The role of masks in reducing risk in the Covid e... - PMRGCAuk

PMRGCAuk

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The role of masks in reducing risk in the Covid epidemic

PMRpro
PMRproAmbassador

I thought others might be interested in these articles -

theguardian.com/world/2020/...

nejm.org/doi/full/10.1056/N...

80 Replies
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From the beginning the ‘Mask’ Issue was due to Shortages, it was obvious that a Respiratory Virus would be spread by Droplets, Coughing etc.....

I remember posting about wearing a scarf across my mouth & nose (stylishly draped of course) when l went to the hospital just before Lockdown......

Post Chemo, when my immune system was wiped out l wore a mask in certain settings & the antiseptic wipes were second nature....

I think it was very poor how they dismissed the wearing of Masks 😷 saying it could spread it more, just total propaganda as there weren’t any available!

I wear a Mask when l go out, my glasses 👓 steam up but l’d rather struggle to see than not wear one!.....

PMRpro
PMRproAmbassador in reply to MrsNails

I don't have the steaming up problem with my masks when I wear my sunglasses as they go far enough down over the mask to prevent it. My other frames with my current prescription would be fine too I think - but they are scratched ...

MrsNails
MrsNails in reply to PMRpro

I had my sunglasses on the other day & was wondering around in a brown tinted steamed up haze 😎

PMRpro
PMRproAmbassador in reply to MrsNails

Bit risky!!!!

Thelmarina
Thelmarina in reply to MrsNails

Glamorous. Think Marilyn Monroe 👍😀

DorsetLady
DorsetLadyPMRGCAuk volunteer in reply to MrsNails

Try one that has adjustment around nose and valve - both seem to help the steaming up issue - not the cheapest, but if we’re going to wear them for months to come worth it -

facemaskfashion.co.uk/?fbcl...

MrsNails
MrsNails in reply to DorsetLady

I have an assortment of masks 😷 l actually find the fabric ones the easiest but really prefer Medical Grade Disposable Masks but they are the ones that make me Steam Up.....

I should be going out later but have bribed Terry & l’m staying home......

Having a real Post MTX Day, DrD has increased my dose to 25mg 😱 so l’m back in bed wrapped in a shawl but a very glamorous one to match my bedding! 😉

Suffererc
Suffererc in reply to MrsNails

What is your post MYX day like(I know what MTX is). I am trying to convince myself that might be an option for me on GP advice. I have refused so far, but things not going well at moment

MrsNails
MrsNails in reply to Suffererc

Hi....

It’s not an easy drug but the first time l was started on it, it worked really well & l got down from 18mg (l’d been stuck at 20mg for some time) to 7.5mg

This is my third time on it, l’ll attach My MTX Story but it needs updating! DrD has recently put me up to 25mg & l’ve never been higher than 20mg previously but l’m really struggling at the moment.

A Post MTX Day for me & everyone is different usually finds me much more tired & lacking in energy, not like the fatigue we get with PMR but at the moment l am generally just not as well as l have been.

When l first went on it, l took it on a Sunday but kept Monday clear so if l wasn’t up to it, l could just stay home....

You do adjust to it in time & to be honest l hardly had Post MTX Days, it’s just now l’m generally more ‘unwell’ anyway.......

I attach the Link as promised but happy to answer any of your questions.

Kind Regards

MrsN

healthunlocked.com/pmrgcauk...

Suffererc
Suffererc in reply to MrsNails

Thank you . Can’t open the link because of status 404 whatever that is. Thank you for replying. One other question, does MTX actually help the PMR or just lower the Pred, but the pain will still be there. I don’t think I am struggling my GP is worried about me being on Pred for nearly 3 years. I look at it as half way there now and she is stressing me out having to think about more meds. 😊

MrsNails
MrsNails in reply to Suffererc

Hi, go into my profile, just click my name or photo on this reply & scroll down you’ll find it on there.

They are not sure why MTX or other DMARDS (Disease Modifying Anti Arthritic Drugs) work as a ‘Steroid Sparer’ but for some people it does......

It certainly did for me the first & second time, this time not so much ☹️

You can PM me anytime if you have a specific question(s)

MrsN

Suffererc
Suffererc in reply to MrsNails

Thank you.😊

PMRpro
PMRproAmbassador in reply to Suffererc

healthunlocked.com/pmrgcauk...

I assume it is this one? Works from here - how strange

Suffererc
Suffererc in reply to PMRpro

Yes thank you. It works. Don’t know why the other didn’t.

Suffererc
Suffererc in reply to PMRpro

How can I save it please.

Suffererc
Suffererc in reply to PMRpro

It ok I found how to save. Thanks 😊

Dewdrop456
Dewdrop456 in reply to MrsNails

I hope you will feel better very soon.

I hope you’re on commission for this! 😂

DorsetLady
DorsetLadyPMRGCAuk volunteer in reply to Thelmarina

Unfortunately not! I have 2 different ones (1 in the wash, 1 to wear!) at the moment, and very happy with them - so as and when I need more ........

Suffererc
Suffererc in reply to MrsNails

Many wore masks from the beginning or some sort of covering. Wipes were seen everywhere too. We always get protests here whatever is advised.

If the rules were followed, albeit they change quite often(the virus has no rules) perhaps we might see a light at the end of the tunnel. Political parties now point scoring again aren’t helpful.

I nor a lot of my friend don’t know anyone who has suffered personally, hopefully that keeps up. Wearing masks has it discomfort but still worth wearing

Have to agree with everything Mrs N says, it was just yet another area where they were totally unprepared. Wearing a mask with any sort of respiratory virus just strikes me as being logical and common sense. Fortunately I don't have to wear glasses for walking or driving so the steaming up is not the end of the world for me. OH finds it really hard though.

PMRpro
PMRproAmbassador in reply to Bcol

They didn't have supplies here in Italy either - so got people to improvise. It is already mandatory in some places again but I gather it is about to be made mandatory outside as well everywhere, It is such a simple measure and as soon as it came in the figures fell - people have got lazy and blasee and the numbers are rising again.

Bcol
Bcol in reply to PMRpro

As you say a simple measure, and people have definitely got lazy/blase. Daughter in law no.2 actually makes masks with a transparent window for those people who need to be able to see lips and/or expressions.

Longtimer
Longtimer in reply to Bcol

I can't see why those type haven't been massed produced, it surprising not seeing people's lips moving that you don't get everything they say....

Especially for those that have to lip read too of course....

Bcol
Bcol in reply to Longtimer

No, I agree its weird I would have thought that one of the big firms would have sussed that one by now.

Longtimer
Longtimer in reply to Bcol

Exactly, perhaps your DIL, could be onto something!!.. 👍

Bcol
Bcol in reply to Longtimer

She does it from home, she has 7 children and three of them have a disability and she sells them on at very nearly cost price and free for those in need. No idea how manages the time!!!! Peter

disabilityonline.co.uk

Longtimer
Longtimer in reply to Bcol

Wow, if I had a hat I would take it off to her!....

Bcol
Bcol in reply to Longtimer

She is an amazing lady with fabulous children and the three with disabilities are all four and under.

Longtimer
Longtimer in reply to Bcol

Oh dear, what a strong lady in more ways than one.....I hope she keeps safe and well!

PMRpro
PMRproAmbassador in reply to Bcol

I did see one commercial one - out of stock!!

Bcol
Bcol in reply to PMRpro

About par for the course

diana1998
diana1998 in reply to Longtimer

And it's hard to recognise people in masks and can't read facial expressions.

Longtimer
Longtimer in reply to diana1998

Yes, but we can put our tongues out!....joking of course.....

diana1998
diana1998 in reply to Longtimer

🤣😂🤣😂 Naughty!

Pongo13
Pongo13 in reply to Longtimer

At work we have masks with clear Perspex centre so kids, and a coworker with hearing probs, can see our mouth. (Steaming up still a bit of a problem).

Longtimer
Longtimer in reply to Pongo13

Very good....understandable....

Thanks again. I think I have persuaded most of my family and friend, but I will still keep banging the drum!

PMRpro
PMRproAmbassador in reply to Omanain

An Italian medic friend keeps posting superb memes on FB comparing wearing a mask with being ventilated - discomfort, interfering with breathing, liberties and whatever. I can never find the originals to pass them on anywhere besides FB though!

jinasc
jinasc in reply to PMRpro

I bought the Ocean View (remember). First time wearing to go to Warfarin at hospital, could not breath or see. So back to the drawing board.................then the weather was fine and I had a call from Neil (hairdresser) he could come and dry cut my in the garden. He came with mask and a Visor. So I now have a "Made in UK" Visor Grade 3 - shatter proof, no steam etc and you clean with alcohol (no I don't use my brandy..............brilliant.

Rose54
Rose54 in reply to jinasc

I have ocean view and find them perfect very comfortable and fit well.

But agree about steaming up .

Unfortunately thay are no longer suppling general public its gone to account holders only

PMRpro
PMRproAmbassador in reply to Rose54

Yes, we got the email asking if we wanted to buy before we couldn't. But there are so many options out there now and we go out so little it will be a while before we need more as we got 12 to start with.

these Ocean views are really great masks, but I bought a 'variety multi pack' of 3 colours each for my husband and I ... unfortunately both packs were the same colour mix, one white, one blue and one gray, and at the time we didn't have the brains for each of us to take two of the same colour to save fighting over who's is who's when they come out the washing machine... numptys! ... but they are great masks, comfortable, no steaming up ad d have a 'nano silver' lining bit in them (they said) which is supposed to help and no doubt justifies the price? So, if I only have mine on for an hour or so, I hang it up outside to air and rotate with the others (I really don't go out that much) so I'm avoiding so many washing machine discussions... its a shame theyre only wholesaling now as when we eventually have to replace them I guess it wont be possible to get more, unless a wholesale purchaser puts them on sale?

I was sent a graph that I don’t seem able to copy here (it’s a photo). It’s from the US and clearly shows that infection rates are higher in places where people take there masks off, bars/coffee shops, gyms, places of worship. Shopping, offices and salons were a lot lower.

squashie
squashie in reply to Griggser

Here in Melbourne, we've become mask wearing experts with the long lockdown. A fellow shopper at the greengrocers gave me the simple solution, Just wipe your specs with a little dishwashing liquid - only a few drops. Lasts for a few days.

London is such a mixed lot. I am now on buses and some just do not wear masks. I loved visiting Italy - no ifs ands or buts - you went inside you had to wear a mask.

PMRpro
PMRproAmbassador in reply to whitefishbay

And they are considering making masks compulsory outside again - they aleady are in some regions. A couple from here were on holiday in Tuscany last week - were arrested and handcuffed for getting out of their car without a mask! They don't mess about here ...

whitefishbay
whitefishbay in reply to PMRpro

I like it. No I love it. Here it is ridiculous. In the NYTimes they talk about only narcissists don't wear masks. Some people have valid reasons to be exempt in the UK but not most of the maskless. Funny how there are no Italians exempt from wearing masks.

Thelmarina
Thelmarina in reply to PMRpro

Bet that gave them a shock! 😅

Didn`t think you were allowed on any public transport without a mask, it should be nationwide, it is compulsory in this city.....

OH has now gone out with mask at the ready....

Haha. Most people wear masks but there are quite a few without.

Are they exempt? Who knows. No one challenges. That’s why I like going to Italy. No questions- Put on your mask you are told as you enter anything.

Yes, I agree......mixed messages not helping anyone.....

Bit of a frivolous comment here BUT wearing a mask covers the wrinkly saggy bits on my face. I'm building up quite a selection now to match different outfits!!! I knew there had to be some good news somewhere ..........

PMRpro
PMRproAmbassador in reply to borednow

I see it in the fact that even if a mask is a bit inconvenient/uncomfortable - it's not half as bad as getting up close and personal with an oxygen supply, not to mention a ventilator!

Thelmarina
Thelmarina in reply to borednow

Also no need to bother with make up, that plus specs and hat means I can meet neighbours without flinching 😂

borednow
borednow in reply to Thelmarina

Every cloud and all that !!!!!

Listening to a depressing phone in radio show that is discussing face masks in uk. Apparently it is law to wear one in shops but stores won’t/ can’t enforce it. Local councils are telling the stores it is the stores responsibility but the Business Secretary has said don’t force the issue.

The abuse that shop workers are getting is horrendous.

What is happening to our society when people will not take a simple measure to protect one another?

Longtimer
Longtimer in reply to Teekay2

Unbelievable...why bully the staff??

My son is an engineer in care homes, last week he was shocked when he was sent to London, and wore his mask in the boiler room, he saw two engineers walking down corridor without masks!!....care workers had them on, can't blame the goverment, where was the management to tell them!!.....

Have saved the nejm article. Thx.

There was a nice quotation on FB the other day, basic message was that wearing a mask was a simple and easy way to show we care for our fellow humans, no matter what our personal feelings are about the mask.

Kendrew
Kendrew in reply to HeronNS

Been reading all the comments and yours reminded me of an altercation I had with a young man two weeks ago. I was in M&S Food, and he walked in holding the neck of his t-shirt up over his mouth and nose. I heard him say to his mate; "Uuh! Better show willing, otherwise it upsets the oldies"! I flew over to him and gave him a right verbal pasting! When I'd finished my rant, I realized I'd been wholly inappropriate but to my utter delight, I received a huge round of applause from other customers!! Job done! Oh...and according to the very young manager....the staff aren't expected to address this if people come in without a mask. I'm sorry, but why not?? Nobody was expecting them to wrestle him to the floor. It's not difficult to ask if someone has a medical reason they can't wear one! If they say no, you ask them to put one on or they'll have to leave the store. If they say yes then no further action....even if you know they're probably lying.

Sending good wishes to all you lovely people and thanking those who have helped me...and still are....for your advice and support. Take care everyone.

PMRpro
PMRproAmbassador in reply to Kendrew

Good for you. And how might he feel if his gran caught it from him and died? Apparently shop staff are being abused and threatened if they tell toe-rags to mask up.

I was watching a water rescue exercise in the village last week - young lad, about 12, was obviously out for a run and stopped to watch. No mask, but every time he got anywhere near anyone he pulled his hoodie up over his face - I was really impressed, Even more by the organiser who shouted "get your mask over your nose!" to the "rescued" person who was strapped onto a spinal board in a cradle attached to ropes to be transported across the river to the bridge to be rescued!

Kendrew
Kendrew in reply to PMRpro

Haha! Unbelievable!

t's not right that shop staff are being abused and thats completely unacceptable. The manager said she would be happy to speak to any person not wearing a mask to which I reminded her (in a very annoyed tone of voice) that she had been nowhere to be seen so how did she intend to do that from her office upstairs when she'd no idea what was happening on the shop floor! I frequently have to tell parents of my nursery class to put their masks on at the nursery door....and to not send their children in with toys from home....and have even turned a child away at the door for rocking up coughing continuously......for which I also received some verbal abuse. It's not easy but it's what's required in order to help make life a bit safer for us all. So many imbeciles and stupid selfish people. Thank goodness most people aren't that stupid!

jinasc
jinasc in reply to Kendrew

I could not wear a mask, but the visor is fine. I told a very close friend of mine who has COPD and when he goes out he has his oxygen bottle in a bag over his shoulder. He had stopped going for his walk early March. Although he was medically exempt he did not wish to pass it on if he did get it. So he tried the Visor, now he can go out for his newspaper and that has freed him from the house and garden.

HeronNS
HeronNS in reply to jinasc

Sadly, the visor is much less effective. I only make this comment so people (like me) who find wearing a cloth mask difficult don't assume a visor will solve their problem. Anyone capable of wearing a mask should continue to do so. That alone will in fact help keep those who genuinely can't stay safer.

Kendrew
Kendrew in reply to jinasc

We've just had a new directive for schools from the local authority with documentation that says visors alone offer little protection because exhaled breath seeps around edges and up through base of visor , therefore we're advised we don't need them. I'm not sure how reliable that information is. Others may know more.

HeronNS
HeronNS in reply to Kendrew

I think this is true. Medical people, like dentists, wear them in certain circumstances for their own protection, but in addition to a mask. I know when things reopened here some people wore visors and no mask, my hairdresser, library workers, but I note they have all ditched the visors and are wearing masks now. One advantage of a visor is it protects your eyes.

I'm a strong advocate for mask wearing for any airborne, droplet spread infection especially COVID.

However, it has concerned me and I wonder .....why in Wuhan China where probably 90% to 100% of the population were already wearing masks everyday , due to enviromental poor air quality, prior to COVID ....then why did the disease spread so quickly ?

I'm really frightened that after what we witnessed on the news last evening from the US President , mask wearing is going to get more difficult to encourage and enforce as a method of flattening this second wave of COVID.

Everyone stay safe..take care..

Knitwit2020

PMRpro
PMRproAmbassador in reply to Knitwit2020

The most likely place to spread is at home where no masks are worn and this is one theory about the Wuhan epidemic:

"It was obvious that the outbreak did not begin at Wuhan wet market once it was known that patient zero, an elderly housebound man had been admitted to hospital on 1st December and the virus causing his illness had been isolated on the 8th of that month. The Wuhan patients from the market started being admitted to hospital by mid-December so it is clear they were introduced to the disease after the elderly man, who himself must have been infected by someone who caught the virus around 15th-25th November. Furthermore several studies looking at mutations in the virus have predicted the virus infecting humans before mid November and one has implied August 2019 as the date of first infection. No-one really knows and it is equally possible that this virus has resided in humans for years. It is likely that the virus emerged in a rural area, anywhere between several years and a few months before December last year, circulating at a low level in the local population, gradually adapting to life in its "new" human host. I also doubt infection arose from contact between humans and any of the animals so far proposed as possible intermediary hosts. My personal theory is that not enough attention has been focused on the Chinese intensive meat-rearing industry - particularly pig farms. The only attempt I know about to introduce the virus to swine was one in which a virus sample was applied to the nose of pigs, this apparently failed to secure infection. Yet we know that pigs are very susceptible to coronavirus infection and we know a pig became infected with SARS-Cov in 2004 by its owner."

It was here in Europe in the autumn, in California in November. Probably sooner, So it had been circulating through families, spread by young workers who picked it up at work or when out at discos or restaurants and took it home. We see now that intensive food production units can cause major pockets of infection - all staff wear masks at work but pick it up from surfaces and the atmospheric conditions mean it gets onto skin, can get into the body through the eyes for example. One person passing it on to their family, friends, colleagues can lead to a massive multiplication of cases after only a few weeks. One case in a restaurant - no masks there - with the wrong sort of air flow can infect a lot of other people. Especially the big buffet ones common in the Far East. It is thought here that well over half of patients either have no or very mild symptoms that wouldn't be noticed - but they spread it very efficiently.

MrsNails
MrsNails in reply to PMRpro

Have you seen the Film “Contagion”? We watched in June & sat there nodding & concurring exactly how these things can spread......

PMRpro
PMRproAmbassador in reply to MrsNails

Not my scene - real-life disasters are bad enough! OH liked disaster movies!!!

MrsNails
MrsNails in reply to PMRpro

It was very interesting as the camera work focused on people coughing then touching a door or whatever then the next person coming along, it was only at the end we discovered who had been Contact Zero/One.....

HeronNS
HeronNS in reply to PMRpro

Exactly what happened in Canada in the "first" wave. Cases were rampant in some nursing homes, and also major clusters in food production - meat packing plants, field workers living in bunkhouses. Now with "second" wave in our highest population provinces we see spread amongst young people, and last news report I heard no move to close bars and restaurants in Ontario, although I think Quebec finally did so very recently.

PMRpro
PMRproAmbassador in reply to HeronNS

Last weekend we had local authority elections - and there was a celebration for one of the winning parties in a local small town. In a Gasthaus. Most of the councillors now are positive - and a focus of 22 confirmed cases and over 100 in quarantine in the 2000 population town. We suddenly also have a load in quarantine, as do a few other local villages. Don't tell me it doesn't spread in pubs ...

HeronNS
HeronNS in reply to PMRpro

Sounds like what's going on in the White House!

What they did during the spring lockdown in NS was actually to make it a lot easier to buy liquor to be imbibed at home. Many restaurants were able to stay sort of open by selling for takeaway only, contact free pick-up or delivery, and if they had a liquor license for regular service they were allowed to supply drinks to the customers with their food order. They also allowed a number of the liquor stores, which are government-run, to stay open for limited hours and controlled numbers in the store - rather like the grocery stores. So there was no free-for-all when the bars reopened because somehow we'd all been kept satisfied and also trained in new behaviour. There was a lot of grumbling that the bars opened before the schools, but as we appear to have been covid-free by then there has, so far, been no transmission either in bars or schools. However number control, although recently increased, and masking protocol, and distancing between "bubble" groups, remain in place. So far so good, we hope people coming into the Atlantic Bubble continue to observe their two-week quarantine upon re-entry as all new cases for several months have been travellers entering or students returning.

katie-w53
katie-w53 in reply to PMRpro

Interesting that the virus was circulating in Europe back in August 2019. If that's the case, how are the authorities still sure it originated in China? Also, given that it remained under the radar at that time, I wonder if that was a weaker strain - you'd think it would be noticed if lots of people were dying.

My parents and I had a very Covid-like illness at the start of December (pretty much bed-ridden for a week, fever over 39C, couldn't speak for coughing, reduced sense of taste). I don't suppose we'll ever know if we had it, but begs the question doesn't it.

PMRpro
PMRproAmbassador in reply to katie-w53

All in the genetic codes - each of the regional variations are slightly different and can be tracked. I imagine in the early days it was abit like now - predominantly assymptomatic or minor symptoms in younger people and where people did get ill they assumed, as they did initially in Wuhan, it was just pneumonia, the old man's friend. Then a doctor looked at chest x-rays and realised it was something nasty and noticed common factors. And Big Brother didn't like it being pointed out which delayed things a bit longer. You have to remember China in particular doesn't have an NHS - and some areas are very remote and poverty stricken.

katie-w53
katie-w53 in reply to katie-w53

Yes, my Dad had pneumonia with the December virus (aged 85) but it cleared up at home with antibiotics (maybe that says is wasn't Covid??). Never had a chest x-ray I don't think. I guess we'll never know.

PMRpro
PMRproAmbassador in reply to katie-w53

Might if you have an antibody test done - if it is positive it will be right. Negative you still might not know.

HeronNS
HeronNS in reply to Knitwit2020

I suppose the wearing of masks because of air quality is different than for infection control? You wouldn't be as careful about touching the face mask with your hands, for example, or about wearing one in a crowded restaurant or air-conditioned office building. And even the kind of mask can make a difference. The N95 masks with a valve are sold for people working where the air is contaminated to protect their own breathing, as in working with chemicals or in dusty conditions. The valve allows their own breath to escape and are therefore useless for infection control.