Therefore it is rational for public health policy to reserve high quality masks for medical professionals, regardless of their effectiveness for the general public.
I wonder how many masks they can manufacture a week in this emergency.
This. "Don't bother with masks" is actually "There is insufficient evidence to show that wearing masks is effective at preventing spread of disease", coupled with "Please don't take away our supply of masks that are for health care workers".
If masks didn't stop the spread of disease, nobody, even doctors, would bother. The problem is that mask usage writ large does not have a cost/benefit point that warrants recommendation by CDC.
If 80% of people who get this are fine, 20% aren’t fine. Some stats suggest 14% severe, 6% ICU. Someone’s going to have to be taking care of all these categories of severity.
One scenario is home care, with only the severest cases transferred to a medical facility. In that scenario, the “general public” may need to be healthcare providers.
I've seen a lot of people suggest not buying the masks when they're in stock at hardware stores so 'hospitals can have some' which I find absolutely hilarious - Just the image of a hospital sending staff down to a Home Depot for some N95 paint masks...
Perhaps. But why does public health policy expect Americans to voluntarily abstain from buying masks, an outcome which is not remotely realistic? It's not like this is an unpredictable situation: it happens in every epidemic. Regardless of masks' effectiveness, enough people believe they are effective to keep them sold out.
If medical professionals need priority, we should have a system to give them guaranteed priority. Then, if there's a remaining surplus, they can be sold to consumers who can buy them relatively guilt-free. (Only relatively, because I suppose the masks could still be shipped elsewhere in the world.) Of course, the government should not force manufacturers to make such a surplus, but it might be profitable for them...
As Wang's study revealed, rates of infection differed between doctors and nurses with [N95] respirators and those without.
Specifically, the authors examined data collected from Jan. 2-22 at six departments within the Zhongnan Hospital. Within the 10-day period, the hospital treated 28 individuals with confirmed cases of COVID-19 and 58 "suspicious" cases. The medical staff in each department followed different safety protocols when treating the patients.
About 280 medical staff in the hospital's Respiratory, ICU and Infectious Diseases departments wore N95 respirators and washed their hands frequently, while about 215 in the departments of Hepatobiliary Pancreatic Surgery, Trauma and Microsurgery, and Urology wore no masks and disinfected their hands less frequently. Although the respirator group encountered confirmed cases more often than the unmasked group — more than 730% more often — no one in the respirator group became infected.
In comparison, 10 people in the unmasked group contracted the novel disease, despite treating fewer infected patients.
"It would appear that N95 respirators, no surprise, protect against health care acquisition of the virus," said Dr. William Schaffner, an infectious-diseases specialist at Vanderbilt University in Tennessee, who was not involved in the current study. The small study is "reassuring in that sense," although there was no reason to think that N95 respirators wouldn't block out the novel coronavirus effectively, he added.
That sounds like a study of N95 masks vs no masks, not N95 masks vs surgical masks. Another study reported here on HN compared N95 masks against surgical masks for respiratory viruses and found no significant difference between N95 and surgical masks[0].
So the mask group was also competely confounded with being infectious disease specialists? Perhaps there were other precautions besides masks and hand washing that they were taking due to their training, even if not explicitly. Still interesting, particularly given the widespread appearance of "don't bother with masks" articles these days.
I wonder how this squares with the fact that 2 healthcare workers in California treating a coronavirus patient contracted the disease? I presume they were wearing masks.
But N95 masks aren't cheap and AFAIK must be disposed after one day of usage. So they must be reserved for the medical workers, while the other can use 3 or 4 layers surgical masks, which should provide adequate protection.
Anyone have any info on the comparability of COVID-19 to H1N1 in terms of transmission methods since we have official trace data, studies and reports on H1N1? Am having this discussion and being pointed out the fact that H1N1's particulate size is actually smaller than COVID-19 (80-120nm vs 200nm respectively).
For something like this, I wonder why the health workers haven’t started using those positive-pressure helmet hazmat suits. Like those from that Outbreak movie.
Thanks for this. The US Surgeon General needs to be fired and delicensed from medical practice after his claim yesterday that no one should buy masks because masks don't work. He has no business representing himself as a qualified medical professional.
His statements are such egregious malpractice that they rise to the caliber of extreme negligence and should expose him given his position to liability and possibly criminal charges for contributory homicide.
South Korea is looking at charging church officials with "murder through willful negligence" (https://www.nytimes.com/2020/03/01/world/coronavirus-news.ht...). The reason? They told church members to remove their masks during services as it was "disrespectful to God." Telling people not to wear masks is murder through willful negligence.
I suspect its also that patient 31 decided that it was ok to run a fever and go to dinner, despite being told that they were at high risk of having the flu.
Masks don't protect you from others, they protect others from you, and if you are a health professional dealing with infected people from vulnerable populations, or a surgeon asking for a scalpel over an open body, you are going to assume that you are infected and capable of transmitting disease out of an abundance of caution. Masks for the general healthy public is borderline hysteria and affects the medical supply chain.
I did my own little experiment with masks which you can also easily repeat the experiment yourself.
Note that this works on the regular masks you can buy from regular shops such as convenience stores that the general public mostly wears.
Put on the mask in cold weather or a chill room and then take a deep breath and breathe out. You will notice a lot of steam is coming off around the sides of the masks and especially around the nose area where these masks are not sealed. Worse if you cough of sneeze! This is even more so after the mask has been worn for some time and gets soggy.
Next, go outside and ask your friend to light a cigarette and exhale smoke in your face while you take a deep breath through your nose. (Wearing the mask as you would normally do). You will find a lot of smoke gets around the mask, mostly around the edges around the nose.
You can make your own conclusions from there. My conclusion was that these things are mostly toys and the majority of people wearing them either do not fit them correctly or do not change often or both, and they also may be putting too much confidence in them.
As I imagine you are expecting to test for smoke in that case by seeing if you can smell it: of course you can smell it, as what you are smelling there is a gas. An N95 mask filters particles larger than some reasonably large size, which hopefully includes giant encapsulated viruses filled with genetic material but is not going to include the odor from smoke which is made up of individual molecules of stuff like syringol. An N95 mask is not some kind of "only oxygen and nitrogen and carbon dioxide (and whatever else you absolutely need from air)" filter: it is just that most scents thankfully aren't harmful, but happen to be correlated with stuff that is.
FWIW, when I wear an N95 mask I do not get steam from its edges (that is either a ludicrously poor fit or you are expecting to be able to breath out too quickly for your mask design), but you also need to remember that breathing out is "safe" while breathing in is not, and yet the pressure in the two cases is very different, so something can be very effective even if it has the issue you are complaining about (and some masks are even designed specifically like that, with pressure vents to make breathing easier so you can exhale quickly without a problem and then pull air in more slowly where the feedback is more clear).
Mask fit is important and that's why fit tests evaluation is done for medical professionals so what you're saying has basis.
I wonder if the decreased number of pathogens makes it a different story, though. For instance if you cut down encountered viral load by 95% do you still have equal likelihood of illness?
[+] [-] Leary|6 years ago|reply
The US has 30 million surgical masks in stockpile.
The US needs 300 million N95 masks for medical professionals. [1]
[1] https://www.cnbc.com/2020/02/28/us-mulls-using-sweeping-powe...
Therefore it is rational for public health policy to reserve high quality masks for medical professionals, regardless of their effectiveness for the general public.
I wonder how many masks they can manufacture a week in this emergency.
[+] [-] jvanderbot|6 years ago|reply
If masks didn't stop the spread of disease, nobody, even doctors, would bother. The problem is that mask usage writ large does not have a cost/benefit point that warrants recommendation by CDC.
[+] [-] Terretta|6 years ago|reply
One scenario is home care, with only the severest cases transferred to a medical facility. In that scenario, the “general public” may need to be healthcare providers.
[+] [-] pkaye|6 years ago|reply
https://www.washingtonpost.com/business/2020/02/15/coronavir...
[+] [-] dawnerd|6 years ago|reply
[+] [-] comex|6 years ago|reply
If medical professionals need priority, we should have a system to give them guaranteed priority. Then, if there's a remaining surplus, they can be sold to consumers who can buy them relatively guilt-free. (Only relatively, because I suppose the masks could still be shipped elsewhere in the world.) Of course, the government should not force manufacturers to make such a surplus, but it might be profitable for them...
[+] [-] jmnicolas|6 years ago|reply
Genuine question : how can a mask "expire" ?
[+] [-] popotamonga|6 years ago|reply
[+] [-] tristanj|6 years ago|reply
As Wang's study revealed, rates of infection differed between doctors and nurses with [N95] respirators and those without.
Specifically, the authors examined data collected from Jan. 2-22 at six departments within the Zhongnan Hospital. Within the 10-day period, the hospital treated 28 individuals with confirmed cases of COVID-19 and 58 "suspicious" cases. The medical staff in each department followed different safety protocols when treating the patients.
About 280 medical staff in the hospital's Respiratory, ICU and Infectious Diseases departments wore N95 respirators and washed their hands frequently, while about 215 in the departments of Hepatobiliary Pancreatic Surgery, Trauma and Microsurgery, and Urology wore no masks and disinfected their hands less frequently. Although the respirator group encountered confirmed cases more often than the unmasked group — more than 730% more often — no one in the respirator group became infected.
In comparison, 10 people in the unmasked group contracted the novel disease, despite treating fewer infected patients.
"It would appear that N95 respirators, no surprise, protect against health care acquisition of the virus," said Dr. William Schaffner, an infectious-diseases specialist at Vanderbilt University in Tennessee, who was not involved in the current study. The small study is "reassuring in that sense," although there was no reason to think that N95 respirators wouldn't block out the novel coronavirus effectively, he added.
[+] [-] yodon|6 years ago|reply
[0] https://news.ycombinator.com/item?id=22456037
[+] [-] tgb|6 years ago|reply
[+] [-] chrisco255|6 years ago|reply
See: https://mobile.twitter.com/skarlamangla/status/1234260334363...
[+] [-] ghostpepper|6 years ago|reply
[+] [-] coconut_crab|6 years ago|reply
[+] [-] ruxmtl|6 years ago|reply
[+] [-] KKKKkkkk1|6 years ago|reply
[+] [-] blackrock|6 years ago|reply
[+] [-] dieselerator|6 years ago|reply
[+] [-] gyrgtyn|6 years ago|reply
[+] [-] gcb0|6 years ago|reply
[deleted]
[+] [-] unknown|6 years ago|reply
[deleted]
[+] [-] droithomme|6 years ago|reply
His statements are such egregious malpractice that they rise to the caliber of extreme negligence and should expose him given his position to liability and possibly criminal charges for contributory homicide.
South Korea is looking at charging church officials with "murder through willful negligence" (https://www.nytimes.com/2020/03/01/world/coronavirus-news.ht...). The reason? They told church members to remove their masks during services as it was "disrespectful to God." Telling people not to wear masks is murder through willful negligence.
[+] [-] KaiserPro|6 years ago|reply
[+] [-] asdff|6 years ago|reply
[+] [-] bouncycastle|6 years ago|reply
Note that this works on the regular masks you can buy from regular shops such as convenience stores that the general public mostly wears.
Put on the mask in cold weather or a chill room and then take a deep breath and breathe out. You will notice a lot of steam is coming off around the sides of the masks and especially around the nose area where these masks are not sealed. Worse if you cough of sneeze! This is even more so after the mask has been worn for some time and gets soggy.
Next, go outside and ask your friend to light a cigarette and exhale smoke in your face while you take a deep breath through your nose. (Wearing the mask as you would normally do). You will find a lot of smoke gets around the mask, mostly around the edges around the nose.
You can make your own conclusions from there. My conclusion was that these things are mostly toys and the majority of people wearing them either do not fit them correctly or do not change often or both, and they also may be putting too much confidence in them.
[+] [-] saurik|6 years ago|reply
FWIW, when I wear an N95 mask I do not get steam from its edges (that is either a ludicrously poor fit or you are expecting to be able to breath out too quickly for your mask design), but you also need to remember that breathing out is "safe" while breathing in is not, and yet the pressure in the two cases is very different, so something can be very effective even if it has the issue you are complaining about (and some masks are even designed specifically like that, with pressure vents to make breathing easier so you can exhale quickly without a problem and then pull air in more slowly where the feedback is more clear).
[+] [-] scarejunba|6 years ago|reply
I wonder if the decreased number of pathogens makes it a different story, though. For instance if you cut down encountered viral load by 95% do you still have equal likelihood of illness?