Rethinking Masks to Flatten the Curve

There's a growing recognition in the scientific and medical communities that wearing masks by the general public might have a place in our virus arsenal. The CDC is rumored to be changing its original stance that masks for the public do no good, and Germany and Austria are considering mandatory use by people while in public places. This pivot makes sense from a data standpoint, and it's backed by preliminary science as well.

Here is the story:

The graph shows the logarithmic increases of deaths due to Covid-19 of major countries as they battle the disease. While Western country deaths continue to double about every three days, the number of deaths in China, South Korea, and Japan have flattened to a crawl. Hong Kong and Singapore are posting similar results, and photos from any of those places show that virtually the entire public is wearing masks.

The logic behind the original CDC and WHO pronouncements is that only specialized N95 masks offer significant protection for the wearer, and even then only if they're used correctly by trained personnel--in other words, fine for doctors and nurses, not so good for the rest of us. Non-medical masks, they said, don't offer protection. This seemed to make sense in the beginning.

But now we know this disease is different from most, in two respects. First, as highlighted by this recent German study, the virus has a very long incubation period. It takes about a week on average for symptoms to appear--but the infected person becomes contagious about two days before showing signs of illness. Second, another study from Iceland indicates that about half of infected people never have symptoms at all, and yet can presumably spread the disease.

In other words, seemingly healthy people can be passing along the virus. Testing and isolating infected people are necessary, but not nearly enough--we need to assume that everyone, young and old, seemingly healthy as well as sick--can be spreading the disease.

The good news is that according to one researcher simple cloth and other masks do indeed keep some virus out, though protection is limited. Even better, they're good at keeping sneezes and coughs in. This makes sense, since any decent covering of the mouth and nose will help to prevent the spread of droplets while sneezing, coughing, or even talking. Masks can also make it harder for the wearer to touch his or her face, one of the ways that the virus can enter the body.

In other words, masks are a two-way street. They do offer some limited protection as a barrier to entry, and they also help to prevent potentially infected wearers from spreading it to people in their vicinity. It follows that if we all wear masks, the virus has to cross two barriers, and that, it seems, will reduce transmission.

I'm not a medical doctor, so while reading up on limited existing literature, I discussed this theory with two infectious disease doctors and a PhD microbiologist, and they all agreed. It makes sense that community mask wearing will reduce transmission of the virus. In fact, the collective opinion was that the main benefits of masks were minimizing spread from the wearer's coughing and sneezing, and from making it harder to touch the face.

If all this is true, the full power of masks will come when we're all wearing them. We don't even need to beta test the idea--South Korea, Japan, Hong Kong, and others have already done that. Two photos sum it up. Hong Kong Station, Hong Kong:

...and O'Hare Airport, Chicago:

There has been a mask shortage for our heroic medical workers, and we need to make sure they have them right away as a top priority. The news is filled with companies stepping up to get masks to hospitals and clinics, and hopefully that need is being filled. In the meantime, any cover is better than none. I've experimented with T-shirts (not great) and bandanas (better), but regardless, I'm going to wear something when I set out to do my shopping. It's not a great look, but it might just help to flatten the curve.