https://www.theatlantic.com/health/archi...ks/609235/
EXCERPT: . . . Should I wear a mask? For health-care workers, the answer is obviously yes. But which masks? [...] For everyone else, the debate is even trickier. For months, the WHO, the CDC, and most public-health professionals have advised that people don’t need to wear face masks unless they have COVID-19 or are caring for someone who does. At the same time, these experts have noted that health-care workers are in dire need of masks, which are running out because of strained supply chains and surging patient numbers.
[...] If masks are limited, conserving them for the people who need them most makes sense. But that message was lost amid the confusing claim that masks somehow protect health-care workers but are useless for everyone else. In recent weeks, that simmering tension has come to a boil. Opinion pieces, news stories, and scientific papers have urged Western countries to use masks widely, emulating the example set by East Asian countries. Masks are mandatory for anyone entering a supermarket in Austria, and anyone leaving their house in the Czech Republic and Slovakia. In the U.S., the CDC is reportedly contemplating a change in guidance, and many public-health experts have already pivoted.
[...] If the virus is traveling through the air, then it seems intuitive that masks would block it. But the evidence for this is all over the place ... Several past studies have found that face masks could reduce the risk of flu-like infections, slow flu transmission in households, and even reduce the spread of SARS, especially when combined with hand-washing and gloves. Other studies have been more equivocal, finding that masks provide no benefit, small benefits, or benefits only in conjunction with measures like hand-washing. “Airflow follows the path of least resistance, and if it won’t enter through the mesh, it can come in from the side,” Bourouiba said. “There’s no evidence whatsoever to suggest that [surgical masks] are protective against the smallest droplets.”
There’s still a good case for masks, though, even if they can’t stop viruses from getting in: They can stop viruses from getting out. [...] This might be especially important for SARS-CoV-2, which can spread without immediately causing symptoms. If people are infectious before they fall sick, then everyone should wear face masks “when going out in public, in one additional societal effort to slow the spread of the virus down,” says Thomas Inglesby of the John Hopkins Center for Health Security.
Some commentators have argued that countries that have thus far succeeded in curbing their COVID-19 outbreaks have widely used masks. But this relationship isn’t as perfect as it might appear. China advocated mask use early on and still struggled to contain the disease. Japan uses masks widely but is now seeing an uptick in cases. Singapore reserved them for health-care workers but still flattened the curve of infections. Many successful mask-using countries relied on other measures, such as extensive testing and social distancing, and many were ready for the pandemic because of their prior run-in with the 2003 SARS epidemic.
In Asia, masks aren’t just shields. They’re also symbols. They’re an affirmation of civic-mindedness and conscientiousness, and such symbols might be important in other parts of the world too. If widely used, masks could signal that society is taking the pandemic threat seriously. [...] Or masks could have the opposite effect...
[...] The debate is somewhat moot right now, because there simply aren’t enough masks for medical professionals, let alone everyone else. ... This might well be why public-health officials have been so loath to recommend mask-wearing more broadly: Hoarders have already begun to exhaust the dwindling supplies...
In the meantime, citizens (and, unfortunately, many health-care workers) will have to make do with MacGyvering their own alternatives. A few studies suggest that homemade cloth masks are less effective than proper medical ones, but are still better than nothing.
[...] The mask debate is so intense because both the stakes and the uncertainty levels are so high. “We’re trying to build the plane while we’re flying it,” Hanage said. “We’re having to make decisions with quite massive consequences in the absence of secure data. It’s a nightmare for your average cautious public-health professional.”
The coronavirus pandemic has moved so quickly that years of social change and academic debate have been compressed into a matter of months. Academic squabbles are informing national policy. Long-standing guidelines are shifting. Within days, an experiment that’s done in a hospital room can affect how people feel about the very air around them, and what they choose to wear on their faces... (MORE - details)
EXCERPT: . . . Should I wear a mask? For health-care workers, the answer is obviously yes. But which masks? [...] For everyone else, the debate is even trickier. For months, the WHO, the CDC, and most public-health professionals have advised that people don’t need to wear face masks unless they have COVID-19 or are caring for someone who does. At the same time, these experts have noted that health-care workers are in dire need of masks, which are running out because of strained supply chains and surging patient numbers.
[...] If masks are limited, conserving them for the people who need them most makes sense. But that message was lost amid the confusing claim that masks somehow protect health-care workers but are useless for everyone else. In recent weeks, that simmering tension has come to a boil. Opinion pieces, news stories, and scientific papers have urged Western countries to use masks widely, emulating the example set by East Asian countries. Masks are mandatory for anyone entering a supermarket in Austria, and anyone leaving their house in the Czech Republic and Slovakia. In the U.S., the CDC is reportedly contemplating a change in guidance, and many public-health experts have already pivoted.
[...] If the virus is traveling through the air, then it seems intuitive that masks would block it. But the evidence for this is all over the place ... Several past studies have found that face masks could reduce the risk of flu-like infections, slow flu transmission in households, and even reduce the spread of SARS, especially when combined with hand-washing and gloves. Other studies have been more equivocal, finding that masks provide no benefit, small benefits, or benefits only in conjunction with measures like hand-washing. “Airflow follows the path of least resistance, and if it won’t enter through the mesh, it can come in from the side,” Bourouiba said. “There’s no evidence whatsoever to suggest that [surgical masks] are protective against the smallest droplets.”
There’s still a good case for masks, though, even if they can’t stop viruses from getting in: They can stop viruses from getting out. [...] This might be especially important for SARS-CoV-2, which can spread without immediately causing symptoms. If people are infectious before they fall sick, then everyone should wear face masks “when going out in public, in one additional societal effort to slow the spread of the virus down,” says Thomas Inglesby of the John Hopkins Center for Health Security.
Some commentators have argued that countries that have thus far succeeded in curbing their COVID-19 outbreaks have widely used masks. But this relationship isn’t as perfect as it might appear. China advocated mask use early on and still struggled to contain the disease. Japan uses masks widely but is now seeing an uptick in cases. Singapore reserved them for health-care workers but still flattened the curve of infections. Many successful mask-using countries relied on other measures, such as extensive testing and social distancing, and many were ready for the pandemic because of their prior run-in with the 2003 SARS epidemic.
In Asia, masks aren’t just shields. They’re also symbols. They’re an affirmation of civic-mindedness and conscientiousness, and such symbols might be important in other parts of the world too. If widely used, masks could signal that society is taking the pandemic threat seriously. [...] Or masks could have the opposite effect...
[...] The debate is somewhat moot right now, because there simply aren’t enough masks for medical professionals, let alone everyone else. ... This might well be why public-health officials have been so loath to recommend mask-wearing more broadly: Hoarders have already begun to exhaust the dwindling supplies...
In the meantime, citizens (and, unfortunately, many health-care workers) will have to make do with MacGyvering their own alternatives. A few studies suggest that homemade cloth masks are less effective than proper medical ones, but are still better than nothing.
[...] The mask debate is so intense because both the stakes and the uncertainty levels are so high. “We’re trying to build the plane while we’re flying it,” Hanage said. “We’re having to make decisions with quite massive consequences in the absence of secure data. It’s a nightmare for your average cautious public-health professional.”
The coronavirus pandemic has moved so quickly that years of social change and academic debate have been compressed into a matter of months. Academic squabbles are informing national policy. Long-standing guidelines are shifting. Within days, an experiment that’s done in a hospital room can affect how people feel about the very air around them, and what they choose to wear on their faces... (MORE - details)