Today is the first day of mandatory masks in Spain. Six months into the Covid-19 pandemic and a solid two months into Spain’s lockdown, I’m finding my point of view on masks has evolved.
Except for N95 masks, a mask doesn’t provide much protection from Covid-19 in the air. I tested this by wearing a paper mask and walking behind someone smoking a cigarette. Since cigarette smoke particles are similar in size to droplets carrying Covid-19, when I smelled the cigarette smoke, I knew my mask wouldn’t screen Covid-19 droplets.
However, as long as masks are mandatory and more than 80% of people wear them, the science looks good for reducing Covid-19 transmission with masks. This public health method uses masks differently from their intended protective purpose.
Allow me to explain. In one experiment, NIH researchers measured the spray of droplets when one of the researcher said “stay healthy” with and without a mask.
You can watch the video if you follow the link above. It’s clear as day (or night?) that a mask reduces droplet emission from speech. The experiment demonstrates why it’s vital for people who are contagious to wear a mask. Masks prevent the spread of Covid-19 droplets. The problem is we don’t always know who has Covid-19.
If everyone wears masks, though, we collectively reduce the Covid-19 droplets available to inhale. A collective effort to reduce Covid-19 presence in the air is the reason everyone needs to wear a mask, not protection from the virus.
I test drove my mask yesterday during my haircut (!!!) and again during my evening walk. I heated up just sitting in the air conditioned barber chair and again walking outside later in the evening, a little more than on previous walks. It’s going to be uncomfortable as the temperatures start hitting 25C more regularly.
I have to admit I’m a bit skeptical of the computer models of this new mask application. However, it’s a cheap experiment and, as long as at least 80% of my fellow travelers are willing to play along, I’m in. I just hope any benefit is clear by the time temperatures are regularly above 25C. I’ll need motivation. And more showers.
There are plenty of other things we’re learning six months into the Covid-19 pandemic. For instance, yesterday the CDC changed its mind about contaminated surfaces. It announced that surface spread of Covid-19 is possible, but unlikely. I don’t want to be the first one to tell you that all those hours you spent wiping down packages with bleach were a waste of time, but, well, from now on, just wash your hands, please.
Speaking of the CDC, here’s a post from a former CDC staffer about how bad things are at the CDC. Many Americans, including me, are disappointed that the CDC didn’t deliver a timely Covid-19 test. Perhaps Americans should be disappointed about decades of CDC budget cuts instead.
Oh, and about the Trump administration’s inability to execute on standard operating procedures during the Covid-19 crisis.
CDC awareness of the threat of spread from China prompted it to activate its emergency operations center on January 20th. That is when a national-level incident-command system should have been activated in Washington. One early task of such an ICS would have been to reach out in January, not March, to industrial collaborators to prepare for the predicted massive need of tests. In 2014, a prompt, government-wide effort coordinated the Ebola response that successfully kept that epidemic in Africa.
Bruce G. Weniger, MD, MPH and Chin-Yih Ou, PhD, “Straight Talk from ex-CDC for the Long Slog Ahead,” 3 May 2020
This insightful essay examines the influence of politics on a scientific organization struggling to deliver good public health. It explains that we should expect the Covid-19 pandemic to extend well into 2021 and that we should not expect a vaccine for at least 18 months. This is the kind of public health information we can hear from former CDC staff, but not current staff.
Because Trump cannot manage anything as long as an intelligence briefing, let alone a full scale public health response to Covid-19, the essay contends that the US has left behind the world where the scientists guide public health policy to a world described as a “natural experiment.”
In the the world of the natural experiment, each state or consortium of states carries out its own Covid-19 experiment. The role of the scientist is simply to observe and report rather than to guide policy. The American dream comes to fruition.
So, it’s no surprise Covid-19 testing is screwed up in the US. The CDC can’t deliver and the administration doesn’t want bad numbers in front of an election. How important is it to the Trump administration not to test?
I hate to report this. Meat producer JBS prevented low wage workers from getting Covid-19 tests after they were exposed to Covid-19 or had symptoms. That’s how screwed up testing is in the US.
Shame on JBS. Eight workers at the Colorado JBS plant have died from Covid-19. After 20 years on the job, the local public health director resigned to “spend more time with family and [focus] on his health.”
America is prioritizing business over safety because Trump needs to win re-election.
There’s so much more to talk about with the Covid-19 catastrophes in Brazil and Russia, the double whammy of Covid-19 and Cyclone Amphan in India and Bangladesh, and a Ramadan Covid-19 spike. But I’m going to end in Bolinas, California, a quaint coast city just north of San Francisco where my family sometimes took summer vacations.
Residents of Bolinas noted that Vò. a town in Italy cloistered from the world the way Bolinas is cloistered, tested all its residents for Covid-19. Bolinas decided to folllow in Vò’s footsteps. What it learned testing all its residents was as much about the how small communities work together as about the actual test results.
… U.C.S.F. researchers agreed to process the tests in Bolinas. They also undertook a parallel testing effort in San Francisco’s Mission District, which is the opposite sort of place: a highly populous urban residential and commercial center at the nexus of several transportation systems. (Historically, the Mission has also been fairly ethnically diverse, and home to much of San Francisco’s Hispanic population. Bolinas is almost ninety per cent white.) Their idea was that, by comparing these very different places, they could bookend a spectrum of conditions that further research could fill in. If we understood how the virus spread under different circumstances, with different factors in play, our modelling would gain nuance.
Nathan Heller, “The Town That Tested Itself,” The New Yorker, 20 May 2020.
The testing was good for scientists and for residents. It showed that a small city can organize itself to fight the pandemic and succeed. What we all need, whether we’re in Bolinas or Barcelona, is the information and guidance to succeed.
Even if you’re not in Bolinas or Barcelona, here’s a list Brad found for all the things your community needs to consider as it relaxes its Covid-19 restrictions. Like everything else with Covid-19, it will change next week and next month. For now, I’m going to put on my mask and buy a copy of Virginia Woolf’s Orlando.
COVID Diary BCN 
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