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Managing us or managing the virus?

Lenawee, Mich. non-profit finds 16,000 N95 masks in warehouse

“When historians tally up the many missteps policymakers have made in response to the coronavirus pandemic,” Jeremy Howard, a distinguished research scientist at the University of San Francisco wrote Saturday, “the senseless and unscientific push for the general public to avoid wearing masks should be near the top. “

It may be moot now. Surgical and N95 masks are virtually unavailable for purchase. Communities are scrounging for them in basements, neglected warehouses, and cathedral crypts for donating to hospitals. People are sewing their own masks and donating them to healthcare workers despite advice from authorities against wearing masks in public to prevent the spread of the novel coronavirus. Why, wearing them might even increase your risk of contracting COVID-19 if you are not a health care worker, Surgeon General Jerome Adams told “Fox & Friends” on March 2.

That “wisdom” is being challenged now, as the New York Times indicated on Saturday. Politico this morning adds to the sense that U.S. authorities trying to manage the pandemic are also trying to manage the public. To be sure, they are trying to reserve the scant supply for medical professionals. Perhaps they are also trying to cover for the Trump administration’s failure to prepare for and coordinate distribution of medical during the worsening pandemic:

But as the crisis has played out around the world and intensified in parts of the U.S., reasons have emerged to doubt the wisdom of this guidance, which ranks among the most forceful warnings against mask use by national health authorities anywhere and does not differentiate between medical-grade masks and simple cloth coverings. A number of societies where mask use is more widespread, and where mask shortages have been less severe, seem to have had more success containing the virus. Now, some health experts, who say there is no evidence for the claim that masks increase users’ risk of catching the virus, are calling for more widespread use of face coverings in the U.S.

“Guidance needs to change and needs to be clear that these nonmedical, nonsurgical masks are beneficial to the general public and should be worn when outside of the home,” said Robert Hecht, a professor of epidemiology at the Yale School of Public Health.

Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review,” The British Medical Journal. 2008 Jan 12; 336(7635): 77–80.

The Centers for Disease Control told Politico it stands by existing guidelines that people who are well should not wear masks to prevent contracting the virus.

But extra measures might have kept more members of the Skagit Valley Chorale healthy. On March 10, sixty members showed up for scheduled practice in Mount Vernon, Wash. The first U.S. COVID-19 death had occurred on Feb. 29 in Seattle, an hour to the south. Arriving choir members used hand sanitizers and refrained from the usual hugs.

The L.A. Times report continues:

Nearly three weeks later, 45 have been diagnosed with COVID-19 or ill with the symptoms, at least three have been hospitalized, and two are dead.

The outbreak has stunned county health officials, who have concluded that the virus was almost certainly transmitted through the air from one or more people without symptoms.

Perhaps existing guidelines are lacking, Politico’s report suggests:

The current federal guidance against wearing masks is at odds with that issued in many other parts of the world, such as the Czech Republic, Beijing and Shanghai, where mask use has been mandated for anyone going out in public. A number of East Asian societies, where mask use is widespread — such as South Korea, Hong Kong and Singapore — have reported lower levels of infection than the U.S. has, despite being closer to the source of the outbreak in Wuhan, China. In Taiwan, where reported levels of infection are also relatively low, authorities have called for people to use face masks whenever they are in enclosed spaces, such as public transportation.

Some Western authorities and public health experts have also begun calling for more widespread use of face masks. On Monday, the government of Austria mandated the use of face masks for anyone entering a supermarket.

I did that for the first time when the neighborhood grocery opened at 7 a.m. Monday. I too found a box of long-expired masks (like those at the top) in the back of a linen closet.

Guess which countries emphasized wearing masks in public.

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Note: The pandemic will upend standard field tactics in 2020. If enough promising “improvisations” come my way by June, perhaps I can issue a COVID-19 supplement.

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