Many people in the community are wearing face masks and gloves in an attempt to protect themselves against the coronavirus.
They might put on these items to go to the shops, or perhaps when taking a walk through the neighbourhood.
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But you’re even less likely to get protection if you don’t take care when putting on these items, while you’re wearing them, and when you take them off.
A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients
Whatever the state of the science, some people appear to be doing things that could defeat the purpose of wearing a mask. Examples include pulling the mask under their chin for a “breather” or to make a phone call; or touching the mask while wearing it.
Through these actions, you can transfer the virus directly from your hands or your mobile phone to your face, increasing your risk of being infected.
The WHO has published some dos and don’ts for wearing face masks covered in the referenced article.
What about gloves?
Gloves prevent the transmission of germs if used properly, and are an integral part of PPE for health-care workers.
However, gloves have not been recommended as a precautionary measure against COVID-19 for the average citizen. That’s largely because of the evidence we have about how the disease is, and isn’t, transmitted.
Wear them right
While there’s no evidence to suggest wearing gloves in the community will protect you, if you do choose to wear them, there are some things you should consider.
Importantly, if you still touch your face with your gloved hands – or even touch your mobile phone – this renders the gloves useless. (See the very informative video demonstrating cross-contamination).
I wear a mask the few times I go to a store or medical office. I do not wear one walking in my neighborhood or if I sit outside chatting with friends- I keep far away.
No gloves except when I pump my gas. Only got gas once in 9 weeks.
Gloves are for me false sense of security. I would touch my face more often if I had gloves on. 💕
Neil, after reading all this, makes sense. But all I could think of is how the n95 itches my nose none stop to the point that I can't take it. I have to take it off in desperation to scratch my nose for relief I don't know if this is common with this mask but would like to know. Also it's very hard to breath. I can imagine how it will be in the very hot summer days😷.
Have you tried applying an anti-itch cream to your nose before wearing your mask?
If you absolutely have to itch your nose through your mask, use the back of your hand and don't forget to wash your hands when you have finished wearing your mask.
Agree with Neil. Just try the best moisturiser you have handy to start with. Anything that makes you sweat washes the oils out the skin and promotes itching.
Masks are always going to be problematic in heat or if worn for any significant time ( until somebody devises an affordable one with cooling backpack - what all Coronavirus nurses really need).
You are using a full face respirator and my opinion (from DIY work) is that's the only type that works properly for nasty stuff, so well done for getting it right. The paper types (even the better ones) are likely to leak somewhere. If you wear glasses and they steam up, you can conclude your mask isn't tight enough.
Make sure to regularly wash out your respirator, and order new filters.
Lol "what is Winstins view on all of this" the only thing he cares about is that I play with him all day🤣. Thank you for your advise I have an appt. With lamanna on the 21st and the respirator is definitely coming on. I live in the suburbs and I'm gonna do my best to protect myself when going to ny city. Thank you, Ernest.
My doctor’s office told us not to wear gloves because they could give a false sense of security. They advise just to wash your hands often and wear a face mask 😷
I find the incorrect use of masks annoying too - going back to well before the pandemic. Given how hard masks are to find now and how expensive they've become, seeing poorly used masks makes it even even more so nowadays.
I have seen this too, and what about the people who are gathering together in huge crowds like beaches etc. Im just baffled by all that. They're acting like they never gonna get to do these things again.
I've forked out for a ventilator. It looks like a mask, but comes with a tiny fan with a carbon activated HEPA filter. I use it for shopping only, being happy to go outside without a mask. I've done my own research on this, as I'm an engineer. For clever stuff, I listen to the advice from you guys on here.
I was a wearing a mask when shopping in the supermarket, ( my supermarket is not very crowded) but today I decided not to. My reasoning is that not having Covid 19 the mask will not protect me from getting it as the virus particles are so small they would penetrate the fabric anyway. And I am not ill with any other condition which is the only reason I would wear the mask to protect others.The jury is out on how effective a mask is , you are correct. Unless you are strict about not touching the mask etc there is no point. Gloves are more or less just giving one a security feeling. Probably using antibacterial hand gel when you enter a shop etc and when you leave are probably better things to do and then again when you get in your car and get home use the gel again. And wash your hands as often as possible and keeping your distance but again the virus may travel further than what we think. The point is covid 19 is not going away any time soon and as my specialist says it's around everywhere
Hi, Roszika. The virus is small, but they are in most cases attached to a droplet through coughing (> 10 micron), which the mask will catch. What I'm not so sure about is that when it hits a surface, the droplet evaporates quickly, leaving the bug in place (hence the advise to clean surfaces), so what happens when it hit the mask? So many unknowns!
I was able to buy one of the face shields which I have seen NHS staff wear; a company I have bought things from in the past, nothing to do with this virus, but to do with my hobby of sewing. I got a marketing email with these face shields and bought one. Whilst I am not leaving the house, I know that I have hospital appointments coming up, and that will me me feel more secure. And at least of the appointments will happen because they can't do a scan over the phone.
Gloves, masks, hand gel, soap and water, disinfectant. It's not a case of either or. Each has its uses and none is foolproof.
Hand washing is a familiar practice and we've all been reminded how to do it right. But a recent televised demo showed how easy it is to do it wrong. On test, unwashed areas (visible in UV light) remained on the hands of every member of the household, more so on the children's. Similarly with surfaces in the home, wiped and supposedly sanitised. And everyone knew they were being tested.
If used badly, gloves and masks are worse than useless, but so is every other safety measure. If used with care and intelligence they are effective and can be a great help.
Thanks Neil for posting. I do not wear a mask when out for a walk, it's not that crowded where I live. However, when I do start going to appts again or grocery shopping I will wear it more as a deterrent to keep people at a distance. When you look healthy people just assume you are. 😳
One thing I read from an infectious disease specialist if you have a mask that can not be easily cleaned after using it you can put it in a paper bag and let it sit for seven days it can then be reused. I get very frustrated when I see on the news people discarding their masks and gloves on the ground or shopping carts.
I agree with the idea that people veer away when they see a mask....fine with me...and I too am annoyed when I see people discarding their wipes and gloves everywhere!! Such disrespect to the people who need to pick them up...
The article at theconversation.com gives useful tips.
I would question official advice in Oz to wear a mask only if you are unwell. For starters if you are unwell you should not be on walkabout. Also, in the northern hemisphere spring-summer brings widespread symptoms of pollen and dust allergy. As people regain free movement there will be plenty of spontaneous wheezing and sneezing out there, from people who are otherwise well. If the person next to you in the queue or on the train were to send out a lungful in your direction, wouldn't you prefer them to be wearing a mask?
The UK government has consistently pooh-poohed the idea that wearing a mask in public has any benefit. I'll say no more to stay onside with the moderators.
I wear mask anytime I get out of my car for stores and etc. My wife showed me how to put mask on with least chance of touching mask. I do not ware mask when doing daily walks, but rarely see anyone else and do social distancing. Carry a bottle of hand sanitizer when out and about. Only wear gloves when pumping gas or sanitize hands right after. Not much different from before CV-19 hit. Blessings.
I'll mask up to protect myself from others and others from me, and if I periodically tuck it beneath my chin this does not equate with contamination so long as I only touch the outside of the mask and refrain from touching my face. Regarding my mobile, it doesn't come out of my pocket when I am out walking. I don't know if I have an asymptomatic case or not, neither do any of you/us unless you/we've been tested. Best to play it safe and mask up and wash hands frequently. Stay safe, humble, helpful, and kind.
I should have mentioned that what few times I go to a store, they have big bottles of hand sanitizer at entrance and exit. This is nice as it saves me from using my own. Blessings.
If you have the possibility: Outside of your home and into the public: USE EVERYTHING !!! (Except on a lone nature walk). If you survive the corona, your entire health will be forever crippled. I use medical gloves and over them even OB or Vet's gloves which reach up to the shoulder, when I go shopping. And because I am 85 with thinned skin - all that over white cotton dermatology gloves over the hand and cotton arm protectors. I also enter the supermarket in a medical hazmat suit, glasses and face shield. On the subject of masks: The practical societies of East Asia have been using masks since decades.
We are learning that a COVID-19 infection can have far broader impact on our health than just a respiratory infection. However, as we gain an understanding of what it might do, the recommended treatment protocol is being modified to prevent or at least mitigate the impact of the infection on our bodies. Certainly for us, avoidance is the far better approach, but I don't think we need fear being forever crippled if we survive an infection.
There is both scientific and practical evidence why people should wear a mask. Germany made it compulsory to wear masks when outside, anytime, anywhere, and their death rate is 75% less than UK. research using lasers and ultra-slowmotion cameras show the effusion of droplets from the mouth and nose after coughing and sneezing. It's not pretty. It also shows the droplets can remain airborne for up to 8 seconds. Wearing a mask prevents this effusion, and of course is vitally important if one is infected, and may be asymptomatic, and also, if not infected, can prevent the inhalation of droplets. Important to remember, as previously posted, that the CV19 virus is always attach to a much larger droplet which cannot violate a correctly fitted mask. Also remember, that by far the major cause of infection is fomite transmission. Even when wearing a mask, if an infected person coughs or sneezes near you, and is not waering a mask, it is highly probable that droplets will attach to your hair and clothing. You get home, wash your hands, remove your face mask, wash your hands again, touch your clothes and/or hair, and it's on your hands again. It's not easy.
I don't wear a mask to protect me really. I wear one just to respect others. Among one of my health issues is COPD.. and I cough a lot. Cough in a store now days gets you a bunch of suspicious looks. It plainly scares people. So I wear one like one would muzzle a dog... except I muzzle myself to reduce the fear... regardless of whether it is effective or not.
Masks seem very confusing. The best way to think of them is as a public good. So if one person wears a cloth mask, risk of infection drops 10%. the more people wearing mask the more protection, up to about 90%. According to statistical and epidemiological opinion.
in addition each person wearing a mask is worth about $6000 to the economy( reduced medical burden and so on), not counting the enhanced ability to resume the economy.According to a study out of Yale U, in Feburary 2020.
And we are talking cloth masks.
So if you up the ante to n95, which we compromised should. Possibly 95-100 %?
Then there is a small opinion paper out of Philadelphia, hospital docs ,that wearing a face shield may be as effective as a mask, protecting from sneeze, 96% at 3 feet, 92% at 6 feet.
Face shields presumably protect by blocking droplets, some aerosols and protecting against touching one's face, which we do unconsciously 90 plus time per day.
Benefits are predicated on proper use, for example if one needs to adjust mask or comfort itch., the best thing to do is sanitize hands, 20 seconds of soap and water or >60%, but less than 90% alcohol , again for 20 seconds, then do the necessary.
Really need 7 masks so that each can be stored in a clean open bag, between use.
Personally i have promised myself to wear a n95 ish mask and a face shield when out and about for the next 1 year. it seems a commitment I may be able to keep. I spray mask inside and out with Peroxide after each use, let dry.
A study that claims to be the first review of all the available evidence of the effectiveness of physical distancing, face masks, and eye protection to prevent spread of COVID-19 and other respiratory diseases has quantified the effectiveness of these protective measures. The study found that greater physical distancing from an exposed person significantly reduces risk of transmission and that N95 masks, particularly for health care workers, are more effective than other face coverings.
The study reported that physical distancing of at least 1 meter, or about a yard, “seems to be strongly associated with a large protective effect,” but that distancing of 2 meters or about 6 feet could be more effective.
The study involved a systematic review of 172 observational studies across six continents that evaluated distance measures, face masks, and eye protection to prevent transmission between patients with confirmed or probable COVID-19, other severe acute respiratory syndrome (SARS) disease, and Middle East respiratory syndrome (MERS), and their family members, caregivers and health care workers up to May 3, 2020. The meta-analysis involved pooled estimates from 44 comparative studies with 25,697 participants, including seven studies of COVID-19 with 6,674 participants. None of the studies included in the meta-analysis were randomized clinical trials.
A subanalysis of 29 unadjusted and 9 adjusted studies found that the absolute risk of infection in proximity to an exposed individual was 12.8% at 1 m and 2.6% at 2 m.
The study also identified what Dr. Chu and colleagues characterized as a “large reduction” in infection risk with the use of both N95 or similar respirators or face masks, with an adjusted risk of infection of 3.1% with a face covering vs. a 17.4% without.
Eye protection was found to reduce the risk of infection to 5.5% vs. 16% without eye protection.
That is really interesting about the N95 mask. I have 3... just 3... that I had before these COOTIES came to town. I keep one handy at all times and rotate them in an attempt to reduce wear and tear. Here in the USA actually finding the N95s is near impossible and folks are just making do with what they can scrounge up or make at home... with the "better than nothing" idea. Hopefully that will change and everyone will be able to find the real deal in the months ahead. I am curious if they are readily available in Australia?
Selected quotes from MedPage Today Editor-in-Chief Martin Makary, MD, of Johns Hopkins University,
Even potentially, in some areas now, we're seeing a second mini-wave within the first wave, so I am concerned about that. I am worried about the fall. I think we can look at the other seasonal coronaviruses and say, "This is a threat."
At the same time, look at Brazil. Brazil is very concerning right now, over 1,000 deaths a day and increasing for a country a little larger than half our size. The most concerning feature is that it's warm in Brazil. It's in the 60s and 70s. Part of Brazil is at the equator. For them to have such a bad epidemic in Brazil with warm climate is a concern for what we could have when the cold season comes back and magnifies the problem.
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I think there are a couple good silver linings that have come out of this horrible tragedy. One, for example, is that we will probably save thousands of people from influenza year to year because of the best practices that the public has now finally accepted, adopted, and believes in. That's important.
We've been oddly complacent about influenza deaths year to year: 81,000 deaths 3–3.5 years ago, just from seasonal influenza, so that is, I think, one positive. Maybe we thought we were too cool for masks in the past and we're now recognizing the value.
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How were they able to manage the coronavirus in China, in a country of 1.1 billion, after the outbreaks in Wuhan and Harbin? You know what he said? He said, "It's because of masks. Everybody wears a mask." I thought, "You know, that is powerful."
The data has come out and the CDC guidance has come out, even last week, that the risk of droplet airborne transmission from person-to-person contact, breathing, from speaking, even, from that airborne droplet transmission, is far greater than from the transmission of the virus through surfaces. We're increasingly learning the value of wearing masks in a situation like that and I think it's powerful.
To our cost, I think we are about to find out in Australia about the value of wearing masks. Restrictions are being lifted and very few people are now wearing masks in public. We had a fraction of flu cases in this year's start to the flu season compared to previous years, with a massive drop in March and April compared to the start of the year, when flu cases are usually at their lowest. (Australia's flu season peaks between April and November).
"Until now, the evidence about whether wearing a mask out and about if you’re healthy reduces your risk of coronavirus infection has been uncertain.
But a recent review in The Lancet changes that. As expected, the researchers found wearing masks protected health-care workers against coronavirus infection. But they also found wearing masks protects healthy people in the community, although possibly to a lesser degree.
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Given masks reduce your risk of infection and reduce the risk of you unwittingly passing on the virus to others, you could certainly make a case for routinely wearing a mask on public transport while we have coronavirus in the community.
This case is even stronger if you are at risk of severe illness, for example if you are over 65 years old or have an underlying medical condition such as high blood pressure, heart disease or diabetes. (My emphasis)
From an article by Hassan Vally, epidemiologist and Associate Professor, La Trobe University
Thanks for this, Neil. I think it will make a big difference for people to know that masks really do help protect the wearers from the virus. They don't just help stop an infected person from spreading disease.
I suspect that the reason why (in some circles) masks have not been worn more often, is because they were thought to be for the benefit of others, and not much for person wearing them. A sad reflection on human nature...
I have probably a folorn hope that society will be the better for experiencing this pandemic. It's always been the case that the best way to prevent the spread of respiratory viruses is for those shedding the virus to wear masks - to stop the spread at its source.
The concerning lack of masks for medical employees early in the pandemic exacerbated the issue, with governments downplaying the value of wearing masks, so the few available could be allocated to those daily risking their lives helping others. I hope governments now ensure that adequate quantities of masks and other PPE is stockpiled to make sure this doesn't happen again. The cost is minuscule compared to stockpiling antivirals with much more limited use by dates.
We show that, when facemasks are used by the public all the time (not just from when symptoms first appear), the effective reproduction number, Re, can be decreased below 1, leading to the mitigation of epidemic spread. Under certain conditions, when lock-down periods are implemented in combination with 100% facemask use, there is vastly less disease spread, secondary and tertiary waves are flattened and the epidemic is brought under control. The effect occurs even when it is assumed that facemasks are only 50% effective at capturing exhaled virus inoculum with an equal or lower efficiency on inhalation. Facemask use by the public has been suggested to be ineffective because wearers may touch their faces more often, thus increasing the probability of contracting COVID-19. For completeness, our models show that facemask adoption provides population-level benefits, even in circumstances where wearers are placed at increased risk. At the time of writing, facemask use by the public has not been recommended in many countries, but a recommendation for wearing face-coverings has just been announced for Scotland. Even if facemask use began after the start of the first lock-down period, our results show that benefits could still accrue by reducing the risk of the occurrence of further COVID-19 waves.
From A modelling framework to assess the likely effectiveness of facemasks in combination with ‘lock-down’ in managing the COVID-19 pandemic
Richard O. J. H. Stutt, Renata Retkute, Michael Bradley, Christopher A. Gilligan and John Colvin.
There should be no doubt now about the importance of wearing a mask when you are at risk of exposure to the coronavirus! The Infectious Diseases Society of America (ISDA) found that wearing any mask – surgical or N95 – led to a large reduction in the risk of developing an infection.
From Guidance on infection prevention for health care personnel (with my emphasis)
The ISDA guideline states that mask usage is imperative for reducing the risk of health care workers contracting COVID-19. The evidence is derived from a number of sources, including a retrospective study from Wuhan (China) University that examined two groups of health care workers during the outbreak. The first group wore N95 masks and washed their hands frequently, while the second group did not wear masks and washed their hands less frequently. In the group that took greater actions to protect themselves, none of the 493 staff members contracted COVID-19, compared with 10 of 213 staff members in the other group. The decrease in infection rate occurred in the group that wore masks despite the fact that this group had 733% more exposure to COVID-19 patients.2 Further evidence came from a case-control study done in hospitals in Hong Kong during the 2003 SARS-CoV outbreak. This study showed that mask wearing was the most significant intervention for reducing infection, followed by gowning, and then handwashing. These findings make it clear that mask usage is a must for all health care providers who may be caring for patients who could have COVID-19.
The guideline also reviews evidence about the use of surgical masks versus N95 masks. On reviewing indirect evidence from the SARS-CoV epidemic, IDSA found that wearing any mask – surgical or N95 – led to a large reduction in the risk of developing an infection. In this systematic review of five observational studies in health care personnel, for those wearing surgical masks, the odds ratio for developing an infection was 0.13 (95% CI, 0.03-0.62), and for those wearing N95 masks, the odds ratio was 0.12 (95% CI, 0.06-0.26). There was not a significant difference between risk reductions for those who wore surgical masks and N95 masks, respectively. The IDSA guideline panel recommended “that health care personnel caring for patients with suspected or known COVID-19 use either a surgical mask or N95 respirator ... as part of appropriate PPE.” Since there is not a significant difference in outcomes between those who use surgical masks and those who use N95 respirators, and the IDSA guideline states either type of mask is considered appropriate when taking care of patients with suspected or known COVID-19, in our opinion, use of surgical masks rather than N95s is sufficient when performing low-risk activities.
More evidence that mask wearing limits coronavirus spread.
One of the reasons SE Asian countries generally performed much better than elsewhere in reducing the death toll from COVID-19 infections, was suspected to be due to community acceptance of mask wearing, along with their previous experience with SARS version 1. This interesting research intriguingly infers that mask wearing was indeed likely to be a significant factor. It's based on the same idea that Google used to predict the incidence of flu cases - measuring the number of searches for flu symptoms, or in this case, masks.
Regions with early interest, adoption of face masks showed modest COVID-19 infection rates
Researchers with the Chinese University of Hong Kong reported findings from an analysis of how public interest in face masks, based on Google Trends relative search volume data, may have affected the severity of COVID-19 infection and potentially contained the outbreak in 42 countries around the world.
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When Wong and colleagues analyzed relative search volume values for “surgical mask” from Jan. 21 to March 11, when the WHO officially declared COVID-19 a pandemic, they observed a significant inverse correlation between interest in face masks and average daily number of COVID-19 cases among 42 regions. The researchers observed a lower number of daily COVID-19 cases in Asian regions, including Hong Kong, Taiwan, Cambodia and Vietnam, that correlated with high search volumes, according to the letter. Wong and colleagues noted that this inverse correlation remained significant after they adjusted for relative search value volume values for “hand washing” and “social distancing” over the same period.
"How effective is mask-wearing? It may be more effective than anyone has ever imagined. In Missouri, two hair stylists who had COVID-19 but who wore masks (and required their clients to wear masks) did not infect any of 140 clients, even though they could not possibly maintain a 6-foot distance when cutting someone's hair.
A recent state-level analysis in the Philadelphia Inquirer reported an inverse relationship between states with more stringent mask policies and the number of new infections. In a recent country-level analysis, the duration of masking wearing was inversely proportional to the risk of death from COVID-19. In Japan (where mask-wearing is nearly universal), the risk of infection and the number of COVID-19-related deaths are exceptionally low.
Mask wearing is a no-brainer, but sadly, in our deeply divided country, it has become a political issue. Some claim that mask wearing is a form of political protest, when in truth, it is a sign that the wearer cares about social responsibility and consciousness. To those who might care more about the economy than about public health, universal mask wearing allows for businesses to reopen. Compared with millions of people out of work and suffering in social isolation, masks are really inexpensive. Opposing the universal use of masks means that a person cares more about their ability to make a foolish choice than he/she cares about the health and economic welfare of their friends, neighbors, and community. Is there a better example of crass selfishness?"
I think one of the problems in USA was the initial message of saying a mask wasn't necessary (so that the low supply of masks could be reserved for medical professionals). When the recommendation changed to require masks, people rebelled and still rebel, the initial recommendation is stuck in their minds and changing it created distrust. For the most part I see masks and was in the store today thinking about how I'm not the only one wearing it anymore, and how I blend in.
I agree. This shows how important it is to stockpile sufficient PPE for when supply lines are disrupted. Provided masks are kept in a cool, dry environment, they should have a long storage lifetime.
Surgical masks are "the type you not only see surgeons wear in hospital, but are being worn by the public in the community. They are generally blue or green. Put them on by holding by the ear loops and hooking over the ears. Make sure you cover the nose, and pull them down under the chin (see diagram below for the correct procedure of putting on and taking off a mask). Pinch the bridge to ensure a good seal around the top of the nose.
You can buy these online, or from a pharmacy, and are relatively cheap.
Many studies show surgical masks are better filters of particles from coughs and sneezes than cloth masks. You’re also less likely to get infected when wearing a surgical mask compared with a cloth mask."
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