Department of Extrapolation: Masks worked in a hospital…

by philg

… so they will definitely work in the general population.

“Universal Masking to Prevent SARS-CoV-2 Transmission—The Time Is Now” (JAMA) says masks worked in the hospital:

In the largest health care system in Massachusetts with more than 75 000 employees, in tandem with routine symptom screening and diagnostic testing of symptomatic HCWs for SARS-CoV-2 infection, leadership mandated a policy of universal masking for all HCWs as well as for all patients. The authors present data that prior to implementation of universal masking in late March 2020, new infections among HCWs with direct or indirect patient contact were increasing exponentially, from 0% to 21.3% (a mean increase of 1.16% per day). However, after the universal masking policy was in place, the proportion of symptomatic HCWs with positive test results steadily declined, from 14.7% to 11.5% (a mean decrease of 0.49% per day). Although not a randomized clinical trial, this study provides critically important data to emphasize that masking helps prevent transmission of SARS-CoV-2.

Therefore, masks will send coronaplague packing:

First, public health officials and leaders need to ensure that the public understands clearly when and how to wear cloth face coverings properly and continue building the evidence base for their effectiveness. Second, although cloth face coverings are generally well tolerated for short periods, with prolonged use they can be irritating or difficult for some people to breathe through, especially in hot or humid environments. Innovation is needed to extend their physical comfort and ease of use. Third, the public needs consistent, clear, and appealing messaging that normalizes community masking. At this critical juncture when COVID-19 is resurging, broad adoption of cloth face coverings is a civic duty, a small sacrifice reliant on a highly effective low-tech solution that can help turn the tide favorably in national and global efforts against COVID-19.

The apparent contradiction between the bold-faced portions is not addressed.

[Potential bad news for American Karens: “It is probably safe for individuals and safe for others to drive alone…without a face covering,” (see this instructional video)]

So… the Swedes and the World Health Organization (advice through early June) are wrong about masks for the general population being effective in reducing plague? How might we be disappointed a few months down the road if we rely on this article?

  1. In a hospital people don’t have any real choice about how far apart to stand (similar to public transport). So the donning of masks won’t lead people to change their “social distance” (risk compensation and see also “Why is Sweden still not asking people to wear face masks?”).
  2. Each hospital worker has been fitted for an N95 mask (choice of at least 6 different styles) by a professional fitter.
  3. Hospital workers dispose of the masks between patients or at the end of each day. Hospital workers have access to handwashing and hand sanitizer within a step or two.

When you look at two members of the general public in a grocery store, none of the foregoing applies. Hospitals and doctors’ offices here in Maskachusetts seem to recognize this. If you need to enter one of these buildings you will be required to put your saliva-soaked face rag back into your pocket. Then you will be required to use hand sanitizer or soap and water. Then you will be given a brand-new clean paper face mask to wear. The bandana that protects society from the plague going exponential is not considered worthwhile protection inside the hospital.

Department of Sweden is still right (Karen Philip’s favorite department!): the Swedes give out free clean masks when people are getting on public transport.

Separately, if it as easy as the Mask Karens say to eliminate a virus by putting masks on the general population, why didn’t we use this technique to eliminate influenza, which has killed literally millions of Americans during my lifetime?

(What’s the downside of relying on masks? If we put our faith in masks and then, a few months down the road discover that they aren’t effective for the general population, that delays the measures that we actually need to take, e.g., moving more activities outdoors under shade structures, decluttering retail environments, having crowded high schools rent empty big box stores so that students can be spread out more.)

Bonus: allegorical photo showing the fate of those who don’t wear a mask, from the old fishing hamlet of Helgumannen. Faro, Gotland.

and another one… (Langhammars. Faro, Gotland)

13 thoughts on “Department of Extrapolation: Masks worked in a hospital…”

  1. Well, it’s academic at this point. Here comes the law in MA, through the legislature, no longer just an executive order: fines for mask noncompliance, fines for failure to quarantine. You must wear some kind of face covering, including a home-made cloth rag. Everywhere, indoors or out.

    https://patch.com/massachusetts/medford/s/h6fgq/fines-for-no-masks-violating-traveler-quarantine-proposed

    The science is settled. Face masks are *proven*:

    “A deadly resurgence of COVID-19 is preventable. We have proven practices to curb the spread of viral infection: wearing face masks, ensuring widely available testing, finalizing formal workplace safety standards, and quarantining tourists coming from hotbed states. But they only work if we all participate.”

    PDF of the bill:
    https://malegislature.gov/Bills/191/HD5181.pdf

    “SECTION 1: For the purposes of this section, ‘face covering’ shall mean any cloth material covering the nose and mouth. A face covering can include any home-made cloth covering, surgical mask, or covering that covers an individual’s nose and mouth, and provides a higher level of protection, including an N95 mask.”

    It’s an emergency so grave they couldn’t even proofread the first paragraph!

  3. @George A.: Only $249 each! We could buy one for all 331 million people in the US for just $82.75 billion. For $100 billion we could get extra batteries and N95 material.

    I love these companies that have “About Us”, “Contact Us” and FAQ sections on their website that don’t tell you anything about who they are. If you dig a little though, the founder is apparently Yezin Al-Qays, who is on LinkedIn, is apparently Canadian, and graduated from McGill University. Also founded FEJ Gear. It looks like the same guy, and you can see the similarities in the products:

    https://www.linkedin.com/in/yalqaysi/?originalSubdomain=ca

    “Building the leading global brand in High-Performance Hajj and Umrah Gear. My role is to design and launching innovative products that provide comfort, safety, and convenience during the grueling annual Hajj pilgrimage.”

    https://fejgear.com/

    I wonder if he’ll get a U.S. Government contract to supply these?

  4. Isn’t it illegal to sell a product in interstate commerce that makes a medical claim without having that claim confirmed by the FDA through randomized, controlled trials? If masks truly worked, then why can’t you buy a “flu mask” every winter (and why hasn’t someone made billions of dollars making and selling “flu masks”)?

    The government can claim that masks save lives, but if you or I did and tried to make money on that statement, then the FDA would shut us down virtually immediately.

    Perhaps our governors should end their mask pronouncements by saying, very quickly, “Warning: This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”

  5. I am a virus colony in/on a nasal membrane, I don’t know or care your expertise or politics. I can be launched by exhaling or sneezing into the air in front of my host in a droplet or aerosol. A few feet away is another set of nasal membranes suitable as my host. Would I have a better chance of colonizing that target by direct transmission or by negotiating one or two cloth or nonwoven textile barriers?

    Now I am this comment’s author. The answer seems obvious to me. What am I missing?

    • You are missing the fact that viruses are harmless exosomes created by the body in response to bodily distress but are not the cause of the distress. Viruses don’t cause illness, nor can they breathe, eat, shit, reproduce, swim or fly. But they do make a very profitable boogeyman.

    • Donald: The Swedes would say that you’re missing risk compensation. The masked people will get a lot closer to each other and that will make it easier for the virus to spread than if they hadn’t been masked. The exception would be a situation, such as riding a bus, where people don’t have any choice about how far apart to be.

      I am guilty of risk compensation with masks myself. In Cambridge, for example, masks are required for walking down the sidewalk. With a mask on, I am often 3′ away from other people and it does not concern me (despite the fact that I don’t know of any proof that the masks people actually wear will block this virus!). With a mask off, e.g., if I am eating at a table outdoors and walk over to a nearby trash barrel to dispose of packaging, I work hard to stay at least 12′ away from anyone else.

    • GB: “Viruses don’t cause illness”? That’s a new one. Got a link?

      Philip: Erin Bromage explains a simple model of Covid-19 infections. The Risks – Know Them, Avoid Them. If it takes 1000 viral particles to be infected:

      If a person coughs or sneezes, those 200,000,000 viral particles go everywhere. Some virus hangs in the air, some falls into surfaces, most falls to the ground. So if you are face-to-face with a person, having a conversation, and that person sneezes or coughs straight at you, it’s pretty easy to see how it is possible to inhale 1,000 virus particles and become infected.

      But even if that cough or sneeze was not directed at you, some infected droplets–the smallest of small–can hang in the air for a few minutes, filling every corner of a modest sized room with infectious viral particles. All you have to do is enter that room within a few minutes of the cough/sneeze and take a few breaths and you have potentially received enough virus to establish an infection.

      But with general breathing, 20 viral particles/minute into the environment, even if every virus ended up in your lungs (which is very unlikely), you would need 1000 viral particles divided by 20 per minute = 50 minutes.

      Speaking increases the release of respiratory droplets about 10 fold; ~200 virus particles per minute. Again, assuming every virus particle is inhaled, it would take ~5 minutes of speaking face-to-face to receive the required dose.

      The exposure to virus x time formula is the basis of contact tracing. Anyone you spend greater than 10 minutes with in a face-to-face situation is potentially infected. Anyone who shares a space with you (say an office) for an extended period is potentially infected.

      If you’re outdoors wearing a mask and you pass within three feet of someone, it seems like the momentary proximity isn’t likely to be dangerous – unless they sneeze or cough in your direction.

    • GB: Thanks for the link. Once again I feel like I’m in a parallel universe.

      1860s: Causal link established between microorganisms and illness.

      2020: Through the magic of the Internet, some Americans think that viruses don’t cause illness.

  6. Masks are at the summit of the “New York Tough” poster commemorating the first battle of the Coronavirus War in NYS. Drawn with allusions to 15th Century Ptolemaic and other ancient explorer “Here be Dragons” maps, it tells the story of New York’s curve flattening:

    “Love Wins” at the summit, with masks under a rainbow. The President sulks in the crescent of a lonely moon, with a female sun looming over him with a supercilious grin. (How the sun and a crescent moon appear in the sky together so clearly is left to the mythical astronomer to ponder). Complete with a river of money flowing down the mountain from the heavens into the Sea of Division, and a hapless fellow dangling from Boyfriend Cliff (hard to say whether he jumped or was pushed.) Cuomo’s three daughters and the family dog, Captain, are the anchors on the tug-of-war team pulling down the curve.

    https://www.governor.ny.gov/new-york-tough-poster

    That one’s going to be in every New York State municipal building and school pretty soon. It’s an amazing story.

Comments are closed.