Philip Greenspun’s Weblog

Given what I have seen of mask usage in practice, I do not think they will be helpful in the U.S. except maybe to delay infections by a few weeks. I agree with the Swedes and the WHO that this is likely to be a multi-year experience with the coronavirus. And there will likely be another similar virus right behind this one. So I think we would slow down viral spread more effectively by restructuring our physical environment so that it isn’t relevant whether people are using a bandana improperly (or wearing a mask with an exhaust valve, which I see regularly among the righteous of Cambridge), etc. More stuff could happen outdoors under shade structures, for example.

I wonder if the mask is like Linus’s security blanket in Peanuts. People like to believe that they can control their fate. We hear that someone died of cancer and ask “Did he smoke?” The person is dead so it shouldn’t matter, but we want to know because we want to be assured that we won’t be killed by a random cancer and that we can extend our lives by clean living. The “science” as of March (and through early June at the WHO!) was that masks wouldn’t protect 8 billion humans from spreading coronavirus. But we didn’t like that answer so “science” gave us a new answer. It is highly comforting because we are controlling our fate, not living or dying depending on the whims of the virus and the accidents of geography (Maine versus Massachusetts, for example, a 14:1 difference in death rate).

Like most people, I hope that the universal mask laws can have some beneficial effect. But I fear that we are setting ourselves up for yet another disappointment and we will whip ourselves for not doing a good enough job. Yes, we wore masks, but too many of us did so without covering our noses. Yes, we wore masks, but that led too many of us to abandon the 6′ social distance. We wouldn’t have had a death rate comparable to Sweden’s if only we had…

This is kind of like the difference between Greek/Roman religion and Christianity. If the barbarians attack and burn your Greek/Roman city, you say “That was a terrible experience, but the gods are capricious sociopaths so we will just have to rebuild as best we can.” If the same thing happens to a Christian, he/she/ze/they must say “God is benevolent and omnipotent, so it must have been our wickedness that led to this bad outcome.”

I wonder if there is a mask experiment happening for us right now. Massachusetts and New York had a big surge in infections and then deaths back before any mask laws went into effect (May 6 here in what is now “Maskachusetts”). Florida and Texas have come out of shutdown. They are pretty well masked. We would expect the arc of the epidemics there to be less dramatic than in NY and MA due to (a) a bunch of restrictions still in place, e.g., no mass gatherings, (b) nursing homes much better protected than in MA or NY. But is the arc yet more attenuated in a way that we can perhaps attribute to Floridians and Texans being under mask orders?

Related:

• “Flu Masks Failed In 1918, But We Need Them Now” (HealthAffairs): In 1919, Wilfred Kellogg’s study for the California State Board of Health concluded that mask ordinances “applied forcibly to entire communities” did not decrease cases and deaths, as confirmed by comparisons of cities with widely divergent policies on masking. … Second, the review of practices in 1918 demonstrates masks must be worn correctly and consistently, fully covering the nose and mouth, with sufficient layers to prevent the spread of droplets. Advocates for masks in 2020 can use this historical lesson to argue that masks must be worn properly, or they will not achieve their objectives. [Summary: this time it is different and Americans will be as good at using masks as surgical nurses]

A variety of U.S. airlines are going the full cattle car route, right? (see https://philip.greenspun.com/blog/2020/06/16/american-airlines-the-magic-of-air-travel-in-the-age-of-corona/ )

The theory is that the magic of masks will protect the 150 people on a 150-person Boeing or Airbus from giving each other the plague. (As a friend notes “If a bandana is effective PPE for Covid, then a saline injection is surely an effective vaccine.”)

Suppose that you’re on one of these Plague Special flights. The person sitting next to you is infected with coronavirus. You’re wearing a surgeon’s mask, which provides almost no protection for inhaling. Your infected neighbor removes his/her/zir/their bandana to drink some coffee or eat a sandwich. That’s not prohibited, right? Why don’t you get coronaplague during the 15 minutes that it takes your middle seat neighbor to eat/drink?

Suppose it is a six-hour coast-to-coast flight. Your exposure to your unmasked middle seat neighbor might be a full 30 minutes. Isn’t that long enough to transmit any virus?

Related:

• “Professor in microbiology, Hans Jørn Jepsen Kolmos, thinks that facial masks will be a solution to protect ourselves from the coronavirus on multiple segments of the journey. Just not on board the aircraft.”

Florida is being described as a Covid-19 disaster zone, but I wonder if the state is being punished for its own success at the March 2020 dogma of Flatten the Curve. Here’s a chart of tests performed and percent positives from John Hopkins:

Florida’s governor ordered a shut down effective April 3. The state began reopening in May. Can we infer from the above data that Florida, with its dense linear city, was a natural plague center, but the dramatic suffering and efforts of citizens actually had a huge effect? From mid-April to mid-June, only a small percentage of Floridians who sought a plague test actually came up positive.

Let’s look at Massachusetts for contrast:

Essentially a textbook unmitigated infectious disease epidemic, right? How about New York?

So… Florida is being pilloried despite the fact that it actually might be one of the most successful examples of flattening the curve!

(Of course, just as noted by the former chief scientist of the European CDC, and just as promised by Flatten the Curve advocates here in the U.S., infections were merely delayed by this success, not prevented. So the current state of Covid-19 affairs in Florida is exactly what one would expect given the successful shutdown.)

Americans in many states and/or cities are required by law to wear “masks” of some sort, but compliance seems to be spotty and competence yet spottier. The “mask” devolves into a saliva-soaked face rag that leaves at least the nose exposed, for example.

What about people who want to protect themselves, not simply pretend to protect others? We’re in Month 4 of Shutdown here in Maskachusetts. Why can’t we buy masks that would actually provide some protection, i.e., a paper N95 mask? Drugstores seem to have ample supplies of surgical-type masks, but I haven’t seen N95 masks anywhere. From the Home Depot site:

This medical supply site seems to have them at $8 each. This site charges $1.80 per mask (real 3M brand), but says to expect a 2-3 month wait.

The health care industry is obviously using a lot more of these than before, but is it really that difficult to make an N95 mask? Or perhaps the process of obtaining certification for a new supplier is lengthy?