11 ms·

Reducing transmission of SARS-CoV-2

62 points by sohkamyung 6y ago

dboreham 6y ago
Finally. What was obvious from the Diamond Princess data months ago has been acknowledged.
- newacct583 6y ago
  Can you be more specific on what you think was going unacknowledged? The abstract is just "wear masks and test like crazy". Which has been pretty much universal consensus since March. There's a whole industry of amateur mask makers on Etsy at this point.
  - coding123 6y ago
    Except that everyone stopped wearing masks about two weeks ago.
    - kevin_thibedeau 6y ago
      For certain narrow classes of everyone.
    - garmaine 6y ago
      In the part of America I live, you cannot enter buildings or public spaces without a mask. Not everyone has the same policies.
  - DSingularity 6y ago
    Until recently wearing masks Was not a CDC guideline
    - newacct583 6y ago
      No one at the CDC (at least no career bureaucrat) ever denied masks were effective, though. It's true that there was concern early on that a public run on masks would put health care workers in jeopardy, so people were absolutely told not to try to procure them. And it's also true that the WHO's messaging on this subject was terribly confusing. But the idea that "Hah! The elites were WRONG about masks!" is just... weird. And doubly so because it's almost always promulgated by a demographic known for... not wearing masks. I mean, seriously: if ("finally!") we're being told to wear masks, I'd expect a genuine mask evangelist to be happy, and to use this to encourage others to wear their masks. But that's not what I hear. It's like it's all a game of political gotcha. It's not. Masks save lives. Wear your mask when you can't stay home.
      - gnusty_gnurc 6y ago
        The "career bureaucrats" had every opportunity to make sure people didn't die, and they failed. You can really just go through the list of wrong information offered at precisely the worst time: subways, nursing homes, masks, the relative safety of being outdoors, etc.
        newacct583 6y ago
        > subways, nursing homes, masks, the relative safety of being outdoors, etc. OK... go through that then? All that stuff seems like areas that have been broadly agreed upon for months. You're going all the way back to March for a bunch of recriminations (some of which I don't understand -- nursing homes were early hot spots and have always been seen so). No one doubts that people got stuff wrong. But that's not a reason to argue against the same people now that they've corrected themselves. I mean... you ARE wearing a mask, right? Right?
      - darkteflon 6y ago
        I’m based in Tokyo and one of the most frustrating things for me personally is that ~90% of foreigners (or people who are visibly foreigners) are not wearing masks when out and about. This despite the fact that the Japanese are almost uniformly wearing them. We are, after all, in the middle of a pandemic. Is this down to the WHO’s early messaging fumbles, misplaced machismo, ignorance, or what? When foreigners here don’t wear masks, they should know that the door is then open for Japanese people to lump all of us in together and say: “look, foreigners don’t give a fuck.”
  - stubish 6y ago
    It depends on the region. This sort of study is still greatly needed in places. Like Australia, where the official statement is: "Surgical masks in the community are only helpful in preventing people who have coronavirus disease from spreading it to others. If you are well, you do not need to wear a surgical mask as there is little evidence supporting the widespread use of surgical masks in healthy people to prevent transmission in public" [ https://www.health.gov.au/resources/publications/coronavirus-covid-19-information-on-the-use-of-surgical-masks https://www.health.gov.au/resources/publications/coronavirus... ] Check out Australian news sites to see all the maskless people.
SeanLuke 6y ago
That is one of the stupidest graphics I have ever seen in an academic journal article.
- henriquez 6y ago
  > For society to resume, measures designed to reduce aerosol transmission must be implemented This is an opinion piece disguised as science. It’s presumptuous of a science writer to make determinations about whether and how society will be permitted to resume. If we want people to be perfectly safe we’d also ban fast food, meat, alcohol, nicotine, driving and sex. But the goal of society is not to keep people 100% safe. Why are we okay with having our liberties trampled over an illness that the CDC estimates has a 0.26% death rate?
  - djsumdog 6y ago
    This entire thing has showed what happens when political leaders don't properly evaluate risk. It's difficult to do so when something new comes along. I think Wendover did a great job of address this: https://www.youtube.com/watch?v=NtX-Ibi21tU https://www.youtube.com/watch?v=NtX-Ibi21tU
  - sacred_numbers 6y ago
    Because the death rate is way higher than 0.26%. If the CDC really thinks it's that low for the general population then they are wrong. The general consensus I have seen, based on antibody tests in New York, Italy, Sweden, and Spain point to a death rate between 0.75% and 1.25% for most developed nations. For less developed nations (which, to be fair, is most of the world) the death rate will be lower because there are fewer old people. I agree that we don't have to shut down everything, but everyone should be wearing masks as much as possible in public. Public smoking is highly restricted, at least partially because of the risks of secondhand smoke, and the risks of COVID-19 are way higher than that. People can do what they want at home, but we have to share public spaces. It's not right for someone else to make decisions that endanger me and my family just because they don't care about the risk.
    - 6y ago
djsumdog 6y ago
I can't really take anything seriously anymore: > Aerosols can accumulate, remain infectious in indoor air for hours I remember Michael Osterholm said CoV2 wasn't airborne, but respiratory, and he made the distinction airborne viruses stay in the air for hours (like Measles). "Aerosols" would indicate they mean respiratory but then they talk about it sticking around for hours. > silent shedders We are told there are asymptomatic people who spread the illness, but there is also tons of research to show they may not (https://pubmed.ncbi.nlm.nih.gov/32405162/ https://pubmed.ncbi.nlm.nih.gov/32405162/) or that some of them weren't even asymptomatic; they had symptoms but no one asked (can't find that link). This whole pieces seems like a long article to say "wear a mask," but all of us see people who wear a mask incorrectly or wear a cloth mask that isn't very effective against viral matter (https://www.acpjournals.org/doi/10.7326/M20-1342 https://www.acpjournals.org/doi/10.7326/M20-1342) and most people don't wash them daily, so they can build up moisture and bacteria (https://publichealth.uic.edu/news-stories/commentary-masks-for-all-for-covid-19-not-based-on-sound-data/ https://publichealth.uic.edu/news-stories/commentary-masks-f...). A lot of people treat them like a fashion accessory or just a thing they have to do and hang them up when they get home. When states mandate masks, you're no longer asking people, and you brake the social contract. A lot of people do it just so they aren't shamed. A lot of people who don't wear masks do it as a political statement. When you boil it down ... it's all either political or shame. There is a lot of explicit social conditioning and behavior modification going on here and it's sinister. I'm sick of pre-pubs that get contracted the following week and everyone going into hyper panic mode always. There are tons of secondary effects (people not going in for regular cancer screenings (https://unherd.com/thepost/professor-karol-sikora-fear-is-more-dangerous-than-the-virus/ https://unherd.com/thepost/professor-karol-sikora-fear-is-mo...), suicide attempts (https://archive.vn/N18t9 https://archive.vn/N18t9), heart conditions, etc.) that will catch up with us. I went into more detail earlier this month about getting fed up with our terrible information situation. This is not a time of honor: https://battlepenguin.com/politics/this-is-not-a-time-of-honor/ https://battlepenguin.com/politics/this-is-not-a-time-of-hon...
- ylem 6y ago
  I think one challenge is that pre-print servers are meant for scientists, not the public. Take physics. If I read a paper on the arxiv in my niche, I can evaluate it's quality. I often referee papers. For me, it's useful to get the early result and if there are gaps, then it's on me to catch them. For those working on Covid19, they are experts, writing for experts. Someone may put out a paper about aerosols in enclosed spaces and how they linger. Someone else might write about how this doesn't verify if the virus RNA detected indicates a live virus. This is how science works and you are seeing it at an accelerated pace. It's actually rather beautiful. But, if you are say a journalist and don't understand this, you can see an article and write a story about it, without understanding that it is preliminary. In short (too late for that), the problem is not that articles on pre-print servers disagree ad we learn more (that's also science)--it is failure of reporting to inform people that these are preliminary results and could be wrong.
KCUOJJQJ 6y ago
>Masks reduce airborne transmission. Not as much as Ebola suits: https://www.welt.de/img/gesundheit/mobile130688133/0391627617-ci23x11-w960/DWO-WS-Ebola-Institut-Aufm-jpg.jpg https://www.welt.de/img/gesundheit/mobile130688133/039162761... 1 Ebola suit for everyone, with an air supply rucksack.
- rspicer 6y ago
  You try finding a PAPR in stock for sale to anyone who isn't a purchaser for a medical provider or first responder agency right now.. True story: I almost bought a 3M PAPR last fall because I wanted it for a "The Expanse" prop replica space suit I've been thinking about building. Decided that a few hundred bucks was too much to spend for the look of something alone, though. That would've been the best gratuitous purchase I ever made, in hindsight. Of course I probably still wouldn't be able to get filters for the thing, and properly caring for and disinfecting non-disposable hardware like that is nontrivial...
nsxwolf 6y ago
How many steps of the scientific method should scientists need to get through before they can make policy? Throughout this pandemic we've been getting whipsawed by "science". Is a few months really enough time to do all the science on a question as difficult as the efficacy of masks during a novel virus pandemic?
- disabled 6y ago
  Masks are prudent, considering that they are a very low risk and low cost prevention intervention, irrespective of demonstrating efficacy. True, it takes a long time (often very long) to establish factual information that becomes widely accepted, but that is not the issue here. Also, the scientific method and peer-review process cannot be altered, and these processes (along with always following a strict code of ethics, staying updated on ethical matters, never compromising on ethics, and never losing sight of all of the above—ever) are even more important during a pandemic. Implying that these processes should be altered is unethical and unconscionable. We have known that SARS-CoV-2 spreads via respiratory droplets, and that it was, most likely, by far, the main mode of transmission (although that would have needed to be demonstrated too, in a pandemic). Wearing a face mask to capture some of those respiratory droplets (even 10%) would at least help, and would not be insignificant if people are required to wear them in public. We know that cloth masks capture more than that though. Also, based on a case report, it is possible that up to 80% of COVID-19 infections are asymptomatic. Considering that, and the fact that it is spread mainly by respiratory droplets, it is prudent to require the public to wear at least cloth masks. Czech Republic (along with Slovak Republic—Slovakia) required people to wear face masks in public starting around March 13, and was one of the first western countries to require this. They are now easing restrictions and are doing well. One of the countries I am sovereign to, Croatia, (US is the other one) has not had any reported coronavirus infections for 3 days in a row. You know, a former war-torn Yugoslav country, still feeling the after effects, with a relatively high and rapidly accelerating quality of life, by western standards. Stuff like mask wearing is not rocket science.
weekoffshopping 6y ago
Good to hear that, Pandemic to endemic
PeterStuer 6y ago
The problem is the scientific community did not immediately denounce those scientists that clearly were putting policy before science. It wasn't just the masks saga. Anyone with basic comprehension of physics and particle data can see how and why masks work, so Don't try to fool the public by lying and don't sit by when some colleagues are basically destroying the whole of the scientific community's credibility just to appease some political interests. Same for 'social distancing' in enclosed spaces. If you let that sort of nonsense stand, how can you not realize you are just throwing the whole of the scientific trust under the bus? And now the latest one: 'Children do not transmit the virus' just because some political parties want to reopen schools ASAP? Just stick to the science, and leave the politics to the politicians. As I said here back in March, the damage done to scientific credibility is the most saddening collateral in all of this. There wil always be some persons willing to do someone's dirty laundry for fame, gain or even just because they genuinly believed it all 'white lies' for the best of intentions. The huge failure of the scientific community was not calling them out.
- shibeouya 6y ago
  What is your evidence that children actually do transmit the virus efficiently? I have seen multiple independent studies from different countries coming down with a very similar conclusion that children are not good vectors for this thing to spread.
  - rumanator 6y ago
    > What is your evidence that children actually do transmit the virus efficiently? OP's point is about if children transmit the virus. Either they do or don't. But your question is about the efficiency of how children transmit the virus. It's an entirely different question although your personal choice of weasel words makes it look differently. It makes no sense to waste time talking about efficiency if you're talking about a known virus transmission vector.
    - votepaunchy 6y ago
      By that measure masks do not work since N95 allows a certain level of particles to transit. Perfection is not necessary, only reducing the replication factor.

62 points by sohkamyung 6y ago

dboreham 6y ago

Finally. What was obvious from the Diamond Princess data months ago has been acknowledged.

newacct583 6y ago
Can you be more specific on what you think was going unacknowledged? The abstract is just "wear masks and test like crazy". Which has been pretty much universal consensus since March. There's a whole industry of amateur mask makers on Etsy at this point.
- coding123 6y ago
  Except that everyone stopped wearing masks about two weeks ago.
  - kevin_thibedeau 6y ago
    For certain narrow classes of everyone.
  - garmaine 6y ago
    In the part of America I live, you cannot enter buildings or public spaces without a mask. Not everyone has the same policies.
- DSingularity 6y ago
  Until recently wearing masks Was not a CDC guideline
  - newacct583 6y ago
    No one at the CDC (at least no career bureaucrat) ever denied masks were effective, though. It's true that there was concern early on that a public run on masks would put health care workers in jeopardy, so people were absolutely told not to try to procure them. And it's also true that the WHO's messaging on this subject was terribly confusing. But the idea that "Hah! The elites were WRONG about masks!" is just... weird. And doubly so because it's almost always promulgated by a demographic known for... not wearing masks. I mean, seriously: if ("finally!") we're being told to wear masks, I'd expect a genuine mask evangelist to be happy, and to use this to encourage others to wear their masks. But that's not what I hear. It's like it's all a game of political gotcha. It's not. Masks save lives. Wear your mask when you can't stay home.
    - gnusty_gnurc 6y ago
      The "career bureaucrats" had every opportunity to make sure people didn't die, and they failed. You can really just go through the list of wrong information offered at precisely the worst time: subways, nursing homes, masks, the relative safety of being outdoors, etc.
      - newacct583 6y ago
        > subways, nursing homes, masks, the relative safety of being outdoors, etc. OK... go through that then? All that stuff seems like areas that have been broadly agreed upon for months. You're going all the way back to March for a bunch of recriminations (some of which I don't understand -- nursing homes were early hot spots and have always been seen so). No one doubts that people got stuff wrong. But that's not a reason to argue against the same people now that they've corrected themselves. I mean... you ARE wearing a mask, right? Right?
    - darkteflon 6y ago
      I’m based in Tokyo and one of the most frustrating things for me personally is that ~90% of foreigners (or people who are visibly foreigners) are not wearing masks when out and about. This despite the fact that the Japanese are almost uniformly wearing them. We are, after all, in the middle of a pandemic. Is this down to the WHO’s early messaging fumbles, misplaced machismo, ignorance, or what? When foreigners here don’t wear masks, they should know that the door is then open for Japanese people to lump all of us in together and say: “look, foreigners don’t give a fuck.”
- stubish 6y ago
  It depends on the region. This sort of study is still greatly needed in places. Like Australia, where the official statement is: "Surgical masks in the community are only helpful in preventing people who have coronavirus disease from spreading it to others. If you are well, you do not need to wear a surgical mask as there is little evidence supporting the widespread use of surgical masks in healthy people to prevent transmission in public" [ https://www.health.gov.au/resources/publications/coronavirus-covid-19-information-on-the-use-of-surgical-masks https://www.health.gov.au/resources/publications/coronavirus... ] Check out Australian news sites to see all the maskless people.

SeanLuke 6y ago

That is one of the stupidest graphics I have ever seen in an academic journal article.

henriquez 6y ago
> For society to resume, measures designed to reduce aerosol transmission must be implemented This is an opinion piece disguised as science. It’s presumptuous of a science writer to make determinations about whether and how society will be permitted to resume. If we want people to be perfectly safe we’d also ban fast food, meat, alcohol, nicotine, driving and sex. But the goal of society is not to keep people 100% safe. Why are we okay with having our liberties trampled over an illness that the CDC estimates has a 0.26% death rate?
- djsumdog 6y ago
  This entire thing has showed what happens when political leaders don't properly evaluate risk. It's difficult to do so when something new comes along. I think Wendover did a great job of address this: https://www.youtube.com/watch?v=NtX-Ibi21tU https://www.youtube.com/watch?v=NtX-Ibi21tU
- sacred_numbers 6y ago
  Because the death rate is way higher than 0.26%. If the CDC really thinks it's that low for the general population then they are wrong. The general consensus I have seen, based on antibody tests in New York, Italy, Sweden, and Spain point to a death rate between 0.75% and 1.25% for most developed nations. For less developed nations (which, to be fair, is most of the world) the death rate will be lower because there are fewer old people. I agree that we don't have to shut down everything, but everyone should be wearing masks as much as possible in public. Public smoking is highly restricted, at least partially because of the risks of secondhand smoke, and the risks of COVID-19 are way higher than that. People can do what they want at home, but we have to share public spaces. It's not right for someone else to make decisions that endanger me and my family just because they don't care about the risk.
  - 6y ago

djsumdog 6y ago

I can't really take anything seriously anymore: > Aerosols can accumulate, remain infectious in indoor air for hours I remember Michael Osterholm said CoV2 wasn't airborne, but respiratory, and he made the distinction airborne viruses stay in the air for hours (like Measles). "Aerosols" would indicate they mean respiratory but then they talk about it sticking around for hours. > silent shedders We are told there are asymptomatic people who spread the illness, but there is also tons of research to show they may not (https://pubmed.ncbi.nlm.nih.gov/32405162/ https://pubmed.ncbi.nlm.nih.gov/32405162/) or that some of them weren't even asymptomatic; they had symptoms but no one asked (can't find that link). This whole pieces seems like a long article to say "wear a mask," but all of us see people who wear a mask incorrectly or wear a cloth mask that isn't very effective against viral matter (https://www.acpjournals.org/doi/10.7326/M20-1342 https://www.acpjournals.org/doi/10.7326/M20-1342) and most people don't wash them daily, so they can build up moisture and bacteria (https://publichealth.uic.edu/news-stories/commentary-masks-for-all-for-covid-19-not-based-on-sound-data/ https://publichealth.uic.edu/news-stories/commentary-masks-f...). A lot of people treat them like a fashion accessory or just a thing they have to do and hang them up when they get home. When states mandate masks, you're no longer asking people, and you brake the social contract. A lot of people do it just so they aren't shamed. A lot of people who don't wear masks do it as a political statement. When you boil it down ... it's all either political or shame. There is a lot of explicit social conditioning and behavior modification going on here and it's sinister. I'm sick of pre-pubs that get contracted the following week and everyone going into hyper panic mode always. There are tons of secondary effects (people not going in for regular cancer screenings (https://unherd.com/thepost/professor-karol-sikora-fear-is-more-dangerous-than-the-virus/ https://unherd.com/thepost/professor-karol-sikora-fear-is-mo...), suicide attempts (https://archive.vn/N18t9 https://archive.vn/N18t9), heart conditions, etc.) that will catch up with us. I went into more detail earlier this month about getting fed up with our terrible information situation. This is not a time of honor: https://battlepenguin.com/politics/this-is-not-a-time-of-honor/ https://battlepenguin.com/politics/this-is-not-a-time-of-hon...

ylem 6y ago
I think one challenge is that pre-print servers are meant for scientists, not the public. Take physics. If I read a paper on the arxiv in my niche, I can evaluate it's quality. I often referee papers. For me, it's useful to get the early result and if there are gaps, then it's on me to catch them. For those working on Covid19, they are experts, writing for experts. Someone may put out a paper about aerosols in enclosed spaces and how they linger. Someone else might write about how this doesn't verify if the virus RNA detected indicates a live virus. This is how science works and you are seeing it at an accelerated pace. It's actually rather beautiful. But, if you are say a journalist and don't understand this, you can see an article and write a story about it, without understanding that it is preliminary. In short (too late for that), the problem is not that articles on pre-print servers disagree ad we learn more (that's also science)--it is failure of reporting to inform people that these are preliminary results and could be wrong.

KCUOJJQJ 6y ago

>Masks reduce airborne transmission. Not as much as Ebola suits: https://www.welt.de/img/gesundheit/mobile130688133/0391627617-ci23x11-w960/DWO-WS-Ebola-Institut-Aufm-jpg.jpg https://www.welt.de/img/gesundheit/mobile130688133/039162761... 1 Ebola suit for everyone, with an air supply rucksack.

rspicer 6y ago
You try finding a PAPR in stock for sale to anyone who isn't a purchaser for a medical provider or first responder agency right now.. True story: I almost bought a 3M PAPR last fall because I wanted it for a "The Expanse" prop replica space suit I've been thinking about building. Decided that a few hundred bucks was too much to spend for the look of something alone, though. That would've been the best gratuitous purchase I ever made, in hindsight. Of course I probably still wouldn't be able to get filters for the thing, and properly caring for and disinfecting non-disposable hardware like that is nontrivial...

nsxwolf 6y ago

How many steps of the scientific method should scientists need to get through before they can make policy? Throughout this pandemic we've been getting whipsawed by "science". Is a few months really enough time to do all the science on a question as difficult as the efficacy of masks during a novel virus pandemic?

disabled 6y ago
Masks are prudent, considering that they are a very low risk and low cost prevention intervention, irrespective of demonstrating efficacy. True, it takes a long time (often very long) to establish factual information that becomes widely accepted, but that is not the issue here. Also, the scientific method and peer-review process cannot be altered, and these processes (along with always following a strict code of ethics, staying updated on ethical matters, never compromising on ethics, and never losing sight of all of the above—ever) are even more important during a pandemic. Implying that these processes should be altered is unethical and unconscionable. We have known that SARS-CoV-2 spreads via respiratory droplets, and that it was, most likely, by far, the main mode of transmission (although that would have needed to be demonstrated too, in a pandemic). Wearing a face mask to capture some of those respiratory droplets (even 10%) would at least help, and would not be insignificant if people are required to wear them in public. We know that cloth masks capture more than that though. Also, based on a case report, it is possible that up to 80% of COVID-19 infections are asymptomatic. Considering that, and the fact that it is spread mainly by respiratory droplets, it is prudent to require the public to wear at least cloth masks. Czech Republic (along with Slovak Republic—Slovakia) required people to wear face masks in public starting around March 13, and was one of the first western countries to require this. They are now easing restrictions and are doing well. One of the countries I am sovereign to, Croatia, (US is the other one) has not had any reported coronavirus infections for 3 days in a row. You know, a former war-torn Yugoslav country, still feeling the after effects, with a relatively high and rapidly accelerating quality of life, by western standards. Stuff like mask wearing is not rocket science.

weekoffshopping 6y ago

Good to hear that, Pandemic to endemic

PeterStuer 6y ago

The problem is the scientific community did not immediately denounce those scientists that clearly were putting policy before science. It wasn't just the masks saga. Anyone with basic comprehension of physics and particle data can see how and why masks work, so Don't try to fool the public by lying and don't sit by when some colleagues are basically destroying the whole of the scientific community's credibility just to appease some political interests. Same for 'social distancing' in enclosed spaces. If you let that sort of nonsense stand, how can you not realize you are just throwing the whole of the scientific trust under the bus? And now the latest one: 'Children do not transmit the virus' just because some political parties want to reopen schools ASAP? Just stick to the science, and leave the politics to the politicians. As I said here back in March, the damage done to scientific credibility is the most saddening collateral in all of this. There wil always be some persons willing to do someone's dirty laundry for fame, gain or even just because they genuinly believed it all 'white lies' for the best of intentions. The huge failure of the scientific community was not calling them out.

shibeouya 6y ago
What is your evidence that children actually do transmit the virus efficiently? I have seen multiple independent studies from different countries coming down with a very similar conclusion that children are not good vectors for this thing to spread.
- rumanator 6y ago
  > What is your evidence that children actually do transmit the virus efficiently? OP's point is about if children transmit the virus. Either they do or don't. But your question is about the efficiency of how children transmit the virus. It's an entirely different question although your personal choice of weasel words makes it look differently. It makes no sense to waste time talking about efficiency if you're talking about a known virus transmission vector.
  - votepaunchy 6y ago
    By that measure masks do not work since N95 allows a certain level of particles to transit. Perfection is not necessary, only reducing the replication factor.