Coronavirus Health - Health and Wellbeing

[UncleEbenezer]

Lady on the left , about 0:39, 'there is no evidence they (masks) protect people who are not sick'
Following on immediately with 'however, ...if you are taking care of a person with COVID-19 you should wear a mask..'
Hmm, go figure.

Could that be two different things?

if you are taking care of ... that would be a medical PPE-grade mask, worn by someone trained to do so.
Wheres no evidence seems more likely to refer to an everyday out-and-about mask.

[Mike4]

This video runs models illustrating the effectiveness or otherwise, of face coverings.

https://www.youtube.com/watch?v=yfeW2l8 ... e=youtu.be

[servodude]

Probability suggests wearing masks will help, but only when it is known who has the virus and who doesn't.

Probability is a funny thing
- if it helps to wear a mask when you know who has the virus
- it also helps when you don't know; it just makes the maths a bit trickier (see Bayes theorem)

Trying to address the OP as this is DAK

What's the truth? I suspect that masks , when used correctly, do offer some protection but they want to maintain supplies for front line staff and carers. Any decent unbiased info out there?

there is a link on the WHO page to a document: https://www.who.int/publications-detail/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak

which while a bit wordier than the original page is also a bit clearer on the guidelines (basically as it provides context alongside its instructions)
- and it boils down to pretty much what the suspicion was

stay safe
-sd

[JohnB]

Moral hazard. If you wear a mask you take less care doing other things.

[redsturgeon]

Moral hazard. If you wear a mask you take less care doing other things.

This type of thinking reminds me of the sort of thing people said when seat belts first became mandatory.

Anyway the government has capitulated in its recent advice suggesting the use of face covering in situations like public transport. If it can help in a crowded carriage then it can also help outside were the overall chances of infection are less but still not zero.

I think those who argue the that the government is keen to conserve stocks for health care workers are on the right track, however the fact that there are medical grade masks available for purchase by the public suggests that there is not an overall shortage but mainly a logistics problem. We have just bought 500 single use surgical masks and could buy thousands if we wanted. These are not the N95 masks that you see being worn in high risk situations but still research has shown enough as far as I am concerned for them to be a useful additional barrier against infection.

Research also shows droplets and aerosols can carry much further than 2 metres so do not think that two metre distancing is foolproof, although it is better than one metre or no distancing.
https://medium.com/@tomaspueyo/coronavi ... d216daa343

The next fallacy is that "inexperienced people" don't use masks correctly, they touch their faces more and don't dispose of them properly. How much time do we think the average person needs to be taught how to use a mask correctly? One hour? 10 minutes? Maybe 3 minutes...

https://www.youtube.com/watch?v=9VbojLOQe94

Really it is not that hard. Once a mask is on then it becomes much more difficult to touch your mouth and nose, two obvious routes for infection.

Why the big problem with mask wearing? I think that at the end of all this when we come to review the steps taken and their effectiveness then mask wearing by the general population will be seen as a key factor in slowing down infection rates and will be mandated in any future outbreak.

John

[johnhemming]

When I first heard of Covid-19 I assessed it as being much more dangerous than I think it is now. At the time I bought some masks, but I have not worn one yet and would not intend to unless there is a legal requirement.

They do reduce the probability of catching Covid-19, but only by a bit. If I think I am infectious with Covid-19 I should not go out rather than go out wearing a mask. In any event I think I have had the disease now.

The key with Covid-19 is not to get a heavy viral load. That way your body can cope with it.

[redsturgeon]

When I first heard of Covid-19 I assessed it as being much more dangerous than I think it is now. At the time I bought some masks, but I have not worn one yet and would not intend to unless there is a legal requirement.

They do reduce the probability of catching Covid-19, but only by a bit. If I think I am infectious with Covid-19 I should not go out rather than go out wearing a mask. In any event I think I have had the disease now.

The key with Covid-19 is not to get a heavy viral load. That way your body can cope with it.

I would wear them in the same scenario as you, eg. perhaps a visit to the barbers in the future will require a mask.

There is still the issue of the asymptomatic carrier though, mandatory masks would help there.

Many people think they have had the virus, many of those people haven't.

What is your evidence that all people can cope with a lesser viral load? Sure a high load is not good but I'm sure some will succumb to even a light load and require medical attention.

John

[johnhemming]

There is still the issue of the asymptomatic carrier though, mandatory masks would help there.

I am not sure they would sufficiently to matter. The gangelt superspreading happended through a mixture of kissing and someone blowing a whistle. Ordinary breathing does not appear to be that infectious. Obviously sneezeing and coughing is.

What is your evidence that all people can cope with a lesser viral load? Sure a high load is not good but I'm sure some will succumb to even a light load and require medical attention.

This to me appeared to be why some of the younger health care workers died. It is also something referred to in the Gangelt video that I posted. It is something that seems logical given the nature of viral infections. The point is that however vulnerable someone is the less of the viral load the better for them.

[AleisterCrowley]

Lady on the left , about 0:39, 'there is no evidence they (masks) protect people who are not sick'
Following on immediately with 'however, ...if you are taking care of a person with COVID-19 you should wear a mask..'
Hmm, go figure.

Could that be two different things?

if you are taking care of ... that would be a medical PPE-grade mask, worn by someone trained to do so.
Wheres no evidence seems more likely to refer to an everyday out-and-about mask.

No, from the context I'm pretty sure it's advice aimed at the 'general public', some of whom may end up caring for a relative with COVID-19

[Mike4]

If I think I am infectious with Covid-19 I should not go out rather than go out wearing a mask.

But surely this is the nub of problem. I'm curious about what it is that would make you think you are infectious and decide to stay in, given there is an asymptomatic and infectious period at the start of the disease of (last time I saw a stat) 5.1 days (median). How would you know you are infectious when you don't feel ill?

The fact people might be infectious when they think they are not is why we should all wear a face covering in public. Or so the argument goes.

[tjh290633]

There is a school of thought that wearing of masks can actually lead to more infection, rather than less. Handling and adjusting the mask with gloved or ungloved hands offers further contamination and the risk of infection.

Having said that, I can see the logic on insisting on facemasks in public transport or in close face to face encounters, such as at the dentist or the opticians.

TJH

How would the dentist would get to my teeth?

It's the dentist and his assistant who wear the masks. Mine does anyway. Outside the actual surgery, you would wear a mask until you are in the fresh air.

TJH

[dealtn]

Really it is not that hard. Once a mask is on then it becomes much more difficult to touch your mouth and nose, two obvious routes for infection.

But people also touch their exposed face and eyes more often, so whilst some "obvious routes" are reduced others are increased.

In addition those wearing masks create concentrated areas where germs etc. are encouraged (nice warm moist conditions in a mask where they are caught and not "allowed" to escape into the air). Because people will tend not to dispose of these in the same way, and replace them as frequently, as professional healthcare workers, this too creates increased transmission issues. These transmissions might not be Covid-19, but other airbourne illnesses too.

It isn't straightforward.

I suspect the issue will come down to ensuring supply to those that really need them, and the general wellbeing of people seeing them being used (even if there isn't a clear healthcare benefit), in determining policy.

[Howard]

From all I hear and read about the success of controlling the spread of the virus there is one key issue.

The whole point of wearing a mask for the general public is to protect other people. It is not to protect wearers.

This was explained in the media a couple of months ago. People who live in the West have misunderstood the reason why people in Asia wear masks. They traditionally do so to show that they are considerate citizens who are not spreading air borne diseases.

It may be one of the reasons why places like Hong Kong have seen such a low infection rate. As Redsturgeon has suggested this may be the reason that the UK Government appear to be slowly moving towards making it compulsory to wear masks on trains etc now that the supply situation has improved.

regards

Howard

[UncleEbenezer]

Really it is not that hard. Once a mask is on then it becomes much more difficult to touch your mouth and nose, two obvious routes for infection.

But people also touch their exposed face and eyes more often, so whilst some "obvious routes" are reduced others are increased.

In addition those wearing masks create concentrated areas where germs etc. are encouraged (nice warm moist conditions in a mask where they are caught and not "allowed" to escape into the air). Because people will tend not to dispose of these in the same way, and replace them as frequently, as professional healthcare workers, this too creates increased transmission issues. These transmissions might not be Covid-19, but other airbourne illnesses too.

All the more so when the encumbrance and its associated warmth and moisture are causing itches and minor discomforts that need to be frequently scratched and adjusted.

I'd be bothered about it because encumbrances like that cause me serious discomfort. I've avoided not just serious (underwater) breathing kit, but even lots of regular clothing such as any wristwatch, for nearly 30 years.

I think there's a whole flawed premise behind much of the discussion: that "worst practice" is the norm.
- Rub your orifices subconsciously? Not if you've had the training of years cooking with hot chillies!
- Get the hands dirty by the things you touch? Well, most of us surely have a head start there from our parents telling us not to touch dirty things. And habits formed out of that such as not using the fingers to open the door of a public loo. If you've had that habit since early childhood, it's not such a big leap to extend it to things that are not obviously dirty.

[servodude]

Rub your orifices subconsciously? Not if you've had the training of years cooking with hot chillies!

I believe that hand sanitizer should be about 70% alcohol
- perhaps the remaining 30% should be Tabasco

- sd

[AJC5001]

People who live in the West have misunderstood the reason why people in Asia wear masks. They traditionally do so to show that they are considerate citizens who are not spreading air borne diseases.

regards

Howard

I've seen other reports that suggest the wearing of masks in Asian countries was due to the air pollution caused by traffic etc.
Nothing to do with preventing infection.

If we extend the seatbelt analogy (I don't wear a seatbelt because I expect to have an accident - in fact the odds of me having one are fractions of a percent. I wear it be4cause it's become the accepted norm. I'm of the generation that started when cars didn't have seat belts, much less legislation. ) then we will eventually all be wearing masks whenever away from our homes because it will be expected (or even legally required) regardless of any epidemic being in progress.

The transmission of C19 is not dissimilar to that of the common cold. I've been around long enough to have enough of those to know that there is an asymptomatic period (normally between visiting grandkids and symptoms appearing), followed by a "I think I might be getting a cold" period, followed by the sore throat/cough, temperature and blocked nose for two or three days, then another period of recovery. For some or all of this I must be infectious. Since all this talk of masks, I have wondered if wearing them may reduce the prevalence of the common cold or 'normal' flu, although if transmission by children is the probable route I have my doubts.

Adrian

[AleisterCrowley]

From all I hear and read about the success of controlling the spread of the virus there is one key issue.

The whole point of wearing a mask for the general public is to protect other people. It is not to protect wearers.

This was explained in the media a couple of months ago. ...
Howard

But if a mask protects someone who is caring for a COVID-19 patient in the home (as recommended by the WHO) surely they provide some protection for the wearer at all times. Masks are not context-sensitive.
Simple masks are not made of some weird unidirectional filter material, although more complex respirators with valves ONLY 'fully' protect the user as exhaled air bypasses the filter system. Obviously there is some protection from larger droplets that can't get through the exhaust port ...

[Lootman]

From all I hear and read about the success of controlling the spread of the virus there is one key issue.

The whole point of wearing a mask for the general public is to protect other people. It is not to protect wearers.

This was explained in the media a couple of months ago. ...

But if a mask protects someone who is caring for a COVID-19 patient in the home (as recommended by the WHO) surely they provide some protection for the wearer at all times. Masks are not context-sensitive.
Simple masks are not made of some weird unidirectional filter material, although more complex respirators with valves ONLY 'fully' protect the user as exhaled air bypasses the filter system. Obviously there is some protection from larger droplets that can't get through the exhaust port ...

Yes, my N99 mask has a one-way valve. I breathe in through the valve but exhale elsewhere. Clearly that mask is designed to help the wearer and not others, although of course any barrier is better than nothing.

[servodude]

From all I hear and read about the success of controlling the spread of the virus there is one key issue.

The whole point of wearing a mask for the general public is to protect other people. It is not to protect wearers.

This was explained in the media a couple of months ago. ...

But if a mask protects someone who is caring for a COVID-19 patient in the home (as recommended by the WHO) surely they provide some protection for the wearer at all times. Masks are not context-sensitive.
Simple masks are not made of some weird unidirectional filter material, although more complex respirators with valves ONLY 'fully' protect the user as exhaled air bypasses the filter system. Obviously there is some protection from larger droplets that can't get through the exhaust port ...

Yes, my N99 mask has a one-way valve. I breathe in through the valve but exhale elsewhere. Clearly that mask is designed to help the wearer and not others, although of course any barrier is better than nothing.

It should be the other way around:
- the air you breathe in should be being filtered (the one I use for my commute ride during bushfire season has a replaceable carbon filter)
- the valve is to assist expiration

As a result of this "mask valves" are less helpful at protecting the herd
- https://www.fastcompany.com/90496717/wh ... nning-them

On some of the more general points

Once you've fitted a mask it shouldn't need constant touching or re-arrangement
- and they can serve as a pretty obvious reminder of what's going on; both for the wearer and any observer
- just don't cut a hole in it so you can smoke

In addition to supply concerns, I think mandating their use would lead to issues of compliance and enforcement
- even being too direct with the encouragement could possibly lead to unrest as differences in opinion bumped against each other
- is it too much to imagine you would see yobs harassing folk for not covering their face (or covering depending on yob's preference)?

I would like to see a policy of education about how they work, why they work and what they do not work for
- it seems senseless to discourage (or not encourage) the use of them because some folk might stand closer to strangers than they should? explain it to them!

To be honest my first thought when I see someone in a mask is to give them a wider berth than usual
- probably because of the high observed correlation with serial killing: Jason Voorhees, Ghostface, Leather Face, Michael Myers et al.

- sd

[Howard]

I am not seeking to be provocative but the previous posts (including mine) suggest that there is uncertainty about something as simple as wearing a mask in the current situation. And we aren't even certain about how the more sophisticated valve models work.

This might suggest that this is one key factor the Government should be educating the public about.

I still hold to the view that the major reason for wearing a mask in public (obviously not in hospital/specialist environments) is to protect others from the virus and that is why many countries are making them mandatory on public transport and other areas where social distancing is difficult.

But I would welcome some clearer guidance from the Government.

regards

Howard