How long can we wait while flattening the curve?

[waltworks]

I guess it's possible masks made things *worse* - I've observed the same. At the store I try to give everyone 6 feet of space - which is a lot and takes conscious effort. Basically nobody else does this - they'll squeeze right next to each other to dig through the freezer case, stand 2 feet apart to chat, etc. Nobody pays attention to the one-way signs in the aisles.

But they're wearing masks, and sanitizing the handles of their shopping carts, so...

At this point it probably doesn't matter, and hindsight is 20/20. But if I were a betting man I'd bet masks had a net effect of zero. The sanitizing everything stuff probably also had no effect. Health theater. C'est la vie.

-W

[Michael in ABQ]

I just finished a very interesting article in the New Yorker.  Why Does the Pandemic Seem to Be Hitting Some Countries Harder Than Others?
https://archive.is/YJRsM


Basically it looks at the death toll in places like Bangladesh, India, Nigeria, etc. that in theory should have been much higher due to inadequate healthcare systems, lax mask use, minimal government response, etc.. However, many of the countries in Africa and Asia have experienced death rates that are an order of magnitude or two lower than predicted. Certainly far lower than rich western countries experienced.

Some of that can certainly be attributed to demographics (not a lot of 80-, 90-year old folks in Benin or Bangladesh compared to the richer countries in North America, Western Europe, and east Asia). However, that doesn't explain all of it. The article also looks at some immunity from other diseases like previous version of coronavirus. There's probably also a lower rate of comorbidities (diabetes, obesity, etc.).

In the end it will probably be years before studies are published and we fully understand why places like Italy experienced such a high death toll while people crowded in the slums of megacities in Africa and South Asia were barely affected.

[jehovasfitness23]

Per the mask comments, they definitely help but as said there are some caveats. Also, there is the type of mask that matters as well.

Here's a real world example of masks very likely working

https://www.livescience.com/hair-stylists-infected-covid19-face-masks.html

[pdxvandal]

Masks help to some degree, no question, but I'm also skeptical about the need to sanitize every surface. It's just not how Covid spreads. Remember when the pandemic first hit you had Dr. Gupta on CNN telling viewers what kind of foods to use a Clorox wipe on from your grocery bag? Silly, at least in retrospect.

I still wear masks everywhere indoors in a public place, but am feeling more confident in eating at restaurants as well as plane travel -- my first flight in 14 months is scheduled for April.

Public K-8 schools also should have been open nationally since January at the latest. There is no evidence schools with young students are spreading Covid (well, high schools and colleges, a bit). My kid is starting a hybrid model next week (after nearly a full year of online).

Anyway, I'm confident Covid is finally beginning to thaw, as more vaccine types are on the near horizon and the virus is having a harder time latching on to people who've been vaccinated or already had it. I'm looking forward to summer and whenever herd immunity is reached!

[GuitarStv]

Public K-8 schools also should have been open nationally since January at the latest. There is no evidence schools with young students are spreading Covid (well, high schools and colleges, a bit). My kid is starting a hybrid model next week (after nearly a full year of online).

In Ontario transmission among school age children was consistently higher than for every other age group starting after school re-opening last October until it was out at the end of December.  Few kids get sick and show symptoms, so testing of children is typically way lower than testing of adults though.  It remains to be seen if this trend continues now that schools have re-opened here again.

[jehovasfitness23]

I still wear masks everywhere indoors in a public place, but am feeling more confident in eating at restaurants as well as plane travel -- my first flight in 14 months is scheduled for April.

Public K-8 schools also should have been open nationally since January at the latest. There is no evidence schools with young students are spreading Covid (well, high schools and colleges, a bit). My kid is starting a hybrid model next week (after nearly a full year of online).

Curious why you feel comfortable eating indoors knowing it's more likely transmitted via air than touch.

Also, everyone talks about opening schools cause kids are ok and not a big spreading area. What about teachers and staff?

There were 3 teachers in one GA school district that died w/in a month.

School staff should have been first in line to get vaccines imo, maybe not over nursing homes, but there could be an argument for it

[PDXTabs]

Also, everyone talks about opening schools cause kids are ok and not a big spreading area. What about teachers and staff?

There were 3 teachers in one GA school district that died w/in a month.

I don't have a horse in this fight, but I have a hard time saying that Scotland is a reckless or irresponsible government: Covid in Scotland: Youngest pupils to return to classrooms.

[Poundwise]

My kids' public school will be opening up full time next week for K-2 students.  All the teachers and staff have had access to vaccines (and I believe the majority have chosen to be vaccinated).  They surveyed parents, to the extent of individually calling each family, and those who wish to keep their children remote or on a hybrid schedule may do so. My feelings are mixed: all the frail elderly in our family have been vaccinated or will be vaccinated soon, but husband and I will probably not get them until April or May at the earliest. We have no desire to catch Covid even though it's likely we'll survive, as we know a lot of people who had a rough time with it, and we don't know what the long term effects on health will be. There's no point in doing hybrid since the cohorts will be mixed, so we may as well go full day or full remote.

But school has been good about safety measures (always masked, 6 feet apart) and we haven't seen much in the way of spreading within classes, though there hasn't been any time in the school year where we've seen fewer than 3 cases a week over the whole school. So, the temptation is strong to choose full time school.

[chemistk]

There are other threads in the Mini Mustaches section that go into deeper discussion about schools being open. I won't go into too much detail, but will say that while kids generally aren't tested, one would expect that if any higher transmission rates were problematic, we'd see plenty of teachers getting sick and unable to teach. I, obviously, know this has happened but I don't think it's any higher than typical community spread.

Our school district (6 buildings) has been open for in person since Sept. with 91% of the students in the district attending in person and virtually no classrooms have had to go virtual because the teacher was sick, nor have any of the district employees (teachers and support staff) passed away.

Mid semester last year, the district was able to determine that, at that time, nearly every case in the district was able to be traced to community spread and not to spread within the buildings.

A single anecdote is only worth so much, but our district's 'experiment' has been going exceptionally well. I will note that we are a reasonably educated, generally suburban district with both the resources and the space to enable good hygienic practices but we're not the only district regionally (or even nationally) to accomplish the 'feat' of a successful school year with spread at rates no greater than the regional rates.

[charis]

Our district has been starting to bring students back since January and while I agree that it appears that younger
children aren't really spreading it and teachers aren't being infected at rates any higher than the rate of community spread, (1) there is zero contact tracing happening because masked and socially distanced contact does not qualify for any tracing (this happened to me personally and it's been widely reported) and (2) the kids frequently get tested only after a household member tests positive and then test positive but are generally asymptomatic

[pdxvandal]

I didn't write that clearly. I've dined inside one restaurant in the past 10 months and it was just last weekend in a very spaced out, well-ventilated, uncrowded place (25% capacity). I'm not actively seeking restaurant experiences but just starting to feel more confident with Covid rates going down and vaccinations on the rise.

In Oregon teachers were put ahead of seniors for vaccinations, which has caused a ruckus. But I tend to agree with the decision, as difficult as it is.

###

Curious why you feel comfortable eating indoors knowing it's more likely transmitted via air than touch.

Also, everyone talks about opening schools cause kids are ok and not a big spreading area. What about teachers and staff?

There were 3 teachers in one GA school district that died w/in a month.

School staff should have been first in line to get vaccines imo, maybe not over nursing homes, but there could be an argument for it
[/quote]

[OtherJen]

Per the mask comments, they definitely help but as said there are some caveats. Also, there is the type of mask that matters as well.

Here's a real world example of masks very likely working

https://www.livescience.com/hair-stylists-infected-covid19-face-masks.html

I think they work if used properly. My mom is the only one of the half-dozen people in her work department who hasn't gotten COVID, and all of her co-workers came to work during the contagious presymptomatic period. Her boss actually went home with symptoms and was so sick that he was off for 5 weeks. But everyone wore masks at work, as per company policy, and mom also wears goggles. Her co-workers were all less careful outside of work and could trace their infections to social events. They didn't spread the virus at work.

[Zamboni]

To be fair, as someone who religiously wears a mask in public settings, it's not clear to me that they helped. My own community (very affluent, very liberal) has 100% mask compliance as far as I can tell. I literally have never seen someone unmasked indoors and people do a good job covering their whole mouth/nose.

Our larger state is super conservative and when I am outside of my own community/county, there's maybe 50% mask compliance at best, though some specific chains (ie Costco, Kroger grocery stores) enforce things pretty strictly.

So there's a huge divergence in behavior on masks... and basically no difference in infection rates/case numbers from my county to any of the others in the state over the course of the pandemic.

I guess you could blame this on people traveling between counties, but like I said, *everyone* here wears a mask, and people caught covid at about the same rate as they did in places where almost nobody does. It really doesn't look like there was much effect from the masks, if any at all.

-W

Hi Walt,

My employer (a large university that is testing EVERY student twice per week) has done rigorous contact tracing that shows masks consistently reduce transmission over the course of the past year. For example, we've had COVID-positive students working closely with others in a lab group indoors for hours where masks were worn strictly & properly the whole time, and no one else in the lab got it.

There was also a published study done with two COVID+ hairdressers who were good about wearing their masks around customers, and not one of the customers got it despite the close contact.

And then there is South Korea and other countries with extremely high cultural mask compliance where transmission was extremely slow for a very long time despite proximity to the epicenter and the fact that they never shut anything down at all. A case study in a culture that can do it properly without constant whining and cajoling and ignoring of the rules because 'merica or freedom or whatever.

So, all of the best data show convincingly that masks + social distancing (together) dramatically reduce transmission if everyone complies properly. It's no longer a matter of scientific debate.

But it's not part of our culture, so we Americans suck at always wearing them when we should (or we leave our nose uncovered, or we pull them down to talk to someone or use our phone in public, or we pull them down while eating or drinking without social distancing, or we pull them down while we walk around the store and only put it back up if we see someone else very near us, etc. etc.) Scientists aren't just making this stuff up to torture you. They've published lots of careful studies and have reached a consensus.

[Zamboni]

As a person who, also, has been religiously wearing a mask in all indoor public places, since March, 2020, I'm pretty skeptical about whether they have much/any effect on preventing transmission of covid. If anything, masks seem to give many people a false sense of security. Over and over again, I've observed people, completely unnecessarily, spend hours and hours in small, crowded, completely unventilated, spaces. When I've challenged them on the wisdom of having 2 hour meetings in tiny rooms, with no windows, the door closed, and no working ventilation, they tell me, "It's okay. We've all got masks on." wtf? I believe a mask helps protect me and others, in case one of us inadvertently sneezes or coughs, during the few minutes we have to go inside a store, or whatever, but if people think wearing a homemade cloth or paper mask is going to do anything, at all, to prevent the transmission of any virus between people who are, for example, riding in a car together with the windows closed, they're just fooling themselves, imho.

Riding in a car with all windows closed has been shown to be a high transmission situation because the amount of virus builds up as the air in the car is recirculated over time. Same with small, enclosed spaces. So your instinct is right. Masks can only do so much. They are not magically a solution if social distancing guidelines are simultaneously ignored.

[waltworks]

So, all of the best data show convincingly that masks + social distancing (together) dramatically reduce transmission if everyone complies properly. It's no longer a matter of scientific debate.

So why didn't it work here? We've got lots of people doing a great job with masks. We had the same outbreak as the rest of the state.

I mean, if you wear a fitted N95 mask in conjunction with social distancing... I bet that works great. If you wear a mask that aunt Betsy sewed and chat at 18 inches while in the grocery store, not so much. So there's not really much point in asking people to wear masks if they're all going to do it wrong anyway, right? From a public health standpoint, I'm not sure asking people to wear cloth masks was useful.

-W

[Laserjet3051]

To be fair, as someone who religiously wears a mask in public settings, it's not clear to me that they helped. My own community (very affluent, very liberal) has 100% mask compliance as far as I can tell. I literally have never seen someone unmasked indoors and people do a good job covering their whole mouth/nose.

Our larger state is super conservative and when I am outside of my own community/county, there's maybe 50% mask compliance at best, though some specific chains (ie Costco, Kroger grocery stores) enforce things pretty strictly.

So there's a huge divergence in behavior on masks... and basically no difference in infection rates/case numbers from my county to any of the others in the state over the course of the pandemic.

I guess you could blame this on people traveling between counties, but like I said, *everyone* here wears a mask, and people caught covid at about the same rate as they did in places where almost nobody does. It really doesn't look like there was much effect from the masks, if any at all.

-W

Hi Walt,

My employer (a large university that is testing EVERY student twice per week) has done rigorous contact tracing that shows masks consistently reduce transmission over the course of the past year. For example, we've had COVID-positive students working closely with others in a lab group indoors for hours where masks were worn strictly & properly the whole time, and no one else in the lab got it.

There was also a published study done with two COVID+ hairdressers who were good about wearing their masks around customers, and not one of the customers got it despite the close contact.

And then there is South Korea and other countries with extremely high cultural mask compliance where transmission was extremely slow for a very long time despite proximity to the epicenter and the fact that they never shut anything down at all. A case study in a culture that can do it properly without constant whining and cajoling and ignoring of the rules because 'merica or freedom or whatever.

So, all of the best data show convincingly that masks + social distancing (together) dramatically reduce transmission if everyone complies properly. It's no longer a matter of scientific debate.

But it's not part of our culture, so we Americans suck at always wearing them when we should (or we leave our nose uncovered, or we pull them down to talk to someone or use our phone in public, or we pull them down while eating or drinking without social distancing, or we pull them down while we walk around the store and only put it back up if we see someone else very near us, etc. etc.) Scientists aren't just making this stuff up to torture you. They've published lots of careful studies and have reached a consensus.

We most certainly have not......................... (reached a consensus).

[Zamboni]

^Sure we have. At least as much as scientists can reach a consensus.

Hi Walt, I understand the frustration, and it's clear that education about how/when to wear masks hasn't worked or sunk in. You are totally right about that. Probably mask compliance just isn't as good in your area as you think.

Also, disposable masks shouldn't be reused daily for a week. I busted my own kids on that one. Cloth masks should be washed daily. Most people don't seem to bother washing very often, I think. Others just can't keep their masks on.

For example, the older guys who stock the grocery shelves where I shop are pretty good about always having their mask on when they see me coming. The rest of the time, I've noticed that they pull it down. Granted, they are by themselves most of the morning, but they are breathing into the freezer section compartments or produce area or meat cabinets with their masks down all morning. The virus is perfectly happy to "chill" literally in there waiting for me to open the door to get some eggos, at which point zillions of little droplets woosh right out at me. My mask can only do so much if there is a ton of virus coming at me in the surrounding air. If they wore their masks religiously and changed them regularly, then it would be fine. But they don't. Instead they wear the same disposable mask all week, and only pull it up when they realize a customer can see them. Most people are NOT infected at any one time, thankfully, thus the illusion that doing it this way is okay, when really it's nearly pointless.

The other day I had to stop and use a public restroom (UGH!) and someone came out of the stall with mask under the chin and only pulled it up to walk by me. Well, obviously that person just spread droplets all over the place in a small enclosed place (never mind all the droplets from flushing the toilet . . . EWW). But they cared enough to pull their mask up to walk past me. Weird.

I've watched people getting off elevators who had their mask down the whole time they were riding it and then they pull it up as they get off because they see me waiting to get on and they need to pass me as they exit. Huh. How is that supposed to help, exactly?

I get it that is absolutely SUCKS to have to wear a mask all day at work. Trust me: I used to work in a cleanroom. It absolutely SUCKS. There's a reason I don't work in a cleanroom any more. I hated it. My face chafes. My lips get chapped. My glasses fog. My face itches and I can't scratch it. In a cleanroom job you'll get fired if you take a little mask break in the cleanroom. In every other job? Well, you get to pull it down to drink your coffee or talk on your phone or whatever and you still keep your job.

So lots of otherwise well-meaning people give themselves little "mask breaks" when others aren't immediately close to them, even if it's in an indoor area where others will be minutes or even seconds later. That's why it's not working in the USA. We just don't have the education and culture around proper mask use to make it work. There are enough people flouting the rules or just not understanding proper mask use to undo the efforts of everyone else.

Ugh. I'm just so sick of COVID. Unhand us, vile germs!

[Fru-Gal]

There were definitely studies that showed the effectiveness of cloth masks. Where I live, mask compliance is very high, & COVID relatively low. Everyone wears a mask outdoors, but the convention that has evolved is you can have it off or down around your neck if you're alone, but as soon as you pass others, you pull it up. That mask wearing works perfectly, because just as we saw with the 1918 flu, we know this spreads via fomites and the main thing is to keep yours to yourself. Outdoors, the virus is not going to float in the air long after it has left your mouth and nose. So based on what I've read, there's nothing wrong with keeping it under the nose or under your chin until you are going to be around other people. It's a prophylactic that keeps YOUR germs to YOURSELF.

On another note, just as AIDS is still with us but as a result of it we normalized condom wearing, which massively reduced the spread of all sorts of other sexually transmitted diseases, I think the upshot of COVID will be mask wearing becoming normalized during flu season, plus a new intolerance of people coughing and sneezing in the workplace/school/stores. As a result, the spread of the common cold and the flu will also drop. At least until enough time passes and we forget about it.

[waltworks]

Yeah, I've read the PNAS paper, which cites the Beijing study that found 79% reduction in transmission when everyone was wearing a mask in a household... so why the hell don't we see just *massive* differences in areas where mask use (my area) is high vs much lower?

I mean, the science says the impact is HUGE here. Either I'm lucky enough to go to the store when all the best mask wearers are there, for the last year, and actually nobody is wearing them, or else my area (and lots of others where mask wearing is practiced well/widely) is some kind of weird outlier, because it sure doesn't seem to have reduced the overall impact of the disease on the actual population.

I also wonder if it's masks, or just less interpersonal contact/social distancing that's given us a respite from the flu this year. It would be nice to know.

For what it's worth, I wear a full respirator for my work a lot of the time, so a cloth mask is hardly an imposition. Hearing people complain about them makes me chuckle.

I'd love to see masks catch on in winter flu season from now on, really. But I have my doubts that'll happen.

-W

[GuitarStv]

Yeah, I've read the PNAS paper, which cites the Beijing study that found 79% reduction in transmission when everyone was wearing a mask in a household... so why the hell don't we see just *massive* differences in areas where mask use (my area) is high vs much lower?

I mean, the science says the impact is HUGE here. Either I'm lucky enough to go to the store when all the best mask wearers are there, for the last year, and actually nobody is wearing them, or else my area (and lots of others where mask wearing is practiced well/widely) is some kind of weird outlier, because it sure doesn't seem to have reduced the overall impact of the disease on the actual population.

Because, (as has been pointed out,) the mask use in your area is not as high as you think it is - or people are not wearing them properly/consistently.  Around here mask usage is pretty good in stores, but there have been regular large gatherings among family (and extended family) in less visible areas with no mask usage at all.  Idiots have let their kids play without masks with other kids . . . who then take the disease back and infect their whole families.  That sort of thing.

[jrhampt]

Long before vaccines were available, two of my local grocery stores that have "drink in" wine/beer bars reopened them so people can hang out and drink. Seriously, go drink at a normal bar, you louts. I've had to adjust my schedule and only grocery shop in the morning now, before the "in store bar" is open, but the people who work in the grocery stores and restaurants have no little choice and even less say in these decisions.

You have bars in the grocery stores where you live???  I'm finding this hard to picture.  And even harder to picture this during covid...

[jehovasfitness23]

Yeah, I've read the PNAS paper, which cites the Beijing study that found 79% reduction in transmission when everyone was wearing a mask in a household... so why the hell don't we see just *massive* differences in areas where mask use (my area) is high vs much lower?

I mean, the science says the impact is HUGE here. Either I'm lucky enough to go to the store when all the best mask wearers are there, for the last year, and actually nobody is wearing them, or else my area (and lots of others where mask wearing is practiced well/widely) is some kind of weird outlier, because it sure doesn't seem to have reduced the overall impact of the disease on the actual population.

I also wonder if it's masks, or just less interpersonal contact/social distancing that's given us a respite from the flu this year. It would be nice to know.

For what it's worth, I wear a full respirator for my work a lot of the time, so a cloth mask is hardly an imposition. Hearing people complain about them makes me chuckle.

I'd love to see masks catch on in winter flu season from now on, really. But I have my doubts that'll happen.

-W

I've seen it first hand. Fam will wear masks in public then have fam/friends over inside w/o masks cause it's their "bubble"   evidence shows this was/is among the main drivers, along with indoor dining/bars

[sui generis]

Yeah, I've read the PNAS paper, which cites the Beijing study that found 79% reduction in transmission when everyone was wearing a mask in a household... so why the hell don't we see just *massive* differences in areas where mask use (my area) is high vs much lower?

I mean, the science says the impact is HUGE here. Either I'm lucky enough to go to the store when all the best mask wearers are there, for the last year, and actually nobody is wearing them, or else my area (and lots of others where mask wearing is practiced well/widely) is some kind of weird outlier, because it sure doesn't seem to have reduced the overall impact of the disease on the actual population.

I also wonder if it's masks, or just less interpersonal contact/social distancing that's given us a respite from the flu this year. It would be nice to know.

For what it's worth, I wear a full respirator for my work a lot of the time, so a cloth mask is hardly an imposition. Hearing people complain about them makes me chuckle.

I'd love to see masks catch on in winter flu season from now on, really. But I have my doubts that'll happen.

-W

I've seen it first hand. Fam will wear masks in public then have fam/friends over inside w/o masks cause it's their "bubble"   evidence shows this was/is among the main drivers, along with indoor dining/bars

Yeah, even in my area where there appears to be high compliance, I am seeing evidence that people seem to all have like 7 different bubbles that they are part of with 3-4 random people in each bubble (or germ pod, as some call it) and I just don't understand what they think they are doing or how they think this bubble thing is supposed to work.

[jehovasfitness23]

Yeah, I've read the PNAS paper, which cites the Beijing study that found 79% reduction in transmission when everyone was wearing a mask in a household... so why the hell don't we see just *massive* differences in areas where mask use (my area) is high vs much lower?

I mean, the science says the impact is HUGE here. Either I'm lucky enough to go to the store when all the best mask wearers are there, for the last year, and actually nobody is wearing them, or else my area (and lots of others where mask wearing is practiced well/widely) is some kind of weird outlier, because it sure doesn't seem to have reduced the overall impact of the disease on the actual population.

I also wonder if it's masks, or just less interpersonal contact/social distancing that's given us a respite from the flu this year. It would be nice to know.

For what it's worth, I wear a full respirator for my work a lot of the time, so a cloth mask is hardly an imposition. Hearing people complain about them makes me chuckle.

I'd love to see masks catch on in winter flu season from now on, really. But I have my doubts that'll happen.

-W

I've seen it first hand. Fam will wear masks in public then have fam/friends over inside w/o masks cause it's their "bubble"   evidence shows this was/is among the main drivers, along with indoor dining/bars

Yeah, even in my area where there appears to be high compliance, I am seeing evidence that people seem to all have like 7 different bubbles that they are part of with 3-4 random people in each bubble (or germ pod, as some call it) and I just don't understand what they think they are doing or how they think this bubble thing is supposed to work.

full disclosure, we both work from home and only go to grocery store. We went over a friend's house that we thought would be outside, they invited us in. They also both work from home and don't do other high risk stuff, that said I still felt "bad" at first and kept my mask on, then removed it.

psychology of humans is an odd thing. That said, it was still a very low risk environment but we were clearly breaking protocol.

[Shane]

At our local Rite Aid, when you go in for a vaccination for flu, or whatever, they try to make you go into a tiny, little room, about the size of a walk-in closet, with no windows and the door closed, in order to get your shot. Supposedly, it's for 'privacy.' While under normal circumstances, that may not be a big deal, during a pandemic of an airborne disease, it seems like just about the stupidest idea in the world to me. Rite Aid's rationalization is, though, that, well, both patients and the Rite Aid pharmacy staff members are all wearing masks. So, it must be okay, right? DUH! NO! In 2021, why would any healthcare provider be insisting that patients enter a small, enclosed space with their employees, who have been entering the same small space, all day long, with a whole bunch of other patients? In January, when I went to get my first shingles vaccination, I refused to go into Rite Aid's little room to get my shot. I, nicely, asked the nurse(?) if I could please get my shot right out in the main part of the store, and, thankfully, she agreed. I guess, if a patient specifically requested to get her shot in a private place, where nobody could see her, and a Rite Aid employee was okay with taking that personal risk, then that would be fine, but it shouldn't be the default, imho. I don't give a shit if people are wearing masks, or not. If entering small, enclosed, poorly ventilated, spaces can possibly be avoided, that's what we should do. To the extent that masks are giving smart people, who should know better, the illusion that it's safe to congregate with strangers in small, poorly ventilated spaces, they are counterproductive, imho.

[OtherJen]

Yeah, I've read the PNAS paper, which cites the Beijing study that found 79% reduction in transmission when everyone was wearing a mask in a household... so why the hell don't we see just *massive* differences in areas where mask use (my area) is high vs much lower?

I mean, the science says the impact is HUGE here. Either I'm lucky enough to go to the store when all the best mask wearers are there, for the last year, and actually nobody is wearing them, or else my area (and lots of others where mask wearing is practiced well/widely) is some kind of weird outlier, because it sure doesn't seem to have reduced the overall impact of the disease on the actual population.

I also wonder if it's masks, or just less interpersonal contact/social distancing that's given us a respite from the flu this year. It would be nice to know.

For what it's worth, I wear a full respirator for my work a lot of the time, so a cloth mask is hardly an imposition. Hearing people complain about them makes me chuckle.

I'd love to see masks catch on in winter flu season from now on, really. But I have my doubts that'll happen.

-W

I've seen it first hand. Fam will wear masks in public then have fam/friends over inside w/o masks cause it's their "bubble"   evidence shows this was/is among the main drivers, along with indoor dining/bars

Yeah, even in my area where there appears to be high compliance, I am seeing evidence that people seem to all have like 7 different bubbles that they are part of with 3-4 random people in each bubble (or germ pod, as some call it) and I just don't understand what they think they are doing or how they think this bubble thing is supposed to work.

That's been our experience, too. I go out once a week to buy groceries and never, ever see anyone without a mask. My husband works with a small, consistent group of people, and I haven't yet fully convinced them that some of them may be carriers. They regularly talk about getting together with various other households, going to bars, etc. I know husband doesn't wear his mask all of the time because he thinks it's "fine."

I've been under the weather for the last 24 hours. I cannot remember the last time when I was this physically fatigued. If he brought COVID home because "everyone at work is careful, it's cool," I will be furious. Assuming I don't get the super fun kind that leaves me bedridden for weeks, with no energy to be angry or anything else.

[waltworks]

So my point, or question is: if we can't get wealthy, educated people to do masks (or at least behavior with masks) "right" to the point that it helps with disease transmission, should we recommend them at all? Would people stay 6 feet away from each other better if they weren't wearing them at all? The 6 feet of distance rule is the most important part (as I understand it) with masks as a fallback when that's impossible.

I'm reminded of the 3 R's (reduce, reuse, recycle) - people focus almost entirely on recycling, which is what you do as a last resort when you've already failed to reduce or re-use. Recycling stuff is a net negative if it means you go out and buy a bunch of crap instead of reducing your consumption or re-using things you already have, but feel good about yourself because you recycle.

-W

[GuitarStv]

So my point, or question is: if we can't get wealthy, educated people to do masks (or at least behavior with masks) "right" to the point that it helps with disease transmission, should we recommend them at all? Would people stay 6 feet away from each other better if they weren't wearing them at all? The 6 feet of distance rule is the most important part (as I understand it) with masks as a fallback when that's impossible.

Distancing is absolutely more important.  Mask wearing certainly doesn't replace it, and anyone who has told you differently is wrong . . . but that doesn't mean mask wearing is without value.

We've had trouble getting wealthy, educated people to eat proper foods and exercise.  Should we recommend these at all?  Just because doing something properly is difficult and not everyone will follow through, it doesn't mean that it's not worth doing.

[waltworks]

I think you're missing my point. I think the masks might have made people INCREASE their odds of getting/transmitting Covid through behavior changes that overwhelmed the limited protection the masks provided.

I guess at this point it doesn't matter. We didn't overwhelm the medical system, so the various stuff we did was "enough", though I do still wonder how much better off we'd have been in the US if we didn't have Trump (or alternately if Trump had told his cult members to take Covid seriously) and instead had a substitute generic president of either party.

-W

[GuitarStv]

I think you're missing my point. I think the masks might have made people INCREASE their odds of getting/transmitting Covid through behavior changes that overwhelmed the limited protection the masks provided.

I'm not sure that the kind of people too dumb to listen to health care professionals about social distancing and masks are likely to have miraculously started to listen to health care professionals about social distancing without masks.  The problem is the stupidity, not the masks.

I guess at this point it doesn't matter. We didn't overwhelm the medical system, so the various stuff we did was "enough", though I do still wonder how much better off we'd have been in the US if we didn't have Trump (or alternately if Trump had told his cult members to take Covid seriously) and instead had a substitute generic president of either party.

-W

I kinda thought that the medical system in the US was overwhelmed at various times in different locations.  More people died than needed to die because hospitals in multiple locations and varying times were forced to triage because of the explosion of sick people.

[jehovasfitness23]

I think you're missing my point. I think the masks might have made people INCREASE their odds of getting/transmitting Covid through behavior changes that overwhelmed the limited protection the masks provided.

I'm not sure that the kind of people too dumb to listen to health care professionals about social distancing and masks are likely to have miraculously started to listen to health care professionals about social distancing without masks.  The problem is the stupidity, not the masks.

I guess at this point it doesn't matter. We didn't overwhelm the medical system, so the various stuff we did was "enough", though I do still wonder how much better off we'd have been in the US if we didn't have Trump (or alternately if Trump had told his cult members to take Covid seriously) and instead had a substitute generic president of either party.

-W

Is this

I kinda thought that the medical system in the US was overwhelmed at various times in different locations.  More people died than needed to die because hospitals in multiple locations and varying times were forced to triage because of the explosion of sick people.

yes, several cities had their hospitals overwhelmed, this is clearly established.

[waltworks]

Well, if even your most educated and intelligent citizens are too dumb to be responsible, then yeah, c'est la vie. I tend to be a bit cynical about that myself and Covid hasn't changed my mind, that's for sure. For every "it's just the flu" MAGA idiot there's a corresponding I-Believe sign person chatting with 5 friends in the cramped entrance to the yoga studio.

There were places that had to shuttle patients between hospitals for a few weeks but we at least didn't go the Italy route. So I'd say the curve flattening was a success overall.

-W

[middo]

Well, if even your most educated and intelligent citizens are too dumb to be responsible, then yeah, c'est la vie. I tend to be a bit cynical about that myself and Covid hasn't changed my mind, that's for sure. For every "it's just the flu" MAGA idiot there's a corresponding I-Believe sign person chatting with 5 friends in the cramped entrance to the yoga studio.

There were places that had to shuttle patients between hospitals for a few weeks but we at least didn't go the Italy route. So I'd say the curve flattening was a success overall.

-W

I have found reading the US perspective very interesting, coming from Australia.  We look at your case loads, death toll and the financial toll for your unemployed and do tend to shake our heads.  We have had 6 days of zero local cases recorded in all of Australia.  There are undoubtedly a few in our hotel quarantines, but we have effectively eradicated after the latest outbreak.

It has also allowed us to let the rest of the world run the big experiment with the vaccine before we roll it out ourselves, which started this week.  I am very glad I live where I live right now.

[Poundwise]

With respect to efficacy of masks, I read last year that tests showed cloth masks to be about half as good as N95s in keeping out viruses about the size of Covid.  If the alternative to wearing cloth masks is not wearing masks, cloth masks are better.

[laserlady]

Well, if even your most educated and intelligent citizens are too dumb to be responsible, then yeah, c'est la vie. I tend to be a bit cynical about that myself and Covid hasn't changed my mind, that's for sure. For every "it's just the flu" MAGA idiot there's a corresponding I-Believe sign person chatting with 5 friends in the cramped entrance to the yoga studio.

There were places that had to shuttle patients between hospitals for a few weeks but we at least didn't go the Italy route. So I'd say the curve flattening was a success overall.

-W

I have found reading the US perspective very interesting, coming from Australia.  We look at your case loads, death toll and the financial toll for your unemployed and do tend to shake our heads.  We have had 6 days of zero local cases recorded in all of Australia.  There are undoubtedly a few in our hotel quarantines, but we have effectively eradicated after the latest outbreak.

It has also allowed us to let the rest of the world run the big experiment with the vaccine before we roll it out ourselves, which started this week.  I am very glad I live where I live right now.

Walt represents the perspective of many people in the US. But there are plenty of us here who don't think that a death toll of more than half a million (undoubtedly undercounted, as shown by excess-death figures), with many others experiencing long-term health effects, looks like "success overall."

[waltworks]

perspective of many people in the US. But there are plenty of us here who don't think that a death toll of more than half a million (undoubtedly undercounted, as shown by excess-death figures), with many others experiencing long-term health effects, looks like "success overall."

Let me be clear: the death toll from Covid is a horrible, horrible tragedy. My point, which might have been poorly made, is that the "flattening the curve" goal was ostensibly about not overwhelming the medical system, and our efforts, inasmuch as we made them (which varied a lot from place to place but as far as I can see didn't produce wildly different outcomes) were sufficient for achieving that limited goal.

It would sure be nice to be Australia, though.

-W

[GuitarStv]

perspective of many people in the US. But there are plenty of us here who don't think that a death toll of more than half a million (undoubtedly undercounted, as shown by excess-death figures), with many others experiencing long-term health effects, looks like "success overall."

Let me be clear: the death toll from Covid is a horrible, horrible tragedy. My point, which might have been poorly made, is that the "flattening the curve" goal was ostensibly about not overwhelming the medical system, and our efforts, inasmuch as we made them (which varied a lot from place to place but as far as I can see didn't produce wildly different outcomes) were sufficient for achieving that limited goal.

It would sure be nice to be Australia, though.

-W

I'm still not sure about the claim that the medical system wasn't overwhelmed.  Hospitals were filled beyond capacity, retired physicians and nurses had to be pulled back into active duty to attempt to reduce shortages, the decision to continue treatment was made by shortage of equipment/staff rather than by doctor and patient preference.  There have been widespread reports of hospital staff experiencing mental problems from high levels of burnout which will continue to impact the field for quite a while to come.  And that doesn't even count the thousands of doctors and nurses who have taken ill or died.

What is your definition of 'overwhelmed'?

[waltworks]

I would define it as "unable to treat patients who need treatment".

We almost got there, I'd say. But not quite, outside of a few places that had to transfer patients around. Maybe at the very beginning in NYC but I'd guess it was too late at that point to do much of a public health intervention, inasmuch as we even understood what was happening.

I mean, we never got to the point of needing the hospital ships and stuff. That's not much of a win, but it's better than needing them.
 
-W

[Cranky]

With respect to efficacy of masks, I read last year that tests showed cloth masks to be about half as good as N95s in keeping out viruses about the size of Covid.  If the alternative to wearing cloth masks is not wearing masks, cloth masks are better.

As a person who has now seen many, many cloth masks for donation, and who has read a lot of studies about mask materials, let me point out the obvious - not all cloth masks are created equal.

Last fall, the university where my dh teaches gave everyone a single cloth mask. It did have the university logo printed on it. LOL But - it was a stretchy single layer of cloth (no info about fabric content). It had non adjustable ear loops. I think that it was worse than useless in terms of keeping your germs in, much less keeping anyone else’s out.

I see many people wearing masks that just don’t fit very well, and the are constantly fiddling with them.

The masks I make have two cloth layers with a nonwoven middle layer (I’ve used various recommended materials for this.) They stand away from the face. They have adjustable cords that go around your head (I only use ear loops for kids). They don’t fall down. When people wear them, they are comfortable enough that they don’t keep pulling them off.

From what I’ve seen recently, wearing a close fitting 3 layer cloth mask *over* a commercial paper mask comes fairly close to an N95.

And this semester, the university gave everyone multiple cloth masks, multi layer, with a filter pocket and filters, with adjustable ear loops.

When you compare mask wearing vs. no mask wearing, you also have to account for what mask is in use.

[mm1970]

I would define it as "unable to treat patients who need treatment".

We almost got there, I'd say. But not quite, outside of a few places that had to transfer patients around. Maybe at the very beginning in NYC but I'd guess it was too late at that point to do much of a public health intervention, inasmuch as we even understood what was happening.

I mean, we never got to the point of needing the hospital ships and stuff. That's not much of a win, but it's better than needing them.
 
-W

Los Angeles was a hot mess for awhile.  Places in Texas too.  Turning people away.

[mm1970]

I've been under the weather for the last 24 hours. I cannot remember the last time when I was this physically fatigued. If he brought COVID home because "everyone at work is careful, it's cool," I will be furious. Assuming I don't get the super fun kind that leaves me bedridden for weeks, with no energy to be angry or anything else.

@OtherJen Ugh, wishing you the best

[Abe]

I would define it as "unable to treat patients who need treatment".

We almost got there, I'd say. But not quite, outside of a few places that had to transfer patients around. Maybe at the very beginning in NYC but I'd guess it was too late at that point to do much of a public health intervention, inasmuch as we even understood what was happening.

I mean, we never got to the point of needing the hospital ships and stuff. That's not much of a win, but it's better than needing them.
 
-W

Multiple states had to stop non-emergency surgeries and procedures for several weeks, so by your definition they were overwhelmed. Hospital ships ultimately were not used as they were initially to allow for covid-specific hospitals vs non-covid hospitals similar to what was done in China. That ultimately was not cost effective once all hospitals in an area became covid ones. Also I don’t think you factor in the human cost of the epidemic on healthcare workers, who were and are overwhelmed mentally. I anticipate a host of early retirement/quitting in the ICUs once the pandemic clears.

[Poundwise]

The masks I make have two cloth layers with a nonwoven middle layer (I’ve used various recommended materials for this.) They stand away from the face. They have adjustable cords that go around your head (I only use ear loops for kids). They don’t fall down. When people wear them, they are comfortable enough that they don’t keep pulling them off.

From what I’ve seen recently, wearing a close fitting 3 layer cloth mask *over* a commercial paper mask comes fairly close to an N95.

And this semester, the university gave everyone multiple cloth masks, multi layer, with a filter pocket and filters, with adjustable ear loops.

When you compare mask wearing vs. no mask wearing, you also have to account for what mask is in use.

Agreed; I also sew cloth masks and we have worked hard to create better fitting masks with nose wires and filter pockets.  My point was that cloth masks, although not perfect, are much better than nothing. But of course if one is wearing them loose, around the chin, or under the nose, or only in some settings but not others, they aren't going to help.

[OtherJen]

Well, if even your most educated and intelligent citizens are too dumb to be responsible, then yeah, c'est la vie. I tend to be a bit cynical about that myself and Covid hasn't changed my mind, that's for sure. For every "it's just the flu" MAGA idiot there's a corresponding I-Believe sign person chatting with 5 friends in the cramped entrance to the yoga studio.

There were places that had to shuttle patients between hospitals for a few weeks but we at least didn't go the Italy route. So I'd say the curve flattening was a success overall.

-W

God, speak for yourself and your own area. My former workplace had mobile morgues parked outside last spring. My cousin is an ER nurse and my friend is a CRNA. This has been hell on them.

[Watchmaker]

Well, if even your most educated and intelligent citizens are too dumb to be responsible, then yeah, c'est la vie. I tend to be a bit cynical about that myself and Covid hasn't changed my mind, that's for sure. For every "it's just the flu" MAGA idiot there's a corresponding I-Believe sign person chatting with 5 friends in the cramped entrance to the yoga studio.

There were places that had to shuttle patients between hospitals for a few weeks but we at least didn't go the Italy route. So I'd say the curve flattening was a success overall.

-W

God, speak for yourself and your own area. My former workplace had mobile morgues parked outside last spring. My cousin is an ER nurse and my friend is a CRNA. This has been hell on them.

Most of my SO's family are in healthcare. Her brother and sister-in-law in Florida are a respiratory therapist and ER nurse, respectively. Besides the physical and mental toll on them, this has, perhaps irreparably, damaged their relationship with their community. Walking out of an overnight 12 hour shift on the COVID floor to see people partying on the beach with no social distancing or masking made him angry in a way he hasn't been able to get over. They are now trying to decide if they'll stay in healthcare. He's the most caring person I know, and he will be a loss to profession if he does leave. Sadly, I think there will be a lot of those losses. 

[wenchsenior]

My sister reported that she was in line at a store today, and the woman in front of her pulled her mask OFF so she could sneeze without covering her face. 

[Jouer]

I would define it as "unable to treat patients who need treatment".

We almost got there, I'd say. But not quite, outside of a few places that had to transfer patients around. Maybe at the very beginning in NYC but I'd guess it was too late at that point to do much of a public health intervention, inasmuch as we even understood what was happening.

I mean, we never got to the point of needing the hospital ships and stuff. That's not much of a win, but it's better than needing them.
 
-W

So the absolute worst case scenario didn't happen* so that's not considered overwhelming. That's a low bar you have set.


* thanks to the initiatives that were put in place 

[OtherJen]

Well, if even your most educated and intelligent citizens are too dumb to be responsible, then yeah, c'est la vie. I tend to be a bit cynical about that myself and Covid hasn't changed my mind, that's for sure. For every "it's just the flu" MAGA idiot there's a corresponding I-Believe sign person chatting with 5 friends in the cramped entrance to the yoga studio.

There were places that had to shuttle patients between hospitals for a few weeks but we at least didn't go the Italy route. So I'd say the curve flattening was a success overall.

-W

God, speak for yourself and your own area. My former workplace had mobile morgues parked outside last spring. My cousin is an ER nurse and my friend is a CRNA. This has been hell on them.

Most of my SO's family are in healthcare. Her brother and sister-in-law in Florida are a respiratory therapist and ER nurse, respectively. Besides the physical and mental toll on them, this has, perhaps irreparably, damaged their relationship with their community. Walking out of an overnight 12 hour shift on the COVID floor to see people partying on the beach with no social distancing or masking made him angry in a way he hasn't been able to get over. They are now trying to decide if they'll stay in healthcare. He's the most caring person I know, and he will be a loss to profession if he does leave. Sadly, I think there will be a lot of those losses.

Exactly. Also, I expect that we'll see a LOT of burnout and PTSD among the medical community once the major pandemic threat has passed. Those conditions can certainly be career-ending.

[frugalnacho]

We already are.  There are people in this thread suffering burnout.

[OtherJen]

We already are.  There are people in this thread suffering burnout.

Right, but like the long-term physical effects, we won't fully realize the mental/emotional effects of COVID on frontline workers until they're no longer in basic survival mode. We're seeing the tip of the iceberg now.