Everything I read on the Internet about masks discourages their use. They say that only a specialized mask called the N95 respirator (difficult to breath through) can protect against the coronavirus. Normal masks do not protect against viruses because viruses are much smaller than bacteria. An N95 mask is difficult to properly put on, removing it takes great care so that you don't touch any virus that might be on its surface, and it must be properly disposed of.
Instead of a mask they suggest frequently using an alcohol based hand sanitizer or washing your hands with soap and water. Don't touch your face. They say a mask is only necessary if you're caring for a known infected person.
I think this advice is wrong. The advice assumes that the primary means of transmission happens because infected people breath virus into the air which become deposited on surfaces that are then touched by people's hands who then touch their face and themselves become infected.
But virus breathed into the air can remain suspended in the air for hours. Yes, it does gradually become deposited on surfaces where it can survive for a couple hours to a couple days, as reported by NBC News (https://www.nbcnews.com/...ading-crisis-n1157551/ncrd1157991):
quote:A preliminary study published this week found the virus could be detected in the air for up to three hours after it was aerosolized with a nebulizer, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel. The newest research, which has not yet been peer reviewed, was conducted by scientists at the National Institutes of Health, Princeton University, the University of California and the CDC.
But if the virus can survive in the air for up to three hours then people can breath it in, and therefore an N95 mask can be effective. Very effective.
That's my reasoning, yet everything I read says masks don't do much good. Why am I wrong?
quote:Third, of course masks work maybe not perfectly and not all to the same degree, but they provide some protection. Their use has always been advised as part of the standard response to being around infected people, especially for people who may be vulnerable. World Health Organization officials wear masks during their news briefings. That was the reason I had bought a few in early January I had been conducting research in Hong Kong, which has a lot of contact with mainland China, and expected to go back. I had studied and taught about the sociology of pandemics and knew from the SARS experience in 2003 that health officials in many high-risk Asian countries had advised wearing masks.
The Times opinion writer is questioning the logic of this recommendation. Restating the author's logic, if it's advisable to wear a mask even when caring for someone who is only suspected of being infected because of their symptoms, why isn't it also advisable when around people who you have no idea whether they have symptoms or not? How can you know you won't round the corner of an aisle in the grocery store just as an irresponsible and symptomatic person begins coughing? Avoiding possible infection by a virus with a 2% or 3% mortality rate seems to strongly encourage mask use.
I haven't been around smokers in years, but I recall how the cigarette smoke people exhale spreads out into the room. Can anyone truthfully say they've ever been in the presence of a smoker and not been able to smell the cigarette smoke? Infected people's exhalations spread out in the exact same way. If it's possible that someone in your vicinity is infected (my state has 13 known cases so far), doesn't it make sense to wear a mask?
Here's an image from February of Dr. Bruce Aylward, senior WHO adviser, explaining the China epidemic:
It doesn't seem as if the CDC and the WHO are on the same page regarding masks.
One more thing, and I think someone already mentioned this. Yes, you need an N95 rated mask or higher to stop viruses. They're really small. But I don't think viruses are often free-floating in the air. I think they're usually in small liquid globules that can easily be blocked by even a poor mask.
What I quoted from the book was certainly not misinformation.
You didn't quote anything from the book, and what you said about it tells us that it is full of misinformation, which isn't any surprise since Michael Savage is a known conspiracy theorist. But conspiracy theories sell books and can really get the pulse going, so happy reading.
Afterward I'll be doing the grocery shopping and I'll be wearing a bandana. I'd wear a mask if I could find one. When I return home the grocery bags will sit in the garage for 48 hours. Bags of groceries requiring refrigeration will be placed in the garage fridge (cold doesn't affect the virus). My clothes will be thrown in the washer and I'll take a shower.
I've now returned from this little southern New Hampshire excursion. I did find a mask - we had three N95 masks left over from when we repainted a bedroom a couple years ago. What follows includes a litany of complaints about how foolish we're being and how terribly, terribly bad and even contradictory the advice is.
Only three people were wearing masks, and I was one of them. I felt very self-conscious, and one lady made a little harumph as she walked past, no way to tell if it was serendipitous or meant for me. I detected no other hostility. I'd estimate there were around 150 people in the store.
While some were in plastic packaging, most fruit and vegetables were just lying out in bins. Any exhaled virus would deposit on them. The U.S. Department of Agriculture has a cononavirus FAQ that says:
quote:We are not aware of any reports at this time of human illnesses that suggest COVID-19 can be transmitted by food or food packaging.
I believe they are telling the truth that they "are not aware of any reports," but this is very misleading as it suggests that coronavirus can't be transmitted by handling or eating contaminated fruits and vegetables. It most certainly can.
quote:Typically, patients acquire COVID-19 through close contacts with others who transmit droplets that land on another’s mouth and/or nose. It is also possible to acquire it if you contact a surface with the live virus, then touch your mouth, nose or eyes.
The second sentence about surfaces agrees with both the CDC and the WHO, but the first sentence about airborne transmission contradicts the WHO, which claims it is not easily transmitted through the air.
I'm sure the WHO is wrong. While it is true that larger droplets do fall immediately onto surfaces, smaller droplets around 5 microns in diameter can persist in the air for up to a half hour, and smaller droplets longer.
I have seen it described several times how the virility of the coronavirus diminishes rapidly with time and distance because the concentration of live virus diminishes, but a virus that can still be detected on some surfaces after 48 hours is not diminishing rapidly, so this, too, seems very questionable. I also question that viral concentration can drop to safe levels. There can be no safe level. All that diminishes with viral concentration is the probability of infection. It takes only one infected cell to manufacture and spew a horde of viral copies.
The advice to maintain a distance of at least six feet from other people is nonsense, for a couple reasons. First, there is nothing sacred about a six foot difference. All that can be said is that the further you are from an infected person who breathes or coughs the less likely it is that you will be infected.
Second, try maintaining a six foot distance in a grocery store. If you're doing your weekly shopping and are visiting most or all aisles you will probably come closer than six feet to people at least a hundred times.
These products were pretty much wiped out, except for store brands: paper products, rice, flour, soup, pasta and pasta sauce.
Checkout lines were long today. There were seven people in my line and it extended back to the aisle, one right behind the other, even though I was the only one with a cart and so everyone else took up very little space (I couldn't use a basket because I had to buy two larger items). I doubt anyone trying to keep the persons in front and in back six feet away would have been unsuccessful.
I used my own bags, figuring they had less time to accumulate any virus than the plastic store bags.
I made several mistakes as I returned home. I pulled the mail out of the mailbox at the end of the driveway, I touched the doorknob of the door from the garage into the house, and I touched the bottom of the banister on my way upstairs to take a shower.
We put the mail in a plastic bag where it will stay for a couple days, and my wife wiped down the doorknob and banister. The rest of it went fine. The freezer goods went into a bag in the freezer of the garage fridge, the refrigerated goods into the fridge portion, and the rest are in a bag next to the snowblower. I left the mask there, too. We'll fetch them all in a couple days.
But the food I purchased and the bags I put it in were in my car, so now my car is potentially contaminated and I have to use it again tomorrow. Much of the interior is plastic and it is predicted that only 10% of coronavirus survives eight hours on plastic, so while that's not perfect it will have to do.
When I entered the house, after touching the aforementioned doorknob, I stripped and threw all my clothes, including my winter jacket, into the washer. I put my wallet, phone, glasses and watch atop the washer. The glasses I'll sterilize with alcohol, and I think my wallet is fine since it never left my pocket (Apple Pay, though with the mask on it couldn't do facial recognition and I had to enter my passcode). But how do you sterilize an iPhone (I used it a lot, not just paying, but checking with my wife about appropriate substitutes)? I'll look it up when I post this message.
Then I went upstairs, touching the aforementioned banister, and took a shower. I touched a light switch, another mistake. As soon as I was in the bathroom I washed my hands with soap and water so that I could stop worrying about touching things. Then I took a shower.
I'll be making another trip to the grocery store next Friday. We'll see if only three people are wearing masks.
Prophylactic measures are not just to protect oneself but also to prevent one from becoming an inadvertent vector during the early infectious stage when no symptoms or only mild symptoms are apparent.
May I suggest simply ordering a grocery delivery and staying home if you're this concerned?
Grocery delivery does not exist in our area. South of here in the more densely populated Boston metropolitan area there are services like PeaPod. Those who can avail themselves of such services should be aware that the virus can persist on surfaces for as long as 72 hours. Delivered groceries should sit in a protected but outer area of your domicile such as the garage, or in a large-size garbage bag in the hallway (wash hands after handling), or under an awning, etc.
The same is true of take out. Starbucks dining rooms are shut down, but many of their drive-throughs remain open. When your car window and the drive-through windows are both open air from Starbucks containing the exhalations of the waitperson can enter your vehicle, deposit on your car's interior and your clothes, and enter your breathing passages. The Starbucks cup could contain virus on its surface. Carry a spray bottle of 70% isopropyl alcohol. Spray the outside of the cup and the cover with alcohol, then wipe clean with a tissue, then do the same for your hands. Spray alcohol on your clothing and the car's interior.
Yes, that is too much. The proper advice is to avoid all drive-throughs.
Ordering take-out delivery has problems, too. If you order a pizza to be delivered then both the inside and outside of the box could have virus. The heat of the pizza is sufficient to kill the virus, but only on the parts of the box that actually are in contact with or very near the pizza. The rest of the box must be sprayed with alcohol. You should avoid coming anywhere near the delivery person or with any air they have recently breathed.
Delivery of Chinese food is a probably a little easier. Hot Chinese food in cardboard containers is more than hot enough to kill all virus. However, the inside and outside of the bag could have deposited virus. Spray with alcohol before handling.
Well, if it reassures you, it was only about ten days ago when I saw maybe one or two people wearing masks in town, at most. On Wednesday I was almost the only person out without a mask; since yesterday it's a legal requirement to cover your mouth outside.
Masks are very difficult to come by in the US. This is typical:
As is this (blacked out portions are addresses and phone numbers of local stores).
The lack of masks in the US will contribute to the virus's spread.
In summary, the coronavirus is extremely contagious and extreme prophylactic measures are appropriate in order to prevent both catching it and becoming a vector for it. Perhaps you are right that this is an overreaction, but as Dr. Fauci reminds the public frequently, it is far better to overreact than under.
President Trump and the Coronavirus Task Force are at this moment holding a press briefing, and I've been listening in:
President Trump spoke first. He mentioned many things that the administration is doing, among them ramping up mask production into the millions, suspension of interest and payments for federally held student loans, and working with Congress to pass an aid and stimulus package that will include aid for small businesses with passage currently targeted for Monday. He mentioned many other things, so those wanting more detail should either listen to the video or read a news article later. There was a lot of "this has never been done before" and "this has never been seen before" and "this is the first time" and "there has never been a thing like this in the history of the word" (the black death comes to mind) and "this is unprecedented" and "no one thought this could happen" and so forth.
Vice-president Pence spoke next. We are making progress against the 15 day plan that began 6 days ago. A person on his staff that he had had no contact with tested positive a day ago, but in the interests of an abundance of caution the vice-president and his wife will be tested later this afternoon.
Admiral Brett Giroir of the USPHS (United States Public Health Service) spoke next. His graph showed how the total number of tests (including results) has reached 190,000 as of yesterday, and over 50,000 tests in just the last two days alone, which means that the rate of testing is growing exponentially. He described who should be tested.
Dr. Fauci spoke next. Mitigation intensity will vary geographically according to need, and California and New York City were mentioned as regions where greater mitigation is required. Unnecessary testing must be avoided at all costs because it consumes precious PPE (Personal Protective Equipment) resources such as gloves, masks and gowns, not to mention the test itself. All elective medical and surgical procedures should be cancelled.
Pete Gaynor, the director of FEMA, spoke next. FEMA is now leading the federal response for all operations of the task force. HHS (Health and Human Services) will continue to provide their expertise on health. His message was a bit breathlessly delivered and hence a bit hard to understand, but I believe he said that FEMA in cooperation with HHS would be coordinating the delivery of services to the entire country, including territories and reservations. He said to buy medical supplies wherever they can be found and that the purchases were reimbursable, but I assume this portion was addressed to medical facilities and not to the public. The process he described did not sound like one that can move quickly because requests for medical equipment from the local level should first go to the states, from states to the local FEMA offices, and from there to the national FEMA offices in DC. He said response is most effective when it is locally executed, state supported and federally funded.
Ben Carson, secretary of HUD (Housing and Urban Development), spoke next. The president has authorized the cessation of foreclosure and eviction proceedings, I think for 60 days. Carson may only have been talking about FHA loans, because he said it covered 8.5 million people, and more people than that have mortgages. HUD does not have the authority to mandate that evictions cannot occur, but they're in contact with all the PHAs (Public Housing Authorities) across the country, and they're petitioning Congress for power to forbid evictions. He didn't explain how private owners of rental properties were involved. Reporting requirement deadlines have been pushed back to April 30th.
The Q/A portion was next, with various people answering.
In answering a question the president said that he wanted to preserve business and industry during the crisis so that economic activity can ramp up quickly when this is over. He ruled out allowing companies receiving federal assistance to use it for stock buybacks.
Pence said that FEMA has just executed a half billion dollar purchase of masks. Coincidentally it was reported yesterday that the federal government had submitted a purchase order for a half billion masks, so it's possible Pence misspoke.
Pence also said that HHS was fully integrated into FEMA, which I think could be another misspeak since that would be a reorganization requiring congressional approval.
Trump criticized throwing away masks after a single use, which has been standard medical practice for decades and decades and possibly for more than a century. Infection used to be a bigger killer of patients and armies than disease and injury - the practice has a solid foundation. Trump wants to sanitize masks. Fauci said there are guidelines for if and when such practices are possible. Masks, gloves and gowns have to be discarded after seeing each potentially infected patient, for obvious reasons.
Don't expect industrial versions of the N95 mask (which are just as good as surgical N95 masks but lacking insurance for that purpose, but the coming legislation is expected to provide that coverage federally until 2024) to be available at Home Depot and Lowes anytime soon, because they're being supplied to medical facilities.
In response to a question from CNN about the three or four months it took for the administration to begin it's response Trump claimed to have shut the country down very early, but that CNN didn't report it, and that the shutdown had saved more than 10,000 lives. Anyone who recalls Trump shutting the country down very early please post a reply to this message with accompanying evidence. Somehow I missed it, along with everyone else.
Dr. Fauci said that he hopes that the PPE shortage problem will be solved in days rather than weeks. We'll know if they were successful if next week we can finally buy masks again.
The president misspoke when he referred to the 1918 pandemic as 1917, evidently confusing it with the recent movie.
Dr. Fauci was visibly squirming in the background as the president responded to a question about using an anti-malarial drug.
The president complained at length about his coverage in the Washington Post, calling it unfair and inaccurate, then took a shot at sleepy Joe Biden. He claimed again that he acted early when he banned travel from China and later Europe.
Responding to another question the president said that his administration did not know about the growing coronavirus epidemic in China until they started seeing public news reports. This contradicts recent stories in the press that his own intelligence services began issuing warnings about the epidemic back in January and on into February. The president closed down travel with China on January 31, but airlines had already begun screening passengers from Wuhan, China, more than a week earlier.
I'm going to skip the remaining 20 minutes of the press conference, I've got things to do.
A couple recent articles are informative. Italy, Pandemic’s New Epicenter, Has Lessons for the World - The New York Times describes Italy's lesson in how not to contain the virus. Now with more than 53,000 infected and nearly 5000 dead Italy is learning how better to deal with the virus, as seen in this image from the top of the article showing medical workers in protective gear. Obviously their firsthand experience has left them really, really, really determined to not become infected:
Another informative article is What Does Coronavirus Do to the Body? - The New York Times, which makes clear why half-hearted or even worse minimal approaches, under the guise that most will catch it anyway, isn't a good option. Insufficient mitigation might overwhelm the medical system of most any nation, leaving inadequate resources to deal with any illness, not just coronavirus, with the result that many, many more could die.
Our increasing experience with the virus is also revealing that it isn't just the old and/or vulnerable who can suffer poor outcomes, because a surprising number of deaths are occurring in the 20-54 age group. A mortality rate of 2%-3% is pretty high, and while 80% of those infected suffer only mild symptoms, 20% experience severe enough symptoms to spend some time on a ventilator, while around 6% will be critical and spend several weeks on a ventilator.
Some will experience permanent health consequences, such as permanent lung damage. The virus can also attack other organs such as the heart, kidney and liver. It isn't yet known whether it can attack the brain. Other damage can result as the immune system attacks its own body while fighting wildly against the virus.
Concern should be both for oneself and for the people one might infect. Yes, you could be one of those who experience the most likely outcome of mild symptoms, but even if you are you could end up infecting someone who isn't so lucky. Individuals working as hard as possible to avoid infection is the best the world can hope for if we're to avoid tens of millions of deaths.
Union Square Farmers Market in Manhattan on March 14:
Audubon Park in New Orleans on March 18:
Clearwater, Florida, again, on March 19:
A wedding in Brooklyn:
Waterwall Park in Houston on March 15:
There are three groups: defiers who refuse to follow health advisories, disbelievers who don't believe there's a pandemic, and fatalists who say everyone has to die of something.
She also claims removal is a danger. You know what the instructions are for removal? It's a single sentence. Tilt the head forward, grasp the straps in the back, pull to the sides, then pull over the head. That's it. A child could do it.
She mentions that someone might touch the front of the mask, pick up coronavirus particles on their hand, then touch their face. This is possible, of course, but also easily avoided. It also means she understands that there could be sufficient coronavirus in the air to accumulate to infectious levels on the mask, which means that if the mask weren't there that the virus would have been breathed in.
Her advice is nonsense and comes from people she thinks are experts, such as our surgeon general, as described in Surgeon General Urges the Public to Stop Buying Face Masks - The New York Times. Jerome Adams repeats the same advice. But under his watch the United States suffered 80,000 flu deaths in 2017, the most in four decades. There's nothing in his background to suggest he's not qualified for the role, but he's a Trump appointee, which puts his competence under a cloud of suspicion since the primary Trump administration qualification is loyalty.
Adams's claim that masks are ineffective for the public while at the same time being effective for health care providers is obviously suspect. This claim seems primarily motivated by his goal to make masks more available to healthcare professionals, which is as it should be, but it is a different argument to say that the masks are ineffective for the public.
This is contradictory. A doctor seeing a suspected coronavirus patient in an examination room obviously needs a mask, but so does a member of the public walking by 150 people, any one of whom could possibly be infected, in the course of grocery shopping.
it has been found that people in the first five days of contagion shed coronavirus at a prodigious rate while often having little or no symptoms. While walking through a grocery store their exhalations will enter the air and eventually settle on food packaging, or in the case of fruit and vegetables, on the food itself.
Protect yourself. Wear a mask, whether it be a real one, a homemade one, or just a scarf. You'll not only protect yourself from infection but also others you might infect. Your groceries, your mail, your takeout deliveries, your Amazon deliveries, any of them could be coated with coronavirus. Do not take them into your house without waiting 48 hours or spraying down with at least 70% isopropyl alcohol.
Here's a video of spring break revelers:
How many do you think will be visiting grandparents soon or have grandparents living at home or even live with their grandparents. How many have professors in a vulnerable age group or with compromised health?
We all have a responsibility to be safe out there, if not for our own sake than for others.
Re: About masks, some examples of extraordinarily bad advice
Chiroptera writes:
There are some very non-essential items I've been meaning to order. But is it ethical? Would I be contributing to the exploitation of vulnerable workers who need the job? Or would I be helping people who can't go without the paycheck?
Many do not agree that extreme safety measures are necessary (masks, gloves, showers and washing of clothes upon return home, sanitizing car interior, etc.), but I think they're making the mistake of thinking the only threat is someone experiencing symptoms. CV can live upon the type of plastic used in much food and product packaging for up to 72 hours, and up to 24 hours on cardboard (see https://www.sciencedaily.com/...ses/2020/03/200320192755.htm). People can be very contagious for several days before they display symptoms.
I ordered a small item from Amazon yesterday, and it didn't occur to me to think about worker safety, but https://www.cnbc.com/...rus-safety-at-amazon-warehouses.html. It says he's working hard to get masks for those who cannot work from home but that they don't have them yet. It's nice to see that someone besides me thinks masks are important for everyone, not just medical workers. I encourage you to read the article. While it doesn't provide hard answers, it's raising the same issues you are.
I just got a calendar notice that I can bring in the groceries I purchased on Friday from the garage. And my shoes, too. My wife is out delivering masks she made (she's a quilter, she found a pattern on-line and ripped off 12 in no time - not N95 but using a tight thread fabric on the outside and way better than nothing) to the locally designated center for such things (the elementary school). I assume the place will not be crowded like a grocery store and that she won't be there very long, but when she returns we'll take measures appropriate to the number of people she encountered, the types of things she touched, and whether she was indoors or outdoors.
I've just started watching the Sunday morning programs. On ABC's This Week Martha Raditz is interviewing acting FEMA head Peter Gaynor, who stated that 600 million masks had been ordered and that they were shipping masks from the stockpile to the states everyday. This is the first I've heard of any stockpile of surgical masks and I'm not sure I believe any such thing exists.
Raditz repeatedly asked specific questions about how many masks were shipping and where they were shipping to, each time coming at the question differently, and Gaynor could only repeat that many masks were shipping to the states every day.
Given this performance of ignorance it isn't clear why Garnor is on the president's coronavirus task force unless it's because of loyalty to the president. We can only hope that the people under him are competent and doing what needs to be done.
--Percy
AbE: Two other people on the program have now mentioned the stockpile, so I guess it must exist.
A significant portion of N95 mask effectiveness is the static charge it carries. Washing an N95 mask in soap and water destroys the static charge, contributes significant wear and tear, and reduces effectiveness by about 25%. Soaking in isopropyl alcohol also destroys the static charge and reduces effectiveness against .3 micron particles by 37% but against.05 micron particles hardly at all, which seems contradictory. I read these figures last night, I can probably dig out the source if anyone thinks it important.
But there's another approach to freeing N95 masks of coronavirus: time. If coronavirus can persist on cardboard for about 24 hours, and if an N95 mask is comparable to cardboard, then letting an N95 mask sit for 24 hours should free it of coronavirus while maintaining its effectiveness. This is the approach I am taking. When I returned from the grocery store on Friday I left the N95 mask with the groceries for 48 hours. I will reuse the mask the next time I go out.
Is this an approach the medical community could use? I'm not sure. A doctor or nurse who sees 50 suspected cases of coronavirus a day would need 50 masks. Where would they keep them for a day?
I have assumed they need a new mask (and scrubs and gloves and a wash down) for each patient in order to avoid possibly exposing a series of patients to the virus, perhaps someone in the medical community can confirm if this is so. The reasoning behind this assumption is that if coronavirus is deposited on the mask's outer surface while inhaling then the coronavirus must be blown out into the room while exhaling.
The general advice I've seen online for medical professionals about N95 masks is to wear them for around four hours or until they become moist, but as I said, that is general advice, not pandemic level advice.
There are around five million medical professionals in the country. If on average they each needed only a couple or three masks a day under normal circumstances then the country's normal usage rate for N95 masks would be around 10 to 15 million per day, and a little more for private use. Since we're quickly running out of masks, usage must have gone way up, and my guess is that it is because doctors and nurses are changing out their masks after each patient. But again, it would be good to confirm if this is so.
Paraphrasing the objection, someone above has questioned figures cited from What Does Coronavirus Do to the Body? - The New York Times because it referred to "percent of people infected" instead of "percent of confirmed cases." In most contexts it is safe to assume these terms are synonymous, especially when statistics are being cited.
The underlying concern is that the coronavirus mortality rate is actually far lower than indicated by confirmed cases, around 4% worldwide. The reason for this is that most countries are only testing people with symptoms and calculate their figures based on the number of confirmed cases instead of the number of actual cases projected statistically.
But Germany is doing statistical testing that projects that the number of people actually infected far exceeds the number of confirmed cases. The mortality rate based on this statistical figure is a mere 0.1%, about the same as the flu (which has a vaccine that reduces the infection rate). But Germany also has a still incredibly low mortality rate of 0.4% for even confirmed cases, so something else may be going on in Germany that isn't understood yet. (I heard these figures on NPR this morning but cannot find a corresponding print story.)
But if the German figure can be confirmed, if coronavirus actually has a far lower mortality rate than currently thought, it would be a major game changer. Business and industry could reopen. Normal life could resume. Depression could be avoided.
If there were sufficient test equipment in this country then we could do the same kind of statistical sampling that Germany is doing and get a good idea of the actual penetration rate into the general population.
But we will know within a week or two if coronavirus is as contagious and dangerous as currently believed, because medical facilities in New York, California and Washington will either be overwhelmed by then, or they won't.
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