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by mcsb4 2283 days ago
I don't understand why we are not trying to interrupt the transmission vectors with masks and hand sanitizer like the Chinese do. They ramped the daily production from 10M to 100M and even advised the use of make-shift masks.

The reaction in the west: masks are not protecting 100% and also we don't have any and we are too lazy to produce them, although they are much cheaper than the economic impact covid-19 has.

1. you go out, you wear a mask

2. you are not allowed into a super market without hand sanitizing

3. you clean your hands when coming home or going into your office

4. wear any kind of glasses

We know the transmission vectors but the whole response in the west is solely based on quarantaine - like we would still not know what viruses are and how they are transmitted.

Reducing social contact is one thing, reducing virus dispersion is the other and it is cheap.

You have a sewing machine? Go start making masks.

12 comments

In Asia, where mask-wearing is common (part of the culture, nothing to do with COVID), sick people wear masks. It's very practical, and also a social signal that "I am ill". As a manager of a business in SE Asia, people coming in sick but wearing masks was awesome. The mask-wearing reduced their infectiousness (because the mask stops saliva-borne virus communication) and made it OK to come in to work if you're feeling well enough to work. It's socially acceptable to not shake a mask-wearer's hand or otherwise touch them. It's as much social signal as anything ("I might be infectious, I'm not going to be offended if you treat me as a walking virus bomb").

Part of the problem for the West is that we wear masks when we don't want to get sick. Masks don't really work for this (the rest of the mask-wearer still gets covered in virus). And if we're diagnosed sick, then we stop wearing masks. Again, that's not how the mask thing works, because this is when masks are most useful. Both as a social signal and practical way of reducing infectiousness.

To use masks effectively, we need to stop wearing them when we're scared, and start wearing them when we're infected. But I think the social change to do this will be difficult.

> To use masks effectively, we need to stop wearing them when we're scared, and start wearing them when we're infected. But I think the social change to do this will be difficult.

Not exactly. Just make it mask season and make everybody wear it. You don't know when you are contagious/infectious, and it might not be at the same time when you are feeling sick. So just make sure everyone wears it.

I don't think it's practical to insist that everyone wears a mask all the time.
Practical from a cultural standpoint or in terms of quantity? IIRC, people are required to wear masks when entering businesses in China now.
Masks do protect you from getting sick.

https://www.ncbi.nlm.nih.gov/pubmed/30229968

The idiotic meme that "masks don't protect you from getting the virus" is incredibly frustrating.

I know H/N loves binary thinking, but the either/or fallacy is harmful and dangerous, especially in this scenario. People fall into it with the age-based impact of the virus too: young people feel completely immune, so why care? The same with masks: they don't protect you 100%, so people just mentally consider them worthless, and then there are dozens of HN posts repeating the misinformation in short order.

> when we don't want to get sick. Masks don't really work for this

They do, they decrease the chance to get infected. They don't guarantee it. The previous poster wrote about exactly this.

Situation: Infected person coughs near a non-infected person.

If the Infected Person is wearing the mask, all good. Cough contained in mask, no virus spread anywhere, everyone OK.

If the Non-Infected Person is wearing the mask, they're still covered in virus-laden cough mess. All they have to do is touch their face once in the next 3 days to catch the virus. Washing their hands will remove the virus from the hands, but not from their clothes, hair, etc.

Also, they're now covered in virus. Everything they touch will be covered in virus. Virus everywhere, infecting everyone. Everyone not OK.

It's possible that a non-infected person wearing a mask might prevent a tiny bit of infection, but it's MASSIVELY more effective on the infected person.

Surgeons wear masks in case they cough on the patient. They don't put a mask on the patient...

And then the virus just dies on non-live surfaces like clothes in a couple of hours.

Like we said several times, masks provide some protection (decreased risk) for a healthy person, they don't protect from getting infected 100%.

No one ever said that mask is more effective on healthy person than on the infected one, I am not sure who you are arguing against. But it is the popular for some reason notion that a mask does not protect a healthy person at all that is plain false as has to go away.

No, the virus lives on non-live surfaces for up to 3 days. This alone invalidates the rest of your argument.
We still don't know how long it lives on clothing. On doorknobs, plastic, stainless steel it can live for 72 hours, yes.

https://www.npr.org/sections/health-shots/2020/03/14/8116090...

The difference in effectiveness is huge, to the point where it's ridiculous to be healthy and wear a mask. Like I said, they don't put masks on surgery patients.

And don't forget the social signal part; if everyone wears a mask all the time, then we don't know who actually considers themselves to be infectious. Whereas if just the infectious people wear masks, then we know who they are and can act appropriately (being grateful that they self-identified as infectious and kept the rest of us safer, for a start).

I think the social signal part has second order effects that make it work out not as you would expect.

If ONLY sick people tend to wear masks then masks will make you a more visible target of fear and hate, which would lead people who are sick to not wear masks.

It's a much better idea to destigmatize the act of mask wearing so we can get larger coverage of sick people with mask s.

> The difference in effectiveness is huge, to the point where it's ridiculous to be healthy and wear a mask.

I think the point is that you have no idea whether you're healthy.

The anti-mask thing in the west is so upsetting, and it's more aggravating because it's the health care workers giving the horrible advice. I don't care that we don't have enough N95 masks for everybody, N95 are for preventing inhalation of virus. What we need are the disparaged "surgical" masks which are for preventing spittle flying everywhere. And they do not have to be high-tech they just have to cover the mouth. It should be mandatory to wear one out of the house. That's what China did.
It seems strange to me as well. I am in Thailand and, in Bangkok at least, most people wear masks, carry disinfecting hand gel and are very wary about close contact with people and surfaces. Stores like Makro (Thai version of CostCo) have mask-wearing guards at the store entrance that take your temperature and provide hand gel, while cleaning crews wipe down the handles of shopping carts with disinfectant.

To be fair, many people in Bangkok already wore masks because of the pollution. So there is no stigma. But it seems that the Thais started taking Covid-19 serious right away, so maybe that's why Thailand, which was on the leader board in number of infections early on, has reached only 114 confirmed infectinos with 1 death as of yesterday. But only time will tell if all the precautions can slow down the spread since it only takes a few infected but symptomless highly social spreaders to really blow things up. And it looks like that may have happened in the last few days.

> It seems strange to me as well.

We don't have nearly enough masks, and the authorities are trying to ensure that as many masks as we have can go to a healthcare setting.

It's why they're giving us incongruous messages: both "masks don't help reduce the risk of transmission", AND "we need to save masks for health care workers". Obviously, since we're trying to preserve the supply for health care workers they do have some utility in reducing the risk of transmission.

I think the easy answer here is that there’s no culture of wearing masks in public and it’s very visible and easy to ridicule.

This isn’t Tokyo, where everyone was wearing masks before this crisis and you get one for 400 yen at any convenience store, even inside the rail station.

Authorities in a democracy work mainly by persuasion, and they have a limited budget of how much they can educate and bend people’s behavior. This is what you would expect a system that takes citizen feedback into account, where citizens have a very strong prior that is inappropriate to the current situation.

Note most people in a democracy are strongly against government propaganda, but propaganda is basically state-owned tax on citizens’ attention. Think about how much attention it would take to educate people until they all voluntarily wore masks, whether that education would be politically popular, and also how many dollars in ad revenue that would have cost in the private attention market (ads).

Good points, but still, it's not consistent to use that low-bandwidth channel for wrong messages.

Sure, say that don't hoard masks, but don't say that it doesn't work anyway. Say that it would only work if everyone would use them. (Because you don't know when you are contagious anyway, so saying only sick folks should wear them is again a bad message.)

Also, saying that everyone should wear them is consistent with don't hoard them. (After all, if doesn't help you if you have masks but don't distribute them to others to protect you and "your loved ones".)

I love how everyone wants to talk about masks and hand sanitizer, but not about gloves or good old soap and water. To me, it's a sign of wanting to score internet points more than to actually inform. The best information I've seen so far suggests that SARS-CoV-2 can survive 2-3 hours as aerosol, 2-3 days on some surfaces. You're much more likely to be exposed or to expose others by touching something than by walking around. The "hottest" thing you've been around recently is probably the door handle or the credit-card terminal you touched when you went to buy a year's worth of toilet paper. And what's the surest way to prevent infection via touch? A physical barrier.

People who walk around wearing masks but not gloves are making a fashion statement. People who are serious about the issue (including health-care workers) wear both.

What does wearing a glove really achieve? You can't get the virus through direct skin contact, so virus living on your skin is not going to infect you. Touching your face while you have virus on your skin is how you get infected, and touching other surfaces while your hand is dirty is how you help spread the infection. Both of these work just as well if the virus lives on a glove rather than your skin.

So no, gloves are entirely useless for protection from this kind of virus. They are much more useless than masks, which could at least temporarily prevent some amount of virus-filled water droplets from reaching your nose.

You're exhibiting exactly the kind of non-science-based attitude I was talking about. Droplets, oh no, run away!

Let's say you're unknowingly infected, like all of those people who were hanging out at bars as though they're invulnerable this weekend. So you have virus on your skin already. Are you more likely to pass it on to others via surfaces if your skin is bare or if you put a glove on it? The answer's pretty obvious. If you touch your face then the probability of infection either way increases again, but (a) people touch their faces less often with gloves on and (b) every time you change gloves the probability drops back to near zero. So yes, gloves do protect you somewhat, and they protect others even more. Just as importantly, there's no sane scenario in which they'd make things worse or deny resources to those who need them more (as with masks). It doesn't make much difference whether the surface transmission route is directly on skin or via face touching. That's why health care professionals use gloves even when dealing with respiratory diseases like COVID-19.

> people touch their faces less often with gloves on

Is that true? I would assume people usually touch their faces because something itches or to adjust glasses/hair/a mask. I would expect gloves to have a minimal impact on this compared to just paying attention to never touching your face. I am open to seeing numbers on this, but don't know where to look for any.

> every time you change gloves the probability drops back to near zero

I think that's only true if you handle the gloves somewhat carefully (not that it's hard to do, but you do have to pay some attention). But washing your hands or using hand sanitizer also achieves the same. So the question comes back to "how often do people wash their hands/use hand sanitizer compared to how often they change gloves?", which is an empirical question I have no clear intuition for, but do expect for differences to not be that large.

> That's why health care professionals use gloves even when dealing with respiratory diseases like COVID-19.

I think healhcare professionals wear gloves for a number of reasons, chiefly because, if you're used to it, you can be more efficient when changing gloves than when washing your hands: medical professionals normally put on a new pair of gloves before touching you, then throw those away after they are done. Most people are not used to it, they do not constantly change gloves, and do not have to deal with moving from patient to patient. So just as I don't think it's useful to tell people to wear surgical overalls and change them every hour, I don't think we can tell them to use gloves the way they are used in a hospital.

Simple thought experiment: you're about to be in a situation where, despite any efforts to the contrary, you expect to be in contact with a hundred other people. It's not that uncommon e.g. in retail. Would you prefer that to be skin to skin, or glove to glove? Would you literally bet your own life and others' on that "entirely useless" claim, or would you take that cheap and basic precaution?
I would definitely prefer free hands IF I also have access to hand sanitizer. I would be much more confident that I have successfully covered my entire hand in sanitizer than if I were to sanitize gloved hands.

I would admit that I would probably feel safer with a mask on though, despite the problems with wearing masks as well.

> The answer's pretty obvious.

It's not particularly obvious to me how gloves are all that different to hand-washing.

In both cases, your hands are disease-free until you touch something that isn't disease-free.

> It's not particularly obvious to me how gloves are all that different to hand-washing.

Only in the sense that hand-washing is more effective. In fact, most recommendations to use gloves also recommend hand-washing immediately after removal. However, it's not practical to wash hands every few minutes, literally hundreds of times a day. Gloves can provide protection between less frequent washings.

> So no, gloves are entirely useless for protection from this kind of virus.

Gloves, even if they do nothing else, act as a strong reminder not to touch your face. Breaking that habit alone can strongly reduce your risk of transmission.

Also to change them (and/or wash your hands) if you touch your face anyway, or forget and sneeze/cough into your hands, etc. They're often brightly colored to reinforce this "reminder" function. They certainly don't have to be. Pretty sure their natural color would be off-white or grey.
You know what else stops you from touching your face?

A face mask.

...ok?

I was more responding to the person about gloves, but what you say is also true.

Just trying to combat all of the people discouraging face mask use, since apparently everyone in America is of the opinion that face masks are useless.
Hubei mandated that anyone who was outdoors wears a mask. They didn't mandate that anyone who was outdoors wears gloves.

Disposable latex gloves are cheaper and easier to access in China than masks and yet China prioritized masks.

It's not either/or. They're complementary, and in a situation of adequate supply for the anticipated demand it would be wise to use both. What I'm objecting to is the fact that people only talk about masks, dismissing with extreme prejudice and hostility any concerns about either effectiveness or supply. Then some of them turn right around and make up objections to glove use. The fact is that no one thing by itself will save us. We need to use all the tools at our disposal, not fixate on one and ignore others.
The virus cannot enter you through your hands. Unless you are switching gloves more often than you are washing your hands how are they going to help?
> 1. you go out, you wear a mask

If you can get a mask.

The mask manufacturers in the West are not going to ramp up without a significant amount of money up front. The last time they did with SARS they almost went bankrupt after it fizzled out and demand collapsed:

https://www.washingtonpost.com/business/2020/02/15/coronavir...

So, you need the US government to either command or fund the manufacturing ramp up.

Unfortunately, that requires people in charge who actually don't suffer from cranio-rectal impaction.

Or we could encourage mask producers to charge more during a crisis.

If mask producers could charge enough that the masks weren't quite fly off the shelves, we would be swimming in masks made and kept in storage for times of pandemic. It is pretty obvious what happens; producers are shamed into not making a profit when demand is high so they don't bother to produce.

You’d think that if the west gets the concept of condoms this wouldn’t be that far fetched...
At the risk of sounding stupid, why hasn't anyone been talking about making makeshift masks using clothing or cloth? There's plenty of that in everyone's home. What about a scarf? Fine, it's not N95 but it can't be any less effective than a simple surgical mask that does blocks spittle.
A scarf (and other soft cloths) sounds problematic, because it traps droplets and then gives them more time to get into your airways. Though it probably helps with someone coughing at you directly. (But you have to instantly remove the scarf, and should wear glasses too, and then remove that too, and then wash your face, then the glasses and then the scarf.)
The surgical masks are disposable which I get but worst case wash your makeshift mask or carry multiple and keep them segregated in bags. It's not as easy as tossing a surgical mask but a viable alternative in a pinch.

And a further thought, I wonder how many surgical masks we'll find floating in the great garbage patch in the next few years. At my work they also threw out all the plastic cutlery so assuming there is a massive trash surge happening. I'm interested in the environmental impact of this outbreak.

Viruses, unlike bacteria can't survive outside of a living host. Thus, they can only decrease over time on an inanimate object. This means if you have ~10 - 20 disposable surgical masks you can reuse them until they're disintegrated. Simply adopt a First In Last Out protocol to maximize the days between reuse. The longest we've seen the literature indicate the virus survives on a surface is 3 days and viral loads decrease at an exponential rate so at 6 days, you're >99.99% safe, at 9 days, you're >99.9999% safe etc. Distributing 20 - 30 disposable masks to every American is not outside of logistical possibility.

Just make sure you wash and dry the mask as soon as it's off your face so bacterial colonies don't have time to multiply.

The masks are to stop you from infecting other people, not to stop you from getting infected.
I don't understand why we're relying on governments to do this for us. Ethanol is not difficult to make at home and we can do it ourselves (I just don't want to share methods because it's questionably legal in my state/kinda dangerous to do with an open flame).
It helps to understand the relative sizes of the particles masks are expected to filter from the air.

A coronavirus is about 0.1 µm while surgical masks start to become effective at around 200 µm and up.

So a coronavirus is about 2000 times smaller than what a surgical mask can filter.

I imagine a chain link fence which is pretty effective at stopping basketballs.

A pollen spore is about 2000 times smaller than a basketball.

Chain link fences are useless in stopping pollen spores, just like surgical masks are useless in filtering coronaviruses.

The only benefit to a surgical mask is to prevent the infected person from spraying large drops of saliva and mucus onto surfaces, there is zero benefit for the uninfected.

If you're uninfected, you don't need a mask unless you're caring for sick patients. And even then a surgical mask is pretty useless, you'd need a quality N95 or N100 mask and eye protection.

Those virus particles usually ride on a droplet of fluid, or another big particle. And you're not guaranteed to get sick if you ingest one virus.
Everyone seems to missing one very big, important thing that masks accomplish, even if they don't stop the airborne virus itself:

Masks stop people from constantly touching and/or itching their mouth and nose.

Think about that for a second, before you tell people how useless masks are.

Near universal masking reduced the rate of all infectious diseases, including influenza down to near zero. The size of the virus is irrelevant, it's the size of the carrier medium which is droplets that are very effective at being caught in masks.
Masks are not effective. There are not only professionals saying this, there are scientific studies, and as a result, fewer surgeons are wearing them, favoring instead a plastic face shield.

Why are they not effective? Because they don’t contain the aerosolized moisture from your breath. Most masks, unless properly sealed against your face and not impeded by moisture in the mask, will bypass the mask entirely and vent out the sides. How long does it take for moisture to impede airflow through the mask? About 30 minutes.

So, unless you are replacing your mask for a new one every 30 minutes, and are ensuring that its properly fit every time, wearing a mask is a placebo at best.

Can a mask block you from spitting on everyone? Sure, but so can your arm or hand when you’re coughing.

CDC appears to be lying about masks since there aren't enough for everyone. This is harmful guidance as many already have masks (eg for sanding/painting)
Do masks even work on things as small as viruses?
Yes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/

The virus is not airborne, it is spread is small droplets. Those are effectively reduced by all kinds of masks.

Masks also prevent you from absent-mindedly touching your mouth and nose.
Masks contain spread. They do not protect from it.

So if you are sick, wear a mask. Here in Germany you still get publicly ridiculed for it.

If masks contain spread and everyone wore one, it would lead to less cases.

The problem is that there are not enough masks to go around. But if there were, i would recommend everyone wears them. Just so it would make it socially acceptable to wear one if you are sick.

Few if any people with it know the exact time they become symptomatic and start viral shedding. Everyone should assume they might be sick when in public and could be shedding. With this standard everyone would wear a mask.
I'd like to see a source that they do not protect from incoming droplets. This seems to be completely false.
Surgeon General sufficient for you? Masks still contain droplet, at least reduce them so even DIY paper towel masks help.

https://www.nytimes.com/2020/02/29/health/coronavirus-n95-fa...

This seems to be a source that they do protect from incoming droplets.

The question was who's officially claiming that they don't mitigate, even moderately, this risk vector.

Masks work, but needs to be disinfected when you get home. (Using steam. Microwave, a plate of water, mask above the water, 3 minutes is the minimum with steam bags, so let's try 10 minutes without bag.)
That's not even true, I saw a study that showed that even makeshift masks reduced the risk of infection, though obviously not as much as a N95 mask.
Same everywhere in Europe I think, people get scared if you are wearing a mask, which should be the opposite...
I'm not an expert, but I believe they stop the droplets, which are vectors for viruses.
It has been proved that most of those masks sold simply aren't closely sewed enough to stop the droplets containing the disease. So in general the mask don't help. Secondly the mask only help avoiding spreading the virus from yourself to other and it doesn't protect from receiving the virus
Please stop spreading this false information and have a look at the infection numbers in China. The masks stop droplets coming from your mouth and nose and if everybody wears them, then they are a very effective mean to massively slowing down the spreading of the virus.

No, the masks are not 100% virus tight. Yes, they prevent spreading of diseases. That's why they are worn by surgeons.

They are 20 cents a piece, that's nothing compared to the current economic costs of useless social distancing as long as people still go to work. Unless we stop the economy, masks and hand sanitizer are the way to go.

This is the advise we are getting

"If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection."

https://www.who.int/emergencies/diseases/novel-coronavirus-2...

"If you are not sick, do not buy a face mask. If you have one already and you are well, it is not recommended that you use it."

https://arstechnica.com/science/2020/03/dont-panic-the-compr...

Is this in your opinion "false information"?

It's really baffling that the WHO is actively recommending _against_ face masks. They even go as far as saying not to wear a mask _even if you already own one_ which they arguably wouldn't do if they were worried about shortages.

I mean, maybe they're going for the social dissaproval angle - you can stop people from hoarding masks by making it socially bad to wear a mask, but that seems misguided if true.

The information about masks is from a public health perspective and not a personnel health perspective due to a global mask shortage. Just because it’s better for society as a whole that all PPE go to where they can help the most people, doesn’t necessarily mean that’s the best result for you as an individual.

If there were an infinite supply of masks the advice would be entirely different.

Not directly, but they are stating they are not recommended, when in fact, they help a bit: - wearing something on your face will help you remember not to touch your face. It's not much, but it's something to reduce spread by hand to mouth contact. - if the mask has good filtration (N95+, sealed on the side), it still offers some protection against dropplet. - if the person wearing it is infected but asymptomatic, they will reduce, at least a bit, the spread (e.g. when sneezing), as long as they're not wearing one with a valve.

So, some protection is better than no protection. Consequently, It's difficult for me to understand why discouraging people from using face masks is a good idea.

Use it properly and keep social distancing, while regularly cleaning your hands.

Not the op, however this advise is misguided.

If you're sick but don't know it, your coughing/breathing is spreading the virus.

So everyone wearing a mask prevents the infected, including those that don't know that they're infected, from spreading the disease.

And for those who are not sick, it may offer small protections.

Tiny downside for a large upside.

The mask not only keeps airborne droplets in, or out. It keeps the wearer from touching mouth and nose involuntarily. This helps protect against smear infections!

I noticed this when I was wearing one during a flu infection. My fingers were frequently surprised to touch the mask instead of my face, and I went "oh, right, don't do that!"

This. Despite trying to be continuously concious about touching my face I am sometimes surprised that I absent mindedly do it. And now when I do it I am reminded and I immediately pull out my little bottle of hand gel and lather up.
It's interesting how much different, and even opposing information is floating around. Just the other day I read an article that said masks are bad because you will and need to touch your face more often...

Regardless, most reputable source for advice is probably from WHO, even though my gut feel/logic would tell me otherwise.

The relevant question is not whether droplets can bypass a mask or not.

The specific question that is relevant is, given droplet exposure containing COVID, are there any differences in infection rates for people wearing a mask (use different levels of mask protection for comprehensiveness, from bandana to N95) versus without a mask?

A mask can be only 10-20% effective but still show a clinically relevant result. If you think about the effectiveness of washing your hands to prevent getting sick, it is probably a low reduction but it is still highly recommended.

People do not argue against hand washing just because the virus can still get into your system through other means. They support hand washing despite its imperfections.

> So in general the mask don't help.

Is that proven?

> Secondly the mask only help avoiding spreading the virus from yourself to other and it doesn't protect from receiving the virus

Doesn't this contradict your first statement? In fact the statement contradicts itself, stopping spreading the virus from one person to another by definition protects from receiving the virus.

Not necessarily. If the primary vector is respiration but the reception can be through mucous membranes, then a mask that doesn’t cover the eyes (or doesn’t protect hands which later rub your eyes), then a mask would be more effective on those infected than it would be for those not infected.
As far as I know a mask is more effective to contain when worn by the infected. But that doesn't mean the not-infected (including those who mistakenly think they are not infected!) to not wear one. Because it does protect. Not only from airborne droplets but also from smear infections.

Reducing the likelihood of infection by ten percent can make the difference between eradication and an epidemic.

> Secondly the mask only help avoiding spreading the virus from yourself to other and it doesn't protect from receiving the virus

This is a large contribution for containment. Masks should be worn by anybody at this point.

Avoiding spreading from yourself to others is half the battle though.