like this, it's reasonable to expect that you present some actual evidence, or is your whole argument that we should ignore evidence? "Homemade masks appear to be reasonably effective" is hardly a compelling case.
- wavepruner 7y ago
  Here's a source that supports OP's claims: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373043 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373043
- etage3 7y ago
  Another study on homemade masks: https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homemade_Masks_Would_They_Protect_in_an_Influenza_Pandemic https://www.researchgate.net/publication/258525804_Testing_t... "Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask. Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection."
- deleted 7y ago
  [deleted]
- JackeJR 7y ago
  I don't think the parent's point was that we ignore evidence but that in the absence of evidence (as opposed to evidence suggesting the contrary), we should use priors to guide what we do. In this case, while there are no double blind randomised studies that suggest that widespread mask use reduces R0, priors tell us that masks use protect against infection in other settings. If we were to weigh the priors, the existing evidence would be leaving towards mask use having a protective effect. The question that we should ask ourselves is, what if the reality turns out to be different? There are 2 scenarios. First, mask use is harmful and the second, mask use has no effect on transmission. The first is very unlikely given what we know and the second will mean that if mask use is encouraged, it will be wasted resources for no gain. If these resources that were wasted were easily obtainable i.e. masks made of old clothing etc, then the downsides aren't serious at all but could have very good upsides if the priors were right. So I agree, that we should encourage widespread home-made masks use and leave the disposable ones to the healthcare workers.
IAmGraydon 7y ago
You can’t reduce the basic reproduction number (R0) of a pathogen. You can reduce doubling time and similar metrics of the actual spread, but R0 is a fixed number. What you are referring to is the effective reproduction number, which is the rate of spread in a population at it’s current state. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number
- mistrial9 7y ago
  citation please
  - IAmGraydon 7y ago
    Added. It’s all in the first paragraph. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number
    - jacquesm 7y ago
      Maybe you should read a bit further than the first paragraph for your future citations? "R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population."
- leethargo 7y ago
  From what I've read recently, I agree with this distinction. It's simply a matter of definition. R_0 is the infection rate without any measures taken. Sometimes, R is used for the net infection (e.g. with social distancing).
- usaar333 7y ago
  Huh? "R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population."
  - 7y ago
msamwald 7y ago
I recently co-authored a scientific commentary on this, ask me anything! "Promoting simple do-it-yourself masks: an urgent intervention for COVID-19 mitigation" (Svara et al. 2020) Pre-print available at https://link.medium.com/LY7RRNr2X4 https://link.medium.com/LY7RRNr2X4 Summary: "We demonstrate that widespread use of masks by the general population could be an effective strategy for slowing down the spread of COVID-19. Since surgical masks might not become available in sufficient numbers quickly enough for general use and sufficient compliance with wearing surgical masks might not be possible everywhere, we argue that simple do-it-yourself designs or commercially available cloth masks could reduce the spread of infection at minimal costs to society."
- codazoda 7y ago
  Here's a mask pattern and some additional information from Forbes. It also links to the CDC's comment. https://www.forbes.com/sites/tjmccue/2020/03/20/calling-all-people-who-sew-and-make-you-can-help-solve-2020-n95-type-mask-shortage/ https://www.forbes.com/sites/tjmccue/2020/03/20/calling-all-... > In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html#crisis-capacity https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/f... This is because the medical industry needs proven methods, and they still suggest homemade masks as a last resort. Maybe we should all be wearing homemade masks in public.
- mcsb4 7y ago
  The biggest challenge is to overcome the mental block of decades of onetime use masks that have to be disposed in incinerators and be produced by ISO 9001 certified medical factories. During world war 2 it was normal to use reusable cotton masks. They just need to be put into boiling water for a few minutes to kill sars-cov-2 at 100%. You should try to get into touch with C. Drosten from Charité hospital Berlin. He recently stated in an interview that self-made masks could have a certain value, so he is not totally averse to this concept and Spahn [1] will listen to him. China has been promoting it, now czech republic is doing it. If Germany also starts promoting it, that will help immensely. The same goes for the hand sanitizer, any +70% alcohol/ethanol will do. No need to be from a factory with medical certifications. I am in France, there is a total lock down here but police still wears no masks and so does nobody else. Super markets have no hand sanitizer at the entrance so the virus will continue to spread. Masks cost nothing compared to the economic damage of the shut down. [1] German minister of health Edit: For those downvoting me, I'd sincerely be interested to hear your arguments.
mberning 7y ago
I do find it ridiculous that we have ignored practical and common sense measures to protect the most at risk, and instead have decided fo trash our entire way of life and the economy along with it. In the future this will be looked back upon as one of the great blunders in history.
- jacquesm 7y ago
  You're right, we should have done both.
m4rtink 7y ago
For reference, the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. This has been in force for a few days & is actively enforced wit a couple people already getting hefty fines. IMHO this is a really good idea, especially because people who are infected and dont know that yet are less likley to infect others. How good the mas is at protecting you is pretty much secondary concern at this point in time.
- pbourke 7y ago
  > the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. That is an amazingly forward-thinking position that we should applaud. The mask thing will be one of those “obvious” things that we’ll look back on in a couple of years and shake our heads at.
  - m4rtink 7y ago
    Unfortunatelly, this (mandatory masks) seems like one of the Czech Republic rules that has not yet been widely copied elsewhere. BTW, its quite an interesting cognitive change - basically in a span of about two days everyone in public has a mask, even anchors and politicians in news coverage! Even the sign language interpetters! Also I found out I feel rather uneasy now watching footage from affected areas, some of them in worse situation than us, with people not wearing any masks. Such a simple way to protect otjers once you thing about it a bit, yet not universally adopted so far...
- graeme 7y ago
  The Czech government was advised by Taiwan, I recall. Could this be the basis? The Taiwanese response has been exemplary.
clircle 7y ago
I believe wide-spread use of masks is an effective measure, but i disagree that evidence-based medicine vice Bayesian belief-updating is to blame here. If masks work well, the statistical evidence will come out, regardless of the statistical tribe you belong to.
alkonaut 7y ago
The argument is usually that it has limited effect when it comes to protecting the wearer. Simpler masks or home made masks can probably prevent transmission somewhat from the wearer by reducing the reach of droplets. The argument against masks is based on 1) that people want them to protect themselves 2) that there aren’t nearly enough masks to do so. So as I understand it, the authorities that say “don’t wear a mask” isn’t answering the question “would transmission be reduced if everyone wore a mask?”, but rather the question “Should I get a mask to protect myself”. Those are two very different questions.
- pavelrub 7y ago
  I haven't seen any evidence supporting the argument that they do not protect the wearer. The argument seems to be that they aren't 100% effective at that, and therefore shouldn't be used for those purposes, which doesn't make any sense. Even 20% reduction in the amount of incoming droplets is significant - both for protecting the wearer, and for reducing R0.
  - kevingadd 7y ago
    Part of the reasoning is that people who believe masks provide them full protection will take more risks than otherwise. Combine that with hoarding and other behaviors and it's possible that promoting widespread use of masks would cause new problems the west doesn't already have. If we had successfully promoted "wear a mask when you're sick" as general US policy in advance we probably wouldn't have these supply chain issues and it would be safe to advise people just wear a mask at all times during the crisis. We didn't, so most people don't have any masks, which means they're going to look at this crisis + advisory and panic buy a big pile of them when supplies are already limited.
- comicjk 7y ago
  I agree that public health authorities have not lied, but that's not the point. "Would transmission be reduced if everyone wore a mask?" is exactly the kind of question public health authorities should be asking! The answer seems to be "yes" even for homemade masks. So, public health authorities should be promoting massive production, testing, and use of masks.
fortran77 7y ago
I use a home-made mask. It's made from two layers of fabric from a "fitness t-shirt" with a layer of filter paper from an air filter in between. I wash it in the washing machine and replace the filter between each use. It completely covers my nose and mouth and chin and wraps around over my ears. I tie it in the back with 4 ties one on the top edge and one on the bottom edge. I have friends tell me "that's dangerous! It may trap particles behind it and make you sicker!" I'm willing to take my chances. I believe - combined with my eyeglasses, it will keep me from touching my face and eyes when I'm out - if someone a few feet away coughs, the large droplet that the virus is riding on will surely get trapped. The pores don't need to be virus-sized to do that. I have a proper "Gas Mask" but I want to save that for a gas attack. That's why we all have one. The NY Times ran an op-ed about this: https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html?action=click&module=Opinion&pgtype=Homepage https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-... I've also seen people mis-wearing N-95 masks. I was behind a couple in the supermarket yesterday who were wearing them and every few minutes they were reaching up to readjust their noseclips. I got this on video, it was so perversely amusing to me. I hope they don't get sick.
aaavl2821 7y ago
That is a misleading statement. The CDC has in fact changed its recommendations to recommend in a crises, even HCPs use home-made masks [0] Health care providers, scientists and health officials are rapidly changing and adapting to the situation. It probably is a good idea for all people to wear homemade / improvised masks to reduce R0 But I'd still hope that civilians with large stores of N95 masks or other PPE would consider donating them to healthcare workers. The optimal scenario seems to be that non-HCPs stay home as much as possible, wash hands, sanitize and wear improvised masks when leaving home, and donate PPE to healthcare workers 9% of COVID-19 cases in italy are HCPs [0] https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/f...
- Marsymars 7y ago
  > But I'd still hope that civilians with large stores of N95 masks or other PPE would consider donating them to healthcare workers. I was at Home Depot today and was surprised to see N95 masks available, though limited in number per customer.
bitxbit 7y ago
It came directly from the Surgeon General himself. That’s the part that shocks me. It’s basically someone saying don’t use condoms because it’s not 100%.

brigandish 7y ago

How widespread is widespread? Japan, South Korea, China, Hong Kong, Taiwan… these are countries in which people wear masks in large numbers on a normal day. They all still have an R0 above 1.

harikb 7y ago
Those countries also have higher population densities and public transport usage than some of the western countries. How can you say the mask isn’t helping?
- brigandish 7y ago
  > How can you say the mask isn’t helping? I didn't but I also didn't make the claim that they would help so I suggest we start by getting claimants to back up their claims before we get anyone checking claims to prove negatives.
  - fspeech 7y ago
    We need universal mask wearing AND unlimited testing. South Korea showed it works. In Japan, even without widespread testing the spreading is still slower than the west. It's true Singapore does not mandate mask use, but they have thorough contact tracing and draconian quarantine laws.
    - octbash 7y ago
      Excuse me - what "draconian quarantine laws"?
      - fspeech 7y ago
        You could lose your residency right for violating quarantine. https://www.channelnewsasia.com/news/singapore/covid19-coronavirus-pr-stay-home-notice-barred-12471954 https://www.channelnewsasia.com/news/singapore/covid19-coron... https://www.wsj.com/articles/asian-countries-wield-fines-jail-terms-to-stop-coronavirus-quarantine-violations-11582824849 https://www.wsj.com/articles/asian-countries-wield-fines-jai...
        octbash 7y ago
        How is that draconian? If you're issued a stay-home notice, STAY AT HOME.
        fspeech 7y ago
        "Draconian" as in I don't see it practicable in my country. Not a moral judgment.
svara 7y ago
They also happen to be the countries that have the most control over the epidemic. https://studylib.net/coronavirus-growth https://studylib.net/coronavirus-growth
taeric 7y ago
Does Japan? Last I saw, they had an inexplicably low curve. Despite not really testing or doing other measures.
- sacred_numbers 7y ago
  I think the reason it's inexplicably low is that they haven't really been testing.
  - javagram 7y ago
    Considering the physical proximity of Japan and China (30% of tourists to Japan are Chinese) the fact that Japanese hospitals haven’t been overwhelmed like Italy suggests the virus is not spreading as rapidly there. (Testing may also be a concern but lack of testing cannot hide overwhelmed hospitals).
    - taeric 7y ago
      But why? I have pushed my air quality hypothesis. What other reasons are there. And you can't just claim social distancing. Unless they have shut down their trains, where people are literally packed in, that just doesn't fly. (So, have they?)
      - MikeAmelung 7y ago
        Couple of possibilities I've been thinking about: The virus has been in Italy for a lot longer than they think, and they get close to each other/have actual contact a lot (I don't know if that's actually true, I've never been to Italy) Maybe they mostly have a particular mutation that is more deadly/infectious
        brigandish 7y ago
        Don't discount the possibility that figures are being massaged in various ways. One is the obvious lack of widespread testing. Another is the reports of people with symptoms being turned away. Then there are the kodokushi[0] numbers which are a clue to how the government already deals with uncomfortable mortality figures - let alone those kudokushi who may die because of the virus - and a over a million deaths a year (I don't know the monthly totals) in which to hide a few hundred (initially) deaths, especially while still in flu season. In short, I trust the figures here about one step more than ones coming out of China. [0] https://slate.com/news-and-politics/2015/06/kodokushi-in-aging-japan-thousands-die-alone-and-unnoticed-every-year-their-bodies-often-go-unnoticed-for-weeks.html https://slate.com/news-and-politics/2015/06/kodokushi-in-agi...
Der_Einzige 7y ago
Uhh, show me evidence that China's official numbers and South Korea have r0 above 1 please. It looks like it's finally under 1 right now...

GordonS 7y ago

I think if you're going to make a post like this, it's reasonable to expect that you present some actual evidence, or is your whole argument that we should ignore evidence? "Homemade masks appear to be reasonably effective" is hardly a compelling case.

wavepruner 7y ago
Here's a source that supports OP's claims: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373043 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373043
etage3 7y ago
Another study on homemade masks: https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homemade_Masks_Would_They_Protect_in_an_Influenza_Pandemic https://www.researchgate.net/publication/258525804_Testing_t... "Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask. Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection."
deleted 7y ago
[deleted]
JackeJR 7y ago
I don't think the parent's point was that we ignore evidence but that in the absence of evidence (as opposed to evidence suggesting the contrary), we should use priors to guide what we do. In this case, while there are no double blind randomised studies that suggest that widespread mask use reduces R0, priors tell us that masks use protect against infection in other settings. If we were to weigh the priors, the existing evidence would be leaving towards mask use having a protective effect. The question that we should ask ourselves is, what if the reality turns out to be different? There are 2 scenarios. First, mask use is harmful and the second, mask use has no effect on transmission. The first is very unlikely given what we know and the second will mean that if mask use is encouraged, it will be wasted resources for no gain. If these resources that were wasted were easily obtainable i.e. masks made of old clothing etc, then the downsides aren't serious at all but could have very good upsides if the priors were right. So I agree, that we should encourage widespread home-made masks use and leave the disposable ones to the healthcare workers.

IAmGraydon 7y ago

You can’t reduce the basic reproduction number (R0) of a pathogen. You can reduce doubling time and similar metrics of the actual spread, but R0 is a fixed number. What you are referring to is the effective reproduction number, which is the rate of spread in a population at it’s current state. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number

mistrial9 7y ago
citation please
- IAmGraydon 7y ago
  Added. It’s all in the first paragraph. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number
  - jacquesm 7y ago
    Maybe you should read a bit further than the first paragraph for your future citations? "R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population."
leethargo 7y ago
From what I've read recently, I agree with this distinction. It's simply a matter of definition. R_0 is the infection rate without any measures taken. Sometimes, R is used for the net infection (e.g. with social distancing).
usaar333 7y ago
Huh? "R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population."
- 7y ago

msamwald 7y ago

I recently co-authored a scientific commentary on this, ask me anything! "Promoting simple do-it-yourself masks: an urgent intervention for COVID-19 mitigation" (Svara et al. 2020) Pre-print available at https://link.medium.com/LY7RRNr2X4 https://link.medium.com/LY7RRNr2X4 Summary: "We demonstrate that widespread use of masks by the general population could be an effective strategy for slowing down the spread of COVID-19. Since surgical masks might not become available in sufficient numbers quickly enough for general use and sufficient compliance with wearing surgical masks might not be possible everywhere, we argue that simple do-it-yourself designs or commercially available cloth masks could reduce the spread of infection at minimal costs to society."

codazoda 7y ago
Here's a mask pattern and some additional information from Forbes. It also links to the CDC's comment. https://www.forbes.com/sites/tjmccue/2020/03/20/calling-all-people-who-sew-and-make-you-can-help-solve-2020-n95-type-mask-shortage/ https://www.forbes.com/sites/tjmccue/2020/03/20/calling-all-... > In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html#crisis-capacity https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/f... This is because the medical industry needs proven methods, and they still suggest homemade masks as a last resort. Maybe we should all be wearing homemade masks in public.
mcsb4 7y ago
The biggest challenge is to overcome the mental block of decades of onetime use masks that have to be disposed in incinerators and be produced by ISO 9001 certified medical factories. During world war 2 it was normal to use reusable cotton masks. They just need to be put into boiling water for a few minutes to kill sars-cov-2 at 100%. You should try to get into touch with C. Drosten from Charité hospital Berlin. He recently stated in an interview that self-made masks could have a certain value, so he is not totally averse to this concept and Spahn [1] will listen to him. China has been promoting it, now czech republic is doing it. If Germany also starts promoting it, that will help immensely. The same goes for the hand sanitizer, any +70% alcohol/ethanol will do. No need to be from a factory with medical certifications. I am in France, there is a total lock down here but police still wears no masks and so does nobody else. Super markets have no hand sanitizer at the entrance so the virus will continue to spread. Masks cost nothing compared to the economic damage of the shut down. [1] German minister of health Edit: For those downvoting me, I'd sincerely be interested to hear your arguments.

mberning 7y ago

I do find it ridiculous that we have ignored practical and common sense measures to protect the most at risk, and instead have decided fo trash our entire way of life and the economy along with it. In the future this will be looked back upon as one of the great blunders in history.

jacquesm 7y ago
You're right, we should have done both.

m4rtink 7y ago

For reference, the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. This has been in force for a few days & is actively enforced wit a couple people already getting hefty fines. IMHO this is a really good idea, especially because people who are infected and dont know that yet are less likley to infect others. How good the mas is at protecting you is pretty much secondary concern at this point in time.

pbourke 7y ago
> the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. That is an amazingly forward-thinking position that we should applaud. The mask thing will be one of those “obvious” things that we’ll look back on in a couple of years and shake our heads at.
- m4rtink 7y ago
  Unfortunatelly, this (mandatory masks) seems like one of the Czech Republic rules that has not yet been widely copied elsewhere. BTW, its quite an interesting cognitive change - basically in a span of about two days everyone in public has a mask, even anchors and politicians in news coverage! Even the sign language interpetters! Also I found out I feel rather uneasy now watching footage from affected areas, some of them in worse situation than us, with people not wearing any masks. Such a simple way to protect otjers once you thing about it a bit, yet not universally adopted so far...
graeme 7y ago
The Czech government was advised by Taiwan, I recall. Could this be the basis? The Taiwanese response has been exemplary.

clircle 7y ago

I believe wide-spread use of masks is an effective measure, but i disagree that evidence-based medicine vice Bayesian belief-updating is to blame here. If masks work well, the statistical evidence will come out, regardless of the statistical tribe you belong to.

alkonaut 7y ago

The argument is usually that it has limited effect when it comes to protecting the wearer. Simpler masks or home made masks can probably prevent transmission somewhat from the wearer by reducing the reach of droplets. The argument against masks is based on 1) that people want them to protect themselves 2) that there aren’t nearly enough masks to do so. So as I understand it, the authorities that say “don’t wear a mask” isn’t answering the question “would transmission be reduced if everyone wore a mask?”, but rather the question “Should I get a mask to protect myself”. Those are two very different questions.

pavelrub 7y ago
I haven't seen any evidence supporting the argument that they do not protect the wearer. The argument seems to be that they aren't 100% effective at that, and therefore shouldn't be used for those purposes, which doesn't make any sense. Even 20% reduction in the amount of incoming droplets is significant - both for protecting the wearer, and for reducing R0.
- kevingadd 7y ago
  Part of the reasoning is that people who believe masks provide them full protection will take more risks than otherwise. Combine that with hoarding and other behaviors and it's possible that promoting widespread use of masks would cause new problems the west doesn't already have. If we had successfully promoted "wear a mask when you're sick" as general US policy in advance we probably wouldn't have these supply chain issues and it would be safe to advise people just wear a mask at all times during the crisis. We didn't, so most people don't have any masks, which means they're going to look at this crisis + advisory and panic buy a big pile of them when supplies are already limited.
comicjk 7y ago
I agree that public health authorities have not lied, but that's not the point. "Would transmission be reduced if everyone wore a mask?" is exactly the kind of question public health authorities should be asking! The answer seems to be "yes" even for homemade masks. So, public health authorities should be promoting massive production, testing, and use of masks.

fortran77 7y ago

I use a home-made mask. It's made from two layers of fabric from a "fitness t-shirt" with a layer of filter paper from an air filter in between. I wash it in the washing machine and replace the filter between each use. It completely covers my nose and mouth and chin and wraps around over my ears. I tie it in the back with 4 ties one on the top edge and one on the bottom edge. I have friends tell me "that's dangerous! It may trap particles behind it and make you sicker!" I'm willing to take my chances. I believe - combined with my eyeglasses, it will keep me from touching my face and eyes when I'm out - if someone a few feet away coughs, the large droplet that the virus is riding on will surely get trapped. The pores don't need to be virus-sized to do that. I have a proper "Gas Mask" but I want to save that for a gas attack. That's why we all have one. The NY Times ran an op-ed about this: https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html?action=click&module=Opinion&pgtype=Homepage https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-... I've also seen people mis-wearing N-95 masks. I was behind a couple in the supermarket yesterday who were wearing them and every few minutes they were reaching up to readjust their noseclips. I got this on video, it was so perversely amusing to me. I hope they don't get sick.

aaavl2821 7y ago

That is a misleading statement. The CDC has in fact changed its recommendations to recommend in a crises, even HCPs use home-made masks [0] Health care providers, scientists and health officials are rapidly changing and adapting to the situation. It probably is a good idea for all people to wear homemade / improvised masks to reduce R0 But I'd still hope that civilians with large stores of N95 masks or other PPE would consider donating them to healthcare workers. The optimal scenario seems to be that non-HCPs stay home as much as possible, wash hands, sanitize and wear improvised masks when leaving home, and donate PPE to healthcare workers 9% of COVID-19 cases in italy are HCPs [0] https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/f...

Marsymars 7y ago
> But I'd still hope that civilians with large stores of N95 masks or other PPE would consider donating them to healthcare workers. I was at Home Depot today and was surprised to see N95 masks available, though limited in number per customer.

bitxbit 7y ago

It came directly from the Surgeon General himself. That’s the part that shocks me. It’s basically someone saying don’t use condoms because it’s not 100%.