CDC considering recommending general public wear face coverings in public(washingtonpost.com)
washingtonpost.com
CDC considering recommending general public wear face coverings in public
https://www.washingtonpost.com/health/cdc-considering-recommending-general-public-wear-face-coverings-in-public/2020/03/30/6a3e495c-7280-11ea-87da-77a8136c1a6d_story.html
110 comments
HN has been pretty hostile to the idea. I submitted Jeremy Howards video and research collation, and got a single borderline insulting comment. Unfortunately people have largely made up their minds thanks to the plethora of attacks on masks.
moral "Your stealing them from healthcare" (lots of people have a couple old masks, or can make one from a t-shirt)
paternalistic "You'll go do stupid stuff if you have a mask" (Exactly why we shouldn't have people wash their hands)
ridiculous "You'll touch the mask and get it on your hands" (Is that worse than inhaling it? Plus it physically prevents you from touching you mouth or nose, which is the real danger.)
insulting "You can't possibly wear a mask correctly" (and why can't we figure that out? Plus it still helps both for protecting other people and ourselves. If something doesn't work perfectly then we shouldn't do anything at all?)
just false "it doesn't work" (except in asian countries and for healthcare workers, and in studies, and in common sense)
moral "Your stealing them from healthcare" (lots of people have a couple old masks, or can make one from a t-shirt)
paternalistic "You'll go do stupid stuff if you have a mask" (Exactly why we shouldn't have people wash their hands)
ridiculous "You'll touch the mask and get it on your hands" (Is that worse than inhaling it? Plus it physically prevents you from touching you mouth or nose, which is the real danger.)
insulting "You can't possibly wear a mask correctly" (and why can't we figure that out? Plus it still helps both for protecting other people and ourselves. If something doesn't work perfectly then we shouldn't do anything at all?)
just false "it doesn't work" (except in asian countries and for healthcare workers, and in studies, and in common sense)
...and experts in the field have been withholding evidence that masks are effective to protect their peers from mask shortages.
https://www.microbe.tv/twiv/twiv-special-lipkin/
timestamp: 33:30
https://www.microbe.tv/twiv/twiv-special-lipkin/
timestamp: 33:30
I agree that wearing a mask is a good idea but I think the risk is that as you breath or cough through a cloth mask it very quickly becomes wet and saturated with virus particles (if you're sick) and then every breath you exhale goes through a sieve full of virus particles greatly increasing the number of droplets in it.
If you touch it, you touch a reservoir of virus particles.
And it probably doesn't protect you significantly from other people's droplets or airborne virus particles as they are too small for the holes in the fabric.
On the other hand even if it reduces the risk 20% it still helps to reduce the R0
If you touch it, you touch a reservoir of virus particles.
And it probably doesn't protect you significantly from other people's droplets or airborne virus particles as they are too small for the holes in the fabric.
On the other hand even if it reduces the risk 20% it still helps to reduce the R0
> breath or cough through a cloth mask it very quickly becomes wet and saturated with virus particles
The alternative is to breathe or cough your virus particles in open-air? That doesn’t make sense.
The alternative is to breathe or cough your virus particles in open-air? That doesn’t make sense.
If you are going out for an extended period of time, carry an extra mask with you so you can change it if it gets wet.
If you’re coughing enough to “very quickly saturate” a cloth mask into a sopping wet rag...don’t go out.
If you can slow down the speed of the water particles the virus is traveling on that will presumably have a positive effect.
Speaking in a 'might help' frame of mind; directing the force of the cough down towards the ground so the virus settles is probably a pretty decent mitigation. Virus on the foot is a lot less likely to infect someone vs virus coughed into their face.
We're not dealing with a parasite; viruses can't move unless we move them.
Speaking in a 'might help' frame of mind; directing the force of the cough down towards the ground so the virus settles is probably a pretty decent mitigation. Virus on the foot is a lot less likely to infect someone vs virus coughed into their face.
We're not dealing with a parasite; viruses can't move unless we move them.
It's not just the US, the WHO is trying to tell people not to use masks unless they are sick or caring for someone that is.
It's irresponsibility on a massive scale.
https://edition.cnn.com/2020/03/30/world/coronavirus-who-mas...
Obviously frontline workers need priority for PPE, but there is zero reason this should stop anyone from making something homemade.
It's irresponsibility on a massive scale.
https://edition.cnn.com/2020/03/30/world/coronavirus-who-mas...
Obviously frontline workers need priority for PPE, but there is zero reason this should stop anyone from making something homemade.
It wasn't just political reasons. There were experts in the field that were spreading misleading information so as not to cause a shortage of masks for healthcare professionals.
One of the leading Epidemiologists, Ian Lipkin, admitted exactly this on the poscast This Week in Virology this week - https://www.microbe.tv/twiv/twiv-special-lipkin/ at timestamp ~33:30.
One of the leading Epidemiologists, Ian Lipkin, admitted exactly this on the poscast This Week in Virology this week - https://www.microbe.tv/twiv/twiv-special-lipkin/ at timestamp ~33:30.
It's really a simple logic: it's hard to enforce strict social distance, and it is hard to know if someone, even myself, is contagious. And there are so many uncertainties. What if I was contagious, and sneezed when someone is in front of me but 6 feet away? What if someone beside me thought Covid-19 was just another type of flu and couldn't care less even though she was already symptomatic? Really, weakness and ignorance are not barriers of survival. Arrogance is.
If nothing else you won't be touching your face uncontrollably if there's a mask. I already wear it when going on grocery runs etc, for that reason, and I notice an increasing number of people are doing the same. If distancing is in place, the main risk is not that you'd inhale something, it's that you touch something and then bring it into your mouth, nose, or eyes. Eyes are not an issue for me since I wear glasses. Mouth and nose are covered by a mask, so I can't touch them directly.
And you can reuse the masks by exposing them to 70C/158F heat for an hour.
And you can reuse the masks by exposing them to 70C/158F heat for an hour.
I thought I read that there was a risk of people touching their mask too much (to adjust it or because it itches), and thus increasing the risk.
Another lie propagated by those who wanted to save mask stockpiles for healthcare workers.
Try it yourself. I'm with OP, and know I'm reducing my chances of being infected by wearing a mask. Like most people, I can't go 5 minutes without poking my eyes or sticking my fingers up my nose. But put on my smoke respirator from the recent bush fires and I have no problem doing an hour long shopping trip. The pressure it puts on my face stops tickling.
Just watching people in the store and you can tell they think they’re protected but the masks are definitely not helping. Especially when they take them off incorrectly.
A full face covering might help people with touching their face but too many people think it will filter out particles.
A full face covering might help people with touching their face but too many people think it will filter out particles.
What's the correct and incorrect way to take the masks off?
CDC provides guidelines for donning/doffing N95 masks here: https://www.cdc.gov/vhf/ebola/hcp/ppe-training/n95respirator...
The process is straightforward. I was shown a different technique than they provided, and am not a fan of having dirty gloves on or around my head and face as they show there.
I have been trained to usa a gloved hand and place it over the center of the mask, use your other hand to lift the straps over your head, and then pull away and discard the mask and gloves. The key is to prevent any contact between the exterior of the mask and your face, and certainly not to touch your face with the gloves.
Removing the mask incorrectly risks exposure to whatever was outside the mask in the first place. For the kind of exposure nonmedical personnel ought to experience, and for extended wear periods, I would think the mask would act to integrate whatever you've been surrounded by. In other words, you've collected 8 hours of crap on the front of it, so you'd want to be extra careful with the dirty part.
The process is straightforward. I was shown a different technique than they provided, and am not a fan of having dirty gloves on or around my head and face as they show there.
I have been trained to usa a gloved hand and place it over the center of the mask, use your other hand to lift the straps over your head, and then pull away and discard the mask and gloves. The key is to prevent any contact between the exterior of the mask and your face, and certainly not to touch your face with the gloves.
Removing the mask incorrectly risks exposure to whatever was outside the mask in the first place. For the kind of exposure nonmedical personnel ought to experience, and for extended wear periods, I would think the mask would act to integrate whatever you've been surrounded by. In other words, you've collected 8 hours of crap on the front of it, so you'd want to be extra careful with the dirty part.
> not a fan of having dirty gloves on or around my head
For what it's worth, the earlier steps include removing outer gloves, and disinfecting the inner gloves.
For what it's worth, the earlier steps include removing outer gloves, and disinfecting the inner gloves.
There are pages of results on Youtube, such as https://www.youtube.com/watch?v=HluIkTbTBIw for a respirator type mask.
I would also recommend if you are following the procedure with a reused mask to immediately wash your hands afterwards since you will be touching a contaminated surface. Guides assume you are using a fresh mask, per health worker procedures.
I would also recommend if you are following the procedure with a reused mask to immediately wash your hands afterwards since you will be touching a contaminated surface. Guides assume you are using a fresh mask, per health worker procedures.
I think the idea is more to stop you from unwittingly infecting someone by shooting droplets while you speak or cough or clear your throat, than to filter out the air you breathe. So it's not your mask that protects you, it's all the other people's masks.
It will filter out particles. Just not as many as a high end mask like an N95. But better than nothing. Studies prove this. The masks-don't-work people are causing extreme harm and killing people.
Sadly the article itself conflates N95 respirators with surgical/home-made masks. Former protect the wearer; latter protect others (primarily).
>the health department there does not recommend that people without illness wear a mask, both because the benefit is uncertain and because there’s a shortage of face masks for health-care workers.
Better to never write "respirator mask" nor "face mask". Those terms perpetuate the confusion.
>the health department there does not recommend that people without illness wear a mask, both because the benefit is uncertain and because there’s a shortage of face masks for health-care workers.
Better to never write "respirator mask" nor "face mask". Those terms perpetuate the confusion.
> N95 respirators with surgical/home-made masks. Former protect the wearer; latter protect others (primarily).
Source?
I think if you use disposable masks or correctly sanitize[0] a homemade mask after each use, the mask will act to protect yourself and others.
There was an interesting article posted recently comparing the efficacy of surgical masks with household materials[1] - to give a rough idea of how effective a homemade mask might be.
You can also find an interesting comparison of N95 with surgical masks on the same site[2]
[0] https://news.ycombinator.com/item?id=22680799
[1] https://smartairfilters.com/en/blog/best-materials-make-diy-...
[2] https://smartairfilters.com/en/blog/n95-mask-surgical-preven...
Source?
I think if you use disposable masks or correctly sanitize[0] a homemade mask after each use, the mask will act to protect yourself and others.
There was an interesting article posted recently comparing the efficacy of surgical masks with household materials[1] - to give a rough idea of how effective a homemade mask might be.
You can also find an interesting comparison of N95 with surgical masks on the same site[2]
[0] https://news.ycombinator.com/item?id=22680799
[1] https://smartairfilters.com/en/blog/best-materials-make-diy-...
[2] https://smartairfilters.com/en/blog/n95-mask-surgical-preven...
Shouldn't any covering help? Like catching 50% is much better than 0%, even if the N95 can catch 95% of particles.
Masks offer very limited protection. It’s similar to wearing medieval platemail to protect against a high powered rifle. Partial protection at best.
Direct sneezes or coughs right in front of you are safer but you also need eye protection. That still leaves the ears open and microabrasians on your skin.
False confidence with the expectation they’re safe with an N95 mask is even worse than no mask at all. It’s like those kids in the news some years ago that held up a book to stop a bullet and killed someone.
If you wear the mask in a constrained area with a group of people, such as an elevator, you may as well not even have it on.
The only sure way to not get the virus is avoiding people.
Direct sneezes or coughs right in front of you are safer but you also need eye protection. That still leaves the ears open and microabrasians on your skin.
False confidence with the expectation they’re safe with an N95 mask is even worse than no mask at all. It’s like those kids in the news some years ago that held up a book to stop a bullet and killed someone.
If you wear the mask in a constrained area with a group of people, such as an elevator, you may as well not even have it on.
The only sure way to not get the virus is avoiding people.
Ears aren't connected to the respiratory system. Lacrimal ducts are, that's why eye protection is important. The virus doesn't enter your lungs through your skin pores either.
You'd be wrong. That's why I mentioned abrasions on your skin. I didn't say on normal, healthy skin that it penetrates.
Viruses can penetrate mucous membranes (the inside of your ear). Mucous membranes are the top spot where most diseases enter to the body. From there they enter to blood stream and spread to tissues, where ever they can spread.
Other folks already corrected the mistaken belief on your ears. They are connected. That said, I'm not sure why you think that matters? It has no importance when we're talking about a pathogen entering the body.
Viruses can penetrate mucous membranes (the inside of your ear). Mucous membranes are the top spot where most diseases enter to the body. From there they enter to blood stream and spread to tissues, where ever they can spread.
Other folks already corrected the mistaken belief on your ears. They are connected. That said, I'm not sure why you think that matters? It has no importance when we're talking about a pathogen entering the body.
Ears are directly connected to the sinuses (via the Eustachian tubes), which is part of the upper respiratory system. There's a reason we have Eye, Ear, Nose, Throat doctors. It's all connected.
As far as I know ear, nose, throat doctors (Otolaryngologists) don't treat eyes and they are called
'Ear, Nose, Throat' doctors, there's no eye in the name. Doctors that treat eyes are Ophthalmologists and Optometrists.
https://medical-dictionary.thefreedictionary.com/EENT
It's possible it has fallen out of favor. I'm a tad on the old side.
It's possible it has fallen out of favor. I'm a tad on the old side.
You're correct, but to add further qualification to your correct assertion- it doesn't matter if they're connected or not. All a pathogen has to do is enter the body by any means, not have direct access to the respiratory system on entry.
I believe this is false. My understanding is that viruses often target specific cells, such as the way the coronavirus targets the aveoli cells in your lungs.
Some viruses are more tissue-specific than others. But viruses do not reach, they passively float until it can jump to cell it can hook up with so it just needs to get into your system.
Yep, I didn't mean "target" in any sort of active way, just functionally. I understand their mechanism is passive.
Then what part of my statement was false?
You said the coronavirus could enter the body by any means. Is this true? Do you have some resources I could read?
I was under the impression that, effectively speaking, it only infects via the lungs.
I was under the impression that, effectively speaking, it only infects via the lungs.
I'm not sure where the best resources to read are, I studied biology and am going off of existing knowledge.
ALL pathogens if they can penetrate the skin get access to a body and can cause infection. Simple as that.
All pathogens aim for is to harvest your cells. Bacteria and single-cell eucaryote will digest and eat your cells. Viruses will go inside your cells and reprogram cell produce new virus particles.
It is that simple and the easiest way to our bodies is through mucus membranes as they lack skin and are protected by a thin layer of mucus, in other word slime and snot. You have mucus membrane in your aerial pathways in your head as eyes, nose and mouth. Also, your lungs are the huge surface area of mucus membrane.
But if your skin for any reason is ruptured it opens access for any pathogen go in that way. Point is if a pathogen has access to your cells or not. Nothing else. Most infectious diseases first get inside of your body via mucus membranes.
Our skin is not only that last layer of the nonliving layer but consists about few inches of separate layers that in microbiological points are just layers of defense against anything that tries to invade the body. Blood vessels are thin, cell walls that allow white blood cells to move between layers. All layers have little living cells as possible and cell types that are hard to use as food.
So if the skin is only damaged it still gives a fairly difficult pathway to pathogen get on without ending with a good fight. If the skin is fully penetrated the situation is different. That's why all deep penetrations to tissues often cause so severe infections. As whatever pathogen with an arrow, knife blade or bullet get deep in a body where is easy to spread and defenses are low.
My posts have been downvoted into oblivion by a bunch of programmers, but ask a doctor if what I'm saying is correct or not. It is.
ALL pathogens if they can penetrate the skin get access to a body and can cause infection. Simple as that.
All pathogens aim for is to harvest your cells. Bacteria and single-cell eucaryote will digest and eat your cells. Viruses will go inside your cells and reprogram cell produce new virus particles.
It is that simple and the easiest way to our bodies is through mucus membranes as they lack skin and are protected by a thin layer of mucus, in other word slime and snot. You have mucus membrane in your aerial pathways in your head as eyes, nose and mouth. Also, your lungs are the huge surface area of mucus membrane.
But if your skin for any reason is ruptured it opens access for any pathogen go in that way. Point is if a pathogen has access to your cells or not. Nothing else. Most infectious diseases first get inside of your body via mucus membranes.
Our skin is not only that last layer of the nonliving layer but consists about few inches of separate layers that in microbiological points are just layers of defense against anything that tries to invade the body. Blood vessels are thin, cell walls that allow white blood cells to move between layers. All layers have little living cells as possible and cell types that are hard to use as food.
So if the skin is only damaged it still gives a fairly difficult pathway to pathogen get on without ending with a good fight. If the skin is fully penetrated the situation is different. That's why all deep penetrations to tissues often cause so severe infections. As whatever pathogen with an arrow, knife blade or bullet get deep in a body where is easy to spread and defenses are low.
My posts have been downvoted into oblivion by a bunch of programmers, but ask a doctor if what I'm saying is correct or not. It is.
Moving forward, masks should be readily available in public places in the same way tissues are.
For example, a large box or auto dispensing machine for individually wrapped, single masks, in libraries, grocery stores, offices, classrooms, movie theaters, etc.
And might as well add motion activated hand sanitizer dispensers at the entrances too.
For example, a large box or auto dispensing machine for individually wrapped, single masks, in libraries, grocery stores, offices, classrooms, movie theaters, etc.
And might as well add motion activated hand sanitizer dispensers at the entrances too.
Some countries are struggling to ban single use plastic bags, now we want everyone to use disposable masks everywhere, the waste from this must horrific
They aren't made of plastic, so I don't think they'll cause even a fraction of as much problematic waste
Normalize the user of cloth masks.
Interestingly, official Singaporean advice recommends masks only for people feeling symptoms. See strategy point 5:
https://www.abc.net.au/news/2020-03-31/coronavirus-singapore...
Also interesting, in a bad way: Strategies 1-4 are plainly beyond the ability of US to implement any time soon.
https://www.abc.net.au/news/2020-03-31/coronavirus-singapore...
Also interesting, in a bad way: Strategies 1-4 are plainly beyond the ability of US to implement any time soon.
This is probably before the virus was better understood. Some argue that the virus can be spread by the host 48 hours before a symptom is developed. Whether true or not, what's so difficult about everyone wearing a mask just to be on the safe side? Is it because there isn't enough masks to wear every day? It's fine with wearing same mask every day as long as it can contain droplets from spreading outside of virus host.
Given the lifespan of the virus on various surfaces, reuse seems fine in any case. If you need to go out every day, cycle between 3. Weekly shopping, just one.
Singapore has thorough testing and contact tracing. They also take quarantine extremely seriously.
It's also beyond much of the US to implement 80-90 degree temperatures that dramatically limit the ability for SARS-Cov-2 to spread as in Singapore.
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767
See: Hawaii, Texas, Nevada, New Mexico, Arizona, much of California and a lot of the warmer south. Which are all seeing between extremely low and low localized per capita transmission levels and hospitalizations, despite the very lagged (and overall mediocre) US response.
The Las Vegas metro area will be 80 degrees on Wednesday. Take a look at their deaths and hospitalizations (despite having millions of people). With their international traffic, vast number of casinos and casino workers, slow speed at which they shut it all down and the initially lagged testing rates, they should be absolutely buried in Covid cases and deaths. They're anything but and they're seeing no big surge in cases.
These temps are the reason why the experts are hopefully anticipating the infection rates to rapidly bend down in the coming weeks, and perhaps peak in May or June. Even very informed people like Bill Gates have spoken publicly about being hopeful about this (see his recent Ted Connects talk, it's about an hour long and almost exclusively about this situation). It's the seasonal temperature increase (and to an extent humidity) factor.
edit: I understand why some people don't like these facts, I understand the emotional response. The numbers don't lie: hotter climates in the US are not seeing the surge in cases, they're not seeing the same hospitalization rates and as a consequence they're not seeing the deaths as in the other climates like NY, NJ, MA, IL, CT, MI.
Check out all the cities in Texas (huge population), their metro areas, and look at the per capita rates of infection, hospitalization and death. Then compare.
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767
See: Hawaii, Texas, Nevada, New Mexico, Arizona, much of California and a lot of the warmer south. Which are all seeing between extremely low and low localized per capita transmission levels and hospitalizations, despite the very lagged (and overall mediocre) US response.
The Las Vegas metro area will be 80 degrees on Wednesday. Take a look at their deaths and hospitalizations (despite having millions of people). With their international traffic, vast number of casinos and casino workers, slow speed at which they shut it all down and the initially lagged testing rates, they should be absolutely buried in Covid cases and deaths. They're anything but and they're seeing no big surge in cases.
These temps are the reason why the experts are hopefully anticipating the infection rates to rapidly bend down in the coming weeks, and perhaps peak in May or June. Even very informed people like Bill Gates have spoken publicly about being hopeful about this (see his recent Ted Connects talk, it's about an hour long and almost exclusively about this situation). It's the seasonal temperature increase (and to an extent humidity) factor.
edit: I understand why some people don't like these facts, I understand the emotional response. The numbers don't lie: hotter climates in the US are not seeing the surge in cases, they're not seeing the same hospitalization rates and as a consequence they're not seeing the deaths as in the other climates like NY, NJ, MA, IL, CT, MI.
Check out all the cities in Texas (huge population), their metro areas, and look at the per capita rates of infection, hospitalization and death. Then compare.
Do you have per capita rate of testing for those locales as well? Otherwise you’re really just comparing mayors/governors from different regions.
This information is available for most states at this point (it's sometimes harder to find city data broken out, that varies; every state has Covid data available, published daily or close to it (a few seem to lag by a day)).
Show me the 500-2500 dead people in Texas per day, which is what should be happening if they were seeing the surge. Show me a massive explosion in positive cases and hospitalizations. The fact is, it's not happening.
34 deaths in Texas and zero big surge:
https://covidtracking.com/data/state/texas/#history
The testing information has been flawed as a resource in all locations except for a few around the world (eg South Korea, which has been a stellar example). You want to look at the deaths and hospitalizations, the flooding of ICUs in the states. The states I've listed are seeing none of the huge surge that the other high-infection rate climates have. The US isn't hiding tens of thousands of recent Covid deaths from the past week. Our testing has ramped up such that we're able to do near a million tests per week now. If Texas cities were seeing hundreds of daily Covid deaths, it would be everywhere in the news, on social media and so on (as it is in NYC).
Take a look at the SF local metro. Take a look at the infections, hospitalizations and deaths. The SF metro should be buried right now, and it's not at all. The Bay Area has 8 million people, where are the 50,000 cases, surging cases by the thousands per day, and hundreds dead per day? It's not happening. It should have been hit early and hard, and it hasn't been.
Los Angeles has a lot of poverty and healthcare problems, it should be an ideal explosion city. It has seen anything but that outcome despite all of its problems. Los Angeles isn't hiding many thousands of dead Covid patients and ICU cases from the past week.
Take a look at San Diego County. Same thing.
You might wonder: why am I bringing this up, why does it matter? We're misallocating healthcare resources based on an incorrect premise that all locations are equally susceptible to SARS-CoV-2 (which has also led to very flawed speculation, extrapolation, on expected national case numbers (eg: 70% will get infected, a million will die; headlines of: your city could be the next NYC)). Simple example: they sent the USNS Mercy navy ship to Los Angeles, it's needed off the coast of NYC to a dramatically greater degree - LA isn't going to see the same kind of surge (theirs will be far more mild). Conceptually we need Texas and Arizona manufacturing resources for the hard hit climates.
Show me the 500-2500 dead people in Texas per day, which is what should be happening if they were seeing the surge. Show me a massive explosion in positive cases and hospitalizations. The fact is, it's not happening.
34 deaths in Texas and zero big surge:
https://covidtracking.com/data/state/texas/#history
The testing information has been flawed as a resource in all locations except for a few around the world (eg South Korea, which has been a stellar example). You want to look at the deaths and hospitalizations, the flooding of ICUs in the states. The states I've listed are seeing none of the huge surge that the other high-infection rate climates have. The US isn't hiding tens of thousands of recent Covid deaths from the past week. Our testing has ramped up such that we're able to do near a million tests per week now. If Texas cities were seeing hundreds of daily Covid deaths, it would be everywhere in the news, on social media and so on (as it is in NYC).
Take a look at the SF local metro. Take a look at the infections, hospitalizations and deaths. The SF metro should be buried right now, and it's not at all. The Bay Area has 8 million people, where are the 50,000 cases, surging cases by the thousands per day, and hundreds dead per day? It's not happening. It should have been hit early and hard, and it hasn't been.
Los Angeles has a lot of poverty and healthcare problems, it should be an ideal explosion city. It has seen anything but that outcome despite all of its problems. Los Angeles isn't hiding many thousands of dead Covid patients and ICU cases from the past week.
Take a look at San Diego County. Same thing.
You might wonder: why am I bringing this up, why does it matter? We're misallocating healthcare resources based on an incorrect premise that all locations are equally susceptible to SARS-CoV-2 (which has also led to very flawed speculation, extrapolation, on expected national case numbers (eg: 70% will get infected, a million will die; headlines of: your city could be the next NYC)). Simple example: they sent the USNS Mercy navy ship to Los Angeles, it's needed off the coast of NYC to a dramatically greater degree - LA isn't going to see the same kind of surge (theirs will be far more mild). Conceptually we need Texas and Arizona manufacturing resources for the hard hit climates.
According to that data NY has tested almost 1% of their population while Texas has tested only 0.1% of theirs. But even if we look only at hospitalizations as you’ve suggested could it be that you’re incorrectly attributing the slower rates to temperature rather than population density? The colder cities in the US are the older cities where people live very closely together. States like Texas have a certain degree of “social distancing” already baked in. Using the drive thru and avoiding the subway and elevators isn’t really a drastic change for Texas. It’s basically impossible for much of New York.
Except that Wuhan is at the same latitude as Texas.
You also failed to mention Washington, which was the site of the first outbreak in the US, and is about as north as you can go and still remain in the union, excluding Alaska. Washington currently has the second-slowest death-count doubling-rate out of any state with at least 10 deaths. Their deaths double every 7 days. It used to be every 3 days. Can’t attribute that to the heat. You know what you can attribute it to? Washington’s response to the outbreak.
Florida’s deaths double every 3 days. Louisiana’s deaths double every 3 days.
Texas’s deaths double every 3 days.
Vermont, another northern state that borders New York state, has the slowest death count doubling rate, at every 12 days.
This is exponential growth. Please stop dealing with absolute numbers. Some states are later into their epidemics than others. Texas is relatively early into their outbreak at ~7 days since the 10th death, but their deaths are growing exponentially as well. The exponential growth curve should be what you’re observing, or else you will make the same mistake that everyone who thinks they’re exceptional makes.
You also failed to mention Washington, which was the site of the first outbreak in the US, and is about as north as you can go and still remain in the union, excluding Alaska. Washington currently has the second-slowest death-count doubling-rate out of any state with at least 10 deaths. Their deaths double every 7 days. It used to be every 3 days. Can’t attribute that to the heat. You know what you can attribute it to? Washington’s response to the outbreak.
Florida’s deaths double every 3 days. Louisiana’s deaths double every 3 days.
Texas’s deaths double every 3 days.
Vermont, another northern state that borders New York state, has the slowest death count doubling rate, at every 12 days.
This is exponential growth. Please stop dealing with absolute numbers. Some states are later into their epidemics than others. Texas is relatively early into their outbreak at ~7 days since the 10th death, but their deaths are growing exponentially as well. The exponential growth curve should be what you’re observing, or else you will make the same mistake that everyone who thinks they’re exceptional makes.
> See: Hawaii, Texas, Nevada, New Mexico, Arizona, much of California and a lot of the warmer south. Which are all seeing between extremely low and low localized per capita transmission levels and hospitalizations, despite the very lagged (and overall mediocre) US response.
And yet Lousiana is getting pounded because of Mardi Gras.
And Florida is likely to follow due to Spring Break.
No state yet has evidence that they have turned their curve over from the standard R0. And, last I checked, practically every state was on the same trajectory past the 100th case.
And yet Lousiana is getting pounded because of Mardi Gras.
And Florida is likely to follow due to Spring Break.
No state yet has evidence that they have turned their curve over from the standard R0. And, last I checked, practically every state was on the same trajectory past the 100th case.
It's still too early to tell, but SF Bay area, California may have gotten a break (vs a NYc/Italy level surge) from having gone shelter-in-place early.
https://brokeassstuart.com/2020/03/30/bay-area-curve-stays-f...
https://brokeassstuart.com/2020/03/30/bay-area-curve-stays-f...
Hotter temperatures do not guarantee the cessation of all possible transmission of SARS-CoV-2, it impedes it in relation to the increase in temperature (and also ideally humidity, particularly indoors). It helps make everything else you might do for slowing the spread more effective and easier. There is very strong evidence at this point that SARS-Cov-2 is susceptible to the same seasonality factors as influenza. We're seeing this demonstrated all around the world simultaneously in warmer climates, from Mexico to sub Sahara Africa to hotter countries in Asia. It's why none of the major cities in Latin America are seeing the kind of infection rates as NYC or Milan (or as Wuhan previously did). It's why sub Sahara Africa isn't getting hammered (despite plenty of international traffic and trade, including previously from China, that should have massively spread it). It's why India still isn't seeing a massive explosion in cases, as has been feared since the beginning of the outbreak in China.
Check out: Mobile & Birmingham & Montgomery Alabama, the Western handle of Florida, Jackson Mississippi, look at other cities in Louisiana that didn't hold Mardi Gras (and one assumes those cities still got a burst of their cases from the Mardi Gras spread event).
Check out: Mobile & Birmingham & Montgomery Alabama, the Western handle of Florida, Jackson Mississippi, look at other cities in Louisiana that didn't hold Mardi Gras (and one assumes those cities still got a burst of their cases from the Mardi Gras spread event).
Latin America is not testing people Nearly enough. That’s the main reason for low counts.
In my country, it is only possible to be tested if you say you were in direct contact with the current 4 confirmed cases (1 deceased), and they would have to confirm that too.
In my country, it is only possible to be tested if you say you were in direct contact with the current 4 confirmed cases (1 deceased), and they would have to confirm that too.
Yes, I understand the reason for the low counts. As I keep repeating, you want to pay attention to the flooding of hospitals with Covid patients, that you can't hide (unless you're very authoritarian with strict media control).
These places are not buried in dead people either. Their intensive care systems are not being flooded. Their hospitals are not being flooded by a million cases.
Mexico is not seeing what NY and other high-infection climates have. Given the poverty, poor healthcare system, poorly prepared healthcare system, high traffic and trade with the US via NAFTA and in general, it should have an enormous number of cases by now, and as a consequence a large number of daily deaths and intensive care cases hammering their healthcare systems in every major city. None of that is happening. It's not happening for the same reason it's not happening in Texas.
These places are not buried in dead people either. Their intensive care systems are not being flooded. Their hospitals are not being flooded by a million cases.
Mexico is not seeing what NY and other high-infection climates have. Given the poverty, poor healthcare system, poorly prepared healthcare system, high traffic and trade with the US via NAFTA and in general, it should have an enormous number of cases by now, and as a consequence a large number of daily deaths and intensive care cases hammering their healthcare systems in every major city. None of that is happening. It's not happening for the same reason it's not happening in Texas.
From everything I've read about COVID-19 and flu-like infections, I'm also inclined to believe that warmer climates help slow COVID-19 outbreaks. It is (in my opinion) the most plausible explanation why certain regions are hit so much worse than others thus far. I also believe a paper I recently read supports this hypothesis.
I've seen the media publish articles with titles like "coronavirus myths busted: warm weather stops the virus". Ironically, these attempts to combat misinformation are dubious themselves, as the truth is probably somewhere in the middle; that is, warm climates may not outright stop COVID-19, but they may certainly hinder it. The fact is, while we can't make definitive statements at the moment due to limited data and understanding of the virus's pathology, we can make educated guesses through observation.
Another contentious point (particularly here in Australia) is the sentiment that children are mostly immune to the virus. The Aus government is pushing this line very strongly as an excuse to keep schools open (i.e. economical reasons).
So yeah, I don't know why I wrote this comment. Probably to stress the fine line that exists between having a mindset which is open to observational theories, while also being critical of "facts" which are pushed to drive political agendas amidst the coronavirus outbreak.
I've seen the media publish articles with titles like "coronavirus myths busted: warm weather stops the virus". Ironically, these attempts to combat misinformation are dubious themselves, as the truth is probably somewhere in the middle; that is, warm climates may not outright stop COVID-19, but they may certainly hinder it. The fact is, while we can't make definitive statements at the moment due to limited data and understanding of the virus's pathology, we can make educated guesses through observation.
Another contentious point (particularly here in Australia) is the sentiment that children are mostly immune to the virus. The Aus government is pushing this line very strongly as an excuse to keep schools open (i.e. economical reasons).
So yeah, I don't know why I wrote this comment. Probably to stress the fine line that exists between having a mindset which is open to observational theories, while also being critical of "facts" which are pushed to drive political agendas amidst the coronavirus outbreak.
Better late than never, but they'll need to put some work into countering all the anti-mask propaganda that's been flying around for weeks now.
Propaganda? Example?
They have been issuing logically inconsistent statements for weeks saying masks don't work for the general public but do work for healthcare providers. It's difficult to then turn around and say masks work for everyone without losing all credibility.
And in many of those cases they were trying to convince people N95 masks wouldn't protect them. Imagine now trying to convince people that less effective things work (surgical masks, cloth masks, folded t shirts, etc...)
Yesterday morning the surgeon general tweeted "They are NOT effective in preventing general public from catching #Coronavirus"
There has been tons of rhetoric designed to discourage the public from buying masks that gives the impression that public wearing masks won't help. A lot of headlines to that effect that lack any nuance at all.
There has been tons of rhetoric designed to discourage the public from buying masks that gives the impression that public wearing masks won't help. A lot of headlines to that effect that lack any nuance at all.
I wonder if this is due to risk of beating facial recognition technology. If masks become common, add in sun glasses and most facial recognition cameras will fail. Governments will be back to zero on tracking their citizens. I know this sounds nuts but I keep thinking why there was such a strong push against public wearing these masks.
A much simpler explanation would be to preserve stocks of masks for medical personnel who actually really need them. It's certainly beneficial for your average person to wear one at all times - look at the declines in flu happening right now as we separate from one another. But it's essential for medical personnel who are on the front lines of this war.
It's often helpful to evaluate conspiracy theories using Occam's Razor. What's the simplest explanation which fits the facts?
It's often helpful to evaluate conspiracy theories using Occam's Razor. What's the simplest explanation which fits the facts?
That's true though, isn't it? A mask will not prevent you from getting the virus, since covering your own mouth from others coughing doesn't really help you. If you are sick though, it protects others.
> A mask will not prevent you from getting the virus, since covering your own mouth from others coughing doesn't really help you. If you are sick though, it protects others.
What is the mechanism for this?
At first, I'd expect it to be the other way around--if I'm wearing a mask and cough the mask is going to bear the full force of my cough. All of the cough is hitting the mask, and the cough is moving at its fastest speed.
If I'm not wearing a mask and you are, my cough is going to be spread out some when it reaches you and slowed by air resistance, so your mask should only have to deal with a fraction of my cough and at lower velocity.
Thus, I'd expect your mask to have a much easier task than mine.
Is it that the drops of moisture (and phlegm and whatever else might be in a cough) are bigger at the point of emission and break apart as they disperse, and so they have a harder time going through a mask at my end than at your end?
If that is the case, I still have to wonder what happens on subsequent coughs. I cough, producing big drops that the mask stops. Still, the viruses in the drops have to go somewhere when the mask absorbs the droplets, right? Does my mask end up moistened with virus-contaminated water? Will my subsequent coughs as they blast air through the mask then be able to knock small virus laden droplets off my mask?
What is the mechanism for this?
At first, I'd expect it to be the other way around--if I'm wearing a mask and cough the mask is going to bear the full force of my cough. All of the cough is hitting the mask, and the cough is moving at its fastest speed.
If I'm not wearing a mask and you are, my cough is going to be spread out some when it reaches you and slowed by air resistance, so your mask should only have to deal with a fraction of my cough and at lower velocity.
Thus, I'd expect your mask to have a much easier task than mine.
Is it that the drops of moisture (and phlegm and whatever else might be in a cough) are bigger at the point of emission and break apart as they disperse, and so they have a harder time going through a mask at my end than at your end?
If that is the case, I still have to wonder what happens on subsequent coughs. I cough, producing big drops that the mask stops. Still, the viruses in the drops have to go somewhere when the mask absorbs the droplets, right? Does my mask end up moistened with virus-contaminated water? Will my subsequent coughs as they blast air through the mask then be able to knock small virus laden droplets off my mask?
My understanding is that, as you said, the purpose of the mask is to stop droplets from coughs and sneezes from getting to other people and surfaces. However if others cough on you when you are wearing a mask, the rest of your face is still exposed so you are not fully protected, and you can still be infected by touching contaminated surfaces and then touching your face. Surgical masks are also not sealed off, so you can breath in aerosol from other people's coughs even with the mask.
Certainly masks will help to some degree, as they will filter out some particles and protect you if someone directly coughs into the mask, but I don't think they are effective compared to things like hand washing.
I am not a doctor, not medical advice.
Certainly masks will help to some degree, as they will filter out some particles and protect you if someone directly coughs into the mask, but I don't think they are effective compared to things like hand washing.
I am not a doctor, not medical advice.
It still reduces particles you inhale. Sure virus is smaller than holes in your average mask but usually virus will be floating in fluid. Those should get stopped by mask.
Personally, I have been using these cheap masks for over a decade whenever I have to clean any dusty place like a garage. If I don't wear one, I am almost guaranteed a a bad allergic reaction. If I do wear one while cleaning, I might sneeze a bit but usually not need Benadryl and pass out for rest of the day.
I imagine same principle applies when it comes to COVID19.
Personally, I have been using these cheap masks for over a decade whenever I have to clean any dusty place like a garage. If I don't wear one, I am almost guaranteed a a bad allergic reaction. If I do wear one while cleaning, I might sneeze a bit but usually not need Benadryl and pass out for rest of the day.
I imagine same principle applies when it comes to COVID19.
It's misleading. Even improvised masks will reduce the chance of asymptomatic carriers spreading the disease, thus reducing the chance of the general public catching it. Note the "general public" language in the tweet. Even if there is a way to parse that tweet that renders it technically correct, it's still phrased in a way that is certain to mislead a lot of people.
The surgeon general also said that Trump — an obese, sedentary senior — is healthier than him. He doesn’t seem terribly concerned with credibility.
There are thin people who are “fat on the inside” who are less healthy than larger people. That said I have no insight into the health of either subject.
There are, but the only two examples are Banach and Tarsky.
An example of what the type of thing intended (I presume) by the previous poster: Fatty-liver disease. "NAFLD is observed in up to 80% of obese people... and in up to 20% of normal weight people". https://en.wikipedia.org/wiki/Fatty_liver_disease
AFAIU, some populations are more likely to exhibit non-overweight, non-obese NAFLD. Likewise for type 2 diabetes.
AFAIU, some populations are more likely to exhibit non-overweight, non-obese NAFLD. Likewise for type 2 diabetes.
Er, what? Pretty sure GP was referring to the difference between subcutaneous and visceral fat. Visceral fat is behind the abdominal wall and puts extra pressure on internal organs.
Maybe a reference to https://en.wikipedia.org/wiki/Banach%E2%80%93Tarski_paradox ?
the current cdc and who guidelines, which are misleading
I wouldn’t call the WHO and CDC positions as propaganda but rather the least bad option given the limited stock of useful masks.
As masks are produced in massive volume then yes encourage everyone wear one as directed.
As masks are produced in massive volume then yes encourage everyone wear one as directed.
The least bad option was to try to explain to the public the slightly complicated truth: they do work, but they're not a bulletproof solution, you still need to do other things to protect yourself such as washing your hands and social distancing, and please don't hoard them since health care professionals need them a lot right now. Instead we were given a simple lie: they don't protect you.
The truth is, I would like a mask, but if my mom has to see a doctor I really really want the doctor to wear a mask that day. And the prior two weeks. And his colleagues.
So, wear a cloth mask, or a bandanna over your mouth and nose. Leave the N95s and surgical masks for the doc.
I don’t believe that lying is ever the least bad option. Truth is good. A good understanding allows people to make rational decisions. But now the population falsely believes that masks don’t help. And if the reason for that is “we were lied to in order to prevent us from buying masks”, then I think that is a terrible reason.
Homemade cloth masks could supplement social distancing and help prevent asymptomatic people from spreading the disease.
Where I live, we have a long way to go to perfectly implement social distancing. Given the severity of the pandemic, anything to help stop the spread should be considered and implemented.
Ultimately we need to change our nature, but that's most likely off topic here.
Where I live, we have a long way to go to perfectly implement social distancing. Given the severity of the pandemic, anything to help stop the spread should be considered and implemented.
Ultimately we need to change our nature, but that's most likely off topic here.
This would have been helpful weeks ago. Now I fear that Americans are set in their coronavirus way - we expect grocery stores to sanitize every item but don't think twice about walking right in front of a cashier with no mask!
Not sure what you’ve been experiencing, but in my town everyone is thinking twice before getting close to anyone.
That’s great now if we could only could produce a couple billion masks
It looks like a typical machine can manufacture a mask 50~100 per minute. For 40 hour work week that is 200k masks per week. So technically we only need 5000 of these machines to produce 1bn a week.
Are the machines made in China?
I'm not sure how that's relevant now that China is largely back to work.
Could probably assume only 90% of that due to typical line down time for maintenance, sku changes, operator error, etc.
The article notes that improvised masks are better than nothing. Do you have a bandanna or a tshirt you could wrap around your head?
It's a pity that's downvoted because thats what some under-equipped health professionals are doing in Europe and US.
This is a perfectly valid question, annoying that it’s getting downvoted so much.
It's all the cabin fever of hn users cooped up in their houses! We're going crazy! We're gonna tear each other apart!
[deleted]
Correct, it even says face covering, not a mask.
I honestly don’t know, aren’t face masks in public illegal?
No, not in the US, why would they be illegal? Some places, like a bank, may want to not let you in (though I even doubt that these days). But certainly not illegal.
In Virginia, it's a Class 6 felony. There are two medical exemptions. One requires carrying "an affidavit" from a licensed physician or osteopath, which specifies "the medical necessity for wearing the device and the date on which the wearing of the device will no longer be necessary and providing a brief description of the device,"
The second is "the declaration of a disaster or state of emergency by the Governor in response to a public health emergency where the emergency declaration expressly waives this section, defines the mask appropriate for the emergency, and provides for the duration of the waiver"
Although the Governor issued an Executive Order, yesterday, telling people to stay at home, he did not include a declaration about masks.
The second is "the declaration of a disaster or state of emergency by the Governor in response to a public health emergency where the emergency declaration expressly waives this section, defines the mask appropriate for the emergency, and provides for the duration of the waiver"
Although the Governor issued an Executive Order, yesterday, telling people to stay at home, he did not include a declaration about masks.
There is a specific exemption for medical use...
https://law.lis.virginia.gov/vacode/title18.2/chapter9/secti...
https://law.lis.virginia.gov/vacode/title18.2/chapter9/secti...
No, that exemption requires a doctor's affidavit or an explicit disaster waiver from the Governor. iii) can only be read with its a) and b) subparts.
ii) is more useful here.
> engaged in ... other activities and wearing protective masks which are deemed necessary for the physical safety of the wearer or other persons
ii) is more useful here.
> engaged in ... other activities and wearing protective masks which are deemed necessary for the physical safety of the wearer or other persons
No, that's your interpretation - not what any court has determined. I would argue that direction from the NIH, CDC, Virginia Department of Health, and/or literally everyone's current doctor constitutes "the advice" needed under the law.
Not a single court on the planet right now would be so idiotic as to side with your interpretation of that law.
Not a single court on the planet right now would be so idiotic as to side with your interpretation of that law.
It's not my interpretation. Just read the thing.
Section iv.) says "upon a) or b)". a) says "carrying on his person an affidavit from the physician"; b) says "the declaration of a disaster or state of emergency by the Governor in response to a public health emergency where the emergency declaration expressly waives this section, defines the mask appropriate for the emergency, and provides for the duration of the waiver"
It's quite clear. Section ii.) gives much more wiggle room; you could cite the NIH, CDC, etc. there. Section iv.) says only the Governor's declaration (with very specific requirements the current emergency declaration doesn't give) or an actual physical affidavit you're carrying with you count for its exemption.
Section iv.) says "upon a) or b)". a) says "carrying on his person an affidavit from the physician"; b) says "the declaration of a disaster or state of emergency by the Governor in response to a public health emergency where the emergency declaration expressly waives this section, defines the mask appropriate for the emergency, and provides for the duration of the waiver"
It's quite clear. Section ii.) gives much more wiggle room; you could cite the NIH, CDC, etc. there. Section iv.) says only the Governor's declaration (with very specific requirements the current emergency declaration doesn't give) or an actual physical affidavit you're carrying with you count for its exemption.
https://en.wikipedia.org/wiki/Anti-mask_law
Not unusual in the US. The KKK liked hiding their faces.
Not unusual in the US. The KKK liked hiding their faces.
American masks are ugly. Other country's masks look stylish.
https://medium.com/@thejanellemj/please-join-me-in-wearing-a...
We have made a big stumble in the US by falsely claiming masks don’t work, seemingly for political reasons. If we can get mask production in place and made available to the public it will help us ease our lock down restrictions which is something we all want to do. We are starting from so far behind so I don’t know if that’s possible now, but we should all be honest and factual, so we can develop solutions and innovate.