The Citizens Handbook
Masking and Eye Shields not Distancing
Australian doctors closely packed at a convention during the COVID-19 pandemic

The Centre for Global Development has questioned whether policymakers have evidence-based answers for recommending lock-downs and physical-distancing to control the Covid-19 pandemic. Physical-distancing is not an option for lower income people, who cannot stay at home because they need to go to work.

Evidence suggests the pandemic can be held in check if people wear surgical masks when near others, and hand-sanitize when entering public buildings or public transit. Masking will be effective in all but a few places, such as bars and restaurants. Mandatory masking would eliminate destructive lock-downs, permitting the normal operation of schools, businesses and the other elements of everyday life.

For months most mainstream media failed to report the rationale behind physical-distancing. It comes from research that shows that viruses are transmitted in tiny droplets sent into the air when people talk, and when they exhale. Loud talking and heavy breathing through the mouth emit more droplets. Avoid joggers and gyms full of puffing people. Because the smallest droplets may float in the air for hours, social distancing by itself may be ineffective in enclosed spaces with poor ventilation. For more info see this video report on research from Japan and a report in the journal Science. Masks are necessary indoors, when near others. They are usually unnecessary outdoors, where transmission is 18 times less likely, except for gatherings where large numbers of people are in close contact. Still, there remain some questions about masks because they don't seem to work in the communityeven though they work in the lab. Face shields that protect the eyes have been shown to provide much improved protection for front line health workers

Infected people with no symptoms can shed large amounts of virus. In fact, as reported in Nature, infected persons may be most capable of spreading the virus 1-2 days before showing any symptoms.

The graph below comes from a study on face masks reported in the June 10, 2020 edition of the Proceedings of the Royal Society.


The study concludes: In summary, our modeling analyses provide support for the immediate, universal adoption of face masks by the public . . .
A September 2020 report in Nature estimates that 40% of transmissions are from people who are asymptomatic. A case study of a Utah childcare center found twelve children with mild symptoms or no symptoms had spread coronavirus to their families.

Even more disturbing is the D614G mutation of the virus. COVID-19, like all RNA viruses, occasionally mutates when making copies of itself. The 614 mutation has made the virus 4-5 times more infectious. In October 2020, researchers reported another variant, 20A.EU1, which originated in Spain and does not look like the original COVID-19 virus. It has now become the dominant variant in Europe. For a graphic, but creepy animation of the rise of coronavirus variants play the map on nextstrain.org. The only good news may be that successful viruses don't usually kill their hosts – so the future may be less deadly than the past.

Surgical masks (typically blue, 3-layer, and pleated) prevent transmission. An international research group led by a team at the University of Hong Kong studied 246 people sick with viral infections. The researchers randomly assigned half of the people to wear surgical masks. Then the team measured viruses present in each person’s exhaled breaths. Between 30 and 40 percent of the people with coronavirus infections exhaled viruses if they wore no mask. But no virus was detected in breath exhaled through a surgical mask. For details see the April 3 report in Nature Medicine. Decorator cloth masks perform about half as well depending on construction; they should be a last resort when surgical masks are not available. Health authorities should make surgical masks or N95 masks mandatory for all indoor public spaces and all large outdoor gatherings. Epidemiologists say that masks should not be worn continuously but only when necessary; some are far more breathable than others. Surgical masks can be disinfected and reused by allowing them to dry 48 hours (washing, and spraying with alcohol both degrade the mask).

Taiwan, a country of 23 million, has performed better than any other country with only 7 Covid-19 deaths as of June 22, 2020. It did not shut down its economy, like less-prepared countries. Instead, according to president Tsai Ing-Wen:
“Upon the discovery of the first infected person in Taiwan on January 21, we undertook rigorous investigative efforts to track travel and contact history for every patient, helping to isolate and contain the contagion before a mass community outbreak was possible. In addition, government . . . took over the production and distribution of medical-grade masks. and devised a system for distributing rationed masks to everyone.” On October 29, 2020, Taiwan reported having no domestic COVD-19 infections in 200 days.

None of this should imply that physical-distancing does not work. But it may be impossible in many places, in densely populated cities, slums, prisons, churches, schools, sports stadiums, public transit, meat packing plants, and elder care facilities. Government insistence on physical distancing has created an immense socioeconomic crisis in many counties. In India, where the government has asked 1.3 billion people to stay home for three weeks, literally millions have been left stranded, homeless, without work, and potentially going hungry. Physical-distancing is undoing years of progress in curbing global poverty.

Governments and policymakers need to take a closer look at the available evidence, and require more social masking and less social distancing. They also need to introduce simple DIY sniff testing, so that ordinary citizens can become active participants in controlling the pandemic.

COVID-19 news in the mainstream media is weak, repetitive and out-of-date. If you want to know what is really going on, visit MedicalXpress.


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