7 ms·

It's surprising to me that cloth masks can't even do the 11% of surgical masks. Which isn't much, but surgical masks are non-optimal for many reasons. Not to me

It's surprising to me that cloth masks can't even do the 11% of surgical masks. Which isn't much, but surgical masks are non-optimal for many reasons. Not to mention that this doesn't seem the same as "while wearing a surgical mask you only get 11% increase in protection" but is a population-level thing. There was still non-compliance that presumably lowered the efficacy. I would've intuitively guessed that the better fit of cloth masks would make them better, but presumably the mask surface of a surgical mask has properties that offset that? Would be great to see numbers for N95 masks. Intuitively I'd assume they'd be much more effective as they have better fit + higher filtration, but of course, confirmation would be great. Fits with what we're seeing in Europe such as airlines banning cloth masks, though. The great incoherent idiocy of anti-* Americans on the issue of masks has always been that they say "cloth masks are ineffective" and propose a solution of "do nothing" instead of "get effective masks."

slg 5y ago
>It's surprising to me that cloth masks can't even do the 11% of surgical masks. Just want to add clarification here. The 11% number is the community impact of the programs designed to increase mask usage. It is not the effectiveness of a mask on an individual level. That number will be much higher since as you said a number of people didn't/don't comply at a societal level.
- majormajor 5y ago
  Thanks! I edited my comment to add notes on that too. At a population level even a small portion of the population wearing masks reducing overall spread is very good to see. Even for surgical masks.
- timr 5y ago
  > That number will be much higher since as you said a number of people didn't/don't comply at a societal level. ...or it will be lower. The study confounds the effects of distancing and mask-wearing. Distancing was higher in the surgical mask cohort. Also, as others note, the confidence interval for the surgical mask group overlaps zero. You can't rule out that the observed effect is due to chance.
  - clairity 5y ago
    yes, distancing does most of the work in most common situations. a mask can only work when conversing closely for a time indoors. otherwise masks do nothing, no matter the filtration rate of the mask, because there's nothing to filter in the first place. distancing is a more universal and sensible mitigation (we're distanced from nearly all of the world population all the time). this is why mask mandates, as currently constructed, are misguided and ignorant at best. the mandate should be to wear a mask when you're intimately sharing air (within ~3ft/1m) with another person indoors. the reason we don't have that sort of mandate is because it would mean we'd have to wear them around friends and family rather than those gross strangers who are out to kill us with their ignorance and malice (they're not). this is also why the current mandates for restaurants (and most retail) makes no sense, as we're only going to be intimately sharing air with our friends and family in those places anyway.
    - YZF 5y ago
      Aren't you sharing air with others in any common indoors space? I thought that was the whole aerosols debate that's basically settled by now, i.e. virus can stay suspending in the air for extended periods. With the Delta variant's characteristics this is also a much bigger problem (i.e. the same indoor space that might have been ok is no longer ok). There were early studies with the less infectious variants that showed how people situated far from each other in indoors spaces infect each other. So the mandate for masking in any common indoor space seems to make a lot of sense.
      - clairity 5y ago
        no, it's not "settled science" like that. the virus must traverse a gauntlet of death before reaching your juicy mucus membranes, including dessication and all manner of external forces that will inactivate it in the meantime. it falls apart in droves outside the body. you need constant exposure to warm, moist, infected exhaust so that the virus has trillions of chances of taking hold in your respiratory system, and it likely takes millions of virus particles making it across for enough to survive the immune response gauntlet inside the body. that a few virus particles in controlled tests miraculously manage to exist for a few minutes in the air has no bearing on real-world transmission rates. that's why a mask can work (better than distancing) in that one particular situation, but distancing is a better general mitigation. by the way, those early "studies" on long indoor spread were conjecture-based (e.g., using models), not rigorous science, and have failed to replicate.
- kragen 5y ago
  Given a really effective intervention for a contagious disease, the effectiveness on a community level will be much lower on an individual level. Think about PRC vs. USA: 4636 deaths in PRC, 618591 deaths in USA, even though it's a four times smaller country. There is no measure that even comes close to reducing your risk of death from covid by a factor of 600 on an individual level, but because they were able to get the R number down below 1, they stopped the epidemic. Normally you would expect effective contagion control measures to have an exponentially larger effect at a societal level than it does at an individual level, even if you don't reach the critical threshold to stop the epidemic: if you can drop R from 2.0 to 1.9, that reduces your individual risk by 5%, but it also reduces the number of cases in the next generation by 5%, the number of cases in the generation after that by 10%, the number of cases in the generation after that by 14%, etc. After 20 generations of transmission you've reduced the number of cases by 64%, which reduces everyone's infection risk by 64%. Of course, with such a high exponential growth rate, that only means that people get infected 1.6 generations later at that point, but if you're comparing different communities at the same time, the difference is about 3:1. So it seems like probably the effectiveness of the mask on an individual level was truly tiny.
  - 908B64B197 5y ago
    > Think about PRC vs. USA: 4636 deaths in PRC, 618591 deaths in USA, even though it's a four times smaller country. 4636 deaths as reported by the CCP to foreign journalists. Same party whose official line is that nothing happened in Tiananmen Square.
    - kragen 5y ago
      This is nonsense, partisan propaganda masquerading as rational thought. Nevertheless, there are many countries that had similarly effective infection control, so even if you choose to believe your hate for China instead of the best unbiased assessments, check out New Zealand, Vietnam, ROC, Thailand, or Australia.
  - gunapologist99 5y ago
    > 4636 deaths in PRC That number is completely laughable. It's literally communist propaganda.
dragontamer 5y ago
I think most of us got cloth masks with the full expectation that they were worse than proper PPE from hospitals (be it surgical masks or N95 masks). I'm not sure if people remember: but there was a shortage of masks of all kinds in March 2020. Cloth masks were the only thing we could get, and we all knew they were kind of crap (a lot of us were using coffee filters stapled onto the masks to increase its effectiveness). ------ Now that the N95 shortage is over (at least, I'm buying N95 duckbills at $1 each these days), I think its time to seriously consider using N95 in the public. At least in America, where we seem to have suddenly a huge influx of N95 availability this year.
- nielsbot 5y ago
  Seems quite reasonable to wear a (K)N95 instead of a surgical mask. Slightly less comfortable, but yes, affordable for most.
  - dragontamer 5y ago
    That "K" means that my ears hurt after 2 hours though. Going for full N95 means that the strap goes all the way around my head and is way more comfortable for extended use (ex: airplane rides or whatnot)
    - nokcha 5y ago
      There are also KN95 masks with headband straps instead of earloop straps. E.g., a web search for "Powecom KN95 Respirator Headband Style".
      - Scoundreller 5y ago
        Also 3M 9502+ KN95 which was subsequently NIOSH N95 approved (but you had to pay more if you wanted the ones stamped for the US market).
    - fma 5y ago
      There are "ear savers" you can get that'll turn the ear loops to headbands. I'll admit I've tried the plastic & velcro ones and didn't like them - but I also don't wear them for hours at a time but just for quick trips so found them annoying to put on and off.
nielsbot 5y ago
The idiocy is intentional and is manufactured by rightist media (and others) hoping to win the bloc of anti-mask "freedom" stance voters.
stolenmerch 5y ago
> The great incoherent idiocy of anti-* Americans on the issue of masks has always been that they say "cloth masks are ineffective" and propose a solution of "do nothing" instead of "get effective masks." I think the "no nothing" solution has more to do with a desire to return to normal than it is a refusal to "get effective masks" and just wear them forever or until some agency says not to anymore. There is a valid point to be made that once you're vaccinated and most people around you are vaccinated it's time to start learning to live with the reality of covid being a mild disease you get once in a while. I suppose a masked up future is one of better public health for some, but for many it is psychologically exhausting to see your friends and coworkers as potentially dangerous vectors of contamination. This is especially dystopian when the government forces you to do this whether it's sensible or not.
- gotoeleven 5y ago
  Wearing a proper mask that actually substantially reduces the chance of contracting or spreading covid is uncomfortable. As many of us have been saying from the beginning (including the CDC initially!) the cloth masks are just the medical equivalent of TSA security theater. Right now they just function as a little badge to indicate which "team" you're on.
  - chitowneats 5y ago
    I cannot understand why this is being downvoted. We would have all been wearing N95's long ago if they weren't difficult for frontline workers to use 8 hours a day. People care about their own health by and large. They will use reasonable strategies for mitigation and reject those that are cumbersome. The people pushing N95 mask requirements are not the same people required to wear them 40 hours a week. The people pushing non-N95 mask requirements are confused about the effectiveness of non-N95 "masks".
- YZF 5y ago
  I mostly agree. The problem is mostly with populations that have a large number of un-vaccinated people. If we could separate those unvaccinated people from the vaccinated people then the vaccinated people could go back to normal and I agree the impact is probably small (not quite sure about "mild disease you get once in a while" but something we could live with). However when you have a 50/50 mix of people who have mild disease you get in a while and people who get a serious disease that leads to hospitalizations and death at a relatively high rate you now have a problem. And it's a problem for the vaccinated 50% who would not be able to get into the hospital when they have a medical emergency, or can't get their scheduled medial procedure done, or bearing the costs associated with those other 50%, or even just having a higher likelihood of getting sick with something they obviously prefer not to get (mild or not). So the governments are optimizing for this (forcing us to do X) ... not for the individual but for public health and public (general) concerns. Just like they're forcing us (and fining us, darn!) not to drive through red lights, or exceed the speed limit. Are they always doing a great job? nope, but hey we voted for those guys (at least in functioning democracies)... So here we are.
jaclaz 5y ago
> Intuitively I'd assume they'd be much more effective as they have better fit + higher filtration, but of course, confirmation would be great. I think that is really hard to say. IF they are properly fitted (that won't normally be the case). As I see it (as well intuitively) if the virus is transmitted "directly" by droplets then cloth, surgical or N95 won't make much difference from a clear plastic shield (as we have seen many in hospitals wear, besides the masks), while if it is transmitted by aerosol the filtration capacity changes matters greatly. Point is whether a (poorly) fitted N95 does actually protect more than a surgical mask. Since a N95 is "harder" to breath in (as it filters much more), it is possible that a lot more non-filtered air comes from the (poor) fitting gaps. In my personal case I have (now) a beard and #1 lesson when years ago I was taught how to wear a N95 (actually a FPP2, almost the same as N95) was that you had to be cleanly shaven, and - besides that - I had to try some 5 or 6 different mask models before finding a suitable one (the mask shape need to be suited to your face shape for a proper fit). This is a pet-peeve of mine, but noone actually wears N95 masks properly: https://news.ycombinator.com/item?id=22728367 https://news.ycombinator.com/item?id=22728367 https://news.ycombinator.com/item?id=23957506 https://news.ycombinator.com/item?id=23957506
- deleted 5y ago
  [deleted]
asdff 5y ago
I'm just as surprised. I used to wear a cloth mask and switched to an n95. When I tried the surgical mask I was amazed at how poorly the thing fit along the cheeks and how hard it was to form a tight fit on the nose that wouldn't loosen immediately. Breathing through it offered no resistance at all, in contrast to your typical cloth or n95 that hug all sides of the mask pretty well to your face. I thought this was because surgical masks are meant to block flecks of spit off your tongue when asking for surgical tools, rather than aerosols from exhaling. Most people I see wearing surgical masks just put them over their ears and have it loosely covering the face, with large gaps along the sides and especially around the nose.
- mikeInAlaska 5y ago
  I have been surprised a few times when wearing a surgical mask looped around my ears, when i had to remove it and then became instantly aware of all the smells of a place I was in. They were definitely isolating me from airborne particles.
908B64B197 5y ago
"Cloth masks" can mean anything. I wish early in the pandemic someone would have made some piece of equipment to asses whether a given cloth mask is good or not. Most people have a few now and I'm sure they would like to use the best one.
- mdp2021 5y ago
  > "Cloth masks" can mean anything [...] I guess the point is "not certified".
- autokad 5y ago
  we could have argued for all masks being sold to post some measurable stat about the mask, but then others would have argued that would have prevented masks from even hitting the shelf and we'd be worse off.
  - 908B64B197 5y ago
    In the first weeks of the pandemic when there was a shortage of surgical masks? Any cloth was better than nothing. Several months into the pandemic? Would have liked to see a program to distribute "better" masks and retire the bad ones.

slg 5y ago

>It's surprising to me that cloth masks can't even do the 11% of surgical masks. Just want to add clarification here. The 11% number is the community impact of the programs designed to increase mask usage. It is not the effectiveness of a mask on an individual level. That number will be much higher since as you said a number of people didn't/don't comply at a societal level.

majormajor 5y ago
Thanks! I edited my comment to add notes on that too. At a population level even a small portion of the population wearing masks reducing overall spread is very good to see. Even for surgical masks.
timr 5y ago
> That number will be much higher since as you said a number of people didn't/don't comply at a societal level. ...or it will be lower. The study confounds the effects of distancing and mask-wearing. Distancing was higher in the surgical mask cohort. Also, as others note, the confidence interval for the surgical mask group overlaps zero. You can't rule out that the observed effect is due to chance.
- clairity 5y ago
  yes, distancing does most of the work in most common situations. a mask can only work when conversing closely for a time indoors. otherwise masks do nothing, no matter the filtration rate of the mask, because there's nothing to filter in the first place. distancing is a more universal and sensible mitigation (we're distanced from nearly all of the world population all the time). this is why mask mandates, as currently constructed, are misguided and ignorant at best. the mandate should be to wear a mask when you're intimately sharing air (within ~3ft/1m) with another person indoors. the reason we don't have that sort of mandate is because it would mean we'd have to wear them around friends and family rather than those gross strangers who are out to kill us with their ignorance and malice (they're not). this is also why the current mandates for restaurants (and most retail) makes no sense, as we're only going to be intimately sharing air with our friends and family in those places anyway.
  - YZF 5y ago
    Aren't you sharing air with others in any common indoors space? I thought that was the whole aerosols debate that's basically settled by now, i.e. virus can stay suspending in the air for extended periods. With the Delta variant's characteristics this is also a much bigger problem (i.e. the same indoor space that might have been ok is no longer ok). There were early studies with the less infectious variants that showed how people situated far from each other in indoors spaces infect each other. So the mandate for masking in any common indoor space seems to make a lot of sense.
    - clairity 5y ago
      no, it's not "settled science" like that. the virus must traverse a gauntlet of death before reaching your juicy mucus membranes, including dessication and all manner of external forces that will inactivate it in the meantime. it falls apart in droves outside the body. you need constant exposure to warm, moist, infected exhaust so that the virus has trillions of chances of taking hold in your respiratory system, and it likely takes millions of virus particles making it across for enough to survive the immune response gauntlet inside the body. that a few virus particles in controlled tests miraculously manage to exist for a few minutes in the air has no bearing on real-world transmission rates. that's why a mask can work (better than distancing) in that one particular situation, but distancing is a better general mitigation. by the way, those early "studies" on long indoor spread were conjecture-based (e.g., using models), not rigorous science, and have failed to replicate.
kragen 5y ago
Given a really effective intervention for a contagious disease, the effectiveness on a community level will be much lower on an individual level. Think about PRC vs. USA: 4636 deaths in PRC, 618591 deaths in USA, even though it's a four times smaller country. There is no measure that even comes close to reducing your risk of death from covid by a factor of 600 on an individual level, but because they were able to get the R number down below 1, they stopped the epidemic. Normally you would expect effective contagion control measures to have an exponentially larger effect at a societal level than it does at an individual level, even if you don't reach the critical threshold to stop the epidemic: if you can drop R from 2.0 to 1.9, that reduces your individual risk by 5%, but it also reduces the number of cases in the next generation by 5%, the number of cases in the generation after that by 10%, the number of cases in the generation after that by 14%, etc. After 20 generations of transmission you've reduced the number of cases by 64%, which reduces everyone's infection risk by 64%. Of course, with such a high exponential growth rate, that only means that people get infected 1.6 generations later at that point, but if you're comparing different communities at the same time, the difference is about 3:1. So it seems like probably the effectiveness of the mask on an individual level was truly tiny.
- 908B64B197 5y ago
  > Think about PRC vs. USA: 4636 deaths in PRC, 618591 deaths in USA, even though it's a four times smaller country. 4636 deaths as reported by the CCP to foreign journalists. Same party whose official line is that nothing happened in Tiananmen Square.
  - kragen 5y ago
    This is nonsense, partisan propaganda masquerading as rational thought. Nevertheless, there are many countries that had similarly effective infection control, so even if you choose to believe your hate for China instead of the best unbiased assessments, check out New Zealand, Vietnam, ROC, Thailand, or Australia.
- gunapologist99 5y ago
  > 4636 deaths in PRC That number is completely laughable. It's literally communist propaganda.

dragontamer 5y ago

I think most of us got cloth masks with the full expectation that they were worse than proper PPE from hospitals (be it surgical masks or N95 masks). I'm not sure if people remember: but there was a shortage of masks of all kinds in March 2020. Cloth masks were the only thing we could get, and we all knew they were kind of crap (a lot of us were using coffee filters stapled onto the masks to increase its effectiveness). ------ Now that the N95 shortage is over (at least, I'm buying N95 duckbills at $1 each these days), I think its time to seriously consider using N95 in the public. At least in America, where we seem to have suddenly a huge influx of N95 availability this year.

nielsbot 5y ago
Seems quite reasonable to wear a (K)N95 instead of a surgical mask. Slightly less comfortable, but yes, affordable for most.
- dragontamer 5y ago
  That "K" means that my ears hurt after 2 hours though. Going for full N95 means that the strap goes all the way around my head and is way more comfortable for extended use (ex: airplane rides or whatnot)
  - nokcha 5y ago
    There are also KN95 masks with headband straps instead of earloop straps. E.g., a web search for "Powecom KN95 Respirator Headband Style".
    - Scoundreller 5y ago
      Also 3M 9502+ KN95 which was subsequently NIOSH N95 approved (but you had to pay more if you wanted the ones stamped for the US market).
  - fma 5y ago
    There are "ear savers" you can get that'll turn the ear loops to headbands. I'll admit I've tried the plastic & velcro ones and didn't like them - but I also don't wear them for hours at a time but just for quick trips so found them annoying to put on and off.

nielsbot 5y ago

The idiocy is intentional and is manufactured by rightist media (and others) hoping to win the bloc of anti-mask "freedom" stance voters.

stolenmerch 5y ago

> The great incoherent idiocy of anti-* Americans on the issue of masks has always been that they say "cloth masks are ineffective" and propose a solution of "do nothing" instead of "get effective masks." I think the "no nothing" solution has more to do with a desire to return to normal than it is a refusal to "get effective masks" and just wear them forever or until some agency says not to anymore. There is a valid point to be made that once you're vaccinated and most people around you are vaccinated it's time to start learning to live with the reality of covid being a mild disease you get once in a while. I suppose a masked up future is one of better public health for some, but for many it is psychologically exhausting to see your friends and coworkers as potentially dangerous vectors of contamination. This is especially dystopian when the government forces you to do this whether it's sensible or not.

gotoeleven 5y ago
Wearing a proper mask that actually substantially reduces the chance of contracting or spreading covid is uncomfortable. As many of us have been saying from the beginning (including the CDC initially!) the cloth masks are just the medical equivalent of TSA security theater. Right now they just function as a little badge to indicate which "team" you're on.
- chitowneats 5y ago
  I cannot understand why this is being downvoted. We would have all been wearing N95's long ago if they weren't difficult for frontline workers to use 8 hours a day. People care about their own health by and large. They will use reasonable strategies for mitigation and reject those that are cumbersome. The people pushing N95 mask requirements are not the same people required to wear them 40 hours a week. The people pushing non-N95 mask requirements are confused about the effectiveness of non-N95 "masks".
YZF 5y ago
I mostly agree. The problem is mostly with populations that have a large number of un-vaccinated people. If we could separate those unvaccinated people from the vaccinated people then the vaccinated people could go back to normal and I agree the impact is probably small (not quite sure about "mild disease you get once in a while" but something we could live with). However when you have a 50/50 mix of people who have mild disease you get in a while and people who get a serious disease that leads to hospitalizations and death at a relatively high rate you now have a problem. And it's a problem for the vaccinated 50% who would not be able to get into the hospital when they have a medical emergency, or can't get their scheduled medial procedure done, or bearing the costs associated with those other 50%, or even just having a higher likelihood of getting sick with something they obviously prefer not to get (mild or not). So the governments are optimizing for this (forcing us to do X) ... not for the individual but for public health and public (general) concerns. Just like they're forcing us (and fining us, darn!) not to drive through red lights, or exceed the speed limit. Are they always doing a great job? nope, but hey we voted for those guys (at least in functioning democracies)... So here we are.

jaclaz 5y ago

> Intuitively I'd assume they'd be much more effective as they have better fit + higher filtration, but of course, confirmation would be great. I think that is really hard to say. IF they are properly fitted (that won't normally be the case). As I see it (as well intuitively) if the virus is transmitted "directly" by droplets then cloth, surgical or N95 won't make much difference from a clear plastic shield (as we have seen many in hospitals wear, besides the masks), while if it is transmitted by aerosol the filtration capacity changes matters greatly. Point is whether a (poorly) fitted N95 does actually protect more than a surgical mask. Since a N95 is "harder" to breath in (as it filters much more), it is possible that a lot more non-filtered air comes from the (poor) fitting gaps. In my personal case I have (now) a beard and #1 lesson when years ago I was taught how to wear a N95 (actually a FPP2, almost the same as N95) was that you had to be cleanly shaven, and - besides that - I had to try some 5 or 6 different mask models before finding a suitable one (the mask shape need to be suited to your face shape for a proper fit). This is a pet-peeve of mine, but noone actually wears N95 masks properly: https://news.ycombinator.com/item?id=22728367 https://news.ycombinator.com/item?id=22728367 https://news.ycombinator.com/item?id=23957506 https://news.ycombinator.com/item?id=23957506

deleted 5y ago
[deleted]

asdff 5y ago

I'm just as surprised. I used to wear a cloth mask and switched to an n95. When I tried the surgical mask I was amazed at how poorly the thing fit along the cheeks and how hard it was to form a tight fit on the nose that wouldn't loosen immediately. Breathing through it offered no resistance at all, in contrast to your typical cloth or n95 that hug all sides of the mask pretty well to your face. I thought this was because surgical masks are meant to block flecks of spit off your tongue when asking for surgical tools, rather than aerosols from exhaling. Most people I see wearing surgical masks just put them over their ears and have it loosely covering the face, with large gaps along the sides and especially around the nose.

mikeInAlaska 5y ago
I have been surprised a few times when wearing a surgical mask looped around my ears, when i had to remove it and then became instantly aware of all the smells of a place I was in. They were definitely isolating me from airborne particles.

908B64B197 5y ago

"Cloth masks" can mean anything. I wish early in the pandemic someone would have made some piece of equipment to asses whether a given cloth mask is good or not. Most people have a few now and I'm sure they would like to use the best one.

mdp2021 5y ago
> "Cloth masks" can mean anything [...] I guess the point is "not certified".
autokad 5y ago
we could have argued for all masks being sold to post some measurable stat about the mask, but then others would have argued that would have prevented masks from even hitting the shelf and we'd be worse off.
- 908B64B197 5y ago
  In the first weeks of the pandemic when there was a shortage of surgical masks? Any cloth was better than nothing. Several months into the pandemic? Would have liked to see a program to distribute "better" masks and retire the bad ones.