I forgot the name, but there's a whole site dedicated to listing what to long/short for various 'immoral' scenarios like major disasters, pandemics, housing crashes, etc.
How are any of those things immoral? Let's say you think there is a pandemic coming and you invest in mask manufacturers. They use your investment to build more mask factories. When the pandemic hits they sell more masks because their new factories can handle the demand spike. Your make more money, and the public gets better protection while being saved from a price spike - all because you offered your money and foresight. You could tell the same stories for the other events.
It really depends what the funds include. What it you fund manufacturers when preppers buy guns/ammunition? What if you fund companies buying out defaulted property during housing crisis just to flip it for more money in a few months?
It doesn't have to be all immoral, but some companies will be.
> Let's say you think there is a pandemic coming and you invest in mask manufacturers. They use your investment
I generally invest in exchange listed companies. When I invest, I'm buying from someone else, not from the company. They already got paid when they floated. They're not seeing a dime through exchange trade unless they make more shares available, diluting everyone else's investment in the process.
So when I invest, someone else gets paid. They may get paid or less than they paid when they bought, but they're getting paid. Not the company I invested in.
Your kids will named and shamed in school cause daddy jacked up the prices when people are dying. The government needs to invest, and even keep a few essential factories on standby or buy, say linens from factories that if needed will make masks. WTH, we invest $700 BILLION in the military and if you don't have antibiotics, scrubs and other basics, what's the point?
The government bailed out car companies and other than jobs, it also means that in a WW scenario, the GM and Ford factories will make tanks instead of cars. Some things re essential.
It's not really the same - I assume you're thinking of VC money going into "boring" businesses in anticipation of a market-altering global event, like investing in Remington because you believe there'll be a war - but catastrophe bonds are a thing: https://www.thebalance.com/catastrophe-bonds-definition-and-...
Hand washing seems like it would serve the same purpose and more effectively (I believe to properly sanitize the cotton gloves, you’d have to bleach them, and how do they protect you anyway? Viruses can’t get through your skin unless you have an cut).
The masks have been shown to be effective in reducing the spread of disease. It’s essentially “cough/sneeze into your elbow” but much more effective.
Have surgical masks really shown to be effective in reducing the spread of disease when worn by people who are not yet infected?
I've been to mainland China, Taiwan, HK, South Korea, Japan, Vietnam, Singapore, Malaysia and Thailand in the last four weeks. China has close to 100% usage of masks in public, mostly the surgical type. The virus is spreading like wildfire there. Every other country I've visited has markedly less mask usage, in particular Vietnam where at least in the south, it's relatively rare to see people wearing them.
Yet in all the other countries it's hardly spreading (obviously I'm excluding the cruise ship off the coast of Japan here, which appears to be a special case).
Well, the best available estimate of the chance that I'm infected is on the order of 0.00001%, give or take an order of magnitude. If I would take countermeasures to every risk of that order, I wouldn't have time to do anything else.
Again: there are other countries where the virus has spread in the community, yet despite virtually no mask wearing the spread has been extremely limited and easily controlled.
No, I believe I read that the typical N95 masks that people use is basically useless against this virus, because it's very, very tiny and can sail right through a mask. It still might reduce your exposure and is probably better than nothing, but I believe only a gas mask would totally protect you.
"...there's no evidence inexpensive surgical masks can protect against flu virus particles small enough to be inhaled into the lower respiratory tract or the lungs"
Most people are not even wearing N95 masks, they're wearing the much more common and cheaper "surgical masks" that don't form any kind of seal around the outside.
Your own cite says that surgical masks are ineffective but properly fitted N95 masks can be effective. I believe that they filter droplets well, e.g. from sneezing.
I think they're better than nothing but as someone else mentioned the virus is 0.1 to 0.3 microns and the N95 only filters 95% of particles 3 microns or larger.
This study only finds that N95 are not more effective than surgical masks. It does not measure the effectiveness of surgical masks vs nothing. Did you actually read the study before posting a link to it?
It's worth also noting that this refers to healthcare workers. The considerations are totally different here, because the likelihood that they'll come into close contact with an infected person is pretty close to 100%. The likelihood that a member of the public will in most Asian countries with 20 or so cases and a few tens of million people is more like 0.00001% give or take a couple of orders of magnitude.
"Most often, spread from person-to-person happens among close contacts (about 6 feet). Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread."
These droplets can infect you through your eyes as well. Like I said, the mask helps, but no it's not virus proof as Wuhan healthcare workers can attest.
That may well be, but the predominant concern is larger droplets from a cough or sneeze. I don't recall seeing anything speaking of airborne transmission.
The virus isn't going to be airborne naked as an individual thing in the free air - it's going to be in droplets of stuff (from sneezing, coughing, etc).
You're picturing a bare virus flying through the air and getting through a mask.
That's not a plausible route of transmission. The virus would be embedded in a much larger particle of human mucus, and an N95 mask will do a fine job of filtering that out.
N95 masks (and other types of HEPA filters) actually perform better on smaller particles.
A very common misconception is that HEPA filters only filter particles larger than 0.3 microns. In fact there's multiple different filtration mechanisms at play, with interception and impaction working better for larger particles, and diffusion being more effective for smaller particles. HEPA filters are rated for their effectiveness at 0.3 microns because that size is the size where the combination of mechanisms operate worst: smaller and larger particles are filtered even more effectively.
There are studies that show that masks (surgical and n95) can help prevent healthy people from getting infected [1][2]. Everyone I've seen claiming the opposite (including supposed experts being interviewed) usually do it without any significant data to back it up (just some high level theorizing). I also rarely see anyone discussing the nuances of efficacy against airborne vs droplet spread viruses. Using just a minimum amount of reasoning it would seem very plausible that masks would be effective against droplets but less effective against airborne diseases.
Now, I'm not one to blindly trust a government agency, but most of the evidence seems inconclusive at this point, and one thing can't be ignored: in mainland China, use of masks in public spaces is near 100%, yet the virus is spreading rapidly. Outside mainland China, far fewer people are wearing masks, yet the virus is not spreading much at all.
> At any given time you can't really know if you're infected or not if the virus is widespread.
Unless you're in China, the virus is not widespread. I imagine they would change their recommendation if it was.
> So why not wear them? Why recommend them for healthcare workers but not the general public?
The chance that a healthcare worker who is treating a suspected CoV case is in close contact with an infected patient is close to 100%. On the other hand, the chance that a member of the general public outside of mainland China comes into close contact with someone who is infected, whether they're in the rest of Asia or not, is within a few orders of magnitude of 0.00001%.
1-Since travel is still occuring out of mainland China, your faith in the virus being limited to the nation of China seems misplaced.
2-Your estimates of the probability are unlikely shift properly as the landscape of infection changes rapidly, and is not apparent to the naked eye.
Humans intuitively do not tend to comprehend exponential/quadratic growth. This video outlines it. The main point is to look how late, in this scenario you'd be saying "no problem" and how quickly it goes from fine, to effed. Note: this is not an endorsement on the other items in this channel, I just think this particular explanation is demonstrative.
> 1-Since travel is still occuring out of mainland China, your faith in the virus being limited to the nation of China seems misplaced.
I never said it was limited to the nation of China, I said it wasn't widespread outside of China and a cruise ship, which remains true despite significant travel still occurring.
Humans are also terrible at intuitively assessing risk, and the current panic is a great example of this.
> Humans are also terrible at intuitively assessing risk
Doesn't that also apply to you? Have you looked into when and where testing is performed? In the US, if you don't have a china travel history, they won't test you.
This has an incubation period that is still indeterminate, and in the US and other large countries, they are barely testing. So you literally don't have a way to be sure of what you're claiming--there's just no data, but somehow you are very confident in what you claim?
Have you read up on the Spanish Flu? Was that just a "panic"? So far, by every measure, this looks to be worse--more transmissible, harder to detect, with a higher mortality rate. The Spanish Flu killed between 1 and 5% of the world's population.
Yes indeed, and to you also. But in the same way that one can learn to better appreciate exponential growth, one can learn to better appreciate risk, and try to apply that knowledge rationally rather than basing decisions on fear.
> Have you looked into when and where testing is performed? In the US, if you don't have a china travel history, they won't test you.
Yes. The most reliable testing procedures are quite invasive and carry at least some exposure risk for the healthcare worker carrying them out, especially if done outside a hospital setting. They also aren't guaranteed to detect the virus in the early stages, or in minor infections. This is one reason why China has moved to include clinical diagnoses as confirmed cases, and it's also why they didn't just test every person on the Yokohama cruise ship straight away.
> This has an incubation period that is still indeterminate
Not really. There are some pretty good bounds on it, especially with the significant number of cases in Wuhan available as data.
I am confident in what I claim (given that what I claim is quite limited). I'm not making predictions here, I'm talking about the current state of things. Beyond that, let's see what happens...
> I'm wondering if the unstated reasoning is that widespread mask usage freaks people out and increases the chance of large scale panic.
Different cultures and situations handle this very differently. I'm hearing reports in London that people are being attacked for wearing a mask in public.
Meanwhile, if you want to scare everyone around you in Hong Kong, go out without a mask and then cough.
Your link & the CDC don't say what you think they say.
CDC's recommendations are that members of the uninfected public should not wear N95 masks.
This should NOT be understood as: CDC says N95 masks are ineffective at preventing airborne infections of Covid-19.
It IS the CDC saying: N95 masks are non-trivial to use correctly, require decontamination protocols or single-use replacement to avoid infection and contamination from used masks themselves (potentially full of virus particles), and protect against a threat many people are unlikely to be exposed to (close proximity infected persons) -- a mix of criteria that make them inefficient to recommend for general public use.
As you see in the link above, CDC absolutely recommends N95+ respirators for EMS and healthcare workers, when working in close proximity to infected persons.
But healthcare workers have a substantially higher airborne exposure risk, as well as professional support and training for properly using N95 masks.
They do say what I think they say, but yeah, I should have clarified that I meant the public, not healthcare workers. (I addressed this more clearly in another comment on the same submission.)
I'm not the slightest bit concerned. No country except mainland China has more than 70 confirmed cases, and deaths worldwide are in the single digits outside of China. These are countries with millions, tens of millions or hundreds of millions of inhabitants. I'm heading to Singapore in a few days, which has the most cases outside of mainland China (likely because they're very good at tracking them) -- 67 out of a population of 5.7 million (0.00001%), and of course all of those people are in quarantine. I imagine some cases haven't been discovered yet, but I have a hard time imagining that changing the order of magnitude.
I'd be willing to travel to many parts of mainland China, but it causes problems for traveling to other countries, so I'm unable to for now.
I'll alter my travel according to the facts as they change, but for now there's absolutely no rational reason I can see for avoiding travel to any country other than mainland China.
Probably the main reason to consider travel slightly hazardous is that you'll be in close proximity to other travelers and people who service travelers, which likely represents some risk.
What if a group of Chinese nationals traveling to a tour get on your plane / bus / etc, or were the previous people in your seat? You don't have that high of a risk from this scenario, but it is more exposure than you'd get at home.
Most organised outbound tourism from China is canceled right now, though there are of course still independent travelers and probably smaller group travel too.
It's also worth noting that the fact that they're Chinese nationals doesn't really move the needle that much on how likely it is that they're infected. About 0.00005% of the mainland China resident population is confirmed to be infected, and the vast majority of those (over 80%) are in Hubei, which given the lockdown makes it very unlikely that you will meet them on an aircraft. Even if you allow for under-reporting the order of magnitude is probably about right.
Additionally there are another 50 million Chinese nationals living in other countries, who I would submit are more likely than those resident in China to be traveling right now, and are also far less likely to be infected. This is one reason why the racism seen recently in Australia and UK against Chinese-looking people wearing masks is so ridiculous.
Surgical masks are meant to stop droplets and large particles but aren't rated to filter airborne particulates. These more or less protect people from sneezing or coughing directly onto one another.
The next step up from a surgical mask is an NIOSH rated mask / respirator. These carry a letter and number rating the letter is either N, R, or P and the number is typically 95 - 100. N95 is a NIOSH filter rating and where the term N95 mask comes from. These will filter out any viruses and other particulates in the air. There are studies showing that N95 Masks are effective.
edit: all that said there are studies that show both types have similar effectiveness at preventing infections in healthcare workers so I wouldn't go around telling people that any of them are useless.
Yeah not only are surgical masks not even clinically effective in this situation, they’re often not worn properly. I’m in Beijing now and you see people with masks not covering their nose, or worse, pulled down onto their chin. A friend of mine tried to remind an older lady in an elevator about proper mask usage, and her response was 你们年轻人管太多了 — you young people worry too much/should mind your own business.
The people in my compound who were confirmed to have the virus (we found out on the 12th) got it at a family gathering over the new year holiday in Shanghai. So obviously they weren’t wearing a mask then.
What seems to be making a difference in China — it’s no longer spreading like wildfire, if you believe the official reports* — is self-quarantine. Most of my friends have barely left home since the beginning of February. For a while, some restaurants that were still open wouldn’t let people sit together in parties larger than 2. And at least in Beijing, everyone who returns to the city after travel must undergo mandatory 14 day home quarantine, with fines or punishments for those caught violating (https://www.nytimes.com/reuters/2020/02/14/world/asia/14reut... though enforcement varies from place to place).
* Wuhan/Hubei are a tragedy no matter how you count. But at least Beijing is doing OK. I mostly trust the official numbers, simply because the Party has a strong vested interest in mounting a response commensurate with the threat. They can’t let the virus spread too much and rip apart the capital; neither can they afford to tank the economy for several months longer than necessary to contain the threat. Even with all the censorship, if you find yourself fighting against reality, reality wins.
> I've been to mainland China, ... HK ... in the last four weeks. China has close to 100% usage of masks in public, mostly the surgical type. The virus is spreading like wildfire there. Every other country I've visited has markedly less mask usage.
I dunno where you were in HK, but the only place I haven't seen everyone wearing a mask is in Soho. Everywhere else, I'm seeing near 100% coverage.
I would have put it closer to 2/3 or 3/4 in HK, versus almost 100% in China. I'm usually around Yuen Long, Mong Kok, TST, Central and Western. Has been a week since I was there though. Compared to mainland China and HK, there's way less mask usage elsewhere. For example in Vietnam I'd say it's more like 5-10%, at least in the south.
Absence of evidence is not evidence of absence. A number of public health authorities, including the US CDC, have stated that there is likely community transmission happening.
It’s comical, but most people I see coughing or sneezing into their elbows, don’t even make a decent attempt at it.
Their elbow is about 5 inches away from their mouth, which doesn’t suppress the saliva and air molecules coming from their lungs anyways. It might catch some of the spittle, but I’m sure most of it becomes aerosolized anyways.
I don't understand why you'd use cotton gloves instead of nitrile or latex gloves. The latter seem like they'd be far more impervious to pathogens.
I'm also really skeptical of the effectiveness of flimsy surgical masks.
I'd expect respirators with filters of the P100 and N95 variety (which respectively filter out 100% and 95% of particles 3 microns or larger) to be far more effective.
It comes down to risk management. I'm going to be overly simplistic in my examples below. Please try to remain flexible as you read this and try not to get too hung up on the numbers. It's an analogy only and not in any way realistic in terms of protection.
Let's just say that N95 masks protect you at 95% effectiveness from airborne contamination, and 50% from touch contamination because it stops you from touching your own face, but doesn't stop you from rubbing your eyes, or penetrating your skin in other locations, or for your food preparers from sneezing on your steak. Surgical masks are, for the sake of simplicity, 80% effective at protecting you from airborne contamination.
Let's also say gloves do 0% to protect you from airborne infection, and varying degrees of protection from physical touch depending on the material. Let's say cotton is 40% touch protection because it provides a physical separation of half a millimeter, but it's porous. It keeps your oily skin from picking up residue from contaminated surfaces as easily as bare skin. Flexible oil-based gloves have a 80% protection, but are more easily penetrated by rough surfaces lowering their total protection value (still fake numbers!). They also cause sweat problems for some people and affect the health of the skin itself if worn daily for many hours at a time.
Gloves don't protect you from contaminated item ingestion. They slightly protect you from transmission through touching your face because they inherently pickup a little less than your oily skin. More likely is that you'd simply avoid touching your face more easily because the gloves would be a mental prompt to remind you that your hands are potentially infected.
Biohazard suits are obviously the most effective form of protection.
So on this spectrum of protection, you have several different vectors you're defending against, and several methods of protection. In bare terms of protection, clearly the highest form of protection is the biohazard suit. Why not go for that? Well the cost is too high both in terms of money and in social outcomes. They're also relatively delicate compared to simple clothing and would have to be replaced far more often. Filters would need to be replaced often as well.
Hopefully my unrealistic numbers above help show that there is no "right" answer, all answers have trade offs, and all answers are more appropriate situationally than others. That's the ultimate point.
Someone who travels via subway everyday might well benefit more from an N95 mask than gloves. The cost might even be provably effective. Cotton gloves might be very beneficial for that individual as well, but clearly wearing oil-based gloves would be more effective for their commute.
Someone who drives by themselves in their car, and works in an office building where no more than 5 to 10 people touch the door everyday, they might be fine without either a mask or gloves, unless they are going shopping. Washing hands and asking sick coworkers to cover their mouth when they cough seems completely satisfactory.
I personally don't use either gloves or masks, but I am prepared with cotton gloves if my region shows signs of infection, and will use them when shopping or touching potentially infected surfaces.
I prefer cotton gloves because they're easy and cheap to make, and they're reusable, and biodegradable. I don't see oil based gloves as being a sustainable solution for an entire nation. That's my own personal preference though and I don't like to push that mindset on others. There are more egregious forms of waste than tiny gloves.
(copy-and-pasting my comment elsewhere in this story, because this is important)
N95 masks (and other types of HEPA filters) actually perform better on smaller particles.
A very common misconception is that HEPA filters only filter particles larger than 0.3 microns. In fact there's multiple different filtration mechanisms at play, with interception and impaction working better for larger particles, and diffusion being more effective for smaller particles. HEPA filters are rated for their effectiveness at 0.3 microns because that size is the size where the combination of mechanisms operate worst: smaller and larger particles are filtered even more effectively.
Nose and mouth can both spread germs from a sick person through coughing and sneezing and get infected with germs. A mask stops both those things from happening. Hands can't get infected with a respiratory infection and are easily cleaned by washing.
Just like agriculture and heavy industry, USA must make sure that medical supplies are made here. In an emergency, no country will let a company export to USA, they need them back home first.
Tariffs and taxes? We've (USA) been central planning for a long time. Just like we've socialist for a long time (welfare programs). You can achieve goals by warping the markets, not just dictating what should happen.
Trusting profit-motivated organizations to make decisions that are aligned with the common good has been proven to be a mistake over and over again; Is actually in healthcare's industry best interest that even more people get cancer; in general everything health related should be highly controlled and supplied by the government itself to avoid such dangerous motivators, even the food industry must be highly regulated to make sure it doesn't make false health-related promises, and in general any product promising health benefits.
Welcome to the end result of Just In Time inventory.
Nobody wants to hold inventory because that represents "wasted money". So, when you need inventory, everybody is screwed.
This is just like the banking crisis of 2008. There is no point in being the Cassandra. If you're right, everybody is screwed. If your wrong, you personally lose.
Better to just bank your money and try to bail out as soon as possible.
not sure about the inventory taxes here, but property tax in general basically serves as the 'income tax' of texas from a state revenue perspective. which is, 'interesting' for a variety of reasons.
I guess this health crisis will also be the end of just in time logistics, as almost nothing is produced in China right at this moment. If anything, the recent trade sanctions debacle in the US might have given some US companies a head-start in helping them not being so dependent on Chinese manufacturing, but I don’t think the advantage is too large.
I wonder if a simple better contract situation exists : the owner of the company could demand that orders are made till X time for the amount of Y. Since demand is strong, they’ll have to accept.
No one in this thread mentioned the federal emergency stockpile of 100mio masks. It seems this is at least in principle the solution to this issue? If a 4 week stockpile turns out to be insufficient, make it a 8 week stockpile, problem solved.
For rotation, can the stockpile be made part of the normal supply chain, so that masks are sold halfway through their shelf life and new ones flow into the stockpile? Or does the size of such a stockpile mean that the masks would expire faster than the market would buy them?
I really don't see how masks, or other emergency equipment, changes things. Stockpiling stuff for emergencies seems to be the thing that governments should do.
How did you come up with the idea that anyone is advocating for some kind of force majeure?
The proposal is for USG to buy a bunch of masks and sell them halfway through their useful life. Absolutely no one, other than you, is interpreting this as a requirement that fresh masks cannot be sold under penalty of law.
That's a bizarre and tortured interpretation of what's being discussed here.
Forcing all mask purchases through the government would be challenging.
The government simply deciding to buy a lot of masks, then sell them as surplus half way through their shelf life, is just a matter of requisitioning funds.
I hope the government is doing stuff like that. I don't plan as if they do, but I hope they do. What's the good of being in a first-world country if the government can't even plan that far ahead?
It's not really about you. As a consumer, you're a blip in the noise, surgical masks are sold to medical professionals.
So for them, the question is whether they go through masks fast enough that selling them halfway through their sell-by span is practical.
The answer is almost certainly yes, although larger hospitals should maintain their own stockpile. The obvious answer: have major hospitals be holding centers for the US strategic mask reserve.
For consumers, there's no reason not to sell a few masks fresh off the line. These goals aren't in conflict.
Thats why I wrote "thread". The HN discussion wasn't at the time I posted this taking into account the government stockpile as a pragmatic solution to the issue, but instead discussing tariffs and other approaches.
This is racism and irresponsible journalism “all but 3 deaths have been in China.”
There is a time lag! The disease doesn’t care if you are Chinese or white. No hospital system can handle the numbers that came first to China, and will soon come here.
Wapo downplaying the virus. Just like they’ve downplayed the threat of globalism. And those who have tried to sound the alarm or argued that we should, gasp, renegotiate trade and bring back some manufacturing, those people are slandered as xenophobic or economics dunces. “Any serious person knows we can’t bring manufacturing back.” “Protectionism is stupid, trade wars hurt us,etc...” And now they want to tell the American public, “no death outside China.” Blood on their hands!
It’s a fact that has no importance other than to mislead. There is no reason to think the virus is any less deadly outside of China or in non-Asian patients. The rest of the world is just a few weeks, give or take local variation in R0, behind and we should expect the same or similar outcomes. That’s according to the experts who spoke at the senate hearing last week.
The fact that only 3 deaths have occurred outside of China (and the vast majority in Wuhan is an important metric in assessing how the virus spreads and how effective or not containment policies have been. There are many, many Chinese people who live outside of China, and emphasizing that the virus is heavily contained in the country of its origin is pretty relevant to anyone who hasn’t visited China recently.
The death rate has very little to do with containment. The rate of infection does. In this case both of these merely represent the time lag, and despite what you think all of the experts agree— we are buying time at this point. Argue with the experts, not with me.
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[ 3.0 ms ] story [ 186 ms ] threadIt doesn't have to be all immoral, but some companies will be.
I generally invest in exchange listed companies. When I invest, I'm buying from someone else, not from the company. They already got paid when they floated. They're not seeing a dime through exchange trade unless they make more shares available, diluting everyone else's investment in the process.
So when I invest, someone else gets paid. They may get paid or less than they paid when they bought, but they're getting paid. Not the company I invested in.
Then if price-gouging laws prevent you from charging more during an emergency you won't make your money back.
The government bailed out car companies and other than jobs, it also means that in a WW scenario, the GM and Ford factories will make tanks instead of cars. Some things re essential.
Is it because masks get more attention and there’s a large overlap between narcissists and people scared of the zombie apocalypse?
I’m kidding about that, but it’s really odd how easily people seem to flock without attempting any deeper analysis.
Hand washing seems like it would serve the same purpose and more effectively (I believe to properly sanitize the cotton gloves, you’d have to bleach them, and how do they protect you anyway? Viruses can’t get through your skin unless you have an cut).
The masks have been shown to be effective in reducing the spread of disease. It’s essentially “cough/sneeze into your elbow” but much more effective.
I've been to mainland China, Taiwan, HK, South Korea, Japan, Vietnam, Singapore, Malaysia and Thailand in the last four weeks. China has close to 100% usage of masks in public, mostly the surgical type. The virus is spreading like wildfire there. Every other country I've visited has markedly less mask usage, in particular Vietnam where at least in the south, it's relatively rare to see people wearing them.
Yet in all the other countries it's hardly spreading (obviously I'm excluding the cruise ship off the coast of Japan here, which appears to be a special case).
It does however provide a data point that masks are likely not very effective at preventing the spread of the virus.
So maybe you're right. But maybe it would have broken out 100x worse by now.
"...there's no evidence inexpensive surgical masks can protect against flu virus particles small enough to be inhaled into the lower respiratory tract or the lungs"
http://www.digitaljournal.com/life/health/do-face-masks-help...
https://www.asahq.org/about-asa/governance-and-committees/as...
Here you go
It's worth also noting that this refers to healthcare workers. The considerations are totally different here, because the likelihood that they'll come into close contact with an infected person is pretty close to 100%. The likelihood that a member of the public will in most Asian countries with 20 or so cases and a few tens of million people is more like 0.00001% give or take a couple of orders of magnitude.
"Most often, spread from person-to-person happens among close contacts (about 6 feet). Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread."
https://www.cdph.ca.gov/Programs/EPO/Pages/Wildfire%20Pages/...
"An N95 respirator is particularly effective against aerosolized droplets that are invisible to the naked eye."
That's not a plausible route of transmission. The virus would be embedded in a much larger particle of human mucus, and an N95 mask will do a fine job of filtering that out.
A very common misconception is that HEPA filters only filter particles larger than 0.3 microns. In fact there's multiple different filtration mechanisms at play, with interception and impaction working better for larger particles, and diffusion being more effective for smaller particles. HEPA filters are rated for their effectiveness at 0.3 microns because that size is the size where the combination of mechanisms operate worst: smaller and larger particles are filtered even more effectively.
https://en.wikipedia.org/wiki/HEPA#Mechanism
[1] https://www.newscientist.com/article/dn3692-face-masks-are-b... [2] https://annals.org/aim/fullarticle/744899/facemasks-hand-hyg...
CDC does not recommend that people who are well wear [a] facemask to protect themselves from respiratory viruses, including 2019-nCoV. - https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-t...
Now, I'm not one to blindly trust a government agency, but most of the evidence seems inconclusive at this point, and one thing can't be ignored: in mainland China, use of masks in public spaces is near 100%, yet the virus is spreading rapidly. Outside mainland China, far fewer people are wearing masks, yet the virus is not spreading much at all.
Sure, it's not likely to decrease your direct infection risk.
But it does decrease the risk of you infecting others.
At any given time you can't really know if you're infected or not if the virus is widespread.
Also the mask would presumably be more effective than coughing into your elbow or a tissue, which they do recommend.
So why not wear them? Why recommend them for healthcare workers but not the general public?
I'm wondering if the unstated reasoning is that widespread mask usage freaks people out and increases the chance of large scale panic.
Unless you're in China, the virus is not widespread. I imagine they would change their recommendation if it was.
> So why not wear them? Why recommend them for healthcare workers but not the general public?
The chance that a healthcare worker who is treating a suspected CoV case is in close contact with an infected patient is close to 100%. On the other hand, the chance that a member of the general public outside of mainland China comes into close contact with someone who is infected, whether they're in the rest of Asia or not, is within a few orders of magnitude of 0.00001%.
I wonder what the rational tipping point would be for mask vs no mask.
2-Your estimates of the probability are unlikely shift properly as the landscape of infection changes rapidly, and is not apparent to the naked eye.
Humans intuitively do not tend to comprehend exponential/quadratic growth. This video outlines it. The main point is to look how late, in this scenario you'd be saying "no problem" and how quickly it goes from fine, to effed. Note: this is not an endorsement on the other items in this channel, I just think this particular explanation is demonstrative.
https://www.youtube.com/watch?v=iIwyMif5EOg&feature=youtu.be...
I never said it was limited to the nation of China, I said it wasn't widespread outside of China and a cruise ship, which remains true despite significant travel still occurring.
Humans are also terrible at intuitively assessing risk, and the current panic is a great example of this.
Doesn't that also apply to you? Have you looked into when and where testing is performed? In the US, if you don't have a china travel history, they won't test you.
This has an incubation period that is still indeterminate, and in the US and other large countries, they are barely testing. So you literally don't have a way to be sure of what you're claiming--there's just no data, but somehow you are very confident in what you claim?
Have you read up on the Spanish Flu? Was that just a "panic"? So far, by every measure, this looks to be worse--more transmissible, harder to detect, with a higher mortality rate. The Spanish Flu killed between 1 and 5% of the world's population.
Yes indeed, and to you also. But in the same way that one can learn to better appreciate exponential growth, one can learn to better appreciate risk, and try to apply that knowledge rationally rather than basing decisions on fear.
> Have you looked into when and where testing is performed? In the US, if you don't have a china travel history, they won't test you.
Yes. The most reliable testing procedures are quite invasive and carry at least some exposure risk for the healthcare worker carrying them out, especially if done outside a hospital setting. They also aren't guaranteed to detect the virus in the early stages, or in minor infections. This is one reason why China has moved to include clinical diagnoses as confirmed cases, and it's also why they didn't just test every person on the Yokohama cruise ship straight away.
> This has an incubation period that is still indeterminate
Not really. There are some pretty good bounds on it, especially with the significant number of cases in Wuhan available as data.
I am confident in what I claim (given that what I claim is quite limited). I'm not making predictions here, I'm talking about the current state of things. Beyond that, let's see what happens...
Different cultures and situations handle this very differently. I'm hearing reports in London that people are being attacked for wearing a mask in public.
Meanwhile, if you want to scare everyone around you in Hong Kong, go out without a mask and then cough.
See: https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html
Your link & the CDC don't say what you think they say.
CDC's recommendations are that members of the uninfected public should not wear N95 masks.
This should NOT be understood as: CDC says N95 masks are ineffective at preventing airborne infections of Covid-19.
It IS the CDC saying: N95 masks are non-trivial to use correctly, require decontamination protocols or single-use replacement to avoid infection and contamination from used masks themselves (potentially full of virus particles), and protect against a threat many people are unlikely to be exposed to (close proximity infected persons) -- a mix of criteria that make them inefficient to recommend for general public use.
As you see in the link above, CDC absolutely recommends N95+ respirators for EMS and healthcare workers, when working in close proximity to infected persons.
But healthcare workers have a substantially higher airborne exposure risk, as well as professional support and training for properly using N95 masks.
> China has close to 100% usage of masks in public
You know, 100% usage in public is an excellent way to ensure that people who are infected wear the masks.
I'm not the slightest bit concerned. No country except mainland China has more than 70 confirmed cases, and deaths worldwide are in the single digits outside of China. These are countries with millions, tens of millions or hundreds of millions of inhabitants. I'm heading to Singapore in a few days, which has the most cases outside of mainland China (likely because they're very good at tracking them) -- 67 out of a population of 5.7 million (0.00001%), and of course all of those people are in quarantine. I imagine some cases haven't been discovered yet, but I have a hard time imagining that changing the order of magnitude.
I'd be willing to travel to many parts of mainland China, but it causes problems for traveling to other countries, so I'm unable to for now.
I'll alter my travel according to the facts as they change, but for now there's absolutely no rational reason I can see for avoiding travel to any country other than mainland China.
Edited to add: numbers are from https://www.who.int/docs/default-source/coronaviruse/situati...
What if a group of Chinese nationals traveling to a tour get on your plane / bus / etc, or were the previous people in your seat? You don't have that high of a risk from this scenario, but it is more exposure than you'd get at home.
It's also worth noting that the fact that they're Chinese nationals doesn't really move the needle that much on how likely it is that they're infected. About 0.00005% of the mainland China resident population is confirmed to be infected, and the vast majority of those (over 80%) are in Hubei, which given the lockdown makes it very unlikely that you will meet them on an aircraft. Even if you allow for under-reporting the order of magnitude is probably about right.
Additionally there are another 50 million Chinese nationals living in other countries, who I would submit are more likely than those resident in China to be traveling right now, and are also far less likely to be infected. This is one reason why the racism seen recently in Australia and UK against Chinese-looking people wearing masks is so ridiculous.
The next step up from a surgical mask is an NIOSH rated mask / respirator. These carry a letter and number rating the letter is either N, R, or P and the number is typically 95 - 100. N95 is a NIOSH filter rating and where the term N95 mask comes from. These will filter out any viruses and other particulates in the air. There are studies showing that N95 Masks are effective.
https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part...
edit: all that said there are studies that show both types have similar effectiveness at preventing infections in healthcare workers so I wouldn't go around telling people that any of them are useless.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868605/
You need to wear them properly. You need to change them regularly. You need to practice effective hygiene like not touching your face.
If the government distributed masks that could be effective to everyone, it’s unlikely they would have a noticeable effect
The people in my compound who were confirmed to have the virus (we found out on the 12th) got it at a family gathering over the new year holiday in Shanghai. So obviously they weren’t wearing a mask then.
What seems to be making a difference in China — it’s no longer spreading like wildfire, if you believe the official reports* — is self-quarantine. Most of my friends have barely left home since the beginning of February. For a while, some restaurants that were still open wouldn’t let people sit together in parties larger than 2. And at least in Beijing, everyone who returns to the city after travel must undergo mandatory 14 day home quarantine, with fines or punishments for those caught violating (https://www.nytimes.com/reuters/2020/02/14/world/asia/14reut... though enforcement varies from place to place).
* Wuhan/Hubei are a tragedy no matter how you count. But at least Beijing is doing OK. I mostly trust the official numbers, simply because the Party has a strong vested interest in mounting a response commensurate with the threat. They can’t let the virus spread too much and rip apart the capital; neither can they afford to tank the economy for several months longer than necessary to contain the threat. Even with all the censorship, if you find yourself fighting against reality, reality wins.
I dunno where you were in HK, but the only place I haven't seen everyone wearing a mask is in Soho. Everywhere else, I'm seeing near 100% coverage.
Their elbow is about 5 inches away from their mouth, which doesn’t suppress the saliva and air molecules coming from their lungs anyways. It might catch some of the spittle, but I’m sure most of it becomes aerosolized anyways.
People, in general, are disgusting.
I'm also really skeptical of the effectiveness of flimsy surgical masks.
I'd expect respirators with filters of the P100 and N95 variety (which respectively filter out 100% and 95% of particles 3 microns or larger) to be far more effective.
Let's just say that N95 masks protect you at 95% effectiveness from airborne contamination, and 50% from touch contamination because it stops you from touching your own face, but doesn't stop you from rubbing your eyes, or penetrating your skin in other locations, or for your food preparers from sneezing on your steak. Surgical masks are, for the sake of simplicity, 80% effective at protecting you from airborne contamination.
Let's also say gloves do 0% to protect you from airborne infection, and varying degrees of protection from physical touch depending on the material. Let's say cotton is 40% touch protection because it provides a physical separation of half a millimeter, but it's porous. It keeps your oily skin from picking up residue from contaminated surfaces as easily as bare skin. Flexible oil-based gloves have a 80% protection, but are more easily penetrated by rough surfaces lowering their total protection value (still fake numbers!). They also cause sweat problems for some people and affect the health of the skin itself if worn daily for many hours at a time.
Gloves don't protect you from contaminated item ingestion. They slightly protect you from transmission through touching your face because they inherently pickup a little less than your oily skin. More likely is that you'd simply avoid touching your face more easily because the gloves would be a mental prompt to remind you that your hands are potentially infected.
Biohazard suits are obviously the most effective form of protection.
So on this spectrum of protection, you have several different vectors you're defending against, and several methods of protection. In bare terms of protection, clearly the highest form of protection is the biohazard suit. Why not go for that? Well the cost is too high both in terms of money and in social outcomes. They're also relatively delicate compared to simple clothing and would have to be replaced far more often. Filters would need to be replaced often as well.
Hopefully my unrealistic numbers above help show that there is no "right" answer, all answers have trade offs, and all answers are more appropriate situationally than others. That's the ultimate point.
Someone who travels via subway everyday might well benefit more from an N95 mask than gloves. The cost might even be provably effective. Cotton gloves might be very beneficial for that individual as well, but clearly wearing oil-based gloves would be more effective for their commute.
Someone who drives by themselves in their car, and works in an office building where no more than 5 to 10 people touch the door everyday, they might be fine without either a mask or gloves, unless they are going shopping. Washing hands and asking sick coworkers to cover their mouth when they cough seems completely satisfactory.
I personally don't use either gloves or masks, but I am prepared with cotton gloves if my region shows signs of infection, and will use them when shopping or touching potentially infected surfaces.
I prefer cotton gloves because they're easy and cheap to make, and they're reusable, and biodegradable. I don't see oil based gloves as being a sustainable solution for an entire nation. That's my own personal preference though and I don't like to push that mindset on others. There are more egregious forms of waste than tiny gloves.
N95 masks (and other types of HEPA filters) actually perform better on smaller particles.
A very common misconception is that HEPA filters only filter particles larger than 0.3 microns. In fact there's multiple different filtration mechanisms at play, with interception and impaction working better for larger particles, and diffusion being more effective for smaller particles. HEPA filters are rated for their effectiveness at 0.3 microns because that size is the size where the combination of mechanisms operate worst: smaller and larger particles are filtered even more effectively.
https://en.wikipedia.org/wiki/HEPA#Mechanism
Critical industries need to be domestic because otherwise the country is left vulnerable in a crisis.
Nobody wants to hold inventory because that represents "wasted money". So, when you need inventory, everybody is screwed.
This is just like the banking crisis of 2008. There is no point in being the Cassandra. If you're right, everybody is screwed. If your wrong, you personally lose.
Better to just bank your money and try to bail out as soon as possible.
On parts inventory, I'm probably quite a bit more in agreement. Holding inventory is risky, but spectacularly useful when there are disruptions.
Through laws?
USA has a strategic reserve of oil. https://en.wikipedia.org/wiki/Strategic_Petroleum_Reserve_(U...
I really don't see how masks, or other emergency equipment, changes things. Stockpiling stuff for emergencies seems to be the thing that governments should do.
The proposal is for USG to buy a bunch of masks and sell them halfway through their useful life. Absolutely no one, other than you, is interpreting this as a requirement that fresh masks cannot be sold under penalty of law.
That's a bizarre and tortured interpretation of what's being discussed here.
The government simply deciding to buy a lot of masks, then sell them as surplus half way through their shelf life, is just a matter of requisitioning funds.
I hope the government is doing stuff like that. I don't plan as if they do, but I hope they do. What's the good of being in a first-world country if the government can't even plan that far ahead?
So for them, the question is whether they go through masks fast enough that selling them halfway through their sell-by span is practical.
The answer is almost certainly yes, although larger hospitals should maintain their own stockpile. The obvious answer: have major hospitals be holding centers for the US strategic mask reserve.
For consumers, there's no reason not to sell a few masks fresh off the line. These goals aren't in conflict.
There is a time lag! The disease doesn’t care if you are Chinese or white. No hospital system can handle the numbers that came first to China, and will soon come here.
Wapo downplaying the virus. Just like they’ve downplayed the threat of globalism. And those who have tried to sound the alarm or argued that we should, gasp, renegotiate trade and bring back some manufacturing, those people are slandered as xenophobic or economics dunces. “Any serious person knows we can’t bring manufacturing back.” “Protectionism is stupid, trade wars hurt us,etc...” And now they want to tell the American public, “no death outside China.” Blood on their hands!
Why would you say that this is racism or irresponsible journalism? It seems like a simple statement of fact.