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Comment by nicoburns | Hacker News Reader

I would not be at all surprised if mask use turns out to be a lot more significant a factor than western governments seem to be assuming. It seems obvious that pretty much any kind of face (mouth/nose) covering is going to be significantly better than nothing at preventing the spread of disease that spreads through droplets. Of course, we should do formal studies. But in the absence of data, masks being effective seems like a sensible default position to take.

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Especially considering it being one of the cheapest (financially, legally, impact on freedom) measures we have at our disposal.

The cost / benefit analysis is so much in favor of mask wearing that I don't understand why they are not made mandatory.

Maybe some HN reader knows about some cost that I am not aware of (ie a few of pounds and a small inconvenience).

It’s been politicized in America. I think it’s really that simple.

Mandatory but with reasonable exceptions (disabled, young children, etc).

That's why special needs schools haven't been able to re-open, even though in theory a ten-year old should be trusted to keep on a mask, due to various developmental conditions (e.g. autism, down syndrome, etc) they sometimes cannot. So we should consider edge cases when discussing mask mandates.

And I acknowledge that some able-bodied adults will abuse any exception provided, but those exceptions remain important otherwise you're just persecuting a subset of the population who are unable to comply.

I still feel weird when wearing a mask myself or when I see somebody with one. Before the Covid situation somebody with a mask would feel threatening. I think we should have a big public campaign promoting mask wearing and make sure public leaders set an example by wearing one.

Bangalore resident here. I felt kinda embarassed wearing a mask initially. But it took about two weeks to get used, and now I feel vulnerable if I am not wearing one. I also tense up a bit if someone else not wearing a mask is within a meter from me.

What about sunglasses? Why doesn't that feel threatening when you see someone slip on a pair of sunglasses, and a hat? After all sunglasses are a form of a mask for the upper part of the face.

Wearing sunglasses is often viewed as impolite too. I am not arguing against masks I am just saying that there are some cultural obstacles that make people uncomfortable wearing them. It would take some leadership to get around those.

Until when do you think mask wearing should be mandatory?

My biggest problem with covid interventions, including masks, is not the cost itself, but a lack of objective/quantitative criteria for deciding when to lift them, rather than “when it doesn’t feel scary anymore”.

(As for the direct costs of masks, well, they are uncomfortable, prevent me from seeing people’s faces which I enjoy doing, and make me feel depressed because they make the world look like a dystopia. Yes, the costs are relatively low, but IMO the difference in probability of death or maiming from covid with and without a mask is also quite low.)

This is what I don't hear anyone talking about.

Right now, my company is saying "we're going back to the office 2 weeks after the province fully reopens". This is great! It's tied to the progression of the virus and gives me expectations about the post-covid world.

I am OK wearing a mask right now. I don't want to be wearing one in 10 years. I want an expectation similar to above, something like "mask wearing will end 2 weeks after the last known case".

I went to the dentist the other day and it was less stress than ordering from my local Thai food place. It really seems like masks are people's way of externalizing their fears, I want to see proper leadership in this area so we don't let these fears get out of hand.

> and make me feel depressed because they make the world look like a dystopia

How do you feel about refrigerated trucks handling morgue overflow of dead grandparents, in terms of dystopia appearance?

> but IMO the difference in probability of death or maiming from covid with and without a mask is also quite low

The probability of death for _you_ is likely quite low, but it's not about you. If masks slow transmission even slightly (and evidence is mounting that they do), that will save lives. Possibly a lot of lives.

I will stop wearing a mask outside of my home when the all cause death count falls back below the threshold for excess deaths: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

Ideally, we would have better metrics.

In Asian countries a lot of people wear mask when they feel sick. This is to protect other around you from getting sick.

I wish this could become a new norm in the western countries.

> and make me feel depressed because they make the world look like a dystopia

Personally don’t care about people’s feelings. Normalize masks already.

That's a silly attitude. The entire movement to wear masks is predicated on caring about other people's feelings. Otherwise, people at low COVID risk (or even high risk but willing to accept it) wouldn't need to bother.

No, it's about caring about other people's health and quality of life (there are long term effects from covid-19). Feelings aren't really figured into it.

To be clear, there's not much evidence that masks _protect_ you from covid. The point is to prevent you from giving it to other people when you have it but don't know about it.

Although not a direct answer to 'when would you not wear a mask anymore' there are objective criteria guiding some of the decision making around phased re-openings (of which some phase would be "no more masks").

Example Criteria: https://kingcounty.gov/depts/health/covid-19/data/~/media/de...

Example Dashboard: https://kingcounty.gov/depts/health/covid-19/data/key-indica...

In our state/county they are essentially mandatory.

You don't have to wear one outside, but if you want to use any public or private business that's located inside of a building - you are required to wear a mask.

> The cost / benefit analysis is so much in favor of mask wearing that I don't understand why they are not made mandatory

They have finally been made mandatory in shops and on public transport in the UK after quite a bit of public pressure. Kind of ridiculous that this wasn't done in March, but better late than never I guess.

I literally just watched a youtube video that sums up the American view on masks

https://www.youtube.com/watch?v=3Q3PSISAZL8

I just.. don't get it man.

That video does not “sum up the American view on masks”. It might at most sum up one American view among many.

Where I live (which is part of the US), I’d say 100% of people wear masks inside of businesses (other than dodgy corner stores selling illegal cigarettes), and about 90% on the street.

It sums up the view of many Americans though. You can see many masks in the video, and also many not masks.

Where I live, in America, it is something like 70% of people with masks. And it is required in stores in my area. Some stores enforce, some do not. Some people wear a mask past the greeter in the store, and then take off their mask once inside.

It appears to at least sum up a (possibly non-random) sampling of non-mask-wearers' views. Certainly more than one view, since multiple people were interviewed.

Indeed it does.

I could find multiple people in France to say on video that vaccines cause multiple sclerosis - a French person could rightfully object if someone claimed that that sums up the French view on vaccines.

I wonder why nobody did any studies on COVID patients asking very simple questions such as "how often did you use a mask in public?".

A romanian doctor complained that about 70% of his COVID patients believed the dissease was a hoax before being infected themselves.

Maybe he was just trying to scare others, and by no means do I try to blame the sick, but maybe if people not wearing masks, not practicing social distancing not washing their hands are more likely to get sick, we could show this data and make the rest do it more -- if this is indeed the case and these measures significantly decrease your chances of being infected.

Masks are believed to be more effective for stopping an infected person transmitting than stopping an uninfected person being infected, so this probably wouldn't be especially useful.

I agree to that,but masks are still useful even for preventing, and my main reasoning was that wearing a mask is a proxy for how serious the person is for all the rest -- social distaning, avoiding crowds, avoiding interaction with people who don't wear mask themselves and so on.

But as someone else commented -- retrospective studies probably are not that useful.

We do not get much information about who still gets the virus. Mostly party goers or is everyone as likely to get it?

Several weeks after the place where I live started the lockdown hundreds of people were still getting it and I was really wondering who these people were.

> I wonder why nobody did any studies on COVID patients asking very simple questions such as "how often did you use a mask in public?".

Because retrospective self-reporting surveys are not useful science.

You could be very right -- I suppose if someone thought COVID was a hoax and was asked if they wore a mask, in a hospital setting, they would be more inclined to say they did, just like how people say they voted for the winner in an election in a much larger proportion than the actual results show.

No one wears a mask in the Netherlands. Not a recommendation, just an observation.

You'll have seen the memes about people wearing a mask and then coughing onto an agar plate.

Here's a study where they did that properly.

It suggests that people should be changing their masks every two hours.

https://www.ijic.info/article/download/10788/7862/

> This study was conducted to check the efficacy of face masks in limiting bacterial dispersal when worn continuously in Operation Theater. A comparison was done to find out difference between fabric and two ply disposable masks. The first sample was collected prior to wearing the mask, using cough plate method holding a blood agar plate approximately 10 -12 centimeters away from the mouth. The personnel were asked to produce “ahh” phonation. Participants were then asked to don the face mask, continue routine work and report to the study center located inside the theater for further sample collections at designated intervals of 30, 60, 90, 120 and 150 minutes after wearing the fabric mask made of cotton. The study was replicated on immediate next day using two ply disposable mask keeping all the other conditions and personnel exactly the same. Bacterial counts before wearing the mask were 5.36±4.38 and 5.7±2.99 on day 1 and day 2 of study. Bacterial counts were 0.96±1.06 (P<0.001) and 0.7±0.87 (P<0.001) at 30 min; 2.33±1.42 (P<0.001) and 2.36±1.03 (P<0.001) at 60 min; 3.23±1.54 (P=0.007) and 4.16±1.78 (P=0.011) at 90 min; 5.63±4.02 (P=0.67) and 4.9±1.98 (P=0.161) at 120 min and 7.03±4.45 (P=0.019) and 5.6±2.21 (P=0.951) at 150min respectively for fabric and two ply disposable mask. Counts were near pre-wear level in about two hours irrespective of the type of mask. There was no significant difference between cotton fabric and two ply disposable masks. Face masks significantly decreased bacterial dispersal initially but became almost ineffective after two hours of use.

> Face masks significantly decreased bacterial dispersal initially but became almost ineffective after two hours of use.

That statement is logically hard to swallow as it's just as hard to breath through a face mask during minute 1 as it is during minute 121.

There are at least 5 mechanisms by which filters can filter out particles. Four of them are explained in this document [1]. Some filter materials also trap particles electrostatically. but I have no idea if that is relevant for masks filtering viruses.

For at least some of the four mechanisms covered in that document (inertial impaction, diffusion, and interception) it seems plausible that once you have a particle caught that way any other similar particle that otherwise might have been caught at the same spot the same way might either bounce off the first particle or dislodge the first particle.

This could eventually reach a steady state where as many particles are coming out as are coming in the other side, just with the individual particles being delayed.

If the particles are small enough so that sieving isn't significant, then there would probably be little change in the ability of air molecules to get through regardless of whether or not the filter is in the early, nearly clean stage or is in the steady state late stage where there are plenty of particles trapped.

[1] http://donaldsonaerospace-defense.com/library/files/document...

Part of the issue is getting people to wear them--properly. People like to pull them down below their nose. Again, there isn't a whole lot of data, but it stands to reason that only covering your mouth somewhat defeats the purpose.

And it follows that using a mask exclusively as a chin brace isn't helping anyone.

I don't follow this line of argument. Theoretically the concern is exhaled droplets which I assume primarily come from your mouth. If the point of a mask is to protect others and not yourself then why would the nose need to be covered?

Your nose has the same issue as your mouth in that regard. Remember, the virus is hanging out in your respiratory system; it stands to reason that the problematic droplets don’t necessarily originate in your mouth, but rather your lungs.

Even if that isn’t the case, your nose and mouth are connected, and both contain mucosal membranes. They’re sharing the same droplets.

In general, when you cough, sneeze, or even breathe, the same droplets are coming out of both your mouth and nose.

What if you're using your nose to exhale?

Most people sneeze out of their noses.

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