
CDC Weighs Advising Everyone to Wear a Mask - fortran77
https://www.nytimes.com/2020/03/31/health/cdc-masks-coronavirus.html
======
Reedx
"masks don't work" and "save them for health workers" was always nonsensical
and covering for the fact we had not prepared for a known threat. I don't just
mean Wuhan in January, but pandemics generally were a known problem. It's not
a black swan event. I get the "noble lie" argument considering the situation
we found ourselves in, but that has long term consequences, seeds confusion
and erosion of trust.

Asian countries have shown the way here. Let's get moving on adopting social
norms and habits around mask usage.

~~~
vanusa
_" Masks don't work" and "save them for health workers" was always nonsensical
and covering for the fact we had not prepared for a known threat._

Of course it was.

But they weren't considering the possibility that the people they were charged
with "protecting" would be capable of independent thought.

~~~
ivanonymous
I don't think the CDC/WHO recommendations started as a noble lie, just as a
medical/bureaucratic orthodoxy, consistently expressed before any shortage.

The orthodoxy drew too sharp a distinction between airborne and droplet modes
of transmission, it didn't anticipate the possibly extensive asymptomatic
spread of this new virus, and it tried, given the low bandwidth of public
health messaging in the old days, to speak simply and authoritartively in
favor of the interventions with the strongest evidence for the largest
effects. Even to healthcare workers, the emphasis in the setting of something
like flu was on handwashing. Masks in clinic went on coughing patients, not
us. For a public less consistently exposed, the number needed to mask to
prevent a single infection was judged too low to bother. Masks in Asia were
seen as public health theater, like spraying fog machines in the streets. And
maybe most dangerously, most complicating a reversal, expressing an
understanding of this mildly counterintuitive finding - covering faces doesn't
stop respiratory viruses - was taken as a mark of scientificness. (And
remember, it's still largely true, the effect is probably fairly small, N95 or
cloth mask no matter. The virus spread well in places with mask-wearing, and
dampened more quickly there for reasons other than masks.)

The CDC/WHO people are under pressure to change deeply held and strongly
stated beliefs in public, and then to live with the implication that their
confident error cost lives. Relative to that, communicating that we should
wear masks, but leave the respirators for medical workers, is easy peasy.

For fun background on the orthodoxy, including a case where a single flu
patient infected dozens of people on a plane in the 70s without managing to
persuade people of some meaningful amount of airborne/fine aerosol spread:
[https://twitter.com/rkhamsi/status/1244659064350670848?s=19](https://twitter.com/rkhamsi/status/1244659064350670848?s=19)

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gruez
>One concern, which Dr. Anthony Fauci, the director of the National Institute
of Allergy and Infectious Diseases, voiced in an interview with CNN, is that
such a recommendation could cause even worse shortages of N95 and other
medical masks for health care workers, who need them most.

If there is indeed a scarcity of masks, isn't this question a no brainer? Of
course the masks should be allocated to hospital workers, who are exposed to
coronavirus for 8+ hours a day, rather than everyone else, who might only come
in contact with the coronavirus some part of the day, if at all.

Also, if there's a scarcity of masks, is there a reason why existing supplies
(eg. in warehouses) or incoming shippments can't be commandeered/seized by the
government under eminent domain?

~~~
wwweston
I'm increasingly of the opinion that there's no such thing as a "no brainer"
when it comes to giving instruction to a broad group of people (and "broad"
might be as small as n=10).

You know the rules of program optimization? (#1 Don't #2 (for experts only)
Don't yet). I suspect that illustrates the issue that experts are having here.
_Yes_ , in any program there are optimizations to be done that can change
margins that matter. But without deeper experience even the average
_practitioner_ is unlikely to have good judgment about this. So the experts
have to balance the effectiveness of higher-resolution explanations where
details will get lost in translation (likely degrading any marginal gains to
be had) with a low-resolution blanket rule that sacrifices potential gains for
an acceptable average.

Several kinds of masks appear to be several degrees of marginally effective,
but it's probably very difficult to give this guidance to the public without
some segment of it hearing "I need N95 masks" and scrambling after supply,
because "Any mask might be helpful to get me to be conscientious about
touching my face and provide a marginal droplet barrier, N95s are for people
spending time with the sick" is a higher resolution message that's subject to
a lot of social/individual entropy.

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tomohawk
There's a shortage of N95 masks, but even a home made mask works wonders. If
you are infected and wearing a mask, when you cough, your chance of infecting
others is much lower.

------
cameronfraser
Previous discussion:
[https://news.ycombinator.com/item?id=22734159](https://news.ycombinator.com/item?id=22734159)

------
andrewon
Finally some sanity from CDC. Early on there's evidence that people got
infected but they didn't know it, yet they can infect others. The only logical
conclusion is everyone should wear mask. See the Asian countries that are
doing that got the virus pretty well controlled. I was surprised CDC didn't
err on the safe side.

You don't need to recommend everyone wear N95. Surgical face masks or homemade
masks works too.

------
melling
The ship is sinking and there aren’t enough lifeboats.

History doesn’t repeat itself but it often rhymes

They are likely waiting until there isn't a supply issue. People will rush out
to buy masks of all types.

~~~
celticninja
any face covering helps though.

one positive is that universal mask use will make facial recognition a lot
harder.

~~~
drivingmenuts
Which is handy until you actually need the police to find an actual criminal.

~~~
celticninja
well widespread facial recognition technology has only just recently been
available to law enforcement and the police have been catching criminals since
their inception. it might be a useful law enforcement tool but it is hardly a
requirement for them to be able to catch someone.

