Working at home two weeks and my mom has already run out of black ink on her printer

[conuly]

Holy shit. I hope her job reimburses this expense. I just put a hefty amount of black ink on auto-delivery, and also paper.

In other news, we ran out of coffee, so I made an emergency run to the dollar store to get more. Nothing else would've impelled me to go there just now, but since I was there already I got more snacks, soup, milk, and bleach. They were sold out of butter, alas... I may have to brave the over-expensive Western Beef pricing! Talked to the cashier, she's stuck, when she's not at work, in a home with ten other people, only one bathroom. Puts my complaints about being cooped up in perspective!

Now, here's a thing I'm curious about. Two people I know - two people who are pretty reliable when it comes to this sort of thing, and whose opinions on science article abstracts I can trust - have recently linked me to this article, using it to back up a claim that use of cloth masks increases spread of disease compared to not wearing a mask at all: https://bmjopen.bmj.com/content/5/4/e006577

The reasoning around this makes sense - even careful users are going to have more moisture near the face, which may breed disease, and most people are not careful users and do all sorts of stupid things with face masks like lower and raise them willy-nilly. And, of course, there's not much quality control on the homemade cloth mask front.

However, the article does not seem to back this conclusion up at all, for the simple reason that they were not ethically able to put together a control group of hospital workers who don't wear masks, and their "normal use" group overwhelmingly used masks, so what you're comparing is "workers who use surgical masks" and "workers who use cloth masks". It's also not clear if the cloth masks were being changed with the same frequency as the surgical masks (twice a shift) or not. And, importantly, we definitely haven't established if using masks all day in a hospital gets results that can be generalized to the casual wearer who only wants to go out briefly to walk their dogs or buy butter.

(Other people, without citing any articles, have suggested that people wearing face masks may go out and about more and thus spread more disease. This is funny. The mere thought of having to breathe through a mask is enough to make me reconsider even the most dire of errands.)

So I don't actually know what to make of this article. Is there any data at all to back up the conclusion that face masks are riskier than no mask? Obviously I want the best and most accurate information so I can make the best choices.

Comments

[lavendertook]

What borough are you in? My folks were from the Bronx. You are in the maelstrom right now. If you're running out of something like coffee, feel free to let me know and I'll get and mail. It's climbing here, but we in MD are not dealing with the numbers you're dealing with.

Stay safe!

[conuly]

I'm on Staten Island. I order 5 pounds of fair trade coffee every month and usually that's enough but with both my mom and sister home full time we ran out three days before our next delivery :) (Happily I saw this coming and ordered an extra two pounds. If I see we've gone through more than half of it in two weeks I'll increase the next order to ten pounds.)

Luckily we should be getting it in the next delivery fair and square. All I really need that I'm worried about sourcing (more accurately, affording - the way they gouge us on this is a travesty) is butter, and I don't think you want to ship that from Maryland.

Though I'll have to see what the supermarket has in stock Monday when I go on my planned outing. If they don't have ramen, I may take you up on your offer anyway.

[lavendertook]

Sure. I'll be here all week, and several more. :-D

[redsixwing]

Literally every study I have seen is comparing cloth masks vs surgical masks and finding that, unsurprisingly, the surgical masks win every time. I have seen nothing, despite increasingly strident annoyance with non-healthcare people who want to be safe, comparing cloth masks to no mask at all. (Well, we have a grand-scale experiment going: we can compare the curves in places that have people near-universally wearing masks to those that don't. Obviously I am not a statistician, but there are services out there to allow you to compare by things like 'cases per capita' and 'time from 100 logged infections.')

The CDC recommends the following for health care providers:

HCP use of homemade masks:
In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.

No guidance for people going to the grocery store. *grump*

I'm coming down on the side of 'cloth masks are better than nothing,' but that's my opinion.

[cynthia1960]

If using a cloth mask frees up surgical masks for health providers, that's how I would decide things for myself.

[redsixwing]

Good point!

Edit: Found one, where at least the figures are public without a login. Still digging.

...oh look at that melannen found better ones. :D

[conuly]

I agree.

[melannen]

There are various studies going around that test the efficacy of improvised cloth masks, but they test just how many droplets make it through, not actual infection rates. Here's one: T-shirt masks. Here's some more, if you follow all the links.

The general conclusion of all of them is that they are substantially worse than properly used disposable masks but substantially better than nothing. They are also mostly testing ability to prevent the wearer from transmitting. (Also, I don't think I've seen anything that tests, say, regularly-sterilized cloth masks vs. reused or over-used disposables.)

In terms of hospital donations, I think a lot of them are using them on emergency room patients and stuff like that just in case, so they can save the good ones for the staff but still reduce transmission risk, and that's probably useful. And if I have to go back to work with the public while it's still a major concern, I will probably try to wear one if I'm allowed just to remind myself not to stick my fingers in my mouth every five minutes.

[rmc28]

Yeah, I looked at that and decided "I'm gonna improvise *something* over my face when I have to go to the supermarket" because it's better than nothing. It's another way of slowing transmission down. For today's government-approved essential food shopping I wore a tubescarf over my nose and mouth. Breathable, better than nothing, and I wasn't the only shopper doing so.

[melannen]

Honestly for the average person for an hour or so of shopping and transit, the don't touch your face value of a bandana or scarf is probably as useful as the filter anyway.

[julian]

Thank you, you are useful and informative and I will now use my painter's masks, because yes.

[highlyeccentric]

I don't know if this data EXISTS but the population to survey on 'average joe using a variety of face mask designs in daily life, or no mask' would be east asian commuters.

[malada]

I'm hand sewing (no sewing machine) some face masks because it's better than nothing. I am not very good at this. A double layer of flannel sheet material. At least they're be soft and comfortable.

It's also a good flag for people to keep their distance.

If I go out I'll add a tissue layer on the inside to catch moisture. Then I return the mask will go into a hand wash with bleach.

I haven't had a chance to test them out in the real world. I'll probably have to in a week or so.

-m

[conuly]

A double layer impairs breathing a lot more, but doesn't improve filtration very much. I'm not sure of the efficacy of flannel in particular, but I wouldn't double it up, not for short-term, incidental use.

[thewayne]

My wife was able to get a pound of butter yesterday, she was happy. We made popcorn last night for watching TV, I used a stick of frozen salted butter that I'd accidentally bought instead of unsalted butter.

[glaurung]

Here's a video in which a doctor who cares for people in ICU on respirators in a NYC hospital talks about what precautions are and are not necessary: https://vimeo.com/399733860. It's a recording of a live conference call, so it's long and there are interruptions and technical glitches.

The brief version:

1. The virus transmits primarily via prolonged close contact with someone who is infected - being within touching distance of an infected person for 15 minutes or more. That's why parties and other large social gatherings are such huge vectors. It gets from the infected person's nose/mouth to their hands/entire body, and then gets onto an uninfected person via touch.

2. It is not clear if it transmits only via skin-skin contact, or if it can get from an infected person's hand to an object to an uninfected person's hand. To be safe, the hospital where the doctor works has everyone who is working with infected or potentially infected people wearing masks because masks prevent you from touching your nose/mouth by accident.

3. They use regular surgical masks for this, not N95. Even when they are in the room of an infected person, giving them medicine or taking their vitals, they only wear a regular surgical mask (and the usual gloves). They only use N95 masks when they are interacting with a patient in a way that can cause tiny particles of saliva to get into the air - changing breathing tubes on a respirator, for instance. I imagine he'd recommend EMS workers wear N95 if they can, since they're more likely to be in situations where an infected person can't help coughing into the worker's face.

4. Wearing a regular surgical mask to prevent unconscious face touching, plus diligent hand washing/hand sanitizing every time they touch something that might have the virus on it seems to be protecting the hospital's personnel from getting infected, even on the unit where they are caring for people with COVID-19.

Given all that, wearing a cloth mask when you go out shopping, and then washing/changing clothes on returning home, makes sense as a protective strategy.

[conuly]

3. They use regular surgical masks for this, not N95. Even when they are in the room of an infected person, giving them medicine or taking their vitals, they only wear a regular surgical mask (and the usual gloves). They only use N95 masks when they are interacting with a patient in a way that can cause tiny particles of saliva to get into the air - changing breathing tubes on a respirator, for instance. I imagine he'd recommend EMS workers wear N95 if they can, since they're more likely to be in situations where an infected person can't help coughing into the worker's face.

My guess is that the reasons for this have little to do with efficacy and everything to do with supply issues - there aren't that many N95 masks at hospitals right now (and if you have any, you should donate them).

Of course, they're also hard to breathe through and kinda a pain, so that's another reason to avoid them if not strictly necessary.

Face Masks

[agoodwinsmith]

I can't find it right now, but there is some evidence that face masks are worse because people touch their faces more while adjusting and fiddling with the mask. As you know if you've worn one for any extended time: they are hot and wet and stiffling.

They are useful for someone who is sick because it contains their contagious bits to them - but then people need to dispose of them (or with cloth: sterilize them) carefully. Touching an infected mask is also trouble.

Finding lots of opinions, but no facts -> Re: Face Masks

[agoodwinsmith]

Cultural comparison
https://www.bbc.com/news/world-52015486
The two studies cited about flu do show a reduction of transmission with face masks even though the article pooh-poohs them:
https://www.huffingtonpost.ca/entry/do-face-masks-prevent-virus_l_5e304a13c5b6ce51a4ec0a09

So - I probably read an opnion piece and thought it was the reporting of a study.

Re: Face Masks

[conuly]

What I've read - aside from the article in this post! - suggests that wearing a face mask keeps people from touching their faces as much, again, provided they wear it properly and don't keep taking it on and off.

Re: Face Masks

[agoodwinsmith]

https://www.washingtonpost.com/outlook/2020/03/28/masks-all-coronavirus/?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR0kSLhhcl_v0wy-HEt3vz8hAGgVBcSH83mV23tv-8Z3_ztvB9yQDSC-AHE

The above is the link to an article behind a paywall at Washington Post, so I have not read it, but it was posted by someone I trust, and the conclusion is that even homemade fabric masks are protective enough to be worth wearing to the grocery store.

Video regarding droplets vs aerosols

[agoodwinsmith]

It doesn't really answer the question regarding masks for non-medical personnel use, but it does give some useful information that might help each person make up their own mind regarding each trip outside the home:

https://www.youtube.com/watch?feature=youtu.be&v=JJpt6Bse0j8&fbclid=IwAR1eVuhVztaFksnCc3Bwp8CQJtQoclBMRS1CvQIaDqd76coTSmVP7vwu_K4&app=desktop

[skygiants]

Further anecdotal data: my father, an infectious disease doctor who works at a New Jersey clinic (that has not yet been as hard hit with COVID-19 patients as some but expects to be in the near future), yesterday just placed a request with us to send him some homemade cloth masks that he can wear around the hospital/he and my mom can wear when leaving the house.

(I asked him if this was because his hospital was short on equipment already, and he said no, they're wearing N95s when working directly with COVID-19 patients, but they need masks to wear around the rest of the hospital/when interacting with each other and the cloth ones work as well for this purpose and are more comfortable.)

[conuly]

Thanks :)

[feng_shui_house]

Before I started sewing face masks to donate I did a LOT of googling around the internet, giving more weight to information posted by hospitals, doctors, nurses, and researchers, with added data from countries that have ordered/asked/habitually use face masks on the general public.

I think the remarks about cloth masks being more dangerous than being unmasked aren't backed up by logic or science. They may not do much good at preventing you Getting the virus, but I think they do reduce the risk of Giving the virus, if only by preventing wearers from touching their mouths/noses and then other surfaces, and also by giving other people a visual reminder to keep their distance.

The one study I found with actual data was about influenza- using cotton face masks reduced the infection rates over not wearing a mask at all. Also, interestingly- the cotton face masks were MORE efficient at capturing droplets/particles after 3 hours of use- so in the case of cotton, the slight dampness caused by breathing seemed to improve it for at least that length of time before removing to wash it.

Properly made double layer, tight weave cotton face masks were about 50% as effective as the N95 masks in that study. They did not increase the chance of becoming ill according to that study.

So I've been making cloth masks to donate to organizations that request them- I'm going with 100% cotton, double-layer, pleated, with cloth ties and a pocket that can take a disposable filter, if they have them. I think they will be of some use, until the proper filter masks are available.

In some hospitals medical care workers are using homemade masks *over* their N95 respirators in an effort to increase the useful lifespan of the N95 (rated at only 8 hours use before disposing of them). Desperate times, desperate measures.