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Comment by trixie_ | Hacker News Reader

If it's raining you bring an umbrella, if it's hot you wear shorts, if there's a pandemic you wear a mask - everywhere all the time. They shouldn't of let people on airplanes, buses, buildings, etc.. without a mask. Don't have one? Here's some scissors cut up a tshirt, or use a scarf. It doesn't need to be N95 perfect. Just a barrier to keep you from touching your face, and to catch a good amount of spit flying out of your mouth every time you open it. Grocery stores, gas stations, offices that are still open, private social gathering, etc.. still no one is wearing a mask (in America at least) Asia was way ahead of us with their health culture on this one, we need to step it up. Unfortunately it's a message that really needs to come from the highest levels. The politicians, news casters, etc.. on TV need to be giving announcements with masks to get the point across.

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It seems like the authorities in the US tried to downplay, even discourage, using mask if you're asymptomatic to prevent people from stocking up and depriving medical professionals of them.

And of course, if you discourage mask buying you're discourage mask manufacturing. The Noble Lie from the High Modernist civil servant versus the free market and a world that's far too complicated for him to understand.

> if you discourage mask buying you're discourage mask manufacturing

how is this true?

Masks are made by manufacturers with the intent to sell them, so if you reduce mask buying and force down mask prices you will reduce the manufacturer's incentive to come up with amazing ways to turn out massive quantities of masks, and you discourage them from preparing in advance for the next pandemic.

you sound like a maximalist capitalist.

We already have a shortage of masks, though... all the incentives to make more masks are there, but we aren't making them fast enough.

I'm pretty sure everyone who can manufacture masks are doing so. Markets can only adjust so fast and we don't have time to wait.

There are two exceptions: one, people who can manufacture masks at great expense but not at market prices. Two, people who could stock up on masks for the next pandemic but now won't because they'll expect the government to disparage their product.

Yes, and this is the correct decision. How many people do you know that are physically ill with COVID-19 that you have to be around for 8hrs a day?

I know 0, and my self-isolation prevents me from being near anyone who is asymptomatic.

By wearing a n95 mask you are giving doctors the middle finger.

I think we underestimate how many of these things are actually floating around. Tons of people have some for painting, sanding, wildfires, construction, etc. They're used extensively in all kinds of jobs. Just 3M, before the crisis, was making 50 million masks a month.

People need to dig around in their garage and get these things out, and then start wearing them. Even the disposable ones can be reused many times, particularly for someone that is just at the grocery store and not intubating COVID patients or something.

I'm sympathetic to the argument that healthcare workers need them, but healthcare workers also need people to wear them so that they don't get sick and show up at the hospital!

Even worse, the US Surgeon General claimed that masks are "NOT effective" for the general public. https://twitter.com/Surgeon_General/status/12337257852839321...

Not just US authorities, but WHO[1].

[1] https://www.cnn.com/2020/03/30/world/coronavirus-who-masks-r...

Like I said, they should of said don't buy a mask - use a tshirt or scarf. You can't get on plane or go into a store without covering your face. Perfect is the enemy of the good.

Yes, face masks are common sense measure to prevent respiratory illness from spreading. Yet, U.S. CDC kept saying don't wear masks even till this date, kept giving Americans the lies of "false security" of wearing mask. I get the intention of preventing a run on precious N95/surgical masks that hurt healthcare workers - but come on, we should have use Defense Production Act to compel factories to make masks and increase productions as wells as impose strict purchase limits and regulate the market on the masks instead of telling people masks are unnecessary. This is to me the 2nd biggest failure of CDC leadership after screwing up with the COVID-19 testing kits.

By the way, we learned that a century ago during the 1918 Spanish flu pandemic - wearing masks help, even with non-N95 masks. Influenza could also caused by corona viruses, also transmitted via droplets primarily, just like the SARS-CoV-2

If we had prepared this response is fine.

However we didnt, so stop promoting ordinary people wearing masks.

[1] Masks protect other people from you spreading the disease if _you_ are sick. This is true, unless you spend your day around covid-19 infected individuals all day long for your job. [2] Doctors and nurses need that mask. They are the ones who spend their day, risking their lives and their families health to treat these people.

Even now the risk of contracting the virus, if you are following isolation protocols, is extremely low.

> However we didnt, so stop promoting ordinary people wearing masks.

Masks reduce risk.

> [2] Doctors and nurses need that mask.

Here's the reason, right here.

Seems like we didn't prepare. There should be enough masks for healthcare professionals and ordinary citizens.

Nobody is debating that, but if it’s between healthcare professionals and everybody else, it’s obvious who should receive priority.

Self-isolation reduces the risk by the largest factor, maybe up to the 99-99.5% level. Guess who cant self-isolate? Doctors.

Wearing a mask, if the entire population is infected, provides a benefit because you are surrounded by infection. Guess which person spends 8 hours a day in a highly infected population? Doctors, especially in the intensive care unit.

If you were worth as much to humanity as a doctor, as an ordinary person, your logic would save fewer lives. However it would increase your chance of being saved.

so stop promoting ordinary people wearing masks.

Stop lying to people that masks aren't effective. Not only does that put people in immediate danger, it makes it more difficult to walk back that advice in a few months, when we're definitely going to want everyone to wear masks when in public.

Doctors and nurses need that mask

So make your own. Even half of a t-shirt is much better than nothing.

The CDC and WHO leadership is a joke. They've failed to take a divisive stand for public safety and have caved to the demands of politicians.

I don't think they'll earn back respect for at least a generation. People won't forget this.

It's not a joke, what WHO did was clearly on purpuse, there's enough evidence now. ,,joke'' would mean incompetency, but what's happening is much worse, and closer to cold war.

The only thing the Defense Production Act is going to help, is placing the federal government at the front of the queue. You can’t spin up a factory that makes X into one that makes Y without months or years of retooling.

By the time more mask factories are up, the capacity will no longer be needed. Same goes for ventilators. Too little too late; shouldn’t have outsourced manufacturing to China a generation ago.

If we had that manufacturing capacity here we would face similar issues since those factories would ideally be shut. If not shuttered, their labor forces would be suffering along with productivity as everyone gets infected.

The better solution is diversification of global supply chains which benefits all countries long-term.

It's OK using same mask every day. It still helps the virus stay local. CDC should tell everyone to wear masks right now.

If we just tell (or force with fine) everyone to wear a mask and have their mouth covered whenever in close proximity with some other person, we can go back to usual life. What's so hard about this?

Like I said, the mask doesnt need to be perfect. A cut up tshirt, bedsheet, or scarf is fine. The point it to keep people from touching their faces and to serve as a barrier for a majority of the large particles exiting your mouth when you open it.

Everyone should wear a mask.

Thought experiment: Take a small sip of beet juice and then simulate a sneeze or a cough while standing several feet in front of your clean white wall. Next, take another sip, wrap a handkerchief around your face and then sneeze / cough / spit. See how far that "virus juice" flies when you wear a mask?

If everyone wore a mask, then all the people who are sick are effectively increasing their social distance from the healthy people. Even if the sick person walks within 6 feet of you, their effective social distance might be greater than 6 feet if they are wearing a bandana, t-shirt, surgical mask, etc.

Wearing a face mask works on a population scale. Everyone should be wearing a mask.

Disclaimer: you will have a beet colored wall, which will not be a joy to clean up. Also your mouth will taste like beet juice.

> if there's a pandemic you wear a mask - everywhere all the time

I thought the expert advice from the WHO is to not wear a mask?

> There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit. In fact, there's some evidence to suggest the opposite in the misuse of wearing a mask properly or fitting it properly.

Do you know better than the WHO?

Yes, see my comments here: https://news.ycombinator.com/item?id=22727995

It's bewildering the US and European guidance on this.

Edit: read this carefully: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2843947/ It will apply to SARS-CoV-2

Why do you think the WHO disagree with you on the facts? It doesn’t seem likely to me that they’re just less informed than you are.

Did you read the paper I linked? Read it, and then tell me what the facts are. Whether or not they are offering advice based on facts or political considerations is a matter of debate. There is no real meaningful debate on the mechanisms of influenza transmission. 1 mechanism is decidedly airborne. How else can you reasonably explain infection rates? Hundreds of thousands of people are letting other people sneeze directly on them? The literature is clear about this, frankly I have no idea what the WHO is smoking.

I'm not qualified to read and evaluate medical research. Are you? I rely on the WHO to understand the situation and what's best for everyone.

Yes, I work at one of the major universities in the US. Watch over the next week as the guidance on this changes.

Frankly, you don't need to be 'qualified' to read review articles in this area--I encourage any logical citizen to do so. Specialist articles?...sure, it's unlikely you will gain much from reading those.

> Do you know better than the WHO?

Apparently.

The one thing I learned from this pandemic is to distrust scientists at the WHO and the CDC and to read the primary literature directly. These folks are far too involved in politics.

If you're not stupid this is clearly to avoid people hoarding on masks which the hospitals are in dire need of.

> If you're not stupid this is clearly to avoid people hoarding on masks which the hospitals are in dire need of.

Better "trick" the public then.

Non, the CDC already had a policy of advising against masks before this pandemic. https://www.cdc.gov/h1n1flu/masks.htm

One way to address mask hoarding in the Czech Republic has been a ban on selling any masks in the categories needed by medical personnel to anyone else than the state, which then bouth the remaining stocks a redistributed them to hospitals, first responders, etc. Similar thing has later been done also for some medicaments that looked promising for treating those seriusly sick with covid-19.

Doing this really seem like a much better way to handle the situation than giving a really really dangerous false advice like this.

Everywhere's the same on this, back and forth about this need vs population at large.

Obviously there's a need that's not being met, but it's nearly two months since masks became hard to acquire.[0] Can we not change the official recommendation to "make a cotton mask and wear it if you go out for groceries; here's a template. Don't use N95 masks, instead donate them"? It would be great to have numbers on this.

[0] anecdotal, Bay Area.

Looks like mask production has been ramping up since January, at least. But numbers of the big picture would be neat to see. https://www.wired.com/story/surreal-frenzy-inside-us-biggest...

I don’t know anything about you but I really struggle to understand that you’ve got some insight into the literature that the professionals at the WHO are missing.

Seems to me that the biggest problem we have is lay people thinking they know better from reading random isolated papers without context and doing their own thing against advice designed to make everyone safer.

Ask the the front line ICU doctors and nurses, they know better.

Yes, it's absolutely essential in these uncertain times that we do not allow ourselves to be led astray by our own best judgement or common sense, but instead rely upon the expert guidance of organizations such as the WHO.

https://mobile.twitter.com/WHO/status/1217043229427761152

I mean they explicitly stated that it's preliminary.

You beat me to it. Regardless of how much you believe arguments from authority, The WHO has lost its place as an authority after their recent actions.

Maybe that’s what the data supported at the time?

Shouldn’t we be going with data rather than ‘common sense’?

Sometimes you have the luxury of multiple trustworthy parties having already each done a large sample size peer reviewed double blind study on just the question you want to know the answer to and have all come to the same conclusion.

Other times that hasn't happened yet and you still need to make a decision about what to do today, not after six months of further study.

You should apply your best judgement given all data available. Take neither common-sense nor study results as gospel.

HN has featured multiple studies on the effects of wearing a cloth isolation masks. They all found it reduced the chances of catching it by over 50%. That's well worth it in my opinion.

And to add to that - the other if not the main benefit of masks is it reduces the chance of transmission from infected people, if they do not know they are infected but wear a mask.

But the WHO say this is not the case. Who should people be listening to?

From what I've read in various articles WHO just says masks might not be 100% effective at protecting you and that's it.

As far as I can tell, they are not saying anything about the other much more important aspect of masks protecting others when everyone wears them.

And that's in my opinion very very wrong and is most likely already costing many lives...

> From what I've read in various articles WHO just says masks might not be 100% effective at protecting you and that's it.

They say there is not enough evidence to back up the idea that the general population wearing masks has a benefit to everyone.

> There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit.

> I thought the expert advice from the WHO is to not wear a mask?

IIRC the CDC recommended against early on, I don't know about WHO or where CDC stands on it now. But interviews like:

https://www.sciencemag.org/news/2020/03/not-wearing-masks-pr...

from other experts give reasons why it is effective:

Q: What mistakes are other countries making?

A: The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others."

// end of interview comment.

Could it be that CDC knew knew masks worked, but didn't want people to stockpile them? Or could it be that most people won't wear them effectively? No idea which, or both.

I believe the right thing to do is to ramp up mask production and try to get a very small number per capita (after healthcare workers have sufficient) to the sick and general population, especially around areas like NYC. Then educate people on how to wear them.

My interpretation is that initially the public needed sit back and let healthcare providers acquire masks, but now it's time to cobble together something to wear when leaving the house, while still observing all other protocols.

I really want to see solid numbers of this comparing cultures/countries with mask wearing to those without.

I'm not convinced masks help either way.

My wife was a nurse in Japan (a big mask-wearing culture) and I was always skeptical of it but from reading some articles of late, I've changed my stance on it and do believe that masks help. Here's some articles I've read lately that discuss this topic:

https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...

> Some people with swine flu travelled on a plane from New York to China, and many fellow passengers got infected. Some researchers looked at whether passengers who wore masks throughout the flight stayed healthier. The answer was very much yes. They were able to track down 9 people who got sick on the flight and 32 who didn’t. 0% of the sick passengers wore masks, compared to 47% of the healthy passengers. Another way to look at that is that 0% of mask-wearers got sick, but 35% of non-wearers did.

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

> ...the vice president of Taiwan, a prominent epidemiologist, gave regular public service announcements... These announcements included when and where to wear a mask, the importance of handwashing, and the danger of hoarding masks to prevent them from becoming unavailable to frontline health workers.

https://www.researchgate.net/publication/258525804_Testing_t...

https://www.maskssavelives.org/

>I thought the expert advice from the WHO is to not wear a mask?

From what I gathered from their guidance the basically say masks are not effective enough to protect you & people do not know how to use them.

Well, the problem is that how well the mask protects you is at this point int time actually a secondary concern. The biggest issue is protecting others from you when you are infected and do not know that yet, which is a very big problem for covid-19 due to many asymptomatic carriers.

Even a piece of cloth covering your mount and nose can reduce the amount of infected droplets you generate be sneezing and breathing significantly if not totally stop transmission barring really close physical contact, so there is really no good reason for everyone not to wear a mask.

That WHO is totally neglecting this aspect of the mask protecting others is almost criminal negligence.

> From what I gathered from their guidance the basically say masks are not effective enough to protect you & people do not know how to use them.

Why give them to nurses and doctors then? It would suffice for the patients to wear them. If they do work at protecting you, then let's say a patient can't wear one, should you wear one? The answer is yes. Therefore the only logical conclusion is that an N95 mask protects you.

A properly worn N95 mask protects you. Any kind of mask protects other people.

WHO said January 15 that there was no Human-Human spread of SARS-CoV-2. They are a politicized organization and you should not depend on what they have to say for unbiased factual information.

There is ample scientific evidence that masks work both to prevent being infected and to prevent infecting others.

The argument seems to be "there is sufficiently low risk from normal daily activities that it's not worth wearing a mask." If that's the case, why can't I leave my house except for groceries? How did all of those people catch this thing if the risk is so low? The reality is that the risk for everyone, given the severity of COVID is high. The risk for healthcare workers is beyond extreme.

>Unfortunately it's a message that really needs to come from the highest levels. The politicians, news casters, etc.. on TV need to be giving announcements with masks to get the point across.

This is how it happened here in Czech Republic - one day as part of the emergency measure face masks (including home made ones) have been made mandatory in public, fullstop. Don't wear one & the police will request you to put on one or face a fine.

This we we went from you in public getting weird looks if you have a mask to anyone not wearing a mask getting weird looks in about two days.

Since then the neighboring country of Slovakia to the east adapted the same rules for mask wearing in public and most recently Austria to the south adapted mandatory mask wearing in shops.

It doesn’t help that almost every news outlet in the US, including medical professionals, said masks are useless if you aren’t sick. I followed that advice unfortunately.

They purposely lied to us under the belief that the lie stopped people from hoarding masks and thereby left them available for medical personnel.

Went to the UW* ER, not for corona, wearing a mask. Doctor came in, gave us funny look, "Why are you wearing those?" Doctors and nurses weren't wearing masks within the ER area. They said that if you have corona, or symptoms, they give you a mask, so when he came in the room and saw us in masks, was worried there had been a mix-up.

* University of Washington, in Seattle.

And this is why we have a problem. We have the power to slow the spread, but culturally masks are unacceptable. So unfortunate.

Also, wear a set of goggles at all times. Please prevent the particles from being contracted in your eyes.

http://www.virology.ws/2018/03/01/influenza-virus-in-the-eye...

While this is perfectly good advice, people who advocate universal mask wearing are more focused on reducing spread _from_ the infected.

Perfect is the enemy of the good, that's why people are obsessed with surgical masks and n95 masks. Simple homemade masks are good enough. Plus they prevent people from touching their own faces.

"There's no reason to walk around wearing a mask." - Dr. Fauci

1m27s video -- https://www.cbsnews.com/news/preventing-coronavirus-facemask...

Hindsight is 20/20. Our “leaders” were encouraging people to go to crowded Chinese New Year celebrations just one month ago!

Do you think they were ready to stop airplanes and require people to wear mask back then?

Is it hindsight if you’re warned weeks or months ahead?

Are things still open where you are? I've legitimately been WFH for the past two weeks and have avoided going into public except when absolutely essential. And that's in line with everyone I know up here in Canada.

The two runs we've done were to the super market & pharmacy (about a week and a half ago) and to my wife's office building since she needed records of employment to let folks start collecting unemployment. At this point a mask is a good idea - but simply not going out is a better one.

Very good idea for those things you need to go out for (like groceries) though. And as the OP says, if it came from the top that everyone should be doing this, using homemade masks if necessary, the social norm could be turned around overnight, just like it was with social distancing.

You should not let people in planes in a pandemic, face mask or not; even with a mask the risk is simply too high for spreading the disease during all the touches during boarding, seating, opening/closing storage bins etc. Even with gloves it is not safe enough.

A full bio-hazard suit is too expensive and quite impractical, less than that is not safe.

Perfect is the enemy of the good. The point is to slow the spread, flatten the curve. Eliminating it is not an option. Shutting down all travel 100% is not an option.

Mandating everyone in airports, on planes, etc.. must be wearing a mask is 100% possible and would have slowed the spread. Don't have a mask? Here's some scissors, cut up a shirt in your luggage and make one.

> still no one is wearing a mask (in America at least)

In Seattle, I'd say around half of the people I've seen in public are wearing masks this week.

The gap between stitches in a shirt is a gaping hole to a virus.

AFAIK, masks are (mostly) not for the virus, they're for the droplets. The droplets are much larger.

[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785820/

[1]: https://www.ncbi.nlm.nih.gov/pubmed/18158720

T-shirt fabric was found to be 75% effective at stopping droplets from spreading in a study[1]. That’s pretty remarkable considering and 95 masks are 95%! I guess that makes them N75 masks?

1. https://www.researchgate.net/publication/258525804_Testing_t...

the "95" part of N95 means it filters 95% of particles smaller than 0.3 microns. A sieve that can filter 95% of rice particles doesn't make a N95 mask either.

You're may be right. But if you wear a mask how does the facial recognition reliably identify you?

I'm only partially joking. For example, McDonald's doesn't allow Halloween masks inside the store to discourage robbery.

Honestly, disallowing Halloween masks in businesses isn't a generally bad stance - there aren't legitimately good reasons to allow them.

I agree, in fact I think it’s a perfectly reasonable stance. I’m just asking about the implications of widespread mask use to a society that generally does not use them. I’m not discouraging the use of masks if it benefits public health.

Stop promoting this. [1] Masks protect other people from you spreading the disease if _you_ are sick. [2] Doctors and nurses need that mask.

Even now the risk of contracting the virus, if you are following isolation protocols, is extremely low.

People who interact with individuals who are sick and need treatment are putting themselves and their families at risk because of you.

Masks largely protect other people if you are sick, yes. Even if you don't know you are sick. They do also provide some protection for you against others. And finally, it doesn't need to be an N95 mask, or even a surgical mask. A scarf or piece of t-shirt still blocks a lot of droplets. All the actual studies I've seen suggest that masks are indeed effective. I suspect that the reason it's been suggested they aren't is due to fear of the shortages you mention. So yes, people shouldn't be hoarding masks. While there's a shortage, non-medical professionals should use homemade masks when they have to go out for essentials.

The isolation measures are doing a lot more than this. Given that you are promoting every one doing this, I would wager that people who are busy or do not understand this guidance would believe they are protecting themselves by wearing a mask.

This false sense of security erodes basic isolation and sanitary measures which are more protective.

I understand people want to feel safe, its better for them to be safe.

There are also people who feel safe and continue to go out without a mask.

People should avoid public spaces where possible, yes. But we still need to get groceries, maybe go to the doctor, a lot of people still have to go to work, etc.

Right now they are scrambling to cushion the blow on the hospitals but by doing so they are putting off the inevitable need for people to get and defeat the virus so we can have herd immunity. Without this old people are still going to be at serious risk once we let everyone out again.

Step 1. Avoid old people and just do normal life, build an immunity.

Step 2. Now enough people are immune we can hang out with old people again.

But we are at Step 0 and are making a big delay for steps 1 and 2 which will still need to happen. There’s a big risk the second wave will be more tragic than the first if people don’t realize it.

The reason why this plan doesn’t work is because 20% of people who get this disease (regardless of age bracket I believe) require hospitalization and a good number of them require an ICU bed. There simply aren’t enough beds or health care workers to address the demand shock that would happen without social distancing, which means people dying at home waiting for a bed.

What is the alternative? Shutting down doesn't work either, because it's not possible to shut down until cases worldwide go to 0, so won't the outbreak just start again after things reopen?

The Brits had that plan for a while but gave up after a few days. I think they realized that the numbers don’t work.

The whole reason for social distancing and #flattenthecurve is to delay mass infections long enough for the scientific/medical establishment to develop a vaccine or, failing that, effective treatments. There's an understanding among policymakers (though perhaps not in the general public) that either everyone's going to have to get it, or a vaccine's gotta be developed. The problem is that with a 2% mortality rate, "everybody's gonna get it" is 140 million deaths, the largest mass casualty event in history. This is a lot like one of those movies where an asteroid is hurtling to the earth and a bunch of random oil roughnecks need to detonate a nuke inside it - it's a hail mary, but not doing anything is not an option. The hope is that the biomedical industry can develop a vaccine, effective treatments, or at least a lot more ventilators and hospitals to blunt the impact before everyone gets it.

It's not just old people who are at risk, BTW. With medical treatment the death rate of under-40s is about 0.2%, 30x less than the ~6% of over-65s. However, young people are still hospitalized at roughly half the rate of old people; if the hospital system is overwhelmed we can expect a death rate of ~5% of young people. That's about a 10 million young people in America alone. That's why it's so important to delay the epidemic long enough to build enough hospitals and ventilators to treat everyone.

> The whole reason for social distancing and #flattenthecurve is to delay mass infections long enough for the scientific/medical establishment to develop a vaccine or, failing that, effective treatments.

This is extremely unlikely unfortunately, most flattened curves end up overtaking the populace at large - the more crucial element to control is the proportion of the population that's sick at any given time to avoid overwhelming healthcare or logistic resources.

I think the factor you're missing here is the hospital bed ratio. When folks, even healthy folks, get Covid-19, it can go badly - so all this social distancing is to let it spread really slowly through the populace - maybe so slow we get a vaccine, but probably not... And while it is spreading we'll ideally have enough healthy people to actually care for the sick ones because if you and everyone around you is bed-bound then people can die from pretty trivial complications of the disease including just starving to death.

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