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Comment by DoreenMichele | Hacker News Reader

We really need two things:

1. Better systems for preventing transmission of disease generally as our cultural default.

2. Better models for helping people genuinely recover, something modern medicine doesn't actually address for most diseases.

We have physical therapy for certain injuries. We don't really seem to have something similar for infections. We think just treating the infection per se is all we need to do. We generally do not school people on how to resolve the issues left behind from antibiotic use, chemotherapy, etc.

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Regarding your first point, the likelihood of a given infectious disease propagating is partly related to the susceptibility of the population. That’s what makes a novel coronavirus so much more likely to become a pandemic.

We know, for example, that cross-immunity from other coronavirus strains do provide some level of immunity to SARS-CoV-2.

Another area of study is how decreased exposure to diverse set of microbes can result in increased incidence of autoimmune disease, and asthma.

While one angle to reduce the spread of disease is to prevent exposure, the other equally important angle is to avoid infection even with exposure (immunity).

I’d be very cautious about recommending population wide masking for extended periods. Our immune systems function by being constantly exposed and tested, and the system can break down if it isn’t provided with a diverse set of challenges to strengthen and build up immunity.

For your second point, I strongly agree that western medicine is particularly inept at providing care beyond treating acute symptoms, particularly chronic/sub-chronic conditions that tend to describe “how we all feel” and that don’t come with a definitive diagnostic test to reference in an insurance claim.

1: Masks! that seems to work.

2: Physiotherapy? Yoga?

3: there are articles about rehabilitation centers for ex-covid patients, in europe + UK at least.

1. Are you suggesting masks as a cultural norm for all eternity? I hope not.

I'm talking about sustainable permanent changes. I like contactless takeout, like Little Caesar's pizza portal as one example.

2. Neither of those are for infections per se.

3. Thanks. I will look for such, but it probably sucks if the past 55 years of my life is anything to judge by.

> 1. Are you suggesting masks as a cultural norm for all eternity? I hope not.

Well in some Asian cultures it was already normalized to wear a mask when you have any kind of symptoms of anything contagious. I was hoping that convention would move west even before this pandemic happened -- so I hope it stays with us.

I think we are already far too accepting of the idea that it's just normal to be germy and ill. I wish that expectation would change. I don't think it has to be that way.

There is a war between your immune system and your environment, with constant escalation. Every time people meet they exchange germs. Most often it's something your immune system has already seen, but sometimes you're tired or it's something that's mutated or that's brand new.

Unless we live in a literal bubble with filtered air, we're going to be germy.

The safest way to not be germy is likely to live in a sunny dry place away from people but then it's usually hot and maybe amazon doesn't deliver.

Sure. We are always germy. But if you feel explicitly under the weather and you have to go out to the store to pick up something, it would be great if you wore a mask - even if it isn't covid times.

I've never done that. I've always just gone to the store. I didn't even really think about it, like of course I'm not going to be wiping my nose and touching things, but I'm also not sanitizing my hands the instant I walk into a grocery story - something I now do every single time.

I do wonder what the effect would be of just having sick people wear masks when they go out?

I have a permanently compromised immune system. I don't live in a bubble. The degree to which my life revolves around germ control is not immediately apparent to most people.

Suffice it say that I don't agree with you. At all.

True eradication of most germs is probably impossible, given how hard it was for smallpox and how hard it currently is for polio. But I don't think there's any inherent reason why all remotely serious diseases couldn't be driven to the level of tuberculosis - something that exists, endemic in every country, but at such a low level that most people have no real expectation they might catch it.

We can treat tuberculosis with antibiotics. Do you think we can just do the same thing with e.g. malaria? The only diseases we've eliminated have been from vaccines, and the diseases we control tend to be from either relatively easy behavioural changes or medicine.

I've been less sick this year than most. I'll probably continue wearing a mask on public transit at the very least. I'm not quite clear what your hope is about the normalcy of being germy and ill, but I think that statistically, we must accept that any group of 1000 people will certainly have somebody asymptomatic but shedding some virus or another. Just as the younger generation is more accepting of wearing gloves/condoms during sex where they receive proper sex ed, wearing masks may continue to be seen as a common sense measure for the foreseeable future.

I was sick in March for two weeks with some kind of Bronchitis. I don't think it was Covid based on the description of the symptoms.

But since working form home, neither me, my wife, or any of my kids have gotten a cold which is kind of amazing.

I haven't had a cold in years. I still have issues because of my genetic disorder, but, yeah. Colds can be avoided and it's wonderful.

1: I hope not either, but in the mean time, if it works and the alternative is long covid or other forms of diseases and permanent disability, it would be a small price to pay. Plus I'm sure there will soon pop up a cottage industry of fashionable masks you can bling to your heart's content.

Maybe we'll replace masks by astronaut's helmets like in all some dystopia games, with lights inside to show our face like in SF movies (so they show the actor's face, glare be damned).

I have an incurable serious condition. My little family lives with a lot of best practices that don't involve anything like masks or helmets.

I keep wondering if there's any way to export those practices to the world at large but it seems extremely unlikely given the open and aggressive hostility I'm met with for any suggestion whatsoever that there might exist a better idea than masks.

What is your suggestion for a better idea than masks for the current respiratory pandemic?

We should be focusing more on not touching our faces and keeping a sufficient distance over masks.

People seem to treat masks like a plus 2 magic item in the game of Pandemic. Once they have one on, they think they are exempt from the need to keep their distance. They also tend to touch their face more, not less, because they fiddle with it etc.

I had some utter and complete asshole blow his nose under his mask standing next to me in a store. I think "don't blow your nose in a crowded public space" would be a vastly superior rule to "wear a mask."

> Better systems for preventing transmission of disease generally as our cultural default.

That's a great way to turn our immune systems to rubbish. In a normal set of circumstances, we get sick and we recover. After a lot of these long-term lockdowns end, I think you're going to see a lot of people getting sick from regular bacterial infections at a higher rate.

Look at what happened when peanuts were removed from a lot of schools in the US to help kids with peanut allergies. More kids developed peanut allergies due to not having exposure (see Coddling of the American Mind)

Except for the fact that allergies are a form of an overactive immune system, so that actually completely countermands your point.

Are there potential concerns with finding ways to prevent transmission of disease? Yes, for sure. Are they a systemic weakening of a society's immune system? No, it's not. If anything, the danger is in preventing disease to the point that lots of folks develop auto-immune disorders.

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