The market for face masks is probably enormous right now but the information out there on which ones to buy is anemic. I assumed this was because masks were such a commodity that it didn't really matter which ones you bought, but this article shows otherwise. Even just among the cotton ones there is quite a difference.
I think the broader point is one that still stands: wearing literally anything over your nose and mouth is shown, by this study, to cut droplet by at least 50%. Even the cotton varieties cut it from 70% to 90%. So...people need to just slap something over their two air exchanging orifices on their faces before leaving the house and contribute to the our greater health.
You're right about the differences in effectiveness but 70% is still pretty good as long as many people are wearing something and not exposing their noses or wrapping the mask lovingly around their chins.
Well, no: the fleece mask broke larger droplets into many smaller ones, resulting in an increase of 10% in the number of droplets compared to the no-mask baseline. Being smaller droplets, they would also hang in the air longer.
You touch your face more when adjusting the mask so if it's not efficient enough it may be a net negative.
Edit: This is one of the main reason the Scandinavian countries recommend against _all_ mask use (including N95) so not sure why I'm getting downvoted for merely saying an inefficient mask could have that problem.
I've seen that idea being tossed around, but are there any sort of studies showing that the increased face touching can indeed make the virus spread more than not wearing masks? It's a geniune question, I'd like to see studies related to that.
For me, it's not really obvious that more face touching (even if that happens in significant numbers across the population), causes the virus to spread more than it would have without face masks. Reason being that it seems like spread through surfaces is not as bad as through the air, so making the air cleaner seems better than making the surfaces cleaner to me.
I think the reason that various authorities advised against masks is political - there simply weren't enough and to direct the supply to clinical workers.
Which is damning in that they treated us like children who couldn't handle the truth and were also so unimaginative that they did not consider alternative face coverings.
The government communication in the UK has been lamentable. Confusing, inconsistent and patronising. On the other hand, we had idiots who stripped the supermarket shelves of toilet rolls and canned tomatoes for months despite being implored not to do so. If they had gone after the masks...
Yes we should not have taken masks that would go to the NHS but don't forget those masks should have been in government stockpiles well out of reach. How can we blame and punish the publics self control (or lack of it) when it's a government failure that caused the issue. Had we all bought masks and the state made them instead of redundant hospitals perhaps we would be in a much better place (less NHS casualties and physical/mental suffering).
All in all it just doesn't sit right with me to justify the government's decision without mentioning they were the ones that put us in the position where it had to be made.
There is now, and was then, plenty of evidence to suppose that enough people would not handle the truth responsibly, and would panic-buy masks rather than adopt alternatives.
Is the US government so impotent that it can't ask retailers to ship their supplies of masks to a commandeered warehouse? Of course some would go missing, but substantially all would arrive.
I personally think one aspect that doesn't get much attention is the matter of public education. At the arrival of the pandemic here in Germany the initial advice was to seriously implement hygiene rules: 1.) Wash hands thoroughly and often, 30 sec long, plenty of regular household brand hand soap, 2.) When coughing or sneezing, turn away from others and put your elbow in front of your face and 3.) Keep distance of minimum 1.5 meters and 4.) Limit contact with people outside your home environment wherever possible.
Assuming everyone followed this advice, at that particular moment we didn't need masks so much (most people were in lockdown anyway) and besides the fact that there were not enough medical masks to go around, there was more danger in using generic face coverings than not because the average Joe didn't know how to do so safely and the virus was not yet under any sort of control.
Around Mid-May, we had a different circumstance. The general public had taken the hygiene rules to heart and been in lockdown quite awhile and the sun came out - Spring sprang, the numbers went down (thanks to lots of cooperation from the general public) and that was when the public education effort went in to the next phase: To give official advice and instruction on how to properly handle face coverings in a way that they help instead of hinder.
Meanwhile everyone, even Grandparents, my mother, and some people's recalcitrant Uncles know how to use Skype and Zoom. We wash hands like surgeons, we can and do handle face coverings without making ourselves sick and I think, for a public education effort that started 5 months ago and was directed at 90 million people, that is simply huge. I try to remain wary of the impulse to judge what we did yesterday with what we know today.
That was a colossal mistake. Not only have they ruined their credibility in this pandemic but they've guaranteed that there will be panic buying during all future pandemics. It was a one-time weapon that provided marginal benefit and terrible long term consequences that go far beyond contagious diseases. Don't be surprised if anti-vaxxers use this incident for decades to come as proof that health authorities lie.
> five of eight systematic reviews found no evidence that the use of masks would provide any benefit in controlling sources of infection or protecting healthy persons from exposure to respiratory infections
Unfortunately, that news article does not contain the links to those reviews. Maybe they are part of the full report, but I can't read Finnish.
> The rates of all infection outcomes were highest in the cloth mask arm, with the rate of ILI statistically significantly higher in the cloth mask arm (relative risk (RR)=13.00, 95% CI 1.69 to 100.07) compared with the medical mask arm. Cloth masks also had significantly higher rates of ILI compared with the control arm. An analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI 1.01 to 2.94) were significantly higher in the cloth masks group compared with the medical masks group. Penetration of cloth masks by particles was almost 97% and medical masks 44%.
Conclusions
> This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.
To be clear, this compared cloth vs. medical masks. There was no “unmasked” arm. So the caution was of the “given the choice, choose medical masks.”
Also this measures auto-protective properties of mask wearing, not preventing spread to others.
You're getting downvoted because you provided zero evidence to backup a claim that seems pretty absurd. Touching your mask to adjust it is not the same as touching your nose, mouth, or eyes directly. Pretty much every reputable recommendation says to wash your hands after removing your mask, which avoids the contamination problem pretty well.
And to your point on Scandinavian countries, where are you getting that information? Here's Norway mandating that travelers from "red" countries wear a face mask until they get home [1] and planning to backpedal on their lax mask policies [2]. Here's Denmark backpedalling on their original mask policy [3]. Here's Iceland updating their policy because they also realized no face masks is a bad idea [4]. Basically, Scandinavian countries now recognize that their original policies were not that great.
Thanks. I didn't know that they've started to backpedal. As for sources I had no idea it was such a controversial topic and something I thought was obvious (again, my point was just that an inefficient mask could be counterproductive) but here's the European Centre for Disease Prevention and Control saying the same thing:
> There is a risk that improper removal of the face mask, handling of a contaminated face mask or an increased tendency to touch the face while wearing a face mask by healthy persons might actually increase the risk of transmission.
I find it hard to believe that any experiments would back up that fact. Do people put their fingers in their eyes/nose/mouth when adjusting their masks ?
Surely having everyone wear a mask is more efficient than banning masks because a small fraction of mask wearers would catch covid when readjusting their masks.
I don't find it hard to believe at all. I see people fidget with their masks all the time. Here's the European Centre for Disease Prevention and Control saying the same thing:
> There is a risk that improper removal of the face mask, handling of a contaminated face mask or an increased tendency to touch the face while wearing a face mask by healthy persons might actually increase the risk of transmission.
I don't doubt some people could self contaminate, I just highly doubt that the risk of self contamination is anywhere close to the risk of regular contamination due to not wearing a mask.
The answer to "improper removal of the face mask" is "proper removal of the face mask" not "tell people not to wear masks"
> You touch your face more when adjusting the mask so if it's not efficient enough it may be a net negative.
Keep hand sanitizer in your pocket. Whenever you touch the mask, sanitize your hands. Both before you touch (in case you touched a COVID19 infected surface, you don't want to add COVID19 to the mask), and after you touch (in case your mask prevented COVID19 from entering your lungs, you don't want to contaminate other things anymore)
Problem solved. At my work, there's hand-sanitizer everywhere now. I don't even need to reach into my pockets anymore.
Or #2: don't touch your mask. Ever. That's how doctors/nurses do it. The hand-sanitizer crutch is what I do because I'm not as good as a doctor/nurse with my discipline. But I'm training myself to never touch the mask.
> Assuming people to be 100% noobs at masks for months is a bit pessimistic.
Or maybe it's realistic. Go read some hospital audits of mask wearing or handwashing. Have a look at any of the research showing that even staff who are trained to use it struggle to do it properly.
Because it's what the state epidemiologists of the Nordic countries are saying, and why they recommend against mask usage. I'm all for masks btw. All I said was that inefficient masks could be counterproductive due to that reason but apparently even that innocent suggestion is heresy here.
> So...people need to just slap something over their two air exchanging orifices on their faces before leaving the house and contribute to the our greater health.
My point is that if the mask is inefficient it could be counterproductive due to fidgeting. See sibling comment about fleece masks that hopefully makes a better case since you can't agree the slightest that anyone would ever fidget with their mask.
Regardless, I don't agree that it's a banality considering the ECDC lists it as an important caveat when using face masks:
> There is a risk that improper removal of the face mask, handling of a contaminated face mask or an increased tendency to touch the face while wearing a face mask by healthy persons might actually increase the risk of transmission.
Obviously I read the thread, otherwise I wouldn't have commented on what you wrote in it.
> Regardless, I don't agree that it's a banality considering the ECDC lists it as an important caveat when using face masks
It's a banality when in absolutely every thread on this subject at least one person states the totally obvious that doing something incorrectly could might potentially possibly may be worse than not doing it at all.
Not washing your hands properly or not being socially distant enough are not counterproductive, they are just unproductive. No-one thinks that less social distance gives you more protection, while wearing an inefficient mask may have the opposite of the desired effect. You're mixing up the "too much anything is bad for you" trope with a serious caveat that has caused whole countries to recommend against face masks.
I'm not mixing anything up, and you aren't fooling anyone any more.
You are using that "serious caveat" because it's the go to trope for anti-maskers seeking to pollute absolutely every fucking discussion on this subject.
I asked you to explain why you're posting anti-masker arguments if you are, as you claim, "all for masks" and all you've done is repeat the same anti-mask bullshit.
Next time I won't bother assuming possible good faith on the part of anyone spouting textbook anti-masker noise.
You know, it's possible to be for masks and still acknowledge it's not the perfect solution. You are the one pushing me into a corner of "either you're with us or against us".
The ECDC guidelines recommend face coverings but still recognise the caveats, but in your eyes they are heretics and anti-maskers for even mentioning it. You appear like a religious fanatic. Very sad to see and it completely kills any serious discussion about the topic.
The ECDC is not here, hammering on the same anti-mask arguments over and over again in every post, ignoring whatever anyone else says that counters it, you are.
Yeah, what a fool I am for discussing the topic at hand. You are the one polluting this thread with ad hominem attacks and overly defensive windmill fighting against imaginary anti-maskers. Again, read the thread before you decide to jump into a conversation next time.
It's not up to you who jumps into a thread or why or when, and when you jumped in it was not to discuss the topic, but to spout anti-mask noise that wearing a mask "may be a net negative", under the guise of 'Hey, I'm just innocently saying what "Scandinavian countries" are saying'.
When you were informed that Scandinavian countries are not taking an anti-mask stance, instead of holding your hands up that your argument was based on something false, you simply carried on making the same anti-mask point by fixating on something else (three sentences from a six page PDF) instead.
After looking at the article for a while, my take away was material aside, the fit matters a lot. They got a very different results with the same materials with different fits. I know from using one the peaked N95 has an awesome fit. I guessing the swath was pressed hard to the face, so no leaks which would explain it's good performance. The best of the cotton masks was again the peaked.
Fit being important isn't good news. You can get a good idea of the material from the ad, but judging fit is hard without trying it on.
The values on N95 can work both ways - allowing air to more easily pass in the in or out direction. If it's in I guess it's not protecting you so well. If it's out it's not protecting others. Out is what they tested. Most seem to be out, but I have one that's in (maybe a manufacturing fault - who knows). It's nicer to wear for long periods than out. In the context of slowing down covid, I'm guessing in is more effective.
A couple of reasons for this spring to mind immediately. Firstly, governments don't want people using the most effective masks because there's barely enough of them to supply hospitals. Secondly, the push for masking has absolutely nothing to do with effectiveness. For instance, people keep pointing to things like the 1918 flu epidemic as proof we've always known masks worked, but as far as I can tell those masks were made of gauze and therefore likely as bad as or worse than the worst mask in the study. And there was an article going around pointing to this study of the effect of reducing the dose of flu virus people were exposed to as proof masks worked better than expected: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342672/ Notice how, at the part of the curve where reducing the amount of virus had the most effect, it took a tenfold reduction or so to reduce the number of people showing symptoms or testing positive by about 30%? On its face that seems kind of bad for the idea of using random non-medical face coverings with much worse filteration, but that's not how it's been spun.
Also, I think a lot of this has to do with what people feel will work based on it having a good narrative attached. For example, there's this fairly widespread idea that valved masks are not OK and worse than random cotton face coverings which I think has even been enshrined as an actual legal requirement in a few places despite clearly not matching up with the test results here. Presumably this is because it feels like deliberately letting your own breath out past the filter via valves is intentionally exposing others, even though anyone who wears an ordinary non-fitted face mask can easily notice that exhalation blows out around the edge of the mask anyway - often with really annoying results for glasses wearers. A bunch of British news organisations even accused our government of telling people to wear "useless" maasks and endangering the public for showing a valved mask in their advice: https://www.independent.co.uk/news/uk/politics/coronavirus-f...
Nice to see some empirical validation of valved N95 masks still being better than the vast majority of other "masks" when it comes to protecting other people. And of course valved N95 masks are the gold standard for cheap masks (not full organic vapor gas masks, etc) even outperforming non-valved N95 in protection of self because of the valve preventing them from becoming unsealed during peak outflow. And of course they are much more comfortable to wear for long periods and during heavy work.
I just wish the US government would go all in on production of real, effective, fit N95 masks and distribute them to everyone.
The authors themselves point out the valved N95 masks might be worse than what the raw results show:
"Furthermore, the performance of the valved N95 mask is likely affected by the exhalation valve, which opens for strong outwards airflow. While the valve does not compromise the protection of the wearer, it can decrease protection of persons surrounding the wearer." [emph. mine]
I'm pretty sure the difference they're referring to is already there in the raw results - remember, they're measuring how well the masks protect others against the wearer by filtering out expelled moisture droplets, and the results show that valved N95 masks are worse than non-valved (though about as good as the very best of the cotton masks).
I doubt the results completely account for the airflow effect, and perhaps the researchers were careful enough to note this.
After all, they merely tested one infected person speaking at whatever level is normal for that person at that stage of the disease. It's quite possible that the typical carrier has stronger flow. Besides, sometimes people yell - quite a few people have reason to be on edge these days.
Ouch. I read droplets and thought 'virus'. That said, my point about the speaker not being representative is still correct. We have no idea if the speaker's speech is typical. It could be their flow is lower than the average.
They tested with four speakers and ran additional tests with one speaker. Results are consistent across the speakers. Consider also that they are measuring the relative filtration of different masks, not the absolute filtration.
I have an even better way, albeit a bit dirty. Take a vape pen and simply put your mask on before exhaling; "eyeball" the size and trajectories of the exhaled vapor, select the mask that wins, and call it a day.
I don't think there's any reason to assume vapour from a pen resembles the droplets in your breath. In fact, that one of them is visible and the other is not should suggest that they might behave very differently.
The number of droplets is just one variable. Slowing down their speed is another. Since droplets are heavy and fall down fast that dry aresols, just having transparent face shield might give protection to others.
I’d be interested in seeing them test the CDC mask pattern for bandanas because that pattern has you make like 9 layers. I slip a piece of shop towel in the folds and put pipe cleaners at the nose bridge.
The low-tech way I've seen (but not cross-calibrated), thanks to a pair of argie firemen: use an aerosol spray can, eg hairspray, to see what makes it through the mask candidate.
I was rewatching Stranger Things last night and Hopper made a comment about how a missing child brings out the crazies (his words, for those somehow not in the know, it's a show set in the 80s, no internet, no mobile phones).
I'm starting to suspect that the media, police, government in all its forms, just used to filter them all out. File their reports and letters in the wastebin.
I do wonder whether we've now just given those people an ability to talk to the whole world via Twitter/Facebook/etc., who aren't filtering them out.
So perhaps the narrative was always there, but pre-internet was easily filtered.
This is correct - I remember people had serious concerns about it in the early 90s when the web first started growing. It gave a vehicle for "the crazies" to find each other, talk to each other, and strengthen their views by validating each other. In many cases, this is a good thing as it allows a healthy diversity to grow in our society. But it is a double-edged sword. While it does help people find their tribe, it also creates unhealthy echo chambers.
There has been a strong anti-science component in the US for literally centuries. These advances have been despite the sentiment. In addition, it isn't like other countries weren't going to space or weren't working on it (just like now). Tech has been mirrored elsewhere for a long time, but an American education might lead you to believe differently (I know mine didn't really mention that things like cars were being developed elsewhere - they just mention the first American to make things).
If you want a fine example of this, look at the push against modern medicine. Folks were eshewing "European-style medicine" for quite some time.
The US Took a really, really long time to eliminate lead from paint and gasoline, comparatively, even though we knew about the harm.
We knew things about climate change before WWII, and the denial then was pretty strong. People were scoffing about Earth Day when I was a child - I'm 42 now.
Anti-maskers were about in the 1910's with the Spanish flu. The anti-vax movement has been around since.. well, around the time we started to have vaccines. Yes, folks lined up for them, but not everyone.
It is a whole heck of a lot easier to be vocal about it now, though, and easier to reach others to try to convince them.
Yeah, it's interesting, even the comment you're replying to betrays the duality.
50 years ago the U.S. put a man on the moon, following the coattails of the civil rights movement, meanwhile suffering through one of the most corrupt presidencies, a resurgence of white supremacy that would echo for decades to come, and the beginning of an ignorant war that would destroy the lives of many tens of millions of Americans (the war on drugs).
And here we are, today, with an American company SpaceX yet again redefining humanity's reach and we are again suffering through easily the most corrupt presidency to date, white supremacy, and ignorance that is destroying American lives.
I think like many it's hard not to look at America today and worry that things are worse than they've ever been. But I think in many ways you're right; America has always been like this. A violent cocktail of the best and worst of humanity, shaken, not stirred.
Do you really think everyone in the 50s was in stem, supported the space program, and innvoates? It's always a minority. They were bombing soldiers, us soldiers with nuclear weapons saying it was harmless to see the effects. Is it sad we don't do that anymore?
Just because you watch TV and have a bad Facebook feed doesn't make it America
The damages and side effects of masks are consistently and systematically downplayed. Benefits are vanishing if exist at all. The group think is such that you will never see any of these mentioned in the media.
Here is a study that shows that cotton masks increase(!) the incidence of flu like diseases:
From first study: "The null hypothesis is that there is no difference between medical masks and cloth masks. ... The control arm was ‘standard practice’, which comprised mask use in a high proportion of participants [NOT "mask free"]." -- this means "increase relative to surgical masks", not relative to no mask.
Second study is only N95s. Just don't wear an N95 if you need more air for aerobic capacity. The OP study shows that they're not _that_ much better than surgical masks anyway.
not sure what your are getting at with the null hypothesis.
Look at the results. Mandatory cloth masks were associated with 3 times as many ILIs (Influenza Like Illnesses). So it is not some tiny statistical variation. It is a huge effect size.
As for the second study, it concludes:"The observed mechanisms may lead to more severe symptoms in individuals with impaired capacity for myocardial compensation."
I am talking about how the all sources of information systematically downplay the negative effects and serious side effects of masks.
Masks do have side effects. The relentless propaganda tells you that is a "mere inconvenience".
Compared to surgical masks. There was no study of unmasked people. I expect it would be 10x.
> The observed mechanisms may lead to more severe symptoms in individuals with impaired capacity for myocardial compensation.
The study was only on N95 masks! Most people are wearing surgical or cloth, it's irrelevant.
> I am talking about how the all sources of information systematically downplay the negative effects and serious side effects of masks.
There appear to be very few, similar to how all sources downplay the negative effects of walking on the sidewalk vs walking in the road.
I would be a lot more sympathetic if you targeted your ire at "washing down surfaces", because that seems irrelevant with respect to spread. But masks work, and that's the long and short of it.
You should give the paper a more careful read, it discusses all that.
The control group was typical use, whatever the staff chose to do, which included not using masks at all.
The use of masks in the control group was about 23%! And that included medical, N95 and possibly cloth masks as well. Whatever they would typically use.
Here is their conclusion:
"Given the obligations to HCW (Healthcare Workers) occupational health and safety, it is important to consider the potential risk of using cloth masks."
This is a bad faith post intentionally spreading misinformation.
Ignoring the quality of these studies, the first concluded that cloth masks were less effective than medical masks, not that the are worse than no mask. It also evaluated and discussed the use of cloth masks to protect health care workers, not to slow the spread of sars-cov-2 via respiratory droplets.
The second, tiny, study says nothing about damage. Their results suggested that surgical masks reduce cardiopulmonary function slightly with surgical masks and a little more with N95 masks.
That is not what the paper found, all you need is to read the abstract:
"Cloth masks also had significantly higher rates of ILI compared with the control arm"
As for the second paper here is the summarry:
"The increased breathing resistance is especially problematic for patients with chronic obstructive pulmonary diseases. Patients with diffusion disorders have reduced capacity to compensate due to the reduced tidal volume. Another example of a population at risk is patients with heart failure. The observed mechanisms may lead to more severe symptoms in individuals with impaired capacity for myocardial compensation."
All I am pointing out is that masks are likely to have serious side effects, all which are completely disregarded and downplayed.
The question is whether I trust your "survey" or the CDC's recommendation.
But also, in both cases based on a quick skim it seems to me like you're misrepresenting the studies. In the first study, the control was "normal practice" which included mask use. In the second study, I see no claims about cardiac damage; I understand it to say that masks make it harder to breathe, which is useful information but not very surprising.
That is exactly right! What the paper says is that masks should be used when necessary and according to the case presented to the medical staff. Not all the time.
When you force people to use the masks all the time you are making the problem worse.
When people are violently objecting to wearing a mask for 10 minutes in the store, I’m less worried about studies focusing on long-term mask usage and more worried about the impact of those spreading doubt.
I am concerned because they are about to force children wear masks 8 hours a day in school. What do you think it will happen when it comes out this was damaging to their health?
I think students with chronic obstructive pulmonary diseases or heart failure should not be in school at all right now with a deadly virus floating around.
We’ve also had studies which claim something along the line of ”Apples cause cancer” and the truth is that it happens only under some certain rare conditions and even then one might have 0.01% chance of increasing their chance to get a cancer by 0.1%. But hey, that’s an increase in possibility nevertheless!
