Coronavirus

[DrGriz]

You realize it matters how much virus you inhale, right? It’s not like you inhale thousands of virus particles and then you automatically get infected!

Dose-response relationship.

This is not really that complicated to figure out.

I agree there should be challenge trials though! No reason not to.

@juk can volunteer!

 

[DrGriz]

I had a neighbor, an engineer type, who got so angry because he felt that masks couldn't possibly work because of the size of the viral particle. I tried to explain to him that the mask didn't have to catch the virus, it only had to catch the droplet in which the virus traveled to be effective.

He was so upset that he refused to come in for any health care for the rest of his life, because it was policy that all patients and visitors mask. In the end, he died of Covid pneumonia, which his wife brought home from the grocery store (he didn't let her mask, either).

It really feels like this discussion comes down along the lines of seatbelt use: "hey, that guy died even while he was wearing his seatbelt, so seatbelts don't work! I'm never wearing one!"

 

[jerry33]

Actually, it is very hard to do a study on mask wearing, because nobody tolerates mask wearing 24 hours a day. Given that health care workers all go home and who knows what they do, despite what they say?

Why you think that the lack of a study that's nearly impossible to do proves anything at all is beyond me.

In the meantime, I am going to continue to wear my readily available N95.

I've found comfort depends on the respirator you wear. I've been using the AlphaProTech N95. They fit me well, are comfortable, and seal well. Four hours is about the maximum life for the mask, which works well with the workday. However, don't get them off of Amazon. They are either counterfeit or rejects. Get them from a medical supply house where they guarantee quality (check first). The ones from Amazon were very poor. Some straps not connected to the mask, others broke while putting them on.

 

[PACEMD]

The WHO review had 10 out of 17 showing negative impact of masks.

Ok, take a deep breath and deal with this one statement, as requested. "Showing negative impact of masks". One thing at a time. Verify and deal with that statement. You cannot move forward with that statement standing in public view without correction. The entire rest of the analysis is null.........

 

[juk]

I think you have moved the goalpost from:

"There’s 100 years of science that says masks aren’t effective."

to:

And you appear to be saying that because there isn't 100% reduction of penetration then they can't be effective at all, unless you have changed your story.

Thing is, we also know that there appears to be more than a simple plus/minus of exposure to whether or not someone becomes ill.

There is also dose, length of exposure, individual susceptibility, and the infectivity of the viral particle/variant among others. And these may be moving targets as a virus mutates. Which, again, makes clinical controlled trials more difficult.

If the mask just reduces the exposure some, it may be and probably often is enough to prevent clinical illness. It might allow, as you clearly recognize, the exposed person's immune system to clean up without clinical illness and very possibly blessing them with a degree of immunity.

It needn't be all or nothing. It's not as if one viral particle and you are in the ICU.

At any rate, I will happily grant you that a procedure mask is not going to do much in a high particle environment, which is why we wear PAPRs or N95s in those environments when we know. I am sure many nurses caught Covid because they were given procedure masks and were exposed before they suspected a given patient had covid. And yes, there are breakthroughs in any event.

And, to make things more fun, a noninconsequential percentage of people don't have the right ACE2 receptors for the virus to take hold of, so they are highly resistant and make studies harder, since we don't know for sure who they are, just that they exist.

Anecdotally but with assurance, I can tell you that my partners who caught it (we've all been real careful to wear N95s rather than the company provided procedure masks) did so from their partners or kids, who all came home with it first. We are a small place, and it's a small sample size, but...

There’s a difference between lab conditions and the real world. There’s condition, stretching, stitching, fit and seal.

I don’t have a paper that correlates the two. Do you?

There’s also infection possible through the eyes. Which may be another reason why masks appear ineffective in the real world.

You’re not wrong about dose. There’s a threshold, below it you’re fine, above it you’re screwed and as you say that threshold is individual to the person and the house of the day.

All of which is immaterial if nobody can show a meaningful benefit to the population.

 

[juk]

One

You realize it matters how much virus you inhale, right? It’s not like you inhale thousands of virus particles and then you automatically get infected! It also matters how rapidly you inhale them!

Dose-response relationship.

This is not really that complicated to figure out. (And you can see this points to using N95 too.)

I agree there should be challenge trials though! No reason not to.

Many of the studies do not show good strong signals of efficacy because no one wears masks in the studies.

One of the trials I use frequently is an on/off trial where you expect a square wave response. This is particularly effective in a non homogenous environment or when the expected signal is small or subject to interference.

 

[DrGriz]

There’s a difference between lab conditions and the real world. There’s condition, stretching, stitching, fit and seal.

I don’t have a paper that correlates the two. Do you?

There’s also infection possible through the eyes. Which may be another reason why masks appear ineffective in the real world.

You’re not wrong about dose. There’s a threshold, below it you’re fine, above it you’re screwed and as you say that threshold is individual to the person and the house of the day.

All of which is immaterial if nobody can show a meaningful benefit to the population.

We are saying that masks affect the dose. What is your problem with that? I get that you are an engineer or scientist of some sort. But what do you know of biology and disease transmission?

How would you design your hypothetical study of effectiveness that you keep wishing for?

You would have to expose a group of people to a deadly virus, some of whom might die because they have risk factors you can't measure, in a specified environment with a specified amount of virus in the air for a given amount of time. Half wear masks, half don't.

That would be:

1) unethical

2) unethical

3) unethical

4) never approved by any ethics committee anywhere.

You can't say just because nobody has performed your unethical study that masks don't work.

I suppose you believe this: nobody studied gravity before Newton, therefore it didn't exist. That's the nature of your argument.

 

[DrGriz]

There’s a difference between lab conditions and the real world. There’s condition, stretching, stitching, fit and seal.

I don’t have a paper that correlates the two. Do you?

There’s also infection possible through the eyes. Which may be another reason why masks appear ineffective in the real world.

You’re not wrong about dose. There’s a threshold, below it you’re fine, above it you’re screwed and as you say that threshold is individual to the person and the house of the day.

All of which is immaterial if nobody can show a meaningful benefit to the population.

Your argument here, regarding the eyes, is dissembling. First off, though, a respiratory virus doesn't care much about eyes. I don't know, but I suspect they eyes don't have a lot of ACE2 receptors for the virus to latch onto. Nonetheless, I wear protective lenses because I don't want patients spitting Covid in my eyes.

You are stuck on this because you are so sure of your hypothesis.

Masks don't have to be perfect to be good.

Firsthand experience by HCWs who work with Covid while wearing ppe suggests that those who get covid don't get it from patients. They nearly always have outside exposures that can be demonstrated.

 

[juk]

We are saying that masks affect the dose. What is your problem with that? I get that you are an engineer or scientist of some sort. But what do you know of biology and disease transmission?

How would you design your hypothetical study of effectiveness that you keep wishing for?

You would have to expose a group of people to a deadly virus, some of whom might die because they have risk factors you can't measure, in a specified environment with a specified amount of virus in the air for a given amount of time. Half wear masks, half don't.

That would be:

1) unethical

2) unethical

3) unethical

4) never approved by any ethics committee anywhere.

You can't say just because nobody has performed your unethical study that masks don't work.

I suppose you believe this: nobody studied gravity before Newton, therefore it didn't exist. That's the nature of your argument.

You know I’ve pointed you at 27 studies. Right?

Why are they not valid?

 

[juk]

Your argument here, regarding the eyes, is dissembling. First off, though, a respiratory virus doesn't care much about eyes. I don't know, but I suspect they eyes don't have a lot of ACE2 receptors for the virus to latch onto. Nonetheless, I wear protective lenses because I don't want patients spitting Covid in my eyes.

You are stuck on this because you are so sure of your hypothesis.

Masks don't have to be perfect to be good.

Firsthand experience by HCWs who work with Covid while wearing ppe suggests that those who get covid don't get it from patients. They nearly always have outside exposures that can be demonstrated.

Masks have to have a demonstrable effect to be good. And that effect has to be positive.

 

[BigNerd]

Plus, plus.......your covid chip can be programmed for safe driving. But it's still a beta version.......

Fauci said the 2023 covid chips need radar because it can't just depend on Vision anymore.

I feel bad about bringing up masks now... can we get back to lemons?

 

[eleison]

Your argument here, regarding the eyes, is dissembling. First off, though, a respiratory virus doesn't care much about eyes. I don't know, but I suspect they eyes don't have a lot of ACE2 receptors for the virus to latch onto. Nonetheless, I wear protective lenses because I don't want patients spitting Covid in my eyes.

You are stuck on this because you are so sure of your hypothesis.

Masks don't have to be perfect to be good.

Firsthand experience by HCWs who work with Covid while wearing ppe suggests that those who get covid don't get it from patients. They nearly always have outside exposures that can be demonstrated.

Those that wear masks... Wouldn't it be safer not going out at all? Most people I see wearing masking are doing things that are not required - going to the gym, visiting the book store, going to bars, restaurants, sporting events, etc. In a way, promoting mask usage actually promotes some people to take risks that they wouldn't have to begin with.

If it's about saving lives, I wouldn't make wearing a mask a panacea for avoiding the virus. I would elevate not going out at all unless it's required. Also, if HWC are already getting covid from outside exposures, what's the point of having patients wear them? Doctors are already going to get it anyways. Shouldn't doctors (nurses, etc.) in general avoid all contact with people in general? Actually, IIRC most patients are required to state they don't have any symptoms of the virus before seeing the doctor, right? So in a way, the patients have a lower risk of spreading the virus since they will unlikely have the virus in the first place.

 

[madodel]

I've found comfort depends on the respirator you wear. I've been using the AlphaProTech N95. They fit me well, are comfortable, and seal well. Four hours is about the maximum life for the mask, which works well with the workday. However, don't get them off of Amazon. They are either counterfeit or rejects. Get them from a medical supply house where they guarantee quality (check first). The ones from Amazon were very poor. Some straps not connected to the mask, others broke while putting them on.

I've been using mostly KN95 because the ear straps are just easier to take on and off than N95. Though I canonly stand the ear irritation for a couple hours, so using the N95 for longer events like air flights. My wife is so sick of wearing a mask 10 hours a day at the hospital for 3 years she doesn't want to do it when out any more. Though the hospital is back to surgical masks everywhere except in known COVID or repiratory infectious rooms where they wear N95. At the height of the pandemic here she was wearing 2 masks with a surgical on top of an N95 because of the shortage of supplies back then to keep the N95 from getting soiled so it lasted longer. We've managed to avoid COVID despite her being exposed almost everyday to active cases, but then we have also stopped going out out to dinner and most other social events where exposure is more random.

It's just so crazy to hear people still keep denying that basic public health efforts don''t work. My wife is also tired of listening to patients get angry and complain about COVID. They have no clue what medical professionals have had to deal with for 3 years now.

 

[jerry33]

I've been using mostly KN95 because the ear straps are just easier to take on and off than N95.

I can assure you that if you have both glasses and hearing aids, ten minutes with the over the ear type is more than anyone can take.

 

[eleison]

We've managed to avoid COVID despite her being exposed almost everyday to active cases, but then we have also stopped going out out to dinner and most other social events where exposure is more random.

So you expect to NEVER catch COVID or any of its variants.... and you will continue to wear masks and stop going out to dinners and other social events where exposure is more random.. FOREVER... That is your game plan?

My parents and I have all caught COVID so we will continue to live as normal. To us COVID is like the flu now; and we treat it like the flu.

 

[jerry33]

So you expect to NEVER catch COVID or any of its variants.... and you will continue to wear masks and stop going out to dinners and other social events where exposure is more random.. FOREVER... That is your game plan?

My parents and I have all caught COVID so we will continue to live as normal. To us COVID is like the flu now; and we treat it like the flu.

How serious your COVID infection is depends a lot on the initial viral load. Respirators reduce the load (at worse) and in some cases eliminate it. Wearing a decent respirator is not particularly annoying.

 

[madodel]

So you expect to NEVER catch COVID or any of its variants.... and you will continue to wear masks and stop going out to dinners and other social events where exposure is more random.. FOREVER... That is your game plan?

My parents and I have all caught COVID so we will continue to live as normal. To us COVID is like the flu now; and we treat it like the flu.

You live your life as you chose. I'll do what I can to mitigate exposure because I understand how this stuff works. As has been posted here COVID is not the flu and has long term consequences for some people. But when large swath gets a bad case of whatever the next deadly pandemic is and makes life hell for healthcare workers and their families, it hopefully won't be me. With RSV and Flu now they are begging people who aren't in respiratory distress to just stay home until it passes. But most people only care about their current inconvenience and have no clue what is serious and isn't and how a little inconvenience can prevent a disaster. And they show up and complain about crowded ERs and poor service. Our hospital here is still short staffed because of all the nurses and doctors who decided to find new jobs or died. They don't need more idiots clogging up an understaffed system.

 

[eleison]

How serious your COVID infection is depends a lot on the initial viral load. Respirators reduce the load (at worse) and in some cases eliminate it. Wearing a decent respirator is not particularly annoying.

So you are saying respirators do not stop the transmission, but it's a positive because it reduces the load and may prevent it. So it about risk mitigation vs benefits. You are also saying in your opinion wearing a decent respirator is not annoying. That makes sense. You are not saying "lock yourself" in a room. You are not saying "zero cases".. etc.

I feel people who have the need/want to wear masks. If COVID is a big risk to them, I feel they shouldn't even be out, period unless it's REQUIRED. Perhaps they have immunity issues.. perhaps they have underlying health issues, etc.. I understand, but instead of wearing mask, just don't go out. Use uber eats.. Zoom calls.. etc..

If I had health issues, that is what I would do. It just wouldn't be worth the risk. When I see people at the book store, at the bars, resturants, etc.. wearing mask, I can't help think that they are idiots. There must be a reason for them to wear masks in the first place.. health reason.. if so, why even be out and about?

 

[BigNerd]

Masks is one of those things where each side believes their science and neither will convince the other (as most things related to Covid go).

No one says masks *cure* Covid... as I'm sure no one believes that masks don't provide some % of reduction of viral load (incoming or outgoing).

But I'm still wondering how lemons figure into this. Maybe...

 

[eleison]

You live your life as you chose. I'll do what I can to mitigate exposure because I understand how this stuff works. As has been posted here COVID is not the flu and has long term consequences for some people. But when large swath gets a bad case of whatever the next deadly pandemic is and makes life hell for healthcare workers and their families, it hopefully won't be me. With RSV and Flu now they are begging people who aren't in respiratory distress to just stay home until it passes. But most people only care about their current inconvenience and have no clue what is serious and isn't and how a little inconvenience can prevent a disaster. And they show up and complain about crowded ERs and poor service. Our hospital here is still short staffed because of all the nurses and doctors who decided to find new jobs or died. They don't need more idiots clogging up an understaffed system.

So you feel with your mitigation plan, you will never get COVID. Ok, that is fair. Good luck with that. To be honest, when will we ever see a time when we don't have a virus of some sort killing people? The flu has been around forever and has been killing hundreds of thousands of people every season. Oh well, people are different. You be you and I will be me.