COVID-19

[Brett327]

FIFY.

Yes, I understand that you believe this... and thank you for reinforcing my point.

 

[DanMa1156]

Here’s at least one peer reviewed source from 2017: https://academic.oup.com/cid/article-pdf/65/11/1934/21677308/cix681.pdfView attachment 34404
View attachment 34406
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The first study I found that recommended N95 masks or respirators, and cautioned against cloth masks or any mask used more than once as counter productive has been recently revised. I originally found it on the CDC’s website last fall, and at that time it agreed with the first article. Alas I didn’t save it before it was changed.
View attachment 34405

So either employ a respirator or single-use medical grade masks. Cloth masks or any mask used more than once can be harmful, although excellent for virtue signaling, or as a Linus-style security blanket to make you feel safe… even if the CDC’s own studies after the 2015-2016 SARS scare don’t support the efficacy.

I'm on crappy internet and will be for some time and what you sent won't load; with that said, is that that paper from 2015 that studied healthcare workers in Vietnam and showed how cloth masks were harmful?

If that's the case, here's my rebuttal:

From the study: "The trial saw 1607 hospital healthcare workers across 14 hospitals in the Vietnamese capital, Hanoi, split into three groups: those wearing medical masks, those wearing cloth masks and a control group based on usual practice, which included mask wearing." So, there was no control group of anyone without masks. The commentary goes on to say: "We should be cautious about cloth mask use in healthcare settings, particularly high-risk situations such as emergency departments, intensive care, paediatric [sic] or respiratory wards."

So, let's be clear:

1. There was no group compared to "no mask use."
2. The recommendation was to use surgical masks in medical settings. Is that different from what the CDC has said?
3. No where does it say that those who used cloth masks had a higher rate of infection than those without cloth masks.

That study was completed in 2015. The authors of the study have since commented on it, in March of 2020:

https://bmjopen.bmj.com/content/5/4/e006577.responses#application-to-covid-19

Published on: 30 March 2020

COVID-19, shortages of masks and the use of cloth masks as a last resort

Chandini R MacIntyre, Academic physician The Kirby Institute, University of New South Wales

Other Contributors:

Chi Dung Tham, Academic physician

Holly Seale, Academic

Abrar Chughtai, Academic physician

Critical shortages of personal protective equipment (PPE) have resulted in the US Centers for Disease Control downgrading their recommendations for health workers treating COVID-19 patients from respirators to surgical masks and finally to home-made cloth masks. As authors of the only published randomised controlled clinical trial of cloth masks, we have been getting daily emails about this from health workers concerned about using cloth masks. The study found that cloth mask wearers had higher rates of infection than even the standard practice control group of health workers, and the filtration provided by cloth masks was poor compared to surgical masks. At the time of the study, there had been very little work done in this space, and so little thought into how to improve the protective value of the cloth masks. Until now, most guidelines on PPE did not even mention cloth masks, despite many health workers in Asia using them.

Health workers are asking us if they should wear no mask at all if cloth masks are the only option. Our research does not condone health workers working unprotected. We recommend that health workers should not work during the COVID-19 pandemic without respiratory protection as a matter of work health and safety. In addition, if health workers get infected, high rates of staff absenteeism from illness may also affect health system capacity to respond. Some health workers may still choose to work in inadequate PPE. In this case, the physical barrier provided by a cloth mask may afford some protection, but likely much less than a surgical mask or a respirator.

It is important to note that some subjects in the control arm wore surgical masks, which could explain why cloth masks performed poorly compared to the control group. We also did an analysis of all mask wearers, and the higher infection rate in cloth mask group persisted. The cloth masks may have been worse in our study because they were not washed well enough – they may become damp and contaminated. The cloth masks used in our study were products manufactured locally, and fabrics can vary in quality. This and other limitations were also discussed.

There are now numerous reports of health workers wearing home made cloth masks, or re-using disposable mask and respirators, and asking for guidance. If health workers choose to work in these circumstances, guidance should be given around the use.

There have been a number of laboratory studies looking at the effectiveness of different types of cloth materials, single versus multiple layers and about the role that filters can play. However, none have been tested in a clinical trial for efficacy. If health workers choose to work using cloth masks, we suggest that they have at least two and cycle them, so that each one can be washed and dried after daily use. Sanitizer spray or UV disinfection boxes can be used to clean them during breaks in a single day. These are pragmatic, rather than evidence-based suggestions, given the situation.

Finally for COVID-19, wearing a mask is not enough to protect healthcare workers – use of gloves and goggles are also required as a minimum, as SARS-CoV-2 may infect not only through the respiratory route, but also through contact with contaminated surfaces and self-contamination.

Governments and hospitals should plan and stockpile proper disposable products such as respirators and surgical masks to ensure the occupational health and safety of health workers. This appears to have been a failure in many countries, including high income countries.

From what I understand, here is what the CDC's stance based on a collection of studies on masks shows.

I don't understand how this late in the game, we're still having arguments. Just wash your damn mask if you're concerned it is liable to cause infections.

Multi-layer cloth masks can both block 50-70% of these fine droplets and particles3, 14 and limit the forward spread of those that are not captured.5, 6, 15, 16 Upwards of 80% blockage has been achieved in human experiments,4 with cloth masks in some studies performing on par with surgical masks as barriers for source control.3, 9, 14, 17 In one study, conducted prior to widespread circulation of the Delta variant, masks worked equally well for blocking aerosolized particles containing both “wild-type” virus and the Alpha variant (a more infectious variant).17

 

[Spekkio]

If that's the case, here's my rebuttal:

Why are you arguing with the CDC's citations? You some kind of epidemiologist or something? /s

Could it also be possible that the laundry list of research now cited on the CDC's website has similar flaws with methodology and conclusions? For example, take a look at the TR study and compare it to what the CDC uses it to conclude.

 

[robav8r]

Ha ha ?

 

[DanMa1156]

Why are you arguing with the CDC's citations? You some kind of epidemiologist or something? /s

Could it also be possible that the laundry list of research now cited on the CDC's website has similar flaws with methodology and conclusions? For example, take a look at the TR study and compare it to what the CDC uses it to conclude

The study I was arguing against as far as I'm aware wasn't on the CDC's website and like I said, my NMCI machine won't load what that commenter posted so I only assume it was the study in Vietnam I mentioned. I've seen it posted throughout the blogsphere of anti-mask/vax right wingers, but they always miss those critical points: 1) the control group wasn't the "unmasked," and 2) the authors themselves have said their conclusions may not be appropriate for COVID-19 given the PPE shortages and the fact they think the reason most of the infections were occuring were because the cloth masks were going unwashed.

Furthermore, send me the TR Study vs. the CDC study you're comparing and I'll see what I can read.

 

[JoeBob1788]

The study I was arguing against as far as I'm aware wasn't on the CDC's website and like I said, my NMCI machine won't load what that commenter posted so I only assume it was the study in Vietnam I mentioned. I've seen it posted throughout the blogsphere of anti-mask/vax right wingers, but they always miss those critical points: 1) the control group wasn't the "unmasked," and 2) the authors themselves have said their conclusions may not be appropriate for COVID-19 given the PPE shortages and the fact they think the reason most of the infections were occuring were because the cloth masks were going unwashed.

Furthermore, send me the TR Study vs. the CDC study you're comparing and I'll see what I can read.

It was a meta of all studies available at that point, 2017. The studies cited for cotton masks were from Singapore, China, Hong Kong, and the Vietnam one you mentioned. The researchers quantified baseline risk of infection, and found that N95 reduced risk by up to 80%; medical masks were less but also effective, and cloth masks provided no protection at all against SARS. This meta was conducted prior to the politicization that has muddied everything, and I found it interesting.

As a NBC PPE SME (wow acronyms), we’ve long been taught by OSHA, the CDC, and DOD med that N95 respirators are the minimum for viral scenarios. We typically use PAPRs.

I’m not a very political person, and I generally dislike both parties. The science and data that existed prior to the outbreak was ignored from the outset, but all that’s above my lowly pay grade. I did explain all of this to my mother, who proceeded to shop in an N95 until the first wave passed her area. My dad (30 year Tomcat RIO) has a history of often contracting double pneumonia, so she didn’t want to risk anything for a while. Her choice, but I’m glad she actually paid attention to data and employed something that actually does something.

 

[Spekkio]

The study I was arguing against as far as I'm aware wasn't on the CDC's website

False assumption.

Furthermore, send me the TR Study vs. the CDC study you're comparing and I'll see what I can read.

It's hyperlinked among all of the 'see all these studies that show masks work.' Here's the cliffnotes: The study wasn't even about mask efficacy, but since an informal survey conducted during the study said most people who contracted covid-19 on TR weren't around a masked individual, the CDC used that factoid to say "this study proves masks on the TR reduced COVID-19 infections by 70%."

 

[DanMa1156]

The page only partly loaded for me, but I'm not sure I get your point. Are you suggesting the only study the CDC has to "prove" mask efficacy was based on the informal survey done WRT to TR? From the abstract:

This report improves the understanding of COVID-19 in the U.S. military and among young adults in congregate settings and reinforces the importance of preventive measures to lower risk for infection in similar environments...

Service members who reported taking preventive measures had a lower infection rate than did those who did not report taking these measures (e.g., wearing a face covering, 55.8% versus 80.8%; avoiding common areas, 53.8% versus 67.5%; and observing social distancing, 54.7% versus 70.0%, respectively).

 

[Spekkio]

The page only partly loaded for me, but I'm not sure I get your point. Are you suggesting the only study the CDC has to "prove" mask efficacy was based on the informal survey done WRT to TR?

No. What I'm suggesting is that particular study lacks academic rigor because it lacks a control group, gathered its data using unreliable personal accounts, and did not analyze for covariance between various NPIs/HPMs. Which is fine because the study's objective and therefore design of experiment was not to scientifically prove the efficacy of masks or any other particular NPI.

But the CDC went ahead and interpreted the study that way on its website anyway, and made the science 101 mistake of 'correlation does not prove causation.' An organization that is as academically honest and scientifically rigorous as people make the CDC out to be would not be using the punchline "this study shows masks reduce the spread of COVID-19 by 70%" as if the TR did nothing but don a bunch of masks and COVID-19 cases plummeted. That's some reddit tier bullshit interpretation.

More importantly, no one should have to check the validity of studies cited by the CDC to support its policies. The TR study shouldn't ever have appeared on their website.

So either one of two things is true:

• The myriad of people who sign their names with 'PhD' working for the CDC know this, but they don't care because it's all a marketing campaign for the 86% of Americans who do not have a college degree in a science or engineering field.
• The CDC as an institution is too dumb to follow basic scientific research principles.

I'm going with the former.

 

[DanMa1156]

@Spekkio - fair points. I think though there was plenty of other evidence and citied studies that do not use TR's informal surveys to show that masks proved effective in reducing spread.

For all the people saying that Fauci/CDC/etc. once said that we don't need to wear masks, recall three things:
1. The virus' spread was unknown for some period of time.
2. When it became known that it was spread primarily airborne, they didn't want people rushing and buying out all the masks out so that medical professionals could have them (this is where Fauci came in with his statements IIRC).
3. When it became clear people could fashion their own cloth masks and they proved to have some level of effectiveness, then they started saying to wear them.

FWIW - if you're of the camp, and I gather you are, "cloth masks are pointless, only N95 will do," will you be wearing/encouraging others to wear the soon-to-be government issued N95 masks?

 

[Spekkio]

@Spekkio - fair points. I think though there was plenty of other evidence and citied studies that do not use TR's informal surveys to show that masks proved effective in reducing spread.

Not a completely true statement. Much like a pile of sticks won't make a fire by themselves, masks need to be paired with other NPIs to be effective. Specifically, 3-6' of distancing and minimal occupancy, which is why Navy policy doesn't take mask wear into account for close contact tracing. They also must be worn the entire time you are around others. No taking them off to eat at restaurants. No taking it down to sip a glass of water. Nothing.

You can easily see how, as a long-term public health policy, this gets untenable. You'd need to shut down any public venue that sells food, and you'd need to strictly enforce minimal occupancy. You'd also need some method of strict enforcement in other public places, as well as private residences. I don't know how you're going to stop people from kissing grandma on her birthday, but that's what it would take here. We don't strictly enforce these things, which is why there is little correlation between mask mandates and the spread of COVID-19 on a macro scale.

But we have vaccines, so none of that should even be necessary at this point.

Masks without these are not a case of 'something is better than nothing.' Once you are contaminated, you are contaminated. I would love a rad worker to start eating in the middle of a CSCA and remark to Naval Reactors "meh, I wore my anti-C's 95% of the time, so I'm good."

 

[DanMa1156]

@Spekkio I see your point, but ultimately agree with the statement that "something is better than nothing." It's a low cost solution with some benefit and limits exposure in places that enforce mask wearing. But to your point: yes, vaccines will be the long term solution and we at some point need to move on with our lives.

 

[Jim123]

FWIW - if you're of the camp, and I gather you are, "cloth masks are pointless, only N95 will do," will you be wearing/encouraging others to wear the soon-to-be government issued N95 masks?

People with health conditions that make them more vulnerable to covid should have been wearing tight-fitting N95 masks months and months ago- instead of relying almost solely so much on everyone else wearing spit catchers.

I agree that we all need to get on with our lives.

 

[taxi1]

masks need to be paired with other NPIs to be effective. Specifically, 3-6' of distancing and minimal occupancy, which is why Navy policy doesn't take mask wear into account for close contact tracing. They also must be worn the entire time you are around others. No taking them off to eat at restaurants. No taking it down to sip a glass of water. Nothing.

Agree 100% with the pair it with other stuff sentiment. The swiss cheese model.

Anything that helps reduce transmission helps, to include wearing the mask to and from the table and having servers wear them.

But we have vaccines, so none of that should even be necessary at this point.

Unfortunately the variants have dropped them from sure things to helping to reduce transmission and severity. And the vaccine uptake has been way below enough to kill the pandemic, so...swiss cheese model.

Once you are contaminated, you are contaminated.

Dosing matters. A lower dose exposure does result in general in less severe disease, controlling for other factors (age, obesity, etc.) Swiss cheese model.

KN95 masks are cheap and readily available right now, are more comfortable than cloth masks, and are proven effective against Omicron and the less contagious variants.

We just had a 40 year old unvaxxed worker die of Covid, left 4 special needs kids behind.

 

[Tycho_Brohe]

People with health conditions that make them more vulnerable to covid should have been wearing tight-fitting N95 masks months and months ago- instead of relying almost solely so much on everyone else wearing spit catchers.

I agree that we all need to get on with our lives.

Agreed, but after watching people panic-buying pallets of toilet paper in the beginning, imagine putting out that vulnerable people should buy N95 masks to protect themselves. Those masks would be harder to find than the PS5.