Why Aren't We Wearing Better Masks? [View all]

[Celerity]

Cloth masks are better than nothing, but they were supposed to be a stopgap measure.

https://www.theatlantic.com/health/archive/2021/01/why-arent-we-wearing-better-masks/617656/



If you’re like most Americans, there’s a good chance you’re going to wear a cloth mask today. Doing so makes sense. It remains the official recommendation in the United States, and it is something we’ve both advocated since the beginning of the pandemic. Both of us wrote articles as far back as March urging people to wear homemade cloth masks. We’re also the authors (along with 17 other experts) of a paper titled “An Evidence Review of Face Masks Against COVID,” which was just published in peer-reviewed form in the Proceedings of the National Academy of Sciences. But it’s past time for better solutions to be available to the public. We first released the paper as a preprint back in April, and it took nine months to go through peer review. We’re happy that it’s published but, to be honest, we’re also deeply disappointed that it’s still relevant. We’d hoped that by 2021 supply chains would have ramped up enough to ensure that everyone had better masks. Cloth masks, especially homemade ones, were supposed to be a stopgap measure. Why are so many of us still wearing them?

Don’t get us wrong; everything we said about the efficacy of cloth masks stands the test of time. Wearing them is much better than wearing nothing. They definitely help reduce transmission of the coronavirus from the wearer and likely protect the wearer to some degree as well. But we know that not all masks are equal, and early on in the pandemic, there was a dire shortage of higher-grade masks for medical workers. During those emergency conditions, something was much better than nothing. There are better possibilities now, but they require action and guidance by the authorities. Even all cloth masks are not equal. Construction, materials, and fit matter, and these can’t be tracked or certified with homemade masks. Unlike cloth masks, medical-grade masks (also called respirators) that adhere to standards such as N95 (in the U.S.), FFP2 (in the European Union), and KN95 (in China) do a much better job of protecting the wearer and dampening transmission. Ideally, they should also come with instructions on how to wear them and ensure that they fit properly.

Because we have written about masks, we’ve become informal advisers to friends, family, and strangers on the internet. We’re not much help, though. When our friends ask us simple questions like “Where should I buy a mask?” or “Is my mask any good?,” we don’t have great answers. We can mumble generalities: Make sure it fits well; here are some guidelines about layers; try to avoid fake N95s. But if we can’t give wholly satisfying answers to such basic questions, then how is the general public expected to fare. Tragically, America is swamped with fraudulent medical-grade masks, some of which are only 1 percent effective. Many masks do not have labels clearly indicating their manufacturer. Some official mask-testing methods are inappropriate, including the use of far higher pressure than normal breathing exerts. No reasonable certification is available for the most useful masks generally available to the public. All of this means that everyone has to somehow figure out for themselves which masks are effective.

We routinely get PR pitches for excellent new solutions as well as snake-oil remedies, and we sometimes have trouble telling them apart—how is an ordinary person supposed to evaluate competing claims? When we share our articles about masks on social media, we are asked where to buy proper masks. Not only do we have no answer, but we often find that marketers will answer instead, directing readers to unreliable, overpriced masks. Worse, the supply situation apparently remains so dire that the CDC still “does not recommend that the general public wear N95 respirators,” because they’re crucial supplies that must continue to be reserved for health-care workers and other first responders. Not all countries have this problem. Taiwan massively scaled up its manufacturing of masks at the start of 2020, such that by April every citizen received a fresh supply of high-quality masks each week, and the distribution system was regulated by the government. Taiwan’s COVID-19 death rate per capita is more than 1,000 times lower than that in the U.S. Hong Kong has been distributing patented six-layer masks (the efficacy of which has been laboratory tested) to every citizen. Singapore is on at least its fourth round of distributing free, reusable, multilayer masks with filters to everyone—even kids, who get kid-size ones. In Germany, Bavaria has just announced that it will be requiring higher-grade masks. If all of these places can do this, why can’t we?

snip

Link to tweet

Link to tweet