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Comment by woofie11 | Hacker News Reader

I was hoping everyone in the US might be able to buy one.

Ideally, they'd be cheap enough for municipalities to buy and distribute.

> I was hoping everyone in the US might be able to buy one.

This burst of PPE being produced in mass quantities are and were never meant to go in the hands of the general public (i.e., non healthcare workers), though. The general public does not need to be walking around with a full face shield, that’ll be a waste of materials, time and money, unfortunately.

Given that they probably would cost $1 to $5, and take almost no space to store, it wouldn't be a terrible thing for people to have a few if they want them. How many people have a $20 multi-tool that stays in a drawer somewhere? Or some bags of rice "just in case" that end up getting thrown in the trash after being forgotten about in the cabinet for 5 years?

It may not be a terrible thing if some percentage of people buy "unnecessary" Personal Protective Equipment. It creates some distributed supply in case something unexpected happens, even if under normal circumstances the equipment is unused.

What about the environmental impact of people buying everything "just in case?" Should we be stockpiling oil like crazy right now when prices are low just in case (while also artificially driving up demand)?

Isn't one of the key criticisms of farm and manufacturing subsidies that they are wasteful uses of our budget while one of the arguments in favor of them is that it maintains our infrastructure "just in case"? What about trying to buy out a foreign company to control a coronavirus vaccine or mandating that all domestic companies fulfill federal government orders before any international orders so that we have enough materials "just in case"?

My point here is that the just in case attitude for non-essential goods like PPE normalizes the same thinking in other arenas and it is unclear where we should draw the line. It is a slippery slope.

Yeah but he said face shield

If we did more "just in case" and less "just in time" we'd be in a much better situation right now. Maybe we need a better tradeoff between efficiency and resiliency.

> Should we be stockpiling oil like crazy right now when prices are low just in case (while also artificially driving up demand)?

yes? there's a national strategic oil reserve. that's exactly the thing it should do.

That line of thinking would've made sense a year ago, but the problem now is that "the unexpected happened". Now even things that cost $1-5 to manufacture can't be manufactured fast enough to meet demand (which is probably something like 100 million to 1 billion masks). If we can't get PPE to all of the healthcare workers or even most of them (and right now we can't) then there's no way they should go to the general public.

100 million or a billion look a lot in normal circumstances. But currently the global demand is probably your numbers times 100.

Here, in the Netherlands we heard they need 4 million facemasks a week. And we're a very small country!

It's not about the money. PPE like face shields are specifically used during procedures that involve significant bodily fluid, like intubation, which is the process of pulling or pushing a tube down a patient's esophagus. Going to to the grocery store does not require a shield.

Secondly disposable medical equipment, when used properly within a healthcare environment, is extremely wasteful. For most consumable items used in a hospital, they are covered in packaging with specific serial numbers and lot numbers that allow reconciliation if it's found that the goods are not sterile or have deficiencies. There is also a provenance or chain-of-command aspect that allows attestation of safety throughout the entire supply chain. While we might be talking about how to sterilize n95 masks, reuse face shields, and asking for donations of PPE from the public right now during a pandemic, the fact remains that in normal circumstances there is massive liabilities that hospitals and clinics would be subjected to if they started sourcing protective equipment from the public that could have been tampered with, may be slightly used and broken, or otherwise could cause harm to the patient and they'd be unable to identify the source of those resources. Everybody stocking a "handful" of PPE isn't a scalable solution to maintain a national supply.

This is one reason why we pay federal taxes.

Stanford hospital, for example, throws away one N95 per patient doctor visit. They are not sterilizing and reusing. So my friend who works there is using many dozens of them per day. It seems like they could come up with material-preserving procedures like sterilization, but they're not.

Because best data to date is that sterilization procedures damage the mask in ways that render it unsafe.

When someone comes up with data finding a safe way to do so, the masks won’t go in the trash. In the meantime, I’d you have the masks to spare, you -should- be using them safely. Masks are pointless if you use them in a way that will get you sick.

Says something about our society, though, that doctors at Stanford can use a mask per chat "just in case", while just across the bay at Oakland Kaiser nurses are working with multiple confirmed coronavirus patients on a single mask...

What does it say?

It seems to me that pretty much every society has struggled to deal with this. Perhaps because it isn't something that has many reasonable direct analogues in our collective experience?

It is very easy to spot deficiencies after the fact. Much harder to spot them before.

It says that there's massive inequality?

I don't think it says that at all. You can't cherry pick two particular institutions and draw some sort of conclusion about "society". In this particular case it seems like the entire conclusion is based on nothing other than preconceived notions of what reactions "Stanford" and "Oakland" trigger in the reader. There doesn't seem to be any particular details about the actual situation at either location and how those institutions are managed.

If anything his comment reinforces negative stereotypes about the two regions. So many people in the Bay Area look down on Oakland like it’s a blighted disease-ridden wasteland and think the peninsula is some kind of haven for the rich and well off.

For reference, one of those institutions is in Palo Alto and the other is in Oakland. While Oakland has been massively gentrified it's still much more affordable to live in compared with Palo Alto.

It's says that some people can't resist spreading rumors and jumping to conclusions. You have no idea how long standard docs are stretching masks.

zbrozek says his/her friend works at Stanford and says this. Is there a reason to doubt this?

Maybe someone like the CDC? https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/d...

You seem confused. This is a complicated topic. That CDC says sterilizing masks is not a safe practice, but in a crisis it's better than having no mask.

> When someone comes up with data finding a safe way to do so

There's the data and very clear recommendations by the CDC on when and how to do it. Whats' the confusing part? I don't think anyone is suggesting this approach during non-crisis times.

>Because best data to date is that sterilization procedures damage the mask in ways that render it unsafe.

There are multiple sterilizing procedures, and multiple material compositions for masks. Which ones were you referring to?

This is untrue. Stanford Medicine released a study around March 22.

The TLDR is 70°C heat for 30 mins. Avoid alcohol, it kills the static charge in the mask fibres.

https://m.box.com/shared_item/https%3A%2F%2Fstanfordmedicine...

No, THAT’s untrue. Look at your own link. You can sterilize the mask to preserve its filtration ability, but no one has shown it maintains fit. A poorly fit N95 is no protection at all, which is why hc workers get formally fit tested when starting a new gig. Which is why That link makes “no one knows what it does to fit” one of its top line bulletpoints.

> A poorly fit N95 is no protection at all

There’s no plausible mechanism of action for masks under which this is true. A properly fitted N95 will block 95% of particles which is less than the kind of hazmat spacesuit with face shield and positive air pressure you’d ideally be wearing if working with someone with Ebola or similar. Maybe it really is impossible to get proper fit on a reused mask. Perhaps it’s only as good as a normal surgical mask which blocks just under 90% of virus sized particles.

Every reduction in the amount of virus that gets into your lungs makes it less likely that you’ll get infected and if infected gives your immune system more time to ramp up. That’s why people care about viral load. Running through someone’s cough is less likely to kill you than being in a small poorly ventilated room with someone coughing uncontrollably for minutes at a time.

Like this one: https://news.ycombinator.com/item?id=22680799

The problem is that there isn't a known safe procedure for sterilization. Universities are working on that: https://news.engin.umich.edu/2020/04/engineers-work-to-decon...

They're setting up one of these[0] in Boston, allowing hospitals to sterilize and reuse 80k masks / day. There's an article[1] in the Boston Globe about it, but I'm not sure what the paywall situation is there.

[0] https://www.battelle.org/inb/battelle-critical-care-decontam...

[1] https://www.bostonglobe.com/2020/04/02/metro/boston-hospital...

"Everybody stocking a "handful" of PPE isn't a scalable solution to maintain a national supply."

No, but there's no harm in it either, and some potential benefit in case it takes a few days for the federal government to organize a response.

We all assume the government is going to make sure the food supply is maintained, but everyone is also buying some extra food just in case there's a temporary gap.

We don't need to choose just one way of preparing for the unknown.

Also, I was just saying the general public might purchase a few of these masks for themselves for their own use, not that hospitals might rely on the public for supplies.

For what, though? And I'm 100% being honest here, what is the specific situation you are envisioning that requires a face shield in your home?

In a medical setting, shields are typically used in conjunction with eye goggles and respirators when performing procedures that have a tendency to cause or be around splashing body fluids. Outside of someone sneezing or spitting on you directly, I can't think of an analogous situation that I come into on even a rare circumstance that a face shield would protect me from.

It's the same mentality as people buying guns.

What situation that could conceivably arise from a pandemic requires an automatic rifle?

It's a generalised sense of "bad things are happening, I need to be prepared for bad things to happen to me".

I don't think that's why people prep and buy guns.

> "What situation that could conceivably arise from a pandemic requires an automatic rifle?"

Good thing that automatic rifles aren't available for sale to the civilian market[1] then, I suppose.

[1] Yes, the pedants will point out that it's theoretically possible with special licensing but it's very uncommon.

Apologies for not understanding the differences between various types of gun and misusing the term.

Still, the point remains - what situation could possibly arise from a pandemic that would require a <insert any type of gun here>?

How about this? https://www.newsweek.com/coronavirus-gun-sales-asian-califor.... Asians don't exactly fit the traditional stereotypes for firearms purchasers but the attacks described and similar bad behavior directed at international students from Asia on college campuses certainly show that there are people out there willing to attack them based on imagined threats and therefore some level of concern by Asians for their personal safety is merited.

I notice that it's "the media are telling them that Asians are being targeted", not "Asians are buying guns because they're suffering from racist attacks". Again, the belief that people will do bad things to each other when order breaks down is much more prevalent than the actual incidence of people doing bad things to each other when order breaks down.

I'm not saying it can't happen - there are always racist assholes out there. But the media will tell one story of a racist asshole harassing an Asian family rather than 100 stories of people being genuinely nice to each other in a crisis. Because we'll click on that one bad story and ignore the 100 nice ones.

I find your dismissiveness of the idea that racist attacks against Asians could be actually be occurring to be disappointing but not surprising in members of the modern left.

I suggest you invest some time reading a recent piece by an Chinese-American author in the NYT: https://www.nytimes.com/2020/04/12/magazine/asian-american-d...

I repeat, I'm not saying it doesn't happen. I am not "dismissing" racist attacks. I'm saying that media will massively over-report any such attacks, and under-report any incidences of people being nice to each other. So we end up with a belief (based on the evidence that we receive from the media) that we're going to be attacked, and not (which is the vast majority of actual interactions) that strangers will help us.

> What situation that could conceivably arise from a pandemic requires a [semiautomatic] rifle?

Rioting, looting, people breaking into your home, police “sick outs.”

See what happens if the electricity goes out or all stores are forced to close.

I've seen what happens when the electricity goes out and stores are forced to close - people are really nice to each other and help each other out whenever they can.

Let me put it another way: if you owned a gun, would "the electricity is out" be a reason to shoot someone?

You store it in your home, then wear it when you go line up for food in case the person next to you turns and coughs or sneezes.

That isn't what a face shield is for and it won't protect you in that scenario.

It is exactly what it is for, to protect from droplets sprayed out of sick people. Particularly to keep it out of your eyes.

Imagine being at the gas pump, and the person next to you sprays gasoline at you. A faceshield might keep your face from getting soaking wet, but if you smell the fumes, it hasn't prevented exposure to your sinuses or lungs.

Except you can't smell a virus.

I'm hoping Doctors aren't being hosed down with concentrated gallons of trillions and trillions of virus. PPEs aren't going to do much in that situation.

For the most part, the virus is carried in the droplets, so if you protect yourself from the droplets, you're way ahead of the game.

The harm right now is that there's not even enough PPE for hospitals, so anyone buying a face shield for themselves, if that were possible, would keep a face shields from going to a health worker who needs it more.

A couple months from now, when pressure on the healthcare system is lower and manufacturing capacity is ramped up? Sure, I'm all for it.

That is a completely different situation from what I'm discussing.

I'm not talking about who should get priority for PPE right now. I'm just talking about the idea of the general public having a couple uses worth of PPE just in case. Is now the right time for them to prioritize buying PPE for themselves over hospital workers? No.

I printed my own frame and cut the shield a large plastic piece from a leftover toy package.

That being said, if I owned a commercial face mask, I would not feel bad. Hording/gouging is not equal to owning your own set of PPE.

Based on a number of reports I've read about the N95 market, there seems to be plenty of PPE available domestically, but it's all being sold to foreign buyers because the government refuses to institute export controls.

"We all assume the government is going to make sure the food supply is maintained"

Do you assume this? I assume that capitalism is keeping the food supply maintained. When that fails, I think we're up the creek.

The government already has its hand in the food supply with all the farming subsidies it hands out. It can either change the subsidies to match the situation, or get heavily involved into the resource allocation as it has done in wartime.

As a good example, European agriculture is currently threatened because there are no foreign workers in the fields. The German government responded by better connecting unemployed workers to local farms, and by changing the rules to allow some foreign workers to come in.

That's just a hint of what governments are capable of. It pales in comparison to a war economy.

Pedantic point: If you’re intubation the esophagus, you’re doing it wrong. :-)

Might this explain the poor survival rate?

I hope a doctor or nurse or respiratory therapist can correct me, but my layman’s impression is that intubation itself isn’t causing deaths as much as having to be intubated means you’re already in dire straits.

I was recently intubated 3 times in the last month and had no ill effects. I know that’s just an anecdote but no doctor ever told me it would be super risky. The alternative to not getting it however usually meant death.

> which is the process of pulling or pushing a tube down a patient's esophagus.

In the context of intubation that is most definitely a bad outcome.

All it takes is one accidental sneeze in a grocery store for a face shield to become useful.

There is a shortage right now and we are collectively trying to address that but it is strange to say that this particular product and the safety practices you describe is the "reason why we pay federal taxes".

Your more general point that having a national stockpile of <insert-critical-item-here> for disasters of various kinds is of course valid, but that is true irrespective of the particular nature of the normal use of those particular items.

And we've learned that the federal government isn't particularly good at stockpiling. I hope we can find a way to have some non-partisan after-action committees to figure out how to do better for the next disaster.

> It's not about the money. PPE like face shields are specifically used during procedures that involve...

There is currently a global pandemic afoot that is spread by droplets expelled from people's mouth and nose. What a tool was being used for 2 months ago isn't relevant; the situation is different now.

> Everybody stocking a "handful" of PPE isn't a scalable solution to maintain a national supply.

If masks or face-shields could be cleaned fairly easily then it probably is a scalable supply. Particularly if medical professionals are allowed to supply their own work tools.

> What a tool was being used for 2 months ago isn't relevant

It is very relevant. These face shields wouldn't protect anyone from airborne/aerosol pathogens or viruses. They have a very specific purpose and that isn't one of them.

If you're talking about adapting construction grade shields (like used for painting, etc) for medical use -- sure. But you aren't going to use a face shield as a replacement for a face mask, which is what it seems like you're arguing for.

If you're saying that you should wear a face shield in public to protect yourself from aerosolized virus -- that's not the point of a face shield. The particles can travel around the sides of the mask too easily. If you want to protect from small, airborne particles, you need a mask.

If someone is facing me and a stream of airborne particles hits a plastic shield instead of streaming out to me, it seems pretty likely that I will be protected.

I'm certainly open to the idea that fluid mechanics are complicated and somehow air currents are going to do unhelpful things, but until I find someone with a paper on the topic I'd much rather be talking to someone wearing a face shield than not.

Plus obviously wearing a face shield will protect against self-inflicted infections from a contaminated finger.

> it seems pretty likely that I will be protected

And you'd be wrong. Sure, a face shield will protect you from liquid streaming out at you (partially). However, it isn't a liquid that you need to protect yourself from in this instance... it is aerosolized particles. And those travel in the air. So when you breathe in, that air can and will move around the face shield.

The sibling comment about smoke moving is exactly right. Smoke is a great example of how small particles can move and travel in the air. If you think that a face shield will protect you from something in the air, you'd be wrong.

Side note: this is how N95 masks are actually fit. (Well, not using smoke, but similar test). If you can smell the chemical used in the test, the fit is wrong.

If you really want to protect yourself from other people sneezing -- stay away from other people. That's why social distancing is still the primary, and best, recommendation.

You say that with great confidence and a lack of sources; and I'm guessing we are equally ignorant on the actual physics of how small droplets move.

The details aren't clear on how the virus is spreading. The virus might have multiple modes of transmission. Closing 2 of them reliably a great deal. There are important things to do with "catching COVID" that aren't binary; starting doses likely matter as well.

I'd rather not talk to you in person if you aren't going to cover your face, tyvm :)

Stop spreading FUD.

> The virus might have multiple modes of transmission. Closing 2 of them reliably a great deal.

Sounds reasonable, but how is a face shield a reliable way to close a mode of transmission if people aren’t spitting liquid in your face?

It increases the effective time large droplets need to spend in the air to get to me, and decreases the airflow around me. It's about the same reason plexiglass screens help, and keeping a 6-foot distance helps.

Plus, it stops me from touching my face.

No, it doesn't stop everything, but it's a buck.

> Plus, it stops me from touching my face.

You would be touching your face if you had correctly fitting PPE, because it's uncomfortable. https://twitter.com/gabbyjackson95x/status/12479391789623255...

This is just common sense. Aerosolized particles are not impeded by a shield. A shield is intended to obstruct ballistic projectiles. If those projectiles are aerosolized and are in the air that you breathe, then the shield will offer no protection at all. Even an N95 mask still can let in up to 5% of these particles. What efficacy is a piece of plastic in front of your face going to do against that?

> If those projectiles are aerosolized and are in the air that you breathe

It seems like you're imagining that the mucus and saliva particles would behave like a gas, but it's a suspension of liquid particles in the air, which behaves slightly differently. Think of breathing onto glass -- a lot of the aerosol I expel adheres to the glass. Some smaller droplets may move around it, but it's still preferable to receive a smaller dose of the virus.

>but it's still preferable to receive a smaller dose of the virus.

Could you explain why you believe that? I haven't found anything definitive on this topic.

[I'm no microbiology expert, so obviously take this with a grain of salt :-).]

I'm not sure whether the initial dose affects the severity of the disease, but it seems clear that it at least affects the probability of infection. The individual action hypothesis [1] posits that each individual pathogen has an independent chance of infecting a host, i.e.

    P(no infection | n pathogens) = P(no infection | single pathogen)^n

So if one is exposed to a single unit of the virus, infection is theoretically possible but unlikely. At higher doses infection becomes overwhelmingly likely.

I don't know how accurate the IAH model is, but there seems to be a good amount of evidence that infection rates are at least positively correlated with dose, e.g. [2].

[1] https://royalsocietypublishing.org/doi/full/10.1098/rspb.200...

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869824/pdf/120...

Well there's two things. There is the 'minimum viable dose' which you can estimate for various diseases, that will most likely result in an infection. And then there is the dose size (above that minimum).

With an exponential curve, whether you start off with 10,000 or 100,000, given that it takes about 2 weeks for our adaptive immunity to kick in, the virus is going to be in the hundreds of millions in either case.

[I work in vaccines, but not as a scientist, so I'm just trying to absorb as much as possible here..]

Yeah that's fair -- there might be some high-exposure situations (like being coughed on) where infection is very likely with or without a face shield.

I suspect that a lot of airbone infections are from inhaling small doses here and there though, considering how long mucus droplets can stay suspended [1] --

> Particles of diameters 1-3 μm remained suspended almost indefinitely, 10 μm took 17 min, 20 μm took 4 min, and 100 μm took 10 s to fall to the floor.

[1] https://www.mintie.com/assets/img/education/Aerosol%20transm...

There is a good New Yorker article on the matter this week:

https://www.newyorker.com/magazine/2020/04/06/how-does-the-c...

I'm really not a medical expert at all. But, just thinking about it one could at least speculate or argue: A smaller payload means the virus takes a longer time to "become very active" in the body and delaying this "ramp up" period may give your body's immune response a longer lead time from when it first "sees" the virus to when it becomes dangerous to you.

Well with an exponential curve, even if the amount of the initial dose changes 10 fold, from 20,000 to 200,000 virons you will get to hundreds of millions in pretty much the same time. I believe adaptive immunity takes about a week or two to kick in, and in that time the virus is going to keep multiplying like crazy, regardless of the dose.

Also, suppose you were living with a partner and both of you got infected. Both of you will continually shed and "re-infect" the other, so would we expect that the infection will necessarily be severe?

> starting doses likely matter as well.

That is something that I've been wondering about too. I work in biotech but not as a scientist. These things are tricky to nail down as they seem to be very individual specific. Theoretically, in an exponential growth model, it wouldn't matter if you were inoculated with 20000 or 200000 virons, after the incubation period post-infection, you're going to be generating a huge amount, millions and millions, of virus particles in either case. Certainly, if you keep getting exposed, you're immune system is going to get overwhelmed quickly, but for a single event, I don't think it matters.

Viral dose does indeed matter. https://www.nytimes.com/2020/04/01/opinion/coronavirus-viral...

It’s analogous to containing a new virus outbreak before it becomes an exponentially growing pandemic.

Thanks for taking the time to post the link, but it wasn't convincing as it lacked data and other relevant scientific information that I was looking for. Personally, I do not consider the NYT to a reliable source of information, but I know many do so maybe the link will help someone else.

It could give your immune system an extra day or two to produce antibodies before it get overwhelmed.

It’s okay to admit you’re wrong. It’s okay to not understand everything. It’s okay to defer to experts.

So many people on HN and in tech have the same attitude that if they just spend 5 minutes thinking about something then they can intuit an answer and that they must be right. This is a dangerous way of thinking. If anyone took what you’ve been saying as correct they’d be endangering themselves and depriving medical professionals of tools they need.

But I'm getting my opinions from the experts? See [0]. They recommend covering your face. I agree with them that cloth is more effective than a plastic shield but I'd expect a plastic shield to still be better than nothing. You've got to try and stop droplets from leaving your mouth and reaching other people.

A face shield would be better than failing to create a makeshift covering from a shirt for most people and it'd be resistant to decomposing so it could be stored long term in a home. It'd be a reasonable thing to stockpile.

[0] https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...

I don’t think it’s reasonable to stockpile given the huge demand for them by medical professionals.

I also can’t imagine a situation where you can order and wait for a shield but don’t have the time or resources to get a surgical mask or cloth.

And obviously the shield alone isn’t going to protect you from particles. And it might not help slow the spread if you’re infected yourself.

But again I’m speculating. If the health professionals say they need them and the public doesn’t, I’ll defer to them. I’m not an expert in their field and I don’t want to pretend to be or cause anyone to think I am.

Isn't the recommendations by many countries to wear even cloth masks (e.g. the recent reversal by the CDC) _because_ there's a good chance COVID-19 can spread via large (i.e. non-aerosolized) respiratory droplets? (Not that it doesn't also spread in other ways, but removing even one vector would be better in this case than not doing so.)

I'm not sure why there is a recommendation to wear cloth masks in other countries (not discounting it, I just haven't looked). However, I believe that the primary rationale for the CDC switching their recommendation that everyone should wear masks has to do with the great numbers of asymptomatic carriers. In this scenario, wearing a mask is not designed to protect the wearer from others. Wearing an ill-fitting mask is not protective to the individual. Instead, wearing a mask is designed to protect others from the wearer. Because people are carriers before they exhibit symptoms (if they ever have symptoms), you can't know if you are infected or not. If you are wearing a mask, you are limiting the potential spread of virus from you. This way, you are keeping any potential virus closer to you so that others are more protected. This goes hand in hand with social distancing. If you use a mask and don't distance yourself, you aren't helping at all. I'm looking for a CDC reference, but this was also the rationale presented in local media reports.

If you're really curious, Ars Technica has a really good writeup of all of the relevant studies.

https://arstechnica.com/science/2020/04/should-you-wear-a-fa...

Most of the research above assumed either surgical or N95-style masks. There was one study that looked at use of cloth (non-medical, non N95) masks, and this was the key finding (from Ars, not the paper):

Wearing cloth masks resulted in significantly higher rates of infection, the authors found. They also noted that in their test, the cloth masks were only 3 percent effective at blocking particles.

Regarding everyone wearing (surgical) masks to protect others:

In a study published April 3, 2020 in Nature Medicine, researchers found that surgical masks reduced the detection of respiratory viruses in aerosols generated by infected people breathing or coughing in a breath-collecting machine.

> Wearing cloth masks resulted in significantly higher rates of infection, the authors found. They also noted that in their test, the cloth masks were only 3 percent effective at blocking particles.

Hoo boy that's misleading by itself. The control group was "use what you normally use", and had the following numbers:

> In the control arm, 170/458 (37%) used medical masks, 38/458 (8%) used cloth masks, and 245/458 (53%) used a combination of both medical and cloth masks during the study period.

Given those numbers, it's basically impossible to use this data to tell us anything about the efficacy of cloth mask vs. no mask. The control group did wear their masks less often, but it's still very unhelpful data.

> I'm not sure why there is a recommendation to wear cloth masks in other countries

You're spreading actively dangerous advice, that has already been proven wrong. DO look up why there is that recommendation.

>https://arstechnica.com/science/2020/04/should-you-wear-a-fa...

> This may lead some members of the public to be lax about ... washing their hands frequently and thoroughly. Moreover, donning [a] mask may lead some people to touch their faces more, some argued.

> simply touching their mask could contaminate their hands if there are viral particles caught on the outside ... a mask wearer could then transfer virus particles from their mask to their face

"May". "May". "Some argued". "Could". "If". "Could".

> negating any benefit of having the mask.

So even with all the above steps that have to occur, it's still no worse than getting a face-full of Covid directly.

Almost every stupid, pointless, dangerous argument against masks boils down to:

People may not wear a mask properly. People may not wash their hands properly.

The first one is used as an argument against masks, so why is the second not only not used as an argument against hand washing, but also used in arguments against masks?

People don't always practice social distancing. So why don't people argue against that? Oh, because that too is reserved for arguments against masks.

It's fucking ridiculous. Why do some people continue to spend so much time and effort trying to discourage use of potentially life-saving items?

A cloth mask can capture some sizes of droplet, but a flat wall that the all the air goes around is not really going to do anything.

> this is how N95 masks are actually fit. (Well, not using smoke, but similar test). If you can smell the chemical used in the test, the fit is wrong.

And if the smell is less strong than it would be if you weren’t wearing the mask the viral load you’ve been exposed to is smaller. You are less likely to be infected and if you are infected your immune system has more time to ramp up so you’re more likely to fight it off.

Go light a cigarette or incense and and see if a face shield prevents you from inhaling any smoke.

Yeah, that is pretty much what I'm imagining. If someone tried to smoke behind a facemask it seems pretty likely that most of the smoke will be caught behind the mask then drift out behind them like a comet trail, or move up/down. Only small wisps would end up traveling forward to where I'd be standing for conversation. The doses of virus would be diluted very rapidly which is helpful.

Ideal scenario would be most of the smoke gets pushed down in a knee-wards direction, which is well within the realm of the imaginable.

>If someone tried to smoke behind a facemask it seems pretty likely that most of the smoke will be caught behind the mask then drift out behind them like a comet trail, or move up/down. Only small wisps would end up traveling forward to where I'd be standing for conversation.

You ARE the person in the faceshield (I assume you meant that instead of facemask), you don't control what other people do so assume they uncovered. The smoke is in the air, it can reach you. Will it get around that shield or not?

How could me wearing a face shield help protect me from catching the virus? It'd be mostly useless; although obviously as mentioned it'd stop me touching my face as much as normal.

This is all about containing the spread.

Although I suppose in hindsight that explains why people were downvoting me.

> it seems pretty likely that most of the smoke will be caught

If your plan is to only block most of the virus then perhaps you should rethink it.

It's like stating that a hole in the hull is not a problem because the rest of the ship keeps most of the water out.

Actually initial viral load seems to be a factor in how severe the disease gets. So keeping any percentage more out of you that you can helps..

This is potentially misleading. Viral load is a significant factor in the seriousness of most infectious diseases. This is why you'll likely be ok if you pass a coughing TB patient in the street and inhale a few bacteria, but are much more prone to contract TB if you spend an entire day cooped up in a small room with the same coughing, infected individual.

This is thought to be why an unexpectedly high proportion of young, healthy doctors and nurses are getting seriously ill from Covid-19. Statically, you'd expect almost all of them to get mild disease.

Light a cigarette and see if you can smell it from six feet away.

I think a better comparison would be to try inhaling wet steam (i.e. a suspension of liquid H2O) from behind a face shield. You'll probably inhale some, but a lot of it will adhere to the shield.

Viruses don't diffuse through the air like smoke. Viruses are contained within the aerosolised droplets of your bodily fluids that are ejected through sneezing, coughing, blowing the nose. The survival of the virus outside of the body exposed to the elements is limited. Viruses have limited lifespans and can only reproduce within the medium of the bodily fluid. Every virus has different characteristics, and may have a longer or shorter lifespan. These characteristics are more or less universal for viruses though. It's not impossible for them to travel longer distances through the air. For the most part they are limited to the initial propulsion from the body. A better analogy would be spraying an aerosol can and watching how the droplets settle.

Nobody is advocating for a face-shield as a replacement for an N-95 mask, but using them together, would reduce the odds of infection.

According to the MIT paper, a typical sneeze will travel over 20 feet.

Additionally, there is mention of the velocity of the particles may be able to penetrate the mask, so a face-shield could help with that, too.

Yes. Defense-in-depth. In China, most hospital red zones required 3 layers of PPE, whether that's two masks and a face shield or such. One layer alone is not very good, and a face shield alone is no good. A mask and a face shield are very good, especially for confined spaces like subways and busses where there are jerks coughing and sneezing all over without hygiene or manners.

Strawman and wrong.

What if I want to protect myself and my facemask from large droplets. I also want to protect myself from accidentally touching my face. Is a face shield okay then?

And if so, why not drop $300 million to get one for everyone in the US? They're cheap, wash easily, and that's less than 0.02% of the last stimulus.

> There is currently a global pandemic afoot that is spread by droplets expelled from people's mouth and nose.

Do you have any source on how face shields are an effective tool against atomized covid19 viruses? The general guidance is that facial masks are effective at barring infected people from emitting contaminated particles, but not good at stopping healthy people from having contact with the virus. Therefore why would an open face shield, which filters zero, be a better solution?

I hear mask promoters say the “it’s to protect others from you” line, only to turn around and say “masks are obviously useful, that’s why doctors wear them.” The truth is, mask use is built on incredibly shaky evidence, so it’s no surprise that now face shields will become part of the hype. Both may indeed be useful, but without a clear model of effectiveness, it’s hard to make good assessments.

Also, tin foil hats. You can't prove they DON'T work, can you? Even if they only add marginal protection, every bit counts. And they might, so can it hurt? This is why we are recommending tin foil hats to all Americans. That and a nice contribution from the tin foil lobby. We expect all Americans to commence procuring and constructing tin foil hats, and arguing about it on social media, and hope that this distracts them from noticing that their government is practically a failed state.

It turns out that "feeling safe" isn't the same thing as being safe, and feelings of safety will not actually effect infection rates, but Americans can't quite grasp that. And, hey, feelings of safety are about all we've got now, so.

You seem to conflate so many things here. Doctors wear mulitiple types of masks. Surgical masks (as are recommended for the general public) prevent a doctor from spitting on a patient accidentally (just as they prevent an infected individual from expelling virus laden spit droplets). Surgical masks provide limited (if any) protection from airborne droplets. Rather an N95 masks (with a seal and filter) is used. To make this effective to protect the wearer, goggles must also be worn. The general public does not wear goggles. Further,training on putting on and taking off masks is provided to medical professionals. Face shields protect from yet another class of dangers (splashing of contaminated fluid). The general public has little reason to wear these.

I thought the entire point of wearing a mask was precisely because we don't have clear evidence as to it's effectiveness. With such a degree of uncertainty (we are literally in the midst of an epidemic) it's not very practical to wait around for perfect information and evidence before you act

That's the general guidance in countries getting overrun by COVID-19. In countries which have stopped it, everyone wears facemasks. Chinese scientists have good data that surgical masks help in both directions.

Face shields reduce flow of air around you. Think of the six foot rule, but add a few more feet. They also reduce projectile sneezes (and "say-it-don't-spray-it" talking, coughs, and even breathing) by quite a bit. Think about sneezing in your elbow, only much better.

> disposable

This is reusable, easy to sterilize w alcohol.

I used a face-shield in October when I was using an HVLP paint sprayer indoors, so there are definite uses besides the current pandemic.

It definitely cost more than a few dollars and is not disposable.

Also, according to the documentation, these are re-usable and can be sanitized w/ alcohol or H2O2.

> intubation, which is the process of pulling or pushing a tube down a patient's esophagus

Hope not. It's endotracheal intubation. Tubing the gut (accidentally) leads to gastric distention as we ventilate the patient, leads to aspiration, leads to aspiration pneumonia, leads to huge increase in morbidity.

> like intubation, which is the process of pulling or pushing a tube down a patient's esophagus.

Hopefully you are intubating a patient’s trachea and not not the esophagus.

Does esophageal intubation happen much? I was intubated a month ago due to non-COVID respiratory failure. I also ended up getting pneumonia but no one knows when I got it. If that happened to me would my medical team have told me? Speaking generally obviously since you don’t know my case of course.

> If that happened to me would my medical team have told me?

I don't know where you are. In England healthcare professionals and their organisations have a statutory "Duty of Candour". They have to tell you when something went wrong, why it went wrong, what they're going to try to do to fix it for you, and what they're doing to prevent it happening again in future.

https://www.cqc.org.uk/sites/default/files/Duty-of-Candour-2...

In general esophageal intubation results in death. The patient is not getting oxygen, and so they die. I believe esophageal intubation gets reported to the Board of Medicine and is a really big deal for the hospital and doctor involved.

> pulling or pushing a tube down a patient's esophagus

No, that's another procedure. Intubating respiratory patients involves targeting the trachea and avoiding the esophagus. An esophageal intubation can be Very Bad.

That said, as an early advocate for face masks for the general public, I'm in 100% agreement that face shields are pointless for the general public. We don't need them.

What's the point of wearing a face mask if you're going to leave your eyes unprotected?

Mostly, to help prevent you the asymptomatic carrier, from spraying your respiratory droplets into the environment.

https://www.theguardian.com/world/2020/apr/02/face-masks-cor...

The CDC is recommending then now. Do you disagree with their expert opinion (nevermind their stand a week ago)?

Finally, with respect to the mask wearer's protection, look into viral load.

To go into a little more depth (I assume you'll see this given that you appear to be monitoring my threads):

You seem to have a mental model whereby any viral particle that bypasses your body's physical barriers has "won" - game over. But that's now how the immune system works. We want to minimize the viral load as much as possible, since with all known infectious organizations there's a dose-response relationship: the larger the dose, the worse the illness often is. Tiny loads are often effectively fought off my the immune system.

We this is vividly in a bacterial illness like TB. In TB, there's little risk if you pass a coughing TB patient in the hall. But if you spend the day with them in a poorly-ventilated office, your risk increases. If you live with the patient, your risk is very high.

The same principle applies with viral illnesses like Covid-19. And given that the only access route that is actively pulling viral particles into the body is the respiratory tract, it stands to reason that protecting that route has a higher payoff than protecting a lower risk route like the eyes.

That's not to say that people in high risk situations like Covid-19 wards of hospitals shouldn't cover their eyes! Obviously, they should and do. However, for most of us, the best protection we can use without using BL4 protection gear (obviously, not practical or needed for the general public) is to wear a mask. Mostly, the mask is to protect others from you, but depending on what kind of mask it is, it can also protect you from the virus.

Finally, most health authorities are now recommending that the general public wear masks. CDC changed their recommendations a week or two ago to recommend wearing masks. As usual, the WHO is moving slowly as large bureaucracies often do, but I don't doubt they'll also recommend them in the end as more evidence of their efficacy emerges.

It is incredible how selfish people are. The frontline workers are desperate for any kind of PPE, but we still have random people, who are mostly staying at home, that want to get in the front of the line.

The majority of the replies from non-medical professionals here on this supposedly intelligent forum perfectly illustrates why that happens. People think they can tackle any problem and come to the correct conclusion with a minute of thinking alone, with no real knowledge or experience or testing. Now extrapolate that to the entire US or world and it is sadly not surprising that people think they know best and doctors and nurses and patients be damned.

Staying at home and limiting spread is the most effective way to help professionals.

PPE helps limit spread. The trick is to buy stuff which doesn't take away from doctors. Cotton masks. Face shields. Etc.

In contrast to nonwoven fabric, a toy factory can produce a billion face shields if you want it to. You can but them online for a buck (in quantities of 10). It ain't taking away from anyone.

If you're not fitted and trained on the PPE you're using, it's more likely to cause harm than to provide any protection. If not direct harm, then by providing a false sense of security.

You need to not only know how to use PPE, but know what it's limitations are, and what it's designed to actually protect you from.

Wearing a shield thinking it provides any protection from an aerosolized virus is a perfect example of having the wrong expectations from a piece of equipment.

These don't look like 'normal' face shields that you'd find in a woodworking shop. They're just splash guards, won't stop anything remotely solid that's flying.

Regular people should not use non-reusable anything. Just because I can spare $100 doesn’t mean I get to trash the earth with disposable junk. Make reusable/washable masks and then I don’t care if people cover their face or behind with it. Masks do help - for allergies, dust, and other things. I do wear a bandana while running because it helps with allergy. Only because I don’t want to risk another lung issue while also being in risk for covid.

Seeing people touching their masks continually while wearing gloves and using a phone is depressing.

Touching one's mask is infinitely better than the alternative of touching one's face, and in the case of a non-symptomatic individual wearing a mask to reduce outbound infectious particles has no bearing at all.

The whole 'masks are too hard to use' thing was a horror perpetrated by gov't officials afraid of private individuals hoarding masks.

> Touching one's mask is infinitely better than the alternative of touching one's face,

No, because the outside of the mask is contaminated and now your fingers are contaminated.

> and in the case of a non-symptomatic individual wearing a mask to reduce outbound infectious particles has no bearing at all.

No, because the outside of the mask is contaminated because those masks are not impermeable and the virus does penetrate it, and so now that persons fingers are contaminated and they contaminate other surfaces.

> The whole 'masks are too hard to use'

So far every single video I've seen of people who aren't HCPs wearing PPE has shown them make mistakes that lead to contamination.

"Wash your hands with soap and water for at least 20 seconds; don't touch your face" is much simpler than the protocols for donning and doffing gloves and mask.

Both of those things seem just as hard as managing a mask. People are crap at handwashing, and face touching is subconscious.

You inadvertently touch your face way more often when wearing a mask, that much is pretty obvious. You also are more likely to be more confident about your safety and behave in a slightly more risky way. Kind of like how cars drive closer to bikers with helmets than bikers without them.

I have found exactly the opposite. I mostly wear a mask because it stops me touching my face.

> No, because the outside of the mask is contaminated and now your fingers are contaminated.

My understanding is that that's a misunderstanding (one that I was under as well).

For people who aren't sick, the worry is that your hands get contaminated (much more common, from surface contact), and then you touch your mask and transfer to the mask, and eventually it works its way in since these aren't N95s.

i.e. it ends up being the same as hand-mouth contact, but people think the mask is keeping them safe from that.

Yes, you're right. That first point was about the DIY cotton masks, not fluid resistant surgical masks.

Right, but even with a cotton mask the worry is hand-to-mask, not the other way around.

When you're out in the world, the potential concentration of viruses will generally be much greater on your hands than on the outside of your mask.

Yes, but touching a dried droplet is much less likely to lead to infection than inhaling one.

When I am out and about, I assume that my fingers are contaminated. When I get to my car, I always do a cleanup down with an alchohol wipe and when I get home, do the ABC wash of my hands and face.

Still, wearing the mask is a constant reminder not to touch my face. some people will still ignore that reminder but not everyone is going to follow the rules 100%.

>No, because the outside of the mask is contaminated and now your fingers are contaminated.

What's the alternative? That your face is contaminated?

>Touching one's mask is infinitely better than the alternative of touching one's face

...assuming the act of wearing the mask isn't the reason for touching the face in the first place (eg. adjusting the mask)

I commented on exactly this on HN a few days ago - when I venture out these days, I notice some people wearing masks, and just in the short time I see them, pretty much every one has adjusted/fiddled with their mask.

The masks I've seen are of varying types, but I guess most are of the 3M DIY/building variety (that is, masks designed to be worn while doing building work).

> Touching one's mask is infinitely better than the alternative of touching one's face

That depends entirely on if there is a viral build up on the outside of the mask.

Discouraging people from using N95 masks was specifically to avoid the private hoarding of masks.

But discouraging use of other masks (and N95) by the public is because they do not protect you if they are used wrong. When any air passed around a mask, then you are at risk. Using them right requires proper equipment, sizing, testing, etc... And getting people properly fit, etc was not something that was remotely practical for the general public. That's not to mention the materials used... properly protecting masks have to be made of high-quality and consistent fibers.

The current recommendations for wearing masks is not to protect the wearer of the mask. It is to protect other people. If you take it as a given that there is widespread asymptomatic cases of the virus, then you don't know if you have it or not. So wearing a mask is to protect other people from you. If you are wearing a mask, any virus that you happen to shed will be trapped as you exhale, or at least not be able to travel very far.

Unfortunately, any help that wearing a mask would offer to the wearer is often countered by the false sense of security that they bring. There are many people in masks that think they are protected so they can ignore keeping their distance from others. This is 100% wrong.

The best way to avoid germs from other people is to distance yourself from other people.

> Unfortunately, any help that wearing a mask would offer to the wearer is often countered by the false sense of security that they bring

Today's cars are extremely safe. Are you saying that they actually increase accidents because it gives people false sense of security? Should we remove some of the protections, for example the seat belt, because that would make people drive more carefully?

Tesla autopilot crashes are a closer analogy. A seatbelt is (generally) not an improperly used piece of safety equipment, it generates actual security.

This is all false. Try to find a scientific citation. I dare you.

N95 masks, incorrectly fitted, are at least as effective as surgical (in studies, they came out ahead, but not by a statistically-significant amount).

In conjunction with handwashing, surgical and N95 masks make a huge difference.

Over 1000 people in America are dying every day of this disease. This thing costs probably $2 and likely provides significant protection.

About 100 people in America die per day from motor vehicle accidents. Next I suppose you're going to tell me that the extra $50 it costs to install a seatbelt in my car is a waste of materials, time, and money too, right?

I think it's more that these would be a pretty involved overstep for regular people to be walking around in. Social distancing + hand washing + a homemade cloth mask is sufficient for regular people. For the same reasons that regular people don't need/shouldn't be wearing N95 masks everywhere, nor should these.

If the argument is that civilians shouldn't wear N95 masks outside, but rather donate them to people who need them even more, fine.

However, if the argument is that you shouldn't wear a $1 mask, which provides substantial protection against COVID, because it's not necessary, I would refer you again to the 1000 people that died yesterday that didn't wear an N95 mask. The amount of mental gymnastics you have to do to hold this belief is frankly astonishing.

If your assertion is "They wouldn't have died if they'd worn an N95 mask", I would refer you to basically any literature about what the point of wearing the masks are.

Your overwhelming condescension also make this conversation much harder than it needs to be. I would consider taking a walk and trying to relax.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190272/

Table 6.

Wearing an N95 mask reduces your chance of contracting SARS by 91%.

I apologize if my frustration comes through here, but the data is very clear and people are dying in the thousands because they're not protecting themselves.

It feels as though arguments will be received with claims of "mental gymnastics", so I will just point out the differences in use and function between a face shield and an N95 mask. You're free to try and purchase a face shield if you'd like.

Best of luck.

Your question was about the effectiveness of N95 masks. Hopefully I've resolved that for you. As for the effectiveness of face shields, I don't have data on that, I just said it was likely to be effective, since it blocks larger droplets from hitting your face or being inhaled.

There's no luck involved, I purchased a face shield almost two months ago, although I usually just wear mask+goggles, gloves if necessary when I need to go out. The face shield is for if one of our family members gets sick and we need to care for each other. Then it will be mask+goggles+gloves+gown+face shield.

My question was not about the effectiveness of N95 masks in a vacuum, it was correcting your assertion that the people that have died in the hospital, did so because they didn't wear N95 masks. It is possible to wear an N95 mask incorrectly, or to contaminate yourself during the putting on/taking off process. The idea that N95 masks inherently make you immune to exposure is ridiculous. The people that died in the hospital could've very well worn N95 masks and still been exposed.

I also believe you're more naive than I originally thought. I think you need luck now more than ever.

I think it's pretty simple. If you don't get the virus, you don't go to the hospital or die in the hospital. If you wear an N95 mask, according to the best data available, you have a 91% smaller chance of catching the virus.

Yes, it's possible to make mistakes donning and duffing. However, that same meta-analysis also showed a large benefit for community use of masks, so actual use, not perfect use. To the extent that there is a problem with improper use, we should be teaching people how to use them instead of telling people not to wear them.

I never said wearing a mask made you immune. Seatbelts don't eliminate your risk either, but at this point only very backwards people drive a car without one.

BTW, as of today, COVID is the leading cause of death in America.

> I think it's pretty simple

Stopped reading after this. It's not.

> If you wear an N95 mask, according to the best data available, you have a 91% smaller chance of catching the virus.

Do you have a link please, because there's no way that's true.

They linked a study and then cherry picked some data from it. IIRC it was a controlled study of ~20 people, and the actual reduction % was "50-90% reduction" where every person ALSO washed their hands a minimum of 10 times per day.

I would also assert that they probably trained each participant on how to use the masks effectively, whereas I suspect OP (and most of the N95 mask hoarders) would contaminate them to the point of being useless.

edit Ah, you responded in a different place saying basically what I just said wrt contamination. Good on you.

Speculation doesn’t make you right. “Likely to” counts for not much.

It’s sad you made that purchase. I wonder if that deprived a doctor or nurse of one. If they died, you’ve essentially condemned them to that. Is your own selfish neurosis worth that?

I know you’re being facetious, but I certainly hope he does no such purchasing.

Eh. That poster believes they've "figured it out", and those that've died just "didn't figure it out." Reasoning won't work, and unfortunately they're able to do whatever they want. I hope Apple has aggressively limited how much PPE they'll waste on civilians.

From your link, about table 6:

> wearing N95 masks (0.09, 0.03 to 0.30, NNT=3, 2.37 to 4.06);

NNT=3 means "number needed to treat". This means that to see the effect at all in one person you need three people to correctly wear a mask.

If 99 people correctly wear an N95 mask only 33 of them have a reduced chance of catching covid-19.

Here are photos of people who have correctly worn an N95 / FPP3 mask. I don't think most of the general public can tolerate this.

https://twitter.com/LondonNurse2015/status/12472750559874252...

https://twitter.com/jbon93/status/1247626644208189444/photo/...

https://twitter.com/RochesterKaren/status/124644595651562700...

https://twitter.com/gabbyjackson95x/status/12479391789623255...

We also know that "doffing" (taking off) the PPE is difficult, and that many healthcare professionals are infected when they take it off. I don't think most members of the public can comply with the complicated donning and doffing protocols.

You need to look into that first one. It's obviously photoshopped. The originals are uncomfortable, but not like that. Here's one of the originals: https://twitter.com/error4null1/status/1241896271927009281/p...

More importantly, the imprints and bruises are from full-mask respirators and goggles (and one FPP3 mask), not N95 masks. Have you ever worn one (and been fitted for one)? I have, when I worked as an EMT years ago. I also have worn one N99 or N95 mask for years when cleaning out my guinea pig cages. It's not that bad.

In terms of doffing the masks, it's pretty straight-forward: To remove the mask: remove it from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water (via WHO).

I'm not sure what's driving your passionate anti-mask campaign (N95 and otherwise), but I urge you to look into what doctors and public health experts have started recommending after considering the evidence and what we know about how this infection is spreading:

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si... (US CDC) https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si... https://www.ucsfhealth.org/education/should-i-wear-a-mask-to... (UCSF) http://www.chinacdc.cn/en/COVID19/202002/P020200310326809462... (Chinese Centers for Disease Control - "Wear a mask when going out.")

Absolutely stay home if you can. It's the most effective way to avoid spreading or contracting Covid-19. But wear a mask if/when you must go out (to grocery store, drugstore, essential job, etc).

There’s no mental gymnastics happening. You’re just ignoring what medical workers are saying and assuming your intuition is infallible. It’s easy to understand why it’s dangerous to deprive those workers of shields to benefit to yourself. And manufacturing cost is not the same as availability. We don’t have instantaneous infinite supplies of these.

These face shields are intended as an alternative to eye protection that is in short supply. They do nothing for respiratory protection. Infection via the eyes is primarily a concern for people interacting closely with contagious patients (i.e. healthcare workers).

To answer your seemingly underlying question: no, if Apple gave you a face shield it doesn't mean you get to go outside.

If no one is going outside, how are there any new cases? Lots of people are "essential workers", they go to the grocery store, the pharmacy, etc.

Yes, HCW exposure is much greater than the average person, but your argument is essentially: Since you aren't driving in a Formula 1 race where the risk of crashing is higher, there's no need to wear a seatbelt.

When we're seeing hundreds of deaths per year from COVID, I'll agree with you, but currently, HCW or no, COVID is one of the biggest threats to your life, and you'd be an idiot to go outside without the best protection you can get your hands on.

Face shields aren’t seatbelts. Someone put it well when they said they’re ejector seats. I assume you aren’t flying jets or intubating patients.

Face shields are to protect against body fluid splatter during invasive bodily procedures and while closely treating patients with explosive coughing fits. Even doctors in hospitals treating Covid-19 patients don't wear them outside those types of circumstances. There is no need for the general public to wear them. It's not like fitting your car with a seat belt, it's like fitting it with an ejector seat.

So your argument is that the risk to the average American is low from COVID? Why do we have 300,000 cases then? Why are 1000 people dying a day? That's already 0.1% of the population, and most of them in the past week!

Lack of testing and a laggard&lackluster response by authorities. USA will be one of the hardest hit countries in the world. There's still no stay-at-home order. Trump wants to reduce what little is being done after Easter. That's going to make the situation considerably worse.

All true, but even with stay at home orders, not everyone stays home. Some people are essential workers and have to go to work. Other people go out for exercise, grocery shopping, etc. If those people have protective equipment available it is truly senseless to not wear it given the extreme danger.

Appropriate equipment yes, absolutely. But even doctors and nurses do not wear face shields routinely around hospitals. They are worn when performing particular procedures and circumstances that don’t apply to most situations even in hospitals.

SARS-CoV-2 is not a routine disease. HCWs are dropping like flies. They obviously not being adequately protected.

Because they’re dying doesn’t mean shields will help. I think the medically inclined people in this discussion are making reasoned arguments. You however are just appealing to hysteria.

I can imagine so many other more likely reasons for those deaths than face shield usage.

Face shields aren’t protective wear in public. Taking them away from doctors and nurses however does increase mortality for them and patients in general.

Plenty of states have stay at home orders. Mine does. It isn’t clear to me the federal government has the authority to issue that kind of order, short of martial law. The US government isn’t identical to many other countries. States are like quasi-countries, legally, authority-wise, and culturally.

The risk is very high, my wife is a nurse here in the UK and is infected. Fortunately she has light symptoms and a light cough. When I am with her we both wear a face mask, but there is no need for a shield because I’m not intubating her her or at risk of heavy splatter from close range explosive coughing. Again, even doctors in hospitals only wear face shields under specific circumstances, which are situations the general public are not likely to find themselves in. That’s why you don’t even see doctors and nurses wearing face shields in public or taking them home. Outside those specific circumstances they don’t need them, and we don’t need them.

I would humbly suggest that doctors very rarely deal with diseases this dangerous (infectiousness + lethality) and that more extreme protection is warranted. As you well know, it is difficult to not catch this thing.

I would much rather overdo my PPE than underdo it. Overdoing it just costs me a little time, underdoing it costs lives and injury.

If you want to see what it takes to have a hospital where no one gets infected, this is instructive. https://youtu.be/9HsGqQCLzLU

You’re not listening to what he said. He argued no such thing. You however seem content to deprive doctors and nurses of important tools and compromise their safety and patient safety so you can selfishly take something that provides zero protection to you.

If time was of the essence for car production and we needed to decide if ambulances or regular cars get seatbelts first, then yes, we'd give them to ambulances.

I'm not suggesting that priority should not be given to HCWs or other high risk people like grocery store employees, but at $2 each, this is something everyone should be wearing as soon as we have enough of 'em.

That this article was written shows clearly that we don’t have enough of them and that any non-medical professional buying them is only contributing to the population of ill and the dead.

They don’t provide the general public any significant protection. It’s basically the same as not wearing one, except you’re condemning health professionals to increased risk, exposure, and possible death.

Face shields are more effective than masks at preventing exchange of droplets.(1) They can be cleaned and reused so it may save money and material for the general public to popularize face shields.

1. "There may be some protection from droplets and liquids propelled directly onto the mask, but a faceshield would be a better choice if this is a concern." https://www.cidrap.umn.edu/news-perspective/2020/04/commenta...

Right, but staying home is even more effective at preventing exchange of droplets. The face shields should be going to people who can't stay home and are forced to be around contagious people.

A huge number of Americans cannot stay home and are not healthcare workers. People have bills to pay, and not every non-healthcare business is closed, unfortunately.

Right but that still doesn't seem like a good enough reason for Apple to start selling these publicly.

Why unfortunately? I'd say it's quite fortunate that grocery stores and gas stations are still operational.

It's unfortunate because these people are having to put their lives at risk, unexpectedly. They didn't ask to be on the frontlines. In addition, many of them haven't been able to get hazard pay or adequate sick pay.

And some of them (especially within those fields) may be forced by their employer to work part-time and not be eligible for employer sponsored health insurance.

> Right, but staying home is even more effective at preventing exchange of droplets.

There are tens of millions of Americans who are currently working, who cannot stay home, and are not medical professionals.

I’d like to leave my house in a month or two. You?

You’re allowed to leave your house. Exercise, pet walking, and essential shopping and other essential activities aren’t banned. Put on a mask and go for a walk in your neighborhood and keep social distancing.

Right - this is obviously what I would do. However, if face shields were helpful for reducing risks for general interaction (no idea if they are) then I’d also want one. The fastest path to leaving the house is reducing the risk of leaving, so some simple PPE (that is more effective than a mask) would be great.

Masks are more effective at preventing spread from untested, asymptomatic infected people though.

That isn't what that sentence means...

Think of it like a squirt gun. If someone is spraying a squirt gun at you, a mask will protect you a bit, but it eventually will be saturated and you'll be wet. However, if you have a face shield, the water will just roll off.

Masks are better at protecting you from small particles. Using a face shield without a mask would do you absolutely no good when you're trying to protect yourself from an airborne pathogen or micro-droplets. When you breathe, you're going to draw in air from around the sides of the shield.

If you have a mask (N95), then you're breathing air in through the filtering fibers of the mask. This is what protects you.

Masks and face shields have two very different purposes.

At some point, I want to leave my house. Like, maybe in June?

A face shield sounds like a prudent way to reduce one’s risk while also being able to interact with others. Why not let citizens buy them after shortages end?

They don’t reduce risk of infection in day to day situations. They’re specialized medical tools used in appropriate situations.

Also, please put on a mask and leave your house. You aren’t on permanent curfew. Do some essential activities each day.

Of course I put on a mask, and I rarely leave the house. I was not aware they were not helpful when generally interacting with others - obviously then I wouldn’t want to wear one.

I do hope to buy a box of N100 masks when this is over. I strongly suspect I'm not alone.

The general public includes about a hundred thousand people whose job puts them in touch with everyone: mostly checkout clerks.

They are at great risk for infection and for being vectors of infection, and are performing an essential service.

These face masks are a great piece of technology for them: effective, reusable, and comfortable enough to wear for a full shift.

It's very simple to just put up a full shield between the clerk and the customers, you don't need to strap the shield to people's faces when there's a static point of contact.

This has the benefit of preventing you from touching your face after touching things customers have touched.

If you're a retail worker and you haven't trained yourself to not touch your face while in work mode, I don't know what to tell you. Be better?

Or to wear protective gear that costs basically nothing. Not touching your face at all is extremely difficult where as wearing a mask is very simple. Why suggest very difficult measures when very simple ones work better.

I had to go to the hospital today for a follow up X-ray after a month long life threatening illness. Every single desk and checkpoint inside either had the glass windows slightly cracked open but essentially closed, or they were draped in plastic covers. My pharmacy also did the same thing.

These aren’t masks. Shields aren’t going to be as helpful as masks and medical workers need them much more and we need medical workers to stay alive.

Several US state governments are strongly asking people to wear masks now. My local government asked so strongly they had to clarify that no, they could not prosecute you for not wearing one. And while they generally demonstrate masks that cover the nose and mouth, the earlier guidance was to avoid touching the eyes, as that was believed to be a major vector for droplet absorption.

So... how do you reconcile your statement with that?

That strong suggestion is so that a person with the virus will be wearing the mask, and therefore less likely to infect other people. That type of mask is more or less useless for protecting its wearer; its purpose is to protect everyone else.

>The general public does not need to be walking around with a full face shield, that’ll be a waste of materials, time and money, unfortunately.

Mostly time given current priorities -- given that we've spent 100000x the materials and money buying every kind of disposable plastic crap every year for no reason at all...

Yes. In January and February, we were "meant to" all keep traveling, spending, going to conferences, and parades. I'm not sure how a passive "meant to" helps. And we were all "meant to" not wear face masks, until just now.

These things are common sense. If you don't believe a face shield will help, why bother sneezing in your elbow?

We have three modes of potential transmission:

1) Large droplets, where face shields increase the effective distance from others. 2) Contact, where faceshield prevent you from accidentally touching your face. 3) Aerosol, where faceshields don't do a thing.

But reducing 2 out of 3 modes of transmission for a buck or two makes complete sense.

Face shields make sense in clinical settings, but do they make much sense for casual use? It's hard enough to get people to wear masks.

They make sense if there's a big apple logo on the front.

The Dutch police is now free to use them as spit masks. Unfortunately there are people who like to spit and cough in the faces of the police (and then being charged with weeks in jail).

But I doubt it will work well against coughing because the airflow can just go around it.

LaVision had this great visualisation about the coughing airflow: https://m.youtube.com/watch?v=kYJvU81DKgk

Maybe some day, but hospitals are obviously going to get priority until they have sufficient PPE for all their employees. Hospitals are already unable to provide sufficient PPE for the doctors and nurses, let alone the rest of the on site staff - so any mask going to a non care provider means a care provider does not have such.

Would just take 6.3 years at current rate of production to make that many.

Unless my math is wrong: 330M/52

Apple is making a million a week and donating direct to regional health services.

Protective Goggles (like the 3M type) would be a better fit for most use cases. No need for touching or readjusting, having to be careful when looking down, etc.

this sort of face shield is useful in clinical situations where the wearer is protected from patients who may cough or sneeze right in their face. for going to the shop what you need is an N95 or just mouth/nose covering mask/scarf.

Might be useful for the shop clerk though, who is seeing a hundred people in a row.

Plenty of essential public areas are building plastic drapes. That’s effectively the same thing but likely cheaper and not depriving medical professionals of anything.

here in the UK they are introducing plastic shields between checkout operators and customers. largely the same and saves staff from needing to wear PPE

Make your own. Transparency sheet with corners cut rounded, foam strip cut from a sponge stuck along one edge of the sheet with double sided tape, elastic strap stapled to two corners. Easy and effective. We have been making and donating them to hopsitals and first responders in our area (not in the US) who are happy to get them.

Do you know where i could download a design spec ? I know a guy who wants to take a crack it making a face shield.

Woofie11 expresses hope that everyone should be able to have a shield, not just health care workers first and people here down vote them?

What's so wrong with that? Do you not believe that yes, everyone should be able to have protective equipment not just health care workers? In what kind of a country do we live where we have to ration health care supplies (a basic one at that -- it's literally clear plastic) to only those working directly in health care? It's merely a hope woofie11 expressed, and I too have the same hope: that yes, our system is good enough to protect everyone and rationing shouldn't be needed.

Woofie11 said nothing about not giving supplies to those that most need it first and nor have I.

From the post above “These pack flat, one hundred per box..." it's clear they are packaged for large organizations. They almost certainly have zero interest in developing individual packaging for consumers.

Didn't vote him down, but it is a bit silly. Apple isn't becoming a medical supply company, they are producing a product to fill an urgent medical need. They don't have the distribution network to supply these to retail, nor is it likely they ever will.

You don't think Apple has literally one of the best distribution networks in the world? What percent of the country is within a few miles of an Apple store that already receives shipments a few times a week?

A lot less than you think. Huge swathes of the country don't have Apple stores. Even living in the Puget Sound region, my nearest Apple store is 25 miles from me.

By and large Apple distribution is "UPS". Both to wholesale and retail.

Apple stores aren't getting any shipments right now. Even if they were, those stores are closed and Apple isn't going to open them to sell a few face masks to consumers. By the time Apple stores open, even fewer people will want face masks. (And Apple won't want them on their shelves regardless)

Apple's distribution network is built around selling consumer electronics, not medical supplies.

This isn't remotely the sort of product Apple would manufacture and sell. It's not worth the time and effort to design retail packaging for it.

Face shields aren’t protective in this context for the general public. No one is intubating coughing patients or working in messy medical situations unless they’re medical professionals. It isn’t sad that hypochondriacs might not have access to them. It’s reality that infinite instant supplies don’t exist. You aren’t entitled to have whatever you want. Especially when you’d be depriving medical professionals safety and life.

if you aren't intubating people or treating severe cases of this stupid virus then get in the back of the line behind everyone who is

Like I posted below, you can make an improvised "face shield" out of plastic food wrap in about 15 seconds. No parts needed. Wrap it around your head at forehead level so it sticks to itself. Keep the bottom part loose, so you can freely breathe.

Readily available, cheap, disposable, lightweight, does not restrict visibility.

If you're working in the wind, you might need to weigh down the bottom part with something, but that's also trivial to do.

Or just put a two-gallon sandwich bag over your head.

Not recommended for infants and small children, of course...

You're saying to literally wrap your face in plastic wrap and leave a little hole to breathe? I think someone's going to try this advice and suffocate.

>You're saying to literally wrap your face in plastic

Are you trolling or serious? I said forehead, not face. Obviously, do not wrap plastic foil around your face.

If it's around your forehead, how is it shielding you?

Plastic food wrap in my country comes in rolls 12-24" wide. This is more than enough to cover your forehead down past your lower jaw.

That would counter the stay at home initiatives. People would think it's safe again.

If they want to make them for sale they should, 1k a mask for the general public.

Why? Most ordinary non-healthcare-worker people have no need for this level of PPE, especially if they're following social distances rules like they should be.

I have seen restaurant employees also wearing face shields, especially if they work cash. A lot of places near me have also been putting up sheets of plastic between the cashier and the customer.

I can't control what other people do in grocery stores. They walk too close and there's nothing I can do about it. I'd like something to keep shit out of my eyes.

not to equivocate but this reminds me of the pro gun control discussion

Masks are shields, not arms. they pose no risk to others.

If you are referring to humans as potentially lethal weapons, and stay at home orders, then, yup.

Wear sunglasses.

Maybe chemical goggles. Though I'm wary of anything that touches my face, because I have to wash my face and worry about pushing the virus into my eyes.

Bear in mind that soap doesn't just wash off the virus, it destroys it. The virus is held together by lipids, which soap dissolves.

Still, that's an interesting point, maybe it's a good reason face shields are better than goggles.

I'm not saying don't get a face shield, but even with shield and mask you still want to maintain distance.

Last time I shopped in a grocery store, I went when it wasn't crowded and prioritized staying away from people. If someone came towards me I went the other way. If someone was already in an aisle pointed toward me, or was pointed the other way but not far along, I didn't go into that aisle just then. If someone stood in front of an item I wanted, I came back for it, or skipped it if it wasn't important.

I also wore a mask, but I treated that store as hostile territory, focused on avoiding people, and got the heck out as fast as I could.

Get a welding mask, then. It'll do the same thing.

> They walk too close and there's nothing I can do about it.

Are you stuck in place? Can you not move? Do you have no voice?

There is a lot you can do, and other do about it.

If you got something directed at your eyes, you’ll be inhaling something anyway. Wear glasses or shades and stop depriving hospitals of limited supplies they actually need. You don’t need it. Buying one is tantamount to endangering lives of hospital workers.

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