I sent them a link to the CDC guidance[1] that includes this picture regarding facial hair styles that are ok[2].
I don't think the notice at the top of said article is helpful whatsoever saying that this isn't advice for covid-19. A proper fit and seal is important. The picture could also be considered somewhat offensive to some.
[1]: https://blogs.cdc.gov/niosh-science-blog/2017/11/02/noshave/
[2]: https://blogs.cdc.gov/niosh-science-blog/files/2017/11/Facia...
In your specific example of volunteer health assessments and triage at a homeless shelter, you probably need real honest-to-goodness PPE, and the organization’s advice was wrong. When I’m going down to the grocery store, though, a cloth mask should be sufficient — and my (admittedly short) beard is not going to keep my mask from blocking droplets from my mouth and nose, assuming it completely covers both of them.
If one's beard is creating even more space between the face and mask, it's of course going to make things worse.
1) They capture a lot of droplets coming out of your mouth. Do you sneeze in your elbow or in someone's face? A face mask does better than an elbow, and for every breath (not just a sneeze). So does a beard for that matter; if your sneeze goes around through a beard, it's catching big droplets too.
2) You know the six-foot-guideline? They effectively increase that distance. A person talking, yelling, sneezing, etc. can carry droplets 15+ feet in a straight line. If we're both wearing masks (or face shields), it's not going in a straight line. Beards disrupt linear airflow too.
3) You can't touch your face.
They don't stop virus aerosol. That's where you need a proper seal.
I'm not actually sure facial hair makes any difference with a cloth mask. Surgical mask would be in between. And an N95 probably becomes a surgical.
https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...
> But the CDC has recommended against mask use. I hypothesized that the CDC was intentionally lying to us, trying to trick us into not buying masks so there would be enough for health care workers.
> But that can’t be true, because the CDC and other experts came up with their no-masks policy years ago, long before there was any supply shortage. For example, during the 2009 swine flu pandemic, their website offered the following table:
> [table in link]
> And during the 2015 MERS epidemic, NPR said South Koreans were wrong to wear masks:
> “[ . . . ] Masks can be helpful for protecting health workers from a variety of infectious diseases, including MERS… But either type of mask is less likely to do much good for the average person on the street…Wearing a mask might make people feel better. After all, MERS has killed about a third of the people known to be infected. But there are no good studies looking at how well these masks prevent MERS transmission out in the community, says Geeta Sood, an infectious disease specialist at Johns Hopkins University. “On the street or the subway, for MERS specifically, they’re probably not effective,” she says. One problem is that the masks are loose fitting, and a lot of tiny airborne particles can get in around the sides of the masks.”
> So if studies generally suggest masks are effective, and the CDC wasn’t deliberately lying to us, why are they recommending against mask use?
It’s also unclear what “masks” meant in the initial phases. An N95 respirator? A surgical mask? A homemade cloth mask? Each of these has different uses and effects. I seriously doubt most people knew the difference in early March, I only had a vague notion. The surgeon general likely is thinking of respirators, because all MDs in hospitals get fitted for it. They know how hard it is to put it on and take it off safely, and know how critical it is for it to be a good tight fit. None of those things are going to be true for most people in early March 2020. If that’s your frame of reference, then it makes total sense that you’d recommend people not buy masks.
Everyone going out and buying N95s when they’re not particularly useful to most people unless in a close confined space is a bad thing. It doesn’t actually save many lives, but does make it harder for people who need it (docs/nurses in close confined spaces, particularly with patients on respirators that aerosolize the virus).
People wearing surgical or cloth masks may help some, probably mostly in enclosed spaces and mostly for exhalation rather than preventing you from inhaling a virus from someone else.
Even then, it’s my understanding that the data isn’t awesome here. Many of the papers I’ve seen are under fairly odd scenarios (for example an airplane, lots of the same air, recycled all over, for hours, where the paper showed positive mask benefit). We don’t have much for bandanas, or masks that were washed 3 weeks ago, or masks that are tighter, masks that are looser. I’d wager it helps, a little, especially indoors.
In other words, this shit is complicated, why assume lying when instead we could just say, “it’s complicated, they didn’t get it 100% right.”
OK, let's say CDC guys screwed up and got caught with their pants down (oh man did they...) and now we have no clear guidelines about it. Then come down from the ivory tower and tell us what you have and let us decide without politicians yelling at us and jerking it around - one day you are an idiot murderer because you're wearing mask, next day you're an idiot murderer because you don't. It just breeds contempt for the whole setup.
By that I mean we spend so much time as scientists living with and making decisions about which course of action to take in the context of uncertain data. Other fields obviously do too, but for a bench scientist, every day is is a constant tradeoff on which data you buy, what experiments will you run to confirm/exclude it, and what’s the downside of that decision. The best rarely speak in full certainty, they talk about probabilities.
Contrast to public messaging or journalism which is, “do this, not that.” This has led to people holding “science” as an identity, a talisman of righteousness. That’s not how science works, but people want to feel better by judging people so here we are.
I personally would have preferred a short, coherent statement on what we know for sure and what we don’t, how confident we are about the same, and to treat people as adults.
Remember spending a few weeks agonizing over how to ramp up ventilator production, rather than focusing on masks? And then finally coming around to masks could be useful, with everyone championing DIY cloth masks? We're four months into this thing and most everyone is still proudly wearing those ersatz face-rags, even spending effort to "improve" them as as fashion accessories. Meanwhile a proper N95 costs around $3 to produce and distribute - I thought we were supposed to be an industrialized society!
Not wearing a mask offers zero protection from an illness which is mainly transmitted through droplets and aerosols.
Wearing a mask offers some protection, ranging from little to very good depending on the type of mask. In the mean time we know that surgical masks offer pretty good protection in particular, but there were studies about SARS, MERS and influenza going back years showing that both FFP2/N95+ and surgical masks do help. We even have studies comparing incorrect, partly incorrect vs correct usage.
The conclusion is inescapable: even if people on average wear masks incorrectly and even if the masks they wear aren't even close to 95% effective, they reduce the rate of transmission. Why on Earth would you not want to reduce the rate of transmission even if by a few percent?
This is what we do not know (still).
There are plenty of results in life science far more counterintuitive than the hypothesis, “people are less strict about social distancing when wearing masks.”
Although we don't strictly need to ask them, since the head of the Chinese CDC said more than a month ago that using masks is essential and that he doesn't understand why Europe doesn't do it. KCDC specialists said much of the same thing, although I don't know if they expressed concern at Europe's lax attitude toward masks.
And finally here's a couple of anecdotes:
* people in supermarkets seem a bit more careful now, since the masks have been introduced. But keeping 1.5-2m distance at all times is hard and this is certainly not always respected. That's the whole point of why one needs masks instead of relying on distancing - distancing doesn't always work, but having a mask on is pretty simple. And even if the wearer screws up, at least they don't easily infect the others.
* before the mandatory mask thing people generally got out of my way when they saw me with my mask on.
Where it does cause harm is early on if everyone gets N95s and the docs can’t get enough (which absolutely happened) then that actually kills more people (docs, nurses, and the people they would have saved).
The right message in retrospect should have been, “don’t go buy masks, save those for people who need the highest performance, but wear a cloth mask when indoors. Wash it frequently.” We screwed up, but it’s not malice and it is complicated.
You can go back a few months and the WHO went on record plenty of times regarding a couple of points
- Health workers really need good PPE and there is a shortage
- When infected people wear a mask, it reduces transmission
- The benefits of a non-infected person wearing a mask are not super well understood/studied and this topic doesn't really come up much because our main audience is healthcare professionals
So they said at one point, focus on getting the masks to health care workers, and then as mask supply increased they said the infected should wear them too, and now that cloth/paper masks are easy to obtain they say everyone should wear them.
It was always a question of supply and availability, there was no conspiracy.
If you looked beyond the headlines and looked at the context it was pretty clear.
At the same time the amount of people that think that have the mask below the nose or just at the chin or mishandling it because it feels "uncomfortable" to them is astounding. I'm not sure but I believe an intubation is more uncomfortable (and yes these are predominantly people at risk ages)
It's just so pointless to go to the bother of getting a mask and then wear it in such a way that you get no benefits from it.
Recommendations try to take everything in to account.
It's easy now to say: just wear masks. But then, there was even a global shortage of masks for health professionals.
In US there's been many warnings to subsidize a strategic PPE supply and production. This was ignored. Early on (COVID-19) a US mask producer asked officials to provide money to expand production. This was ignored.
It wasn't just easy to predict, it was predicted various times.
But we won't build something now against it because it's a long time ago.
The problem with lying is that your intent doesn’t matter, you still lied, and in a society that is built on gradations of trust, you’re trading against your own credibility every time you lie. You don’t get a discount on the price of your lie simply because you were acting in a paternalistic manner, in fact, Officers and employees of the government taking a paternalistic position makes their lie worse and increases the cost to their own credibility in the long run.
However, lots of people don't trust (various types of) "authority". And for them, the lie is further proof of their prior lack of trust.
It's a hard problem, which has been made a lot worse by the politicising of masks, in particular.
My own prior is that Asian people have been wearing masks for many years, and I am inclined to believe that masks are (somewhat) useful. However, there's been so little research on mask-wearing by the general populace that I am deeply uncertain about those benefits.
It is one thing for us as laymen to discuss the efficacy of masks, staying at home, shutting down the economy, not partaking in the activities we used to enjoy and so on. It is an entirely different thing for a person in some kind of authority, like "public health", where your primary domain of expertise is communicable diseases to step out of their lane (which is communicable diseases) and say despite the supposedly high risk of death and bodily destruction that an apolitical virus with neither vices nor virtues nor policy positions can wreck, it is entirely okay to go out and protest something, but only if it is something that "we in authority" currently agree is worth protesting. This is, by the way, not long after the 9th Circuit said allowing Churches to reopen (even with limitations) would make the Constitution into a suicide pact.
People don't trust authority because authority doesn't want to stay in its own lane. Take Anthony Fauci, he has done a remarkable job staying out of the fray as much as possible and simply acting as an advisor to the President and to the people, and people trusted him even when they wanted to imagine their own politics on him. As a civil servant, absolute standout guy, and he's now considered one of the most trusted medical professionals in the country because he stays in his lane, meaning he allows his politics to take a backseat (not even the backseat, it's back in the trunk) to his job and Office (Director of the National Institute of Allergy and Infectious Diseases).
Forgive me, I went on a small rant, but to conclude, when you have lying in the first instance and not staying in your lane in the second, one of the effects is going to be a loss of credibility, and that's both just and understandable. Choices have consequences, and that includes lying, and that includes using your unelected Office for activist purposes. Even when you're right about something, up to and including the efficacy of masks, you've already lost credibility, and in the case of masks, you've already directly contradicted yourself. (I mean "you" as in public health officials recently, not you specifically my fellow HN).
But what is a thinking person supposed to think when the Surgeon General is saying don’t wear masks in a pandemic caused by airborne viri?
In urban (educated) zones likely to be hotbeds for outbreaks, could the state not do a little nuance and say “hospitals need the N95s and you need a bandana”
Everybody has got a bandana, but if I were to start walking into stores with one before sanctioned, someone would be calling 911. In the meantime, how many weeks go by at R 3...
The WHO actually has a definition for this, when the droplets carrying the disease are <5μm they spread further and drift around for longer and that's when they start calling it airborne instead of droplets, COVID-19 is not in this category.
It's still good to wear a mask, I've lost count of the number of times over the years that some excited extrovert straight up spit in my face because they were worked up about something. lol.
https://www.who.int/news-room/commentaries/detail/modes-of-t...
Recently I've read an interview with Drosten (the German virologist which came up with one of the Coronavirus tests) say that they're starting to see airborne transmission as an important transmission factor, maybe not a strong as droplets but comparable. This is especially the case in poorly ventilated spaces.
We already knew for instance that SARS is transmitted through aerosols. Then a new thing comes up which is related to the above and is basically named SARS-2 and we forget about the aerosols and instead think we should wash our hands a lot. Words can't express how stupid this is.
After looking closely I found a small move into the wrong direction (maybe caused by something else?!??)
I think it can change something: currently masks are seen as a necessary evil in stores and public transport. They could and should become ubiquitous.
With mask usage in Germany I see only negative trends in the growthrate of both case and death. I think to make them work something has to be changed.
There is a good chance that it now only works as a reverse placebo - it makes people feel confident and pushes them into more risky behaviour - most likely net negative.
No. Not in 2020. Not with the vast majority of the population. Nuance is dead.
There seems to be a trend to paint people as imbeciles who can't tie their own shoelaces without somebody standing over them, and then on investigation it turns out not to be true.
There was a story a while back about a couple who drank fish tank cleaner (containing chloroquine) after Trump touted chloroquine against the coronavirus. Come to find out the couple were not fans of Trump but were having marital difficulties, so now you've got to weigh the possibility that these two were stupid enough to drink poison against the possibility that the woman discovered a way to intentionally poison her husband and pin it on Trump:
https://nypost.com/2020/04/29/homicide-cops-investigate-deat...
More often than not, when you see someone doing something apparently colossally stupid, it's because you don't know the whole story rather than because they're actually that stupid. People understand nuance plenty when it's important to them.
> Mesa City police declined to comment on the investigation but told the paper that the probe was “normal protocol” for non-natural deaths and noted that the case has not been ruled a homicide “at this time.”
In left-leaning publications they omit "at this time" and make that the headline.
But the interesting thing about the story isn't the police determination. That hasn't been made yet, so it tells us nothing, and anyway the police would have to prove it beyond a reasonable doubt. The whole point is using that excuse creates a lot of reasonable doubt even if it was completely intentional.
The value of the story is that it gives us some new evidence. The narrative that somebody recklessly drank fish tank cleaner after a Trump recommendation loses credibility when you learn that the person was anti-Trump and thereby not inclined to unthinkingly believe whatever he says, up to and including drinking something with a label on it that says poison. Meanwhile a plausible alternative explanation exists.
I have much more faith in the KCDC for example and otherwise I want to see studies.
And anyway, people are unfairly accused of hoarding masks. It turns out that in the US, Australia, Germany (and probably other countries) China was buying up all the masks.
Regarding the masks, I went deepy down that rabbit hole in February and March. Most production happens in China. China didn't produce anything, needed what was there for themselves and had closed down a lot cities and ports and such. At the same time, demand increased by orders of magnitude around the world. hence the shortage. China didn't buy masks en mass from other countries, they didn't need to. A ,ot of fraud happened as soon as production resumed. No, people who, with a financial interest, tried to help sort out the shortage once the German government failed to do so, are sitting on tons of masks they bought in good faith for 5 - 10 times the normal price. Currently prces are down to roughly 2x the pre-Covid-19 prices. See the problem? People hoarding made the issue even worse.
Hordng mass during that period for retail sales or your own use, thus preventing PPE from getting to medical care professionals, is the deffinition of hoarding.
All of your mentioned institutions are publishing or using studies. Go look them up. But maybe accept that the people behind them know more about the subject than you do.
I don't know if China needed the masks, or if they needed to weld people in their apartments, but apparently they did that anyway. See for example the article "Billions of face masks sent to China during Australian bushfire crisis". This was happening around February.
Spiegel published an article in which a distributor of protection equipment got orders for months of inventory within a day from various Chinese customers. They also claimed that all the other distributors which they knew had a similar situation on their hands. In fact they got so many orders that they alerted the ministry of health about an upcoming bottleneck in procuring PPE.
Then there's the US: "U.S. exported millions in masks and ventilators ahead of the coronavirus crisis". $17.5 millions worth of masks exported during January and February.
And this is in addition to the hundreds of thousands in PPE they received as donations from all over the world.
The average Joe buying a 10 or 20 pack for himself & family is first of all not hoarding, as this is a very small quantity and secondly didn't cause the shortage.
The proble I have is, that now people accuse every institute or offical body of lying. Because they got, in people's minds, the mask thing wrong. Why can't we just accept that even experts can be wrong? Starting to accuse others of lying is the first step towards conspiracy theories, IMHO, as it only leaves black and white. And what is it that the WHO and co. have to be right 100% right from the start and everybody else is just asking questions?
It's mighty noble to donate to Italy after they confiscated all the inland mask production and bought tons of masks from everywhere else. And then they also pressured European politicians to prasise the communist party when receiving said donations.
Not every institute, just the WHO and to some limited extent a few others. Stop setting up this straw man, because that's clearly not the case for me and I listed some organizations which I do trust - because they've proven that they're competent.
Experts can be wrong, sure they can. But if their literal job is to protect us from such pandemic situations and they fuck up, they deserve some criticism.
If they persist in not recommending masks when already most countries are recommending them, like the WHO did until 1-2 weeks ago, they are uselessly incompetent and should be ignored.
It seems to me that the original misinformation on this subject has caused a continued belief that masks are not helpful in reducing transmission. Initial public health recommendations cannot easily be walked back. Once the meme is sufficiently embedded, it's nearly impossible to dislodge.
For a long time I was under the impression that surgical masks don't really help the wearer. There are some studies showing comparable effects to an N95, but I was assuming incorrect N95 usage and I was incorrectly dismissing the benefit of even low double-digit protection.
The thing that convinced me to take a closer look was an interview with the German infection specialist Peter Walger, which said that:
* all masks protect the wearer to a certain degree
* medical grade surgical masks clearly offer partial protection. This was a grave error, which made personnel also in clinical practice not trust the masks and wear them for protection.
The last Sars or Coronavirus illnesses differed from this one, as in those cases asymptomatic people were not spreading the virus very much.
So the (reasonable) assumption was that people mostly know when they are contagious and stay at home.
In that scenario "community masks" (everything below FPP-2) don't matter much.
When researchers found that Covid-19 is different (and that has to do with the massively higher virus load in the throat, where former similar diseases built most of the virus load in the lungs), the stance changed.
That is a good thing! Learn new information, adapt your response.
What's fueling conspiracy theories now is that the messaging back then centered on "we need to preserve masks for the medical community", which was a smaller component of the motivation, sure, but got mostly conflated with the real argument. I think that is because it was much easier to explain to the public and to journalists.
In hindsight that was a mistake. But the conspiracy theories that health officials just flip-flopped for no reason is wrong, and it's damaging the fabric of society even more.
"Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus"
"which was a smaller component of the motivation, sure, but got mostly conflated with the real argument. I think that is because it was much easier to explain to the public and to journalists."
They simplified (and arguably over-simplified) the public communication.
Insisting that they lied is uncharitable at best, and a hallmark of all sorts of conspiracy theories right now.
The point is that when almost all contagious people stay at home, we don't need community masks. We only need them because contagious people are asymptomatic (that's new!), tehrefore don't know about their status and therefore go out in public.
To be fair, I remember looking it up on the CDC website when this all started, and they explicitly stated any masks are not necessary (or useful) unless you are caring for a sick patient.
Too bad this pandemic overlapped with the flu season and with a period of time where many people had colds, thereby rendering the above assumption null and void.
> When news of a mysterious viral pneumonia linked to a market in Wuhan, China, reached the outside world in early January, one of my first reactions was to order a modest supply of masks. Just a few weeks later, there wasn’t a mask to be bought in stores, or online for a reasonable price — just widespread price gouging. Many health experts, no doubt motivated by the sensible and urgent aim of preserving the remaining masks for health care workers, started telling people that they didn’t need masks or that they wouldn’t know how to wear them.