Posts Tagged Masks

Leadership

I don’t know about you, but I’ve gotten pretty tired of this rule by decree we’ve fallen into at every level of government and party now. I’d love to blame our terrible political class, but we are the ones who vote them into power – we’ve fallen prey to a miserable tribalism in America and elect politicians purely on cultural grounds instead of their ability to lead.

But we need these decrees you say, why if everyone wore a mask we’d have this infection licked. Maybe, but even so I see plenty of people walking around with masks below their noses or even their mouths or wearing bandanas or balaclavas so they are technically in compliance but not really helping. And there are enough nut jobs on both sides of the mask divide or people who can’t stand even a whiff of perceived criticism I just roll my eyes. And my eyes are getting worn out over way more than just masks.

Leaders educate and motivate so that when crunch time comes we all work together to get the job done. We are stuck with politicians and a media that do their darnedest to make us dumber, divided, and sullen by hectoring and lying.

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Masks Gone Wild

How to correctly wear a mask – it’s left as an exercise for the viewer to determine which of the three ways presented are correct.

I demonstrated a fourth way yesterday as I put mine on my wrist as we walked from the library to the grocery store as a way to keep it handy but not worry about losing it. You should have seen the looks I exchanged with drivers wearing theirs.

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Masquerade

There is a chart that’s been floating around the inter webs for a while now that purports to show the effect of masks on coronavirus spread.  Let’s just say it’s more full of shaving cream than a 10 pound can of Barbasol.  Rather than delve into the chart, let me provide my thinking (right, wrong, or indifferent) about maskology.  

Let’s start with how you get infected.  You have an infected person who is emitting viruses.  You have an uninfected person who is taking the viruses in.  If you don’t interact with an infected person, you can’t get infected (I include encountering their viruses later on a surface and then taking that in somehow as part of interacting, but since this is about masks and CDC says (and let’s hope their right about something for a change!) surface contact is an unlikely infection route we will ignore it). 

So rule number one is limit your interactions with other people, and one A is don’t touch your face until after you wash or otherwise disinfect your hands.

But let’s say you do interact with an infected person.  You have to take in a certain threshold of viruses before you are likely to become infected, so you can think of it as ignorable risk until you hit a certain number, then your risk rapidly climbs as you take in more, and then it reaches you’re pretty much going to get infected after this number  – a big S curve of risk versus viral load (number of viruses you take in).  And you know what – the value where the risk starts to climb, where it hits 50%, and then becomes virtually certain is going to vary somewhat by person.  But for the sake of this thought process we’re just going to say when you hit a certain viral load you’re infected.

How much virus that person emits depends on what they are doing – just breathing, talking, sneezing, coughing, singing, talking loudly and excitedly, etc.  And again, it’s going to vary from person to person based on how infected they are, what stage of their illness they are in, and probably another half dozen things that we are, you guessed, going to ignore other than people emit the virus at different rates.

So you have an infected person, not wearing a mask, they emit virus at a rate such that at the geometry (i.e. distance, relative positions, direction of emitting and taking in) the uninfected person will receive an infectious viral load in 10 minutes.  So if you interact with that infected person for 10 minutes you become infected.  For you advanced thinkers out there, we’ll pick the leading edge of the rise in probability so we can say you can stand there for 10 minutes before you start up the rise in infection so you’re safe as houses until that 10 minute mark.

Now let’s add a mask.  The infected person puts on a typical cotton mask.  This reduces the number of viruses that reach the uninfected person – but by how much?  And that’s where the evidence get’s thin.  So I’m going to pick a reasonably conservative number that also happens to make the math work out easier, and say that the mask decreases the viral load per minute by 30% – so 70% makes it through.  I know, I know, if you blow particles through the material you may well come up with a higher value, but given fit, variation etc. etc. I’m picking a value that is for illustration purposes only since we don’t know the real value and it probably will vary with how well it fits, the actual material, if you wear it below you nose like some people do, etc. etc.  So that means that means you need 1/0.7 longer to reach the infectious threshold so I’ll do the math for you that means 1.4286 times longer or about 14 minutes, 17 seconds instead of 10 minutes. 

Now let’s add another mask.  The uninfected person puts on a typical cotton mask.  I’m one of those weirdo’s who thinks that to a first order if a mask  stops virus from leaving at a certain rate it stops it entering at the same rate, so we will pick the same 30% reduction.  That means that 49% of the virus gets through (70% times 70%) which I’m going to round to 50% to make the math easier.  Which means you have twice as long, 20 minutes instead of 10, before the viral load reaches the infection point.  So I think that instead of saying a mask cuts your risk by x% it’s better to think it takes longer, probably significantly longer to reach the same risk level as without a mask.

That’s how I see masks working.  They allow you to interact longer with infected people before becoming infected yourself.

What does that mean in practice?  Here’s an example.  Let’s say you go to get your hair cut.  Amy and Betty are both infected (so, yeah, a true story except for the names), and both take 10 minutes of close interaction to complete a haircut.  And the rules are both you and the stylist are masked.  When I get my haircut, the stylist is above and right behind breathing over the top of me, so the geometry is not good.  Let’s say Amy, for whatever reason, emits enough virus that without masks you are infected in 6 minutes.  So with masks, it will take 12 minutes.  You only interact for 10, so you and everyone else whose hair she cuts are not infected.  Man, masks are wonderful!  

Betty, for the sake of comparison, emits emits 50 percent more virus – maybe she’s a non-stop talker, maybe she’s a loud talker, maybe she’s in poor shape and breathes heavily, maybe all three, who knows – enough virus that without masks she infects others in 4 minutes.  So with masks, it will take 8 minutes.  You interact for 10, so she infects everybody whose hair she cut that day.  Man, masks are worthless!

So tell me, what is the effectiveness of masks if someone did a study?  If Amy and Betty work at the same salon and were infected the same day, you would be tempted to say 50% since half of the people who got their haircut that day were infected and everybody wore masks.  If Amy and Betty worked at different salons and were sick at different times, you would likely see one study that said masks are 100% effective and another that said they had no effect – and all of us would go see, I’ll keep right on believing what I want to believe because SCIENCE!

I will mention that there is some evidence and a lot of feeling that viral load affects how sick you do get with COVID, which is a very variable disease in its severity, so even Betty’s clients may see benefit from wearing a mask because even though they still were infected, they might not get as sick as they would have if they didn’t wear a mask.  

Masks are one more layer of protection that ultimately can be overcome, so wear them but don’t rely on them.  

And if you see a graphic that says if both people wear a mask you only have a 1.5% chance of infection, remember it’s full of shaving cream.  You stay close enough to an infected person long enough, you’ll get infected too even if you both wear masks (unless you’re both wearing N95s in which case it would take literally days).

For really super advanced people, let’s talk N95 masks which in theory are guaranteed to only let in 5% of tiny particles, so you would have 20 times longer – so if it takes 10 minutes without masks, just you wearing an N95 would give you 200 minutes before starting to run the risk of infection.  And I’ve read that they let in more like 3%, so you have 33 times longer.  And N99 masks – well, you get 100 times longer.  That’s right, an N99 is not 4% better than an N95, it’s 5 times better.  When you compare masks, you need to compare what they let thru, not what they stop.

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You Can Tell Them Apart by the Mask

Funny how masks became another way we divide ourselves into two opposing tribes. The science and data for the effectiveness of cloth masks on lowering your transmission or susceptibility to viruses, let alone the Wuhan virus, is inconclusive, so I suppose it lets us argue while each side can claim the mantle of science and data. What would be really nice is if we could get some elegant experiments soon enough to guide us.

I come down firmly on the side of I don’t know, I don’t see how it hurts, so I wear a mask indoors but not outdoors. But if I don’t happen to have one and I need to go indoors, I don’t sweat it. Basically, my value proposition is the cost is low and the benefit is unknown but probably there. Full confession, I have a couple of old N95 dust masks so those are the ones I usually wear and I do think their benefit is likely and large despite age and use. So yeah, I cheat.

I do find a few things interesting about the tribes. Back at the start of this, when the recommendation was don’t wear a mask because it doesn’t help and you are depriving heroes from theirs, it was the compliant kids who were all about not wearing the mask while the rebels were all about asking why not – pointing out that people always wore masks in prior pandemics and that asian countries which were doing well against the virus all wore masks and then one day the experts said, hang on, asymptotic spreading changes everything and the whole world flipped upside down on masks. Masks don’t stop you from catching the disease, they stop you from spreading it (no word on what all those medical personnel wearing masks felt about this turn of events). Now the compliant kids are all about wearing the masks, urging others to wear a mask for the sake of their fellow man, not themselves, and the rebels are all like how did cloth become one way so that it lets the virus in my mask but doesn’t let it out of your mask and there’s no data while forgetting about all those reasons to wear one they pointed to before the experts said wear a mask. Strange.

I get the effect of the Trump distortion field on Hydroxychloroquine which means once again we divide up into tribes based on how we feel about Trump. But if you think a medicine is effective or not, or hope it’s proven to be effective or not based upon how you feel about a particular politician, you really should have your head examined. It’s almost enough to make me despair for humanity. The only sane, human, reasonable, caring position is that you hope Hydroxychloroquine is effective against COVID19 (but only rigorous efficacy trials can prove it) so that we have an effective treatment and many lives are saved and much suffering is reduced or averted. I would have preferred that gargling with hot water was effective as a whacked out viral video claimed way back in late February even though that meant that some crazy quack was right because look at how many lives would have been saved and how much suffering would have been averted if only it were true.

When the facts change, I change my mind.

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