Yves here. I am glad to read that wearing masks do provide some protection to wearers, even though it’s only partial. I am still a bit nervous about going to my gym, which allows only a maximum of 10 people in its >3000 square foot, 14′ foot ceiling space at any one time, which means it is much less densely populated that a typical grocery store (and the max when I’ve been in in is 7 other people; 3 to 5 is typical; most are geriatric so just about no one is breathing hard). I’ve kept my mask on the whole time on the assumption it would do me some good (patrons are required to wear masks at all times….except when exercising!!!), so it’s comforting to have confirmation.
Note this post is from a UCSF prof. USCF has been doing a lot of cutting-edge Covid-19 research.
By Monica Gandhi, Professor of Medicine, Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco. Originally published at The Conversation
Masks slow the spread of SARS-CoV-2 by reducing how much infected people spray the virus into the environment around them when they cough or talk. Evidence from laboratory experiments, hospitals and whole countries show that masks work, and the Centers for Disease Control and Prevention recommends face coverings for the U.S. public. With all this evidence, mask wearing has become the norm in many places.
I am an infectious disease doctor and a professor of medicine at the University of California, San Francisco. As governments and workplaces began to recommend or mandate mask wearing, my colleagues and I noticed an interesting trend. In places where most people wore masks, those who did get infected seemed dramatically less likely to get severely ill compared to places with less mask-wearing.
It seems people get less sick if they wear a mask.
When you wear a mask – even a cloth mask – you typically are exposed to a lower dose of the coronavirus than if you didn’t. Both recent experiments in animal models using coronavirus and nearly a hundred years of viral research show that lower viral doses usually means less severe disease.
No mask is perfect, and wearing one might not prevent you from getting infected. But it might be the difference between a case of COVID-19 that sends you to the hospital and a case so mild you don’t even realize you’re infected.
Exposure Dose Determines Severity of Disease
When you breathe in a respiratory virus, it immediately begins hijacking any cells it lands near to turn them into virus production machines. The immune system tries to stop this process to halt the spread of the virus.
The amount of virus that you’re exposed to – called the viral inoculum, or dose – has a lot to do with how sick you get. If the exposure dose is very high, the immune response can become overwhelmed. Between the virus taking over huge numbers of cells and the immune system’s drastic efforts to contain the infection, a lot of damage is done to the body and a person can become very sick.
On the other hand, if the initial dose of the virus is small, the immune system is able to contain the virus with less drastic measures. If this happens, the person experiences fewer symptoms, if any.
This concept of viral dose being related to disease severity has been around for almost a century. Many animal studies have shown that the higher the dose of a virus you give an animal, the more sick it becomes. In 2015, researchers tested this concept in human volunteers using a nonlethal flu virus and found the same result. The higher the flu virus dose given to the volunteers, the sicker they became.
In July, researchers published a paper showing that viral dose was related to disease severity in hamsters exposed to the coronavirus. Hamsters who were given a higher viral dose got more sick than hamsters given a lower dose.
Based on this body of research, it seems very likely that if you are exposed to SARS-CoV-2, the lower the dose, the less sick you will get.
So what can a person do to lower the exposure dose?
Masks Reduce Viral Dose
Most infectious disease researchers and epidemiologists believe that the coronavirus is mostly spread by airborne droplets and, to a lesser extent, tiny aerosols. Research shows that both cloth and surgical masks can block the majority of particles that could contain SARS-CoV-2. While no mask is perfect, the goal is not to block all of the virus, but simply reduce the amount that you might inhale. Almost any mask will successfully block some amount.
Laboratory experiments have shown that good cloth masks and surgical masks could block at least 80% of viral particles from entering your nose and mouth. Those particles and other contaminants will get trapped in the fibers of the mask, so the CDC recommends washing your cloth mask after each use if possible.
The final piece of experimental evidence showing that masks reduce viral dose comes from another hamster experiment. Hamsters were divided into an unmasked group and a masked group by placing surgical mask material over the pipes that brought air into the cages of the masked group. Hamsters infected with the coronavirus were placed in cages next to the masked and unmasked hamsters, and air was pumped from the infected cages into the cages with uninfected hamsters.
As expected, the masked hamsters were less likely to get infected with COVID-19. But when some of the masked hamsters did get infected, they had more mild disease than the unmasked hamsters.
Masks increase Rate of Asymptomatic Cases
In July, the CDC estimated that around 40% of people infected with SARS-CoV-2 are asymptomatic, and a number of other studies have confirmed this number.
However, in places where everyone wears masks, the rate of asymptomatic infection seems to be much higher. In an outbreak on an Australian cruise ship called the Greg Mortimer in late March, the passengers were all given surgical masks and the staff were given N95 masks after the first case of COVID-19 was identified. Mask usage was apparently very high, and even though 128 of the 217 passengers and staff eventually tested positive for the coronavirus, 81% of the infected people remained asymptomatic.
Further evidence has come from two more recent outbreaks, the first at a seafood processing plant in Oregon and the second at a chicken processing plant in Arkansas. In both places, the workers were provided masks and required to wear them at all times. In the outbreaks from both plants, nearly 95% of infected people were asymptomatic.
There is no doubt that universal mask wearing slows the spread of the coronavirus. My colleagues and I believe that evidence from laboratory experiments, case studies like the cruise ship and food processing plant outbreaks and long-known biological principles make a strong case that masks protect the wearer too.
The goal of any tool to fight this pandemic is to slow the spread of the virus and save lives. Universal masking will do both.
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Masks help. Mask + face shield appears to be the gold standard:
“Face Shields Reduced Percentage of Health Workers Infected With Covid-19 From 19% to Zero”
https://www.latestresearchnews.com/2020/08/19/face-shields-reduced-covid19-transmission/
Of course, face shield without mask = totally worthless, but a lot of people don’t seem to have figured that out.
I just checked the Home Depot website. I need more than one of those flimsy medical-grade shields for face protection during an upcoming masonry project.
Well, guess what. They’re outta stock on just about everything.
Damn Chinese, asleep on the supply chain job.
One little pandemic and they let us down!
Now, could the cone heads please do a serius study of the # of people who realy, realy have underlying health conditions that preclude them from wearing masks.
If wearing a mask keeps me frome being a bio weapon then that same barrier should also filter out some of the spit we all put into the air.
What are Marine DIs doing? Screaming at recruits from a distance seems not as intimidating.
This is borderline bullying and there’s little effort made to hide your aggressive tone.
I have a disability which prevents me from wearing a mask in some situations. The disease process which I unfortunately have is complex, its effects vary from patient to patient and from day to day and from environment to environment.
It is hard enough living with a disability, just in the “living with a disability” aspect. The misunderstandings — either intentional or accidental — and the microaggressions which you’re also on the receiving end of make matters worse.
Why the heck should I — or anyone else — have to be the subject of a “study” which proves what we say to your satisfaction? Just who do you think you are?
And while we’re on the subject of scientific proofs, where’s yours when it comes to mask effectiveness in various countries’ infection control? I’m still waiting for a documented, repeatable and testable methodology which explains why maskless Wales (apart from public transport and a few other narrow, specific applications) has one of the lowest infection rates in Europe (Daily Chart tab) — far better an outcome than masked-up-to-their-eyeballs Germany, France, Spain and even Scotland (to give a really like-for-like U.K. comparison with the same starting conditions). I won’t even go there by dragging mask poster-child Japan into this and how they convinced themselves masks were all they needed to end lockdowns, which it was, right up until it wasn’t.
I’m certainly not against considering masks in some circumstances. Aircraft is a good example. But unless the evidence of infection rates vs. mask adoption is explained by scientific-proof standards of explanation, what you’ve got is conjecture and suggestively. Don’t be harping on at me with hoitytoity demands until you can provide me with that. And don’t you dare try on this kind of implied disability shaming, in any circumstances.
No
I consider people like you who question mask use as being effective…as endangering my life. That’s abusive. And I will squawk and foment when posts like yours are made.
It’s not going to kill you to wear a mask. Please. It’s like being OK with no speed limit (I’m a perfect driver! I don’t need no rulz!) Or any of the other hundreds of things regulated to keep the population ‘safe’.
This is not about not wearing a mask without reason. This is about not wearing a mask with a reason.
The original commenter demanded a “serius study of the # of people who realy, realy have underlying health conditions that preclude them from wearing masks” (sic) It is in their eyes and, apparently, yours too, now not only acceptable but essential that disabled people’s word isn’t taken but must be corroborated by some (unspecified) research by (unidentified) experts who can opine and report on the matter. Then, presumably the disabled people can either be granted — or denied — their discretion to wear, or not wear, a mask (in undisclosed ranges of conditions or limitations).
All this on the back of evidence which would not, ever, be sufficient to allow masks to be marketed as medical devices. Such evidence as there is is miles away from the level of scientific proof medical claims must normally meet. In the early stages of the COVID-19 situation this was entirely acceptable — there was simply no data available. Now, though, it is possible to collate randomised trial data (it’s not possible for controlled trials as there’s no placebo so you cannot have the control trial element) and define a mask protocol. I await that with curiosity. It has not been provided thus far. That is fine, I will wait until it is available and review it with interest when it is published and peer-reviewed.
In the meantime, however, you insist that I be subjected to just such a scientific medical standard of evaluations that you yourself cannot provide me with so my claims can be verified. That’s being kind to your stance, on some readings of what you wrote, you’re not even prepared to allow that. But I’ll be generous and assume you will allow medical exemptions, after completion — and “passing” of a medical intervention on me.
Unbelievable. 60 years of disability rights. Gone. In less than 6 months. You’re back to meting out the degradations of the medical model of disability. All over again. I simply cannot believe that there are some who would presumably label themselves as “progressive”, “liberal”, “of the left” or just merely “nice people” who would jump at the chance to trample on the needs of the disabled, solely so they can get their needs met.
Go hang your head in shame. If you have any.
No again.
YOU should be ashamed — I AM DISABLed!
Why again can’t you wear a mask? Your mouth is fused shut or?
Unbelievable indeed.
Then as a disabled person you should know better. For one thing, your disability is your private and confidential information and you never should be in a position where anyone forces you to disclose it to justify someone else’s interests.
And for another, you should also know that disability manifests itself in different ways and affects different people differently. Even for the same condition. Your disability affects you and only you know what that effect is. If I was, as you did to me, to sit in judgement on you, your disability and what you can and can’t tolerate, that would make me at best ignorant and at worst tyrannical, especially if I followed it up by making you do certain physically-impacting things.
And finally, unless you have a cognitive impairment, you didn’t address any of the points I raised and there’s no excuse for that in a debate.
Your aggressive demonization of disabled people and their ability or otherwise to wear masks is a disgrace. Do you not read a single thing that disability rights groups have been saying?
Whether you are or aren’t, it reads a bit like you’re elevating your individual needs over the well-being of the group.
To be fair, an ICU nurse explained to me the other day that as long as one person in a group of two people is wearing a mask, it is redundant that everyone wear one. In other words, your being a mask-dodger poses less of a risk to anyone else if they’re masked.
If you’re venturing out into a public place where PPE is required for health reasons, the simplest approach may be to simply avoid going to those places unless it’s absolutely essential. Wearing a mask for a few minutes is hardly a mortal sacrifice, nor is it much of a knee bend, if that’s secretly really your gripe. I elect not to go to restaurants or cafes or bars anymore — simply because the hazmat vibe kills any desire to repair to such establishments to enjoy the atmospheres they previously provided. When I pickup my takeaway, however, I don my mask.
As with all our needs, we can all present them but, where there is a conflict, there has to be a balancing exercise. I have no problem in participating in that. That said, I’ve not seen any mechanism for that (although Ireland’s “Citizens Assemblies” would seem a good candidate for how to approach it).
But there is simply no desire for that to happen as far as I can tell. And one thing I know with absolute certainty: masks have brought out just about the worst in people. On both sides of the debate. That should be added to the list of harms they cause, if a methodical and comprehensive evaluation of them were to be done.
This is the most absurd/sad thread I’ve ever read on this website. I suppose this is what happens when people essentially live their lives online, insulated from the messy outside world. I’ll leave you with this nice quote from Taleb’s, The Masks Masquerade article:
https://medium.com/incerto/the-masks-masquerade-7de897b517b7
A commenter demands that people with a medical exemption for mask wearing are to be subjected to some unspecified but accusatory “study” — with the implication that disabled people must somehow “earn” their right to their exemptions — and I, in turn, demand that, if that is to be the case then a similarly high bar, that of a medical-scientific burden of proof, is applied to mandatory mask wearing.
I invite the production of such proofs, if they exist. I invite a scientific standard of theory that even explains anomalies in mask ordinances, their absence and infection rates.
That invitation was open to you. Instead all you can come up with is casting aspersions on the quality of the subsequent discussion (which you didn’t evidence or offer any explanation for — I’m spotting a trend here with you!) and some nonsense from Taleb about burglaries.
The absence of evidence isn’t evidence. It’s only evidence of an absence of evidence.
If you can’t offer evidence to justify what sounds like drumhead trials of disabled people via some “study” into their mask exemption rights, why are you supporting the idea? And why aren’t you addressing the issues I identified with it but instead going off the topic I raised?
Clive, Where do I say that I support anything you accuse me of supporting? To be clear, I do not think disabled people should be part of a study to determine if they should be allowed to go without a mask. In fact, that was one of the main absurdities I was referencing in my comment. In this thread, and in others you are bullying commenters (I’m spotting a trend with you!) who are advocating putting a piece of cloth over your mouth and nose so you don’t spread your nasty germs to others. Nobody is asking for your DNA or to sacrifice your first born and you haven’t even provided any hypothetical disabilities that would preclude someone from wearing a mask. In response to your verbose commentary advocating against the use of masks for lack of evidence of their effectiveness (p.s. there are plenty of studies showing effectiveness, which apparently don’t meet your standards — I am not sure that study will ever exist), I have two words for you: precautionary principle.
P.S.:
Clive,
Without more detail, it is difficult to accept your claim. The reason for the hostile reader reaction is that “I have a condition” has been massively abused by people in the US who are really just ideological refusniks.
MDs have said that people who can walk and speak without using oxygen can wear masks. Other studies have shown that wearing as many as six masks on top of each other does not reduce the user’s blood oxygen level.
If the issue is steam buildup on your glasses or high humidity near your eyes (you have said you have a very serious and degenerative eye condition) you could wear construction goggles which would go over your glasses, which would create an environment for your eyes separate from the mask area. These are separately desirable because they protect you even more from Covid-19 since the tear ducts are now recognized as a point of entry for Covid-19. And they are cheap, around $10 here. I’m getting a pair to wear when I am in high risk settings, like on airplanes.
The determination of whether conducting some sort of “study” into mask exemptions for disabled people is permissible is simply a matter of law.
As the subject of the study is people with a disability it already falls foul of one test of unlawful discrimination: it affects disabled people disproportionately. As it would affect only disabled people, it is the textbook definition of “affecting disabled people disproportionately”.
The subsequent test of legality is that, even if this study was disproportionately affecting disabled people, it would still have a defence if it could show it was a proportionate means of achieving a legitimate aim. Reducing COVID-19 infection is a legitimate aim.
But it would have to both meet a balance-of-probabilities level of evidence that not only are medical exemptions for mask wearing being abused, that that abuse is causing harms to a degree that outweighs the harms caused to disabled people by having to be put through a process of “proving” the exemption eligibility and there were no other alternatives to reintroducing the medical model of disability and subjecting disabled people to such assessments (alternatives like allowing self-declarations and self-certifications).
This would be a very difficult case for a federal or state government or NGO which attempts to introduce a policy of a requirement of medical proofs to qualify for mask exemptions to win. It would be off to a bad start just on the disproportionate targeting of disabled people. And the facts of countries achieving good levels of infection control without mask ordinances and countries experiencing poor levels of infection control with mask ordinances would definitely be in play.
Generally, no-one has any right or business telling a person with a disability how their condition affects them, how they should respond to that, what is or isn’t good for them etc. This is pretty boilerplate human / disability rights (pg. 22):
Telling disabled people what they must and mustn’t do by way of enforced use of medical devices demands the highest levels of justification. As does singling them out for special “studies”.
I empathize with your fear of losing hard-won accommodations, but this is about life in the public space, so I am not sure the right to self-determination in our private lives is the relevant standard.
It isn’t. And I empathize as well.
This is not a question of self-determination in our private lives. It is the requirement (as mooted by the original commenter) that people with a disability must undertake a medical intervention (assessments, tests, being required to provide details — the specifics were not spelt-out but the demand was to “prove” in a medical standard of evidence way that you “qualify”) or else be forced to wear a mask without any exemptions.
My response stands: if you require me to provide a medical-standard of proofs (of the harms a mask causes me), I require you to provide the same medical-standard of proofs that masks are a Medical Device as opposed to, say a piece of apparel. If they are such a product, they can be marketed as such because they have proved that they are safe, effective, have a defined protocol and contraindications (including black-box warnings, if applicable). You cannot demand something of another person which you are either unable, or unwilling, to do yourself. Where I live, the requirements for Medical Devices are listed here. They do run to over a thousand pages — that’s just the standards, the evidence base needed would be considerably more detailed. Certainly more than a few hamsters.
If people don’t want to have to substantiate their claims for a product’s legitimacy to a scientific / medical standard, then why should I have to? And I’ll make this deal with anyone who wants it: you don’t demand that of me, and I won’t demand that of you.
If the abled bodied create a system (in this case, mandatory mask-wearing) that is so poorly designed that it can’t distinguish between situations where able-bodied people abuse a legitimately-created exemption for disabled people (who can’t wear a mask and disabled people use the exemption perfectly validly) then that’s your problem, able-bodied people. You cannot take a predicament created by solely by able-bodied people — where some of the able-bodied people try to play the system — and dump the collateral damage onto the disabled. Such as by making us undergo “studies”, “assessments” or “evaluation boards”. We are all-too-familiar with such things. Get your own house in order, able-bodied people. Don’t expect the disabled to be the garbage barge for your inability to come up with a workable systems for mask mandates, exemptions and policing/enforcement.
If you’re unable to deliver this system (because the police can’t enforce it with the resources they have, the courts won’t convict because the ordinances are unworkable and AGs won’t prosecute because they’re faced with multiple, overlapping and contradictory laws) you all should have thought about it before sticking your necks out.
Finally, if you wonder why, sometimes, disabled people are tough, implacable and unyielding, well, it’s after decades (lifetimes for many) of being on the receiving end of crap like this. If we wait for the able-bodied to put themselves in our places, make sure our interests are defended and don’t end up the first group to be given a good kicking when things get difficult, we’ll be waiting for Hell to freeze over first. I could not ask for a better examples of that as has appeared on this very page.
If I see a person without a mask in an indoor environment, I stay far, far away (20’+) and evaluate the environment. If I can’t stay away from them or there is poor ventilation, I leave. I don’t care if they are a cultural war anti-masker or a disabled person. My choice is to simply leave.
Most people with a breathing disability could at least wear a face shield. If they are not willing to do even that, then I really want to stay away from them because I assume they have a culture agenda.
That leaves it up to the establishment to figure out if they want to have people like me leaving, or the person not wearing the mask. If they want to do special hours for people who can’t wear masks, I am fine with that.
Because of the anti-mask culture and confined spaces, I am staying away entirely from things like airplanes. I suspect there will be a point later this year when I may need to get on a plane for business. I have already figured out which airlines I would fly based on their policies on masks and social distancing etc. on planes.
MDs have said that people who can walk and speak without using oxygen can wear masks. Other studies have shown that wearing as many as six masks on top of each other does not reduce the user’s blood oxygen level.
To preface, I follow all mask protocols diligently. That said, for me it’s obvious how “robust” the air is when I remove the mask. I look forward to that first breath of fresh air upon removal. No MD’s or studies are going to change my mind about something that is clearly self-evident to me. And I imagine many feel the same way.
Umm . . . it seems the animal studies provided empirical evidence (data) in a controlled experiment that is part of a scientific process.
Masking is also very useful when an unanticipated sneeze sneaks up on you with hands full.
The next stage from laboratory testing in any claims for safety and efficacy of a medical device is to have a properly constructed and data-gathering from a large scale trial on real people in real-life.
It was that which I clearly referred to in my comment.
You cannot market or make any claim for the medical benefits of a device purely on laboratory studies.
Clive
I’m sick of arguing…I’m sick of selfish people who think they’re special because ___.
Wearing a mask, even without knowing what your special disability is, is not going to harm you. But your wilful obstinance has been noted for future reference. The studies are numerous, plenty of youtubes refuting antimask bs…I’m tired. I am sick of fighting for my life…I am sick of stupid people making it impossible to protect what’s left of my health.
Did you read the article?
I understand your stature here…but you are fomenting nonsense with your special disability that prevents you from being part of that non-existent ‘society’.
Wearing a mask to protect others is pro-social. See how that works?
Do you wear a seat belt (mind the speed limit etc) or is your disability let you off the hook for that when the officer pulls you over?
I have no stature, although it is kind of you to say so.
We will have to agree to be of different minds on this one.
There is no doubt whatsoever in my mind you are absolutely genuine and believe in what you are saying to the very core of your being. And if you live with a disability, as we do, sometimes you’re tired beyond tired beyond tired because life is hard to the point of excruciating. We act desperately because we’re in desperate situations. Pain, loss, hardship and we are alone because, whilst sympathy may be extended by kindhearted people but they don’t know what we are and how we live.
I’m lucky in one thing only (well, a couple of things now I come to think of it). I live in the U.K. where there is just the faintest hint of the social contract left, hanging on by its fingertips. So I fight for all its worth to preserve some semblance of equality for disabled people. You can tell me otherwise since you know better than I, but I think in the US, it’s more a grim battle for mere survival for disabled people and you can’t give any quarter because if you do, you’ll be obliterated. So I understand your feistiness — it’s a self-preservation necessity.
I also have the luxury of being able, if the need arises, to buy my way out of trouble. So the stakes for me probably aren’t as high as they are for you, faced with the rapacious US “healthcare” system.
I hope we can both appreciate one another’s perspective here, in time. At least to some degree. Stay safe, stay well and stay as strong as you obviously are, certainly if not physically then in spirit (which I can feel the worth of, all the way over here).
furies,
The drink drive analogy doesn’t work, because people can choose whether or not to drink. What you are doing is to equate a choice to drink alcohol, to a choice to go out in public. These are in no way equivalent. Everyone should be able to go out in public.
Consider:
1. Some people really do have conditions which make mask wearing difficult or traumatic.
2. You don’t need everyone to wear a mask to effectively reduce transmission. All you have to do is to keep the reproduction rate below unity.
Here’s a moral problem for you. You know there are going to be bad actors who will deliberately ignore guidance and put others at risk. Unless you want to live in a police state (and, I’d suggest you shouldn’t), there’s nothing you can do about such actors. What you’re doing is to favour bad actors above people who have good reasons not to wear masks.
You are misconceptualising the issue, and your aggressive attitude doesn’t help.
No. Those who think they’re above community boundries are risking others financial and physical health. Sorry for the aggression but I’m not sure how to live my life surrounded by selfish people who think the rules don’t apply to them.
People are dying and being harmed. Antimaskers are agents of that harm. Did YOU read the article?
MY life is at risk. You bet I’m aggressive.
Sorry I can’t seem to post in gentle, lighthearted manner. My brother died last week from complications from Covid so there’s that. I’m sure I’m not the only one.
furies:
I am sorry to hear about the loss of your brother from Covid complications. My daughter is a teaching NP who had warned us of being careful in public and going to work. She has sat with the Covid afflicted so they would not die alone.
I mostly agree with your stance on wearing a mask coupled with social distancing with little exception. With 80% of the people wearing masks, there is an impact resulting from transmission of the virus and as a protection against the virus. The former being less than the later. https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-how-face-masks-prevent Numerous links here
He’s not fomenting anything. He was responding to a comment, and you jumped in to berate him, clearly without any understanding of his argument and perspective.
The problem is that nobody can assay masks in experimental conditions where people will be challenged with infectious virus particles unless you can ensure (as with the mild flu strain mentioned in the article) there is no live threatening risk. Likewise challenging vaccinated individuals to check vaccine efficiency.
Assays with hamsters are telling: masks protect reducing frequency of infection and severity of disease. Yet masks are not necessary all the time and everywhere. Of course masks interfer with breathing and in some instances are contraindicated. When this is the case it would be advisable to have an official note from a physician explaining the contraindication.
My experience in Spain is that though masks are mandated everywhere the police is not being strict and they will not enforce the law in low risk situations. They are acting (in general) with common sense. I can imagine that not using masks for a reason might cause you trouble in a daily basis.
This article gives an interesting and reasonable explanation on the puzzling case of symptomless infections and I think it is generally correct but I have caveats. Symptoms develop (mostly) as a consequence of the immune response (pain, inflammation fever…). Symptomless infections suggest a muted innate immune response. These could effectively be related with low initial multiplicity of infection as the article says or could be due to known viral interferences with the innate system or both.
I do agree with what you say. The only difficulty that’s presented in one point you raise is that of physician-supplied exemptions. Certainly in the U.K. legal system (I suspect the same is true elsewhere), only a court can rule on a) whether a person is disabled and b) whether the disability has a substantial and long-term, i.e. it can’t have a trivial or very transient, effect on the activity being otherwise required. This definition Is derived from EU equality law so is I am almost certain EU-wide in its application as a minimum.
So when it comes to either litigation or challenging civil penalties — which is where this will end up if society continues to be unable to resolve the problems and issues — there is no such thing as undisputed medical evidence. Both parties can get medical expertise on their side. And the resultant hotly-contested legal wrangles are fiendishly complex for courts to have to decide on.
A doctors note or letter is not, then, going to be the end of the story. It’s just going to be the first page in a long, long tale of woe. Is this really where we want to drive our shared existences? Are people really thinking any of this through? I for one am not convinced we are.
“documented, repeatable and testablemethodology which explains why maskless Wales”
I’m assuming you mean the country, not the mammal.
The Rain? Might eliminate or mitigate particular (viral) transmission.
I think it’s our Clive who’s doing the bullying here.
You’re telling me I should just accept what amounts to some sort of intrusive, discriminatory and unproven medical court martial and — when I have the temerity to say no, I’m not doing that and I won’t be quietly acquiescing to anyone saying this is what should happen to me and I won’t be bullied into just going along uncomplainingly with it — you think I’m the one with the problem?
Man, your choice of language is odd, here: since when did cooperation = quiet acquiescence? Do you cover your mouth when you sneeze or cough? If so, do you also feel the invisible jackboot of the decorum police on your neck? The dictates of manners and beneficence is a curious tyranny.
I do get that there must come a trade-off at some point where we either accept some lesions on the lungs or the unseen lesions on our collective psyche from living in an atomized, schizoid-tinged atmosphere for too long; seeing people running around in masks day in/day out, let alone having someone lunge away from your 6 foot berth as though you were holding an unpinned grenade is just bad for the brain long term. That’s why it seems like it would have been a good measure to batten down hard and get all of this over with early on, opting for short term pain/long term gain (a framing favored by modern-day libertarians).
Did you read my comment in the right way? The reference to acquiescence was with regards to acquiescing to be the subject of a “study” into medical exemptions to mask wearing.
Disabled people have been the subject of many such medical studies in the past. Usually, disabled equality campaigners criticism of such exercises is because they deliberately ignore the mantra “nothing about us, without us” — imposing able-bodied interpretations of how the world works for us on us.
It sounds like you don’t want disabled people anywhere near these kinds of decisions about our lives. This reaction comes as little surprise to me, having seen it a hundred times before. It’s all too familiar, but no less depressing for that.
I’ve never diminished disabled people, and I apologize if I presented anything in such a manner that might’ve suggested it. Indeed, my mother was blind and my sister suffered from an acute anxiety disorder most of her life. Incidentally, in the case of my mother, there was no way to effectively Nerf the landscape in order to mitigate the hazardous coupling of buckled sidewalks & gravity.
It’s not the best of all possible worlds, I’ll grant you; but we each make the sacrifices necessary to be able to go out into it and have our day.
I am going back to work soon and I am a bit worried about the students who can’t wear masks because of health conditions. I worry about them getting anxious about being questioned all the time about not wearing a mask. But there will be students who can wear masks and won’t because they don’t think they do anything. I won’t be able to tell whether a student has a legitimate reason from looking at them and if they have to have a badge or something, it would be even worse. Anyway, a bit of conundrum
Btw, the animal studies cited above are hypothesis testing experiments, which is pretty much gold standard for science. Whether the results transfer to humans is a different question, but the author did back up claims with converging evidence. Not sure a study with humans exposed to virus with/without mask would get past ethics.
Interesting, I wonder then if the family members of the first infected in a household suffer more severe symptoms? I don’t think people are wearing masks in their home, and the opportunities for the exchange of high viral loads from family member to family member seem abundant.
Indeed. Some say your likeliest way of getting infected is from a family member.
As for the masks, if this business about viral dose is so well established and well known you do wonder why the CDC wasn’t telling people from the beginning to wear cloth masks. The confusing information we have received from the experts has much to do with the public’s confusion and disagreement on the matter.
Me, I wear a mask but not outdoors.
i suspect that the confusing info at the start was because of the need to get the info out as fast as possible, because not doing that will lead to more fatalities. its better to be hyper aggressive than not, but they also had to temper it some, because if they told every one to mask up, there will be a mad rush to get them (remember the TP shortage?), and doctors and nurses need it too, or the entire ‘health care’ supply will collapse
The CDC utterly botched the messaging back in February and March and it is now so politicized that it is very difficult to recover.
People were panicking and buying up N95 masks. As somebody who has worked in several types of respiratory protection, including supplied air, it was clear to me back then that you would need fit testing for an N95 mask to be truly effective. You also need to know how to put it on and take it off without cross-contamination that largely would negate wearing it in the first place. The average person doesn’t know how to do that unless they work in active biological and chemical hazard environments. Particulates like dust and asbestos are much less of a cross-contamination issue.
So they pleaded with the public to not wear masks, meaning N95 masks that medical workers needed But they weren’t focusing on the cloth mask concept yet, primarily because the focus was on protecting the wearer. The US has not experienced a singificant disease like this since 1968 at the latest (1918-19, 1957, and 1968 flus have old photos showing people wearing cloth masks). The focus in the US is each person protecting themselves. The Asian cultures have been on the frontlines of the respiratory viruses over the past 30 years and have developed the culture of putting on cloth or surgical masks at the first whiff of issues. The Asian population in Richmond, BC, a suburb of Vancouver, started wearing masks in January and largely avoided cases.
The US got lucky over the past 50 years and has dodged a few of these respiratory disease bullets that have trained some of the other countries (including parts of Canada) on how to prevent widespread infrection by every person playing their part. Instead, we have relied on effective government actions and luck to prevent a widespread epidemic. The luck ran out this time, as well as the competence.
The science has been really, really clear over the past three months that mask wearing combined with good ventialtion and basic hand washing hygiene can keep cases way down. Many countries even have their mass transit up and functioning well now with very little spread if you have good ventilation, wear a mask, don’t talk, and disinfect your hands. That effectively eliminates the transmission in mass transit.
It is very unfortunate that wearing a mask has become a culture war. I think it will likely suppress the US economy by at least a couple of GDP percentage points or more for at least another year, maybe more. It will likely delay hiring millions of workers. But that is a small price to pay for “freedom”.
Anecdotally, this appears to be the case.
A friend got infected but insisted that she had been rigorously self-isolating. Her live-in boyfriend had no symptoms, but also got tested when she got sick. He tested positive. He had been the one leaving the house to go run errands and such, and did remember being in a store with an unmasked person who sneezed. He tested positive but remained asymptomatic, she ended up with pneumonia.
Makes sense in that he got a brief exposure but the viral load was low because he was masked, and so never developed symptoms, while she was exposed to him 24 hours a day, unmasked, and so received a much heavier exposure.
he could have been unmasked, wasnt stated one way or the other, but repeated exposure could make it more dangerous. course even wearing a mask wont protect you from being exposed if you touch where droplets of the virus are, and you touch your face, which seems to be some thing us humans cant stop doing. now lots of people can be invested, and have no symptoms ever, while others seem to go from the ‘mild’ version to the life threatening. and the mild an stay with you the rest of your life, and be very painful.
In Pediatrics, it has been observed that often the first kid in a family to get an infection like chickenpox often does not develop a very bad case, popbably because the kid got a relatively small dose of the virus, out somewhere in the community.
The second and subsequent kids in the family tend to get a worse infection, thought to be related to a higher dose of virus from close, prolonged exposure to the kid who brought the virus home.
I like this non professional demo of the effectiveness of masks
https://www.youtube.com/watch?v=x6cTDGqcUpA
Good one!
There has been anecdotal information for a couple of months now about the importance of viral load, and how some of the asymptomatic people spreading the virus may be people who got a low viral load, so didn’t get really sick.
Simultaneously, there has been increasing evidence that aerosols (smaller than 5 microns) are probably a major contributor to spread.
So we have been personally structuring our safety approach around:
1. Mask wearing;
2. Face shields and/or safety glasses/goggles in potentially intense exposure environments;
3. Basic hygiene with hand washing or, if hand washing is not viable, alcohol based hand sanitizer;
4. Ventilation (open windows or fresh air exchange/MERV 13 filtration into HVAC) targeting at least six room air volume changes per hour if indoors; and
5. If you can’t get six fresh air or MERV 13 filtered room air volume changes per hour, then add standalone HEPA (True HEPA or H13) air purifiers to get up to at least six clean air changes per hour in a space you will occupy for a period of time ($300 per 500 sf of room to get 5-6 changes).
At this time, it is not rocket science. It is just rolling up the shirt sleeves and doing it.
The policy mess and word salads coming out of the CDC/FDA etc. mean that businesses, schools, etc. are utterly confused about what they need to do and what they can do. Much of this was becoming evident in May and June. By mid-August, it should be crisp messaging from CDC and the President with bills already passed in Congress to provide funding to make things happen to re-open the economy.
The intense focus on just re-opening the economy at any human cost means that the re-opening is disorganized and will likely be slow with lots of local shutdowns due to re-infections and fear. The willful federal incompetence, starting at the tippy-top (Trump), is going to delay economic and health recovery by months, if not years.
The first evidence of the price of incompetence on the economy (health price already well established) is today’s 1.1 million new jobless claims as that may be the start of an upwards trend again.
The United States has deliberately chosen to be a shitshow.
I read somewhere that HEPA-rated vacuum bags work real well as mask material – Miele U6 bags used in their uprights should work well.
>USCF has been doing a lot of cutting-edge Covid-19 research.
But they aren’t an “elite” school??? They don’t have the vocabulary to investigate this properly! /s
NC published a video that had Dr. Ghandi discussing this, a few weeks ago, which we took note of at work. UCSF has had some informative videos on Youtube.
We made the decision to provide cloth masks made by a local seamstress. We provided the materials based on this publication in particular, but the detailed ones all say similar things, which is to say at least two layers, high thread count cotton interior and synthetic/hydrophobic/electrostatic outer layer.
https://pubs.acs.org/doi/10.1021/acsnano.0c03252
We also put in nose wires because that’s crucial to fit. (If your glasses are fogging, it’s because your nose fit is inadequate). You can make it out of the best materials in the world, but if it doesn’t fit your face properly, it won’t be effective because you’ll just breathe around it.
Masks with higher filtration are harder to breathe through, for obvious reasons.
I am surprised that, at this late date, any of this is still an issue. Really. I hope the video will prove salutary to those a bit slow on the uptake. I have been sending it around for the last few days when I encounter slow-uptake types.
Here are the links, again, for materials for home-made masks:
Adding 2 layers of Filti filter yields 97.9% efficiency but only 14% resistance (easier to breathe through):
https://www.fast.ai/2020/07/10/upgrade-your-mask/
“Masks slow the spread of SARS-CoV-2 by reducing how much infected people spray the virus into the environment around them when they cough or talk.”
It’s a bit more complicated than that. A person without a mask may generate mostly (by mass) large droplets, which fall quickly to the ground, due to gravity, rendering them harmless to other people unless they are in close range or will transfer these droplets manually from surfaces to their mucous membranes. The same person wearing a cotton bandana or a Buff-type neck gaiter made of spandex may effectively aerosolize the heavy droplets, which will now linger or get recirculated in the air volume of indoor space, exposing other occupants to higher cumulative viral loads. See https://www.the-scientist.com/news-opinion/simple-tool-evaluates-mask-performance-at-blocking-droplets-67814 for experiment description.
“may generate mostly”
Um, hedging your bets a bit?
No betting, just an honest assessment. The world is not binary, only the propaganda is. Saliva production varies wildly between people and varies for the same person with time, e.g. depends on hydration level. It is one of the primary factors in producing large droplets. I’m fairly certain you’ve encountered this phenomenon or the droplets themselves contacting your face at some point in life.
First mention of viral load wrt COVID I saw anywhere was Ignacio on this very website in the very early days.
This is a great post. The message needs to go far and wide. My wife lost a first cousin a few weeks ago. Passed away in the hospital in Tuscaloosa after two weeks in their care – the last four intubated and on a ventilator. Sadly, she believed the divisive nonsense regarding masks and paid a high price for taking medical advice from politicians.
Sorry to hear that.
The AP story about the outbreak at Pacific Seafood in Newport, OR, is seriously untrue. The affected workforce aren’t locally based. They’re gang-boss run imported workers from Eastern Europe and Mexico.
It was very difficult to contract trace the workers because of language difficulties. Not many Oregonians sprak Roumanian, and almost none speak the Mayan language, Mam.
This was big news in the local press (I live nearby). Any thoughts as to why AP elided this?
Daughter & grandson now have tonsillitis.
In August?
Any correlation with the masks?
Re-breathing pathogens?
https://www.businessinsider.com/anti-maskers-say-they-cant-wear-masks-because-medical-conditions-2020-5
Sweden seems to be an outlier in terms of Covid strategy. One of their strategies is to rely on the maturity and cohesion of their citizens. They also have been very concerned about mental health (stress, anxiety, depression, etc.), a concern that seems lacking in many other jurisdictions.
“Anders Tegnell, chief epidemiologist at Sweden’s Public Health Agency, has repeatedly expressed skepticism that face masks will control virus outbreaks, the Financial Times reported.
“It is very dangerous to believe face masks would change the game when it comes to COVID-19,” said Tengell, who is considered the country’s equivalent of Dr. Anthony Fauci from the White House COVID-19 task force.
He noted that countries with widespread mask compliance, such as Belgium and Spain, were still seeing rising virus rates.
“Face masks can be a complement to other things when other things are safely in place,” he said. “But to start with having face masks and then think you can crowd your buses or your shopping malls — that’s definitely a mistake.”
He completely brushed off the prospect of wearing masks last month, saying, “With numbers diminishing very quickly in Sweden, we see no point in wearing a face mask in Sweden, not even on public transport.””
https://nypost.com/2020/08/19/swedens-tegnell-wearing-face-masks-may-be-very-dangerous/
The studies I have seen discuss only viral load or spread factor. They never discuss that masks must be properly used, that people fiddle with them, touch them with their hands, don’t sterilize them, they collect other microorganisms, etc. In my locale, I see people going in and out of stores, taking them off, putting them on, etc.—behaviour not recommended by experts. Reports are that they also give a false sense of security and people think “they’re safe” and do not practice more important preventive measures.
So, any mask study that does not include all the factors involved is very dubious and limited. If you are insulted, please contact Anders Tegnell.
Anders Tegnell said they can be a complement. That is an argument for masks, properly used, where the numbers of infections warrant.
Sweden had a higher death rate than all of it’s neighboring countries which would support this articles thesis that masks = lower viral load = less severe symptoms. Further, some of the data shows Sweden actually did lockdown but voluntarily, not by government mandate. You can also see this in many other countries where people voluntarily went into “lockdown” before government mandated it.
Your second to last paragraph regarding improper mask usage: the world is not an operating room, but a person wearing a mask in a store and taking it off when they get outside is better than no mask at all. Further, there are plenty of studies suggesting fomites play a much smaller role in transmission than originally suspected. The evidence regarding a false sense of security is actually the opposite of what you suggest.
Lastly, Anders Tegnell is a bureaucrat and he is partly responsible for the most deaths in Sweden in 150 years. Did you expect him to say, oops I made a mistake?
https://www.newscientist.com/article/2251615-is-swedens-coronavirus-strategy-a-cautionary-tale-or-a-success-story/
https://www.cnn.com/2020/08/20/europe/sweden-deaths-highest-coronavirus-lockdown-intl/index.html
For all the experiment based studies that show some cloth mask efficacy, there are even more that show it is not effective.
It predominantly comes down to aerosol science vs. droplet science. There is still no scientific evidence that cloth masks are effective against respiratory viral transmission via aerosols (which is associated with the healthy, asymptomatic in a population), both for inhalation and exhalation. More and more studies and observations are showing that asymptomatic transmission is somewhere between rare to nonexistent, which is consistent with all other respiratory viruses. Therefore if you are healthy with no symptoms then it is not likely that wearing a mask is helpful or necessary.
If you are symptomatic and actively coughing or sneezing, cloth masks can stop droplets that contain virions from a sneeze or cough but whether that translates into mitigation of viral transmission is debatable as well. One still has to consider mask fit, leakage, and mask handling by people. Capillary action will wick viral particles to the outside of a mask and people are constantly adjusting and playing with their masks increasing the potential for surface contamination and fomite spread vs. not wearing a mask. Furthermore there are no standards in masks. Handerkerchiefs were found to be only .7% effective in testing by the National Academies of Sciences Engineering and Medicine so not effective at all. Without standards, fit, and proper handling, any beneficial effectiveness cloth masks in capturing droplets may be lost to say merely covering your cough/sneeze into your elbow sleeve, a common courtesy that has always existed.
If you are actively coughing or sneezing it is better for you to just stay home rather than wear a mask. If you are seeking to avoid illness from others, it is better to get yourself a KN-95 (or N-95 if you can get them) and do a test fit. Relying upon numerous masks of random strangers that you encounter that have no standards and are constantly being touched will likely not offer good protection to you, even if studies do show some effectiveness. Your life and health are definitely worth it, so take matters into your own hands and don’t risk it by relying on others.
Beyond experimental studies of actual cloth masks, simple observation of different geographic locations also shows no consistent correlation between mask use and COVID statistics. Some show positive correlation while others are negatively correlated so establishing a causal relationship is not likely.
Huh? Your comment about asymptomatic transmission is false. For most virus, peak infectiousness is just before symptom onset and right after. There is evidence that Covid hews to that pattern. That means asymptomatic transmission most occurs, in the form of presymptomatic transmission. See here, for instance:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm
Moreover, whether asymptomatic cases are infectious after the infection is active is not known because that population isn’t even well identified, let alone studied, and to assert much is known about them is bonkers.
Moroever, children, who have no or few symptoms, are increasingly recognized to be major transmission vectors:
https://www.washingtonpost.com/health/2020/08/20/children-coronavirus-spread-transmission/
I have never seen a bona fide study that found that masks are ineffective and you provide none.
Agnotology is a violation of our written site Policies. Please find your happiness elsewhere.
Agnotology. In the context of this crisis “culturally induced” fear and ignorance explains a lot. I’ve been using the analogy of the guy who goes out after a blizzard with two feet of snow on the roof of his car, and then is shocked when he makes a short stop and suddenly blinded. But it’s much deeper than that, isn’t it? During the Second World War gas masks were carried by soldiers, and at least near at hand for many civilians. After the World Trade Center came down there was a flood of videos describing how to harden living spaces against potential chemical or biological threats. Mail was for a brief time viewed suspiciously and handled with greater care. But there the propaganda machines of culture and subculture worked hard at inducing fear, where here its more about exploiting (even spreading) ignorance.
I have to disagree with John as well. Those “studies” he mentions about mask use not being effective primarily are making the case that mask use will not prevent you from getting the virus. At least the ones I have read. The article here and the studies elsewhere are not saying that mask use is an ironclad preventative from getting the virus. Rather, their purpose is to reduce the viral load, just like this article discusses. A recent real life example is here in South Carolina; https://www.forbes.com/sites/nicholasreimann/2020/08/12/coronavirus-cases-drop-46-in-parts-of-s-carolina-with-mask-mandates-compared-to-areas-without/#296ed9d57123.
Late to comment on this article. The mention of that ship – the “Greg Mortimer” – struck a memory chord. Yeah, about 60% of the passengers aboard came up sick with this virus out of about 220 passengers, but they were lucky here. About 70 of those passengers were from a medical convention so were either doctors or dentists. This was after the pandemic was underway so I was saying to my wife about how even medicos thought that they could dodge this bullet. Unsuccessfully as it turned out.
With all due respect to Dr. Gandhi, her logic is deeply flawed. I will highlight the rather oblivious holes in it in my points below:
1. The main vector of infection for viruses, which has been known for decades is aerosolized particles. It is NOT from people spraying their saliva on you.
2. With cloth masks, the air flow follows the path of least resistance. That means that the airflow is passing in and out of the sides of the mask. How is that protecting anyone from aerosolized particles??? Here is a quote from Canadian physicist D.G. Rancourt, written directly in response to the COVID-19 outbreak, published in May 2020. Titled, Masks Don’t Work: A review of science relevant to COVID-19 social policy.
. And I will highlight one other key section of his research,
3. Dr. Gandhi makes the statement, “people get less sick if they wear a mask”. All one needs to do is to pull out the statistics related to Sweden to completely blow up everything that she says. Consider that in Sweden, there was no lockdown and no mask policy. People try to make a big thing of the death per capita rate but if you actually look at the data, you find something very interesting. Of the covid-19 deaths in Sweden, only 4% were people under 60 years of age (i.e. the working and circulating population). The other 96% were people above 60 and the highest deaths were in the 70-79 and 80 and above age brackets. And 70% of those deaths were people in senior care facilities (i.e. closed environments)!!! And let’s look at the present Sweden’s weekly deaths and cases (a dubious term because someone tested positive for covid-19 is scientifically meaningless since PCR tests are not to be used for diagnostic purposes as pointed out by the inventor Kary Mullis and also it is not associated with someone actually manifesting any symptoms whatsoever) data. Both are way down with weekly deaths in the single digits.
5. Your body contains on average, 30 trillion cells, 40 trillion bacteria and 380 trillion viruses (i.e. human virome) of which an estimated 15% (i.e. 57 trillion) are coronaviruses. What this highlights given the sea of bacteria, fungi and viruses in which we live is that it is our exposure to these viruses, bacteria, and fungi that matures and strengthens our immune systems. So, the notion that we should avoid all germs is preposterous and actually damaging to our health!
So rather than focus on wearing masks which have dubious value in limiting your exposure to the virus, the conversation should be around people strengthening their immune systems via nutritionally dense foods and supplements such as vitamin D (especially important for people of african descent), vitamin C, vitamin A, zinc and selenium. Unfortunately most doctors know nothing about this because they don’t learn it in medical school. These are all critical nutrients needed to strengthen and modulate the immune system to fight coronaviruses and respiratory illnesses. Then more than the estimated 80% of the population with strong immune systems ,who don’t even manifest symptoms of covid-19 because it is resolved by their immune systems before symptoms are manifest, would have immune systems strong enough to deal with the virus as has been shown in places like Sweden and Switzerland.
I’ll go with Denis Rancourt and with others who are warning about the consequences of conforming & consenting to and complying with the diktat to wear face coverings.
https://www.rcreader.com/commentary/masks-dont-work-covid-a-review-of-science-relevant-to-covide-19-social-policy
The face mask is a symbol of authoritarianism and alienation.
http://newlevellers.blogspot.com/2020/08/humankinds-last-battle-with-nature-by.html
This is my position from a quote from an article which discusses the facts vs the fictions surrounding this new viral infection, with the quote located in the section heading “Fiction #1: Wearing a face mask will protect you and others from the coronavirus”, http://newlevellers.blogspot.com/2020/08/what-are-truly-verifiable-facts.html
“[T]he face mask should be viewed as a device used by authoritarians to control the masses and enforce compliance to lawless edicts. The mask lulls wearers into feeling protected from biological harm. Meanwhile, the real harm being done to them is psychological and spiritual. By submitting to mandatory face-covering orders based on flawed science and imposed by either unelected-but-politicized medical officials and technocrats or elected-but-compromised politicians who hold positions in all levels of government—these mask wearers don’t realize that they’re handing over their precious liberties, their individuality, and even, one might say, their very souls to soulless tyrants.”
And I enjoyed this comment by LuckyLuke1976 on the website Lockdown Sceptics
Obviously, we’re going to disagree, based on how much we trust the unelected bureaucrats who are pushing face coverings in the dubious name of “public health” for the overall “public good”. I stopped trusting these people and their lackeys on social media — yes, even including here on naked capitalism — long ago.
Sign posted @ local haunt on the river (…A liver runs through it…)
“About The Masks
If you want to wear a mask, that’s okay.
If you can’t wear a mask because of a health reason, also okay.
If you are not comfortable with people not wearing masks, this may not be the place for you, and that’s okay too.”
This has generated a bunch of 1-star reviews on Yelp…
https://www.yelp.com/biz/river-view-restaurant-and-lounge-three-rivers
One of the premier authorities on public health, Osterholm, savaged this very paper calling it bad science and saying it should never been published because it is dangerous.
You can hear him on his recent live podcast at about 36 minutes.
“Not a shred of evidence”. Yes I listen to him. I deleted a FB post I had shared about her claim after I heard him say that.