By Lambert Strether of Corrente
“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” –Margaret Mead
Despite the sound of distant trumpets — “we few, we happy few” — in the epigraph from Margaret Mead, masking remains one of the layers of protection (the “Swiss Cheese Model“) used by many Americans to protect themselves from the neurological and vascular effects of SARS-CoV2, which seem to defy treatment. From the New York Times:
28% of all adults is not a negligible number. (Sadly but typically, the Times didn’t categorize its subjects by income or occupation.) Dominant it’s not, but there are more committed mask wearers, especially in this environment, than there were, say, Volkswagen Beetle owners, back in the day when we’d wave at each other on the road. There are far more mask wearers today, and far more ability to fraternize. Organize, even (as the Corsi-Rosenthal box builders seem to have done, interestingly).
An Op-Ed in the Los Angeles Times, written after our absurdist President’s Ionesco-like remark that “the pandemic is over,” presents one way forward:
Ordinary Americans who cannot afford to be ill — and that is truly tens of millions of us — now have to appeal directly to America’s working medical professionals:
Please make your medical offices safe for us to enter by using N95 masks and top-rated HEPA air filtration. Too many of us are at risk to become severely ill, develop chronic illness or die if we catch COVID, even if we are newly boosted. Just as importantly, many of us are the sole caretaker for someone else, people who depend on us for their everyday needs. We are desperate to avoid getting sick for their protection as well as our own. And the reality is that healthcare providers, run ragged after the last three years, can’t afford to get sick either.
Crucially, we cannot let infectious air be so prevalent that people delay going to a hospital in an emergency because they fear catching COVID there…,
I am speaking directly to our doctors, dentists, nurses, specialists of every kind, all our providers of routine and critical care: In the absence of any backup from government officials, we need your help now. We need to be able to come into your offices for the checkups you always nagged us to keep up with — and we want to get. As your patients, we need a professional commitment from you to practice good infection control.
If you cannot see your way to having everyone inside your office, staff and patients alike, to wear an N95 or equivalent mask all day, please at least create some hours every week when that is the rule for everyone — a required masking portion of the day. Offer this as an option when patients call to make an appointment.
Medical examining rooms and waiting rooms are often windowless. To support masking efforts, get HEPA filters, which are affordable for offices and effective at capturing COVID particles from the air.
And if you understand how much we value our health, if you are among the medical professionals who have been grieving over the nation’s pandemic failures, if you remain committed to preventing infections, please work with colleagues inside your prestigious professional associations to promote clear and effective infection control standards. Your patients can’t do this. The CDC made clear it no longer will. But we hope you can.
I agree with the sentiments and the point of attack, and I think that medical professionals are not as heartless as they are often depicted in anecdotes on my Twitter feed (many of which I repurpose here). I do think that marketing collateral would be needed, along with an FLCCC-like organization. We’ll see. (Of course, what would be really helpful is a public relations campaign — propaganda does work, as we know from current events — on the national scale from a government not dominated by eugenicist views, but we are not at that point, now.)
This post will be a little bit of a smorgasboard. Covid is, in my view, by no means over, even it has plateaued. Nevertheless, the press of awful events to be chronicled has diminished, leaving time to consider topics that we blew past, or which only recently emerged. This post will consider three: mask fit, mask manufacturing, and masks on the movie set (where compliance is near 100%).
But first, let me quote a new study from the American Journal of Preventive Medicine, “Modeling COVID-19 Mortality Across 44 Countries: Face Covering May Reduce Deaths,” and never mind that I hate that locution “face covering”:
This study examines a hypothesized association of face-covering mandates with COVID-19 mortality decline across 44 countries in 2 continents.
In a retrospective cohort study, changes in COVID-19‒related daily mortality rate per million population from February 15 to May 31, 2020 were compared between 27 countries with and 17 countries without face mask mandates in nearly 1 billion (911,446,220 total) people. Longitudinal mixed effect modeling was applied and adjusted for over 10 relevant demographic, social, clinical, and time-dependent confounders.
Average COVID-19 mortality per million was 288.54 in countries without face mask policies and 48.40 in countries with face mask policies….
The results of this study show a significant association between face mask mandates and reductions in COVID-19 mortality. This evidence supports the positive impact of face mask policies on saving peoples’ lives.
Marketing collateral this is not. But it could certainly be converted! (Perhaps the Brains Trust will weigh in on the methodology, which is a bit above my paygrade.)
Wiith that, let us turn our our maskstravaganza.
I really should have thought of this [slaps forehead]:
I've been trying to explain this for two years now. N95s were designed primarily for male caucasian faces. KN95 and KF94 standards came about not because we wanted a knockoff mask standard, but because Asian faces could not pass fit tests with N95 masks. https://t.co/uUkXVXkPXv
— Naomi Wu 机械妖姬 (@RealSexyCyborg) September 27, 2022
And some advice:
The takeaway is mask fit over everything, check with @masknerd for the best ones to try with tested filtration, stick with whichever of those has the best fit.
— Naomi Wu 机械妖姬 (@RealSexyCyborg) September 27, 2022
Of course, if there were some sort of size standard, like there is for shoes, say, we would have to rely less on anecdotal exchanges on Twitter threads. Perhaps the brain geniuses at CDC could create one.
Indeed, one would think that the Diversity, Equity, and Inclusion DEI industrial complex could be focusing on centering masks for Asian and Black (and not merely White) faces, instead of spending their time rooting out micro-aggresions and so forth (unless, of course, you consider breathing air polluted by an infectious pathogen a micro-aggression). The
DIE DEI folks have a lot of clout in industry and academia, so what say? Save some lives?
The Bill of Health Blog makes the point better than I can, centering the disabled: “The Mask-Optional DEI Initiative“:
Recently, I remotely attended a mask-optional, in-person meeting where campus leaders proudly proclaimed that DEI (diversity, equity, and inclusion) is my college’s “top priority.”…
I should be clear here that this was not specifically a meeting focused on DEI work, but a required department meeting where we were, once again, reminded of this strategic priority by leaders from outside the department. I should add, too, that “access” to the meeting via Zoom only existed because my department chair continues to provide it against a clear university expectation that everyone but those with “approved” accommodations work in-person.
My employer, like many universities, has followed a pandemic trajectory from remote work, to in-person work with masking and vaccine requirements, to in-person work that closely mirrors 2019, except for a small number of people at the institution “electing” to still mask.
Campus buildings — where in-person work is once again the norm — are now adorned with signs that declare with what feels like an overly proud tone that “masks are not required in this building.” And it’s both the moving on from still-necessary, effective, proven mitigations, and the tacit celebrations that such moving on has occurred (as perhaps demonstrated by the tone I read into that sign), that make me question what the managerial performance of an “investment” in DEI is meant to achieve.
I will be direct: .
Moreover, the rejection of masking as a necessary mitigation will continue to prolong the pandemic and increase its harm for everyone, and especially for disabled students, staff, and faculty at institutions of higher education (a population that is likely increasing, for we do not yet know the pandemic’s full harm nor have we curtailed uncontrolled viral spread).
While the ongoing purposeful exclusion and/or harm of disabled students, staff, and faculty is certainly not the first illustration of hypocrisy being hardwired into many DEI performances, it is clear evidence that many institutionally-sponsored DEI initiatives project a better future largely divorced from the current material reality and organizational culture that necessitates “improvement.”
(I would ask also about ventilation.) But where’s the lawsuit? Meanwhile, “an ongoing commitment to purposeful exclusion” seems a little gentle. Why not use the original German, Lebensunwertes Leben? Because society-wide, that’s what the policy amounts to.
From the New York Times in March 2022, “Why American Mask Makers Are Going Out of Business” (example; example):
It is hard to know precisely how many of these [small American mask manufacturing] companies were born during the pandemic; 36 of them are members of the American Mask Manufacturer’s Association, which they formed to lobby Washington. Virtually all experienced [a] same boom and bust phenomenon,,, At first, customers who could no longer obtain masks through their normal supply channels were beating down their doors. The same was true during the Delta and Omicron waves, when masks were also scarce.
But as soon as the waves crested, and Chinese companies, determined to regain their market share, began exporting masks below cost, the customers disappeared.
The government’s answer to this pattern is its own buying power. During his State of the Union address on Tuesday night, President Biden promised that the government would begin to rigorously enforce provisions in the law that call for the federal agencies to buy American-made goods whenever possible.
The plight of these small mask companies, however, suggests that reviving American manufacturing — even when the underlying rationale is national security — won’t be easy.
“Resilience is the byword of the day,” said Marc Schessel, a hospital supply chain expert who is working to develop alternative supply chains for personal protective equipment. And resilience — that is, creating extra manufacturing capacity that can get the country through an emergency — is what the small mask makers say is their value to the country.
Wait. Schessel is a supply chain experts. That means he wants to optimize the chain so that there’s no slack or inventory; “tight coupling” as Yves calls it. But we don’t have to accept that model. Why can’t we put masks into inventory? (Good masks that, America being diverse, fit all faces.) More:
The mask manufacturers I interviewed for this article said the Biden administration had expressed interest in buying their masks, but it has yet to happen. Even if it did, it would be unlikely to put much of a dent into Chinese dominance. As Mr. [Mask Manufacturer] Bowen put it in a recent email to the White House, “Hospitals drive the mask market.” Since their incentives are to reduce costs, he wrote, “Any plan that allows imported masks to cost less than U.S. made masks will result in a foreign government controlled U.S. mask supply — as currently exists.”
To put it another way, the modern imperative of maximizing shareholder value will always put efficiency and cost over resilience.
That’s an interesting perspective on the priorities of our ginormous monopolized system of hospitals, isn’t it? There’s no consideration for the health of patients and health care workers at all. How do these hospital buyers sleep at night? The article concludes:
Despite the president’s vow to have the government buy American, the most likely scenario remains what it has been for months: the small mask manufacturers will go out of business, hospitals will continue to import Chinese masks — and the country will again be caught short when the next pandemic arrives.
Plus ça change….Because we’re not a serious country.
Masks on the Movie Set
The film industry is different:
Public: eating/partying indoors is fine. Just get your booster if you want. You do you.
Film/TV industry: test, vax, measure CO2, isolate, quarantine, ventilate, mask when not on camera, clean the air. No exceptions.
— Debbie Winslow (@Debbie_Winslow_) September 23, 2022
Here’s what one contractor does:
We aim for CO2 less than 1000ppm, and if we can’t get there, we introduce HEPA/air scrubbers/air movers into the stages/sets. Here are examples of what I did for some productions. pic.twitter.com/NqoBsNZyiS
— Erin Bromage Ph.D. (@ErinBromage) September 22, 2022
1000 is a little high, to my mind, because my rule of thumb is outdoor air. Another:
— Lazarus Long (@LazarusLong13) September 21, 2022
But why? Why, you ask? Why does a crazy industry like Hollywood have such good protections for workers, and my workplace — or college, or hospital, does not? The answer:
Think masking is for idiots?
This thread is for you.
In what industry are people considered to be THE assets?
Doctors. Lol. Wrong.
— Lazarus Long (@LazarusLong13) September 21, 2022
“The talent” is not expendable. But you are (unless you believe that labor is the source of all value, which puts a different spin on who’s expendable, but that is a topic for another time).
I’d like to conclude by kicking CDC’s twitching corpse a little, but I’m not yet ready to look at 3M’s respirators, designed in 2008 for a pandemic situation just like our own, and why CDC never recommended their use.
Instead, I’d like to close with a look at trust (or, I suppose, if we wish to be modern, “pro-sociality”). From STAT, “The CDC’s latest blunder is really about trust, not masks“:
The bigger concern here is not with what the CDC actually said, but with the fact that there is a deep lack of trust in our society. People don’t feel like they can rely on one another to follow guidelines that aren’t enforced with mandates or penalties. And while there’s good reason for why that trust has evaporated, the CDC’s choice to release or withhold information to us all should not depend on whether some people might abuse that information. The public deserves to be told the truth about where the science stands; the public also deserves competent governors and public health department chiefs who can communicate nuance and decide what policies make sense to implement at a community level.
There’s no question that trust must be rebuilt between members of the public, and between the public and health agencies and leaders. But for this to happen, we must all acknowledge that the lack of trust is what’s bothering us.
For now, at least until we can get that 28% figure higher — masks work for the flu, colds, and childhood respiratory diseases, too — or at least stomp the mocking and policing and smile-extortion, we might give consideration to treating masks as a trust marker. A mark of solidarity, if you will.
 I hate pseudo-scientific locution “face covering” because it’s false: The eyes (“the windows to the soul”) are not covered by masks, and last I checked the eyes were part of the face, at least for humans. Indeed, most mask designers, when constructing their use cases, seek to avoid such scenarios as users walking into walls, into traffic, falling downstairs, etc.
 I doubt that a standard as simple as shoe sizes could be constructed for “mask fit”; see the fitting process here, for example. But we could surely do better, such that half the globe isn’t left out by the parameters we think are universal, because they apply to us!
 What, not even fundraising?
 I have not looked at the Center for Disease’s standards guidance for its hospital infection control material. If CDC guidanceon masks is as horrid as its guidance on airborne transmission, it will be optimized for cheap-jack, non-functional Chinese goods bought in bulk for pennies.
 There is also, apparently, a large contract with big manufacturers like 3M. That way, giant hospital monopolies can purchage from giant manufacturing monopolies. All fine, I suppose, except if there’s one thing mask manufacturing needs, it’s real innovation — not just for fit, but as I keep screaming, for fashion* — and giant monopolies just don’t do that. NOTE * For example: Why on earth don’t we sell masks to school children with stickers? Kids love stickers, or did in my day. And so on, and so on.
Re: Taylor Lorenz
Boy, does it hurt to be on the same side of an issue as PMC media drama queen *Taylor Lorenz* and on the opposite side of Glenn Greenwald, Matt Stoller, and so many other great minds I mostly trusted before Covid.
Also, I certainly do not see anywhere near 20% of people in shops here in eastern Massachusetts (outer Greater Boston) wearing masks. On the other hand, it might be that the mask-wearers also go out less.
Ah, now I see what you meant. That link from Lorenz snuck in, and then WordPress changed it to an embed. I deleted it.
That said, I was sort of stunned to find a really good link on her Twitter feed. You never know.
As for Lorenz versus Greenwald et al., I tend not to be on the “sides” of individuals. At least I try not to be.
This should provide a summary of the vapid, self-victimizing Lorenz vs. the usually incisive Greenwald.
I want to be clear, I was not in any way criticizing your inclusion of a Tweet by that person.
As for Greenwald, for me it’s not a “side,” it’s just the enormous disappointment in someone I admired. I guess you really can’t be cynical enough…
> it might be that the mask-wearers also go out less.
I feel highly confident that this is true. People who are willing to accept the (mild) discomfort of mask-wearing and the risk of social opprobium from the more numerous maskless are likely to pursue other ways of risk reduction, such as avoidance of crowds, shopping at low-traffic hours, and other forms of “physical distancing”.
Great post Lambert, and thank you for continuing to call out the wretched situation on campuses and for pointing out the DEI puffery versus actually inclusive actions and policy. Covid is supposed to be “over” in Canada too of course – the rest of the covid control measures at the border are now going to end October 1. Nevertheless, in the notice for a fire alarm testing and inspection at my home, the following request is included:
“While the fire alarm technicians are on site and entering suites, please isolate from them. You can do this by isolating in a separate room within your suite or by leaving the suite all together. The suite fire alarm service is an important step in the fire inspection, and we want everyone to continue to stay safe.”
This is the first time this type of request has been added to such notices since the official provincial pandemic safety requirements were made optional, and then dropped early this year.
Thanks again for the yeoman’s service here! Fan. Tastic.
I seem to remember John Lennon saying something like the war is over (if you want it).
COVID-19 could be over if the President Biden wanted it to be over.
If Biden flooded American society with N95s and directed the propaganda machine to promote the wearing of N95s (or better), we could get pretty close to rendering the pandemic over.
What would the cost be to society compared to what we’ve already spent?
But that would be too much like right.
My husband and I in our sixties wear a mask every where, in doors or out. We wear Kn95 as they do fit us better. The fit does leave something to be desired. Occasionally, I get the glasses fogged up. We stay out of any place crowded and try to go to the store early in the morning. I haven’t been to a doctors office but have taken my Mother and the flimsy worthless surgical masks they wear frightens me to death. I have an N95 for my mother and I try to stay outside. My biggest fear is visiting a dentist. I cannot find any that wear anything but the surgical mask. Not a chance I am going in and let these people get a few inches from my face. What an F up situation this is now.
> Occasionally, I get the glasses fogged up
YMMV, but my 3M Aura 9320+ has an adjustable foam nosepiece that makes for a very good seal that is also comfortable. Because of it, glasses do not fog.
I lost part of a filling and really need to go to the dentist. But I’m really nervous of exactly what you say – letting people get a few inches from my face. …. That said, maybe this is as good a time as any to do it since we seem to be in a lull?
I’m in the same boat. Nasal spray and alcohol solution nebulize before and after is my plan.
Depends on masking and ventilation. Dentistry is an aerosol-generating procedure, so if the dentist and assistant won’t mask, I’d find someone who will
I recently caved and went to dentist for cleaning and check-up. I was due just as the pandemic started to it has been awhile. The office is in an old house and the window in the exam room opens. Otherwise, no way.
I am of the Caucasian persuasion and yet the PowCom KN95 fits me better than any other mask. Also, it looks better.
I think it is just that I have a lower BMI than most North Americans.
Re “face coverings,” I too am a stickler about vocabulary, but I think there’s such a thing as too much stickling (for example, I’m not going to bother checking whether “stickling” is considered a word). I interpret “face covering” not as a pseudo-scientific thing, but as an attempt to avoid negative associations of the word “mask.” After all, the traditional function of a mask (outside of technical and medical realms) is to conceal. That is the most common literal meaning of the verb “to mask.” The robber’s mask is a staple of law-and-order iconography. I’m not defending “face covering”, this is just my interpretation.
Adding: in spite of my stickling, I’m extremely grateful to NC and especially Lambert for being the voice of sanity on everything about the pandemic.
We recently watched a movie made last year and it had a COVID Co-Ordinator and some other COVID related jobs in the credits. What a sad commentary on our society that people who work in the entertainment industry are better protected than our so called essential workers.
You know they’re essential because we’ve been given permission to take them for granted.
Here in Arkansas, my guess is that maybe 2-3 percent wear a mask. And … as a footnote … my personal level of trust is zero. And, the idea that at some time in the future I will suddenly trust the CDC et al … well … nope. It won’t happen. And … making “mandates “law”? Would be a non-starter for me. So. Yes. Net. The handling of all this has been/is a complete fiasco. IMO.
I wish it was anywhere near 25% in my college class. It seems to be just me and one other student out of thirty and the teacher. That is a glorious 6% in the ultra Blue San Francisco Bay Area. At least they do have indoor filters. Don’t know how good it is, but it is there.
It is true that the liberals I know are much more likely to wear masks than the libertarians and conservatives I know, but the liberals almost all wear very loose surgical masks. I don’t know why they bother; it is a talisman I guess.
I do feel as if I’m part of a giant group hypnosis experiment. So many people I know are treating the pandemic as over, entirely over. After all they’ve been told it is. I feel as if I seeing something they don’t see – a future with years and years of big new waves of infection – and then wonder if I’m nuts. I do think that a lot of the excess mortality will simply be ignored by the government; it will be covid but we won’t be told so.
I agree entirely. It is just that mask wearers are at least acknowledging the exist of Covid and even crappy cloth surgical masks offer some protection even if minor. Not wearing anything at all in a crowed room with over thirty people for an hour and a half…
Well, we are just six weeks into the semester. I can’t wait to see how many of my classmates are going to get ill.
Earlier today Donald Trump Jr. tweeted:
I believe that Trump Jr. is expressing in his vividly nasty and stupid way the anti-masking viewpoint of the great majority of the public, not just in the U.S., but generally in the Anglosphere. I don’t think the accumulation of long covid cases and increasing disability rates are likely to bring back masking – it would take a large scale increase of hospitalizations and deaths from a new variant to do so.
I agree that “face coverings” as a term is an attempt to avoid the negative connotations that “masking” has. Last week I noticed it used on a sign at an entrance to a supermarket I shop at:
Right after reading this I noticed thar neither cashier had a mask on. Yesterday the sign was still up and one out of two cashiers was masked. This is a national chain – Aldi – and at their website their nationwide policy is expressed in these terms:
As a man in my mid70s with a chronic condition that impairs my immune system, I expect to mask in public for the rest of my life. Situations develop, not necessarily to one’s advantage – one adjusts one’s behaviour accordingly.
There is no such thing as a “white” face or a “black” face or an “Asian” face. Some people just have to make shit up for a living.
Really? Westerners living in Asian countries often have a hard time finding clothings that fit their size when they go shopping at local shops/department stores. They usually just buy all their clothes back in their home countries when they go back for vacation, etc. It must follow that Asians generally have smaller faces no? I am not sure why this bothers you so much.
MWRA (https://www.mwra.com/biobot/biobotdata.htm) jolted up today (9/29). From the one body part that doesn’t lie. More than you can say for the gobmutt, the powers that be, the bigdeals, etc. etc. etc.
I highly recommend using a mask brace to ensure the mask fit is as good as possible. Some types of N95 masks don’t fit well on me and the mask brace helped fix it (my glasses no longer fogged up). I have only used “fix the mask” braces and they are great but their sizing chart isn’t easy to use. On the Mask Nerd spreadsheet you can also see how the mask brace can improve surgical mask filtration efficiencies from 41% to 88% (FG300 C1 surgical mask).
Another interesting N95 mask is the strapless masks that adhere to your face. They are pretty comfortable and don’t require loops around the ears or head. I like them, but I view them as more of a situational mask. Like many others I like the 3M Aura the best. I just wish I listened to all the recommendations from people on this site earlier.
I agree 100% in a mask brace (a.ka. Badger frame). I don’t need one with the Aura, because it has elastic headbands, but I did with an earlier N95 that had earloops. The fit was much improved.
The strapless mask is what we use with me stepmum. She is a small person and the N95 didn’t fit well, we think she may have caught It at her hairdressers (small nose means she wasn’t having the qtip shoved up the sinuses again, so not positive on that). The strapless worked well, fit to her face and didn’t need to remove straps for her hair to be washed.
As bizarre as it might seem, a half face respirator (for asbestos or paint spraying) for $35 might be a great solution for specific people. Totally reusable, long lasting cartridges with true HEPA protection. I use an ancient North 3500 model for work and have no issues. Fit and finish are excellent.
The good news is that the more masks sold means the more money 3M has to pay out on PFAS claims.
I have a beard, what is the best mask for beards?
There isn’t one really, unfortunately (I hate shaving, skin issues). However if you have a big beard there are some techniques you can use to help it play well with respirators (such as wrapping it with an exercise band, and often used by religious HCWs who can’t shave. Consider the following resources for more info:
One of the fun things about riding a motorcycle is that, when you pass a motorcyclist coming the other way, you frequently give each other a little salute. It helps build a community, and it’s just fun.
It would be nice if we could do something like that between people wearing respirators. I’m not sure what the correct gesture would be, it doesn’t have to be elaborate and in fact shouldn’t be, but it should be something that’s hard to miss if you’re looking for it.
Vulcan salute? Clenched fist?
you could do this quickly:
make eye contact
point to your own mask
Vulcan salute, but I am biased, being Jewish.
BTW, by far the best masks available, if I may be so bold, are made by envo mask. They are comfortable, fit well with no fiddling, give you the option of an exhaust valve if you want it , and can hang comfortably around your neck when you take them off. They are about 80 bucks to buy, but the replacement filters are only a buck or two so they are quite inexpensive over the long haul and don’t create a lot of waste.
They are a serious company that has been around for a long time, and have excellent delivery and customer service. Strongly recommended.