Can the positive experience of Hong Kong with clean disposable paper masks translate to Americans using filthy reusable face rags?

I was an early believer that Americans could mask up and #LeaveHomeSaveLives. This belief was substantially based on the positive experience that Hong Kong, Taiwan, Japan, and China have had with keeping various viruses under control. Beginning in May, with coronaplague well past peak in the U.S., a lot of governors began to share my enthusiasm for masks. The Massachusetts face rag order went into effect on May 6.

(peak was April 8; Professor of Epidemiology Donald J. Trump said the plague would be on the decline by Easter; Easter was April 12:

data from the IMHE prophecy site.)

However, since the disposable paper masks that are favored by health care workers and Asian consumers aren’t readily available, Americans are primarily using filthy cotton face rags that they wash periodically and touch all of the time (retrieving from pocket or cupholder, even if not when on face). Facebook post from a humanities professor friend:

After sewing my own three ply face masks, and buying a few not so great ones locally, I just got a pack of masks from a T-shirt company in San Francisco that actually seem quite good. They are three ply (Correction: just realized they are four ply, even better), with two lightweight inner cotton layers, and a heavier (doubled) cotton/poly blend outer fabric, and are big enough to cover the whole face. They also tie on, so feel more secure than having elastic over the ears, and also have a way to easily insert filters too. There’s lots of people selling masks, but these are the best I’ve found so far, so figured I’d pass it along.

Even Shutterfly is selling cloth masks, despite there being no photo customization option:

WHO says that masks work only if the wearers have ready access to the very things that Americans don’t have access to: sinks for handwashing and/or hand sanitizer. This is easy in the Shanghai Metro. Use any station’s clean restroom. But how can it be done in New York City or Boston, the plague centers of the U.S., especially if most places that actually have public restrooms are now closed?

Three questions, then:

  1. Do we think that the governors’ orders to “rag up” will affect coronaplague transmission?
  2. If “yes”, will transmission be reduced or increased by these saliva-soaked occasionally washed rags?
  3. Will there be any way to figure out whether our guess was correct? What data can we look at in June, for example, to figure out if the Massachusetts May 6 “rag up” order had any effect?

Related:

  • Danish professor of microbiology explains why we are stupid (ordinary folks will incubate the virus in their warm moist face rag, then touch it, then leave virus on surfaces that others will touch)
  • “I Wear My Face Mask in the Car” (make sure to watch at 2:25 when Bill Gates comes in)
  • My favorite question, from a latter-day female-identifying Socrates… What I don’t get: If masks work, why aren’t we back at work? If masks don’t work, why are we being asked to wear them?
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A typical American hospital during coronapanic

The author of Medical School 2020 gave me an update on his training hospital. They have roughly 1,100 beds. They have admitted 24 Covid-19 patients since the plague began. There are currently 7 Covid-19 patients in the hospital. Residents have been working week-on/week-off due to the shortage of cases from which they might learn. “We’re allowed to do elective surgeries as of this week,” he said, “and I thought there would be a huge backlog, but there isn’t. We’re still not busy.”

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Do countries with better medical systems have higher Covid-19 death rates?

Asked for his theory on why death rates from Covid-19 varied so much from country to country, a Dutch friend said that he thought that countries that had “better” health care systems, in the sense that they were able to keep more “zombies” alive, would end up with a higher death rate. “Nigeria doesn’t have a lot of 90-year-olds on permanent life support,” he pointed out, “so coronavirus is going to have a tougher time killing people there.”

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Update from the Massachusetts License Raj

As in the early decades of Indian independence, all business activity in Massachusetts is forbidden except what is specifically permitted. Our state’s License Raj has released an update: “When can my business reopen?”

Although barbershops can reopen on May 25, flight schools are specifically forbidden from reopening: “TBD – not Phase 1. Comprehensive plan is being developed” (i.e., government officials are spending taxpayer funds on a “comprehensive plan” for an activity in which only a few hundred residents of Massachusetts participate).

The best news for those who are passionate about optimizing health: Medical marijuana shops are still considered “essential” and can conduct business as usual (maybe because stoners are the best at following WHO guidelines regarding proper use of face masks?).

Own a residential summer camp? Your business is finished. We start “Phase 1” on May 25. You’re in “Phase 3,” to which no date is attached. Whale watch boat where all of the tourists are outside in the seabreeze and sun and you can set capacity at any fraction of the Coast Guard max number? You’re done. Phase 3.

The governor and his subordinates did not address the stay-at-home mom’s question that I cut and pasted previously:

What I don’t get: If masks work, why aren’t we back at work? If masks don’t work, why are we being asked to wear them?

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American-style lockdown…

From Atlantic, “Dear Therapist: My Boyfriend Had an Affair and Now We’re Stuck at Home Together”:

I found out during the stay-at-home orders that my boyfriend of eight years has been cheating on me with a co-worker for at least four months (that I know of). He lied to me by saying that he was going out for errands, but he was really meeting with her in a parking lot. She is married.

What do patients get when they swipe their Visa card at the therapist’s office?

And how does he reconcile his love for you with, presumably, having sexual contact with another person during a global pandemic and potentially infecting you with a deadly virus?

(I’m disappointed that the therapist did not ask “Were they both wearing homemade masks?”)

How about an update to “Not All Who Wander Are Lost” for the Cower-in-Place age: “Not All Who Are ‘Running Errands’ Are At Target”?

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Why can’t we get ice cream during coronashutdown?

The only way that I am able to demonstrate my usefulness to children is taking them to ice cream shops. Recently, however, this has been a failure. On the first warm Sunday of what we here in Massachusetts jokingly call “spring”, it took 30 minutes to get a few cups. Where the shop previously would have had perhaps 4 or 5 people working behind the counter, only 2 soldiered on, perhaps unaware that unemployment now pays much better than scooping obesity. They had no soft-serve, which is what my customers actually wanted, and wouldn’t put the ice cream into cones, but would put cones into a bag and let customers reconfigure their ice cream once in a secure location.

Earlier this week, I took the kids to Bob Lobster, a seaside shack with picnic tables (closed off with yellow tape against a virus that survives only 30 seconds in sunlight; people are supposed to eat in their cars) that is walking distance from 2B2. There is a tempting ice cream cone sign outside. They had no ice cream to sell. I said “After we get back to Hanscom, I’ll take you to McDonald’s on 128 and we can get McFlurries.” McDonald’s had no ice cream to sell.

What’s going on? If sales at fast food outlets are down at least 50 percent, why don’t they have ice cream? Is it that all of the workers are at home soaking up unemployment and there aren’t enough to clean the soft serve machines?

A few snapshots from the trip. All of the bumper stickers are from one car.

Update: Success in Maynard, MA! With a minimal wait, we obtained four legal cups of take-out ice cream with edge-of-the-law cones stuck on top (not legal to serve ice cream in a cone, apparently).

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Security clearances during the coronapanic

A friend from graduate school needs a security clearance for some work that he is doing (I guess I can’t ask what!). An investigator telephoned me to check out his story and mine. She said that this would have been an in-person interview (which she prefers) during ordinary times, but that it was all phone-based due to coronaplague.

When our enemies have mined out all of our secrets five years from now, will that turn out to have been a hidden cost of the shutdown?

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Plague-proof the U.S. with nursing home and hotel pairings?

One of my bored-in-quarantine activities is mocking Facebook friends for their faith in various Utopian government-run schemes for winning the war against the evil coronavirus. Most of these schemes require a perfectly efficient government, the elimination of the Constitutional rights of healthy young people, and a perfectly compliant population (including the 22 million undocumented).

Usually they respond by defriending me, because the only thing more offensive than someone who doesn’t hate Donald Trump is a Holocough Denier. Occasionally, however, they’ll ask “What would you do, then?”

My first response is “I’m sure that ‘Do nothing’ would be a better plan than what U.S. state and federal governments have done.” Then I will disclose my favorite plan, which is to pair eldercare facilities with hotels so that all of the workers in a nursing home, for example, could move into the associated hotel as soon as a plague was declared, receiving battle pay for their 24/7 quarantine. In non-plague times the hotel could receive regular guests. Presumably there wouldn’t be too many left by the time the plague was upon us, so there would be hardly any non-staff guests to kick out. Any worker that didn’t want to suffer through the quarantine could leave, forfeiting the battle pay and, at least for the duration of the plague, the job at the nursing home.

The advantage of the above scheme is that nursing homes could be much better protected than they are now and have been during coronapanic. Currently, workers come and go every day, with no possibility of testing for the virus itself, and get a basic forehead temperature check when they report for work. A single asymptomatic infected worker could easily wipe out an entire nursing home. A second advantage is that it would be safe to run the rest of the society, including schools, for anyone under age 60 and in reasonably good health. Data from mass.gov:

It is true that some people younger than 60 died, but 98.3% had “underlying conditions.”

How much of a hit would an economy take it everyone over 60, plus those with a serious health condition, retreats into bunkers? Workers over age 40 are considered to be of such low quality by employers that the government has to force companies to hire and retain them.

I thought that this was an original idea, but of course a friend pointed me to an interview with Knut Wittkowski (“For 20 years, Wittkowski was the head of Biostatistics, Epidemiology, and Research Design at The Rockefeller University’s Center for Clinical and Translational Science”):

The ideal approach would be to simply shut the door of the nursing homes and keep the personnel and the elderly locked in for a certain amount of time, and pay the staff overtime to stay there for 24 hours per day.

It is essentially the same as my idea, but with cots instead of comfortable hotel rooms.

(The rest of the interview is packed with heresy against the Church of Shutdown:

Governments did not have an open discussion, including economists, biologists and epidemiologists, to hear different voices. In Britain, it was the voice of one person – Neil Ferguson – who has a history of coming up with projections that are a bit odd. The government did not convene a meeting with people who have different ideas, different projections, to discuss his projection. If it had done that, it could have seen where the fundamental flaw was in the so-called models used by Neil Ferguson. His paper was published eventually, in medRxiv. The assumption was that one per cent of all people who became infected would die. There is no justification anywhere for that.

Knowing that the epidemic would be over in three weeks, and the number of people dying would be minor, just like a normal flu, the governments started shutting down in mid-March. Why? Because somebody pulled it out of his head that one per cent of all infected would die. One could argue that maybe one per cent of all cases would die. But one per cent of all people infected does not make any sense. And we had that evidence by mid-March.

Scientists are in a very strange situation. They now depend on government funding, which is a trend that has developed over the past 40 years. Before that, when you were a professor at a university, you had your salary and you had your freedom. Now, the university gives you a desk and access to the library. And then you have to ask for government money and write grant applications. If you are known to criticise the government, what does that do to your chance of getting funded? It creates a huge conflict of interest. The people who are speaking out in Germany and Switzerland are all independent of government money because they are retired.

One third of all deaths in New York State were in nursing homes. One could have prevented 20,000 deaths in the United States by just isolating the nursing homes. After three or four weeks, they could have reopened and everybody would be happy.

That would have been a reasonable strategy. But shutting down schools, driving the economy against the wall – there was no reason for it. The only reason that this nonsense now goes on and on, and people are inventing things like this ‘second wave’, which is going to force us to change society and never live again, is that the politicians are afraid of admitting an error.

It is a good thing that this guy is retired. He is definitely never going to get funding again!)

It is probably too late to do anything about coronaplague, but I wonder if we could implement this system in time for the next virus that turns out to be smarter than humans. I’m not sure that it would cost any money to have it ready to go. One thing that is cheap during a plague is hotel rooms. I would think that a hotel near a nursing home would be happy to have a contract guaranteeing them 75 rooms paid for during the duration of any plague on condition that they evict the general public. Who pays for the hotel rooms during the plague? Medicare! They’re going to be saving a ton of money during a plague due to the deaths of beneficiaries and the shutdown of ordinary health care, so let them use some of these savings to isolate the nursing home workers.

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Only about 1.7 percent of Danes had Covid-19 antibodies back in April

“Estimation of SARS-CoV-2 infection fatality rate by real-time antibody screening of blood donors” (medRxiv; thanks, Colin!) describes testing donated blood in Denmark (nearly 10,000 samples) and finding that only 1.7 percent were positive for coronavirus antibodies. The blood had been donated April 6-17.

Does this mean that, now that the Danes are emerging from their bunkers, they will essentially start all over with a coronaplague? If 98 percent of the population has no immunity to plague, how is that different than if 100 percent of the population has no immunity (presumably, the situation back in December/January)? If it wasn’t safe for people to mix back in mid-March, now that 2 percent of the population is presumed immune, it is suddenly safe?

What do we make of this seemingly crazy low number for a purportedly exponentially growing disease that had at least two months to run free in Denmark? Here are some possibilities:

  • Except in certain high-density cities, coronaplague is not very contagious, nowhere near as ferocious as we were told
  • A lot of people simply aren’t susceptible to coronaplague, just as a lot of people won’t catch a cold that is going around, and, having never been truly infected, don’t develop antibodies
  • The antibody tests that we have are not reliable for determining if someone has previously been infected with coronaplague

[Another aspect of the paper that I suspect won’t interest anyone:

Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 82 per 100,000 (CI: 59-154) infections.

In other words, a person under 70 who actually does get infected with this evil virus has a 0.082% of dying (about the same as the annual risk of death from commuting via motorcycle 4,000 miles per year). Given the current popular mood, however, I think any number larger than 0% will be a sufficient justification for cowering in a bunker.]

Some other studies in the most plague-ridden areas have found 20-30 percent of the adult population with antibodies. That too, however, suggests to me that a lot of people are somehow naturally immune.

Readers: Could Denmark have truly missed this first wave of plague?

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