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 workers.
Even a scarf made of a t-shirt over the nose and mouth will likely reduce RO when used at scale on the population. The best way to protect healthcare workers is to reduce the R0 below 1. Nothing else will help. Widespread use of homemade masks, though not tested in a double blind trial, is low risk enough and seemingly effective enough to encourage.
Countries enforcing widespread mask use have lower ROs.
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."
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.
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.
According to an article on Quora, "At What Temperature Do Viruses Die?" ¹, for what it's worth:
> All [known] strains of virus can be inactivated at 70 °C.
For reference, an autoclave used for sterilization is around 121 °C.
> A minimum temperature range to inactivate most virus is 48°C to 60°C. Some virus still able to survive at temperature below 60°C e.g. adenoviruses(dsDNA naked virus) relatively thermostable, it able to withstand temperature at 56°C for 10min.
Viruses exist where there is life, it's not a mound I'm willing to die on, but it's accurate here on Earth. There is life that lives in temperatures higher than 70 °C, therefore there are viruses that can survive in temperatures higher than 70 °C: http://www.rcn.montana.edu/Publications/Pdf/2005/4_18Young.p...
There can be some or many kinds of viruses that survive under all sorts of conditions, by that doesn't necessarily imply that a particular virus does so as well.
I imagine viruses from underwater volcanic plumes would be pretty heat tolerant. But I don't know if they are a danger to humans or if we are too cold to host them.
Respectfully, I wish people would stop popping into discussions about coronavirus to say "Actually, ...".
Most educated people know that viruses aren't alive in the traditional sense. People who aren't as educated simply don't care, and I don't blame them. Using the more scientifically precise term helps nobody, except scientists, in this situation.
Should software engineers stop using the word "kill" in POSIX-land because CPU processes aren't really "alive"? Give me a break.
I didn't bat an eye at this until you dropped in with a "Respectfully..." that sounded awfully insincere. Did your sentence really intend to convey respect? Because it came off as disingenuous.
> Respectfully, I wish people would stop popping into discussions about coronavirus to say "Actually, ...".
I answered his question while also correcting a minor mistake. Also I'm not sure what you're quoting there.
> Most educated people know that viruses aren't alive in the traditional sense. People who aren't as educated simply don't care, and I don't blame them.
Are you trying to insult your grandparent? Most people on HN aren't willfully ignorant and are quite open to new knowledge.
It’s controversial. Some would characterize viruses as alive (because they replicate and evolve). So it’s fair to say that you can kill them (prevent from replicating). Debating the semantics of this is not helpful.
> 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.
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.
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.
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 is pretty much secondary concern at this point in time.
> 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...
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 mask” isn’t answering the question “would transmission be reduced if everyone wore a mask?”, but rather the question “Should I get a mask to protect myself”. Those are two very different questions.
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.
I agree that public health authorities have not lied, but that's not the point. "Would transmission be reduced if everyone wore a mask?" is exactly the kind of question public health authorities should be asking! The answer seems to be "yes" even for homemade masks. So, public health authorities should be promoting massive production, testing, and use of masks.
I use a home-made mask. It's made from two layers of fabric from a "fitness t-shirt" with a layer of filter paper from an air filter in between. I wash it in the washing machine and replace the filter between each use.
It completely covers my nose and mouth and chin and wraps around over my ears. I tie it in the back with 4 ties one on the top edge and one on the bottom edge.
I have friends tell me "that's dangerous! It may trap particles behind it and make you sicker!"
I'm willing to take my chances. I believe
- combined with my eyeglasses, it will keep me from touching my face and eyes when I'm out
- if someone a few feet away coughs, the large droplet that the virus is riding on will surely get trapped. The pores don't need to be virus-sized to do that.
I have a proper "Gas Mask" but I want to save that for a gas attack. That's why we all have one.
I've also seen people mis-wearing N-95 masks. I was behind a couple in the supermarket yesterday who were wearing them and every few minutes they were reaching up to readjust their noseclips. I got this on video, it was so perversely amusing to me. I hope they don't get sick.
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.
Wearing masks is common in several asian countries even before c19 was a thing and I'm not aware of anyone showing that it's causing harm at the population level. I consider that reasonable evidence that wearing them has no significant negative physiological effects.
I could see negative behavioral effects such as making people more careless because they're feeling safer. But again, effective containment in above-mentioned countries would also serve as evidence against that actually being an issue.
The hypothesis that face masks have a net negative effect is a very strong claim, before considering it we'd need some evidence that points in that direction.
I guess if you believe that's actually true, you should be advocating for doctors to stop wearing masks...
But that's not something we do, because we have enough priors that masks help that we will continue to use them.
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.
Another study on homemade masks: https://www.researchgate.net/publication/258525804_Testing_t...
"Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask. Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection."
This is by no means a personal attack but this is approximately the thought pattern the parent comment is arguing against.
Absence of evidence does not prevent you from making decisions or otherwise coming to conclusions. The fact is, you can make decisions with no evidence at all. Your outcome may be no better than chance but also likely no worse.
Not making a decision can be worse than chance, especially in time critical or low information environments and if you always “wait for the evidence” you will end up being worse than a magic 8-ball at the most crucial moments.
There is no "not making a decision". It's not that you can make decisions without evidence, you must make a decision even without evidence. Not wearing a mask is as much as a decision as wearing one.
Professional and Home-Made Face Masks Reduce
Exposure to Respiratory Infections among the General
Population. Marianne van der Sande. 2008. doi:10.1371/journal.pone.0002618
I run freesewing.org, the website linked to in the Forbes article (1).
The university hospital here in Antwerp where I live is actively reaching out to the community asking them to make masks. (2)
I'm not a scientist, but here's something that I can do, so I'm trying to help. I trust the doctors, that's good enough for me.
That is a misleading statement. The CDC has in fact changed its recommendations to recommend in a crises, even HCPs use home-made masks [0]
Health care providers, scientists and health officials are rapidly changing and adapting to the situation. It probably is a good idea for all people to wear homemade / improvised masks to reduce R0
But I'd still hope that civilians with large stores of N95 masks or other PPE would consider donating them to healthcare workers. The optimal scenario seems to be that non-HCPs stay home as much as possible, wash hands, sanitize and wear improvised masks when leaving home, and donate PPE to healthcare workers
How widespread is widespread? Japan, South Korea, China, Hong Kong, Taiwan… these are countries in which people wear masks in large numbers on a normal day.
Those countries also have higher population densities and public transport usage than some of the western countries. How can you say the mask isn’t helping?
I didn't but I also didn't make the claim that they would help so I suggest we start by getting claimants to back up their claims before we get anyone checking claims to prove negatives.
We need universal mask wearing AND unlimited testing. South Korea showed it works. In Japan, even without widespread testing the spreading is still slower than the west. It's true Singapore does not mandate mask use, but they have thorough contact tracing and draconian quarantine laws.
Well, I live in Japan and went out properly today for the first time in days, and I can tell you that the R0 is above 1 by eye simply by the way people are behaving.
Social distancing isn't happening much at all, and unless the population is magically becoming immune then there's no way R0 is less than 1. The real questions are whether that will translate into symptomatic and serious cases, and when.
But there isn't a big spike in pneumonia/ER/ICU numbers either. So it's supposedly not a case of high undetected number of infected running around, laying in hospitals, and it doesn't seem like the government is trying to downplay it either, even if their testing protocol is not extensive enough. (Though they are of course incentivized due to the Summer Olympics.)
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?)
There are a number of thoughts I have, but I'm puzzled as well. My first explanation is that the Japanese are simply more hyegeinic than most other countries I've been to. Fastidious is the word that comes to mind. They wash hands often, wear clean clothes, wear masks or stay home when sick, don't shake hands or touch often.
Second explanation that comes to mind is that they tend to be just healthier than other countries. They have low obesity, exercise correctly and routinely, walk and ride bikes to get where they go, and do all of this even when elderly. The counterpoint to this is that they have a really high smoking population.
The first one could explain why it isn't spreading there. Without testing, hard to know if that is accurate. Reports from other threads supports that it is there, but not severe cases. (Sadly, anecdotes...)
Second is also tougher to square. The risk pool is supposedly older people, per reports from Italy. But, that doesn't seem to square with age profiles of Japanese. So??
One difference could be that old people in Japan are all too often living a solitary existence or not in frequent touch with their family. My wife brought this up last night as I was discussing this thread with her and out of everything I've seen, read, and considered, this seems to be the one thing that could stop it - they were already socially distancing the most vulnerable group.
The virus has been in Italy for a lot longer than they think, and they get close to each other/have actual contact a lot (I don't know if that's actually true, I've never been to Italy)
Maybe they mostly have a particular mutation that is more deadly/infectious
Don't discount the possibility that figures are being massaged in various ways. One is the obvious lack of widespread testing. Another is the reports of people with symptoms being turned away. Then there are the kodokushi[0] numbers which are a clue to how the government already deals with uncomfortable mortality figures - let alone those kudokushi who may die because of the virus - and a over a million deaths a year (I don't know the monthly totals) in which to hide a few hundred (initially) deaths, especially while still in flu season.
In short, I trust the figures here about one step more than ones coming out of China.
I can't square that it has been in Italy substantially longer than Japan. Nor that Italians touch each other more than Japanese. Have you ever seen the videos of commuter trains in Japan?
So, possible, but seems not as likely to be the explanation.
It would need testing to show they don't have a prevalence of "mild" cases. Not to mention we should have numbers on how often they wear masks. Last I saw, it was not everyone that did that.
People don't wear N95 masks here, they wear cheap masks you can pick up in any drug store for just a few coins.
How would an entire country obtain N95 masks and training and proper fitting (it's done by trained fitters) and dispose of them properly, and do that daily? (if not more often)
Every time I go out I see the cheapo ones left in the street because there's a vague notion they should be disposed of "properly" so I don't see this idea working at all.
Public mask wearing prevents the wearer from emitting droplets. You don't need n95 for that. Also please read the article in discussion, this virus is not that easy to transmit, even for hospital workers.
How does an R0 greater than 1 in every country and population the virus is present in square with "this virus is not that easy to transmit"?
I can't do it.
> read the article
Okay, maybe they can square it:
> Luckily, methods were found that protected all the new health-care workers: none—zero—were infected.
> But those methods were Draconian. As the city was locked down and cut off from outside visitors, health-care workers seeing at-risk patients were housed away from their families. They wore full-body protective gear, including goggles, complete head coverings, N95 particle-filtering masks, and hazmat-style suits.
They failed, it was probably the use of "Draconian" that let them down.
I also read the paper you provided, not just the abstract, and it spends a lot of its time talking about N95 masks. Here is from a part it spends on facemasks:
> whereas for the facemasks the efficiency can vary from 10% to 90% (Guha et al., 2017)
Have you read Guha's paper? I've got it here. I have so many problems with someone relying on that paper beyond its narrow applicable scope. I wonder if they've ever worn a mask. I digress.
Additionally (we're back to the paper you shared), you should count how many times "except the low-filtration adult surgical mask" or some combination of those words following except comes up in that paper.
It's also a model and not a study. Let me know when there's a study that shows masks work (the Guha paper mentioned is a study, in a lab, not using people or even a model of a face), in use by the general public, in the kind of settings they wear them, and it's the kind of masks they usually wear.
I believe wide-spread use of masks is an effective measure, but i disagree that evidence-based medicine vice Bayesian belief-updating is to blame here. If masks work well, the statistical evidence will come out, regardless of the statistical tribe you belong to.
It came directly from the Surgeon General himself. That’s the part that shocks me. It’s basically someone saying don’t use condoms because it’s not 100%.
I do find it ridiculous that we have ignored practical and common sense measures to protect the most at risk, and instead have decided fo trash our entire way of life and the economy along with it. In the future this will be looked back upon as one of the great blunders in history.
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.
Change in behavior can change basic reproduction number. That is what happened with SARS. Making basic reproduction number smaller is whole point of those curfew laws and of closing shops we now have. It is also the point of washing hands often and keeping distance.
It is defined as "expected number of cases directly generated by one case in a population where all individuals are susceptible to infection". And that is possible to influence by behavior. If no one even meets anybody, no sick person can generate next case. If people live in over-crowded houses, one person will infect many more.
"R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population."
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).
Maybe you should read a bit further than the first paragraph for your future citations?
"R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population."
“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 about how “draconian” China’s behaviour is etc, but they protected their medical staff by making sure they were adequately equipped. It read a bit like jealousy.
> 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!
My wife is an R.N. and is the clinical care coordinator on a cardiac critical care unit in northern NJ that has been converted to a negative pressure covid-19 unit. They currently have two positives and several suspected under treatment. They do not have enough PPE gear to see every suspected patient using full protection, i.e. gown, goggles, N95 mask, gloves, etc. This is a fact that bothered me much more than her. It's possible to prevent transmission to health care workers without full PPE on every case. See for reference this article currently linked on HN front page: https://www.newyorker.com/news/news-desk/keeping-the-coronav.... Naturally I still wish she was wrapped head to toe in antiviral something every time she goes near the place, but my fears are those of a layperson and I have to trust her professional judgement.
It seems though that the US couldn’t actually go back to the moon or maybe even put people into space without the Soyuz, so now so it’s lost those capabilities amongst others, that is my point.
Even in a crisis, all that economic wealth and military dominance that the US claims to have can’t put masks and gowns on people that need them, so is there really much steam left in the tank ? I hope there is and I’m sure there is, it just needs to find the right channels. God Bless America!
no country has the ability to go to the moon tomorrow. if there were a pressing reason to do so, the US and probably china or russia could do it eventually, but it takes time to organize that sort of effort. it's probably true that the time between deciding to go to the moon and actually doing it would probably be longer today, but a large part of that might be increased expectations for the crew's safety.
it's a similar story with the PPE. the US has moved a lot of manufacturing capacity overseas because it's economically efficient. the US is certainly wealthy enough to manufacture as much of this stuff as needed, but it isn't a switch that can be flipped overnight and the unit cost would be much higher due to regulatory burdens like worker protection.
The ICU videos out of Wuhan have the doctors wearing triple PPE.
China has a lot of experience with SARs and other respiratory viruses. They are basically ground zero right.. so I would expect people to listen to China when they say you need masks.
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.
3M's general offices, corporate research laboratories, and some division laboratories in the US are in St. Paul, Minnesota. In the United States, 3M operates 80 manufacturing facilities in 29 states, and 125 manufacturing and converting facilities in 37 countries outside the US (in 2017).[66]
I don’t believe 3M would buy white-label products, they employ several hundred research scientists and have invented countless original products / innovations.
Quote from a Minneapolis/St. Paul Business Journal article related to the mask manufacturing ramp up at 3M for COVID19:
“‘We're seeing increased demand for our respiratory protection products, and we're ramping up our production worldwide, in China, around the world to meet that demand.’ (Mike Roman, 3M CEO)” [0]
Nothing about that statement gives me any confidence that a single 3M N95 mask is produced in the U.S. In fact, it sounds downright evasive to me.
3M and the various US surgical mask manufacturers have been ramping up production since, if I remember rightly, January, but that's not enough to cope with even the normal demand for them let alone the extra supplies needed due to the coronavirus.
There’s zero evidence that I can find showing that a single N95 mask is actually currently manufactured in the U.S.
Quote from a Minneapolis/St. Paul Business Journal article related to the mask manufacturing ramp up at 3M for COVID19:
“‘We're seeing increased demand for our respiratory protection products, and we're ramping up our production worldwide, in China, around the world to meet that demand.’ (Mike Roman, 3M CEO)” [0]
Nothing about that statement gives me any confidence that a single 3M N95 mask is produced in the U.S. In fact, it sounds downright evasive to me.
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.
We all understand Ricardo's law of comparative advantage. The problem is what happens in a supply chain disruption. In that case it's better to have at least some inefficient local capacity instead of nothing.
As an extreme example, the US continues to manufacture it's own military aircraft instead of buying from China. Even though China might be willing to sell them cheaper than we can make them.
The problem is that each individual country will (reasonably!) not allow critical medical supplies to be exported during a crisis. It worked out mostly okay this time, because the countries with large domestic mask production all got their crisis under control before the rest of the world got it. If the next pandemic happens in China and the US simultaneously, we're not going to have any masks at all.
And note that "mostly okay" here doesn't mean we have anywhere close to enough masks. Just that, with extreme rationing, we can ensure most but not all doctors have the absolute bare minimum of protective gear.
Exactly! I too understand the theory of competitive advantage, but in light of this new information, current economic/business/free-market theory needs to be rebuilt from the ground up to take into account risks (global supply chain disruption, customer base vanishing, etc) seriously considered.
Or maybe shouldn't there be emergency plans that had all the steps to remodel current production lines in the country to adjust to production of medical supplies?
Like, in China, factories that made bedding products are re engineered to make masks, suits, etc.
These are exceptional conditions, so if you had the protocols in place (blue prints, machine configurations, assembly line structure, briefings for management, briefing and courses for factory workers), maybe it was doable.
And maybe it would be of low maintenance, just when new machines were introduced, you'd release a new document to configure that machine.
The main problem would be raw material, but again, maybe with planning and study new materials and combinations could be used (even if not perfect).
This would be only a problem for countries with little to no industry, but that's where organizations like the EU should come into play.
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 ERs before the restrictions were loosened.
A broad array of moderate measures (stringent hand washing, surgical masks all the time, 6 foot rule except during exams, etc.) combined with isolation of only identified “close” contacts has worked in a few different places now.
The question of asymptomatic spread is still confounding experts. It seems they can’t fully explain the spread in some places without it, but they can’t explain lack of spread in some places with it.
When left in a situation where data is conflicting and unreliable, I think the path forward has to always balance the conflicting interests. Just like you can’t send the entire ER department home in the middle of an epidemic, you also can’t exhaust your entire years supply of hazmat gear in a week, and you similarly can’t crater your entire economy to put on a show of strong action.
Measured responses ultimately are what will save the most lives, because they can be sustained for the reasonable expected duration of the outbreak rather than shock and cripple the whole system in a matter of weeks.
> 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.
Exactly this. Evidence seems to be that, if you measure, you see exponential growth of infections. Only a few places have seen the same curves on severe cases.
> It seems they can’t fully explain the spread in some places without it, but they can’t explain lack of spread in some places with it.
They surely can. They just have to assume there are way more asymptomatic cases than they have been assuming, and a relatively small susceptible population.
Yes, if most of those people do not transmit the virus (or transmit very little), that could lead to a similar scenario if there is insufficient testing. South Korea would need to be a very exceptional point.
Anyway, whatever are the ratios, Japan and South Korea should be different because of mask usage too.
My point was you could have exponential growth with asymptomatic being the dominant number. All of the dire numbers assume that there is a fixed rate of low severity to high severity cases. What if asymptomatic is the norm? Could there be something about the places seeing high severe cases that makes them unique?
And it is not just Japan anymore. Germany and Norway both have low severity numbers. Most of the US is finding that the more they test, the more active cases they find today. We could really use testing that let us know the cases they missed a month ago.
It is accepted that asymptomatic is common. It is also expected that a large number of asymptomatic cases demands a large number of severe cases.
What if there is an environmental agitator that causes the percentage of each to vary? High diesel fumes, as an example, could swing it so a larger portion are high severity.
Atul Gawande is a voice i’m happy to listen to here, and this is a small ray of hope.
He’s a practicing surgeon, public health researcher, educator, and he was one of the early champions of wide use of checklists in hospitals to reduce infection rates and complications.
He is not prone to blowing sunshine and rainbows, either.
it's more or less unforgiveable that our american healthcare workers don't have the PPE they need to protect themselves. attrition among our healthcare workers is going to be very high, especially because unlike singapore, we use the most inefficient quarantine guidelines when we suspect that they have been exposed.
people are sewing masks to make up the difference between what is needed and what we can supply. the federal government can't seem to supply the states with much of anything. and purchasing domestically-produced masks is becoming rapaciously expensive, with some manufacturers charging $7 per mask. allegedly our domestic manufacturers are ramping up production. but let's face it, that takes time. and we don't have time, because once one of our healthcare workers gets sick, they're out of commission for weeks.
i will not abide by this disaster for our heathcare workers. i am working with an established charity to raise money to purchase thousands of n95 respirator masks from chinese manufacturers so that those masks can be shipped and donated directly to hospitals in epicenters like new york.
i'm calling it the million mask campaign because i hope that we can eventually donate at least a million masks to hospitals in need. in reality, we will need many millions of masks if we want to protect our healthcare workers, but everything we can bring to bear on their behalf will be beneficial.
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.
I have seen the progress in China since the late 1990s. A rate of change impossible for a modern westerner to believe. China is not a photograph but a video on fast-forward.
people were saying this about the USSR in the 1930s (see beyond the urals by john scott). it's always faster to catch up than to break new ground. their rate of progress will slow dramatically as they approach the state of the art.
maybe, maybe not. it's impossible to say. developing new stuff is a very different game from catching up, especially when you get to manufacture mid-tech stuff for the west and take a loose interpretation of intellectual property. as a state, china currently seems much more able to direct its resources towards worthwhile endeavors than the US, but afaik they are still pretty far behind when it comes to cutting-edge stuff. the new j-20 fighter isn't a match for the f-22, let alone the f-35. they can't touch the level of US silicon fabs without annexing taiwan. I've read some convincing arguments that it may have an edge in cyberespionage/warfare, but it's always hard to judge those capabilities.
The same way the US is considered first world with half of its population living in poverty, a third or more without proper healthcare, almost one percent in prison, etc.
There is no evidence the average Chinese person is "much more capable" than the average American.
And the Chinese were evidently not "diligent" enough to shut down wet markets despite years of repeated warnings from epidemiologists, nor were these civil servants forthright enough about what was happening fast enough to prevent spreading this illness to other countries.
Stereotypes in either direction are dangerous, unfounded, and unproductive.
Chinese Americans objectively have better SAT and ACT scores (so much so that they get screwed by affirmative action policies)
Maybe Chinese themselves aren't "more capable" but the Chinese elite who can get to America and likely the Chinese elite who stay in China are certainly "more capable"
They have a collectivist culture with "tiger parents" who force kids to study far harder than the average throughout the non Asian world. Sometimes, stereotypes are simply true.
The only reason the civil servants do dumb stuff like you describe is the CCP. If you removed literal communism and the orwellian society, they will beat us long term. Imagine that the government of Taiwan ran modern China. It would be unstoppable...
I expect you'll be hard-pressed to convince people that SAT and ACT scores are predictive at anything other than taking SAT or ACT tests unless you're controlling for an equal amount of study effort.
This mindset and the ideological blinders it introduces is a huge problem.
When china went aggressive on the virus people looked at it as draconian measures because of the ideological lens, not looking further to see the measures were absolutely necessary by scientific fact.
When Singapore started to spring into action, the western press was musing about election posturing all the while nobody prepared.
Ideology kills. We need science. And maybe then we can feel morally superior again
Small city-states (Singapore, Hong Kong) with dense urban populations were always more cautious about epidemics.
And it's not like no one was speaking about how unprepared the 'West' has been for years. (Bill Gates' TED talk is making the rounds now that talks exactly about this.)
It's not ideology. Not morality. It's simply a matter of cost-benefit analysis. Public health has been put on the backburner for decades, life expectancy was slowly creeping up, people were getting lazy, and the biggest problem was obesity.
And even though experts were constantly recommending more spending, more stockpiles, etc. it found no traction in politics. And here we are.
> When china went aggressive on the virus people looked at it as draconian measures because of the ideological lens, not looking further to see the measures were absolutely necessary by scientific fact.
None of this would have been necessary if the doctors reporting the Wuhan virus weren’t killed for presenting bad news. There’s clear evidence that the Chinese waited far too long to start acting and alerting others. Also there’s absolutely no reason to believe the Chinese are reporting accurate numbers.
The ideology that’s dangerous is authoritarian government. It happened in Chernobyl and it’s been repeated time and again with China and their respiratory illnesses from easily preventable sources.
I misspoke, there’s no evidence I’m aware of that they were killed. But given China’s history of abusing critical citizens, it wouldn’t be surprising. What’s more accurate is that doctors who spoke up about the impending disaster died of the disease (perhaps unnecessarily) after being censured for their free speech.
Yes China is too slow. First case in December and few dozen cases in January then lockdown. If China had a great president from the free world like mr Donald Trump, then they could act much more quickly and shutdown the whole country since day one. I remember Mr. Trump has an uncle who was a professor at MIT, so that he could understand the seriousness of COVID19. Make China Great Again!
and the u.s. is not intentionally misleading the people right now when it's clearly in front of us? the u.s. government is blatantly lying and even profiting off of the virus.
and your comment about china continuing to manipulate numbers is poor speculation on your part. i am unable to find the article at the moment, but the WHO representative who was there was asked that question, and he stated that there was no reason he saw that numbers were being manipulated. he stated that once the response ramped up, that they were taking it very seriously and were quite methodical.
that's a poor argument. for one, the u.s. has concentration camps as well, just not to that scale. secondly, if one just focuses on these types of arguments, then you ignore all the ways that china is positively surpassing the u.s. their ability to handle infrastructure and crisis like this greatly surpasses the u.s. and other countries. they are logistics and operations experts. the u.s. is flailing about without any shared direction whatsoever.
You talking about the Chinese, or the US with for profit prisons and slavery enshrined in the US constitution (slavery allowed in punishment of a crime deemed guilty by 12 white men).
A couple of weeks ago there was some news about salt treated masks deactivating virus. I just found this site that claims to make them https://vkmask.com/ anyone know anything about them? Are they real or a scam.
Even a scarf made of a t-shirt over the nose and mouth will likely reduce RO when used at scale on the population. The best way to protect healthcare workers is to reduce the R0 below 1. Nothing else will help. Widespread use of homemade masks, though not tested in a double blind trial, is low risk enough and seemingly effective enough to encourage.
Countries enforcing widespread mask use have lower ROs.