7 ms·

Mask wearing is incredibly effective with N95-equivalent masks, which are now easily and plentifully available. If everyone wore masks with proper filters, we

Mask wearing is incredibly effective with N95-equivalent masks, which are now easily and plentifully available. If everyone wore masks with proper filters, we might be done by now. The world seems too dumb to notice the difference between a piece of cloth and a proper filter. If everyone wears N95 masks, the virus basically doesn't seem to spread.

gfodor 5y ago
Agree of all the stupidity in this pandemic, the false equivalence implied by leadership between n95s and cloth masks has probably killed the most people counterfactually. Particularly if you assume it has led to a false sense of safety by cloth-wearers, leading them to take risky behavior like going indoors they would have avoided otherwise if their cheap masks were explained to be insufficient protection.
- metiscus 5y ago
  I tend to agree with you on this. I've got some anecdata and commentary. So obviously I'm not the CDC or a doctor so don't decide anything based on my story here. My wife works in the hospital and employees are only given one mask a month or so and must use the hospital provided equipment. For staff that are not in the covid units, incidents of transmission and overall infection rates have been very low. For those in the covid units themselves, the infection rates are 60-70%. The PPE situation is still quite poor, gowns and face shields are being reused where in ordinary times they would be disposable. For ordinary people without regular contact with the infected and who take reasonable precautions (modeled in my anecdata by the staff outside the covid units) I believe that the masks combined with frequent hand washing are probably pretty effective. If you're in suboptimal circumstances and in constant contact with the infected I don't know. It's hard to tell with all of the PPE reuse. The story being told is that the cloth masks reduce spread from you to others but do not overtly protect you. I can see circumstances where improper doffing techniques could cause these to be counterproductive but overall I tend to believe this. Properly fitted N95 masks have similar protection of others but also protect you from some, but probably not all exposures.
  - woofie11 5y ago
    > My wife works in the hospital and employees are only given one mask a month or so and must use the hospital provided equipment. Really? I mean really? N95 masks are not reusable. They have an electrostatic layer that degrades after hours of moisture from breath. In hospitals in Asia, where this is done right, infection rates have been close to zero. US companies have a glut of N95 mask stock right now because no one will buy them due to cheaper alternatives. In addition, tons of places produce tested N95-equivalent masks which have not gone through certification procedures. Where is your wife? That seems like a class action waiting to happen.
    - metiscus 5y ago
      Central Florida. I believe the issue is two-fold. The Hospitals have contracts etc with GPOs that often require the hospital to make most if not all of their purchases (PPE and Drugs, there is some discussion about GPOs being partially to blame for drugs shortages). If those organizations are unable to source, or unwilling to source PPE (speculation - due to market value being over contract value?) then the hospitals receive a restricted supply e.g. a shortage. The second axis is that this is not a situation that is generally known and hospital staff are generally underrepresented politically. To whom is the Nurse Assistant or LPN to complain to about their company practices? If you complain, you risk termination etc. Given that most took the vaccine the issue is partially mooted but still remains.
      - woofie11 5y ago
        Well, no. The issue isn't mooted. 1) The vaccine doesn't prevent you from catching COVID19; it prevents symptoms. Your body fights it off. We know nothing about how it impacts long COVID or spread. I mean, we know it reduces them, but is it a 10% effect? 90%? If hospital staff are spreading COVID to patients, we've got a problem. 2) Vaccinated people in contact with non-vaccinated is how you get vaccine-resistant mutations. We need vaccines and proper masks, especially in hospitals. If there's an issue like that, it seems like an anonymous complaint might help. Letters to newspapers, regulators, and hospital leadership, all cc:ed so they know others have received them, outlining that: - Proper masks are available: links to US plants having overstock, new technologies (e.g. Korean nanofiber) - Used N95 masks don't work - Reuse of N95 at the institution That puts a lot of pressure on leadership to address the issue. Enforcement actions usually go nowhere if an issue was already resolved by the time the agency gets there, and it's a lot cheaper to deal with early rather than late.
majewsky 5y ago
> If everyone wears N95 masks, the virus basically doesn't seem to spread. I don't know about elsewhere, but at least here in Germany, it would be literally illegal for an employer to require their staff to wear N95 masks at all times. Worker protection laws mandate 30 minutes of break time without a mask for each 90 minutes worked with a mask on. (Disclaimer: IANAL.)
- mattkrause 5y ago
  Really? That seems like it would make a lot of things exceedingly difficult (e.g., certain kinds of medical procedures or scientific experiments).
endgame 5y ago
The world was told by the public health apparatus, up to and including the U.S. Surgeon General, that masks were not effective. The circle was then squared by telling people to wear "face coverings" and, well, here we are. I would have hoped that in our current age of misinformation, that sources people trusted would not actively lie, but there you go.
- DanBC 5y ago
  > I would have hoped that in our current age of misinformation, that sources people trusted would not actively lie, but there you go. Find a meta-analysis of mask wearing to prevent infection that was published at the time. Or find some RCTs of mask wearing to prevent infection. There are lots of papers looking at infection control - it's an important part of healthcare. Have a look at how they describe the quality of evidence. Here's a well-known paper, published in a high impact reputable journal in June 2020. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Distancing is rated at "moderate certainty" > Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face masks only achieve "low certainty" > Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. These certainty ratings come from GRADE. https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-grade/ https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-... Low certainty means "The true effect might be markedly different from the estimated effect". This doesn't feel like lying. It feels like making the best of a bunch of not very good data.
  - 5y ago
DanBC 5y ago
> If everyone wears N95 masks, the virus basically doesn't seem to spread. Most of the very many dead healthcare professionals were wearing N95s that had been properly fitted.
- 8bitsrule 5y ago
  1. I haven't seen that idea claimed anywhere. 'Most','very many'??? 2. There was a great shortage of N95s for hospitals for a long time. (Let alone 'nursing'-home death-traps, where 33% of US deaths - 179,000 - have occurred. [0]) Sterilization methods took months to emerge. 3. Consider how dense viruses get in IC units, compared to retail locations. [0] https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html https://www.nytimes.com/interactive/2020/us/coronavirus-nurs...
- jonplackett 5y ago
  In the UK at least I don't think that's true. I saw an article the other day saying they'd given the FFP3 (out N95 equivalent) masks to the nurses in the ICU where patients are on ventilators, but the nurses dealing with the less sick patients just had surgical masks. Unfortunately, the less sick ones were up and about, coughing everywhere, not connected to machines to regulate their breathing and so those coughs are going into the air. Sadly lots of NHS staff have died.

gfodor 5y ago

Agree of all the stupidity in this pandemic, the false equivalence implied by leadership between n95s and cloth masks has probably killed the most people counterfactually. Particularly if you assume it has led to a false sense of safety by cloth-wearers, leading them to take risky behavior like going indoors they would have avoided otherwise if their cheap masks were explained to be insufficient protection.

metiscus 5y ago
I tend to agree with you on this. I've got some anecdata and commentary. So obviously I'm not the CDC or a doctor so don't decide anything based on my story here. My wife works in the hospital and employees are only given one mask a month or so and must use the hospital provided equipment. For staff that are not in the covid units, incidents of transmission and overall infection rates have been very low. For those in the covid units themselves, the infection rates are 60-70%. The PPE situation is still quite poor, gowns and face shields are being reused where in ordinary times they would be disposable. For ordinary people without regular contact with the infected and who take reasonable precautions (modeled in my anecdata by the staff outside the covid units) I believe that the masks combined with frequent hand washing are probably pretty effective. If you're in suboptimal circumstances and in constant contact with the infected I don't know. It's hard to tell with all of the PPE reuse. The story being told is that the cloth masks reduce spread from you to others but do not overtly protect you. I can see circumstances where improper doffing techniques could cause these to be counterproductive but overall I tend to believe this. Properly fitted N95 masks have similar protection of others but also protect you from some, but probably not all exposures.
- woofie11 5y ago
  > My wife works in the hospital and employees are only given one mask a month or so and must use the hospital provided equipment. Really? I mean really? N95 masks are not reusable. They have an electrostatic layer that degrades after hours of moisture from breath. In hospitals in Asia, where this is done right, infection rates have been close to zero. US companies have a glut of N95 mask stock right now because no one will buy them due to cheaper alternatives. In addition, tons of places produce tested N95-equivalent masks which have not gone through certification procedures. Where is your wife? That seems like a class action waiting to happen.
  - metiscus 5y ago
    Central Florida. I believe the issue is two-fold. The Hospitals have contracts etc with GPOs that often require the hospital to make most if not all of their purchases (PPE and Drugs, there is some discussion about GPOs being partially to blame for drugs shortages). If those organizations are unable to source, or unwilling to source PPE (speculation - due to market value being over contract value?) then the hospitals receive a restricted supply e.g. a shortage. The second axis is that this is not a situation that is generally known and hospital staff are generally underrepresented politically. To whom is the Nurse Assistant or LPN to complain to about their company practices? If you complain, you risk termination etc. Given that most took the vaccine the issue is partially mooted but still remains.
    - woofie11 5y ago
      Well, no. The issue isn't mooted. 1) The vaccine doesn't prevent you from catching COVID19; it prevents symptoms. Your body fights it off. We know nothing about how it impacts long COVID or spread. I mean, we know it reduces them, but is it a 10% effect? 90%? If hospital staff are spreading COVID to patients, we've got a problem. 2) Vaccinated people in contact with non-vaccinated is how you get vaccine-resistant mutations. We need vaccines and proper masks, especially in hospitals. If there's an issue like that, it seems like an anonymous complaint might help. Letters to newspapers, regulators, and hospital leadership, all cc:ed so they know others have received them, outlining that: - Proper masks are available: links to US plants having overstock, new technologies (e.g. Korean nanofiber) - Used N95 masks don't work - Reuse of N95 at the institution That puts a lot of pressure on leadership to address the issue. Enforcement actions usually go nowhere if an issue was already resolved by the time the agency gets there, and it's a lot cheaper to deal with early rather than late.

majewsky 5y ago

> If everyone wears N95 masks, the virus basically doesn't seem to spread. I don't know about elsewhere, but at least here in Germany, it would be literally illegal for an employer to require their staff to wear N95 masks at all times. Worker protection laws mandate 30 minutes of break time without a mask for each 90 minutes worked with a mask on. (Disclaimer: IANAL.)

mattkrause 5y ago
Really? That seems like it would make a lot of things exceedingly difficult (e.g., certain kinds of medical procedures or scientific experiments).

endgame 5y ago

The world was told by the public health apparatus, up to and including the U.S. Surgeon General, that masks were not effective. The circle was then squared by telling people to wear "face coverings" and, well, here we are. I would have hoped that in our current age of misinformation, that sources people trusted would not actively lie, but there you go.

DanBC 5y ago
> I would have hoped that in our current age of misinformation, that sources people trusted would not actively lie, but there you go. Find a meta-analysis of mask wearing to prevent infection that was published at the time. Or find some RCTs of mask wearing to prevent infection. There are lots of papers looking at infection control - it's an important part of healthcare. Have a look at how they describe the quality of evidence. Here's a well-known paper, published in a high impact reputable journal in June 2020. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Distancing is rated at "moderate certainty" > Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face masks only achieve "low certainty" > Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. These certainty ratings come from GRADE. https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-grade/ https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-... Low certainty means "The true effect might be markedly different from the estimated effect". This doesn't feel like lying. It feels like making the best of a bunch of not very good data.
- 5y ago

DanBC 5y ago

> If everyone wears N95 masks, the virus basically doesn't seem to spread. Most of the very many dead healthcare professionals were wearing N95s that had been properly fitted.

8bitsrule 5y ago
1. I haven't seen that idea claimed anywhere. 'Most','very many'??? 2. There was a great shortage of N95s for hospitals for a long time. (Let alone 'nursing'-home death-traps, where 33% of US deaths - 179,000 - have occurred. [0]) Sterilization methods took months to emerge. 3. Consider how dense viruses get in IC units, compared to retail locations. [0] https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html https://www.nytimes.com/interactive/2020/us/coronavirus-nurs...
jonplackett 5y ago
In the UK at least I don't think that's true. I saw an article the other day saying they'd given the FFP3 (out N95 equivalent) masks to the nurses in the ICU where patients are on ventilators, but the nurses dealing with the less sick patients just had surgical masks. Unfortunately, the less sick ones were up and about, coughing everywhere, not connected to machines to regulate their breathing and so those coughs are going into the air. Sadly lots of NHS staff have died.