There's been a lot of chatter lately about stuff we got wrong during the COVID pandemic. Fair enough. Nearly everyone worldwide got some or all of the same things wrong, though, so I'm not super inclined to hate specifically on Dr. Fauci or the CDC or WHO about it. It was just a really hard problem that came at us at very high speed.
But there's one particular "mistake" that deserves a little more attention: masks. A lot of people seem to think that mask mandates were proven to be just a piece of pandemic theater, and it's true that cloth masks and medical masks turned out to be of minimal use against COVID. But that doesn't mean masks are useless. Just the opposite. Recent studies have shown that we actually needed to mask better by encouraging broad use of N95 masks. Even better would be a program that distributes and fits N95 respirators individually.
I don't personally like this. I tried N95 masks a couple of times late in the pandemic and found them annoying. Nonetheless, they're what works.
This is something we should prep for. Maybe in a future pandemic we can reduce the social distancing to three feet and keep the kids in school. Lessons learned. But we should also be prepared to wear those annoying N95 masks anytime we're indoors. Unfortunately, I don't think this is a lesson that's gotten much airtime.
N95 masks are usually pretty flimsy, with flimsy straps that don't pull the mask to the face firmly. I used to use 'em, and was dissatisfied with the face-fit. I switched to a P100 respirator, and it's much better. I use one that has wide (>1in) straps that go around the head, and I can cinch those suckers tight -- to the point that I can't feel any air going past between the mask & my skin. And to boot, P100 respirators are sturdy enough that you can just replace the filters. I've been using the same one for 1.5yr, replaced the filters once so far.
Much better than N95 masks.
Good for you! A note in passing -- if you can feel air passing between the mask and your skin, the mask is providing zero protection.
Make $170 per hour. its very hard to find jobs nowadays. In this situation, you have access to a wealth of resources to help you with your working abilities. Be motivated to promote Thousands of works such as copy paste things through job boards and career websites vx10 on internet.
Just Take A Look At This>>>>>>>>>>>>>>> https://simpleaccess11.blogspot.com/
Make $170 per hour. its very hard to find jobs nowadays. In this situation, you have access to a wealth of resources to help you with your working abilities. Be motivated to promote Thousands of works such as copy paste things through job boards and career websites vx10 on internet.
Just Take A Look At This>>>>>>>>>>>>>>> https://shorturl.at/pqjkM
that is simply wrong.
The mask is providing impaired protection but it is providing protection.
By simple air flow mechanics, a mask is reducing potential 'contaminated' air inflows and at worst, ensuring that the air flowing into respitory system is less burdened with viral matter.
This is of course as well true of cloth and medical - except weaker. Reduction rather than elimination. Reduction being materially beneficial as even partial reductions give immune system improved chances.
And as that is important to infection (and the outgoing as well to spread infection), and we are not talking about asbestos but virus, this is entirely Cost-Benefit analysis reasonable result.
Of course the idea that a Respirator is the solution over masks of any sort when adoption of masks themselves was a challenge (and a cost) is typical Bourgeouis Left professionals engaging in academic excercises of self-defeating futility.
The questions here are not Zero - 100% on-off black-vs-white ones, but gradations of risk reduction.
Umm, whose N95 masks?
There are different sizes. shapes, to cover many of the different face shapes that work with them. Early non-N95 masks were pretty bad - a lot of stuff was NOT sized or shaped correctly and a fair amount of it was too small. Unlike proper hospital supplies - which were also in short supply.
Being an engineer, I got back of the head straps to engage the loops of our early stupid masks without sawing my ears off and allow more tension to hold the mask against our faces.
Then I checked different shapes, and my wife and and I got masks that fitted right. In my case, a KN95 mask with a deep fit under my chin, and a malleable metal clip that allows me to create a tight seal over and around my nose. Kept us good for 3 years, then we got one of the new strains - and with all our boosters, nothing other than a very short cold.
But then, my mother was a public health nurse, then a Navy Nurse - she was VERY practical, and saved MY life a number of times - including a massive measles infection in Maui in the mid-50s. I was iced down like a fresh fish for a lot of the time. including a ice turban to keep my brain cool. When the fever finally broke I looked like a fine polka-dot blanket.
N95 masks used properly work. There is no need to go further unless we are dealing with a highly contagious airborne version of AIDS, smallpox, or rabies with no vaccine or treatment.
The real issue is sanity about risks. Within weeks of the onset of COVID it was totally obvious that except in high risk situations (ie. people in contact with vulnerable people like the elderly) masking, social distancing, etc could be totally volutary - the death rate was low and it was clear we were not going to be able to stop the spread. Instead we tried to enforce masks, social distancing, closures, etc.
The damage to trust done by this will kill millions if we have a global pandemic of a more dangerous disease.
Obvious to whom?
"Acceptable death rate" is a concept that is unacceptable to most people.
"Maybe in a future pandemic we can reduce the social distancing to three feet and keep the kids in school. Lessons learned."
Unless the future pandemic impacts children more heavily than adults, or its vector particles are viable longer-term outside of human hosts. But sure, if in 2026 there's a global pandemic of covid-19, we'll be very knowledgeable of what to do in response!
Agree with you 100% about N95 masks or respirators. We now keep a supply of N95s stocked at home (same as we do with spare batteries, jugs of water, and a first aid kit).
The other lesson we should take from all of this is to invest much more heavily in research, including detection. I'm afraid that that's getting lost, though, as far too much of the politics of all of this reduces more or less to "Lockdowns were unpleasant and it's the fault of Fauci/big government/know-it-alls who didn't know it _all_! Next time I'm going to go with my gut and just eat horse paste!"
We already had N95 masks. Thanks to global warming, there are a lot more forest fires. We've been having seriously bad air in late August into September. Sometimes, everything gets covered with ash. The sky turns yellow and stays that way for days. We bought a box of 3M N95 masks so we could go to the grocery store. When COVID hit, we were ready.
Most plagues in human history have hit hardest at the young and the old. Covid is extremely unusual in its lack of effect on infants. (The Spanish Flu was REALLY weird; it struck hardest at working age adults.) Based on history, it's extremely likely that the next pandemic WILL impact children more heavily than adults.
IDK. I feel like if everyone had a stockpile of the much cheaper KF94 masks, we'd be far better off.
Post-pandemic, I hope the Biden administration (and the rest of the world) learned the lesson of supply chain bottlenecks and logistics constraints to have contracted with manufacturers to stock distributed warehouses with a few billion masks.
And bonus if everyone installed UV systems into their HVACs, starting with institutional buildings.
+1 And all the whining about how uncomfortable masks are would disappear.
This post is exactly right. Cloth masks accomplished three things:
1. If you were coughing or sneezing, it protected others from you;
2. It kept you from touching your mouth and nose, two possible routes of infection;
3. It was a form of signaling, to remind others to social distance.
They were useless for aerosolized virus.
Can someone educate me, please? When people refer to "cloth masks" are they talking about (a) lower-quality store bought masks (ie, non N-95 masks) or (b) simply wrapping a piece of cloth around one's face (ie, a bandana)?
1. If you were coughing or sneezing, it protected others from you
Precisely.
And if all or most of us wore cloth masks, we’d reduce overall transmission. In particular, we’d “bend the curve downward” (remember that?) and reduce the overwhelming of hospitals that was such a threat in early 2020.
I will easily agree that cloth masks don’t do much to protect the wearer directly , but by reducing the number of cases the protection for everyone - including the wearer - can be substantial.
N95s are indeed uncomfortable to wear for any length of time, but the attitude “it’s N95 or nothing” is seriously misplaced. It leads to mask resistance that hurts us all.
Exactly, exactly.
The all or nothing reaction is a classic Perfect being the enemy of the Good.
and the analysis of cloth as useless off-base for the very reason you cite - it is a misanalysis of the tool as a "personal safety / infection prevention device" rather than a "transmission risk reduction tool."
Accomplishing (1) is of material utility.
They were and are not useless against the virus, they were and are a transmission reduction device, and since cheap and easily worn, modest reduction of incoming but more importantly outgoing viral cloud from coughing / breathing is useful.
If one analyses as a prevention device in same order as N95 then of course one ends up saying useless, but that is not the mode of utility - there is far too much black-and-white reaction.
They weren't useless. They just weren't as good as properly designed masks.
"They weren't useless. They just weren't as good as properly designed masks."
Exactly. And properly designed masks were in very short supply, and desperately needed by medical professionals dealing with sick patients.
Which means, in the beginning, cloth masks were about as good as we could get. Once more high-quality, properly-designed masks were available at reasonable cost, switching to them was the right thing to do.
It did drive me crazy having so many people bitch about how ineffective masks were when they were trapsing around wearing cloth masks (face coverings) and not even wearing those properly. Those masks mostly deserved the scorn they received. The recommendation on cloth masks was put out because there was extreme shortage of n-95 in early months. Unforturately CDC never seemed to hammer home the message that n-95 or kn-95 mask were HUGELY more effective. Wearing them didn't bother me too much, but I was never in a situation in which I needed to keep one on all day.
If someone wasn't going to wear a cloth mask properly, what were they odds they would wear a *95 mask properly?
The N-95 masks worked fine. Policies expecting humans to wear them doomed to failure to a great extent because they expected humans to comply. Herding cats would have been easier.
Also, it isn't easy to put on an N-95 to where it actually provides respiratory protection. Practice and testing to make sure you've gotten it right are a must, which of course nobody ever gets.
Also beards are a big no-no. Sadly, they've become a Fashion Must among the elderly (at minimum). I was amazed by all the old dudes with chest length Duck Dynasty beards, and a little respirator embedded somewhere in the middle. NO! That doesn't work! (And looks really stupid.)
If you wear a respirator, as opposed to a cloth mask, you need to be shaved along the surface where the respirator seals. No beards. No mutton chops. And no handlebars, unless you can tuck them in.
One might think women would have it made ... but too often, respirators come in one size, and it's for men.
That's ironic since they were invented by a woman, Sara Little.
I don't know about Fashion Must, but it's been nearly 50 years since I last shaved. I was well aware that my beard rendered my mask ineffective, but I wore a mask when and where requested and nobody, even in medical offices and hospitals, ever commented on the beard.
A couple of years ago, a randomized controlled trial in Canada showed that N95 masks were just as ineffective as cloth masks and surgical masks.
Thankfully, this site permits links.
I can’t find the study you mention, but here are several general comments on mask studies. To begin with, there are ethical problems with deliberately exposing people to COVID-19. This means that it is unlikely that a randomized controlled trial testing the effectiveness of masks to prevent the transmission of COVID-19 will ever be performed.
What has been tested in randomized controlled trials is the effect of providing people with free masks and asking them to wear them. As a general rule, a lot of people in the test group or groups don’t wear provided masks. Often, a lot of people in the control group do wear masks. You say that the study you are referring to was conducted in Canada a couple of years ago. At that point, Canadians were probably getting advice to wear masks from a lot of sources independent of the study, and Canadians are wealthy enough that the cost of masks was probably not an impediment to wearing them. So the difference in mask wearing between the test groups and the control group may have been quite small.
There’s also an issue of how to measure difference in transmission. If you measure the number of cases of COVID-19 in the test group and compare it to the number of cases in the control group, that will miss a lot of transmission because it will let you detect transmission to individuals in your study, but not transmission by individuals in your study to individuals outside of your study. Since masks are believed to be more effective in preventing transmission from the wearer than in preventing transmission to the wearer, this approach disregards too much data to be very meaningful. Therefore, the good studies measure the number of cases in a community. Communities are randomly assigned to the test group or the control group, and the treatment (encouraging people to wear masks) is applied to people in the communities in the test group. This results in a relatively small sample size, and has the potential for cross-contamination (because COVID can spread from one community to another), so it’s easy to get results that aren’t statistically significant.
Failing to find a statistically significant result in one study doesn’t mean that masks aren’t effective, or that N95 masks aren’t more effective than cloth masks.
Some Canadians, using data from Ontario's health care system, published a study showing that getting a COVID vaccine decreases your likelihood of being admitted to a hospital as a result of a car crash. I think this says something about the kind of people who have problems with masks and vaccines. Some people just value their lives more than others.
A classic example of "correlation does not imply causation".
I find it easy to believe that people who have been vaccinated against covid have a lower car crash rate than those who haven't been vaccinated, but to assert a causal link like "getting a COVID vaccine decreases your likelihood of being admitted to a hospital as a result of a car crash" is going further than the data support.
The other thing we need is inexpensive air scrubbers for schools, offices, shops and such. A scrubber is a box loaded with items similar to nested whiffle balls. The idea is to provide a huge surface area in a small volume. Water is sprayed or misted in here while air is pumped through. More effective than filters and it never clogs. Just change the water frequently. Also we need to arrange air flow from ceiling down to the floor. We have already solved this long ago in semiconductor fabs.
Keeping the air free of viruses, bacteria, pollen and dust will solve all sorts of health issues.
These work great:
https://a.co/d/hMZcMON
Prior to Covid, South Korea had outbreaks--and came up with their KF-94 masks. More comfortable to wear and effective, and I don't think require formal fittings to work well. That said, beards can be a problem.
Stick neosporin up your nose.
No, not like that!
https://news.yale.edu/2024/04/22/common-antibiotic-may-be-helpful-fighting-respiratory-viral-infections
It’s pretty rich that people like DeSantis put blame on Dr. Fauci and the vaccine for Covid. The reality it was the decisions of DeSantis to open up Florida’s economy just at the time that Delta hit that caused tens of thousands of more deaths in Florida. During the first wave of Covid Florida and California had roughly the same rate of deaths. But DeSantis abandoned precautions and thus Florida was hit very hard by Delta. At this point Florida is 7th in deaths per million. California is 38th. DeSantis acts like this is a success.
I think it’s really clear that the parts of the country that took the most precautions had the lowest death rates. But most stories I’ve seen regarding “lessons we’ve learned” from Covid mostly talk about the economy or minor fluctuations in school test scores.
And the effect on California could have been reduced, but: https://revealnews.org/article/california-created-a-massive-medical-reserve-with-acute-care-beds-ventilators-and-n95-masks-and-let-it-collapse/
Desantis was all for keeping Spring Break going just after Covid hit.
People looking at how it spread looked at cell phone data. It looked like Spring Break help spread covid across the country.
The cell phone data and covid outbreaks also mapped truck travel--from cities to meat packing plants.
I had a front row seat to this pandemic and from where I sit, the lesson is for Republicans to go fuck themselves. Let them die next time. That’s my advice to the medical researchers and pharmaceutical companies. Don’t bother.
I would agree, except that the behavior of Republicans puts OTHER people at risk, eg the elderly, the very young, people with respiratory conditions.
If there were some way to keep Republicans from circulating among sane non-sociopaths, then fine, let them Christian Freedom themselves and their families and friends to death. But absent that, WE have a problem.
The rest of us are going to keep our distance and stay home until it passes… just as we did in 2020.
My mom died in December 2020 in assisted living while I was working my ass off trying to solve the problem. I have no illusions about the cost.
As I recall the Obama administration looked into storing N-95s and found there was a real problem with storing an adequate number due to their short shelf life. Their solution was to design easy to operate mask making machines that would be stored at government warehouses along with large quantities of raw materials. Apparently the shelf life of the raw materials is not an issue.
Anyway, early in the Trump administration, the designs were ready to go and the contracts ready to let. Trump, in his war on all things Obama, dumped the whole plan. He also threw out the "Pandemic Playbook" the Obama administration developed.
It seems to me that Obama's administration had arranged to get some people from the CDC, or some such agency, stationed around China. Their high level mission was to be on the lookout for disease outbreaks and short-circuit the resistance of local Chinese officials to reporting any bad news up the line. Trump got rid of them as well.
(Off topic, but let's not forget the destruction of the nuclear deal with Iran as well.)
“Their high level mission was to be on the lookout for disease outbreaks and short-circuit the resistance of local Chinese officials to reporting any bad news up the line. Trump got rid of them as well.”
James Fallows wrote about this in an piece or The Atlantic title <The 3 Weeks That Changed Everything. The planned followup, once we learn about an outbreak, was to have the President of the United States call the President of China and convey that the outbreak needed to be contained as quickly as possible. Trump didn’t make that call because he was in the middle of negotiating a trade deal with China and didn’t want other issues to get in the way of that.
https://www.theatlantic.com/politics/archive/2020/06/how-white-house-coronavirus-response-went-wrong/613591/
On January 14, the World Health Organization said it had been told by China, "preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission." By then Trump knew better, but he didn’t inform the World Health Organization. Nor did he inform governors in the United States that they might soon have to deal with a pandemic so they could begin preparing.
I use a rule of thumb with an N95: it has to dimple when I inhale or it isn't fitted well.
During the pandemic the Sikh religion explicitly told men they could shave their beards to allow proper masking.
Indoor air filtration was missing from this post. That very likely will cut down the number of circulating viruses if well implemented. And it doesn't require the people that shout freedom when you ask them to wear a mask to do anything.
This seems like a much better solution for the America that actually exists.
Most N95 masks are not comfortable. That may be a design requirement so they are leak free. Designing an effective mask that is also comfortable would help encourage use. The real problem with masks is the political opposition, which represents disobedience to scientific authority, which is ironic considering its use to arouse authoritarians.
KN95 masks that I've used are much more comfortable than the N95 I've used, and from what I've read, very effective. I use KN95 when in crowded indoor spaces. Recently there's been an uptick in COVID in my area so I'm wearing the mask more often.
The US is not the only country in the world and many countries did much better than the US and European countries at containing Covid until vaccination was nearly complete. Those countries had much lower death rates.
I have not read every post-mortem piece, but those I have seen in major media (and in this blog) basically ignore the information from these countries.
And again, the next pandemic could be much worse and how bad it will be will probably not be known until there has potentially been a lot of transmission. We need to know what has to be done to prepare for the worst case, and those measures should be applied immediately. They could be relaxed as more is known - you can't do it the other way around. Most analyses - which again are incomplete in not including the countries where death rates were actually low - are probably promoting the wrong lesson in implying that measures will not have to be as strict next time.
I agree with these points but I'm not sure cloth masks were a total failure. I think it's plausible they helped for source control. The idea is that people exhale large droplets which then shrink through evaporation, especially in dry air. The evidence for this, as with most things mask-related, is weak.
Yes. Cloth masks help prevent transmission even if they don’t do much to protect the wearer. Fundamentally they’re a partial barrier that reduces the velocity of outgoing breath: if I’m wearing a mask I’m effectively further away from you.
Because of that, if all or most of us wore cloth masks, we’d reduce overall transmission. In particular, we’d “bend the curve downward” (remember that?) and reduce the overwhelming of hospitals that was such a threat in early 2020.
I will easily agree that cloth masks don’t do much to protect the wearer directly but by reducing the number of cases the protection for everyone - including the wearer - can be substantial.
Spread of airborne diseases is exponential; reducing the exponent even slightly integrates to a lot more survivors.
N95s are indeed uncomfortable to wear for any length of time, but the attitude “it’s N95 or nothing” is seriously misplaced. It leads to mask resistance that hurts us all.
Masks WORK! - even a poor mask stops 90% of the tiny droplets with virus particles - and you need a number of virus particles to become infected
It's like seatbelts - they don't save you in any crash - just most of them
Here (NZ) for the first two years we had less deaths than usual as the reduction in flu deaths was greater than the Covid deaths
Even after we opened the borders the death rate here was one of the lowest in the world.
I would say one of the main lessons to be learned is that when you need to do something it needs to be done FAST
"Masks WORK! - even a poor mask stops 90% of the tiny droplets with virus particles"
That's kind of the whole debate here. Early on, they thought that the main vector for Covid transmission was droplets exhaled when people sneezed or coughed. Those were pretty large and a cloth mask could *help* reduce transmission. As it turns out, though, Covid also travels on microscopic aerosols that you can exhale just through regular respiration and that gets around most masks. A well-fitted N95 or better respirator is really the only way to protect yourself from that and most people don't wear even those correctly, so the effect was probably pretty minimal in the aggregate.
The fact that we know about aerosol transmission now suggests -- and I'm surprised Kevin didn't mention this since he wrote about it quite a lot during the pandemic -- was the use of UV room disinfection as a public health measure. From what I read the last couple of years (and maybe there's better science available now), UV filters and disinfection lights were highly effective at reducing the amount of Covid aerosols in a room. In a future Covid outbreak it could be that people can be allowed to gather and socialize more freely 1. if they're tested and 2. the room is equipped with UV disinfection.
There's no reason to think the next pandemic will be relatively less harmful to children as COVID has been, it's quite possible children will be more vulnerable and schools will have to close regardless of whether idiots don't want them to or not.