[mcsb4]

Again another article that doesn't even mention the use of masks and hand sanitizer.

The cost of the epidemic now goes into the trillions, self-made cotton masks are cheap compared to the economic damage. They can be disinfected in boiling water and if everybody uses them they will help to stop the spreading of the virus.

In all the countries mentioned in the article people wear masks when in public, often just against pollution (i.e. Thailand).

The moment we open our mouth we spread germs, even more so when we speak. And when we touch our nose or mouth, we have them on our hands.

Thus entering a supermarket without a mask and without first disinfecting the hands should be forbidden.

Social distancing is one thing, stopping the virus at the source is another and seemingly very effective measure.

[raaaaraaaa12]

We have face mask mandatory now in Czech Republic, Italy scared us and goverment reacted quickly. Its not over yet but we are on the right track.

https://news.expats.cz/health-medical/breaking-face-covering...

[aneutron]

Can you please attest to the correctness of the news about the Czech government stealing a shipment of masks that was meant to be delivered to Italy [1] ?

If so, is there something the "outsiders" are missing (e.g. some political bs between the two countries) ? Or is it just plain old theft ?

[1]: https://www.reuters.com/article/us-health-coronavirus-czech-...

[raaaaraaaa12]

https://www.radio.cz/en/section/curraffrs/why-chinese-masks-...

Czech authorities during a customs raid last Tuesday mistakenly seized 101,600 facemasks gifted by a branch of the Red Cross in eastern China to a Chinese community in Italy. Although Czech officials apologized for the mix-up, the Italian newspaper La Repubblica on Sunday published a bogus article claiming the Czech state had “stolen” that shipment – and much more.

Czechs would send 110,000 facemasks to Italy on Monday (March 23), dispatched along with an evacuation bus of 43 Italian nationals heading home, as agreed with the Italian Embassy in Prague.

--- My comment is that our goverment officials or those policemans are probably stupid...

[TeMPOraL]

> --- My comment is that our goverment officials or those policemans are probably stupid...

Or they thought "better safe than sorry", given that smugglers aren't stupid and you can't just believe it was sent by Red Cross just because the courier says so.

If anything, I'd ask why La Repubblica published a bogus article.

[hguant]

>If anything, I'd ask why La Repubblica published a bogus article.

Seasons come and go, but click bait is eternal

[krab]

It's not clear how the masks appeared in that storage. It may be well possible the masks were stolen by somebody who wanted to sell them. The company owning the storage didn't comment.

The masks were sent to Italy within a few days.

[rat9988]

Why does he have to? You can do your research on internet nowadays and be just as well informed as him.

[rfrey]

A good faith interpretation of aneutron's comment is that they heard this report on Reuters; saw the author is from the Czech Republic and thought it was a good opportunity to find out about "local news" on the issue to get a different perspective.

Agree it sounded confrontational, but it probably wasn't.

[aneutron]

You are correct. There are generally some "hidden" fact. Like some news outlets try to run the story as something that it isn't. It was not confrontational at all.

[ttoinou]

Not the whole world speaks your language :-)

[Kiro]

How does that work when it's impossible to buy masks anywhere?

[krab]

A lot of people was/is sewing them at home. My wife (data scientist in a normal life) made some for our family incl. grandparents and also for some neighbours. A link from a local "Etsy" [1].

The government even made an exception so the sewing supplies shops could open.

[1]: https://www.fler.cz/zbozi/oboustranna-rouska-11339514

[ceejayoz]

They're making their own.

Sometimes, quite stylishly: https://www.huffpost.com/entry/president-slovakia-coronaviru...

[0x38B]

Wow, that same article says "As a reminder, you don’t need to wear a mask unless you are sick"...

[ardy42]

> "As a reminder, you don’t need to wear a mask unless you are sick"...

But of course, you may not know that you're sick... so wear a mask.

[avmich]

Mask obstructs airflow. After some hours spent without fresh air somebody gets a headache.

Your mileage may vary, of course.

[i_am_proteus]

A t-shirt or bandana or scarf will make an excellent makeshift mask. This is not the equivalent of an N95 mask that should be used by health care professionals, but is good for ordinary citizens in public.

[m4rtink]

Yep, especially as the main purpose of the mask is to protect you from potentially infecting others. Asymptomatic carriers are a huge problem for the coronavirus pandemic - people might be spreading it without knowing and might only get ill much later.

By using even a very rudimentary mask, the infected droplets have it much harder to get out to other people and to contaminate surfaces. Also you are less likely to touch your face, so less hand contamination & thus less surface contamination.

Of course this only works if everyone has a mask, but given how easy it is to make simple cloth masks I think this is a fully reasonable requirement.

[largespoon]

Try aliexepress

[ardy42]

> Try aliexepress

I'd be surprised if that worked at all. At least one Chinese ecommerce website is preventing foreign IPs from even viewing item listings for masks. When you try to view the item from the search results, it gives you an error saying something like export is prohibited.

Also China has pretty much shut down air travel to the country to prevent "imported cases," so air freight capacity from is greatly reduced: https://www.nytimes.com/2020/03/26/world/asia/china-virus-tr...:

> The halt to almost all international passenger flights in and out of China will make it even harder for other countries to import N95 respirators, disposable surgical masks and other personal protection gear from China for their own doctors and nurses. About half the world’s airfreight typically moves in the bellies of passenger aircraft, while the rest travels aboard air freighters.

> Previous, large-scale cancellations of passenger air services to China have already created an acute shortage of air cargo capacity over the past two weeks.

[ceejayoz]

> About half the world’s airfreight typically moves in the bellies of passenger aircraft, while the rest travels aboard air freighters.

Turns out we can just keep those passenger aircraft flying.

https://www.wired.com/story/airlines-use-empty-passenger-jet...

> But Monday afternoon, Delta said it’s putting an unspecified number of passenger jets back in the air, flying out of 13 American airports and to 70 destinations overseas. Delta’s not selling any tickets for those planes, however. Rather, they’ll be operated by Delta’s cargo arm, running charter flights to cater to anyone who needs to move a package or pallet.

[bitexploder]

I ordered a number of masks yesterday from Aliexpress. It works. Shipping is slower than usual, but not crazy.

[Kiro]

Can you really say it works until you've actually received them? What masks did you order by the way?

[hristov]

The problem with use of masks in the US is that we do not have enough masks and we need them all for health care workers. If there aren't enough masks for health care workers, doctors and nurses will stop coming to work people won't be able to get medical attention the death rate will sky rocket because of lack of simple medical procedures, there will be panic in the streets, etc.

For this reason our media seems to be under strict orders to de-emphasize masks and just talk about distancing and hand washing.

It is very regrettable that we have a completely incompetent federal government that did not stock up on masks even though they had plenty of warning but these are the facts. If we ever make enough masks so that all the health care workers are covered, then yes all civilians should wear masks. I am sure then the media will start talking about masks.

[tekkk]

You are confusing "masks" as "surgical masks" aka. N95. He is meaning just the regular masks with no filtering whatsoever, that are very easy to manufacture. Hell you can even make them yourself. The N95 however, are quite difficult to build and require specialized machines to manufacture the filtering part, somebody linked a good article to it a couple days ago.

https://www.npr.org/sections/goatsandsoda/2020/03/16/8149292...

All in all, there is in my opinion no excuse to not to have everyone wear government provided masks, even though they don't offer complete protection. That would make it culturally the norm and hence many of the people who start coughing, but aren't sure do they have the virus, would at least have the mask covering their mouths to catch most of the escaping droplets. And also it would make it a little more difficult for everyone to rub their facial areas with their hands.

[magduf]

Surgical masks don't need to offer complete protection. For one thing, something is better than nothing. But more importantly, the reason people in Asia wear these masks isn't really to protect themselves from getting sick, it's to protect everyone else from getting sick from them. It's a product of a culture that values acting in the interest of the group instead of only in your own selfish self-interest.

So it's sorta like "herd immunity": if everyone is wearing a mask to keep everyone else from catching whatever they might have, it makes it much harder for diseases to spread around and everyone benefits.

[covingkj]

To be clear, surgical masks and N95 masks are different things. Both are in short supply in the US.

[tekkk]

Ahh, yes I was a bit confused on the terminology. So surgical masks are just masks with some filtering capability but without a respirator.

And N95 is a respirator, which is different from mask as it protects the wearer better from airborne particles?

[jmalicki]

This 3M product brochure explains it more clearly than anything else I've seen.

https://multimedia.3m.com/mws/media/1794572O/surgical-n95-vs...

Surgical masks: 1. keep the wearer from infecting the patient 2. keep fluid spray (e.g. bleeding) from getting in the face

N95 respirators are meant to protect the wearer from airborne particles, which surgical masks don't really do at all, since they don't form a seal and air and particles still go around the mask into the mouth. Many N95 masks have an ubobstructed one-way output valve for easier breathing that will not protect the patient from the wearer.

And as it mentions, surgical N95 masks (the blue respirators many medical professionals wear in news photos lately) do both.

* Edit: Another 3M brochure shows that many of their non-N95 masks are also tested for filtration efficiency, even though not certified by NIOSH.

http://multimedia.3m.com/mws/media/312703O/masks-and-respira...

[ValentineC]

> So surgical masks are just masks with some filtering capability but without a respirator.

Surgical masks mainly prevent droplets from entering your nose and mouth, and your breath/sneezes/coughs from affecting others.

[ksec]

And the trillions of loss in economy could have been much lower if everyone wear a mask ( Surgical or not ) and kept business opening. It will also greatly flatten the curve in public health services, while buying time to find a vaccine or improve health services capacity.

There is no reason why Mask's supply problem could not be solved when you are looking at a comparatively speaking trillion of dollars package not to save the economy, but barely holding it up so it doesn't fall.

I am still baffled at the insistence that mask are useless, surgical or not. When there are ample of evidence to suggest it is the best tool to help and stop virus from spreading.

[DanBC]

PPE recommendations are a bit confusing.

WHO currently says that healthcare professionals in non-AGP areas who aren't doing AGP should wear surgical mask, gloves, apron, and do a risk assessment for eye protection. All of that PPE is single use. This is the current practice in English NHS settings. See here: https://twitter.com/OutbreakJake/status/1242020875328684038

If aerosol generating procedures are happening the healthcare professional needs a fit-tested FFP3, gown, gloves, and eye protection. https://twitter.com/OutbreakJake/status/1242233685392396289?...

Surgical masks are fluid resistant, and this is an important part of their protective property. Home made cotton masks tend not to be fluid resistant.

[im3w1l]

If you are in contact with infections substances all day every day you need 99.99999% (I'm pulling this figure outta my ass, but you get the picture) protection. To bring R0 below 1 you need 75% protection. That's why we saw advice like "just wash your hands" - ultimately inadequate, but it wasn't apriori silly.

[bitexploder]

A lot of masks sold retail can’t be used in hospital settings in America. Many hospitals have strict rules about procurement and origination of things like N95 masks. Meanwhile, I can order comparable masks from China and have them in less than a week in quantity. It’s very much cultural as well as government response (why we are sucking so much at controlling this).

[DanBC]

> I can order comparable masks from China

Why would you buy safety critical equipment from China? There are good reasons those hospitals have such strict requirements.

http://www.xinhuanet.com/english/2020-03/12/c_138870714.htm

> A joint law enforcement operation by government agencies including the State Administration for Market Regulation (SAMR) was launched in early February, with over 80 million defective face masks and 370,000 other faulty PPE items seized, SAMR official Yang Hongcan told a press conference Thursday.

https://elpais.com/sociedad/2020-03-25/los-test-rapidos-de-c...

(350,000 tests supposed to have 80% specificity but actually have something like 30%).

[bitexploder]

For our use, faulty KN95 masks are better than nothing. Maybe they suck but it’s better than nothing and probably better than home made masks. You have to shop around and find reputable sellers that have been in business a while to mitigate risks as much as possible. I trust Aliexpress slightly less than Amazon these days which says a lot. Amazon used to have my unquestioning trust. Now I barely use them in favor of other retailers.

[Karrot_Kream]

Are they? It's unclear whether KN95 masks are better than a piece of fitted fabric around your mouth and nose. That's the trouble with masks; we don't know what works and what doesn't.

[bitexploder]

I wi work on the assumption that it is at least as good with a probability to be better. We know how this virus is transmitted and what is needed to filter it, it’s just a particle. We have strong evidence from the healthcare community that these masks keep workers COVID-19 free. They definitely work on other viruses of a similar size...

[ceejayoz]

> Why would you buy safety critical equipment from China?

Hospitals have done this for decades.

[magduf]

>Why would you buy safety critical equipment from China?

1) Because that's where it's made

2) Because they're obviously a lot more competent at public health than we are. We don't know WTF we are doing.

[markbnj]

> If there aren't enough masks for health care workers, doctors and nurses will stop coming to work people won't be able to get medical attention the death rate will sky rocket because of lack of simple medical procedures, there will be panic in the streets, etc.

No, for the most part they won't stop coming to work, for better or worse. My wife is an RN in charge of a critical unit caring for confirmed covid-19 patients. They were asked to reuse masks and gowns a week ago due to lack of supply. As far as I know none of them has refused to go to work, and she in particular will be on 4 12-hour shifts this week.

[kstenerud]

If you look at the data here [1] (desktop edition because the mobile edition doesn't have drill down), you can see that all countries (including Asian) are following the same pattern in the "daily increase" graph (click a country on the left to see its data). The only outliers are China and South Korea (flatline), and Japan (flattened curve).

So while masks may have some effect, it hasn't been enough to give different graphs to Asian nations in general.

[1] https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594...

[Bartweiss]

Wait, which countries are we referencing outside of those three?

Thailand looks straightforwardly exponential so far and has fairly heavy mask use, agreed. But Singapore, Taiwan, and arguably Malaysia seem too early to call: they're still plausibly on either of a European curve or South Korea's ramp-then-flatline.

Vietnam, Cambodia, Laos, Mongolia, and Burma all seem to be below the line for meaningful data. And Hong Kong isn't broken out. So I guess my questions are: do Indonesia and the Philipines have "mask cultures" to a level comparable to South Korea and Japan, and are their testing regimes wide enough to rely on those curves?

I don't know the answer to that. And I agree that the "masks work" graph/meme circulating is questionable. But unless I'm missing something/somewhere, this data just looks like "too soon to call"?

[mcsb4]

Did you read the NPR article? The very first chart shows that there is a big difference between the various countries. The logarithmic scale allows for much better visualisation than the almost nonsensical charts on the John Hopkins statistics page. The circles are also a completely inadequate visualisation. I.e. much better would be coloring countries by incident rate per 100.000 inhabitants.

They do a good job collecting all the data but a seriously bad job visualising them.

[rjzzleep]

Yeah, except you happily disregard the fact that a lot of asian countries including china have reimported cases mostly from Europe and the US. I'm pretty curious how this plays out in those countries.

[ValentineC]

> In all the countries mentioned in the article people wear masks when in public, often just against pollution (i.e. Thailand).

Singapore resident here. Not enough people are wearing masks in Singapore, and the government has only distributed a token 4 masks per household (family members living at the same address), with no further measures to allow a family to replenish their mask supply.

A lot of us can't buy new ones at reasonable prices even if we want to.

[Roritharr]

German resident here, our chief virologist that everyone listens to, Christian Drosten, was firmly against mask usage in the common population, until just now, the RKI was similarly unhelpful when communicating advice for the disease.

The population is completely confused and feel righteous anger now telling people off when they wear professional (medical disposable, or ffp3/n95) masks to go shopping or elsewhere. It's insane.

[danmaz74]

I don't know about that expert, but the reason I usually hear about not using masks is so that health professionals could get them - ie, the problem is that supply isn't currently enough for everybody, and we should prioritise those for which it's most helpful.

[ceejayoz]

The problem with using "masks don't work!" to keep the supply available for healthcare is later on, when supply is available for universal mask wearing, they'll have eroded public trust when they do the 180 on the advice.

They should've instead:

* Banned sales of masks to the public until healthcare and other essential workers had enough stock.

* Honestly conveyed the reasons for the above ban, in WWII-style "do your part" advertisements etc.

* Encouraged homemade cloth masks, bandannas, etc. to reduce the spread of droplets.

* Ramped up surgical mask production to get supply to the general public as soon as possible.

[cmurf]

a) implies competency b) where's the profit? U.S. is a country where solidly 1/3, with enough political capital to prevent alternatives, believe that healthcare is a product not a right

(another 1/3 don't care because the system doesn't affect them, until it does)

[a_tractor]

>where solidly 1/3... believe that healthcare is a product not a right

And I guess the opposing 1/3 just don't understand the difference between positive and negative rights?

Healthcare, as a matter of fact, does represent a collection of products and services, and access to those products and services represent a positive right because it requires somebody else to provide something for you.

It is only negative rights, those which define what other people can not do to you, that should be considered inalienable. The right to free spreech doesn't require somebody else to go to school for 20 years so that you can express yourself, they just aren't allowed to prevent you from doing so.

Intentionally or not, people like you confuse the issue by treating both positive and negative rights as the same, and actually do not seem to understand, or are avoiding acknowledgment of the fact, that treating a positive right as some kind of natural right carries the high potential that you will be demanding access to another human being's labor or resources against their will, and in America, 1/3 of use are against the enslavement of others.

[Roritharr]

That makes total sense, but the communication discouraged people from wearing any kind of mask, even self-made ones.

[rkachowski]

This is one message that has me really confused. Why are masks being sold to the general public if this is the case? It's as if manufacturers and suppliers are helpless but to profit from public demand and the fault is a personal moral failure on behalf of everyone that wants to buy a mask for their own use. How can medical supplies be interrupted by public usage? Are doctors expected to swing past a pharmacy on the way to work and stock up on the supplies they need?

And then in many Asian cultures it's considered a moral failure to not wear a mask in these times, yet hospitals function. This problem clearly isn't universal, or inherent in capitalist functioning.

[marnett]

At least in the US the main reason is the public hysteria that would be brought on by the mass cultural shift. The reality is most households in the US do not have masks. There would be similar chaos that the US has seen with toilet paper but on a more dire scale because they DO actually help and, unlike toilet paper, when they are gone they WON'T be replenished in a timely manner because there is a shortage of retail masks.

It's propaganda. It is reasonable propaganda as having to have actual PSAs on how to sew your own masks or make them out of materials at home would really start ramping up the general anxiety.

[bitexploder]

Thank you. This is extremely frustrating and shaming individuals who buy masks is dumb. Why are they in the retail system at all if they are so important for healthcare workers?

[PeterStuer]

It is saddening to see the experts also succumb to straight lying to the public. I'm sure they think this is 'for the best', because there aren't enough masks to go round and what there is needs to go to first line healthcare workers.

But trust is hard to gain and easily lost. A real compounding factor in this crisis is also that our leaders have lost all credibility. In many, if not most, countries, the citizens just know that actions that were and are being taking are neither competent nor in their best interest. The specific implementations of democracy we implemented never selected for reason, precaution nor long term benefits or well-being for all.

So most of us have a political 'leadership' (and I do not mean a specific country or party, it's mostly across the board, with few exceptions) that has lost all credibility, trust and moral authority long before this happened, leaving the population already at best confused, but mostly mistrusting and (justifiably) cynical.

For scientists to go 'on message', telling obvious non-truths, just further undermines the already shaky ground they were on after decades of anti-science propaganda.

I really, really hoped they would refrain from this, but, judging by what is happening in my own country and what the science community is publicly communicating (privately it is a completely opposite discourse), I sadly must say that the opposite is true.

[kijin]

To add a bit more data to your assertion, most of the 9,000 cases in South Korea can be traced to a handful of gatherings where people didn't wear masks.

First there was the cult in Daegu, where believers are not allowed to cover their faces because apparently their god can't see through fabric. Mass infections also occurred in churches where people took off their masks to eat or sing together, or tried to "sanitize" one another's mouths with a folk remedy. A gym in Cheonan was responsible for the majority of cases in that province, and recently there was a small burst of cases in an insurance company call center in Seoul.

Meanwhile, the subway in Seoul is just as packed with people as always, but I haven't heard of a single case that was conclusively traced to the subway. Why? Everyone wears a mask when riding the subway and sanitize their hands afterward.

Masks have been so effective that the Korean government has even stopped publishing locations that were visited by infected people if they are known to have worn a mask while visiting them. Yes, they still track down each and every case outside of the Daegu area.

[casperc]

Any chance you have some sources on this? There a lot of talking around the subject of masks, but I don't have any articles or similar to show people when discussing this.

[kijin]

The bit about masks is my own conclusion based on a lot of different local sources.

The closest thing to a comprehensive source about the distribution of infections in South Korea that I can find is [1], which still contains too much Korean-in-a-canvas that can't be automatically translated:

54.6% of cases are related to the Shincheonji cult

0.5+0.7+0.5% various other churches and religious groups

1.3% Daenam Hospital (almost all cases occurred in the psychiatric ward, as well as the attached funeral home where the Shincheonji cult leader held his brother's funeral)

1.2% related to gyms

1.2% related to the call center in Guro-gu

3.6% nursing homes

6.3% related to other mass infections (this includes other call centers, nursing homes, etc.)

11.3% contact with people infected from one of the other sources

3.3+0.6% infected overseas

14.9% other/unknown

Of course this doesn't say anything about masks. But you can clearly see that unlike in many other countries, ~70% of cases in Korea are concentrated in a handful of clearly delineated groups, with relatively little spillover into the general public. It takes a bit of familiarity with the religious landscape of Korea and the workplace culture to recognize that most of these groups are where people don't wear a mask. (As for nursing homes, the elderly often have difficulty breathing through a mask, not to mention they're together 24/7.)

Some people still got infected while wearing a mask, though, so it's not bulletproof. But it seems that the effect becomes visible as a kind of herd immunity when aggregated over a large population.

As for the government not publishing locations visited with a mask on, here's an example from my city's official Instagram account [2]. It says that the infected person's movements on some days are redacted because she wore a mask on those days (among other precautions) and therefore didn't make any epidemiologically significant contact with other people. You can compare this with other press releases by the same account that contain a lot more location data for other people.

[1] https://coronaboard.kr/en/#source-card-slide

[2] https://www.instagram.com/p/B-Iy3G7lTQs/

[Yizahi]

I use self made cotton mask to go for groceries. It's garbage - it doesn't fit tightly around the face and most of the air I inhale or exhale goes through the sides unobstructed. Proper masks would be nice but unavailable everywhere and of course washing hands is a must.

[TheAdamAndChe]

It's not about protecting you from other people, it's about protecting other people from you. Many people are asymptomatic or very mildly sick, yet are able to infect other people. When you cough or wipe your nose, you risk infecting other people. The cheap mask prevents you from touching your face as much and catches heavier particles that can't curve around the bends of the facemask as easily like water and mucus.

[claudeganon]

No, it actually does protect you, just not as effectively as N-95s. That’s why hospitals are seeking out donations of homemade masks right now.

“The masks don’t do anything” story was just something floated around to prevent runs on hospital supplies. A better strategy would’ve have been to say “everyone make and wear your own masks and it will afford us some additional amount of protection.”

[slantyyz]

Dr Michael Lin, the author of that PDF on COVID that was posted here a while ago had this to say:

"A T-shirt is 79% as effective as a surgical mask. So if someone is coughing next to you and you can't escape, breathe through your shirt sleeve. Any filtration is better than none."

[1] https://twitter.com/michaelzlin/status/1241052444798279680

[Symmetry]

I wouldn't rush to assume that it was part of a deliberate deception. People assume the function of an item from its intended use all the time and surgical masks genuinely don't provide that much protection from some viruses like measles or chicken pox. I think it's just a case that "they don't protect you" being the unexamined received wisdom and people just not bothering to look at actual studies.

[claudeganon]

I wish this was true, but I saw this claim made by more than one public-facing scientist that I’m certain knows better. If we had started adopting mass mask wearing, we could have helped reduce the spread and had people geared up to make masks for frontline healthcare workers.

[downerending]

One perhaps underappreciated benefit of even a "garbage" mask is that it's a great reminder not to touch your face. That might turn out to be important.

[leguminous]

The doctors in my fiancée's department (ophthalmology and optometry at a major state university) have been officially prohibited from wearing masks, even if they provided a mask themselves. They are right in front of all of their patients' faces.

[DanBC]

I'm not defending that, but here's recommendations for preserving PPE: http://www.ihi.org/communities/blogs/covid-pandemic-conservi...

> Other potential considerations being explored include:

> Limiting use of N95 masks to only procedures where respiratory secretions can be aerosolized, including intubation for PUI or COVID+ individuals. Use loop surgical masks for all other encounters. Read the latest guidelines on keeping the coronavirus from infecting health care workers.

> Limiting use of loop masks to only encounters with patients on droplet precautions such as PUI or COVID+ or other flu like illness investigations.

It sounds like their department has implemented this second recommendation. I feel like that's sub-optimal.

[pragmatic]

Why?

Wondering what the reasoning is for this?

Family member works in a similar dept at large hospital and they have stopped seeing patients.

[ls612]

Jealousy. Can’t have some people seen having masks when others can’t get them.

[SuoDuanDao]

It looks to me like a bit of an indication who has the most social capital. China was late to the party because the local chief of police overrode the doctors during the early days of the crisis.

The rejection of masks looks to me like a similar prioritization of law enforcement's preferences over public health.

[dirtyid]

This. Asian countries that have ostensibly contained it well has wearing masks in common (except Singapore but it's still at 20%). Their other responses vary in scope and strictness. That said, most of them are islands or small countries.

But then you have Vietnam, also pervasive mask usage. Shares landborder with China which is leaky at best. They were also very proactive like the other countries but have a fraction of the resources. I don't think it's an answer for containment, many that cracked down early are seeing record case levels now, but I wonder if it's enough to reduce spread and severity.

But the rationale that made sense to me is that covid19 spread via respiratory particles, and mask reduce the viral load over time, which reduces risk of infection and severity since your body will have more time to recognize the infection and ramp up antibody production much earlier in the virus’s exponential growth cycle. Reduces R0 when ubiquitous. Maybe it spreads the curve and crushes it at the same time by reducing severe cases.

Seems like a cheap experiment short experiment to run honestly. Give one group of essential workers masks vs control. Test in 7 days and collage symptom severeness etc. Giving everyone surgical or home made masks is cheaper and less damaging than what's happening now. The HK SARS tsar who was also part of the Wuhan investigation team endorse public mask usage.

[checker659]

Exactly. Masks are like dampeners. Even if not everyone's masks are good (cloth masks), they'll still slow the spread, hence significantly fattening the curve.

Advising people to not wear mask is the biggest disservice the American government (and the CDC) did to its people. Just asking people to cover their mouths with bandanas and scarfs would've helped a lot.

I shudder when I see reporters in a breakout zone reporting without masks on. Man.

[koonsolo]

Sure, but it needs to be a 'proper' mask.

Yesterday I was in a shop and saw 2 different people with a scarf over their mouth. You would think this is no problem, but they both had to keep this scarf up with their hands... . Seems like the most effective way to spread and receive germs.

Govermnent needs to be clear what the protocol is.

[Donald]

Even cloth filters out 70% of respiratory virus particles. The notion that only a properly fitted N95 mask is effective is ridiculous and is probably costing lives.

[checker659]

This. Also, nobody ever talks about double masking. You know, if you've got no N95, then put on two surgical masks (each facing the other way). If you don't have surgical marks, wear two cloth masks and wash them with antiseptic solution daily.

[koonsolo]

Sure, but if you inhale 30% of that from your hand into your mouth, and exhale 30% to your hand, it loses more than just not touching your face.

[bagacrap]

sure, but this seems like a minor quibble. Much cheaper for govt to manufacture and distribute simple surgical or cotton masks than shutdown entire GDP/forgo all tax revenue. The masks in question are not complicated to produce, whereas respirators and n95 are.

[LZ_Khan]

I genuinely wonder if the use of masks is the biggest factor in stopping the transmission. When I went to Asia mask wearing was common everyday as a protection against transmission/pollution. It was almost even a fashion item. But here in the US, when the outbreak happened and I went grocery shopping with a mask I was stared at and given fearful looks as if I had the virus already.

[yboya]

Many more people would use masks and gloves if they were available for purchase. This could never be implemented in the US unless the government was supplying everyone with masks. At this point it’s almost criminal to buy masks for yourself when health workers don’t have access to enough of them.

[didgeoridoo]

But I was assured by the media that masks are useless, and that hand sanitizer is only for bacteria...?

[Spoppys]

Cloth masks may be counter productive

https://dx.doi.org/10.1136%2Fbmjopen-2014-006577

[svara]

This paper is being misinterpreted everywhere in this very misleading fashion. See this blog post Raina MacIntyre (the first author) wrote to clarify this: https://iser.med.unsw.edu.au/blog/impact-ppe-shortages-healt...

People misrepresenting this study are doing tremendous harm, it has to stop.

[wtdo]

That is not what that study says. Yes, cloth masks are not as effective as medical masks. But the study does not compare cloth masks with no masks. The three groups in the study are:

> medical masks, cloth masks or a control group (usual practice, which included mask wearing).

Yes, the cloth mask group had more infections than the medical mask group and the control group. But the control group included wearing masks as usual. It does NOT say cloth masks are less effective than nothing. "No mask" was not studied. Cloth masks might be less effective than wearing no mask (I personally doubt that), but this study didn't say anything about that hypothesis.

[supdatecron]

There was a study that showed cotton masks can actually be worse. A medical person showed me the other day, I’ll have to ask for the link

[geerlingguy]

This is the only definitive study I've seen, and it recommends cotton masks: https://www.cambridge.org/core/services/aop-cambridge-core/c...

[svara]

Probably the MacIntyre et al. paper. It's being misinterpreted everywhere in this very misleading fashion. See this blog MacIntyre wrote to clarify this: https://iser.med.unsw.edu.au/blog/impact-ppe-shortages-healt...

People misrepresenting this study are doing tremendous harm, it has to stop.

[supdatecron]

Thank you for sharing this updated clarification. I just shared it with that medical professional who showed me the original. Hoping to spread this clarification

[Maximus9000]

There is also a study that shows many studies findings cannot be reproduced: https://en.wikipedia.org/wiki/Replication_crisis

From where I stand, the countries that have a culture of wearing masks are doing better with regards to coronavirus. At the very least, it seems like a good hypothesis.

[zorak]

I'm reminded of Naseem Taleb's statement that when you measure a table with a ruler, you are also measuring the ruler with the table.

[throwaway_pdp09]

I've read repeatedly (and heard on the radio several times) that wearing a mask if YOU are infected will help protect other people, but if you are not infected then it has no known protective effect ie. is not thought to be any more protective than not wearing one.

Do you have any evidence to back up you talk of masks?

(And if YOU are infected you should not be out anyway)

Edit: I was thinking of non-medical situations. @j7ake below, clearly pointed out they work in medical situations, something I was not contesting at all but did not make clear. The original post talked of "wearing masks in public" which was clearly not in medical situations and I was following through that.

[cyphar]

This was a coordinated (dare I say "propaganda") campaign by US and other government officials in order to try to avoid mask shortages[1]. A noble goal, sure -- but the net result is that people are now misinformed about the efficacy of masks.

The evidence very much shows that wearing masks can reduce community transmission rates of SARS-like viruses -- up to 70% even with just plain surgical masks[2]. And even if you don't buy that, everyone wearing a mask means that asymptomatic carriers (who have no idea they're sick) cannot spread it as effectively.

[1]: https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-... [2]: https://medium.com/@adrien.burch/whats-the-evidence-on-face-...

[h91wka]

> This was a coordinated (dare I say "propaganda") campaign by US and other government officials in order to try to avoid mask shortages[1]. A noble goal, sure -- but the net result is that people are now misinformed about the efficacy of masks.

There's nothing noble about it. This is extremely short-sighted. What is easier to solve, shortage of masks, or shortage of ICU beds and medical personnel?

I would imagine that a face mask is a relatively low-tech good that can be mass-produced at scale. You cannot ramp up production of ICU beds and nurses and doctors. If this is true, then the consequences of this "noble" decision will make Chernobyl blush.

[cyphar]

Avoiding mask shortages is a noble goal (note that you're agreeing with me here -- mass-producing masks would also have avoided shortages). Whether or not the method employed was ethical or not is a separate question (and I agree with you that it was not because of how short-sighted it was).

[h91wka]

> note that you're agreeing with me here

I am not. My point is that solving the problem of mask shortage by allowing the infection to spread at full speed is like setting your home on fire to deal with a clogged pipe.

[catalogia]

To say that somebody had a "noble goal" is to state that their intentions were good, not malicious. That is not the same as being correct. You are pointing out that they were shortsighted fools who did more damage than good, which I agree with, but that's not incompatible with having good intentions.

The road to hell is paved with good intentions.

[KarlKemp]

Scott Alexander has a good post on this, and he convinced me of a “good faith” explanation for the recommendations against (or, more accurately, “not in favor of”) face masks: https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...

[nullc]

His explanation does not explain statements like https://twitter.com/Surgeon_General/status/12337257852839321...

[cyphar]

I hadn't seen that post before, and it does seem quite reasonable -- but I don't think it really vindicates the advice (nee propaganda) from government officials, unless there was no other way to alleviate shortages. The conclusion is effectively "we don't know for sure, but they do appear to help somewhat" -- which means that (all other things being equal) not recommending masks appears to be a net negative.

[throwaway_pdp09]

Finally someone posted something factual. Thanks! Reading now.

[nopinsight]

You do NOT know if you are infected. Asymptomatic carriers is a major problem for COVID-19. A figure I saw was about 50% of infections come from them.

Here's evidence and list of 34 science papers backing up the utility of masks in slowing down a viral epidemic:

Thread with charts, articles, link to paper summaries: https://twitter.com/jeremyphoward/status/1242894378441506816

ADDED: Just the list of papers & their brief summaries: https://docs.google.com/document/d/1HLrm0pqBN_5bdyysOeoOBX4p...

[throwaway_pdp09]

Could you post the list here for us who can't use twitter (permanently disabled JS).

[llarsson]

Then your browser does a shitty job of telling Twitter that. Properly blocked JS gives you a link to "legacy" Twitter, which works perfectly without JS. At least viewing, which is all I do.

Does this link work for you?

https://mobile.twitter.com/jeremyphoward/status/124289437844...

[throwaway_pdp09]

I've never been able to use it. I get sent to a "do you want to use legacy twitter?" thing, I click Yes and it just gives me the same screen again, every time.

Happens I proxy through squid - it might have something to do with that. If I go direct (no proxy) it works. Interesting.

At least I can get to it, and will read your link this evening. Thank you.

[llarsson]

Until I started blocking JS using uBlock Origin, my blocking must have been incomplete. Because I also saw that screen and it never worked. Now, it does.

[j7ake]

This advice is completely contrary to anything that happens inside a hospital. Nurses and doctors are wearing surgical masks (and N95 masks plus face shield if performing actions that may generate aerosols) to protect themselves from getting sick while treating patients.

The problem is that you can have COVID19 and be contagious without showing symptoms. Mandating everybody to wear some sort of mask should reduce transmissions because it should reduce the viral load in the air. By how much? It is not clear, but it's not worth waiting for results from a randomized double blind clinical trial during a global pandemic. I would put money that the effect of putting on a mask will be at least as effective as washing hands.

The danger to be careful of is if wearing mask can make you more sick, but the current actions from healthcare workers around the world suggests it is not the case.

Another point some people argue is that wearing a mask in public means one less mask for health care workers. This is false on two fronts, one because mask supplies will soon flood the market and there are DIY solutions to masks that can reduce transmissibility; two because what's best for health care workers is not to get sick at all.

[foobarian]

I am hopeful that the US public may warm up to masks in public in the future. It seems likely this would cut down on the spread of seasonal flu and common colds.

[raaaaraaaa12]

Yes that's right even your own DIY face mask protect other people. And that's enough to slow down spreading...

You dont know for first ~5-6 days whether you are infected or not.

https://www.businessinsider.com/people-are-making-diy-face-m...

Don't worry too much about effectiveness of DIY face masks - in few months Respilon and other Czech companies will put on market face masks made from nanomaterials which filters virus much more effectively ;)

[throwaway_pdp09]

Valid rebuttal, thanks.

OK, I think that the mask over your own face is to prevent viral spread in largish water particles caused by coughs and sneezes, not general breathing (I'm not sure general breathing spreads much virus anyway, but I don't know).

So if you are infected and not showing symptoms ie. not coughing/sneezing then arguably the mask is not doing anything.

Arguably not, but we need more data - can anyone comment with sources?

[mcsb4]

> So if you are infected and not showing symptoms ie. not coughing/sneezing then arguably the mask is not doing anything.

It prevents you from touching your mouth and your nose and thus getting it on your hands.

There is an excellent video visualising the spreading of germs:

https://www.youtube.com/watch?v=I5-dI74zxPg

How To See Germs Spread (Coronavirus) by Marc Tober

Maybe that convinces you.

[raaaaraaaa12]

Even if you are breathing calmly mask will catch some small water droplets so spreading is somehow contained. It's true that after ~1 hour wowen mask will become wet and no longer effective. But it's not problem wear some other masks in your bag and change it... Currently there's huge shortage of respiratory protection products globally so your old wowen tshirt will help you :)

[Lewton]

> not coughing/sneezing then arguably the mask is not doing anything.

People cough and sneeze all the time even if they're not sick.....

[haunter]

> wearing a mask if YOU are infected will help protect other people

How do I know I'm not infected? There are a lot of asymptomatic carriers, that's the main problem.

A lot of people still think that no symptomps = not infected = no mask needed but that's totally wrong

[mantas]

Wearing mask discourages you from touching your face with your hands.

If someone sneezes at you, even most simple mask will stop at least 50% of viruses. If someone was far away and only a small load reached you, that may be enough to keep you safe.

> (And if YOU are infected you should not be out anyway)

The big problem is to know when you're infected. Mask keeps others safe if you're not aware that you're infected.

Some reports say that you start distributing viruses pretty much immediately after getting it yourself. Even if all contacts (which is far from guaranteed) get traced and you get checked and/or isolated in a day or two, you'd be already spreading viruses for that timeframe.

[throwaway_pdp09]

> Wearing mask discourages you from touching your face with your hands

Good point!

> If someone sneezes at you, even most simple mask will stop at least 50% of viruses

sounds plausible, but any reference for that figure?

[mantas]

That's what is posted in our local media. I'm not sure if it comes from local gov agencies or WHO or something else.

FFP2 / N95 respirators - 90-something percent, medical "blue" masks - 80 percent, home-made piece-of-cloth style ~ 50%.

Wearing sunglasses is encouraged too. Both to stop the load if someone sneezes at you and discourage from touching your eyes.

[brutt]

N95 - 95% at least.

Medical mask - 96,4%.

Home made mask - 60-96% (depends on cloth and sewing).

https://www.researchgate.net/publication/258525804_Testing_t...

[mantas]

Maybe you and I have different medical masks in mind? I was talking about masks like this:

https://cdn.shopify.com/s/files/1/0080/6830/0851/products/6_...

https://www.123rf.com/photo_138981777_stock-vector-person-we...

https://phonetub.com/products/100-disposable-face-surgical-m...

The main problem with blue masks and home made is that they tend to get wet from breath and their effectiveness go down the drain.

[endorphone]

"no known protective effect"

Right. No one has ever studied contagions among the community at large and the effect of masks. When you hear people say there is no evidence, this is what they are referring.

"is not thought to be any more protective than not wearing one"

This is taking that claim too far, and is seldom what they're saying. Or rather never what they are saying.

Early on there were PDAs that discouraged masks because a) there is a weird social effect in much of the West where people get panicky, and somehow view someone else wearing a mask as increasing the odds, or at least the reality, that they instead will get sick, b) to discourage personal buyers competing with medical buyers, c) because the odds of coming into contact with a SARS-CoV-2 carrier was very low, whereas it's high to very high for medical professionals.

We need to discard with that bullshit. We know with overwhelming evidence that masks work -- that's why medical professionals wear them -- and even the lowly surgical mask has the same effectiveness blocking pathogens in as they do out, especially aerosol pathogens like this one.

And of course we know that people can be spreading this without symptoms, so it would be a massive win just for that.

As supplies normalize and manufacturers ramp up, we're quickly going to be at a place where most in the West will be wearing a mask of some fashion, and it will be officially encouraged. This whole weird anti-mask paranoia will have cost lives.

Masks aren't a panacea, of course, They should be properly worn and rotated. Add that they increase the effort the lungs have to exert, especially N95 masks, so in a unfortunate irony people with compromised lungs -- the most vulnerable to COVID-19 -- have the most difficulty using masks.

[throwaway743]

>a) there is a weird social effect in much of the West where people get panicky, and somehow view someone else wearing a mask as increasing the odds, or at least the reality, that they instead will get sick

Definitely experienced the stigma of wearing one in public. Have had reactions ranging from stares to hurriedly moving away from me.

> We need to discard with that bullshit. We know with overwhelming evidence that masks work

To add, why else would NY ask older folks to wear masks when going outside?

Also, this NIH study adds to support that masks are effective.

https://news.ycombinator.com/item?id=22485453

[endorphone]

"Definitely experienced the stigma of wearing one in public"

People can be deeply illogical when it comes to personal protection. I did a summer stint during college with a factory, assembling some part of an air conditioner system for cars. This was done with huge, incredibly loud machines. Fiberglass. Etc.

The company offered ear plugs, eye protection and masks. No one used them. There was a 0% utilization rate. It was bizarre. I did, however, and earned snarky comments, critical suggestions, and lots of sideways glances. People really seemed to feel that my concern for myself made the threats more real.

I'd like to say that when I left everyone had followed the path I blazed, but it was the same as it always was. People still sabotaged their own health and hearing to avoid looking "paranoid".

[magduf]

Where was this?

I used to work as an intern at a shipbuilding company making aircraft carriers. People wore stuff when they were required to, so hard hats were always worn, and the attached earmuffs seemed to be generally worn when someone was working with something very loud.

However, at one point I was helping an inspection in a tank and there was a noxious odor, and I couldn't breathe in it. The shipyard worker with me went ahead and went in and did the test, but after this I tried to procure a respirator and they refused to get me one, saying it wasn't necessary for the work I was doing.

Music concerts are another place where you don't see people using personal protection much, though I will say that's changed in the last 10 years from what I've seen. I do see a minority (but a growing one) of people wearing earplugs, and we now have a lot of choices for "musician's earplugs" being sold which are designed to have a neutral frequency attenuation.

[throwaway_pdp09]

A quick scan and search does not use the word 'mask' or 'protection' anywhere I can see.

> why else would NY ask older folks to wear masks when going outside?

I don't know. Is there any evidence that significant proportion of experts are recommending this practice, and why BECAUSE THAT'S WHAT I'M ASKING FOR.

[nullc]

> Right. No one has ever studied contagions among the community at large and the effect of masks.

It's been studied. There has not been a randomized controlled trial because performing one would be extremely unethical.

There is plenty of study evidence to support their use, just nothing meeting the gold standard of a RCT and there never will be one against a true live fire contagious disease.

The irony with all this is that the US administration really want to get people back to work as soon as possible. Massive deployment and mandatory usage would be the safest way to do that the soonest.

Too bad they already foreclosed that option by materially misleading the public.

[cyphar]

> Right. No one has ever studied contagions among the community at large and the effect of masks. When you hear people say there is no evidence, this is what they are referring.

Actually, they have[1,2]. According to one study, surgical masks helped cut down the community spread of SARS in Beijing by 70%[3]:

> Always wearing a mask when going out was associated with a 70% reduction in risk compared with never wearing a mask.

But if you're specifically referring to randomised trials on mask efficacy during an on-going pandemic, you're right that there are no such studies -- because it would be unethical. So effectively all of the relevant studies are retrospective (which does introduce recall bias), but these are basically the best studies we can do ethically.

[1]: https://medium.com/better-humans/whats-the-evidence-on-face-... [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993921/ [3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322931/

[throwaway_pdp09]

> that's why medical professionals wear them

Of course we know it works for them, because in your own words "coming into contact with a SARS-CoV-2 carrier was low, whereas it's high for medical professionals"

> We know with overwhelming evidence that masks work

Yes they do, for medical professionals. I'm referring to non-medical situations, and I guess I didn't make that clear. I'm trying to understand why... well, I explained in my first post. I'm not looking for opinions but for actual solid evidence. Which someone (not you) actually provided.

[endorphone]

We don't work for you. Your various snotty replies aren't useful.

"Of course we know it works for them"

How does this anti-logic make any sense? Do you think the masks have a sensor that turns off the "works" bit if it's on the face of a medical professional or not?

This is bit like demanding to see research that gravity has an impact on alpacas. We know fundamentally how gravity has an effect on mass, so it follows. Just as we know the fundamental filtering ability, and contagion spread limiting, of masks, including even surgical masks. We know that the CDC is telling health workers that don't have masks to even use a bandana wrap, as not only does it stop face contact it has some limited utility in stopping the tiny droplets of liquid that are one of SARS-CoV-2's vectors.

[mcsb4]

Many people don't know they are infected and also there is not enough testing capability in many countries. For example Heidi Klum tired to get tested after catching a cold and it took her several days to be accepted for a test. Now she is not exactly your average Joe and would be willing to shell out a few 1000 dollars to get tested.

Unless that situation changes, masks are a good alternative. And yes, only if everybody wears them.

[mikemotherwell]

Let's assume healthy people do not need a mask. In fact, let's take it as Gospel, and the statement "Healthy people have no use for a mask" as absolutely true.

Given we know there are people with COVID-19 who are asymptomatic, any "Healthy people have no use for a mask" can simultaneously be true, and be practically irrelevant, as any definition of "healthy people" is necessarily impossible to prove. You simply can not know you are free of Corona Virus, short of having recovered from the virus.

If the standard was EVERYONE wears a mask, asymptomatic people would be a non-issue. Any advice contrary to the 100% mask usage argument has to explain how we deal with asymptomatic people. Short of testing everyone all the time, what would that even be?

TL;DR In a world with asymptomatic COVID-19 people, a 100% mask policy seems the sane default position.

[throwaway_pdp09]

Then WHY ARE SO MANY EXPERTS TELLING US WHAT I QUOTED?

What you say (and others too) makes sense to me and I could well believe it true, but I'm NOT claiming that masks are useless unless you are infected, I'M ASKING IF ANYBODY KNOWS WHY EXPERTS ARE SAYING OTHERWISE (or whether I just heard an unluckily skewed sample)

Plus, I also asked for a citation to back up the poster's position, not common-sense arguments (which are a good starting point but not evidence in themselves).

[j7ake]

Which experts are saying masks are not effective? From what I read the experts (curiously from countries that did not prepare enough masks for their hospitals) say it is not recommended for the general public to wear a mask. They definitely still recommend nurses, doctors, and sick people to wear one. But they never explicitly say that masks do not reduce transmission. They may have said "there is little evidence to suggest..." which is not the same as masks do not reduce transmission.

The official position for many countries that are containing the virus suggests wearing a mask when out in public. One notable exception is Singapore.

Here is the Korean society of infection FAQ that says wearing a mask can reduce transmission:

https://translate.google.com/translate?sl=ko&tl=en&u=http%3A...

[throwaway_pdp09]

Thanks, I've updated my original post.

[mikemotherwell]

Masks may be 100% irrelevant for healthy people, but we have asymptomatic people. There is no way to ascertain who is healthy, ergo "healthy people don't need masks" is practically redundant. What am I missing?

Oh, and you want citations, sorry, my bad:

https://docs.google.com/document/d/1HLrm0pqBN_5bdyysOeoOBX4p... - 30 some citations on masks.

[throwaway_pdp09]

> What am I missing?

See my reply https://news.ycombinator.com/item?id=22701821 Mind, I just don't know if what I'm saying there holds water.

Citations are good, following up!

[SuoDuanDao]

I imagine to prevent mask shortages and to make law enforcement easier.

[RedBeetDeadpool]

So I was in agreement with this, and the science is that yes it only helps in containing the infection if the person infected is wearing the mask.

However, if healthy people aren't wearing the masks, and only the unhealthy are, then the unhealthy don't want to signal they are unhealthy so they don't either. A huge part of getting the infected to wear masks is to get the healthy to wear masks so the infected don't put a huge label on themselves that indicates: "diseased", "corrupted", "infectious", "frail", "unclean" etc.

Logic says one thing, but people are not logical like machines.

[Lewton]

Seriously. How is it possible to still be ignorant about the (up to) 2 week asymptomatic incubation period? This is the entire reason why the virus is so dangerous!

And where did OP mention anything about masks protecting the carrier from infection?

[throwaway_pdp09]

See my other reply. Plus I said "And if YOU are infected you should not be out anyway"

[ceejayoz]

> Plus I said "And if YOU are infected you should not be out anyway"

The point you're missing there is that some people are asymptomatic. They don't know they're infected.

[throwaway743]

https://news.ycombinator.com/item?id=22485453

[nikbackm]

You might not know that you are infected.