Keeping the coronavirus from infecting healthcare workers • Hacker News Board

Re: Keeping the coronavirus from infecting healthcare workers

#131

Post by pbourke » Sat, Mar 21, 2020, 7:12 PM UTC

m4rtink wrote: post #53

ZhuanXia wrote: post #7

The shameful lies about masks not working for civilians will kill thousands. Evidence based medicine (over the modern Bayesian Science-based medicine) has paralyzed our health officials from making common sense calls off priors. Homemade masks appear to be reasonably effective. The official response should be to make some form of improvised mask required when out of home, and ration regular mask for health care worke…

For reference, the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. This has been in force for a few days & is actively enforced wit a couple people already getting hefty fines. IMHO this is a really good idea, especially because people who are infected and dont know that yet are less likley to infect others. How good the mas is at protecting you…

> the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home.

That is an amazingly forward-thinking position that we should applaud. The mask thing will be one of those “obvious” things that we’ll look back on in a couple of years and shake our heads at.

Re: Keeping the coronavirus from infecting healthcare workers

#132

Post by fspeech » Sat, Mar 21, 2020, 7:27 PM UTC

taeric wrote: post #69

javagram wrote: post #65

Earlier quoted context omitted.

Considering the physical proximity of Japan and China (30% of tourists to Japan are Chinese) the fact that Japanese hospitals haven’t been overwhelmed like Italy suggests the virus is not spreading as rapidly there. (Testing may also be a concern but lack of testing cannot hide overwhelmed hospitals).

But why? I have pushed my air quality hypothesis. What other reasons are there. And you can't just claim social distancing. Unless they have shut down their trains, where people are literally packed in, that just doesn't fly. (So, have they?)

Don't they wear masks on trains?

Re: Keeping the coronavirus from infecting healthcare workers

#133

Post by dang » Sat, Mar 21, 2020, 7:28 PM UTC

ZhuanXia wrote: post #15

China has half the world’s manufacturing ability, a civil service selected strongly for cognitive ability, a much more diligent and capable people, and a large population. Not to mention experience in pandemics of this type. China will become zeroth world shortly. We will have to get used to them surpassing us.

Please let's not go into nationalistic flamewar.

We detached this subthread from https://news.ycombinator.com/item?id=22646393.

Re: Keeping the coronavirus from infecting healthcare workers

#134

Post by edelcombi » Sat, Mar 21, 2020, 7:33 PM UTC

msamwald wrote: post #24

ZhuanXia wrote: post #7

The shameful lies about masks not working for civilians will kill thousands. Evidence based medicine (over the modern Bayesian Science-based medicine) has paralyzed our health officials from making common sense calls off priors. Homemade masks appear to be reasonably effective. The official response should be to make some form of improvised mask required when out of home, and ration regular mask for health care worke…

I recently co-authored a scientific commentary on this, ask me anything! "Promoting simple do-it-yourself masks: an urgent intervention for COVID-19 mitigation" (Svara et al. 2020) Pre-print available at https://link.medium.com/LY7RRNr2X4 Summary: "We demonstrate that widespread use of masks by the general population could be an effective strategy for slowing down the spread of COVID-19. Since surgical masks might no…

I've been promoting this idea as well. https://www.facebook.com/edelsmurf/posts/10157054028823201

I've sent pleas to several local and national government agencies and health directors, but it's unlikely that such e-mails will be read, so information needs to be disseminated another way. The fact that the western world hasn't called for widespread use of even cloth masks is unconscionable. Presume you're already infected to protect others.

Re: Keeping the coronavirus from infecting healthcare workers

#135

Post by taeric » Sat, Mar 21, 2020, 7:35 PM UTC

fspeech wrote: post #132

taeric wrote: post #69

Earlier quoted context omitted.

But why? I have pushed my air quality hypothesis. What other reasons are there. And you can't just claim social distancing. Unless they have shut down their trains, where people are literally packed in, that just doesn't fly. (So, have they?)

Don't they wear masks on trains?

Have you seen the trains? No amount of mask would stop some spread there.

Re: Keeping the coronavirus from infecting healthcare workers

#136

Post by m4rtink » Sat, Mar 21, 2020, 7:36 PM UTC

pbourke wrote: post #131

m4rtink wrote: post #53

Earlier quoted context omitted.

For reference, the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. This has been in force for a few days & is actively enforced wit a couple people already getting hefty fines. IMHO this is a really good idea, especially because people who are infected and dont know that yet are less likley to infect others. How good the mas is at protecting you…

> the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. That is an amazingly forward-thinking position that we should applaud. The mask thing will be one of those “obvious” things that we’ll look back on in a couple of years and shake our heads at.

Unfortunatelly, this (mandatory masks) seems like one of the Czech Republic rules that has not yet been widely copied elsewhere.

BTW, its quite an interesting cognitive change - basically in a span of about two days everyone in public has a mask, even anchors and politicians in news coverage! Even the sign language interpetters!

Also I found out I feel rather uneasy now watching footage from affected areas, some of them in worse situation than us, with people not wearing any masks.

Such a simple way to protect otjers once you thing about it a bit, yet not universally adopted so far...

Re: Keeping the coronavirus from infecting healthcare workers

#137

Post by edelcombi » Sat, Mar 21, 2020, 7:38 PM UTC

mcsb4 wrote: post #29

msamwald wrote: post #24

Earlier quoted context omitted.

I recently co-authored a scientific commentary on this, ask me anything! "Promoting simple do-it-yourself masks: an urgent intervention for COVID-19 mitigation" (Svara et al. 2020) Pre-print available at https://link.medium.com/LY7RRNr2X4 Summary: "We demonstrate that widespread use of masks by the general population could be an effective strategy for slowing down the spread of COVID-19. Since surgical masks might no…

The biggest challenge is to overcome the mental block of decades of onetime use masks that have to be disposed in incinerators and be produced by ISO 9001 certified medical factories. During world war 2 it was normal to use reusable cotton masks. They just need to be put into boiling water for a few minutes to kill sars-cov-2 at 100%. You should try to get into touch with C. Drosten from Charité hospital Berlin. He r…

If the intended goal of wearing a mask is to protect others (since you have no way of knowing that you're not infected), then there's no practical reason that a mask can't be reused, whether sanitized or not.

Re: Keeping the coronavirus from infecting healthcare workers

#138

Post by kevingadd » Sat, Mar 21, 2020, 7:47 PM UTC

pavelrub wrote: post #91

alkonaut wrote: post #77

Earlier quoted context omitted.

The argument is usually that it has limited effect when it comes to protecting the wearer . Simpler masks or home made masks can probably prevent transmission somewhat from the wearer by reducing the reach of droplets. The argument against masks is based on 1) that people want them to protect themselves 2) that there aren’t nearly enough masks to do so. So as I understand it, the authorities that say “don’t wear a ma…

I haven't seen any evidence supporting the argument that they do not protect the wearer. The argument seems to be that they aren't 100% effective at that, and therefore shouldn't be used for those purposes, which doesn't make any sense. Even 20% reduction in the amount of incoming droplets is significant - both for protecting the wearer, and for reducing R0.

Part of the reasoning is that people who believe masks provide them full protection will take more risks than otherwise. Combine that with hoarding and other behaviors and it's possible that promoting widespread use of masks would cause new problems the west doesn't already have.

If we had successfully promoted "wear a mask when you're sick" as general US policy in advance we probably wouldn't have these supply chain issues and it would be safe to advise people just wear a mask at all times during the crisis. We didn't, so most people don't have any masks, which means they're going to look at this crisis + advisory and panic buy a big pile of them when supplies are already limited.

Re: Keeping the coronavirus from infecting healthcare workers

#139

Post by graeme » Sat, Mar 21, 2020, 7:56 PM UTC

m4rtink wrote: post #53

ZhuanXia wrote: post #7

The shameful lies about masks not working for civilians will kill thousands. Evidence based medicine (over the modern Bayesian Science-based medicine) has paralyzed our health officials from making common sense calls off priors. Homemade masks appear to be reasonably effective. The official response should be to make some form of improvised mask required when out of home, and ration regular mask for health care worke…

For reference, the government of Czech Republic made masks (of any type, including self made or even scarfes) mandatory while out of home. This has been in force for a few days & is actively enforced wit a couple people already getting hefty fines. IMHO this is a really good idea, especially because people who are infected and dont know that yet are less likley to infect others. How good the mas is at protecting you…

The Czech government was advised by Taiwan, I recall. Could this be the basis?

The Taiwanese response has been exemplary.

Re: Keeping the coronavirus from infecting healthcare workers

#140

Post by craftinator » Sat, Mar 21, 2020, 8:08 PM UTC

ghostpepper wrote: post #32

JackeJR wrote: post #25

Earlier quoted context omitted.

I don't think the parent's point was that we ignore evidence but that in the absence of evidence (as opposed to evidence suggesting the contrary), we should use priors to guide what we do. In this case, while there are no double blind randomised studies that suggest that widespread mask use reduces R0, priors tell us that masks use protect against infection in other settings. If we were to weigh the priors, the exist…

How can you rule out the possibility that mask use has a net negative effect so easily?

Simple reasoning. We know that viruses can be transmitted through saliva. Covid-19 generally presents with a cough. Coughs aerosolize saliva. Wearing a mask or face covering catches most particles, and absorbs energy from all particles, so they dont travel as far. Less virus mass, and a smaller projection plume will result in less spread. Less spread results in a lower R0.

I realize that you are just enjoying being contrary here, but please try to think through your argument and ensure it isn't incorrect in itself before posting.