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WHO’s statement itself says that the mask is helpful when you are caring for someone with a suspected infection, therefore it admits the mask can provide some level of infection protection. It likewise says the mask should be worn by someone coughing or sneezing, showing that it protects others from your germs.

The obvious answer to the “wearing masks in a wrong way” is to teach people to use and dispose of them correctly, just like we don’t dismiss hand washing because many people don’t know how to do it.

I think these statements by health authorities are simply because there has been no RCT of mask wearing among the general public and for them lack of evidence is equivalent to evidence of absence.

The decision to treat absence of evidence as evidence of absence is surely driven by evidence of absence of masks, if you pardon the pun. It's very reasonable to prioritize healthcare workers who are far more exposed than anybody else and the lack of formal, peer reviewed studies is a welcome opportunity to subdue a panic buying bidding war.

If truth was the only concern, I think that comparing the rough numbers between "masked countries" and "unmasked countries" should be more than enough to recommend masks. It's a planet-wide experiment and the control group is clearly seeing worse results. And it's not just SEA countries, there are also places in Europe that didn't play down masks, like the Czech Republic. And their metrics are looking quite good so far, with far more liberal measures than in neighboring Bavaria, except for the masks. With much of the intra-European spread being incubated in ski resorts one would expect them to be hit quite hard as well. And the Czech Republic doesn't have a magical stockpile either, from what I'm reading there's a lot of improvisation going on there regarding masks.

Speaking of improvised masks, would vacuum cleaner bags be a good MacGuyver material that's present in almost any household? It's surely better at filtering than random t-shirt cloth, but would there be a risk of ruining lungs with fibers from the bag material? The fact that they are apparently safe to force air through them in living quarters with a two kilowatts blower suggests that they don't shed anything harmful, but I'd be glad to hear any counterarguments from the wide variety of expertise present in hn readership.

I'd like to see the terms 'hording' and 'panic buying' discouraged. They're being almost universally used to simply refer to people who simply have different needs, preferences, or concerns... and the net effect is shaming people for being cautious or prepared.

The end result is that in some places people are being denied the ability to purchase up more than a few days of supplies at once, forcing repeated trips out that increase everyone's risk.

Virtually no one simply concerned for their own safety is creating a big problem for anyone with their purchases (at least not above and beyond the background level of synchronized need)-- sure, a gouger wanna-be here or there is a problem-- but that is its own separate thing.

> better at filtering than random t-shirt cloth,

Cotton is pretty good at absorbing water, if we're in the land of pure speculation it wouldn't be unreasonable to guess that it's not bad for droplets.

I agree that it's both important and difficult to distinguish between hoarding and a laudable and well invented switch to a lower supermarket run frequency. But this will create temporary shortages even in the most cooperative and well-meaning environment if everybody tries to switch at the same time. Everybody needs to put on the brakes a little for a soft ramp-up of per trip volume or else you get an actual survival of the most ruthless shopper situation.

The characterization as "hording" and "panic buying" though is resulting in bad public policy: https://www.nbcbayarea.com/news/coronavirus/san-mateo-county...

A comment I've heard from someone at a grocery supplier is that stores haven't even called in to restock many out of stock items because they're simply overwhelmed. It's not clear to me what good public policy would be to address that, beyond patience.

Telling people to hold off a bit would probably be prudent but with low item limits already being implemented by some stores and even ordinances being discussed, ... makes holding off sound potentially unwise. :( exactly opposite the needed effect.

> Speaking of improvised masks, would vacuum cleaner bags be a good MacGuyver material that's present in almost any household? It's surely better at filtering than random t-shirt cloth, but would there be a risk of ruining lungs with fibers from the bag material?

https://smartairfilters.com/en/blog/best-materials-make-diy-...

This notes it is very hard to breathe through the vacuum cleaner bag in comparison to a surgical mask. It is more effective at filtration. I’m not sure about the possibility of it releasing fibers. The analysis on that link suggests to me that for a DIY, cotton is probably the right balance although it doesn’t provide nearly the same level of protection as an official surgical mask.

Here's what makes sense to me:

* The single most effective intervention we have right now is staying home and avoiding every unnecessary contact, as authorities recommend.

* Worn carefully, several kinds of masks probably have a range of marginal positive effects.

* BUT recommending them runs the risk of (a) people over-relying on them and not following isolation protocols (b) people wearing them incorrectly for a mix of less effective benefits and added risks (c) contributing to a run on masks which constrains supply for medical workers where the benefits are more critical.

If this is all true, it can simultaneously be the case that official guidelines against masks are reasonable recommendations and that it's also a reasonable recommendation to wear masks (on top of other more important precautions).

I'm sure that masks are not the sole factor in gentler curves in those countries. They do seem to be a common factor.

I totally agree and it's likely that the public will be much better equipped after this pandemic ends. So all of us will have a box of disposable masks at home, and will be educated about when and how to wear them properly.

Right now, the average person probably only has 1 or at most a few masks, they don't dispose of them after use and probably wear (put on/off) them in a wrong way.

You know, you could have learned how to put on a mask properly within the time period you spent arguing here. It’s not fucking rocket science.

I was recently on a flight where a person on my row had difficulties taking her seatbelt off. After what seemed like two minutes the flight attendant assisted her. I'll even admit that it sometimes takes me a second to do it correctly when I try to only take it off with one hand. Despite this we still recommend that people use their seatbelts. In addition to this we play videos that instruct people on the usage of seatbelts. Imagine if we argued against recommending seatbelts because of the lack of education on using them despite never having attempted to explain how to use them.

Don't they also teach you how to put on that oxygen mask on the airplane?

> you could have learned how to put on a mask properly within the time period

I'm mostly arguing the other side here, but I should point out that well fitting an N95 mask is actually pretty tricky depending on the shape of your face.

I expect that even a lot of medical professionals don't manage it. You only really can tell that you've done it wrong if exposed to something you can smell or taste very strongly that the mask should stop.

A poorly fitted mask is almost certainly a big improvement over nothing, however.

I’m not talking about N95 masks here. I’m firmly in the camp suggesting the following: leave N95 masks to frontline health workers, and wear surgical masks when you go out. Which is at least consistent with government recommendations in Mainland China and Hong Kong (just checked, see https://news.ycombinator.com/item?id=22726566). Oh and there are two doctors in my family who recommend the same.

Tell us how to put on a mask.

We'll tell you how many errors you've made.

The Zeno mask: impossible to wear safely.

This!

The fact is that in "the wild", so many different factors are at play that it's very hard to establish the impact of one particular factor on the numbers.

In a sense, establishing the exact impact of wearing or not wearing masks is as difficult as establishing the exact impact of the population pyramid on how things evolve. Combine both and things become even more obtuse.

Worst case is that one ends up confounding correlation with causation which leads to harmful conclusions. Such as over reliance.

What you are saying is the rational sensible middle ground in this discussion. Most domain experts are very careful in the type of recommendations they make.

I'm not a domain expert, and so I put my trust in domain experts. I haven't heard any micro biologist or health care expert urge wearing masks as a basic necessity. I do hear them urge to vigorously wash hands, practice physical distancing and generally stay at home as much as possible...

There have been studies that indicate that masks are effective. There have been studies that showed no effect which also had low compliance. There has never been a study which showed people taking risky behavior because they were wearing a mask, as far as I've been able to determine.

To me that above comment sounds like rationalizing to justify misleading the public and risking their lives, out of some paternalistic assumption which has not ever been even suggested by the applicable science.

In practice, what little I've seen of people wearing masks causes a change in behavior -- additional distance, etc. from people around them. It raises awareness, and looks like it should reduce risk.

Most of the concern that people might take on additional risky actions would be adequately addressed by making it clear that masks aren't a sure thing-- especially if not expertly fitted and coupled with additional PPE and procedures.

Plenty of people are in "essential" jobs or just need to get groceries. In the bay area, many people already have used masks due to the history of fires... and many of those people are failing to use them because they have been materially and intentionally mislead by people who have, or ought to have, a professional obligation to provide honest information to them.

The loss of trust from this, as the public realizes it was mislead, will have lasting negative effects.

For an example of people relying on masks, not social distancing, here are photos of recent football matches. https://www.bbc.co.uk/sport/football/52084121

I used to be strongly anti mask, and I'm slowly changing that position, but I do struggle when I see 60,000 people turn up to horse racing in Cheltenham UK and some of them are wearing masks but doing dumb stuff -- pulling them off to cough or smoke or drink.

I can give you infinitely more examples of people neither wearing masks nor obeying social distancing, and that is in fact supported by your “example”. I hope “anti-mask” people could stop attacking the straw man already.

But the solution is "don't hold mass gatherings", it isn't "hold mass gatherings but encourage people to wear masks".

> contradicts official WHO guidance

A few weeks ago official WHO guidance included:

- that there was "no clear evidence of human-to-human transmission" of the virus

- that international air travel should not be suspended "because of the social disruption they cause and the intensive use of resources required" (nothing about the efficacy of such a move).

Well look at us now. Maybe, just maybe, their guidance on this topic is also flawed.

The lack of critical thinking on the issue of masks is astonishing. There are study after study[0] showing that masks mitigate the transfer of virus particles. Then there's common sense which points in the same direction.

---

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810906/

https://www.ijidonline.com/article/S1201-9712%2808%2901008-4...

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

God, I was so annoyed reading WHO statements and people quoting them as an authority when this first started to blow up in China.

The numbers quickly went from dozens to hundreds, and they still tried saying there was no chance of human-to-human transmission (pretty unlikely that they all ate the same food and that a virus with the main symptom being coughing isn't transmitted by coughing) and that it'd all be contained and there was no need to worry.

In this crisis, the WHO has been bending over so far backwards that it's spinning donuts to serve as a political mouthpiece for certain governments. There was panic over people being under-supplied and under-prepared, and one of the main supplies in short supply was masks. Masks aren't perfect, but even if they're reducing transmission by 10% and keeping people from touching their mouth, that's a decent effect.

> Those Asian cultures have a different epidemic curve not due to mask wearing, but because a totally different social structure, prior experience concerning epidemics, preparedness, attitude towards authority & emergency measures and other factors. So it's a fallacy of cherry picking to say that it's 'because they wear masks and all our authorities are wrong'.

And you’re not cherry-picking because what exactly?

Pointing out that there are a huge number of other factors that influence the spread of COVID-19 in each country is not cherry-picking, it's highlighting that you can't simply look at said graph and say "it's because they wear masks."

Saying the difference is due to other factors but “not due to mask wearing” is cherry-picking everything else other than mask wearing.

> Or are you stating that the WHO is lying?

yes, the page does indeed state that. what do you think of the cited research, vs nitpicking the hero image?

Out of the 7 references, most of them are journalistic articles and not actual scientific research.

The question is 'does wearing masks out in the public decrease virus spread, when social distancing measures are already in effect?'.

One linked (not cited...) research examines virus transmission and effects of mask use in a hospital setting - irrelevant for the question.

Another examines filtration properties of homemade masks, and concludes that they have little if any effect if not used with other measures, and doesn't (!!!) recommend their use.

A third one, a SCMP journalistic article refers to a Chinese scientific journal article that has been retracted.

I don't find these as very compelling arguments.

https://docs.google.com/document/u/0/d/1HLrm0pqBN_5bdyysOeoO... (linked on the page) was what I was referring to, not the list of references which I agree are not very compelling. SSC did a writeup too: https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...

Thanks for sharing more detailed thoughts!

We need to use our own common sense here sometimes, and the WHO are not making sense here. Kind of how they don't make sense regarding Tiwan and breast feeding. The WHO is being careful to say don't wear a mask unless you are ill, but with this virus we don't know until several weeks after we are infected, they are also mixing recommendations for non medical staff with recommendations with medical staff.

It is not that WHO is lying, it can be misinformed or just do not know something. Previous global epidemic happened over 100 years ago, so I don't blame them for lack of knowledge.

We all have to learn and try new things, so if WHO says "mask are not helping" while there are evidences (maybe just correlation, but we just don't know for now!) that in some countries masks seems to help we should ask WHO if they are really sure. BTW: the fact that WHO pretends that Taiwan does not exists does not help investigating masks/no masks question.

"Wear a mask if you are coughing or sneezing" - sure, the problem is that even if someone breaths normally, talks normally can spread the virus. The problem with the coronavirus is that it has long incubation time. Someone might spread virus without having any symptoms.

My masks protects someone else, not me (unless I am wearing some pro stuff), as I am not spreading virus 2 meters around me, but 50 cm - maybe this is not that much, but in case of something that spreads according to power laws it might be a visible factor.

So the WHO doesn't know but some random techies on a forum do? That's absurd.

Some random techies on a forum, as well as East Asian governments and medical experts. But hey, what do they know.

But it's not an East Asian government or a medical expert who made the website that started this thread, is it? It's fasteddie31003, whose HN profile reads "Software engineer in San Francisco."

Leave the medical advice to medical experts, just as you expect the medical experts to keep their mouths shut about the advantages of Rust over Go or whether Vue is the right choice in 2020.

You mean like [0][1][2]?

[0] http://www.chinacdc.cn/yyrdgz/202001/t20200123_211390.html

[1] https://www.coronavirus.gov.hk/eng/health-advice.html

[2] http://www.cdc.go.kr/index.es?sid=a2

Well I can't judge [0] and [2] for rather obvious reasons, but [1] would have been a much better link than what was posted, and it has a much more differentiated views on masks. The website that started this thread is plain bad. The Hong Kong page [1] contradicts OP's site in its recommendation of N95 masks ("N95 respirators are generally not recommended for use by the general public in community settings because special training is required for proper wearing and removal of the mask. Otherwise the infective risk due to inadequate protection and contamination may be ironically increased." [1] vs "N95 masks are better than surgical masks" on the OP's site).

Then there's stuff like "Going in public without a mask in a pandemic is like riding a motorcycle without a helmet." That's bad because it implies that surgical masks protect you, but all the information by actual experts seems to say that they generally don't, and that their primary purpose is to prevent the spread of the infection by people who don't know they have it.

I mean, the page even admits that "We only have anecdotal research at this point" on the efficacy of masks. Yet the headline claim, "Western countries are experiencing higher rates of COVID-19 infections compared to Asian countries because of the West's aversion to wearing masks", implies direct causation between mask wearing and infection rates. Why should anyone trust someone who makes such elementary mistakes?

We need the computer people (myself included, obviously) to keep doing the computer things and leave giving medical advice to the medical experts. The OP's website is bad and they should take it down.

I think saying “misinforming”, “dangerous”, or relying solely on the generic guidance of the WHO is a bit strong.

I think common sense prevails. Wearing equipment that filters airborne particulates will expose a person less than going without.

Personally, I would prefer being overprotected versus becoming a statistic in a WHO researcher’s Excel spreadsheet.

"Common sense" leads to empty aisles that are usually stocked with toilet paper.

I think that points more to how fragile the world economy is. You have a personal choice where you can do everything to increase your chances of survival, or go with common/generic advice that’s provided to society as a whole. I guess it depends on what your goals are.

My goal is not to be an asshole, and to survive too, by listening to people who actually know their shit instead of using their "common sense" to guess. If we relied on common sense, the earth would still be flat, and we'd still prohibit women on their period from pickling food.

Mask wearing is mandatory in several countries. This is not a situation where people are making shit up, this is a situation where you have several authorities saying different things. In the absence of solid evidence, applying common sense to evaluate the arguments of those authorities is a lot better than just picking one of the authorities and proclaiming "This is the truth!"

Hi,

Your comment fails to offer a counter-argument to the comment you are replying to; you are just repeating the position that the comment explicitly refutes.

> Or are you stating that the WHO is lying?

In fact, the site linked in the comment explicitly states that.

It refutes nothing — it's some layperson's uneducated opinion based on a couple of cherry picked statistics (as gombosg already pointed out).

Let the epidemiologists guiding global responses to the pandemic provide guidance and everyone else should call out anyone trying to peddle their own made up conclusions.

A grocery store aisle is about 4 feet wide.

Given the minimum 6 feet of social distancing, then there is no room for maneuvering around people here.

And all it takes is for one idiot to cough in your face without covering themselves, while you are walking past them, to get sick.

And now, you have a 14 day incubation window, to wait to see if you indeed got sick from this person.

The point of masks is that everyone must wear it, while in public. No exceptions are allowed.

This is a team effort. And all it takes is one person, to screw it up for everyone.

If someone coughs in your face then you're probably going to get infected whether you wear a mask or not, because the virus can get in via your eyes, and none of the "wear masks all the time" people are telling you to also wear eye protection all the time.

2019-nCoV transmission through the ocular surface must not be ignored: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

And furthermore, even if the virus can't directly infect you via your eyes, the virus particles can move from the eye area to the nose/mouth after removing a mask, e.g., by touching one's face (even with washed hands) or when taking a shower or washing one's face.

> none of the "wear masks all the time" people are telling you to also wear eye protection all the time

Huh? The earliest local news article I could find[0][1] that mentioned the importance of wearing glasses and goggles was back in January. But we didn't wait for the authorities to tell us -- we did our own research, and I purchased my pair of goggles in mid January.

[0]: https://news.rthk.hk/rthk/ch/component/k2/1504801-20200125.h...

[1]: https://www.reuters.com/article/us-china-health-hongkong/hon...