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The novel coronavirus pandemic in the United States will be remembered in part as an era of shortages. A shortage of ventilators to treat patients in severe respiratory distress. A lack of testing that permitted COVID-19 to spread unchecked across the country. A healthcare system that couldn’t protect its own workers from coronavirus, let alone the general public, thanks to a personal protection equipment (PPE) shortage.
The lack of initial coronavirus testing and the shortage of medical grade face masks in the United States stand out because the opposite—widespread testing and mass distribution of face masks to the general public—have helped “flatten the curve” of coronavirus in China, South Korea, Taiwan and other Asian countries, even as the curve exploded exponentially in the United States and Europe.
In fact, George Gao, head of the Chinese Center for Disease Control and Prevention, recently told Science Magazine that the Western world’s biggest mistake so far was not requiring everyone to mask up.
“The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks,” he said. “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 pre-symptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.”
As we’re learning, when we make our essential trips to the grocery store and the pharmacy, we’re navigating an atmospheric river of lingering saliva streams, dribbling droplets and meandering microdroplets, some perhaps carrying coronavirus. That’s why I’ve been masking up for all my essential trips for the past three weeks.
I wear the preformed surgical mask above mainly to prevent myself from infecting others, should I happen to be an unknowing asymptomatic coronavirus carrier. The mask covers my mouth and nose and fits my face snugly, but it’s not airtight, which means coronavirus could get in or out. In the hierarchy of protective masks, it’s inferior to the airtight N-95 respirator models and superior to surgical cloth masks which are literally ranked “better than nothing.”
Last week, rumors swirled in the nation’s capital that President Donald Trump and the CDC were going to reverse course and advise all Americans to wear protective face mask in public. It would be quite the change in course. Prior CDC policy, now scrubbed from the website, stated:
“Wear a face mask if you are sick when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. … If you are NOT sick: You do not need to wear a face mask unless you are caring for someone who is sick (and they are not able to wear a face mask). Face masks may be in short supply and they should be saved for caregivers.”
The guidance didn’t take into consideration that novel coronavirus can be spread by asymptomatic infected people. Critics have accused the CDC of sending a mixed message. Zeynep Tufekci lays it out nicely in her New York Times opinion piece, “Why Telling People They Don’t Need Masks Backfired:”
“First, many health experts, including the surgeon general of the United States, told the public simultaneously that masks weren’t necessary for protecting the general public and that health care workers needed the dwindling supply,” Tufekci writes. “This contradiction confuses an ordinary listener. How do these masks magically protect the wearers only and only if they work in a particular field?”
The answer is that masks work for everybody; healthcare workers, the new class of “essential” workers and the stay-at-home public alike, and can help flatten the coronavirus curve if enough people wear them and continue to practice social distancing and hand washing on their essential runs to the grocery store and the pharmacy.
The problem is there are not enough masks for everybody, specifically the quality surgical masks and N-95 respirators, thanks to panic-buyers, preppers, hoarders, price-gougers, poor pandemic planning and the collapse of the “just-in-time, made-in-China” supply chain.
Any hopes that Trump and the CDC would address the PPE shortage in a meaningful way were dashed Friday when the CDC released its new guidelines, “Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission.”
The CDC’s basic gist is this: Do it yourself. It’s calling on all Americans to make their own cloth masks, out of whatever materials they have lying around. These homemade masks are inferior in protection compared to surgical masks and N-95 respirators, which, by the way, are now totally verboten.
“The cloth face coverings recommended are not surgical masks or N-95 respirators,” state the new guidelines. “Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.”
If you don’t want to wear a cloth mask, the commander-in-chief says you don’t have to. It’s not really a code. It’s just a guideline!
“I am choosing not to do it!” Trump said smugly at Friday’s daily coronavirus presser.
Presumably, the President’s instructions apply to choosing to wear a surgical mask or an N-95 respirator as well, despite being advised not to do so by the CDC.
At the time of this writing, there were 305,000 confirmed COVID-19 cases in the United States and 7600 deaths.
Last Wednesday during the Shasta County Health and Human Services Agency’s virtual coronavirus press conference, I asked Public Health Officer Dr. Karen Ramstrom if the general public should wear masks when conducting their essential activities.
“I think we’re in this place where we’re looking at all options,” she said. “The more of these mitigation measures you can layer on top of each other, the more successful we’re going to be. I think if we had all of our dreams come true and we had a vast supply of surgical masks we would have every resident have one and wear them when they go out to have their basic needs met.”
Whenever a doctor mentions all our dreams coming true, she’s about to tell you why they aren’t.
Anyway, if all my dreams come true, everybody who wants to will be wearing an N-95 respirator or similar face mask when they’re out running their essential errands. When worn correctly, the N-95 forms an air-tight seal with the face and protects the wearer from inhaling particles as small as the coronavirus. They used to sell for under a dollar. Now they’re hard to find at any price.
“Unfortunately, we don’t [have enough masks for everyone] and we have to make sure we have supplies available for our health care providers to keep them safe as they’re taking care of all of us,” Ramstrom said.
That means the general public will have to find another source for masks. It’s time for some coronavirus entrepreneurs to step up, Ramstrom suggests.
“So, the idea is, are there other ways to have masks available that are not the kind that are approved through more formal channels for medical use?” she posited. “Whether they’re homemade or some innovative company comes along, and they make them?”
Dr. Ramstrom cautioned that masking up doesn’t make you a superhero. It’s just one more precaution in a long line of precautions, from handwashing to social distancing, necessary to stay six steps ahead of coronavirus.
“We have to make sure the users know that it [wearing a mask] does not replace social distancing,” she said. “All it does is add another layer of protection to the people around that individual, so you’re not sharing your potentially early symptoms and virus spread with the people around you.”
As of this writing, there are 20 confirmed COVID-19 cases in Shasta County, 418 people who’ve tested negative and three people who’ve died.
I’m hoping to ride out the Shasta County coronavirus curve with a half-dozen surgical masks and one N-95 respirator, which I’m going to recycle as many times as possible.
If we haven’t turned the corner by then, there’s always the elastomeric respirator pictured below. It’s supposedly better than the N-95 with renewable filters. I’m in this for the long run.