Keeping the coronavirus from infecting healthcare workers • Hacker News Board

Re: Keeping the coronavirus from infecting healthcare workers

#21

Post by kingaillas » Sat, Mar 21, 2020, 2:20 PM UTC

zaroth wrote: post #3

There is a lot of conflicting data. China went full hazmat with the influx of new healthcare workers they sent into Hubei, but Singapore and Honk Kong took significantly more measured approaches which ultimately have also been successful in limiting exposure. The US policy of 14 day quarantine for healthcare workers who had even limited exposure to a COVID patient was never sustainable and threatened to shut entire E…

> but Singapore and Honk Kong took significantly more measured approaches which ultimately have also been successful in limiting exposure.

I think Singapore and Hong Kong (and South Korea) were able to aggressively test (e.g. temperature readings at airports), contact trace (e.g. grab location data off phones), force mobile apps for tracking and checking in, etc. All of that gave them the option of a measured approach.

China had to go full in because they realized they had a uncontrolled pandemic brewing for a month before they took any significant action.

Re: Keeping the coronavirus from infecting healthcare workers

#22

Post by [deleted] » Sat, Mar 21, 2020, 2:21 PM UTC

GordonS wrote: post #12

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 think if you're going to make a post like this, it's reasonable to expect that you present some actual evidence, or is your whole argument that we should ignore evidence? "Homemade masks appear to be reasonably effective" is hardly a compelling case.

[deleted]

Re: Keeping the coronavirus from infecting healthcare workers

#23

Post by makomk » Sat, Mar 21, 2020, 2:21 PM UTC

jtdev wrote: post #8

bamboozled wrote: post #2

“Health-care facilities don’t remotely have the supplies that would allow staff members to see every patient with all that gear on.“ As the article states, China had that ability. If that statement is true, It’s amazing to me that this is something China can do and not the U.S.A. The country that put man on the moon not even a century ago! Incredible. I feel like there are a lot of acquisitions lately that go on abou…

U.S. leaders of industry along with our political establishment have undermined American security by outsourcing the production of critical resources to an authoritarian, communist nation (China). It’s high time we wake up and hold these people accountable.

This. Something ridiculous like 95% of surgical masks and 75% of N95 masks are normally imported from China, because theirs were slightly cheaper. Almost all of them have been diverted to domestic use. Now the US, with almost no manufacturing capabilities, has doctors and nurses who are forced to use dubious improvised masks whilst China increases its international influence by selling a small fraction of its output at inflated prices to desperate countries in Europe. I've seen a load of dumb takes on social media blaming this on a lack of "leadership and competent diplomacy", but having a leader who grasps the diplomatic advantage of doing this is no good if your country can't make the damn masks in the first place.

Re: Keeping the coronavirus from infecting healthcare workers

#24

Post by msamwald » Sat, Mar 21, 2020, 2:21 PM UTC

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 not become available in sufficient numbers quickly enough for general use and sufficient compliance with wearing surgical masks might not be possible everywhere, we argue that simple do-it-yourself designs or commercially available cloth masks could reduce the spread of infection at minimal costs to society."

Re: Keeping the coronavirus from infecting healthcare workers

#25

Post by JackeJR » Sat, Mar 21, 2020, 2:23 PM UTC

GordonS wrote: post #12

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 think if you're going to make a post like this, it's reasonable to expect that you present some actual evidence, or is your whole argument that we should ignore evidence? "Homemade masks appear to be reasonably effective" is hardly a compelling case.

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 existing evidence would be leaving towards mask use having a protective effect. The question that we should ask ourselves is, what if the reality turns out to be different? There are 2 scenarios. First, mask use is harmful and the second, mask use has no effect on transmission. The first is very unlikely given what we know and the second will mean that if mask use is encouraged, it will be wasted resources for no gain. If these resources that were wasted were easily obtainable i.e. masks made of old clothing etc, then the downsides aren't serious at all but could have very good upsides if the priors were right.

So I agree, that we should encourage widespread home-made masks use and leave the disposable ones to the healthcare workers.

Re: Keeping the coronavirus from infecting healthcare workers

#26

Post by codazoda » Sat, Mar 21, 2020, 2:27 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…

Here's a mask pattern and some additional information from Forbes. It also links to the CDC's comment.

https://www.forbes.com/sites/tjmccue/2020/03/20/calling-all-...

> In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/f...

This is because the medical industry needs proven methods, and they still suggest homemade masks as a last resort. Maybe we should all be wearing homemade masks in public.

Re: Keeping the coronavirus from infecting healthcare workers

#27

Post by quartzite » Sat, Mar 21, 2020, 2:28 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.

How can China become zeroth world shortly when half of the country is still living in third world conditions? I suppose if you only consider how the wealthiest in Shanghai and other Tier 1 cities live their lives then yes China is approaching parity with the West but that ignores that America's per capita income is almost 5 times higher than China's.

China also has the nasty problem of many of its best and brightest wanting to come to America and the West where they will have political freedom and more broadly freedom of expression, something that cannot be bought in China no matter how wealthy one becomes.

Re: Keeping the coronavirus from infecting healthcare workers

#28

Post by phreeza » Sat, Mar 21, 2020, 2:30 PM UTC

jtdev wrote: post #4

Can we all agree that outsourcing the production of critical medical supplies to China over recent decades was a bad idea? I understand the “golden arches” theory, and the intent if globalism, but I feel that COVID19 has revealed what a short sighted, deeply flawed view the globalists have.

I would argue the opposite is the case. The disease affects basically all countries, so what matters is the global supply of these goods. So we are better off if countries can specialize on their respective competitive advantages. In the scenario you propose, every country would have their own very inefficient mask industry which would now be just as or even more overwhelmed.

Re: Keeping the coronavirus from infecting healthcare workers

#29

Post by mcsb4 » Sat, Mar 21, 2020, 2:31 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…

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 recently stated in an interview that self-made masks could have a certain value, so he is not totally averse to this concept and Spahn [1] will listen to him.

China has been promoting it, now czech republic is doing it. If Germany also starts promoting it, that will help immensely.

The same goes for the hand sanitizer, any +70% alcohol/ethanol will do. No need to be from a factory with medical certifications.

I am in France, there is a total lock down here but police still wears no masks and so does nobody else. Super markets have no hand sanitizer at the entrance so the virus will continue to spread.

Masks cost nothing compared to the economic damage of the shut down.

[1] German minister of health

Edit: For those downvoting me, I'd sincerely be interested to hear your arguments.

Re: Keeping the coronavirus from infecting healthcare workers

#30

Post by leethargo » Sat, Mar 21, 2020, 2:31 PM UTC

IAmGraydon wrote: post #17

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…

You can’t reduce the basic reproduction number (R0) of a pathogen. You can reduce doubling time and similar metrics of the actual spread, but R0 is a fixed number. What you are referring to is the effective reproduction number, which is the rate of spread in a population at it’s current state. https://en.wikipedia.org/wiki/Basic_reproduction_number

From what I've read recently, I agree with this distinction. It's simply a matter of definition. R_0 is the infection rate without any measures taken. Sometimes, R is used for the net infection (e.g. with social distancing).