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Comment by adev_ | Hacker News Reader

Not so surprising. You have also the same outliers with Hong Kong and Taiwan.

- In Japan, people naturally respect social distancing. Touching someone is considered rude, everyone bows instead of shaking hands and nobody kiss.

- Almost everybody wear mask when they are sick to avoid contaminating others. They do that since way before Cornavirus and on voluntary based.

- Washing hands is common, being clean (bath culture) is part of common minimal respect.

- People listen and obey to their government.

- Last but probably very relevant: they have a completely different place of the elders in society. In Japan, the elders often live alone, sustain their life by themselves: it's a matter of proud. Even contact with their own kids is often sparse. Meaning, probably also lower risk of infection.

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I don't think this is the answer.

- There's no more social distancing in Japan than in the US. Nobody goes around hugging, shaking hands with, or kissing strangers in the US. Trains are still packed.

- Most public bathrooms don't have soap and I've rarely seen people wash their hands after using the bathroom anyways.

- People don't listen to the government - most people I know are arranging or participating in flower viewing parties despite the government's requests not to.

- Lots of the elderly in the US also live alone. I doubt the numbers are significantly different enough to affect transmission either.

TBH I had a hard time finding comparable statistics (re: single housing seniors and washing hands) though, do you have sources for any of those claims?

I agree with every point you're making, so I wonder if it isn't just one big factor: lots of people routinely put on masks at the first suspicion that they might be sick, even before they're sure. They just go ahead and do it just in case. And they do this all the time, so there's no delay due to self-consciousness or unfamiliarity or having to go buy a mask. It's just ordinary life.

Like taking shoes off in the house and making high school a college-admissions death march, maybe this widespread East Asian custom will spread in the West as well.

But we are being told that masks don't hep with prevention. Do you mean that sick ones do that not to spread?

Masks absolutely help. You are told otherwise for a whole other reason: to stop hoarding masks.

This has been asserted by so many different people, but there doesn't seem to be much scientific evidence backing it up. Why are you so sure?

There is evidence indicating it helps to prevent infection and to help prevent spreading infection.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153448/ “The overall effectiveness of vaccination and mask wearing was 9.9% and 8.6%, respectively.”

There aren’t nearly enough masks to go around for the general population so it would be reckless to recommend people in the USA wear (commercial quality) them right now due to the need for all available supplies to go to healthcare workers.

That paper also has:

> Hand washing (1.447, 1.274–1.644) and gargling (1.319, 1.183–1.471), however, were not associated with protection. In the natural setting, hand washing and gargling showed a negative association, which may have been due to inappropriate infection control measures or aggregating infected and non-infected children to conduct those measures.

So hand washing isn't effective and masks are? That's the opposite of what we're being told for a different disease. Are you going to say we shouldn't wash our hands?

I think there are plenty of other studies showing that hand washing can make a big difference.

But I don't think that negates the whole paper. It could be that the methodology used for the hand washing data is more flawed than the mask portion.

The recommendation is not to use masks unless you are sick.

Japanese people use masks all the time though, and it seems to help?

Even in Japan they traditionally only wear masks when sick.

not sure why you are being downvoted, as this was very much what we were told by outlets like cnn, etc. "dont where masks, they dont work and health care workers need them to not get the virus"

I was basically treated like a country bumpkin in a work channel (Amazon) for suggesting if you are going outside (Seattle) you should wear a mask.

> they dont work and health care workers need them to not get the virus

Isn't that an obvious oxymoron?

I don't think so, but its definitely a contradiction in logic...

That would depend on the assumptions, those being:

- context i.e. clinical setting vs on the street

- type of mask

- skill set of those using the equipment

For example, knives are very effective in surgery when they are:

- in a surgical theatre

- a scapel

- used by a surgeon

I don't suggest doing surgery in the street with a knife from your kitchen draw used by a teenager.

Surgical masks are designed to prevent you spreading viruses. That is the type most people wear in Japan. N95 masks are designed to protect you.

> Surgical masks are designed to prevent you spreading viruses

That maybe true but that doesn't change the fact they help you from catching it as well.

It simply doesn't make any sense going one way is 100% and the other is 0%

And what we want is to chip away at the R0 in as many ways as possible.

And that's skipping the fact people thinking they are protecting themselves are also protecting others.

If there were an unlimited supply of surgical masks that would make sense. If you wearing a mask deprives actually sick people of wearing one then you are still worse off then not wearing one.

Imagine if everyone didn't just accept this lie and we retooled factories 2 months ago

https://www.news-journalonline.com/business/20200320/coronav...

When you sell to the public to protect themselves they can fund a lot more than a hospital and maintain it for long periods of use.

Other than just letting people all die off and getting herd immunity any possible solution will involve everyone wearing masks.

We have a year more of this, there is still time to change direction.

Good advice 1 year too late.

> It simply doesn't make any sense going one way is 100% and the other is 0%

It's not 100% vs 0%. It's probably something like 70% vs 5% (Disclaimer: I'm pulling numbers out of my ass).

When someone who is sick wears a mask, they dramatically cut down on how much virus is PROPELLED OUT OF THEIR MOUTH. That's the big win. It still likely comes out their nose or is on their hands. But at least it isn't propelled with a cough or sneeze so if you wipe surfaces and avoid contact, you're probably okay. That mask protects dozens of people.

When a healthy person wears a mask, he protects only himself and the only thing he is "protecting" against is airborne droplets into his mouth. Most masks don't cover the nose and eyes which are the primary transmission routes for droplets. Most people don't breathe with their mouth open. You're probably safer simply wearing glasses, especially safety glasses. A lot of famous singers wear glasses/sunglasses all the time for exactly this reason.

A mask shortage will exacerbate these scenarios. One healthy person taking a mask away from one sick person is a TERRIBLE tradeoff.

Conceptually, I agree completely. Your conclusions are right.

Factually, perhaps you never have seen a mask such as we are discussing here. They do cover the nose. Perhaps not perfectly, but to a very large extent.

They don’t do very much unless you follow a protocol that you aren’t.

When they get wet and uncomfortable, you adjust the mask, and now you are transmitting the virus to the surfaces you touch.

Washing your hands and avoiding contact with crowds are the main ways to avoid getting sick. Everything else may help, like using your ring finger knuckle to press elevator buttons or wearing gloves that you change frequently or a mask. But they will only help marginally.

They don't do much to protect you from getting infected.

They do a lot to prevent you from infecting other people.

If masks don't prevent you from getting infected then why do medical professionals want masks? Everything I've read suggests that masks reduce your risk of infection, and that pairs with the common sense idea that filters in front of your respiratory tract entrance would reduce the risk of foreign particles entering and infecting you.

Simply putting on a mask does a great deal to limit the spread of a virus you already have - you’re not spewing particles all over your environment due to respiration.

Simply putting on a mask does very little to keep you from getting sick, because you’re very unlikely to be following proper PPE donning/doffing procedures. Unless you your house set up as a “clean zone” with two rooms between it and the outside world - one for removing PPE, and one for putting PPE on - then it’s really not helping much for reducing your exposure.

It makes sense to me.

I don't think that's how things work. Infection is a probabilistic thing. Maybe you'll get infected and maybe you won't. A high quality mask properly fit and worn according to an exacting protocol will reduce your risk of infection by X. Compromising on any of those factors may mean your risk is only reduced by Y and Y is less than X, but that doesn't mean it's a complete waste to wear a mask without a clean room or without fitting.

In one of the articles linked in this thread there is a study showing mask usage in children is nearly as effective as intervention against flu as vaccines are. I only read the summary of that paper but I don't think the children are working with clean zones or following doffing procedures carefully.

The article does mention that the effectiveness of masks was greater along older children. To me, that connects with what I wrote earlier. The better you are about using your mask, and here I expect mask diligence comes with age, the better a result you will have, but something is still better than nothing.

Oh, so that's why every hospital room has an air sealed clean zone that medical professionals have to enter to put on ppe?

For those that don't know, this is sarcasm. Most ICUs don't have any sort of sealed off clean zone.

> Most ICUs don't have any sort of sealed off clean zone.

Right - most ICUs aren’t set up to handle infectious diseases.

Here’s the CDC recommendation on doffing procedure. Note the repeated mention of the “doffing area”: https://www.cdc.gov/vhf/ebola/hcp/ppe-training/n95Respirator...

They simply need masks to protect their patients. They can never be sure that they themselves are not infected, and they treat a lot of severly ill (non COVID-19) patients in hospitals. If they spread the virus, those patients are at very high risk.

If that were true, all the medical professionals in America would already be infected.

Proper use of PPE very much decreases your chances of infection.

Pretty much all masks protect you to some extend, but the extend and the way in which they offer protection is different.

Surgical masks protect you from inhaling larger particles to some extend, but there’s large holes in it’s coverage, so you still basically get a bunch of contaminated air in, especially when spending time in a saturated room. What they do do however is prevent you from spraying droplets all over everyone near when you sneeze/cough/exhale, and that’s their main benefit. Protecting others from the bacteria and viruses in those droplets.

I think a study was done that indicated they make you about 30% less likely to get sick.

More highly rated masks (generally called respirators), will completely seal your mouth and nose (at least to a much greater extend than a surgical mask) and prevent bad stuff from coming in much better. Generally this is indicated in the form of a rating N95, N99, N100 (actually 99.97). And indicates what percentage of bad stuff the mask is likely to keep out. They’re less useful for protecting others, since there’s still some exhalation valve to get rid of excess air (still mostly same usefulness as surgical mask though).

Medical professionals generally want the N95 masks, but they’ll happily settle for just a surgical mask if that’s the only thing available.

It is too early to know whether what Japan has done is enough and whether it will be effective long term.

That said, It isn't just people wearing mask, or something innately Japanese. At the beginning of last year they had a serious flu outbeak[1]. This years flu cases saw a major reduction when measures to combat COVID-19 came into effect[2].

I have noticed a lot of little things that have come into effect as a response to covid-19.

* Medical clinics put signs up saying don't come in if you have flu like symptoms, phone and keep yourself isolated. That allows them to keep the vast majority of people with mild colds and flu separated from those with possible COVID-9.

* Stopping schools reduced the numbers of people on public transport.

* Putting pressure on companies to allow people to work from home.

* The supermarket bakery started wrapping all bread and pastries before putting them out, previously you would place what you wanted in a tray and they would wrap it.

1. https://www.nippon.com/en/japan-data/h00386/japan-gripped-by... 2. https://twitter.com/adtimmering/status/1240900101687480320?s...

Nobody goes around hugging, shaking hands with, or kissing strangers in the US.

Depends on the part of the US. Huggers actually exist.

> - Most public bathrooms don't have soap and I've rarely seen people wash their hands after using the bathroom anyways.

Where are you from? I see the opposite in Tokyo.

> most people I know are arranging or participating in flower viewing parties despite the government's requests not to.

Doesn't sound like the majority to me either.

Man sorry to say but all your comments are completely wrong.

- Social distancing does not exist in large cities like osaka and Tokyo. And that's a lot of people. Try to take a train at any time of the days and see if you can keep more than 10cm apart from anyone else. Good luck.

- Masks: there's no masks sold anywhere as we speak. And that's been a month already.

- Washing hands: more common than in other countries maybe, but I still see lots of guys who dont even rinse their hands after taking a piss. Both old and young.

- Listen to government: laughable claim. The government has been asking for social distancing and still in my neighborhood I can see parents and kids going together to play in parks with no care whatsoever.

- Elders in society? Ever heard of filled up nursing homes? yes, that is a thing in Japan.

> I can see parents and kids going together to play in parks with no care whatsoever.

I don’t know if they have no care. They’ve just weighed the horror of staying in their home with a kid for days on end against their chances of getting infected and chosen what makes sense for them.

So they decide to risk their own and their childrens lives as well as countless others just because they cannot stand their children for more than a couple of hours. Very responsible.

You risk you and your children’s lives any time you get in a car. That’s not irresponsible, that’s life.

So that leaves either green tea or nato as the magic antidote.

Do you know these are the real reasons or are you just rehashing what you have read? This feels more like confirmation bias. Can't imagine the rest of first world countries are completely shut down and here Japan is just doing fine with 1000s of ppl picnicking etc. There has to be something else going on..

That's.. actually a very salient point.

>Do you know these are the real reasons?

I don't pretend to know, that's my personal thoughts, I think they are. I am rather often in Japan for family reasons.

> Can't imagine the rest of first world countries are completely shut down and here Japan is just doing fine with 1000s of ppl picnicking etc.

I personally think one of the main reason is currently the exposition (or non-exposition) of the elders.

They account for over 95% of the victims. If for a reason the elders are more isolated / protected / healthy. It ends up impacting a lot how deadly the pandemia is.

> They [elders] account for over 95% of the victims.

Half the most severe cases in France are under 60 years of age. It begs the question of why Japan is also not seeing anything like that.

Deaths are certainly one thing to consider in terms of age, however if Japan had a mass spread of the virus I would expect to see a lot of ICU cases regardless. Even when countries aren't testing properly, the intensive care cases (or lack thereof) reveal what's going on eventually. I think it goes beyond the isolation of old people for Japan.

It's similarly puzzling as the German case to death ratio, versus eg Spain (comparable case counts, 15 times the deaths). I've seen that one explained that older people in Germany are far less likely to live with their families vs Spain or Italy (so fewer of the most vulnerable are catching it in Germany). And yet, Germany also has three times the cases of Switzerland, with the same number of deaths. Something is very strange there. The low recovery figures out of Germany might imply they're not deep enough into the outbreak, time wise, to have the death rate spiking yet.

(www.begthequestion.info)

> And yet, Germany also has three times the cases of Switzerland, with the same number of deaths

Switzerland is a much smaller country than Germany or France. Proportionally to their inhabitants they are highly infected.

But Switzerland is special, both largest cities in Switzerland are highly multicultural and with many people who were traveling in infected area every week, including in Italy.

What happened currently in Switzerland was easy to anticipate.

In Germany's case the main explanation from lead virologists is that they are testing much more and were lucky to catch it early. Germany had from the beginning a capacity of about 100k tests per week. Now they are increasing that.

So in conclusion, for Germany the number of infections is a bit closer to reality, where in Italy and Spain that number is/was much more far off.

Well, we won’t know whether the picnicking was fine until about 2 weeks hence. I hope it was indeed fine, but I’m doubtful.

a few random points to consider:

- Hong Kong, Taiwan, Singapore, Vietnam all in much warmer climate.

- hot spots in Italy and Japan are likewise in the northern region: Lombardy in Italy and Hokkaido in Japan.

- wearing masks during a global pandemic isn't apparently as fashionable in Japan.

- many Japanese elderly, or over 30K per year, die unnoticed in solitude. so it might take a while to catch up.

But on the other hand:

- In South Korea, most infections trace to a middle-aged lady "Super Ajumma" who is also a member secretive cult. Without the cult, the total infected with the virus in SK would be comparable to that of other Asian neighbors. So outside China, the spread of the virus doesn't seem so bad in Asia overall.

And even _in_ China, cases per capita are not that high (lower than most of Western Europe). In _Wuhan_ is another matter, of course.

Assuming China is not lying which is definitely up for debate.

Could you link some sources to your claims?

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3550308 For some informed ideas about temperatures/climate and coronaviruses

Specifically, https://i.imgur.com/ekiFd9S.png You will see that the largest outbreaks occur at the same temperature gradients

So do most of the major cities in the world. That's a hell of a confounding variable.

did you read the paper, or just comment of the cuff?

I live in Japan. "Washing hands is common" this is incorrect. Most bathrooms do not have soap and many people do not wash their hands.

"People listen and obey to their government" This is also not true, many hanami events have been cancelled but there were actually more people out viewing yesterday than last year. I am relatively sure the turnout will be higher than last year to many of the parks.

>> there were actually more people out viewing yesterday than last year.

Incorrect from my close observation of three Tokyo hanami locations with which I have become familiar over a long period.

The density of picnickers has been lower than I have observed over previous years. Furthermore, the respect for mutual distance through eye contact has been new and noticeable.

With Japan, things are not always as they appear. There appearances are everything. They will do everything to look clean, but it doesn't mean they really are. Even the masks are a bit of a show. There is, of course, truth behind it. They don't fake when they wash themselves and clean things up, and the masks really protect others, but don't assume they all behave the same way when no one is watching.

And while they tend to touch each other less then westerners they are also packed, and often go to public places in large groups.

For the elders, I don't know. The traditional way is to have everyone in the same house: children, parents, and grandparents. But the modern way leaves the elders by themselves. The traditional way would leave them very exposed, but I don't know how many are living like that. It is also more common for children to sleep with their parents.

And while the Japanese are generally more obedient and disciplined than we are, I am not entirely convinced about their faith in the government.

All and all, I think your points are mostly valid. But for me, it isn't as clear cut.

If they only behave the same way when someone is watching then it works. Same with obedient in and faith to government, the end result is they do what the government tell them to do. Pretentious or genuine does not matter.

Don’t know why you’re getting downvoted, anyone who lives here in Japan can confirm that these points are absolutely correct.

No. They simply don't test enough and they have good incentives not to do so. And please don't inconsiderately project your stereotypical image of Japanese, or Asian, on this matter unless you had spent a good amount of time (>20 yrs) in a relevant community.

The article gave several problems with that theory. If Japan's curve was where it is "supposed to be" weeks ago when people were making the same argument you are now, where are the piles of bodies and overwhelmed ICU's? They may eventually get there of course, since anything besides lockdown seems very risky these days. But the passage of time has proved your argument wrong time and again. More consideration is needed to understand what has happened there.

Though I certainly think they should just ramp up the testing and make it easier.

- People do shake hands in Japan. In Western countries hand-shaking is limited almost exclusively to business (I’d imagine the same goes for Japan).

- Washing hands is common, but not necessarily any more of a practice than in Western countries. But in many places like in subway station bathrooms they do not have soap.

Some of the cultural things like mask wearing (which was born out of the density and close proximity in public transit) are shared between Hong Kong, Taiwan, and other Asian countries, but a lot of things are also different culturally so I don’t think you can easily attribute these reasons as “not surprising” with regards to coronavirus growth.

> In Western countries hand-shaking is limited almost exclusively to business

I can't speak for all Western countries, but in the US I shake hands with every new person I meet, whether in a professional or social settings. I'll also shake hands as a greeting for acquaintances I'm not close with. (As opposed to a hug for close acquaintances.)

Which city? This is not at all ordinary in my experience (at least in social settings - it’s normal in business settings).

Parent was probably referring to outgoing people who don't spend most of their time in the Internet.

It’s hugs or nothing, and hugs are only for family or good friends you haven’t seen in a while.

In my experience, the handshake-as-greeting between men in social situations is common in the Midwest US, at least.

Might be an age/generational thing. At least my generation (20s and 30s) it’s definitely not commonly done outside of formal business meetings.

Hot tip, if you’re in Japan and don’t want to shake hands right now. Bow first. I find people of Japan will shake hands to make you feel welcome if you don’t bow.

I just had a young doctor in a hospital shake my hand, I would say out if the important cultural need to be polite and pay respect to someone older. I don’t care or blame him even though I was surprised.

On a side note, I would say upwards of 75% of people in Tokyo are wearing masks

> On a side note, I would say upwards of 75% of people in Tokyo are wearing masks

I’d say more like 50%, but I think it used to be more, so now I wonder if everyone simply ran out...

Maybe it's not a big demographic on Hacker news (or non-US western countries either), but there's a lot of hand-shaking that goes in in churches. That was true in my church up until a few weeks ago.

Taiwan had a much more comprehensive and thorough strategy, considering their threat was much higher due to close economic ties and travel with China.

https://jamanetwork.com/journals/jama/fullarticle/2762689

https://www.bbc.com/news/world-asia-49178314

I don't think the model in the paper accurately reflects the recent cross-strait relations. China already closed the border to Taiwan several months ago to retaliate Taiwan's arm purchases from the U.S, which brought nearly two months to handles the situation for Tsai. Though, Taiwan's response still has been much better than any other Western countries which already had three months to prepare against the situation while did absolutely nothing for the period.

Counter point: My Japanese friends have been and still are going out to bars every night like nothing happened.

Maybe this shows the relative importance of different measures?

Not saying that we elsewhere should go out to bars, since we're thoroughly lacking in the other parts.

Edit: downthread people suggest a lack of testing, probably a better explanation.

Why shouldn't they? There are probably no cases in the community.

I have heard the same from a Japanese friend, not in a major city either. Seems even families are going about normally with their children, to McDonald's and such.

What they're not doing is sending their children to school. Maybe that intervention alone is enough to suppress it.

I heard that because school is out the young people just went out instead.

The real difference lies in the responsible community surrounding you which doesn't behave like nothing happened.

Have you caught the JR Yamanote in peak hour?

I’ve never been touched by so many strangers so much in life.

Workers in japan also rarely take sick leave, even at this time.

Even in mildly packed trains people are basically breathing all over each other.

If you've ever been in a mens bathroom in Japan ... washing hands doesnt happen, let alone with soap

It’s just a little token splash of water.

I feel like we (the US) do a lot better just by advising the elderly to stay home, give them resources (free delivery, services brought to their home, etc) much more effectively then basically throwing our economy in a 40% GDP drop shitter.

Well, in France 50% of ICU patients are under 60.

Interesting. One of the themes of the classic Japanese film Ponyo is how separating elders from the rest of society is bad for both.

And Japan has strong laws requiring filial care for elders.

Anyway, sequestering elders isn't uniquely Japanese. USA is famous for that.

"- Last but probably very relevant: they have a completely different place of the elders in society. In Japan, the elders often live alone, sustain their life by themselves: it's a matter of proud. Even contact with their own kids is often sparse. Meaning, probably also lower risk of infection. "

The elderly in Japan are extremely active and are very well socialized with other elderly thanks to public transportation and compact cities. They are very independent and mobile. Considering that Japan never took active quarantine measures on a nationwide scale, it's honestly a mystery why Japan is an outlier.

> They are very independent and mobile. Considering that Japan never took active quarantine .

And that makes the situation better, especially if you compare to country like Italy where a huge majority of kids still live with their parents and grand parents, potentially can infecting them.

https://cdn.statcdn.com/Infographic/images/normal/6413.jpeg

If social distance and mask works in public space, it does not at home.

> Almost everybody wear mask when they are sick to avoid contaminating others.

The U.S. response is absurd.

I went grocery shopping the other day, and despite clear evidence of panic (empty shelves, hurried shoppers, long lines), but not a single person wore a mask.

Somehow, everyone is too scared to go to work, but not scared enough to wear a mask.

We're on course for the worst depression in history because we don't like masks?

No, we're not wearing masks because we don't HAVE any.

I live in Brooklyn and I'd love to wear a mask. I'd love to have been wearing a mask every day for the past two weeks.

But where exactly do you suggest I find one since they're sold out literally everywhere, and we're also getting advice not to wear them so they can be saved for healthcare professionals!

You ought to reexamine your assumptions. We love masks but don't have any.

Sheesh.

Wrap a t-shirt around your face and use a clothespin to secure it. It's not perfect but from the best of my reading it's far better than nothing.

I was referring to either storebought masks or homemade ones.

Literally some paper towel, wire, and rubber bands [1].

If you're willing to break out a needle and thread you can make a durable cloth one. [2] [3]

> we're also getting advice not to wear them so they can be saved for healthcare professionals!

AFAIK, surgical-quality sterilizing masks are separate from what you'd probably find in the store; you're not pulling from the same stock.

(Though I seem to recall some charity effort of people sewing masks for doctors, so IDK what the actual U.S. healthcare regulations are.)

[1] https://www.youtube.com/watch?v=aNjpH5lBZ8w (University of Hong Kong-Shenzhen Hospital)

[2] https://nypost.com/2020/03/20/doctors-are-now-running-out-of...

[3] https://www.deaconess.com/How-to-make-a-Face-Mask

EDIT: "Sheesh"

> I'd love to have been wearing a mask every day for the past two weeks

Well, that’s the reason they are sold out, and heath professionals are desperately asking for donations.

You don’t need a mask unless you are sick. For protection you need a mask and glasses, but keeping your hands clean and away from your face does 95% of the job.

> You don’t need a mask unless you are sick. For protection you need a mask and glasses, but keeping your hands clean and away from your face does 95% of the job.

Except you do, because carriers without symptoms are contagious and the main drivers of this pandemic.

And no, coronavirus doesn't have wings, they are carried by water droplets, and any sort of barrier that can stop water droplets is better than no barrier at all.

If you’re truly asymptomatic then you wouldn’t be coughing.

There are lots of other things that can cause coughs, especially now that spring allergies are starting to kick in.

1. coronavirus isn't the only thing that cause coughing 2. coughing isn't the only way people spread out water droplets 3. you also don't want water droplets from other people landing directly on your face 4. nor you want to accidentally touch your face after touching potentially contaminated surfaces 5. people like you are being a hazard to their communities with this kind of behavior

Wear a scarf. The OP didn't say criticize people for not wearing mask-alternatives in a time of a shortage, they critized people for not wearing anything. DIY masks may not be as effective, but they still help (some top HN post claimed 70%-80%). This isn't a situation where if you can't do something perfectly you might as well not try. This is a situation that calls for doing anything within reasonable measures (don't raid hospitals for masks etc).

Paper masks are in shortage in Vietnam but that doesn't stop people from wearing big respirator kits or cloth masks that they rotate out.

Scarves are about the least effective makeshift masks, catching less than 50% of virus sized particles. A tea towel/dish cloth catches over 70% and a vacuum cleaner bag is over 80%, almost as good as a surgical mask.

> Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/

> ... catching less than 50% of virus sized particles.

This is true but irrelevant.

You want to catch larger globs that carry virus-sized particles, and almost any material will help to some extent with this.

Not discouraging it, just pointing out that there are much better alternative materials.

But breathing through a vacuum cleaner bag is too hard.

Still, it might work if you did a radical pleat. I'll try it.

As I recall, two layers of cotton t-shirt is the best option.

That would be awesome but I think you meant a "radial" pleat.

Huh. I meant radical in the sense of large surface area. And I was thinking ~cylindrical.

But radial is a great idea. And as soon as I started playing with paper, the ancient muscle memory of folding filter paper came back to me.

Edit: OK, I used filter paper from a shop vac, 20 cm wide by 30 cm high, with six faces triangular faces on the top and bottom, and eight faces on the sides. The ends of the faces on each side are sewed together, with an elastic strap connecting them. So the base is a diamond, ~18 cm wide and ~12 high. There's cloth edging on the top and bottom, and a cloth-wrapped 1 cm x 5 cm strip of aluminum edging to seal the top of the nose.

Well technically we didn’t like masks before... if we like them we like them now that the situation is bad.

Try making your own mask: https://smartairfilters.com/en/blog/best-materials-make-diy-...

Some folks have only recently been made aware of the actual usefulness of masks. Before a couple of days ago, I saw and believed the stuff being put out by the CDC. Next time I am shopping I will have a make-shift mask on.

Unfortunately there simply aren't enough masks produced in western countries. If governments directed factories to produce face masks, like they are currently doing for ventilators, then we could have enough. And I believe most people would actually wear them if they were widely available and governments directed it.

It seems like that would cost less, and might also be more effective than shutting down half the economy?

If it were more effective, don't you think at least one country on earth would have thought of that?

Masks may be able to help a little, but odds are good that if you're in a bus with an infected person coughing or sneezing, you'll be infected with or without a (regular surgical-style) mask. Those masks are almost entirely designed to keep stuff in, not to keep them out of your nose/mouth/eyes.

The slightly reduced incidence of infection from direct contact would not at all affect the greatly increased incidence from much more frequent direct contact. Which is why no country is relying on it.

Many countries did think of that. In most of East Asia, including Japan, many factories have been diverted to mask production and delivering masks to the general public has been a key government priority.

The masks is more for the coughing/infected person to wear, although they help reduce transmission on either side.

Think of widespread use of masks as a kind of surrogate herd immunity. Not as a surrogate vaccine. It's only effective in a statistical sense. But it is effective.

I feel the crux of Japanese resilience (vis a vis Western) has been their tendency to consider and act in the group's interest, rather than in own interest.

However, it's far from over and time will tell. Yesterday I saw many people doing hanami, cautiously.

> “Those masks are almost entirely designed to keep stuff in”

“Keeping stuff in” is exactly the point. Covid-19 causes mild symptoms for most, so many people walk around infecting others without even realising it. Where there is widespread use of masks, transmission is greatly slowed/reduced.

The point of wearing the mask is not only to protect yourself, but even more so to protect others in case you are infected.

I don't think anybody has masks to wear even if they'd like to. I certainly don't. The US surgeon general was also adamantly advising people not to buy masks over the past month. At this point, any and all masks are being redirected to hospitals, as there is a critical shortage. Paint shops in my local area have donated their entire supply to the local hospital -- the health department is encouraging people to hand sew masks to donate. If we had a surplus for every family, I'm sure things would look different.

I actually have two old FFP1 R rated masks in my closet from the past two pollen seasons. Since I only used them during the pollen season, they're probably still okay. But I haven't been wearing them recently, since the effectiveness of them hasn't really been clear. There's really also the stigma of being a leper, although that didn't really stop me during the pollen season.

> went grocery shopping the other day, and despite clear evidence of panic (empty shelves, hurried shoppers, long lines), but not a single person wore a mask.

That means nobody knew they were sick and went shopping anyway. Which is good.

Many people in the US think masks are like gas masks, used to prevent dangerous things from getting in your body. Masks are used to prevent people from spreading a disease, and you should assume anyone wearing one is sick.

It also means nobody who was sick but didn't know was wearing a mask that would have helped limit others' exposure. Which is kind of relevant here, where you are infectious to others for days before you feel sick.

For the elders point only if they have some disease that can impact the family. So it also makes sense their death rate is lower

>In Japan, the elders often live alone, sustain their life by themselves: it's a matter of proud. Even contact with their own kids is often sparse

I doubt this is true. In most Asian cultures including Japan the children live very close to parents and take care of them all their life.

- Almost everybody wear mask when they are sick to avoid contaminating others. They do that since way before Cornavirus and on voluntary based.

We're told that masks do not work

Nobody should be saying that masks do not work. When worn by a sick person, they very effectively prevent droplets from leaving the mouth. They also help not breathing in contamination, as airborne viruses are usually contained in droplets. But there are other ways to get infected, so they don't help as much as people think they do.

There was definitely a lot of press early on basically saying masks (and latex gloves) don't work.

Generally they were clickbaity articles with headlines stating exactly that, but content stating the more reasonable idea that masks/gloves don't work (and may in fact cause more problems than they solve) if you don't use them correctly.

eg. someone buys a mask, keeps using the same mask day after day while handling the mask in way that may make the inside of it a contaminated surface, etc.

This should not be downvoted. There have been plenty of articles downplaying the importance of masks.

There are plenty of articles but that doesn't mean they are correct. Here is a peer reviewed study demonstrating that masks are helpful.

https://www.sciencedirect.com/science/article/pii/S221133551...

Masks provide two benefits. They protect other people from you when your are ill but currently asymptomatic and they protect you from "splashes" caused by people coughing and sneezing without covering their mouth.

maps7 didn't say masks don't work; they said that we've been told they don't work. maps7 is right, a lot of headlines at the least have been saying things like that.

Yeah, I am in the pro-masks camp but I feel like I can't wear one without being judged because the public have been told not to. I'm in Europe by the way.

Indeed. Here’s the US Surgeon General spreading disinformation on Twitter.

> Seriously people- STOP BUYING MASKS!

>?They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk! http://bit.ly/37Ay6Cm

https://twitter.com/Surgeon_General/status/12337257852839321...

The Surgeon General is correct. Masks are for the sick.

They said masks aren’t effective at stopping people getting sick. That’s misinformation. If they weren’t effective at reducing infection healthcare workers wouldn’t wear them.

Saying there aren’t enough for healthcare workers isn’t. Save respirators and surgical masks for healthcare workers. Wear a mask if you’re going outside even if it’s just a tshirt covering your face.

>If they weren’t effective at reducing infection healthcare workers wouldn’t wear them

Yes, they would. The healthcare worker may already be sick, and are regularly closely interacting with people that have compromised immune systems. An illness that wouldn't slow down a nurse may kill a patient.

Are you saying masks dont help in preventing ingestion of airborne viruses? That sounds like horse shit. Yes you can still get sick by touching contaminated surfaces and then touching your face...

Anytime a mask would prevent you from ingesting an airborne viruses, it becomes a contaminated surface.

So as your clothes and skin except that when you are wearing a mask you dont get sick.

Removing a contaminated mask involves both touching a contaminated surface and touching your face, which you say can still get you sick.

Have you read this article? https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-...

> Third, of course masks work — maybe not perfectly and not all to the same degree, but they provide some protection. Their use has always been advised as part of the standard response to being around infected people, especially for people who may be vulnerable.

That quote does not fully describe what is advised, but wearing one when you are knowingly interacting with an infected person is different than general use.

If we agree that masks slow the spread of disease from and to wearers then we are in clear disagreement with the Surgeon General. Masks work and the general populace should be encouraged to wear makeshift masks until such time as there are enough surgical masks for everybody or the crisis is over.

We don't agree. Masks would only help in the event that someone coughed/sneezed directly on your face but missed the eyes. Even then, removing the mask and washing your face without contamination would be difficult.

Makeshift masks don't necessarily even help in that situation, become a liability when contaminated, and putting it on then removing it causes additional risk.

This is why that someone also needs to wear a mask.

Don't worry, people aren't morons and have been using masks in Japan and other countries for decades just fine.

Yes, masks can hold contaminated droplets --that's their purpose. When people don't use masks on the other hand, those droplets that would have remained on the mask now end up everywhere else, and now you have a far more spread vectors with basically everything being potentially contaminated.

Using a mask ensures that a lesser percentage of your contaminated droplets end up in other places.

If you are sick, masks are great. Even homemade ones. This is about healthy people wearing masks.

> If you are sick, masks are great. Even homemade ones. This is about healthy people wearing masks.

First, masks work better when both sides use them. In Japan, healthy people wear masks as well during flu seasons because it makes it offers better protection than wearing nothing.

Second, in the specific context of COVID-19, how do you know they're healthy? That's the key, because asymptomatic cases are estimated to be the main driver of this pandemic by far. And it's only worsened by the fact that only few tests are available.

> If they weren’t effective at reducing infection healthcare workers wouldn’t wear them.

Have you seen the pictures of healthcare workers using "effective" mask protocol? Have you also noticed that said protocol almost always includes goggles?

If I can't trace the seal lines on your face for an hour after you remove your mask, it isn't doing shit for you as a healthy person.

If you are sick, however, that's a different story. The mask prevents droplets from being spewed out of your mouth at 120km/hr (70mph for the heathens) when you sneeze.

"If I can't trace the seal lines on your face for an hour after you remove your mask, it isn't doing shit for you as a healthy person."

Just because it isn't 100% effective doesn't mean it's not doing anything. Exposure isn't binary--the quantity matters.

Healthcare workers have very little room for error because they're constantly exposed to large quantities of the virus. For them, blocking 80% of droplets from a cough is useless, of course, because they're surrounded by infected coughing people all day long. Even 99% isn't good enough for them. But for someone going to the supermarket once a week, blocking 80% might mean the difference between a deadly level of exposure and a level that their immune system can fight off.

Also, this whole "only sick people should wear masks" refrain rather exasperatingly ignores that we don't know who's sick and who isn't. That's exactly why this virus is so difficult to contain. Supply issues aside, the only way to make sure all the sick people are wearing masks is to get everyone wearing masks.

> Also, this whole "only sick people should wear masks" refrain rather exasperatingly ignores that we don't know who's sick and who isn't.

And your argument exasperatingly continues to assume infinite availability of masks.

The masks most help when people are coughing or sneezing significantly. That's really obvious last I checked.

Someone not coughing or sneezing is spreading the virus roughly the same amount whether they wear a mask or not. Covid-19 doesn't actually seem to produce nasal secretions like the flu does so surface contact spread isn't quite the same.

If you want to spread good advice, tell healthy people to start wearing their glasses instead of contact lenses. It's probably more effective than a mask on a healthy person--especially since it prevents people from poking at their eyes with dirty fingers.

"And your argument exasperatingly continues to assume infinite availability of masks."

Except the part where I wrote "supply issues aside". Of course there's a limited supply. That doesn't mean masks wouldn't be effective if we had enough of them. I think we should prioritize making more, not just for healthcare workers, but for everyone.

"Someone not coughing or sneezing is spreading the virus roughly the same amount whether they wear a mask or not."

Scientific consensus so far is that coughing, sneezing, and talking is responsible for the majority of spread. Surface spread is secondary.

"probably more effective than a mask on a healthy person"

Again, we don't know who's healthy and who isn't.

Expect he is wrong and spread dangerously false information and pushed people toward danger. And you are also doing it here as well. His "correctness" is reflected in the number of infected people in the US, which is over 27000 now. Japan, despite having a head start and having a far higher population density, is at 1050. Let these numbers sink for a minute, and ask yourself what you could be doing better.

In Japan, people use masks to protect the community, which includes themselves as well as people around them.

When I read that I was suddenly wondering if maybe they were appointed by Trump due to similar communication style.

We were and some were being mocked who wore them and called racist (this is when the virus was only in wuhan).

This downplay is one of the major reasons for the slow public adoption of safety measures.

Look at who is telling you masks do not work. None of the authoritative sources I've seen over here have said that. They say things that can be misinterpreted that way, like "don't stop transmission" or "don't need masks" or "don't help as much". I haven't seen an authoritative statement that they don't help, either catching or spreading. Yet over here, despite many households already having good masks due to recent fires, few people are wearing them.

The CDC was being intentionally misleading to manipulate the public instead of speaking the plain uncomfortable truth that masks are useful but in a shortage (caused by catastrophic government failure at a simple task of stockpiling cheap nonperishable, valuable equipment) they want you to leave masks for people who need them *more. This has been called out by at least one epidemiologist.

If you are sick, masks are an effective way of preventing others from catching it.

If you are healthy, masks do not prevent you from getting sick.

It's a fairly easy misunderstanding to make.

Then why do doctors wear them in hospitals?

Surgical masks? To prevent the spread of bodily fluids.

Originally to protect the patient in surgery, not the surgeon.

No. You clearly have no idea how this works, and are basically an armchair health expert spreading patently false and dangerous information.

Health care workers are required to use masks to protect immunocompromised patients.

In Japan, people use masks to protect the community and goes both ways ---which is why it works.

>Health care workers are required to use masks to protect immunocompromised patients

Protect them from what? Their potentially disease carrying bodily fluids.

I don't have the slightest clue what misinformation you think I'm spreading. You have responded to four of my posts, and none of the replies give any reason to think healthy people should wear masks.

I gave two reasons, I'll give them here again:

1. Masks do work. Wearing a mask obviously provides a better protection than nothing for a healthy person.

You can also read a few studies https://journals.sagepub.com/doi/10.1177/003335491012500206 https://annals.org/aim/fullarticle/744899/facemasks-hand-hyg...

Mask isn't a substitute for hygiene and social-distancing, it's a complementary countermeasure.

2. You don't know for sure a person is healthy right now, and asymptomatic cases are the main drivers of the contagion.

The misinformation you're persistently perpetuating is that US surgeon general is right in saying

> Seriously people- STOP BUYING MASKS!

>They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!

which is not only wrong but also outright dangerous. How dangerous is this? Look at the spread rate and the number of cases in US vs Japan.

Yes, there is panic buying. The Japanese government is handling the situation by managing the responsible distribution of the masks itself. Like most countries, US may not be able to meet the full demand immediately for the masks that are necessary to slow down the spread, and yes, health care workers do need them, but that can't justify giving dangerous advice and lies to public.

>You can also read a few studies

The first study only advocated wearing a mask when sick,or within three feet of someone who was sick, and concluded

>there was no detectable additional benefit of hand sanitizer or face masks over targeted education on overall rates of URIs, but mask wearing was associated with reduced secondary transmission

And from the second

>facemasks seemed to prevent household transmission of influenza virus when implemented within 36 hours of index patient symptom onset.

So both say "wear a facemask when sick or interacting with the sick."

>You don't know for sure a person is healthy right now, and asymptomatic cases are the main drivers of the contagion.

Asymptomatic doesn't mean healthy though. If you feel unwell in anyway a mask is a good idea. Erring on the side of caution is different than everyone always wearing one.

>How dangerous is this? Look at the spread rate and the number of cases in US vs Japan.

Aren't masks common in both South Korea and China?

I made a mistake. I was reading about a study yesterday trying to show that stomach problems were a common symptom for people with coronavirus. This had me thinking "asymptomatic" meant showing irregular symptoms, when it is showing no symptoms.

That said, if you are asymptotic you aren't coughing or sneezing, so I'm unsure of how helpful a mask would be.

Yes, you are making a lot of mistakes. No, on the contrary, both studies encourage the use of masks. And it's totally beyond me why you're so bent on distorting the fact and trying to get that dangerous message of discouraging the use of masks.

Go back the first study and read the full sentence that you conveniently cut in the middle:

> In this population, there was no detectable additional benefit of hand sanitizer or face masks over targeted education on overall rates of URIs, but mask wearing was associated with reduced secondary transmission and should be encouraged during outbreak situations.

See the part about secondary transmission which you deleted? Also remember that unlike in that study (which was conducted in households with a known sick patient), in reality, there are sick people (both symptomatic and asymptomatic) whom you don't know in advance that they're sick and do not wear masks --which is something you can't fix by education and instead have to implement mass quarantine because now everything could be infectious and people have to avoid everything.

Second study:

> In conclusion, our results suggest that hand hygiene and facemasks can reduce influenza virus transmission if implemented early after symptom onset in an index patient.

And make sure you also read the word influenza, and remember that with COVID-19, the main driver is asymptomatic cases by far. Which means everyone should wear a mask.

> Aren't masks common in both South Korea and China?

Yes, masks are common in China and South Korea now, which is reflected in their low transmission rates: China 0.06%, South Korea: 2.0%. Compare that to 35% in US. Initial outbreaks in China and South Korea were driven by people not using masks. The spread rates plummeted after the implementation of countermeasures which include, surprise, use of masks by everyone!

> That said, if you are asymptotic you aren't coughing or sneezing, so I'm unsure of how helpful a mask would be.

Coughing isn't the only way people spread water droplets ---people do that just by talking. Virus is also carried in aerosol that remain in the air for longer periods. Coronavirus isn't the only thing that cause sneezing or coughing (especially in this season, so there could be people who think they just have pollen allergies while in reality they are symptomatic carriers of SARS-CoV-2). And regardless, it obviously is better than nothing. Yes, it's not going to be 100% effective, but even a 1% difference will be the difference between life and death for some people in your community.

Really, what are you trying to achieve by pushing this nonsense? If all people in the US don't start using masks already, they won't be able to achieve the success in suppressing the spread rates seen in Japan, China, South Korea, Taiwan, Hong Kong (all are countries where mask usage by everyone is high) within the same time frame. The growth will be stronger, there will be far more sick people and more and more fatalities. Is this what you want? If not, just stop, please, and start acting responsible as a member of your community. Please.

>Go back the first study and read the full sentence that you conveniently cut in the middle

I cut there for brevity, as it clearly means "the hand sanitizer and facemask usage outlined and tested in the study should be encouraged." You can't ignore everything else in the paper and say they are advocating everyone wears a mask.

With the second study, even what you quote supports my position. "After symptom onset" means "when sick."

>especially in this season, so there could be people who think they just have pollen allergies while in reality they are symptomatic carriers of SARS-CoV-2

If you are coughing or sneezing, you should be wearing a mask.

>If not, just stop, please.

So far, you have posted two articles that support my claim, and made references to various statistics implying face mask usage is responsible for the good stats. I am not spouting nonsense that will kill people, this is the WHO's position.

Are you being thick on purpose?

You are lying, you know you are lying, and you keep lying.

1. And you can't ignore the context and the conclusion of the study and cherry pick half sentences. What a convenient "brevity" that is. They do encourage use of masks in their limited context. Yes they don't say everyone, they say contagious people, and as I explained to 10 times already, in the context of a disease with asymptomatic spread, the requirement translates to everyone.

And for the nth time, mask isn't a substitute for hygiene and social distancing (which apparently is your faulty understanding because you keep bringing it up), it is complementary and effective countermeasure.

What part of this is so hard to understand?

2. "After symptom onset" is the contagious period for flu. For SARS-CoV-2, it starts before symptom onset. Meaning potentially everyone, again.

So no, both studies do encourage the use of masks for everyone.

And then there are indisputable, order of magnitude differences in infection rate numbers between countries that use and don't use masks --which you're also conveniently but consistently silent about. Try going to Japan and telling people that masks don't work ---but also tell them that US discouraged its people from using masks and has an infection spread rate of 35% with over 38000 infected people and nearly 400 deaths in a shorter timespan. See the reaction you get. Actually, no, I take it back, please don't ever come to Japan. Please stay wherever you are, we don't want people like you.

You are bent on harming yourself and people around you, and I'm done talking to you. The last thing I am going to say to you is: you are a disgrace and a harmful element to your society, to this world, and I am happy that at least my country is giving the right directions, doing the right things and that mine is a society where people like you get the reaction that they deserve.

>You are lying, you know you are lying, and you keep lying

I am not. You are being overly passionate and stating things are obvious facts without sufficient data. Even the prevalence of asymptomatic spreading is unclear right now.

>And you can't ignore the context and the conclusion of the study and cherry pick half sentences

I didn't ignore it, a studies recommendation is meaningless without the experimental results. I commented on the results. Similarly, you don't need the part I omitted to say...

>in the context of a disease with asymptomatic spread, the requirement translates to everyone.

This is not how studies work. You can't use this to assume long term use of masks by those without symptoms is beneficial. That kind of use may have unaccounted risks.

>And for the nth time, mask isn't a substitute for hygiene and social distancing (which apparently is your faulty understanding because you keep bringing it up),

I have no idea what part of my last post you think brought this up, the quotes from the studies? At no point have I tried to claim masks were a substitute for hygiene or social distancing, I don't know what led you to that idea.

>What part of this is so hard to understand?

The part where you attack something I didn't say is confusing.

>--but also tell them that US discourage their people from using masks and has an infection spread rate of 35% with over 30000 infected people and nearly 400 deaths in a shorter timespan.

It's a bit hard to talk with someone who accuses me of "cherry picking" data and then makes these random comparisons that ignore most of the world and any other potential factors.

>The last thing I am going to say to you is: you are a disgrace and a harmful element to your society, to this world,

All for following the recommendations of organizations like the WHO. Have a nice day, I hope you are fortunate enough to stay healthy, and remember to properly dispose of your masks after use.

A hazmat suit is better than a respirator. A respirator is better than a surgical mask. A surgical mask is better than a tea towel/dish cloth. A tea towel is better than a T-shirt. A T-shirt is better than a scarf. A scarf is far better than nothing.

Nothing short of a hazmat suit will prevent you from catching the virus but all of the above will reduce the chances of you catching it. There aren’t enough respirator, or indeed surgical masks for healthcare workers, never mind everyone else. But we should not let the perfect be the enemy of the good.

Removing a mask from your face will put your hands in contact with vulnerable areas that otherwise would be avoided.

Additionally, if a homemade mask were to become contaminated, repeated handling could put you and others at greater risk.

Wash your hands. Wash your mask. There aren’t enough surgical masks for healthcare workers and they’re reusing them after bleaching or exposure to UV. You can reuse a dish cloth after washing it.

This only works if you change your mask every time you remove it, and have no further contact with the mask until you clean it.

I'm baffled how one office spreading patently false information that defies logic and physics could be so effective.

Not using a mask as community will ensure that virtually everywhere is potentially contaminated and you are under a larger risk and at all times --not isolated to the moment when you remove the mask (which people typically do at a place where they can wash/cleanse their hands anyway).

So for crying out loud, please stop spreading this nonsense! Masks don't replace washing hands, general hygiene and social distancing, it supplements them. And of course they do work: https://doi.org/10.7326/0003-4819-151-7-200910060-00142 https://doi.org/10.1177/003335491012500206

>Not using a mask as community will ensure that virtually everywhere is potentially contaminated and you are under a larger risk and at all time

How does a healthy person wearing a mask prevent contamination?

> How does a healthy person wearing a mask prevent contamination?

How do you know they're healthy? That's the key, because asymptomatic cases are estimated to be the main driver of this pandemic by far. And it's only worsened by the fact that only few tests are available.

Which is amusing when they follow that with: save them for healthcare workers.

It's mind-bendingly confusing. Everyone seems to lap it up though.

and Bidets! TOTO knows whats up!

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