Is the WHO's coronavirus advice that the public should not wear masks putting people's lives at risk?

[Hip]

The World Health Organization (WHO) have repeatedly stated that the populace do not need to wear masks or respirators, and that for the general public these offer no protection from coronavirus.

The WHO say:

There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit.

Source: here

Technically the statement may be correct: there may be no specific evidence; but it does not take a rocket scientist to tell you that if masks are vitally important for protecting doctors and nurses who treat coronavirus patients, then they are almost certainly going to be useful for protecting members of the public. So in reality the WHO's statement is not a truthful one.



And here is the self-contradictory statement by the US Surgeon General, tweeted 29 Feb 2020:

Seriously people- STOP BUYING MASKS!

They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!

Source: here

So somehow when medical staff wear masks, it protects them from coronavirus; but when the general public wear them, it does not work!

For the general public, according to this dubious advice, masks only stop other people from catching your coronavirus infection, but masks do not stop you from catching the virus.

Only if you are a doctor or nurse does the mask stop you from catching it! Obviously that makes little sense.



Avoiding mask shortages for frontline medical workers was no doubt the reason for making such statements. I expect the WHO and other medical authorities wanted to prevent panic buying of masks. That may be a laudable objective, but if we are going to justify distorting the truth for such ulterior purposes, then we might as well condone China's distorting the truth, for the ulterior purpose of preserving Chinese social order.

Rather than telling white lies about masks, a better option might have been to get industry to make billions masks on an emergency schedule, so that there would be enough for everybody. We could have started this at least two months ago, when containment of Chinese coronavirus epidemic looked like it might fail.

In Taiwan, they had the foresight to see this pandemic coming, and greatly ramped up their mask production as a response, opening 60 new production lines to make masks, so that everyone in the country was well supplied with them. So far in Taiwan, there have only been 5 deaths.



Do masks make a big difference? Well the coronavirus death toll is about 100 times higher in countries which do not use masks for the general populace (figures accurate for 5 April):

Countries where the populace are not generally wearing masks:

• UK Coronavirus Worldometers — Deaths: 4,934
• France Coronavirus Worldometers — Deaths: 7,560
• Germany Coronavirus Worldometers — Deaths: 1,479
• Italy Coronavirus Worldometers — Deaths: 15,362

Countries where the populace nearly all wear masks:

• Taiwan Coronavirus Worldometers — Deaths: 5
• Hong Kong Coronavirus Worldometers — Deaths: 4
• Japan Coronavirus Worldometers — Deaths: 77
• South Korea Coronavirus Worldometers — Deaths: 183

If it is masks that have dramatically reduced the viral spread and death toll of coronavirus, then the advice from the WHO on face masks may be responsible for the death of tens of thousands so far — and still counting, because the global death toll is going to be in the hundreds of thousands in a few days, and then in the millions in a few weeks time.



On the 4 April, the US performed a U-turn on its advice about the populace wearing masks, and now the CDC advises people to create their own cloth face covering.

But the UK remains behind the curve, and still follows the WHO's potentially lethal advice that masks or cloth face covering are not necessary for the general populace.

The WHO are at the moment apparently reviewing their doctrine that masks worn by the general populace are of no benefit, examining unpublished evidence from Hong Kong that demonstrates their efficacy.

But even if they do soon U-turn on their advice, it comes too late for the people who have already died from coronavirus.

 

[Rufous McKinney]

Source: here

Technically the statement may be correct: there may be no specific evidence

These are the Catch 22....statements. There is no specific evidence regarding masks and the new corona virus. Who has had time in the last 3 months to do a good study on that? Hence- no specific evidence.

Why do doctors and nurses wear masks in hospitals? For zero reason?

WHO - they keep discussing mask shortages....CNN article below

https://edition.cnn.com/2020/03/30/world/coronavirus-who-masks-recommendation-trnd/index.html

 

[Rufous McKinney]

This link - leads to a lab who test Protective Equipment like masks...interesting reading.

https://www.nelsonlabs.com/testing/bacterial-viral-filtration-efficiency-bfe-vfe/

 

[Hip]

There is no specific evidence regarding masks and the new corona virus. Who has had time in the last 3 months to do a good study on that? Hence- no specific evidence.

There's no specific evidence that a ton of bricks falling on you from a great height will badly injure you; but anyone with commonsense will tell you that it will!

Likewise, when we have loads of published studies demonstrating that medics wearing surgical masks or respirators are substantially protected from catching viral infections from their patients, it's a commonsense no-brainer to predict that if the general public wear masks, it will dramatically slow this pandemic. So I think a massive screw up by the WHO and their advisors from various countries.

 

[Hipsman]

Rather than telling white lies about masks, a better option might have been to get industry to make billions masks on an emergency schedule, so that there would be enough for everybody. We could have started this at least two months ago, when containment of Chinese coronavirus epidemic looked like it might fail.

Totally agree! Solving problems on psychological level seems to be the go-to way not only with ME, but generally with societal problems. Only when problem gets so out of hand that they (people in charge) can't control what's happening in society do they start taking effective measures.

 

[ellie84]

Countries where the populace are not generally wearing masks:

• UK Coronavirus Worldometers — Deaths: 4,934
• France Coronavirus Worldometers — Deaths: 7,560
• Germany Coronavirus Worldometers — Deaths: 1,479
• Italy Coronavirus Worldometers — Deaths: 15,362

Countries where the populace nearly all wear masks:

• Taiwan Coronavirus Worldometers — Deaths: 5
• Hong Kong Coronavirus Worldometers — Deaths: 4
• Japan Coronavirus Worldometers — Deaths: 77
• South Korea Coronavirus Worldometers — Deaths: 183

Maybe you should specify what kind of mask. I'm in Italy and I remember going to the hospital on March 13th for a visit and every patient in the hospital (plus the staff) was wearing a mask, I was the only one not wearing one. I can tell you by mid March everyone was wearing masks outside of home. So much that it's now mandatory to wear them plus gloves in some regions of Italy. In my region it's mandatory to wear masks and gloves only inside shops, I read that in others it's mandatory from the moment you step outside home. The thing is it's difficult to find them and mostly we can find surgical masks, which they say only protect you from possibly spreading the infection, not from getting it. And that's actually the only reason we are told to wear masks for: not spreading the virus if we are asymptomatic or mildly symptomatic but not tested. The general communication from the government here has always been to wear masks or at least cover with scarfs etc. In some regions we have also been sent home some free masks from the region government. But mostly we have to buy them (the prices have been skyrocketing and they only let you buy a few).

So maybe in those Asian countries they used different types of masks or they started using them immediately? Police also has the order to confiscate any PPE or other product to allocate them to hospitals here, so it shouldn't be a problem of the population "stealing" masks from health workers.

The "mask" issue is controversial, there are opposite opinions. That tweet you quoted is total nonsense though. I think it's rather reasonable for the general population to wear surgical masks or something to that effect, provided they can find them and of course health care workers should have priority. Then hospital staff should wear higher level protection, but I get that supplies of those are even harder to find.

I don't know if I made any sense and if I actually managed to say what I wanted to say, it's late and I'm

 

[Hip]

The thing is it's difficult to find them and mostly we can find surgical masks, which they say only protect you from possibly spreading the infection, not from getting it.

That's what some are saying about surgical masks: that they only protect others, but not you (but even that will help reduce transmission, so it's not an argument against the use of surgical masks to control the pandemic).

However, studies like this one found that in hospitals, surgical masks were just as effective as N95 respirators in preventing medical staff from catching influenzavirus.

It is true that surgical masks are not as good as N95 respirators at filtering out the smaller respiratory droplets that float in the air (airborne droplets); but surgical masks are fine for blocking the larger droplets that are ejected from people's mouths, and which, because of their large size, usually fall to the ground within a meter. Plus a surgical mask will also stop you from touching your mouth and nose, which helps prevent viral transmission.

The CDC are finally sensibly recommending that people improvise their own masks or cloth face coverings, so that the masks can go to the frontline medics, as they should when there is limited supply.

One study found that a mask made from a cotton T-shirt filtered viral particles to some extent, but is not as effectively as a surgical mask (51% filtering efficiency for the T-shirt, versus 89% efficiency for the surgical mask). But even T-shirt material I think should block the larger droplets.

 

[pattismith]

As you said the mask utility to fight a very contagious respiratory virus don't need any research, it's just common sense.
Here in France, only some doctors were warning about masks needs for public on TV (but not on every channels), while government where spreading lies everywhere...

So maybe in those Asian countries they used different types of masks or they started using them immediately?
….I don't know if I made any sense and if I actually managed to say what I wanted to say, it's late and I'm

I think they mostly use surgical masks, but as you said they started immediately.
Thank you for giving us informations about Italy, do you remember when Italian started wearing masks, maybe when lots of people were already dead and after quarantine started?

 

[Hip]

The experts who advised the World Health Organisation that face masks are not necessary for the general populace include Prof David Heymann from the UK, as this Guardian article says:

These are some of the many factors that the World Health Organization will take into account when it considers the recommendations about face masks put to it by independent advisory committees, including the one that I chair.

David Heymann is professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine.

Prof David Heymann appears to be the chair of the panel of advisors on masks:

In the coming days, a panel of WHO advisors chaired by Professor David Heymann is set to look into new research that could lead to a change in advice regarding the use of face masks.

Source: here

 

[ellie84]

Thank you for giving us informations about Italy, do you remember when Italian started wearing masks, maybe when lots of people were already dead and after quarantine started?

If I'm not wrong national quarantine in Italy started on March 9th. On March 13th I went to the hospital for a visit and everyone inside the hospital (very few people, as most visits were cancelled) was wearing masks. Few were wearing them in the streets or elsewhere, but at the time they were impossible to find, you would have to have bought them in advance.

I would say that by the 3rd-4th week of March almost everyone was wearing them. You guys know the "numbers" better than me, but I think it was definitely late. The thing is, even if you wanted to wear them, there has been a long period when it was really difficult to find them. Only in the last 1-2 weeks they're starting to reappear on the market.

 

[pamojja]

Is the WHO's coronavirus advice that the public should not wear masks responsible for the death of millions?

Till today about 70,000 died of corvid, compared to the about 490,000 from the usual influenza and pneumonia worldwide deaths during the same time period.

The most hardly hid areas already report declining daily covids deaths. Therefore I highly doubt we'll be even getting a fraction of those usually dying of influenca and pneumonia each year. Only someone not looking at the actual numbers could accuse the WHO millions of deaths due to covid alone.

However, I completely agree with face-mask 24/7 one would really could substancially reduce the yearly in total about 3 million influenza and pneumonia deaths (2017 figure).

 

[Hipsman]

Till today about 70,000 died of corvid, compared to the about 490,000 from the usual influenza and pneumonia worldwide deaths during the same time period.

Influenza viruses have been wide spread in the world for centuries, this virus is new and has spread to only a tiny fraction of population, so you can't compare it like that.

One way to see the difference between Covid-19 and influenza and pneumonia is to look at how it has effected health of politicians and famous people, for example in Iran many politicians have died from Covid-19, I never seen that high profile individuals just die every year in high numbers from viruses.
From wikipedia:

Multiple Iranian government ministers and senior officials have been diagnosed SARS-CoV-2 positive, as well as 23 members of the Iranian Parliament (around 8% of all MPs). At least 12 sitting or former Iranian politicians and officials had died from the virus by 17 March 2020.

 

[Cipher]

I thought I might share a paper from 2006 I found recently discussing making DIY respirator masks from pre-shrunk T-shirts in the event of a pandemic and consequent shortage of respirators. The proposed design seems superior compared to many other cloth-based designs circulation online.

Simple Respiratory Mask

Virginia M. Dato,

* David Hostler,* and Michael E. Hahn*
Author information Article notes Copyright and License information Disclaimer

To the Editor: The US Department of Labor recommends air-purifying respirators (e.g., N95, N99, or N100) as part of a comprehensive respiratory protection program for workers directly involved with avian influenza–infected birds or patients (1). N95 respirators have 2 advantages over simple cloth or surgical masks; they are >95% efficient at filtering 0.3-μm particles (smaller than the 5-μm size of large droplets—created during talking, coughing, and sneezing—which usually transmit influenza) and are fit tested to ensure that infectious droplets and particles do not leak around the mask (2–4). Even if N95 filtration is unnecessary for avian influenza, N95 fit offers advantages over a loose-fitting surgical mask by eliminating leakage around the mask.

The World Health Organization recommends protective equipment including masks (if they not available, a cloth to cover the mouth is recommended) for persons who must handle dead or ill chickens in regions affected by H5N1 (5). Quality commercial masks are not always accessible, but anecdotal evidence has showed that handmade masks of cotton gauze were protective in military barracks and in healthcare workers during the Manchurian epidemic (6,7). A simple, locally made, washable mask may be a solution if commercial masks are not available. We describe the test results of 1 handmade, reusable, cotton mask.

For material, we choose heavyweight T-shirts similar to the 2-ply battle dress uniform T-shirts used for protective masks against ricin and saxitoxin in mouse experiments (8). Designs and T-shirts were initially screened with a short version of a qualitative Bitrex fit test (9) (Allegro Industries, Garden Grove, CA, USA). The best were tested by using a standard quantitative fit test, the Portacount Plus Respirator Fit Tester with N95-Companion (TSI, Shoreview, MN, USA) (10). Poor results from the initial quantitative fit testing on early prototypes resulted in the addition of 4 layers of material to the simplest mask design. This mask is referred to as the prototype mask (Figure).


Figure
Prototype mask. A) Side view, B) Face side. This mask consisted of 1 outer layer (≈37 cm × 72 cm) rolled and cut as in panel B with 8 inner layers (<18 cm2) placed inside (against the face). The nose slit was first placed over the bridge of the nose, and the roll was tied below the back of the neck. The area around the nose was adjusted to eliminate any leakage. If the seal was not tight, it was adjusted by adding extra material under the roll between the cheek and nose or by pushing the rolled fabric above or below the cheekbone. Tie b was tied over the head. A cloth extension was added if tie b was too short. Finally, tie c was tied behind the head. The mask was then fit tested.

A Hanes Heavyweight 100% preshrunk cotton T-shirt (made in Honduras) (http://www.hanesprintables.com/Globals/Faq.aspx) was boiled for 10 minutes and air-dried to maximize shrinkage and sterilize the material in a manner available in developing countries. A scissor, marker, and ruler were used to cut out 1 outer layer (≈37 × 72 cm) and 8 inner layers (<18 cm2). The mask was assembled and fitted as shown in the Figure.

A fit factor is the number generated during quantitative fit testing by simulating workplace activities (a series of exercises, each 1 minute in duration). The Portacount Plus Respirator Fit Tester with N95-Companion used for the test is an ambient aerosol instrument that measures aerosol concentration outside and inside the prototype mask. The challenge agent used is the ambient microscopic dust and other aerosols that are present in the air.

A commercially available N95 respirator requires a fit factor of 100 to be considered adequate in the workplace. The prototype mask achieved a fit factor of 67 for 1 author with a Los Alamos National Laboratory (LANL) panel face size of 4, a common size. Although insufficient for the workplace, this mask offered substantial protection from the challenge aerosol and showed good fit with minimal leakage. The other 2 authors with LANL panel face size 10, the largest size, achieved fit factors of 13 and 17 by making the prototype mask inner layers slightly larger (22 cm2).

We do not advocate use of this respirator in place of a properly fitted commercial respirator. Although subjectively we did not find the work of breathing required with the prototype mask to be different from that required with a standard N95 filtering facepiece, persons with respiratory compromise of any type should not use this mask. While testers wore the mask for an hour without difficulty, we cannot comment on its utility during strenuous work or adverse environmental conditions.

We showed that a hand-fashioned mask can provide a good fit and a measurable level of protection from a challenge aerosol. Problems remain. When made by naive users, this mask may be less effective because of variations in material, assembly, facial structure, cultural practices, and handling. No easy, definitive, and affordable test can demonstrate effectiveness before each use. Wearers may find the mask uncomfortable.

We encourage innovation to improve respiratory protection options. Future studies must be conducted to determine levels of protection achieved when naive users, following instructions, produce a similar mask from identical or similar raw materials. Research is needed to determine the minimal level of protection needed when resources are not available for N95 air-purifying respirators since the pandemic threat from H5N1 and other possible influenza strains will exist for the foreseeable future.

One might improve the design by soaking the t-shirts in salt water and letting them dry:

Universal and reusable virus deactivation system for respiratory protection

Abstract

Aerosolized pathogens are a leading cause of respiratory infection and transmission. Currently used protective measures pose potential risk of primary/secondary infection and transmission. Here, we report the development of a universal, reusable virus deactivation system by functionalization of the main fibrous filtration unit of surgical mask with sodium chloride salt. The salt coating on the fiber surface dissolves upon exposure to virus aerosols and recrystallizes during drying, destroying the pathogens. When tested with tightly sealed sides, salt-coated filters showed remarkably higher filtration efficiency than conventional mask filtration layer, and 100% survival rate was observed in mice infected with virus penetrated through salt-coated filters. Viruses captured on salt-coated filters exhibited rapid infectivity loss compared to gradual decrease on bare filters. Salt-coated filters proved highly effective in deactivating influenza viruses regardless of subtypes and following storage in harsh environmental conditions. Our results can be applied in obtaining a broad-spectrum, airborne pathogen prevention device in preparation for epidemic and pandemic of respiratory diseases.

 

[PatJ]

Masks4all has some interesting quotes, graphs, and other information.

The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.” – China’s CDC Director (March 27)

Note that the area in the graph that says 'no masks' also lists other measures that are thought to have helped in reducing the rate of infections.

 

[Wayne]

Masks4All

This website features the following 4-minute video, which describes the Masks4All movement in the Czech Republic. I thought it was a very well done (and optimistic) video. It's encouraging to see how well the Czech Republic has done since the onset of the pandemic, and they credit wearing masks with much of that success.

How to Significantly Slow Coronavirus? (featuring Minister of Health of the Czech Rep.)

However, I completely agree with face-mask 24/7 one would really could substancially reduce the yearly in total about 3 million influenza and pneumonia deaths (2017 figure).

I ran across a story about what happened in Florida when a hurricane "interrupted" the flu season a few years ago. Apparently, people for the most part had to "shelter in place" for 2-3 days or so, and it was subsequently noted that these measures dropped the number influenza cases by 80% or so from what they had been projecting.

My hope is that when reviewing some of the "lessons learned" from this pandemic, there'll be a greater awareness of how relatively easy it might be to reduce the severity of flu season(s). -- I also have a hope hospitals will finally implement better measures (like frequent hand washing) to protect people from hospital infections, which are deadly to so many people every year.

 

[pamojja]

My hope is that when reviewing some of the "lessons learned" from this pandemic, there'll be a greater awareness of how relatively easy it might be to reduce the severity of flu season(s).

Well the really best would be if everyone realized stroke and CVD together cost even 5-6 times of yearly worldwide lifes than pneumonia, and how easy it could be prevented. But I've no illusion that will happen.

https://www.worldlifeexpectancy.com/world-rankings-total-deaths#WORLD RANKINGS

 

[Judee]

One might improve the design by soaking the t-shirts in salt water and letting them dry:

I was wondering about this...i.e. whether it would be possible to coat them in something like colloidal silver to kill the viruses. Thanks.

 

[Hip]

I was wondering about this...i.e. whether it would be possible to coat them in something like colloidal silver to kill the viruses. Thanks.

I would not have thought it would make too much difference, even if you could find a substance which disables the virus. If the fabric of the mask is able to block and soak up a respiratory droplet containing the virus, then the mask has worked.

 

[Rufous McKinney]

I would not have thought it would make too much difference, even if you could find a substance which disables the virus. If the fabric of the mask is able to block and soak up a respiratory droplet containing the virus, then the mask has worked.

Soak in the iodine solution?

 

[Dufresne]

Governments are scrambling to buy N-95 masks by the tens of millions. This makes me wonder how many masks, on average, a hospital worker goes through in a shift? Apparently an impressive number.