Hospital workers make masks from office supplies
bloomberg.com
bloomberg.com
Structurally those masks are pretty solid. I can easily wear a single surgical masks for quite some time.
But would need some way to disinfect it!
EDIT: if everyone wore masks, like in Japan (where I live), then it would limit the spread. If you're in early stages of the infection and you have no idea, but you war a mask then you're less likely to infect other people.
AFAICT Japan isn't doing anything radical to stop the spread and yet the virus is not spreading much. At best Japan asks infected people to stay at home. No lock downs or quarantines. Bars, cafes, gyms and theaters are all open. Life goes on.
What's the magic? Almost universal use of masks is the only reason I can think of because I haven't seen any other measures in the society.
Yes, they closed schools but they usually close schools to some degree due to influenza.
Reports are that they are not testing enough. We can't tell who is doing it the right way. We'll only know few months down the line.
5-14 day incubation period. 5-7 day low symptom period. 5-14 days to death.
Imagine Abe having to announce on TV that nearly half a decade of national identity is meaningless, down the drain, over, done for, and they’re out of a shitload of cash with nothing to show.
https://www.theguardian.com/world/2017/jun/13/japan-accused-...
This is all to say, even if you had this spike in deaths, I’m skeptical it would be reported until it was too late.
I'm totally spitballing here, but conscientiousness is a well known confounder in health studies.
2) Many more cases among young people. Presumably partly because there's lots of testing, but perhaps also just the chance of which groups it spread within. The age breakdown is at https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus...
3) It takes a while for people to die, and the epidemic caught Germany later than Italy. For sure there are a lot more deaths coming in Germany
For more insightful comparisons of cases between countries it would be great to have total cases categorized into asymptomatic/mild/severe.
This approach makes some sense, if someone was so sick that getting coronavirus or even a standard flu caused immediate death, indeed the primary reason that a given person died is the condition that person already had.
Right now DE is #5 in term of cases and #11 in term of death. Either the way they count death is different or they are way better at detecting cases and FR/SP have many (100k+) undetected cases.
This is the case. Germany tests 10k-12k people a day - everyone with a symptom. Other big countries only test 1-2k per day, i.e. only severe hospitalised cases. So the undetected/unregistered case count is an order of magnitude higher in FR/ES/UK.
I don't have good data for Germany overall, but at least here in Berlin a large chunk of the currently known infections spread through night clubs, giving you lots of fairly young and otherwise healthy infected. If there was spread from those to more vulnerable groups, they're likely not infected long enough to have died from it yet.
All reported Corona deaths in the German media that I am aware of were linked to pre-existing health conditions.
This isn't correct. Latest numbers I've seen are 1 test for every 200 residents. That's pretty far ahead of everyone else, but not anywhere close to testing everybody in the country.
Simple: there isn't enough of them around for everyone to wear. There never was.
Simple cloth masks Asians wear all the time don't do such thing. Pollutants go straight through these masks.
It wasn't replenished after H1N1. Hard to convince politicians to buy things we may or may not use.
Virus outbreak agreed clinical practices
There has been no incentive for reusable masks. By not reusing the mask, there is zero chance of it transmitting infection to other patients. The policy makes sense if you are rich and not having a shortage. Hopefully the hospitals have been smart enough to not incinerate the used masks, because even recycled ones are better than a handkerchief.
UV light can breakdown material.
Probably because, in normal cases, it's easier to manage contamination with disposable items than items that need to be disinfected. If you can't disinfect, there's no ambiguity about whether the disinfection was thorough enough.
I think they may be able to be disinfected by UV light:
Evaluation of Five Decontamination Methods for Filtering Facepiece Respirators (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781738/)
> UVGI, ethylene oxide (EtO), and VHP were found to be the most promising decontamination methods; however, concerns remain about the throughput capabilities for EtO and VHP. Further research is needed before any specific decontamination methods can be recommended.
This is also worth noting:
> It was also found that decontamination using an autoclave, 160°C dry heat, 70% isopropyl alcohol, and soap and water (20-min soak) caused significant degradation to filtration efficiency.
But the fact that as the world's richest country, we don't even have the administrative ability to keep a national emergency stockpile of essential medical supplies like face masks to get to hospitals immediately is just... I can't even.
By sheer coincidence, I happened to spend a week in Mexico City the day swine flu hit it, a decade ago. For the next several days, there were policemen everywhere distributing masks to the public. Instant response, zero shortage.
I am genuinely curious what the root cause is here, if you did a "five whys" analysis. Not a knee-jerk thing, but the real answer.
Is it that political squabbling has left things unfunded? Unappointed administrators have left things undone, unmaintained, or backlogged? Was it a conscious decision to decentralize and expect each hospital to be responsible for maintaining its own emergency supply? A belief that supply chains would handle it and stockpiling not needed? Is there a stockpile somewhere that isn't being released?
I'm really looking forward to a newspaper exposé on this one, because it's a true scandal.
Spread is the big differential on bioterror, and most other forms of terrorism do not require a team with members that have 2 PHDs each.
It's like, what's the difference between a terrorist nuclear attack and a full-scale nuclear war? In the former scenario, you're talking a small number of low-yield devices triggered in one country; the rest of the world still stands able to provide assistance. In the latter scenario, there's nobody left to help who hasn't also been blown to ashes.
https://www.reuters.com/article/us-health-coronavirus-canada...
You’re absolutely right. When a mask is expired, it should not be used. There is a reason for the expiration date and it’s not just for profiteering or some malicious motive.
Lot of expiration dates you see in medicines is FDA regulated and should be taken seriously.
An expired mask will almost certainly be better than no mask. And especially so stored well with no visible degradation – it's heat & contamination by elements that could jeopardize their essential properties.
(Some N95 masks I bought during last year's northern California fires are individually sealed in cellophane with no expiration date. Stored in a cool, dry place they'd likely be fine decades from now. If some governments bought flakier masks in more-fragile packaging with early expiration dates, that's on them.)
How do you know that your N95 mask is “fine”? Ultra fine submicron particles in your lungs can lead to a lot of problems. These fibers are essentially plastic.
Let's say it's the Zombie Uprising of 2040, and I open a well-stored, individually-wrapped N95 mask from 20 years ago.
It's got no expiration date on it (as per the ones I bought last year), & it looks good, & doesn't give off any dust, & it smells the same as I recall new masks smelling. I'll figure that's "fine" – unless & until someone has specifically shared some study demonstrating their dangerous-yet-imperceptible degradation.
Is there such a study, or is this just "there be dragons" fear-of-the-unknown?
This is not true. The FDA dates are ultra-conservative for liability reasons. The military has done a lot of research (well, asked other people to do research) on this, and found that the vast majority of "expired" medicine is perfectly fine:
> To save money on regularly replacing its drug stockpile, in 1985 the US Air Force asked the FDA to test some products. Since then, the FDA has found that 90% of over 100 prescription and over-the-counter drugs tested could be used safely past their expiration date, a Pentagon spokesman told the Associated Press, adding that the dates tended to be very conservative. Products were tested by either the manufacturer or the FDA, but always with agency supervision.
Source: https://www.thepharmaletter.com/article/fda-tests-let-milita...
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/FAQ-N95.aspx
Take that for what you will.
All an expiration date really means is they never bothered to test the efficacy beyond a couple years, but the compounds are remarkably stable.
https://www.npr.org/sections/health-shots/2017/07/18/5372578...
At the very least, give them to service workers.
Face masks are running out in many countries, not just the US. This isn't really a product of the atrocious healthcare system the US has, it's just a product of not being well-prepared for disaster scenarios.
Think about how most companies don't check whether their backups work. Now, replace "working backups" with "stocked-up pandemic supplies".
You said it yourself: "Here we are talking about profits comparable with the entire world's wealth". What do you exactly think is going to happen if americans try to spend "the entire world's wealth" on health care?
I don't believe your implications but even I could make a more convincing case for them than that.
However, it was depleted during the 2009 H1N1 outbreak and never replenished. Instead, their budget was used for what they thought were more pressing concerns at the time — stockpiling drugs/equipment for other emerging diseases.
Source: https://www.washingtonpost.com/investigations/face-masks-in-...
Edit: So how are stockpiles of masks somehow not part of downsizing the federal government?
That still remains to be seen. Right now the states with the most cases (CA, WA, NY, see [0]) are firmly Democrat, with much fewer cases in Republican and swing states.
It's possible that the number of cases in those states won't rise to critical numbers, and thus have limited effect on his reelection odds.
[0] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/case...
This can be seen in polls of how the current administration is handling the Coronavirus [0], with an extremely sharp divide between Republicans and Democrats. The vast majority of Republicans approve of the current administration and their handling of it, whereas very few Democrats do.
This, of course, may change significantly between now and election time. The polls quoted by fivethirtyeight are also from early in March, and the public opinion may have shifted since then.
[0] https://fivethirtyeight.com/features/how-concerned-are-ameri...
From your own reference:
> This party-line split isn’t that surprising, though: According to experts, many public health issues — which are seemingly nonpartisan — have become increasingly polarizing.
So no surprise that Republicans think their guy's doing good, and Democrats think he's doing badly.
It's surprising (and a little disappointing really) that 538 didn't seem to consider where independents split on it.
Can you explain to me how that's relevant here? The grandparent post said that "This will cost them dearly in November," which is not borne by evidence at this point in time.
If you have evidence that points to the fact that Republicans or independents are considering voting Democrat based on this issue, I'd love to hear it.
>> Most urban counties are blue. Cannot blame Dems for infectious disease based on density of cases.
GP asserted that incidence of SARS-CoV-2 didn't correlate with majority voting inclination.
> If you have evidence that points to the fact that Republicans or independents are considering voting Democrat based on this issue, I'd love to hear it.
If you have any proof that Republicans or independents are more inclined to vote, or to vote Republican, as a direct consequence of the Republicans' handling of this pandemic, I'd love to hear it.
On the basis that the pandemic is likely to be the causal factor in a global recession, there's plenty of evidence that would factor negatively in the US election [1]
1: https://fivethirtyeight.com/features/americans-views-of-the-...
> the fact that independents appear persuadable on the economy is a point in favor of the theory that a recession would indeed damage his reelection chances.
Pervasive managerial culture causes oversight to become opaque, phrasing it in terms of vague financials instead of specific structure by domain experts.
Economic annealing makes margins thinner and thinner ("cost cutting"), leaving no slack for any change in conditions.
These trends are happening to individual private institutions, as well as at the government level. Stockpiling masks is impossible if it's no longer in your vocabulary.
As soon as a metric becomes a target, it ceases to be a good metric. The market is a large part of our national religion, appointing metrics supreme in a circular fashion.
I simply don't know how to process the news that we both waste $1 trillion dollars per year on our military, and we haven't built a $5m (or hell, $50m) machine that can allow us to totally source N95 masks from the raw materials up. Does Walmart seriously think more deeply about supply chains than our disaster prep and military?
It's at times like these you should question whether it really is the "world's richest country". I'm sure you can find certain metrics where it is, but that's irrelevant if the country is unable to respond to disasters like a hurricane or an epidemic.
Still difficult to understand how in Japan everyone wears these masks every day and in the West they can’t be produced.
Towards the end it states...
“We showed that a hand-fashioned mask can provide a good fit and a measurable level of protection from a challenge aerosol.”
Positive pressure DIY mask.
The positive pressure mask is about providing only safe air to the wearer, protecting them from others.
The passive respirator I wear when sanding or working with solvents is P100 (P means tolerates oil, N means doesn't and the 100 is better than the 95 you see in N95), but it is also backwards. It protects my airways, but has an exhale valve which lets my lung leavings right out into the atmosphere, and it does nothing for my eyes.
Perfection is the enemy of the good.
People can make homemade masks. Here, women who have sewing machines are making them for everyone around.
https://www.cambridge.org/core/journals/disaster-medicine-an...
Someone took that data and used it for this more accessible article.
https://smartairfilters.com/en/blog/best-materials-make-diy-...
I know China doesn't have their act together on many areas of health and sanitation. But we should adopt good practices and remove the stigma in the US that mask = bad.
Why isn't a proper manufacturing operation at a paper company, quilt company, halloween costume company, etc etc etc producing a big volume of hacked masks to be distributed to tons of hospitals?
The US closed and withdrew all their employees from the US Consulate in Wuhan on Jan 26th. Can't say we didn't know it was serious.
Masks shortage have been known for a while. The tinfoil hat in my says because the US wants this to spread. I have no other logical explanation.
Higher level view on efficacy of different home-available materials for filter masks -> https://smartairfilters.com/en/blog/best-materials-make-diy-...
More technical 2013 article from the "Society for Disaster Medicine and Public Health" on different material efficacy -> https://drive.google.com/file/d/1AjwLMkEufJ2SSHRYyXpp3QY9jvQ...
Lastly some sewing patterns for masks -> https://so-sew-easy.com/face-mask-sewing-patterns
"... it was found that tobacco smoke as it comes from a cigarette is an extremely concentrated aerosol with a relatively stable distribution of sizes ranging from 0.1 to 1.0 micron, peaked between 0.2 and 0.25 micron."
Source: https://www.sciencedirect.com/science/article/pii/0095852260...
https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguid...
What a crazy time to be living.
If you want to try both alcohol and bleach just don't mix alcohol and bleach at the same time as that will create chloroform.
https://www.ncbi.nlm.nih.gov/books/NBK214356/
edit: ignore the idea of using alcohol as it will destroy the electrostatic absorption of an N95 mask.
http://www.imcclinics.com/english/index.php/news/view?id=83
Key excerpt:
"The new coronavirus is sensitive to heat. It can effectively inactivate the new coronavirus by heating for 30 minutes at 56 degrees Celsius. Therefore, the single dry heat sterilization (70 degrees Celsius heating for 30 minutes) can effectively inactivate the virus without affecting the protective function of the mask."
In fact, that was covered by your article: 2. The disinfection method of spraying alcohol on the mask will destroy the electrostatic absorption of the mask, causing filtering efficiency of the mask lowering below 95%.
They can make and save the handsome profit to retrofit their factories to manufacture other things later.
Because hospital and ICU maximum capacity is something less than double average daily caseload, so it's easily overwhelmed by a local surge.
> It can't be that the formidable US healthcare system
The US healthcare system is notably fragile, not formidable.
Citation needed. I've seen numbers that suggest the US has 2.5x ICU beds per capita compared to European average. It also costs 3.6 _trillion_ dollars a year. Surely at least some of this money contributes to it being less "fragile"?
The number per capita isn't the key thing, the number in excess of normal use available per capita is. If the US has and uses more because it is worse at keeping it's population off ventilators normally, that doesn't help.
> It also costs 3.6 _trillion_ dollars a year. Surely at least some of this money contributes to it being less "fragile"?
No, the cost is directly a consequence of the main source of the fragility, a financing structure that, among other inefficiencies, promotes micro-optimizations around short-run, single-actor financial efficiency in a system with multiple no cooperating actors rather than systemic efficiency where it promotes any kind of optimization at all.