Comment by timr | Hacker News Reader

Comment by timr | Hacker News Reader

Parent Full thread

"A huge percentage (maybe 30-45%)? of people that I see wearing masks seem to be putting them around their chins or wearing them over their mouth but with nostrils exposed or hanging around their neck. Or I see people pulling them down and only pulling them back up when they walk by someone or go into a store (most stores have signs on the entrance requiring masks but state that improvised is OK). It's incredibly frustrating seeing people wearing PPE incorrectly and/or treating it as optional outside of stores."

This fixation on masks is puzzling to me. The evidence for their effectiveness is weak (particularly for non-medical masks) at best, and people have turned "social distancing plus masks" into "masks plus social distancing", which is exactly what public health experts were trying to avoid.

As you've noticed, a huge percentage of people don't know how to wear masks or don't care to know. Even if they do know and care, it's incredibly inconvenient and difficult to wear a mask properly, so people generally don't. Moreover, as you've also noted, people are consuming medical equipment that really should be reserved for professionals. It's exactly what researchers said would happen when the mandatory mask idea was floated, and it's why the CDC didn't recommend masks in the first place (and why the WHO still doesn't).

More and more research is calling out mask laws as a questionable idea:

https://www.cebm.net/covid-19/covid-19-masks-on-or-off/

https://www.dora.dmu.ac.uk/bitstream/handle/2086/19526/Face%...

https://bmjopen.bmj.com/content/5/4/e006577?ijkey=24b32ab627...

https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v...

https://www.cidrap.umn.edu/news-perspective/2020/04/data-do-...

https://www.bmj.com/content/369/bmj.m1422

And yet, every day, I see comments judging people for not wearing them, not wearing them properly, etc. Again, there's little evidence for doing it, they're misused/misworn in practice, and they seem to lead to a false sense of security. Why are we doing this, again?

If wearing masks is so ineffective then how is it possible to explain the fact that health care workers who are wearing PPE are less likely to get the infection compared to the normal people without PPE?

Health care workers are (hopefully) wearing at least professionally made surgical masks, if not proper N95 respirators, and actually know how to use them.

(I think wearing masks makes sense as long as there's a chance they'll help—but I don't think there's evidence that they necessarily do help either.)

I do not think that masks alone will be effective but in combination with other measures they will have an effect.

Ok, say most people fail to use masks to protect themselves (they take masks under their skin for example) but how does it affect protecting other people? Considering that many cases are first asymptomatic then wearing masks may considerably limit the spread.

primarily to reduce the likelihood of infectious people infecting other people.

This is not complicated.

Every Single Avoided Infection Reduces The Pandemic.

Whataboutism is irrelevant.

The virus simply does not care about logic.

It only cares about math.

If I'm infectious and wear a mask and avoid infecting you, then you and everyone you would have infected do not get the disease (from me).

If I'm part of 5% of people who are actively trying to avoid spreading the infection, then it probably does not matter much and the virus spreads and spreads and spreads.

If I'm part of 90% of people who are actively trying to avoid spreading the infection, then it matters a great deal and the virus vanishes.

That is why we are doing this.

> Every Single Avoided Infection Reduces The Pandemic.

No, you're trying to apply logic with incorrect data.

Corona is so contagious that nothing short of a Level 4 biohazard facility can stop it, if that.

> That is why we are doing this.

No, it's just feel-good corona theater. We need herd immunity sooner than later. Let's get to 80% ASAP!

Are you implying the nations who have reduced infections to manageable levels have made their entire countries biosafety level 4?

How long do you think herd immunity will last because its up for debate. What should we tell the families of the 0.08 - 0.8% of the world population who died when it turns out to not be long? Even if herd immunity lasts forever, if we get a vaccine months later many died for no reason.

We don’t really have attribution on masks vs. contact tracing.

I don't understand how that's relevant to my questions

So ideally we'd all line up to get voluntarily exposed, 40% (the symptomatic) of the population, across all walks of life and professions, are bedridden for one or two weeks, and society just takes the 0.5-5% hit in population (no clinical care)? I guess some people really think that's better than the alternative.

So how do you explain the fact that not every health care worker has been infected?

We do not have to avoid 100% new infections. Just enough that R0 goes below 1.

WearsAMaskEveryWakingMoment is not 1-to-1 with WantsThePandemicStopped. The latter includes everyone, maskophile or not.

It is dangerous to equate "acts as I do about X" with "cares about X".

The mask is not there to protect you.

It’s to protect other people from you.

The problem is that in order to be effective, everyone must be wearing a mask, and wearing it properly at all times.

This includes when they are talking on their cell phones. You’ve seen people pull their mask down, while talking on their phones. Well, these people may be spreading the virus around when they do that.

*"The problem is that in order to be effective, everyone must be wearing a mask, and wearing it properly at all times."

The problem is that masks are not effective, and the sources I cited demonstrate this.

And yet not all health care workers are infected by SARS-CoV-2 while there are enough stories where a single person has infected large group of partying people without PPE.

Besides, it is not important to protect everyone. It is just enough to reduce R0 below 1.

Healthcare workers are different because:

1) They're trained in correct PPE use

2) They wear a full set of PPE

3) They're supervised when putting it on and taking it off to avoid contaminating themselves

4) They have dedicated areas to don and doff PPE.

5) They use huge amounts of PPE. (A team will use about 30 sets of PPE per ICU patient per day.)

6) They have access to alcohol hand gel (often carrying it on them)

7) They have plentiful and easy access to handwashing facilities - elbow operated faucets, soap, running water.

8) They've been trained in handwashing, and they are regularly audited in handwashing.

You fail to understand that we do not have to make it 100% secure for everyone (also it fails for healthcare workers time to time) but it would be enough if we can make R0 to become below 1.

If a person only puts a mask on while being inside and otherwise wears it under the chin then well, bud luck, not much change to avoid infection but when infected, this person will spread it less likely to somebody else who is handling the mask properly.

Rather than arguing why we "fail to understand", you should consider reading some/all of the links I provided to find out why the research supports our position.

I have reviewed it and most of it is questionable. The level of research is - we do not know - more research is needed.

Btw. did you realize that the second link you provide supports the opposite conclusion?

It does not:

"On this occasion, we believe public-facing communications regarding the scientific view on the balance of risks and benefits of widespread uptake of face masks have exceeded the scientific evidence base. Efforts to communicate a position so strongly in favour of widespread use of masks in the community, against current WHO advice and in the face of persistent evidence gaps and debates, risk promoting policy that is based more on eminence—the track record, credentials and status of the authors—than on evidence."

Ie. more evidence is needed. Weak. Rest of the discussion actually supports usage of masks.

Perfect is enemy of good enough in this case.

I am not claiming that masks are the only solution. Quite to opposite. The solution is a combination of multiple measures.

The most effective has been early social distancing so far.

The evidence is staring at you in the face.

The Chinese were able to halt the spread of the virus through combinations of social distancing, physical isolation, lockdowns, and wearing masks in public, whether N95 or KN95.

Gloves also help limit the spread, but you have to be aware of not cross-contaminating everything. As well as hand sanitizers.

Obviously, wearing the masks alone will not do the job. You need a full spectrum of behavioral changes, in order to halt the spread of the virus. Especially the combination of social distancing, plus masks. And everyone must get educated about it. No excuses!

But at this point, you have to question if all this is worth it, as states are opening up prematurely because people want to go to the beaches.

Hell, I want to go to the beach too! But the virus containment fight is not over.

The 2nd wave is coming, and it’s going to be bad!

Reply on news.ycombinator.com