Again another article that doesn't even mention the use of masks and hand sanitizer.
The cost of the epidemic now goes into the trillions, self-made cotton masks are cheap compared to the economic damage. They can be disinfected in boiling water and if everybody uses them they will help to stop the spreading of the virus.
In all the countries mentioned in the article people wear masks when in public, often just against pollution (i.e. Thailand).
The moment we open our mouth we spread germs, even more so when we speak. And when we touch our nose or mouth, we have them on our hands.
Thus entering a supermarket without a mask and without first disinfecting the hands should be forbidden.
Social distancing is one thing, stopping the virus at the source is another and seemingly very effective measure.
Can you please attest to the correctness of the news about the Czech government stealing a shipment of masks that was meant to be delivered to Italy [1] ?
If so, is there something the "outsiders" are missing (e.g. some political bs between the two countries) ? Or is it just plain old theft ?
Czech authorities during a customs raid last Tuesday mistakenly seized 101,600 facemasks gifted by a branch of the Red Cross in eastern China to a Chinese community in Italy. Although Czech officials apologized for the mix-up, the Italian newspaper La Repubblica on Sunday published a bogus article claiming the Czech state had “stolen” that shipment – and much more.
Czechs would send 110,000 facemasks to Italy on Monday (March 23), dispatched along with an evacuation bus of 43 Italian nationals heading home, as agreed with the Italian Embassy in Prague.
---
My comment is that our goverment officials or those policemans are probably stupid...
> --- My comment is that our goverment officials or those policemans are probably stupid...
Or they thought "better safe than sorry", given that smugglers aren't stupid and you can't just believe it was sent by Red Cross just because the courier says so.
If anything, I'd ask why La Repubblica published a bogus article.
It's not clear how the masks appeared in that storage. It may be well possible the masks were stolen by somebody who wanted to sell them. The company owning the storage didn't comment.
A good faith interpretation of aneutron's comment is that they heard this report on Reuters; saw the author is from the Czech Republic and thought it was a good opportunity to find out about "local news" on the issue to get a different perspective.
Agree it sounded confrontational, but it probably wasn't.
You are correct. There are generally some "hidden" fact. Like some news outlets try to run the story as something that it isn't. It was not confrontational at all.
A lot of people was/is sewing them at home. My wife (data scientist in a normal life) made some for our family incl. grandparents and also for some neighbours. A link from a local "Etsy" [1].
The government even made an exception so the sewing supplies shops could open.
A t-shirt or bandana or scarf will make an excellent makeshift mask. This is not the equivalent of an N95 mask that should be used by health care professionals, but is good for ordinary citizens in public.
Yep, especially as the main purpose of the mask is to protect you from potentially infecting others. Asymptomatic carriers are a huge problem for the coronavirus pandemic - people might be spreading it without knowing and might only get ill much later.
By using even a very rudimentary mask, the infected droplets have it much harder to get out to other people and to contaminate surfaces. Also you are less likely to touch your face, so less hand contamination & thus less surface contamination.
Of course this only works if everyone has a mask, but given how easy it is to make simple cloth masks I think this is a fully reasonable requirement.
I'd be surprised if that worked at all. At least one Chinese ecommerce website is preventing foreign IPs from even viewing item listings for masks. When you try to view the item from the search results, it gives you an error saying something like export is prohibited.
> The halt to almost all international passenger flights in and out of China will make it even harder for other countries to import N95 respirators, disposable surgical masks and other personal protection gear from China for their own doctors and nurses. About half the world’s airfreight typically moves in the bellies of passenger aircraft, while the rest travels aboard air freighters.
> Previous, large-scale cancellations of passenger air services to China have already created an acute shortage of air cargo capacity over the past two weeks.
> But Monday afternoon, Delta said it’s putting an unspecified number of passenger jets back in the air, flying out of 13 American airports and to 70 destinations overseas. Delta’s not selling any tickets for those planes, however. Rather, they’ll be operated by Delta’s cargo arm, running charter flights to cater to anyone who needs to move a package or pallet.
The problem with use of masks in the US is that we do not have enough masks and we need them all for health care workers. If there aren't enough masks for health care workers, doctors and nurses will stop coming to work people won't be able to get medical attention the death rate will sky rocket because of lack of simple medical procedures, there will be panic in the streets, etc.
For this reason our media seems to be under strict orders to de-emphasize masks and just talk about distancing and hand washing.
It is very regrettable that we have a completely incompetent federal government that did not stock up on masks even though they had plenty of warning but these are the facts. If we ever make enough masks so that all the health care workers are covered, then yes all civilians should wear masks. I am sure then the media will start talking about masks.
You are confusing "masks" as "surgical masks" aka. N95. He is meaning just the regular masks with no filtering whatsoever, that are very easy to manufacture. Hell you can even make them yourself. The N95 however, are quite difficult to build and require specialized machines to manufacture the filtering part, somebody linked a good article to it a couple days ago.
All in all, there is in my opinion no excuse to not to have everyone wear government provided masks, even though they don't offer complete protection. That would make it culturally the norm and hence many of the people who start coughing, but aren't sure do they have the virus, would at least have the mask covering their mouths to catch most of the escaping droplets. And also it would make it a little more difficult for everyone to rub their facial areas with their hands.
Surgical masks don't need to offer complete protection. For one thing, something is better than nothing. But more importantly, the reason people in Asia wear these masks isn't really to protect themselves from getting sick, it's to protect everyone else from getting sick from them. It's a product of a culture that values acting in the interest of the group instead of only in your own selfish self-interest.
So it's sorta like "herd immunity": if everyone is wearing a mask to keep everyone else from catching whatever they might have, it makes it much harder for diseases to spread around and everyone benefits.
Surgical masks:
1. keep the wearer from infecting the patient
2. keep fluid spray (e.g. bleeding) from getting in the face
N95 respirators are meant to protect the wearer from airborne particles, which surgical masks don't really do at all, since they don't form a seal and air and particles still go around the mask into the mouth. Many N95 masks have an ubobstructed one-way output valve for easier breathing that will not protect the patient from the wearer.
And as it mentions, surgical N95 masks (the blue respirators many medical professionals wear in news photos lately) do both.
* Edit: Another 3M brochure shows that many of their non-N95 masks are also tested for filtration efficiency, even though not certified by NIOSH.
And the trillions of loss in economy could have been much lower if everyone wear a mask ( Surgical or not ) and kept business opening. It will also greatly flatten the curve in public health services, while buying time to find a vaccine or improve health services capacity.
There is no reason why Mask's supply problem could not be solved when you are looking at a comparatively speaking trillion of dollars package not to save the economy, but barely holding it up so it doesn't fall.
I am still baffled at the insistence that mask are useless, surgical or not. When there are ample of evidence to suggest it is thebest tool to help and stop virus from spreading.
WHO currently says that healthcare professionals in non-AGP areas who aren't doing AGP should wear surgical mask, gloves, apron, and do a risk assessment for eye protection. All of that PPE is single use. This is the current practice in English NHS settings. See here: https://twitter.com/OutbreakJake/status/1242020875328684038
If you are in contact with infections substances all day every day you need 99.99999% (I'm pulling this figure outta my ass, but you get the picture) protection. To bring R0 below 1 you need 75% protection. That's why we saw advice like "just wash your hands" - ultimately inadequate, but it wasn't apriori silly.
A lot of masks sold retail can’t be used in hospital settings in America. Many hospitals have strict rules about procurement and origination of things like N95 masks. Meanwhile, I can order comparable masks from China and have them in less than a week in quantity. It’s very much cultural as well as government response (why we are sucking so much at controlling this).
> A joint law enforcement operation by government agencies including the State Administration for Market Regulation (SAMR) was launched in early February, with over 80 million defective face masks and 370,000 other faulty PPE items seized, SAMR official Yang Hongcan told a press conference Thursday.
For our use, faulty KN95 masks are better than nothing. Maybe they suck but it’s better than nothing and probably better than home made masks. You have to shop around and find reputable sellers that have been in business a while to mitigate risks as much as possible. I trust Aliexpress slightly less than Amazon these days which says a lot. Amazon used to have my unquestioning trust. Now I barely use them in favor of other retailers.
Are they? It's unclear whether KN95 masks are better than a piece of fitted fabric around your mouth and nose. That's the trouble with masks; we don't know what works and what doesn't.
I wi work on the assumption that it is at least as good with a probability to be better. We know how this virus is transmitted and what is needed to filter it, it’s just a particle. We have strong evidence from the healthcare community that these masks keep workers COVID-19 free. They definitely work on other viruses of a similar size...
> If there aren't enough masks for health care workers, doctors and nurses will stop coming to work people won't be able to get medical attention the death rate will sky rocket because of lack of simple medical procedures, there will be panic in the streets, etc.
No, for the most part they won't stop coming to work, for better or worse. My wife is an RN in charge of a critical unit caring for confirmed covid-19 patients. They were asked to reuse masks and gowns a week ago due to lack of supply. As far as I know none of them has refused to go to work, and she in particular will be on 4 12-hour shifts this week.
If you look at the data here [1] (desktop edition because the mobile edition doesn't have drill down), you can see that all countries (including Asian) are following the same pattern in the "daily increase" graph (click a country on the left to see its data). The only outliers are China and South Korea (flatline), and Japan (flattened curve).
So while masks may have some effect, it hasn't been enough to give different graphs to Asian nations in general.
Wait, which countries are we referencing outside of those three?
Thailand looks straightforwardly exponential so far and has fairly heavy mask use, agreed. But Singapore, Taiwan, and arguably Malaysia seem too early to call: they're still plausibly on either of a European curve or South Korea's ramp-then-flatline.
Vietnam, Cambodia, Laos, Mongolia, and Burma all seem to be below the line for meaningful data. And Hong Kong isn't broken out. So I guess my questions are: do Indonesia and the Philipines have "mask cultures" to a level comparable to South Korea and Japan, and are their testing regimes wide enough to rely on those curves?
I don't know the answer to that. And I agree that the "masks work" graph/meme circulating is questionable. But unless I'm missing something/somewhere, this data just looks like "too soon to call"?
Did you read the NPR article? The very first chart shows that there is a big difference between the various countries. The logarithmic scale allows for much better visualisation than the almost nonsensical charts on the John Hopkins statistics page. The circles are also a completely inadequate visualisation. I.e. much better would be coloring countries by incident rate per 100.000 inhabitants.
They do a good job collecting all the data but a seriously bad job visualising them.
Yeah, except you happily disregard the fact that a lot of asian countries including china have reimported cases mostly from Europe and the US. I'm pretty curious how this plays out in those countries.
> In all the countries mentioned in the article people wear masks when in public, often just against pollution (i.e. Thailand).
Singapore resident here. Not enough people are wearing masks in Singapore, and the government has only distributed a token 4 masks per household (family members living at the same address), with no further measures to allow a family to replenish their mask supply.
A lot of us can't buy new ones at reasonable prices even if we want to.
German resident here, our chief virologist that everyone listens to, Christian Drosten, was firmly against mask usage in the common population, until just now, the RKI was similarly unhelpful when communicating advice for the disease.
The population is completely confused and feel righteous anger now telling people off when they wear professional (medical disposable, or ffp3/n95) masks to go shopping or elsewhere. It's insane.
I don't know about that expert, but the reason I usually hear about not using masks is so that health professionals could get them - ie, the problem is that supply isn't currently enough for everybody, and we should prioritise those for which it's most helpful.
The problem with using "masks don't work!" to keep the supply available for healthcare is later on, when supply is available for universal mask wearing, they'll have eroded public trust when they do the 180 on the advice.
They should've instead:
* Banned sales of masks to the public until healthcare and other essential workers had enough stock.
* Honestly conveyed the reasons for the above ban, in WWII-style "do your part" advertisements etc.
* Encouraged homemade cloth masks, bandannas, etc. to reduce the spread of droplets.
* Ramped up surgical mask production to get supply to the general public as soon as possible.
a) implies competency
b) where's the profit? U.S. is a country where solidly 1/3, with enough political capital to prevent alternatives, believe that healthcare is a product not a right
(another 1/3 don't care because the system doesn't affect them, until it does)
>where solidly 1/3... believe that healthcare is a product not a right
And I guess the opposing 1/3 just don't understand the difference between positive and negative rights?
Healthcare, as a matter of fact, does represent a collection of products and services, and access to those products and services represent a positive right because it requires somebody else to provide something for you.
It is only negative rights, those which define what other people can not do to you, that should be considered inalienable. The right to free spreech doesn't require somebody else to go to school for 20 years so that you can express yourself, they just aren't allowed to prevent you from doing so.
Intentionally or not, people like you confuse the issue by treating both positive and negative rights as the same, and actually do not seem to understand, or are avoiding acknowledgment of the fact, that treating a positive right as some kind of natural right carries the high potential that you will be demanding access to another human being's labor or resources against their will, and in America, 1/3 of use are against the enslavement of others.
This is one message that has me really confused. Why are masks being sold to the general public if this is the case? It's as if manufacturers and suppliers are helpless but to profit from public demand and the fault is a personal moral failure on behalf of everyone that wants to buy a mask for their own use. How can medical supplies be interrupted by public usage? Are doctors expected to swing past a pharmacy on the way to work and stock up on the supplies they need?
And then in many Asian cultures it's considered a moral failure to not wear a mask in these times, yet hospitals function. This problem clearly isn't universal, or inherent in capitalist functioning.
At least in the US the main reason is the public hysteria that would be brought on by the mass cultural shift. The reality is most households in the US do not have masks. There would be similar chaos that the US has seen with toilet paper but on a more dire scale because they DO actually help and, unlike toilet paper, when they are gone they WON'T be replenished in a timely manner because there is a shortage of retail masks.
It's propaganda. It is reasonable propaganda as having to have actual PSAs on how to sew your own masks or make them out of materials at home would really start ramping up the general anxiety.
Thank you. This is extremely frustrating and shaming individuals who buy masks is dumb. Why are they in the retail system at all if they are so important for healthcare workers?
It is saddening to see the experts also succumb to straight lying to the public. I'm sure they think this is 'for the best', because there aren't enough masks to go round and what there is needs to go to first line healthcare workers.
But trust is hard to gain and easily lost. A real compounding factor in this crisis is also that our leaders have lost all credibility. In many, if not most, countries, the citizens just know that actions that were and are being taking are neither competent nor in their best interest. The specific implementations of democracy we implemented never selected for reason, precaution nor long term benefits or well-being for all.
So most of us have a political 'leadership' (and I do not mean a specific country or party, it's mostly across the board, with few exceptions) that has lost all credibility, trust and moral authority long before this happened, leaving the population already at best confused, but mostly mistrusting and (justifiably) cynical.
For scientists to go 'on message', telling obvious non-truths, just further undermines the already shaky ground they were on after decades of anti-science propaganda.
I really, really hoped they would refrain from this, but, judging by what is happening in my own country and what the science community is publicly communicating (privately it is a completely opposite discourse), I sadly must say that the opposite is true.
To add a bit more data to your assertion, most of the 9,000 cases in South Korea can be traced to a handful of gatherings where people didn't wear masks.
First there was the cult in Daegu, where believers are not allowed to cover their faces because apparently their god can't see through fabric. Mass infections also occurred in churches where people took off their masks to eat or sing together, or tried to "sanitize" one another's mouths with a folk remedy. A gym in Cheonan was responsible for the majority of cases in that province, and recently there was a small burst of cases in an insurance company call center in Seoul.
Meanwhile, the subway in Seoul is just as packed with people as always, but I haven't heard of a single case that was conclusively traced to the subway. Why? Everyone wears a mask when riding the subway and sanitize their hands afterward.
Masks have been so effective that the Korean government has even stopped publishing locations that were visited by infected people if they are known to have worn a mask while visiting them. Yes, they still track down each and every case outside of the Daegu area.
Any chance you have some sources on this? There a lot of talking around the subject of masks, but I don't have any articles or similar to show people when discussing this.
The bit about masks is my own conclusion based on a lot of different local sources.
The closest thing to a comprehensive source about the distribution of infections in South Korea that I can find is [1], which still contains too much Korean-in-a-canvas that can't be automatically translated:
54.6% of cases are related to the Shincheonji cult
0.5+0.7+0.5% various other churches and religious groups
1.3% Daenam Hospital (almost all cases occurred in the psychiatric ward, as well as the attached funeral home where the Shincheonji cult leader held his brother's funeral)
1.2% related to gyms
1.2% related to the call center in Guro-gu
3.6% nursing homes
6.3% related to other mass infections (this includes other call centers, nursing homes, etc.)
11.3% contact with people infected from one of the other sources
3.3+0.6% infected overseas
14.9% other/unknown
Of course this doesn't say anything about masks. But you can clearly see that unlike in many other countries, ~70% of cases in Korea are concentrated in a handful of clearly delineated groups, with relatively little spillover into the general public. It takes a bit of familiarity with the religious landscape of Korea and the workplace culture to recognize that most of these groups are where people don't wear a mask. (As for nursing homes, the elderly often have difficulty breathing through a mask, not to mention they're together 24/7.)
Some people still got infected while wearing a mask, though, so it's not bulletproof. But it seems that the effect becomes visible as a kind of herd immunity when aggregated over a large population.
As for the government not publishing locations visited with a mask on, here's an example from my city's official Instagram account [2]. It says that the infected person's movements on some days are redacted because she wore a mask on those days (among other precautions) and therefore didn't make any epidemiologically significant contact with other people. You can compare this with other press releases by the same account that contain a lot more location data for other people.
I use self made cotton mask to go for groceries. It's garbage - it doesn't fit tightly around the face and most of the air I inhale or exhale goes through the sides unobstructed. Proper masks would be nice but unavailable everywhere and of course washing hands is a must.
It's not about protecting you from other people, it's about protecting other people from you. Many people are asymptomatic or very mildly sick, yet are able to infect other people. When you cough or wipe your nose, you risk infecting other people. The cheap mask prevents you from touching your face as much and catches heavier particles that can't curve around the bends of the facemask as easily like water and mucus.
No, it actually does protect you, just not as effectively as N-95s. That’s why hospitals are seeking out donations of homemade masks right now.
“The masks don’t do anything” story was just something floated around to prevent runs on hospital supplies. A better strategy would’ve have been to say “everyone make and wear your own masks and it will afford us some additional amount of protection.”
Dr Michael Lin, the author of that PDF on COVID that was posted here a while ago had this to say:
"A T-shirt is 79% as effective as a surgical mask. So if someone is coughing next to you and you can't escape, breathe through your shirt sleeve. Any filtration is better than none."
I wouldn't rush to assume that it was part of a deliberate deception. People assume the function of an item from its intended use all the time and surgical masks genuinely don't provide that much protection from some viruses like measles or chicken pox. I think it's just a case that "they don't protect you" being the unexamined received wisdom and people just not bothering to look at actual studies.
I wish this was true, but I saw this claim made by more than one public-facing scientist that I’m certain knows better. If we had started adopting mass mask wearing, we could have helped reduce the spread and had people geared up to make masks for frontline healthcare workers.
One perhaps underappreciated benefit of even a "garbage" mask is that it's a great reminder not to touch your face. That might turn out to be important.
The doctors in my fiancée's department (ophthalmology and optometry at a major state university) have been officially prohibited from wearing masks, even if they provided a mask themselves. They are right in front of all of their patients' faces.
> Other potential considerations being explored include:
> Limiting use of N95 masks to only procedures where respiratory secretions can be aerosolized, including intubation for PUI or COVID+ individuals. Use loop surgical masks for all other encounters. Read the latest guidelines on keeping the coronavirus from infecting health care workers.
> Limiting use of loop masks to only encounters with patients on droplet precautions such as PUI or COVID+ or other flu like illness investigations.
It sounds like their department has implemented this second recommendation. I feel like that's sub-optimal.
It looks to me like a bit of an indication who has the most social capital. China was late to the party because the local chief of police overrode the doctors during the early days of the crisis.
The rejection of masks looks to me like a similar prioritization of law enforcement's preferences over public health.
This. Asian countries that have ostensibly contained it well has wearing masks in common (except Singapore but it's still at 20%). Their other responses vary in scope and strictness. That said, most of them are islands or small countries.
But then you have Vietnam, also pervasive mask usage. Shares landborder with China which is leaky at best. They were also very proactive like the other countries but have a fraction of the resources. I don't think it's an answer for containment, many that cracked down early are seeing record case levels now, but I wonder if it's enough to reduce spread and severity.
But the rationale that made sense to me is that covid19 spread via respiratory particles, and mask reduce the viral load over time, which reduces risk of infection and severity since your body will have more time to recognize the infection and ramp up antibody production much earlier in the virus’s exponential growth cycle. Reduces R0 when ubiquitous. Maybe it spreads the curve and crushes it at the same time by reducing severe cases.
Seems like a cheap experiment short experiment to run honestly. Give one group of essential workers masks vs control. Test in 7 days and collage symptom severeness etc. Giving everyone surgical or home made masks is cheaper and less damaging than what's happening now. The HK SARS tsar who was also part of the Wuhan investigation team endorse public mask usage.
Exactly. Masks are like dampeners. Even if not everyone's masks are good (cloth masks), they'll still slow the spread, hence significantly fattening the curve.
Advising people to not wear mask is the biggest disservice the American government (and the CDC) did to its people. Just asking people to cover their mouths with bandanas and scarfs would've helped a lot.
I shudder when I see reporters in a breakout zone reporting without masks on. Man.
Yesterday I was in a shop and saw 2 different people with a scarf over their mouth. You would think this is no problem, but they both had to keep this scarf up with their hands... . Seems like the most effective way to spread and receive germs.
Govermnent needs to be clear what the protocol is.
Even cloth filters out 70% of respiratory virus particles. The notion that only a properly fitted N95 mask is effective is ridiculous and is probably costing lives.
This. Also, nobody ever talks about double masking. You know, if you've got no N95, then put on two surgical masks (each facing the other way). If you don't have surgical marks, wear two cloth masks and wash them with antiseptic solution daily.
sure, but this seems like a minor quibble. Much cheaper for govt to manufacture and distribute simple surgical or cotton masks than shutdown entire GDP/forgo all tax revenue. The masks in question are not complicated to produce, whereas respirators and n95 are.
I genuinely wonder if the use of masks is the biggest factor in stopping the transmission. When I went to Asia mask wearing was common everyday as a protection against transmission/pollution. It was almost even a fashion item. But here in the US, when the outbreak happened and I went grocery shopping with a mask I was stared at and given fearful looks as if I had the virus already.
Many more people would use masks and gloves if they were available for purchase. This could never be implemented in the US unless the government was supplying everyone with masks. At this point it’s almost criminal to buy masks for yourself when health workers don’t have access to enough of them.
That is not what that study says. Yes, cloth masks are not as effective as medical masks. But the study does not compare cloth masks with no masks. The three groups in the study are:
> medical masks, cloth masks or a control group (usual practice, which included mask wearing).
Yes, the cloth mask group had more infections than the medical mask group and the control group. But the control group included wearing masks as usual. It does NOT say cloth masks are less effective than nothing. "No mask" was not studied. Cloth masks might be less effective than wearing no mask (I personally doubt that), but this study didn't say anything about that hypothesis.
Thank you for sharing this updated clarification. I just shared it with that medical professional who showed me the original. Hoping to spread this clarification
From where I stand, the countries that have a culture of wearing masks are doing better with regards to coronavirus. At the very least, it seems like a good hypothesis.
I've read repeatedly (and heard on the radio several times) that wearing a mask if YOU are infected will help protect other people, but if you are not infected then it has no known protective effect ie. is not thought to be any more protective than not wearing one.
Do you have any evidence to back up you talk of masks?
(And if YOU are infected you should not be out anyway)
Edit: I was thinking of non-medical situations. @j7ake below, clearly pointed out they work in medical situations, something I was not contesting at all but did not make clear. The original post talked of "wearing masks in public" which was clearly not in medical situations and I was following through that.
This was a coordinated (dare I say "propaganda") campaign by US and other government officials in order to try to avoid mask shortages[1]. A noble goal, sure -- but the net result is that people are now misinformed about the efficacy of masks.
The evidence very much shows that wearing masks can reduce community transmission rates of SARS-like viruses -- up to 70% even with just plain surgical masks[2]. And even if you don't buy that, everyone wearing a mask means that asymptomatic carriers (who have no idea they're sick) cannot spread it as effectively.
> This was a coordinated (dare I say "propaganda") campaign by US and other government officials in order to try to avoid mask shortages[1]. A noble goal, sure -- but the net result is that people are now misinformed about the efficacy of masks.
There's nothing noble about it. This is extremely short-sighted. What is easier to solve, shortage of masks, or shortage of ICU beds and medical personnel?
I would imagine that a face mask is a relatively low-tech good that can be mass-produced at scale. You cannot ramp up production of ICU beds and nurses and doctors. If this is true, then the consequences of this "noble" decision will make Chernobyl blush.
Avoiding mask shortages is a noble goal (note that you're agreeing with me here -- mass-producing masks would also have avoided shortages). Whether or not the method employed was ethical or not is a separate question (and I agree with you that it was not because of how short-sighted it was).
I am not. My point is that solving the problem of mask shortage by allowing the infection to spread at full speed is like setting your home on fire to deal with a clogged pipe.
To say that somebody had a "noble goal" is to state that their intentions were good, not malicious. That is not the same as being correct. You are pointing out that they were shortsighted fools who did more damage than good, which I agree with, but that's not incompatible with having good intentions.
I hadn't seen that post before, and it does seem quite reasonable -- but I don't think it really vindicates the advice (nee propaganda) from government officials, unless there was no other way to alleviate shortages. The conclusion is effectively "we don't know for sure, but they do appear to help somewhat" -- which means that (all other things being equal) not recommending masks appears to be a net negative.
Then your browser does a shitty job of telling Twitter that. Properly blocked JS gives you a link to "legacy" Twitter, which works perfectly without JS. At least viewing, which is all I do.
I've never been able to use it. I get sent to a "do you want to use legacy twitter?" thing, I click Yes and it just gives me the same screen again, every time.
Happens I proxy through squid - it might have something to do with that. If I go direct (no proxy) it works. Interesting.
At least I can get to it, and will read your link this evening. Thank you.
Until I started blocking JS using uBlock Origin, my blocking must have been incomplete. Because I also saw that screen and it never worked. Now, it does.
This advice is completely contrary to anything that happens inside a hospital. Nurses and doctors are wearing surgical masks (and N95 masks plus face shield if performing actions that may generate aerosols) to protect themselves from getting sick while treating patients.
The problem is that you can have COVID19 and be contagious without showing symptoms. Mandating everybody to wear some sort of mask should reduce transmissions because it should reduce the viral load in the air. By how much? It is not clear, but it's not worth waiting for results from a randomized double blind clinical trial during a global pandemic. I would put money that the effect of putting on a mask will be at least as effective as washing hands.
The danger to be careful of is if wearing mask can make you more sick, but the current actions from healthcare workers around the world suggests it is not the case.
Another point some people argue is that wearing a mask in public means one less mask for health care workers. This is false on two fronts, one because mask supplies will soon flood the market and there are DIY solutions to masks that can reduce transmissibility; two because what's best for health care workers is not to get sick at all.
I am hopeful that the US public may warm up to masks in public in the future. It seems likely this would cut down on the spread of seasonal flu and common colds.
Don't worry too much about effectiveness of DIY face masks - in few months Respilon and other Czech companies will put on market face masks made from nanomaterials which filters virus much more effectively ;)
OK, I think that the mask over your own face is to prevent viral spread in largish water particles caused by coughs and sneezes, not general breathing (I'm not sure general breathing spreads much virus anyway, but I don't know).
So if you are infected and not showing symptoms ie. not coughing/sneezing then arguably the mask is not doing anything.
Arguably not, but we need more data - can anyone comment with sources?
Even if you are breathing calmly mask will catch some small water droplets so spreading is somehow contained. It's true that after ~1 hour wowen mask will become wet and no longer effective. But it's not problem wear some other masks in your bag and change it... Currently there's huge shortage of respiratory protection products globally so your old wowen tshirt will help you :)
Wearing mask discourages you from touching your face with your hands.
If someone sneezes at you, even most simple mask will stop at least 50% of viruses. If someone was far away and only a small load reached you, that may be enough to keep you safe.
> (And if YOU are infected you should not be out anyway)
The big problem is to know when you're infected. Mask keeps others safe if you're not aware that you're infected.
Some reports say that you start distributing viruses pretty much immediately after getting it yourself. Even if all contacts (which is far from guaranteed) get traced and you get checked and/or isolated in a day or two, you'd be already spreading viruses for that timeframe.
Right. No one has ever studied contagions among the community at large and the effect of masks. When you hear people say there is no evidence, this is what they are referring.
"is not thought to be any more protective than not wearing one"
This is taking that claim too far, and is seldom what they're saying. Or rather never what they are saying.
Early on there were PDAs that discouraged masks because a) there is a weird social effect in much of the West where people get panicky, and somehow view someone else wearing a mask as increasing the odds, or at least the reality, that they instead will get sick, b) to discourage personal buyers competing with medical buyers, c) because the odds of coming into contact with a SARS-CoV-2 carrier was very low, whereas it's high to very high for medical professionals.
We need to discard with that bullshit. We know with overwhelming evidence that masks work -- that's why medical professionals wear them -- and even the lowly surgical mask has the same effectiveness blocking pathogens in as they do out, especially aerosol pathogens like this one.
And of course we know that people can be spreading this without symptoms, so it would be a massive win just for that.
As supplies normalize and manufacturers ramp up, we're quickly going to be at a place where most in the West will be wearing a mask of some fashion, and it will be officially encouraged. This whole weird anti-mask paranoia will have cost lives.
Masks aren't a panacea, of course, They should be properly worn and rotated. Add that they increase the effort the lungs have to exert, especially N95 masks, so in a unfortunate irony people with compromised lungs -- the most vulnerable to COVID-19 -- have the most difficulty using masks.
>a) there is a weird social effect in much of the West where people get panicky, and somehow view someone else wearing a mask as increasing the odds, or at least the reality, that they instead will get sick
Definitely experienced the stigma of wearing one in public. Have had reactions ranging from stares to hurriedly moving away from me.
> We need to discard with that bullshit. We know with overwhelming evidence that masks work
To add, why else would NY ask older folks to wear masks when going outside?
Also, this NIH study adds to support that masks are effective.
"Definitely experienced the stigma of wearing one in public"
People can be deeply illogical when it comes to personal protection. I did a summer stint during college with a factory, assembling some part of an air conditioner system for cars. This was done with huge, incredibly loud machines. Fiberglass. Etc.
The company offered ear plugs, eye protection and masks. No one used them. There was a 0% utilization rate. It was bizarre. I did, however, and earned snarky comments, critical suggestions, and lots of sideways glances. People really seemed to feel that my concern for myself made the threats more real.
I'd like to say that when I left everyone had followed the path I blazed, but it was the same as it always was. People still sabotaged their own health and hearing to avoid looking "paranoid".
I used to work as an intern at a shipbuilding company making aircraft carriers. People wore stuff when they were required to, so hard hats were always worn, and the attached earmuffs seemed to be generally worn when someone was working with something very loud.
However, at one point I was helping an inspection in a tank and there was a noxious odor, and I couldn't breathe in it. The shipyard worker with me went ahead and went in and did the test, but after this I tried to procure a respirator and they refused to get me one, saying it wasn't necessary for the work I was doing.
Music concerts are another place where you don't see people using personal protection much, though I will say that's changed in the last 10 years from what I've seen. I do see a minority (but a growing one) of people wearing earplugs, and we now have a lot of choices for "musician's earplugs" being sold which are designed to have a neutral frequency attenuation.
> Right. No one has ever studied contagions among the community at large and the effect of masks.
It's been studied. There has not been a randomized controlled trial because performing one would be extremely unethical.
There is plenty of study evidence to support their use, just nothing meeting the gold standard of a RCT and there never will be one against a true live fire contagious disease.
The irony with all this is that the US administration really want to get people back to work as soon as possible. Massive deployment and mandatory usage would be the safest way to do that the soonest.
Too bad they already foreclosed that option by materially misleading the public.
> Right. No one has ever studied contagions among the community at large and the effect of masks. When you hear people say there is no evidence, this is what they are referring.
Actually, they have[1,2]. According to one study, surgical masks helped cut down the community spread of SARS in Beijing by 70%[3]:
> Always wearing a mask when going out was associated with a 70% reduction in risk compared with never wearing a mask.
But if you're specifically referring to randomised trials on mask efficacy during an on-going pandemic, you're right that there are no such studies -- because it would be unethical. So effectively all of the relevant studies are retrospective (which does introduce recall bias), but these are basically the best studies we can do ethically.
Of course we know it works for them, because in your own words "coming into contact with a SARS-CoV-2 carrier was low, whereas it's high for medical professionals"
> We know with overwhelming evidence that masks work
Yes they do, for medical professionals. I'm referring to non-medical situations, and I guess I didn't make that clear. I'm trying to understand why... well, I explained in my first post. I'm not looking for opinions but for actual solid evidence. Which someone (not you) actually provided.
We don't work for you. Your various snotty replies aren't useful.
"Of course we know it works for them"
How does this anti-logic make any sense? Do you think the masks have a sensor that turns off the "works" bit if it's on the face of a medical professional or not?
This is bit like demanding to see research that gravity has an impact on alpacas. We know fundamentally how gravity has an effect on mass, so it follows. Just as we know the fundamental filtering ability, and contagion spread limiting, of masks, including even surgical masks. We know that the CDC is telling health workers that don't have masks to even use a bandana wrap, as not only does it stop face contact it has some limited utility in stopping the tiny droplets of liquid that are one of SARS-CoV-2's vectors.
Many people don't know they are infected and also there is not enough testing capability in many countries. For example Heidi Klum tired to get tested after catching a cold and it took her several days to be accepted for a test. Now she is not exactly your average Joe and would be willing to shell out a few 1000 dollars to get tested.
Unless that situation changes, masks are a good alternative. And yes, only if everybody wears them.
Let's assume healthy people do not need a mask. In fact, let's take it as Gospel, and the statement "Healthy people have no use for a mask" as absolutely true.
Given we know there are people with COVID-19 who are asymptomatic, any "Healthy people have no use for a mask" can simultaneously be true, and be practically irrelevant, as any definition of "healthy people" is necessarily impossible to prove. You simply can not know you are free of Corona Virus, short of having recovered from the virus.
If the standard was EVERYONE wears a mask, asymptomatic people would be a non-issue. Any advice contrary to the 100% mask usage argument has to explain how we deal with asymptomatic people. Short of testing everyone all the time, what would that even be?
TL;DR In a world with asymptomatic COVID-19 people, a 100% mask policy seems the sane default position.
Then WHY ARE SO MANY EXPERTS TELLING US WHAT I QUOTED?
What you say (and others too) makes sense to me and I could well believe it true, but I'm NOT claiming that masks are useless unless you are infected, I'M ASKING IF ANYBODY KNOWS WHY EXPERTS ARE SAYING OTHERWISE (or whether I just heard an unluckily skewed sample)
Plus, I also asked for a citation to back up the poster's position, not common-sense arguments (which are a good starting point but not evidence in themselves).
Which experts are saying masks are not effective? From what I read the experts (curiously from countries that did not prepare enough masks for their hospitals) say it is not recommended for the general public to wear a mask. They definitely still recommend nurses, doctors, and sick people to wear one. But they never explicitly say that masks do not reduce transmission. They may have said "there is little evidence to suggest..." which is not the same as masks do not reduce transmission.
The official position for many countries that are containing the virus suggests wearing a mask when out in public. One notable exception is Singapore.
Here is the Korean society of infection FAQ that says wearing a mask can reduce transmission:
Masks may be 100% irrelevant for healthy people, but we have asymptomatic people. There is no way to ascertain who is healthy, ergo "healthy people don't need masks" is practically redundant. What am I missing?
So I was in agreement with this, and the science is that yes it only helps in containing the infection if the person infected is wearing the mask.
However, if healthy people aren't wearing the masks, and only the unhealthy are, then the unhealthy don't want to signal they are unhealthy so they don't either. A huge part of getting the infected to wear masks is to get the healthy to wear masks so the infected don't put a huge label on themselves that indicates: "diseased", "corrupted", "infectious", "frail", "unclean" etc.
Logic says one thing, but people are not logical like machines.
Seriously. How is it possible to still be ignorant about the (up to) 2 week asymptomatic incubation period? This is the entire reason why the virus is so dangerous!
And where did OP mention anything about masks protecting the carrier from infection?
Another effing article that completely ignores Taiwan... I’m no taiwanophile, but why is it that a first-world democracy with a successful strategy against Covid is being completely ignored by media?
Just to be clear, Taiwan did not have huge flows of mainland Chinese soon after the outbreak though. They closed the border to all travelers with PRC passports in mid-February. They did take some drastic measures that have worked.
Mid-February was already weeks after the epidemic starts to be on the news. They also repatriated businessmen from China. Given business and cultural ties between the two countries, I find hard to believe that less Chinese traveled between them than between China and Italia.
> They closed the border to all travelers with PRC passports in mid-February
And before that they had plenty of people coming in from China with active Covid infections - returning from New Year including people from Hubei.
The US enacted their travel ban to China on 31st Jan, yet that hasn’t helped the US...
Now Taiwan is getting cases from other countries (returning citizens and foreign migrant workers) e.g. yesterday: “Meanwhile, the 15 patients deemed to have contracted COVID-19 overseas all returned to Taiwan in the period March 16-23. The countries they had visited were the U.S., the United Kingdom, New Zealand, Spain, Malaysia, Monaco and Mexico.”
Taiwan is still allowing foreign migrant workers to enter the country, as they need them for their economy.
To add to that. mainland China banned citizens from traveling to Taiwan as individual tourists 2019 July because of other reasons. So yes Taiwan did not have huge flows of mainland Chinese.
But they did, for business. There are also millions of Taiwanese that either live or work in the PRC. Taiwan was one of the major international destinations for flights from Hubei and not coincidentally one of the first countries with cases outside China.
Another one is Hong Kong. They are tightly packed in a small geographic space, have an active border with China (not sure about it now), and a highly trafficked airport.
> Now, however, Hong Kong is providing a very different object lesson -- what happens when you let your guard down too soon. The number of confirmed cases has almost doubled in the past week, with many imported from overseas, as Hong Kong residents who had left -- either to work or study abroad, or to seek safety when the city seemed destined for a major outbreak earlier this year -- return, bringing the virus back with them.
Hong Kong is legally part of China, not a separate country, and its coronavirus strategy has been overseen by the same top Chinese officials as in mainland China.
That is not true. Hong Kong has its own government. Yes, the government collaborates with China but we have a separate legal system and are treated as a separate country for customs and immigration purposes.
> We have a separate legal system and are treated as a separate country for customs and immigration purposes.
Of course Hong Kong has its own legal system and maintains its own customs and immigrations. However, mass epidemological response is carried out in accordance with the demands of mainland China, and so it is no surprise that Hong Kong is not being distinguished from mainland China as the OP expected.
> mass epidemological response is carried out in accordance with the demands of mainland China
Hong Kong seemed to have its own strategy, which makes sense, since it’s culturally unique to Beijing. Also of note, when Beijing published infection statistics, it excluded Hong Kong.
I hadn't heard about this, but that's fairly baffling. According to Johns Hopkins [1], Taiwan has ~300 confirmed cases at a population of 23M+. I'm not sure how accurate nor reliable the numbers are, but if anywhere near true, that's a herculean effort with great results. Of course, the measures outlined in the article you linked didn't come out of thin air, but are the result of massive cooperation and work.
Taiwan's government has been pretty open, since the government in power has been trying to contrast themselves from China and HK's governments which have issues with transparency. They have an English status page https://www.cdc.gov.tw/en for results. They're also reporting the origin of the imported cases.
Edit: Taiwan's case count is also low enough that they're still reporting updates using confirmed case numbers to track the spread from different cases.
Here in Taiwan now just had some delicious bittermelon and pork rib soup after a gym session. All had hand sanitizer at the door and temperature checks and all wear mouth masks. Really impressive what they've done here. Feels safe and relatively normal. American here and staying safe in Taiwan till this blows over. It's funny people say be safe in Asia but I fell a lot safer then in USA!
Not only are businesses open in Taiwan, it is one of the few countries where the schools are still open. Taiwan immediately began targeted testing, then contact tracing and quarantining suspected cases. The government distributed disposable surgical masks and people commonly wear masks in any public area. Some supply chains from China are disrupted, and the Computex trade show may yet be cancelled or disabled. Otherwise the economy in Taiwan is in motion.
These steps are more drastic than the "do nothing" approach we saw from some Western governments in the early days, but far less drastic that what those governments have had to resort to because they dropped the ball at the outset.
Because Taiwan didn't have a chance to handle such mass infection (which is better than having it of course), so it is not a good model to follow for western countries which are already in a hell.
Sure, what about Taiwan? Is there anything that Taiwan did which was significantly different from what South Korea or Singapore did to prevent the wide spread of the virus?
One interesting thing is rather than stop flights from Wuhan they had inspectors ride on the flights and check the passengers mid flight and then quarantine anyone questionable on arrival.
Wouldn't it make more sense to test and ask all passengers to wear masks before they board the plane? By the time they are flying in crowded airplane, it's too late. This approach doesn't seem to make much sense.
A physician from Korea recently did an AMA on Reddit and said:
'It is hard for anyone to predict what will happen in the future in this volatile situation. However, South Korean experts think that if the situation doesn't get better within the month, it will last up to 6 months. If the situation exacerbates within 6 months, it's apparent that this will become a much more difficult scenario than previously imagined. There would be a high chance of economic repercussions of this outbreak. Moreover, the resources of medical personnel may be entirely exhausted in this situation, which would lead to more deaths. In South Korea alone, 300,000 deaths would be a fair prediction from such a scenario.'[0]
Seems too early to conclude this has been contained yet.
honest question: why do we keep looking to physicians for guidance? They are highly trained in case by case treatment but not epidemiology. They are not taught to make population wide predictions about the future, they just diagnose and treat. They have access to some anecdata and that's about it. Professors, epidemiologists, and medical researchers have a lot more training and practice in the arena we care about.
In general they have some idea what they are on about re diseases. Also they tend to be fairly down to earth in that they deal with patients directly rather than abstractions.
The discussions in these threads are just so demonstrative of the erosion of trust that now exists between the lay people and the experts of society, and even amongst experts themselves.
Fake news, profit motives, political expediency, political correctness, and so many other social factors have made this a real CF for anyone trying to make sense of this and genuinely do the right thing.
I am sorry if I don't have anything positive to contribute, I'm just so disappointed in the state of affairs right now and how selfish forces have coopted the means of causing positive, effective action.
My key takeaway from this entire situation is that authorities in Europe and USA don't understand how exponent works. Every country that is now suffering from the pandemic went through "c'mon, it's just 10 cases" phase. We had ~two months to observe how the situation unfolds in Asia, yet learned nothing. As for me, back in late February when I checked the dashboard and saw that ~10 cases were registered in my country, I decided that "nope, I am not going to use public transportation any time soon".
It should be mandatory for any politician or government clerk to take an exam in differential equations. There _was_ time to prepare, and there was a chance to contain the situation.
Yeah. And the funny thing is, a lot of people in the west - and presumably, most politicians and people in high places - understand how compound interest works. And it's the same thing.
You could literally rephrase the pandemic as: "Imagine total cases are dollars, then $country has 1000 dollars on their account, with 30% daily interest capitalized daily". Maybe that would've gotten through better?
> Europe and USA don't understand how exponent works.
Oh, they know how exponents work. They only care when it affects their bottom line. It's clear that the working class are just lambs for slaughter when the corporate overlords look at them.
Never attribute to malice that which is adequately explained by stupidity. By delaying the response they made their bottom line sink exponentially deeper.
It's a bit of luck that the coutry had a private biotech company that makes tests for viruses, and the CEO of said company looked at Wuhan and decided to get samples from China.
I suppose, just like every country has a military or people managing their transportation infrastructure, there should be a "pandemic watch". (Well the US had a good one until Trump/John Bolton defunded it)
Some of the politicians did heed the advice, at least when it came to managing their share portfolios, taking the opportunity to sell up while telling their constituents there was no imminent threat:
You're plainly wrong. In early January, S.K. government actually summoned all the private biotech companies and ordered them to prepare against potential epidemic scenarios.
Europe and the US even had more time, there is no excuse. It was clear from the day one how to or not to act. Europe and the US did not act at all in the beginning until it was to late to check each single case.
It’s not clear what ‘day 1’ means in the context of China though. China has kicked out all western reporters, constantly lies like Russia even when the truth is visible in the background, and arrests citizens who try to get around this system.
The west was never going to believe what was happening in China because it is impossible to know without invading them.
So have Thailand, the Philippines and Indonesia (440 million people).
They've all had fewer cases than Luxembourg so far.
I've yet to see a good explanation for it, other than maybe the premise about seasonal temps and humidity (northern vs southern hemisphere). There's no evidence they're massively lying about their numbers (which would show up in the form of a demolished hospital system and thousands dead of pneumonia). Vietnam has also done incredibly well overall, showing no indications of being crushed by cases, despite their proximity to China.
Mexico is also not being crushed at all by the virus, despite being right next to the US as Vietnam is right next to China. Mexico shares enormous trade and traffic with the US. They should be buried in pneumonia cases given their overall context (population size, economy, testing rate, healthcare system). They have just over half the cases of Finland (obviously Mexico isn't testing at a high rate, I'm sure it's more than just 600). If many thousands of people were dying of Covid in Mexico right now, it would be showing up blatantly. Latin America's case load has largely been low vs population sizes (with only a few exceptions), as with the rest of the southern hemisphere. Mexico is technically northern hemisphere, and I wonder if they don't have some of the southern hemisphere benefit (as perhaps India does), limiting the rate of infection vs nations that are further north. And will that flip at all in the coming months.
It'd be very interesting to see a comparison of avg temps and humidity among nations most affected (or least) during the outbreak timeframe. Including looking at locations such as Italy, France, Germany, Spain, NYC, Texas, Southern California, Seattle, South Korea, parts of Mexico, Thailand, and so on.
Basically, due to seasonal temps and humidity, is South Korea's task made far easier than Italy's task? Does that considerably alter the infectiousness of SARS-CoV-2 in South Korea vs Italy? Is their equation half the effort they've put in (and credit on that), and half good luck of location. Mexico sure as hell isn't avoiding being overrun by it due to maximum testing.
I spent many hours last night doing a deep dive on the latest research on the impact of humidity on viruses, infectiousness and the respiratory system. It's fascinating stuff.
I have wondered that for a while, especially since countries like Malaysia had outbreaks long before Italy. Originally I thought: https://simonsarris.com/sunlight (note: data last updated March 16)
But there are several axes that could matter just as much as quarantine/lockdowns: Humidity, sunlight (as proxy for vitamin D levels, or simply UV), pollution (which also affects sunlight), median age (47 in Italy, 30 in Malaysia, that's huge), and mask use.
Bergamo has low sunshine in Feb and March comparatively.
Places hard hit, and their average sunshine on selected months:
* Wuhan: 100 (In Feb)
* Paris: 79-129 (Feb-March, North France harder it by # of cases, cannot find death info)
* Bergamo Italy: 100-150 (Feb-March average)
* Seattle WA: 100-150 (Feb-March)
* Iran sunshine varies a lot by locale. But some places like Rasht, its very low light: 90, 78, 71, 113 for Jan, Feb, Mar, April
Places less hard hit:
* Bangkok 250-275 (Feb-March)
* Kuala Lumpur 185, 192, 208 (Jan Feb March)
* Ho Chi Minh City, 272 (March)
* Seoul: 175-200 (Feb-March) South Korea contained it of course, but their lethality numbers are also lower, and its the lethality that I find odd in all this.
I'm really starting to think there might be something to this. In the US, I keep waiting for the other shoe to drop in places like California, Texas and Florida and the days keep going by and we are not seeing anything like the death toll New York is having. California had some of the very first cases in the US and took in at least one cruise ship of infected people. Florida's governor has been openly defiant against shutting the state down and they only have 29 deaths so far. If ever there was a place in the US where virtually every single inhabitant is vitamin D deficient it is New York City, even in the summer time.
There is something to it, I just don't know why nobody is talking about it much. It's pretty painfully obvious if you start digging into the data, researching the outbreak map, and looking at the temps & humidity levels in the areas. SARS-CoV-2 appears to more or less be obeying what influenza does when it comes to seasons, temps, and humidity (along with perhaps sunsine / vitamin D as a factor).
NYC should be cranking humidifiers, pushing humidity up to 50% in every space where people exist (except hospitals). It'll dramatically slow the infectiousness of SARS-CoV-2 imo. Super low human space humidity is the best friend of a respiratory virus.
Why aren't San Antonio and Houston buried in cases? Same reason Mexico and Los Angeles are not (relatively speaking, and especially compared to eg NYC).
Las Vegas should be buried in cases, they have tons of international traffic, a zillion opportunities for the virus to be transited around, spread to casino workers and everywhere. Their ICUs should be overflowing to an epic degree. Las Vegas has an inverted humidity map, peak humidity there is November to March, and avg high temps stay up near 55 to 60 degrees (influenza at least hates temps over ~60-65+ F).
How about Santa Fe or Phoenix? Super low case loads, as with Houston and Austin and other similar locations.
Florida isn't seeing a particularly bad outbreak in its cities.
Albuquerque and Phoenix have inverted humidity seasons, their peak humidity times are roughly October/Nov to March.
Wuhan's low sunshine season is November to March. Temps are often well below 50 degrees during that period (and essentially never get to 65+), not high enough to interfere much with influenza or probably SARS-CoV-2. It gets cold enough during flu season there to require persistent indoor heating, which dries everything out, lowering indoor humidity levels dramatically, amplifying potential infectiousness.
It's a consideration. However, where is the million dead people that should be happening between these nations given the 440 million people? The virus would be destroying them at this point. We've seen what it can do in Italy, the US, Germany, France, etc. in terms of spreading and hitting ICU units, killing people. It has a 10% mortality rate despite Italy's best efforts, and a 5.7% mortality rate in France (among positive tests). France has an elite healthcare system. So with no testing, Indonesia, Thailand, Vietnam, Cambodia, Philippines - they should be falling over and buried in dead people by now. China was being ravaged by it and had to implement extreme measures rapidly.
Depends when it really took off in each country, the time from transmission to requiring hospitalisation can be fairly long, 2-3 weeks. It seems a country can probably avoid testing for a decent period of time until the wave of hospitalisations hit them.
Check the population pyramid for these countries. They have a way smaller fraction of old people, and a way larger fraction of young people. This has a big effect on fatality rates.
Thailand is older than the US or China at the median. In their case, they're not a young nation, like the Philippines is (Vietnam, Indonesia and Mexico, 30-32 at the median, are more of a mixture between the two). And of course Italy, Germany and Spain are very old nations (Germany & Italy being nearly twice the median age of the Philippines).
Youth certainly has a big impact on mortality rates with Covid, and not such a huge impact on ICU rates. Close to half of the most serious cases in eg NYC and France are of people under 50.
We'd see the system overload in places like Thailand and Mexico, as their ICUs would still flood with people over the age of ~20 (and as you note, they'd potentially have a lower mortality rate due to fewer old people as a percentage of the population; although Mexico does have a very high obesity and diabetes rate in their specific context, which might complicate their mortality factors (recently noted as a concern by one of their govt health officials)).
What about Florida (and Arizona) in the US? Those states are overrun with old people and they are actively avoiding testing and mandatory isolation. Florida has 29 deaths right now attributed to Covid-19 and their governor is being criticized daily for his poor response.
At least initially I read that Philippines didn’t even have testing capability and had to send samples to Australia to be tested. You don’t find what you don’t look for.
You wouldn't have to look for them in these situations (the context of these nations), it would show up in your intensive care system and swamp your hospitals with thousands upon thousands of ICU-level cases.
That effect even showed up somewhat in Russia, in heightened pneumonia cases (they're now admitting it's likely far more widespread than the positive case results would imply). It's not easy to hide or disregard if you have high figures, which one would expect of poorer, very vulnerable nations with huge populations so close to China - unless there's another explanation. These nations didn't implement the type of disciplined system (matched with mass testing) that South Korea followed, and there's no sign of crushed healthcare systems with many thousands dead from pneumonia.
If you look at the shape of causes of death in Russia, heart disease and pneumonia are unusually high, and life expectancy is low, even compared to China. There is a plausible way for coronavirus to sneak up on Russia until the hospitals fill up with extra pneumonia cases.
That's assuming that there is a culture of going to the hospital when you have bad flu conditions. It's safe to assume that for the vast majority of laborers in third-world countries, hospital services are not within reach. They just tough it out at home.
Italy has a very old and sick population. More of their seniors are already on life support with several other diseases. I would expect less developed countries with poorer access to healthcare to have fewer very vulnerable individuals.
Side note: when at the time of death you have 4 or more illnesses, and one of them is CV, on what basis is the cause of death attributed to just a single condition? It seems Russia has taken a different stance to the West in this regard but it's not clear to me which is correct. It doesn't seem ideal to ignore co morbidities.
What if there are multiple strands of the virus, and Europe is being dominated by the more potent one? We might not even be surprised that the more potent version ended up on the other side of the planet.
https://nextstrain.org/ncov shows there is a massive number of genetic variants. I have yet to see anyone successfully show that the variants have different behaviours, as that is hard to do. However any strains that are more contagious should dominate over other strains.
Due to international travel, and especially citizens returning home, the different strains are coexisting within the same country.
They have even used strains and genetic trees to trace individuals that transmitted the virus.
"South Korea has used data from surveillance cameras, cellphones and credit card transactions to map the social connections of suspected cases. "
None of these things are available to health departments in the United States unless someone voluntarily allows it.
The United States has a weak federal containment strategy when it comes to pandemics since most of the decision making is left to Governors. Louisiana allowed Mardi Gras. Florida didn't issue guidance on their beaches until most of spring break was over. One state next to another such as Illinois and Missouri have vastly different mandates.
The United States lost the battle of containment. The only thing left is the war to not overwhelm the medical system.
Where did this researcher get the anonymized mobile phone location data points from ?
Also, I think it's important to clarify that:
"Every cell phone user has to be tracked so the cell network knows how to route their calls ..."
... would be more accurate if we said:
"Every cell phone has to be tracked ..."
Many pieces of the cellular network have no idea who the handset (or other device) is assigned to, or who is using it - they just know that that SIM card is up on the network, and needs to be routed appropriately ...
Of course the telecom itself, for many purposes - not the least of which is billing - needs to know a personal identity behind a SIM card.
What I am saying is that individual cell sites - and other pieces of the cellular infrastructure - are only indirectly (or not at all) connected to personal identity of the mobile subscriber. Call routing can be done just fine without any idea of subscriber identity in meatspace.
Testing more thoroughly would also provide us with a better understanding of the virus' properties, like the distribution of symptoms, severities, and mortality rate. I think one of the main reason for general fear and panic has been the alleged high mortality rate, with numbers up to 5% being mentioned. But there's a strong selection bias in those statistics (people with severe cases get tested more often), so the actual number is likely much lower.
It's a small sample, but it's a comprehensive one as everyone was tested. On the Diamond Pricess, it only reached 20% of the people on board, and of those 60% had no medical symptoms. Overall 1% of people catching it died.
As a cruise ship the passengers tend to be older, but the crew tend to be younger.
Doesn't matter if you test 1 million people or 10,000 people, if you aren't doing statistically significant tests, it's meaningless to draw conclusions.
If physical distancing is successful in reducing the reproduction number (R0), you will then want to track, trace and isolate every case to prevent further outbreaks when you relax the rules.
"better understanding of the virus' properties, like the distribution of symptoms, severities, and mortality rate"
Random and self-selecting testing doesn't seem to offer much in that. Imagine going to a Nics game and asking everyone there who they support, chances are you'll get a lot of Nics fans.
How does that give you a better indication of mortality rate or severity if you have no idea how many people actually have it, because you only have a statistically insignificant tests.
Sure, if you're in the stage where you want to lock down specific people (like South Korea) then random widespread testing works to increase the number of locked down people.
But if you're in a country where you've locked down everyone already, then testing could well be increasing the risk.
If the population assumes they've tested positive, and acts like they are, then what does testing add?
> If the population assumes they've tested positive, and acts like they are
That is a fair point, and I agree that testing is most important when there are a limited number of cases - a stage which was essentially missed by Western governments but hopefully will have another opportunity.
I don't agree that populations are acting like they have tested positive, though, or can do that en masse.
If you know yourself to be positive, you should ideally be taking stricter measures - like having people leaving food at your doorstep.
Only people who are not infectious should be involved in food and resource distribution.
In order to enact that, you would need to actually test.
The purpose of random testing or testing of more people who have exposure but no symptoms would be to limit household spread by separating people from their households or having the households act differently knowing that they'll be constantly exposed.
The trouble is, the mortality rate is highly dependent on the degree to which health services are overwhelmed, because the health services are playing such a critical role in keeping people alive for a few weeks until they get better.
To the extent that mortality rate may depend more on transmission rate, health service dynamics and availability of people and equipment than on the disease itself.
This is very different from the mortality rate in a non-pandemic situation.
Mortality rate has also shown to be highly dependent on comorbidity which varies country to country. Presumably a county where residents have easy, affordable access to health care will be healthier on average and have fewer comorbidity concerns that will lead to death from Covid19. Just speculating but perhaps this is one of the things going on in Germany? Germany has a much lower Covid19 mortality rate than other countries.
Correct. South Korea had to trace only a very small number of chains/events. Now they have many cases and it will become very hard to trace all of them. They cannot be everywhere. Additionally they had more staff to do this, other countries cannot easily copy that strategy.
Caution is certainly called for. There will probably be recurring outbreaks.
But, the benefits of widespread testing are there for every nation, at any stage of the pandemic, to access if they have the will and competency in leadership to do it.
I think it is an interesting case. It seems that shutting everything down and locking everybody in their homes is still the fastest method.
But if you look at the outcome and impact on entire country investing in aggressive testing and tracking cases seems better return on investment even with higher number of cases.
One potential problem I see with this is locking everything is easier to implement and has less risk that it won't work at all. With a week delay between your actions and the results, not restraining your population and instead hunting cases might put you in a situation where you suddenly learn your actions had no effect and now it is too late for drastic lockdown to rein in the cases.
Italy, Veneto Region: our first delivery of masks for our family (3) just got volun-delivered. They are single-use and it is very emphasised on an accompanying sheet that they will not stop the virus, they are for when you have to absolutely go out, as we are still on lockdown: transgression of which has gone from €260 in fines up to €4000. Of course, when the masks were delivered a whole bunch of people immediately went to the communal post-boxes area to pick them up and talk about it.....oh, well.
Doesn't look like the trend there is really changing since it peaked around March 8th. Seems pretty consistently in the low hundreds of new confirmed a day.
Look at the infection rates in those countries: they're S-curves. New infections are being found, but the rate of increase is far lower than it was previously, and the majority of cases are cleared up. That shows they're likely on the tail end of the problem.
For European countries and the US, the curve looks asymptotic. There's no telling how high it'll go at this point.
Well she's probably right not to trust the American healthcare system. It was pretty bad before, and it's going to be a completely dysfunctional disaster pretty soon.
Meanwhile, China is able to build an emergency pandemic hospital in 10 days.
All countries which the rest of the World relies on production of masks, gloves, plastic items, electronics, medical equipment have done well.
The rest of World which includes once capable nations (who have now outsourced everything and now don't have capacity to produce even bandages for their population) is now screwed.
Another factor is that schools remain closed. We know children are largely asymptomatic and their R0 is 2x - 8x greater than the general public. We’ll see how they fare when they reopen schools. That said we just need enough mitigating measures to push R0 < 1. If it’s 2 now, then two 30% measures will work, or three 20% measures, ...
The thing is, South Korea (and many other Asian countries cited as having handled COVID19 relatively well, such as Taiwan, HK, Singapore, Japan) have all learned from the 2003 SARS epidemic and others, while the Western countries did not. This is not just in terms of politics/preparation to disasters, but also in the civilization - in Asia even the most radical and extreme measures are accepted by the population as everyone there knows what a pandemic can cause, while in Germany people are having "corona parties" and there have been numerous incidents of people spitting or coughing at other people.
Additionally, in many Western countries healthcare systems have been wrecked by neoliberalism profit-first ideology (Germany, UK), by austerity following the 2008 financial crisis (Italy, Spain, Greece) or by decades of incompetency (USA), combined with the end of stockpiling of critical assets such as face masks, gloves and other PPE after the end of the Cold War.
The key point of "shutting down" is to avoid overloading the healthcare systems, or at least to try to limit the overloading.
It might have something to do with people remembering a previous disease outbreak, it might also be primarily a question of how collectivist vs individualist the societies are and how strongly the population follows government suggestions/orders.
Considering that, you'd expect South Korea or Japan to do better than Germany, Germany to do better than the US or Italy. And even within Germany, you'd expect large cities to do worse, with Berlin leading the charge. Would Hamburg be affected as much if it wasn't for their holidays falling right into that time?
> in Asia even the most radical and extreme measures are accepted by the population as everyone there knows what a pandemic can cause,
Well, yes and no. They might have been more willing to accept that 30-40 years ago, but definitely not these days. They've been always known for militant labor unions, religious fanatics, and political extremism -- the last two attributed to the outbreak in South Korea this time around. There are still religious groups defying the gov't's plea not to hold mass services in South Korea today.
> in many Western countries healthcare systems have been wrecked by neoliberalism profit-first ...
South Korea suffered a much smaller coronavirus, MERS, not too long ago and they found out that they were awfully unprepared for a public health crisis of that scale (only 130+ were infected and 30+ death), so they spent the next several years preparing for the "next" crisis. Their gov't removed all potential legal/legislative barriers that had hindered their response last time around and private biotech companies started working on reagents and the medical infrastructure almost as soon as the outbreak in Wuhan became known.
Great for them, so far, but let's hope that a vaccine is found and fast. This cannot be maintained for ages. The mask thing, even if not N95 makes sense, you don't touch your face. Go home wash etc etc.
There's no possible hope of a vaccine that comes fast. We already have a 'found' (made) a bunch of candidate vaccines that might work, but there's a huge gap between having a candidate vaccine and something that's available to inject in nearly everyone. It takes a year or so of testing to see what it actually does and if it really makes things better and doesn't hurt healthy people.
So we hope that there's a vaccine coming next year, but we're certain that there will be no vaccine this year. This will definitely be going on for many more months no matter if it "cannot be maintained".
I think comparing Singapore, a tiny, highly urbanized island nation, with the US, a continent size country with a vast number of points of entry, is a little bit apples to oranges.
Don't get me wrong, I do think that some Asian countries took great measures to contain the virus, and some western countries failed to do so, but I doubt the same measures would be equally as effective everywhere. This is relevant because the spread of the virus is a multifaceted and complex issue, and reductionist explanations might take us down the wrong path if not careful.
Why is it anytime usa screws up its because its a diverse nation that's different from all the other nations?
Maybe sometimes the USA is just incompetent and usually it can get away with being incompetent without consequence because nobody wants to poke the 800lb gorilla, but sometimes consequences do happen.
Because pretty much all of Europe did the same so it isn't exclusive to USA?
NY did almost as many tests in a day as some european countries have done total. Of course they are going to have a spike in cases. No-one believe (in Europe at least) that the number of cases are the truth, and we pretty much know that a lot of people aren't being tests. Portugal until 2 days ago was rejecting tests still of people that had no 'known' chain of contagion. (Source, ex-wife works in the frontline of this crisis)
I don't see how "other people screwed up too" is a counter argument to my argument that "usa is different from every country in the world and thus its impossible to do things right" is bullshit. They're two completely different claims.
It is difficult to compare reported cases across countries, and certainly there are many countries that have dropped the ball (Iran especially comes to mind). At the risk of sounding unfeeling, a clearer picture will probably emerge once the deaths start rolling in, since dying is a very binary state and less subject to measurement bias due to gov (in)action.
I agree. But even with deaths will be tricky. Some countries define any death that tests positive as a COVID death, while others only mark it as so if no other more pressing co-morbilities are found.
Arguments like this are a longstanding template to excuse everything from crappy broadband to poor health outcomes in general. Yes, America is big, but bits don't get tired in long fiber links, and health care outcomes are independent of distance. America needs to start examining why we lag in so many quality of life issues.
The real reason is just that the US is not as highly developed as the most highly developed countries in Western Europe or East Asia.
I always thought it was weird when people say things like “the US is the worst in the developed world on so many measures!” A bit like someone saying “I’m one of the shortest people in the world who’s 180cm or taller”.
Singapore is very dense but it is also very authoritarian. They can take measures that would be both legally and socially unthinkable in the United States.
Yes, they just recently shut bars and clubs, and forced restaurants to allow one meter of spacing between patrons. I can't imagine American governments ever doing something so authoritarian.
And what would those specific measures be, pray tell? If anything, Singapore's measures have been more moderate than what's happening today in the USA.
There is a great deal of fallacy to be gleaned by the comparison between the two states - but quite a bit of truth, though, too.
The American cavalier "invincibility" attribute seems to be truly at play here - witness the kids in Florida - whereas in South Korea, a state composed, traditionally, of an enslaved population: the obedience bit has been key.
It's an uncomfortable thought, but it is rugged American hubris which is propagating the virus right now throughout the country. And it was Korean humility and selflessness which brought it down to controllable levels. This article is a flowery way of pointing that out, imho ...
South Korea is basically an island, conducted serendipitous did large scale pandemic drill in December, has a compliant population with mandatory civil service and memory of recent authoritarian government, can mobilize techno-authoritarian surveillance.
My question is, what is happening in Japan? Except wide spread mask usage, they have systemic undertesting at 1/6 capacity, no social distance measures, nothing shutdown, old population like Italy. Their hospitals should have been overwhelmed with dead by now. Are they just leaving the old to die at home? France and Italy aren't counting deaths at home as part of statistics. Maybe something similar? Which loops back to S.Korea, why so eager to trust their numbers. Their politics is fairly corrupt.
> South Korea is basically an island, conducted serendipitous did large scale pandemic drill in December, has a compliant population with mandatory civil service and memory of recent authoritarian government, can mobilize techno-authoritarian surveillance.
And they didn't even try to shutdown churches, bars and clubs, while churches consistently have been the largest sources of mass infection. And your may also want to know that literally every single media has been criticizing every single action taken by the government. What an authoritarian government.
> Which loops back to S.Korea, why so eager to trust their numbers. Their politics is fairly corrupt.
They earned their trust by reporting 7000 cases, taking the risks of huge political disadvantages. All the other first world countries were reluctant on doing that due to the exact opposite motivations. And unless you have some ideas on the modern political landscapes in S.K., I would recommend not to inconsiderately speak up a such fairly strong opinion.
I didn't say they were authoritarian government but a large segment of SK population grew up under SK dictatorship which has implications on compliance. Same with Taiwan, Singapore is still single party dictatorship etc. I'm well aware of the domestic SK reaction (negative) around alleged mishandling of the response which is just extra incentive to manipulate test data. Cho Kuk was 6 months ago. Record high unemployment since GFC. Nothing about this administration suggest it's not above fixing stats on top of overall high testing rate especially with the high stakes of underperforming. Almost every SK president has been mired in corruption scandals, many were imprisoned for shady dealings. Why would this be any different?
Yeah, they could have found a working formula, but they could also be lying like other first world countries that we know are under reporting deaths via recatorigzation of likely covid deaths to other deaths to depress the impact. SK corruption and transparency index is comparable to France and Italy who already acknowledged doing so. Add the geopolitical layer of western media trying to grasp at any alternative strategy that doesn't involve Chinese style lockdown. Very few reports even mentions SK contact tracing is closer to Chinese techno-authoritarian techniques than not, which ultimately makes SK response not a useful model for these countries until they get desperate. Which is my main point, media is fixating on SK testing and contact tracing when latter is not possible in many first world countries.
Lots of theories. They have a culture that doesn't shake hands or hug, they caught cases early and had a relatively low infection rate (they claim 80% did not spread the virus), a culture of wearing face masks or possibly it is just due to low testing rates and is actually worse than the numbers suggest.
I have no idea where this stereotype comes from, but South Korea is known for militant political movement (eg, labor unions, super right-wingers) and religious fanatics:
> ... compliant population with mandatory civil service and memory of recent authoritarian government, can mobilize techno-authoritarian surveillance. ...
Isn't it relative to western countries? S.Korea is like Israel, a large part of the population with civil service experience who can follow instructions, but also some religious fanatics / cults who don't give a fuck. The government has more accessible, non-emergency options to crackdown, last I heard Korean officials is trying to contain the cults via lawsuit and criminal charges. Can you imagine US suing a church, arresting a pastor for holding congregation? In Canada we have been trying to recall our citizens abroad and it wasn't until things got bad that 1million+ snow birds decided to return. Prior to that kids were going on spring break. No one took things seriously until last week after a month escalating warnings. And this is in a city with SARS experience. Down south is even more of a shit show. As for techno-authoritarian surveillance - health officials cross referencing CCTV footage, location data and cred card reports - that would not fly here as a "public" option which is why it's rarely mentioned in any of these TEST OFTEN and contact trace articles. The uninformed would attribute those techniques to China. The informed would immediately understand that wouldn't work in many western countries without massive legislative overhaul.
The cost of the epidemic now goes into the trillions, self-made cotton masks are cheap compared to the economic damage. They can be disinfected in boiling water and if everybody uses them they will help to stop the spreading of the virus.
In all the countries mentioned in the article people wear masks when in public, often just against pollution (i.e. Thailand).
The moment we open our mouth we spread germs, even more so when we speak. And when we touch our nose or mouth, we have them on our hands.
Thus entering a supermarket without a mask and without first disinfecting the hands should be forbidden.
Social distancing is one thing, stopping the virus at the source is another and seemingly very effective measure.