We are thinking about masks wrong. You want every one else to wear a mask because they might have the virus, and if they do, the mask will stop droplets and aerosols from entering the air you breath and landing on surfaces that you may touch.
And of course, you should wear a mask too -- to protect others.
Had we all worn masks right when this started (simple cloth masks would do) this virus would not have spread so much and so easily.
It includes a variety of evidence for masks, including for impromptu masks and their quality.
Some key points from my linked article:
* You should (like many doctors and care staff) re-use your good quality masks, and the article explains how. (e.g. put it in a breathable bag, like paper, date it, and wait four days)
* If you have a good mask, like an N95, wear a lower quality mask over it, to preserve re-use of the good quality mask.
* For good fit, the mask should not touch the lips.
As it notes in the article, wearing a mask can be bad if it causes you to touch your face more. Though at the moment there has not been a single documented case of "smear" (person to object to person) transmission. And there was a 2.5 hour choir rehearsal with minimal touching that caused 75% of the attendees to become infected. So I have an old N100 respirator from wildfires a couple years ago that I am wearing when out.
One of the interesting side effects is that you can smell the ambient ozone when you take it off, since the respirator has been removing it. Don't be fooled, a typical suburban area reeks of ozone, but it's not perceptible because your nose ignores it as background.
It’s misleading to say there’s no evidence of smear transmission. Take that choral rehearsal you mention. Could have been that they breathed in droplets, also could have been that a droplet found their way to a shirt, the person touched their shirt, touched their face, bingo. The virus is known to survive on surfaces for several hours. In close, confined quarters the answer to smear vs droplet is likely “yes”.
Masks are most useful in stopping droplets from people who are actively shedding virus. This is probably the key driver for why in some mask wearing societies transmission is far lower.
Masks are clearly helpful in confined spaces and in the immediate radius of someone who coughed a few seconds ago. These conditions are what medical personnel face daily, hence they wear masks. Similarly people like Uber drivers or grocery clerks likely would benefit if well fitted and they don’t touch their face more.
Masks are maybe useful when around those who aren’t coughing (you make droplets when you breathe or talk) but generally that social distancing 6ft should cover that. Still, if you don’t touch your face more, it doesn’t hurt and might help a little.
Masks aren’t doing a whole lot walking around the street. As you and the article note if a mask makes you touch your face more, it could even be harmful.
In almost all of these cases, social distancing and hand washing is likely far more effective than masks. “Are masks useful?” is a complicated question, but as the article suggests, it’s probably, “a little, wash your hands, keep distant, that helps much more.”
I've never seen a study that says "wearing a mask can be bad if it causes you to touch your face more." I've seen loads of studies that say that masks work to substantially prevent transmission of viruses, including SARS, the closest cousin to the current threat.
At this point, articles that say that masks increase COVID transmission that do not cite legitimate scientific studies should be considered disinformation, and their authors should be considered potential threats to public health and shunned and/or ignored. We are dealing with a virus that does not respect lofty rhetoric and does not negotiate. It can only be defeated through clear thinking and science.
On the DIY mask issue: I've tried making a couple, based on online instructions. It's very obvious in use that without literally taping the filter material to my face, the airflow goes around the edges.
Anyone who's done any rural polypipe plumbing knows how hard it is to control water flow. Air is harder. None of the DY mask designs I've tried are worth a pinch of the proverbial.
Anyone here know of any better designs? I'm not fussed myself (live in the sticks, very easy to avoid people), but I'd like to make something useful for my elderly mother.
If you have a 3D printer or know someone with one, there are a couple designs that can be 3D printed or the 3D printed parts can be combined with commonly available materials:
(Ironically, the only friend I have with a 3d printer is over the nearby NSW/QLD border that has been closed due to the pandemic crisis. Not an insuperable problem however).
Wearing a face mask is compulsory here in Czech Republic for a third week now and you can even get fined for not doing so. According to our government this is one of the most important measures introduced to slow down the spread of the virus. Our PM is even trying to convince other EU governments to do the same. People are advised not to touch their face and clean their mask by washing it in boiling water every day. It’s not too complicated and hopefully will be effective.
KN95 masks are available from China. Those are an excellent choice for the general population and do not affect the supply of N95 masks to medical personnel. More people need to step and and distribute.
Conterfeit and defective items are very general problems throughout all industries. Standard is standard. Importer should do the due diligence to test it and ask for certificates.
I just don't see anything wrong with the standard itself.
tl;dr: This is misinfoformation; Netherlands tests masks against the wrong specification and blamed on China.
KN95 marks that are bought by the Dutch government are not resistant to oily particles (the N stands for Not resistant to oil)[0]; while the European FFP2 standard specifies the mask has to be able to block oil particles [1].
>Netherlands tests masks against the wrong specification and blamed on China.
>KN95 marks that are bought by the Dutch government are not resistant to oily particles (the N stands for Not resistant to oil)[0]; while the European FFP2 standard specifies the mask has to be able to block oil particles
Both of these statements are contradicted by the scmp article you've linked:
>The problem with the Chinese masks was first discovered by hospitals that received them, with health workers finding the masks did not fit properly [...] Dutch broadcaster NOS cited a source saying that the Chinese face masks were “not FFP2 quality nor of the lesser safety level of FFP1 – some sort of FFP0.8 at best”, meaning they had less than half the filter efficiency required for the FFP2 designation.
>Dutch government bought KN95 and tested it against FFP2 and claims it's defective.
The SCMP article says
>Dutch broadcaster NOS cited a source saying that the Chinese face masks were “not FFP2 quality nor of the lesser safety level of FFP1 – some sort of FFP0.8 at best”,
While I can understand that it can be taken to mean that the masks were subjected to to FFP2 testing (including oil penetration), that would be a very uncharitable/cynical interpretation. A more charitable interpretation of that would be that the FFP2/FFP1 standards are being referenced without oil penetration testing involved, since europe doesn't seem to have separate standards for oil/non-oil like with N95/P95 in north america. This theory is consistent with them comparing against a fictitious standard/rating of FFP0.8.
Also, I did some research myself and found the original statement by the health ministry[1]. It actually made no mention of FFP ratings, and only acknowledged that the masks carried a KN95 rating, and that the masks "did not meet the quality standard", which I've taken to mean KN95 rating, not FFP2 rating. I could not find any source that directly said the masks were tested against FFP2 (with oil penetration) and failed.
The NOS article clearly mentioned FFP2 rating in the second paragraph (from Google Translate):
"This concerns almost half of a batch of 1.3 million so-called FFP2 masks, 600,000 pieces. "
>"This concerns almost half of a batch of 1.3 million so-called FFP2 masks, 600,000 pieces. "
That's a quote by the newspaper, not the government agency. Also like I mentioned earlier, it's understandable to call them "FFP2" masks since the average european reader might not have a point of reference for what (K)N95 is.
It really boggles one's mind that a mask would be referred as FFP2 repeatedly and somehow be tested under KN95 that only existed in China* and was only recently approved in the Netherlands.
But it's all just speculation at this point without more information from the health minister.
* Granted it doesn't differ from the American standard by far.
Update: It's never indicated on whether the marks were tested under KN95 or FFP2; saying they used the wrong specs and blamed on China was probably too early or wrong.
The CDC is recommending KN95 for healthcare workers and I know firsthand of multiple people selling them to hospitals. (I'm bringing some in myself to resell, am very familiar with the market.)
Yes. I have been promoting this message nonstop for the past few days. I created https://www.maskssavelives.org/ to help promote the benefits of mask-wearing in reducing COVID-19' virality.
That's painful to read, it does not address the blatant lack of causality demonstrated in the FT chart with masks / no mask regions. You can't make that claim at all. If masks were that effective, SK and other countries wouldn't have engaged in their massive testing, quarantining programs at all.
>There are 2 main types of masks used to prevent respiratory infection: surgical masks, sometimes referred to as face masks, and respirators. These masks differ by the type and size of infectious particles they are able to filter. Face masks are used more commonly for respiratory viruses that spread via droplets, which travel short distances and are transmitted by cough or sneeze. Face masks often fit loosely, and prevent the wearer from spreading large sprays and droplets, as well as preventing hand-to-face contact. N95 respirators block 95% of airborne particles. They are tight fitting and prevent inhalation of smaller infectious particles that can spread through the air over long distances after an infected person coughs or sneezes
The difference right now is that everyone might be carrying a lethal pathogen that we have no treatments for.
This is a wrong and dangerous message and it needs to be stopped. Both things are true: a) health workers need masks and b) people should wear masks when they go out.
There are no masks available to the public now. Realistically if you don't already have a mask your only option is to make one, which is not hard. Go to YouTube and find a video. A couple layers of cotton can work and is much better than nothing, at stopping your droplets from spreading if you sneeze or cough.
If you already have a mask wear it when you go out. No health care worker wants your mask. Wear goggles too.
And yes masks help prevent respiratory infection which is why health care workers wear them.
Stop with the "you shouldn't be wearing one" nonsense. It is false and dangerous.
I live in New York City. I haven't left my building in weeks, but I can see people on the sidewalk outside of my window, and I see other residents of my building in the lobby when I go (briefly!) to pick up laundry and mail.
Many of them are wearing surgical masks. Not N95 masks, true, but not home-made masks either. I don't know where they're getting the masks, but clearly they have some.
Every time I see this, I honestly kind of want to scream at them.
If you want to wrap a piece of fabric around your nose and mouth, by all means, it certainly can't hurt. But if you have a supply of real masks somewhere, you should donate them.
I keep a box of surgical masks, since I'm one of the weirdos who wears one when sick even in the US! I've got 3. The box is years old, they're expired, they're not sterile any more, and I'll keep re-using them until they fail (the elastic stretches). As desperate as hospitals are these still aren't donatable.
Is it okay if I use masks that I bought years ago? (N95 in my case.) As far as I'm aware there's no way a healthcare worker could get access to the masks I already have.
I am not saying that you should keep or donate them, but if you choose to donate them, the Seattle Mask Brigade Page includes a link to other groups organizing mass collection of unused but opened N95 masks.
I apologize if you’ve already explored this but I figure it could help others.
>As far as I'm aware there's no way a healthcare worker could get access to the masks I already have.
AFAIK locally (Czech Republic) hospitals have accepted donations of respirators and even hand made cloth masks. Maybe something similar is possible with hospitals in your are as well ?
I bought in 2014 100 chirurgical masks => they're now expired (and I have ~15 left after giving all others to friends and colleagues after warning them about this) but from what I read the statements were that they can still be effective (not anymore 100% but at least more than 0%, which is more than not wearing anything).
This. If you're wearing a mask, then there's a healthcare worker somewhere who you're preventing from wearing a mask. That healthcare worker is taking care of patients who definitely have the Cornavirus, and is getting up close to them while they're coughing. They need that mask more than you do.
And I don't mean this in an abstract way. There are numerous places accepting mask donations right now. If you have a mask, you should donate it. Stat.
By all means donate your n95 and surgical masks, but many studies show that DIY masks are nearly as effective in stopping asymptomatic spread so the messaging should be around asking everyone to wear a (DIY) mask when they go out.
I personally arranged to donate several thousand gloves per size from just one lab at MIT. Lots of places have safety glasses outside the medical field, any shop might have boxes of spares laying around.
You are right in that medical professionals need proper equipment. At the same time it is very dangerous not to say that anyone else should have at least a home made mask when going out, to avoid possibly spreading the infection further if they are infected and do not know it yet.
The ship is sinking and there aren't enough scuba diving suits.
There are professionals willing to jump into the water to try and patch the hull so it sinks more slowly, giving everyone time to get airlifted off by helicopter. Unfortunately, they're drowning while attempting the repairs because they're not wearing proper scuba diving gear. Meanwhile, normals are keeping the gear for themselves in the hope it might be easier to swim to safety once the ship goes under.
This isn't a very good analogy—but I hope my point comes through. It's not every person for themselves. We need to help the people trying to help everyone.
Until healthcare workers aren't complaining about not having enough PPE to do their jobs safely, this is the correct line of thinking, zero sum or not.
Personally, given the vastly greater risk of exposure for them, I don't think it's a zero-sum game at all, which is precisely why all available supplies should go to them first.
I guess I'm not convinced that the 10th one shouldn't go to them too. They are dealing with a vastly increased risk of exposure than I am, and likely with significantly greater infectious loads as well, which may^[1] increase the severity of the disease.
If for some reason I had to spend a lot of time in close proximity to other people, that might merit a homemade mask, but otherwise I think I'd be doing a far better job protecting both of us and everyone else we interact with (in the process of obtaining food and essential supplies) by giving it to my wife before she heads out for her next shift at the hospital.
Firstly, if everyone does this, there's 10% fewer masks for doctors than there'd be otherwise. I would posit that their need is so much drastically greater that they really should get every last one.
Remember—your job is to stay six feet away from everyone else, on the off chance they might have the Coranavirus. Doctors and nurses are getting up close with people they know for sure have the Coronavirus, all day, every day.
But more importantly, the masks are disposable! It's not like you can keep one and use it indefinitely.
It defies common sense to not wear a personal mask. Like donating your six shooter to an outgunned military. The marginal benefit to you is so much more than the marginal benefit to them.
More like donating your ballistic vest to a military that's expected to win eventually but with heavy losses. The marginal benefit may be low due to the sheer scale of the problem they're facing, but it still might save a life—and what if every American made a mask and donated it instead of wearing it themselves?
It's also possible—likely, even—that the severity of the disease in an individual is correlated with the magnitude of the initial infectious dose, and healthcare workers without effective PPE are going to be most at risk for high doses, which will act as a multiplier on the benefits of PPE usage for them. In the analogy, one might compare this to the chance that a stray, tumbling bullet fired in a high arc by the enemy will hit you while you're trying to buy groceries, vs. the chance that a soldier on the front lines will be lethally wounded by a deliberate shot. Who needs the vest more?
As noted here^[1], this is all very much up in the air, but the more I think about it, the more my brain rejects the marginal benefit argument as an illusion. Healthcare workers are on the front lines, and by most accounts it's their labors that'll cut the mortality rate from 10+% to ~1-5%. They need all the help they can get, and the rest of us need them to stay healthy and able to do their jobs.
I've been considering knitting my own mask(s), but haven't been able to find anything on whether it would actually work - like, would it be too porous to do anything? (Plan was 1-1 ribbing wide enough to not stretch, so the layers would kinda double-up on their own)
That says people are doing it because the government forced them to, not that it is easy or that they are doing it right. In fact the only tip seems to be to make it out of cotton so you can wash it.
And for once I think our government was right in forcing everyone to wear a mask. As it turns out, it is not really hard to comply with something rather drastic like this & the whole nation pretty much equiped itself with hand made masks in a couple days.
I went out today in the second biggest city here in Czech Republic and you can see most people with self made cloth masks, a couple with simple single use disposable masks and just a single person with something looking like a respirator. And zero people without a mask.
Of course it's ethical to wear it. If you have some to spare, then it may be ethical also to share with others.
We've been donating some of our N95 masks to the local hospital, but I'm not donating all of them. My family is important too.
As for age, I have noticed that the older ones had crumbly rubber foam and the straps are more delicate, but the melt-blown fabric itself seems perfectly fine. We've re-strapped some with new elastic and replaced the foam with closed-cell foam.
It's far from clear how long masks will be effective against SARS-CoV-2 (aka Coronavirus) for.
First, when testing their masks for their effectiveness, the manufacturers of these masks were certainly not testing them against SARS-CoV-2, as it didn't exist five years ago. Even now, it's very unlikely any manufacturers are testing their masks against SARS-Cov-2. What they were probably testing them against is various toxic fumes and smoke -- the things they're actually rated to be effective against, not viruses.
Second, some filters used in respirator-style masks have charcoal in them, and that charcoal will absorb fumes from the environment while in storage, so depending on what environment a filter is stored in and for how long the charcoal may not be as effective at absorbing various toxic fumes and smoke that these filters were tested for, but for all we know they may still be quite effective against filtering out SARS-CoV-2 viruses.
Third, it's well known that some manufacturers put bogus expiration dates on their products, and the products are good well past the expiry date. This is a phenomenon well known in the food industry. I'm not sure how widespread it is among mask manufacturers, but I wouldn't put it past them to also have unreliable expiry dates.
The CDC has some guidelines regarding the use of expired masks: [1][2] and they approve of the use of some such expired masks. However, it's not clear what tests they actually used to decide on the suitability of such masks, and if these masks were actually tested against SARS-CoV-2. It is pretty unlikely that they had randomized, double-blind trials of hundreds of people wearing masks and hundreds not and exposing them all to SARS-CoV-2 to see which got infected. Their tests were probably much more imperfect, and so their results less reliable.
All in all, there's just too little information to know how effective expired masks are against infection by SARS-CoV-2, but they're probably better than nothing.. especially the ones the CDC has blessed in their research.
A friend of mine is setting up a manufacturing line for masks here in NL. They're sourcing raw materials from abroad, where masks are interdicted but materials are not, and then go on to make the actual masks locally. Super interesting project and I'm proud of him for getting off his butt and making an actual difference here.
Before we do this, we have to establish a culture of wearing masks during flu season so that there is always enough stock when people "must" wear masks for public health reasons. Right now may not be the best time to tell people they must because that siphons masks from the first responders.
When better to establish that long term behavior when there is an immediate, credible threat? Even if it does slightly increase pressure on the medical mask supply (who will be prioritized with the certified masks, regardless), how many lives will this save in the next pandemic? Or every flu season, for that matter. It seems unrealistic to think Americans will start wearing masks everywhere after this has all blown over if they were not previously conditioned to do so.
A better time to establish a mask wearing trend would be a time where masks were readily available, and stores were easily accessed. Let's plan to stock up for this fall.
If a mask can prevent one person from infecting others, it can prevent 16 people from being infected over the next two weeks, if you assume doubling every 3 days.
Given there is a shortage and we can’t all have masks, who would you prefer have them, people on the front lines who see the infirm and immunocompromised or joe and jill schmoe who’re supposed to be staying home?
I don't think it's that clear cut. The Schmoes are still leaving the house to grocery shop and get exercise. Two masks could make the difference for them and/or everyone near them in the next week. What will two masks do for a hospital full of healthcare workers?
As the article says, "Don’t buy masks (or use new masks you might have at home) while there is a shortage for healthcare workers, especially not N95 respirators (which are difficult to use properly anyway). Make a mask at home. Skiers & snowboarders, wear your buffs or ski masks. Donate any unused masks or respirators you may have to healthcare workers."
Apparently, given the recent education push, most people didn’t know how to wash their hands properly either. The answer isn’t to give up, it’s to educate.
And if you can't wear a mask for some reason, you should still be covering your face with something. Even a bandana is a lot better than wearing nothing at all.
Masks do protect the wearer! And you do not need an N95 mask to do this. Even a simple homemade mask offers some degree of protection. This[0] was a good explanation of both of these ideas.
tldr: There is reason to believe that large droplets, not the tiny droplets that N95s are designed to filter, are the primary threat, and any sort of physical barrier between those and your mouth/nose will help.
I see a lot of people saying that we shouldn't wear masks in order to preserve the supply for healthcare workers, but I think this is ridiculous. You
need a mask when you go out both to protect yourself and to protect others. A better message is, to preserve the supply for healthcare workers, make your own mask, or use a simple dust mask or a rave mask.
Very few viruses are true aerosol transmitted (measles is), it’s likely COVID is droplet based so coarse masks will help. Even with an N95, true aerosols can make it through, though obviously not 100% transmission (95 means block 95% of 0.3 micron particles, individual viruses are a factor of 2-3 smaller usually).
I think the path forward is clear (if there was enough supplies to go around): 1) Stay at home or 2) wear a face mask. If there was enough supply, I don't think we should argue with this. It's for everyone's safety. So let's ramp up supply and do either 1) or 2)
Question: is there a recommended way to clean a cotton mask or mask of other material? Does running it through the wash risk contaminating other clothes? Should I instead spray it down with alcohol or wet-and-zap it in the microwave for 30 sec, similar to sponge disinfecting?
Washing it in boiling water for 5 minutes should be enough but you should do it at least every day. This is what our government advise us here in Czech.
Don't see it linked in this thread yet, but it's worth noting Slate Star Codex looked at the literature and decided on a weak "yes" [0], assuming your use of a face mask isn't depriving a medical worker of one.
Exactly, it has no more weight than water cooler talk. In a number of aspects it exhibits wishful thinking that is counter-factual, especially in regard to home-made masks.
And of course, you should wear a mask too -- to protect others.
Had we all worn masks right when this started (simple cloth masks would do) this virus would not have spread so much and so easily.