
CDC considering recommending general public wear face coverings in public - ceejayoz
https://www.washingtonpost.com/health/cdc-considering-recommending-general-public-wear-face-coverings-in-public/2020/03/30/6a3e495c-7280-11ea-87da-77a8136c1a6d_story.html
======
erentz
Posted this two days ago but it was flagged, maybe now it won’t be?

[https://medium.com/@thejanellemj/please-join-me-in-
wearing-a...](https://medium.com/@thejanellemj/please-join-me-in-wearing-a-
mask-71e0e3f4fe4a)

We have made a big stumble in the US by falsely claiming masks don’t work,
seemingly for political reasons. If we can get mask production in place and
made available to the public it will help us ease our lock down restrictions
which is something we all want to do. We are starting from so far behind so I
don’t know if that’s possible now, but we should all be honest and factual, so
we can develop solutions and innovate.

~~~
nohat
HN has been pretty hostile to the idea. I submitted Jeremy Howards video and
research collation, and got a single borderline insulting comment.
Unfortunately people have largely made up their minds thanks to the plethora
of attacks on masks.

moral "Your stealing them from healthcare" (lots of people have a couple old
masks, or can make one from a t-shirt)

paternalistic "You'll go do stupid stuff if you have a mask" (Exactly why we
shouldn't have people wash their hands)

ridiculous "You'll touch the mask and get it on your hands" (Is that worse
than inhaling it? Plus it physically prevents you from touching you mouth or
nose, which is the real danger.)

insulting "You can't possibly wear a mask correctly" (and why can't we figure
that out? Plus it still helps both for protecting other people and ourselves.
If something doesn't work perfectly then we shouldn't do anything at all?)

just false "it doesn't work" (except in asian countries and for healthcare
workers, and in studies, and in common sense)

~~~
yread
I agree that wearing a mask is a good idea but I think the risk is that as you
breath or cough through a cloth mask it very quickly becomes wet and saturated
with virus particles (if you're sick) and then every breath you exhale goes
through a sieve full of virus particles greatly increasing the number of
droplets in it.

If you touch it, you touch a reservoir of virus particles.

And it probably doesn't protect you significantly from other people's droplets
or airborne virus particles as they are too small for the holes in the fabric.

On the other hand even if it reduces the risk 20% it still helps to reduce the
R0

~~~
xref
If you’re coughing enough to “very quickly saturate” a cloth mask into a
sopping wet rag...don’t go out.

------
m0zg
If nothing else you won't be touching your face uncontrollably if there's a
mask. I already wear it when going on grocery runs etc, for that reason, and I
notice an increasing number of people are doing the same. If distancing is in
place, the main risk is not that you'd inhale something, it's that you touch
something and then bring it into your mouth, nose, or eyes. Eyes are not an
issue for me since I wear glasses. Mouth and nose are covered by a mask, so I
can't touch them directly.

And you can reuse the masks by exposing them to 70C/158F heat for an hour.

~~~
cortesoft
I thought I read that there was a risk of people touching their mask too much
(to adjust it or because it itches), and thus increasing the risk.

~~~
dawnerd
Just watching people in the store and you can tell they think they’re
protected but the masks are definitely not helping. Especially when they take
them off incorrectly.

A full face covering might help people with touching their face but too many
people think it will filter out particles.

~~~
hanniabu
What's the correct and incorrect way to take the masks off?

~~~
jimmyswimmy
CDC provides guidelines for donning/doffing N95 masks here:
[https://www.cdc.gov/vhf/ebola/hcp/ppe-
training/n95respirator...](https://www.cdc.gov/vhf/ebola/hcp/ppe-
training/n95respirator_coveralls/doffing_16.html)

The process is straightforward. I was shown a different technique than they
provided, and am not a fan of having dirty gloves on or around my head and
face as they show there.

I have been trained to usa a gloved hand and place it over the center of the
mask, use your other hand to lift the straps over your head, and then pull
away and discard the mask and gloves. The key is to prevent any contact
between the exterior of the mask and your face, and certainly not to touch
your face with the gloves.

Removing the mask incorrectly risks exposure to whatever was outside the mask
in the first place. For the kind of exposure nonmedical personnel ought to
experience, and for extended wear periods, I would think the mask would act to
integrate whatever you've been surrounded by. In other words, you've collected
8 hours of crap on the front of it, so you'd want to be extra careful with the
dirty part.

~~~
yencabulator
> not a fan of having dirty gloves on or around my head

For what it's worth, the earlier steps include removing outer gloves, and
disinfecting the inner gloves.

------
everybodyknows
Sadly the article itself conflates N95 respirators with surgical/home-made
masks. Former protect the wearer; latter protect others (primarily).

>the health department there does not recommend that people without illness
wear a mask, both because the benefit is uncertain and because there’s a
shortage of face masks for health-care workers.

Better to never write "respirator mask" nor "face mask". Those terms
perpetuate the confusion.

~~~
matthewbauer
Shouldn't any covering help? Like catching 50% is much better than 0%, even if
the N95 can catch 95% of particles.

~~~
BuckRogers
Masks offer very limited protection. It’s similar to wearing medieval
platemail to protect against a high powered rifle. Partial protection at best.

Direct sneezes or coughs right in front of you are safer but you also need eye
protection. That still leaves the ears open and microabrasians on your skin.

False confidence with the expectation they’re safe with an N95 mask is even
worse than no mask at all. It’s like those kids in the news some years ago
that held up a book to stop a bullet and killed someone.

If you wear the mask in a constrained area with a group of people, such as an
elevator, you may as well not even have it on.

The only sure way to not get the virus is avoiding people.

~~~
jobigoud
Ears aren't connected to the respiratory system. Lacrimal ducts are, that's
why eye protection is important. The virus doesn't enter your lungs through
your skin pores either.

~~~
DoreenMichele
Ears are directly connected to the sinuses (via the Eustachian tubes), which
is part of the upper respiratory system. There's a reason we have Eye, Ear,
Nose, Throat doctors. It's all connected.

~~~
aznumeric
As far as I know ear, nose, throat doctors (Otolaryngologists) don't treat
eyes and they are called 'Ear, Nose, Throat' doctors, there's no eye in the
name. Doctors that treat eyes are Ophthalmologists and Optometrists.

~~~
DoreenMichele
[https://medical-dictionary.thefreedictionary.com/EENT](https://medical-
dictionary.thefreedictionary.com/EENT)

It's possible it has fallen out of favor. I'm a tad on the old side.

------
symplee
Moving forward, masks should be readily available in public places in the same
way tissues are.

For example, a large box or auto dispensing machine for individually wrapped,
single masks, in libraries, grocery stores, offices, classrooms, movie
theaters, etc.

And might as well add motion activated hand sanitizer dispensers at the
entrances too.

~~~
mustardo
Some countries are struggling to ban single use plastic bags, now we want
everyone to use disposable masks everywhere, the waste from this must horrific

~~~
koheripbal
They aren't made of plastic, so I don't think they'll cause even a fraction of
as much problematic waste

------
everybodyknows
Interestingly, official Singaporean advice recommends masks only for people
feeling symptoms. See strategy point 5:

[https://www.abc.net.au/news/2020-03-31/coronavirus-
singapore...](https://www.abc.net.au/news/2020-03-31/coronavirus-singapore-
how-it-fought-the-virus/12100072)

Also interesting, in a bad way: Strategies 1-4 are plainly beyond the ability
of US to implement any time soon.

~~~
adventured
It's also beyond much of the US to implement 80-90 degree temperatures that
dramatically limit the ability for SARS-Cov-2 to spread as in Singapore.

[https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767](https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767)

See: Hawaii, Texas, Nevada, New Mexico, Arizona, much of California and a lot
of the warmer south. Which are all seeing between extremely low and low
localized per capita transmission levels and hospitalizations, despite the
very lagged (and overall mediocre) US response.

The Las Vegas metro area will be 80 degrees on Wednesday. Take a look at their
deaths and hospitalizations (despite having millions of people). With their
international traffic, vast number of casinos and casino workers, slow speed
at which they shut it all down and the initially lagged testing rates, they
should be absolutely buried in Covid cases and deaths. They're anything but
and they're seeing no big surge in cases.

These temps are the reason why the experts are hopefully anticipating the
infection rates to rapidly bend down in the coming weeks, and perhaps peak in
May or June. Even very informed people like Bill Gates have spoken publicly
about being hopeful about this (see his recent Ted Connects talk, it's about
an hour long and almost exclusively about this situation). It's the seasonal
temperature increase (and to an extent humidity) factor.

edit: I understand why some people don't like these facts, I understand the
emotional response. The numbers don't lie: hotter climates in the US are not
seeing the surge in cases, they're not seeing the same hospitalization rates
and as a consequence they're not seeing the deaths as in the other climates
like NY, NJ, MA, IL, CT, MI.

Check out all the cities in Texas (huge population), their metro areas, and
look at the per capita rates of infection, hospitalization and death. Then
compare.

~~~
bsder
> See: Hawaii, Texas, Nevada, New Mexico, Arizona, much of California and a
> lot of the warmer south. Which are all seeing between extremely low and low
> localized per capita transmission levels and hospitalizations, despite the
> very lagged (and overall mediocre) US response.

And yet Lousiana is getting pounded because of Mardi Gras.

And Florida is likely to follow due to Spring Break.

No state yet has evidence that they have turned their curve over from the
standard R0. And, last I checked, practically every state was on the same
trajectory past the 100th case.

~~~
adventured
Hotter temperatures do not guarantee the cessation of all possible
transmission of SARS-CoV-2, it impedes it in relation to the increase in
temperature (and also ideally humidity, particularly indoors). It helps make
everything else you might do for slowing the spread more effective and easier.
There is very strong evidence at this point that SARS-Cov-2 is susceptible to
the same seasonality factors as influenza. We're seeing this demonstrated all
around the world simultaneously in warmer climates, from Mexico to sub Sahara
Africa to hotter countries in Asia. It's why none of the major cities in Latin
America are seeing the kind of infection rates as NYC or Milan (or as Wuhan
previously did). It's why sub Sahara Africa isn't getting hammered (despite
plenty of international traffic and trade, including previously from China,
that should have massively spread it). It's why India still isn't seeing a
massive explosion in cases, as has been feared since the beginning of the
outbreak in China.

Check out: Mobile & Birmingham & Montgomery Alabama, the Western handle of
Florida, Jackson Mississippi, look at other cities in Louisiana that didn't
hold Mardi Gras (and one assumes those cities still got a burst of their cases
from the Mardi Gras spread event).

~~~
peachepe
Latin America is not testing people Nearly enough. That’s the main reason for
low counts.

In my country, it is only possible to be tested if you say you were in direct
contact with the current 4 confirmed cases (1 deceased), and they would have
to confirm that too.

~~~
adventured
Yes, I understand the reason for the low counts. As I keep repeating, you want
to pay attention to the flooding of hospitals with Covid patients, that you
can't hide (unless you're very authoritarian with strict media control).

These places are not buried in dead people either. Their intensive care
systems are not being flooded. Their hospitals are not being flooded by a
million cases.

Mexico is not seeing what NY and other high-infection climates have. Given the
poverty, poor healthcare system, poorly prepared healthcare system, high
traffic and trade with the US via NAFTA and in general, it should have an
enormous number of cases by now, and as a consequence a large number of daily
deaths and intensive care cases hammering their healthcare systems in every
major city. None of that is happening. It's not happening for the same reason
it's not happening in Texas.

~~~
jkhaui
From everything I've read about COVID-19 and flu-like infections, I'm also
inclined to believe that warmer climates help slow COVID-19 outbreaks. It is
(in my opinion) the most plausible explanation why certain regions are hit so
much worse than others thus far. I also believe a paper I recently read
supports this hypothesis.

I've seen the media publish articles with titles like "coronavirus myths
busted: warm weather stops the virus". Ironically, these attempts to combat
misinformation are dubious themselves, as the truth is probably somewhere in
the middle; that is, warm climates may not outright stop COVID-19, but they
may certainly hinder it. The fact is, while we can't make definitive
statements at the moment due to limited data and understanding of the virus's
pathology, we can make educated guesses through observation.

Another contentious point (particularly here in Australia) is the sentiment
that children are mostly immune to the virus. The Aus government is pushing
this line very strongly as an excuse to keep schools open (i.e. economical
reasons).

So yeah, I don't know why I wrote this comment. Probably to stress the fine
line that exists between having a mindset which is open to observational
theories, while also being critical of "facts" which are pushed to drive
political agendas amidst the coronavirus outbreak.

------
catalogia
Better late than never, but they'll need to put some work into countering all
the anti-mask propaganda that's been flying around for weeks now.

~~~
everybodyknows
Propaganda? Example?

~~~
catalogia
Yesterday morning the surgeon general tweeted _" They are NOT effective in
preventing general public from catching #Coronavirus"_

There has been tons of rhetoric designed to discourage the public from buying
masks that gives the impression that public wearing masks won't help. A lot of
headlines to that effect that lack any nuance at all.

~~~
GhostVII
That's true though, isn't it? A mask will not prevent you from getting the
virus, since covering your own mouth from others coughing doesn't really help
you. If you are sick though, it protects others.

~~~
tzs
> A mask will not prevent you from getting the virus, since covering your own
> mouth from others coughing doesn't really help you. If you are sick though,
> it protects others.

What is the mechanism for this?

At first, I'd expect it to be the other way around--if I'm wearing a mask and
cough the mask is going to bear the full force of my cough. All of the cough
is hitting the mask, and the cough is moving at its fastest speed.

If I'm not wearing a mask and you are, my cough is going to be spread out some
when it reaches you and slowed by air resistance, so your mask should only
have to deal with a fraction of my cough and at lower velocity.

Thus, I'd expect your mask to have a much easier task than mine.

Is it that the drops of moisture (and phlegm and whatever else might be in a
cough) are bigger at the point of emission and break apart as they disperse,
and so they have a harder time going through a mask at my end than at your
end?

If that is the case, I still have to wonder what happens on subsequent coughs.
I cough, producing big drops that the mask stops. Still, the viruses in the
drops have to go somewhere when the mask absorbs the droplets, right? Does my
mask end up moistened with virus-contaminated water? Will my subsequent coughs
as they blast air through the mask then be able to knock small virus laden
droplets off my mask?

~~~
GhostVII
My understanding is that, as you said, the purpose of the mask is to stop
droplets from coughs and sneezes from getting to other people and surfaces.
However if others cough on you when you are wearing a mask, the rest of your
face is still exposed so you are not fully protected, and you can still be
infected by touching contaminated surfaces and then touching your face.
Surgical masks are also not sealed off, so you can breath in aerosol from
other people's coughs even with the mask.

Certainly masks will help to some degree, as they will filter out some
particles and protect you if someone directly coughs into the mask, but I
don't think they are effective compared to things like hand washing.

I am not a doctor, not medical advice.

------
matthewbauer
This would have been helpful weeks ago. Now I fear that Americans are set in
their coronavirus way - we expect grocery stores to sanitize every item but
don't think twice about walking right in front of a cashier with no mask!

~~~
buzzerbetrayed
Not sure what you’ve been experiencing, but in my town everyone is thinking
twice before getting close to anyone.

------
rdtwo
That’s great now if we could only could produce a couple billion masks

~~~
thkim
It looks like a typical machine can manufacture a mask 50~100 per minute. For
40 hour work week that is 200k masks per week. So technically we only need
5000 of these machines to produce 1bn a week.

~~~
koolba
Are the machines made in China?

~~~
thkim
[https://www.kingsing.com/product/561-en.html?gclid=EAIaIQobC...](https://www.kingsing.com/product/561-en.html?gclid=EAIaIQobChMI6LTNmOnD6AIV06uWCh3RGgypEAAYAyAAEgKZm_D_BwE)

------
newshorts
I honestly don’t know, aren’t face masks in public illegal?

~~~
Bedon292
No, not in the US, why would they be illegal? Some places, like a bank, may
want to not let you in (though I even doubt that these days). But certainly
not illegal.

~~~
5555624
In Virginia, it's a Class 6 felony. There are two medical exemptions. One
requires carrying "an affidavit" from a licensed physician or osteopath, which
specifies "the medical necessity for wearing the device and the date on which
the wearing of the device will no longer be necessary and providing a brief
description of the device,"

The second is "the declaration of a disaster or state of emergency by the
Governor in response to a public health emergency where the emergency
declaration expressly waives this section, defines the mask appropriate for
the emergency, and provides for the duration of the waiver"

Although the Governor issued an Executive Order, yesterday, telling people to
stay at home, he did not include a declaration about masks.

~~~
koheripbal
There is a specific exemption for medical use...

[https://law.lis.virginia.gov/vacode/title18.2/chapter9/secti...](https://law.lis.virginia.gov/vacode/title18.2/chapter9/section18.2-422/)

~~~
ceejayoz
No, that exemption requires a doctor's affidavit or an explicit disaster
waiver from the Governor. iii) can only be read with its a) and b) subparts.

ii) is more useful here.

> engaged in ... other activities and wearing protective masks which are
> deemed necessary for the physical safety of the wearer or other persons

~~~
koheripbal
No, that's your interpretation - not what any court has determined. I would
argue that direction from the NIH, CDC, Virginia Department of Health, and/or
literally everyone's current doctor constitutes "the advice" needed under the
law.

Not a single court on the planet right now would be so idiotic as to side with
your interpretation of that law.

~~~
ceejayoz
It's not my interpretation. Just read the thing.

Section iv.) says "upon a) or b)". a) says "carrying on his person an
affidavit from the physician"; b) says "the declaration of a disaster or state
of emergency by the Governor in response to a public health emergency _where
the emergency declaration expressly waives this section_ , defines the mask
appropriate for the emergency, and provides for the duration of the waiver"

It's quite clear. Section ii.) gives much more wiggle room; you could cite the
NIH, CDC, etc. there. Section iv.) says only the Governor's declaration (with
very specific requirements the current emergency declaration doesn't give) or
an actual physical affidavit you're carrying with you count for its exemption.

------
crazypython
American masks are ugly. Other country's masks look stylish.

