“New York City, with a population of about 8.4 million, has had over 28,000 coronavirus deaths as of May 18. Meanwhile, Hong Kong has officially recorded only four Covid-19 deaths, despite having 7.5 million residents.
One reason that could help explain the stark disparity: In Hong Kong, nearly everyone wears a face mask in public.
If any city in the world was likely to experience the worst effects of the coronavirus, Hong Kong would have been a top candidate. The urban area is densely populated and heavily reliant on packed public-transit systems, and it has very few open spaces. Moreover, a high-speed train connects Hong Kong to Wuhan, China, where the coronavirus originated.
Hong Kong, it seemed, was doomed.
But almost as soon as the outbreak first began in the city, millions of residents started wearing masks in public. One local told the Los Angeles Times that the government didn’t have to say anything before 99 percent of the population put them on.
Experts now say widespread mask usage appears to be a major reason, perhaps even the primary one, why the city hasn’t been devastated by the disease.
“If not for universal masking once we depart from our home every day, plus hand hygiene, Hong Kong would be like Italy long ago,” K.Y. Yuen, a Hong Kong microbiologist advising the government, told the Wall Street Journal last month.”
“Starting last spring, pro-democracy activists took to the streets of Hong Kong to protest a set of laws that would give mainland China — which isn’t supposed to have full control over the city until 2047 — more power over Hong Kong. To protect themselves from police tear gas and avoid the city-state’s ubiquitous surveillance cameras, millions of protesters donned masks.
In an effort to quash the movement last October, Hong Kong’s China-backed government banned the wearing of face masks in public. The hope was that forcing demonstrators to show their faces would make them stay home instead.
Just a few months later, the coronavirus happened.
As the coronavirus first hit the city, Hong Kong Chief Executive Carrie Lam fumbled her response, not wearing a mask during a press conference and, eventually, wearing one incorrectly in public. She also asked government employees not to wear masks.
By April, public health experts in Hong Kong were calling on the government to not only repeal the mask ban but also to mandate the wearing of masks in public as a means of curbing the coronavirus’s spread.
But by then, almost everyone was already wearing them, ban be damned. Indeed, the fact that the government seemed to advocate against masks may have helped make them more popular. Almost in protest, residents started wearing masks in large numbers and helping the most vulnerable communities obtain them.”
“The city has faced pandemics before, including the 1968 flu, which began in Hong Kong and killed about 1 million people worldwide. When SARS came to Hong Kong from mainland China in 2003, residents took it seriously and nearly everyone wore a mask. Partly as a result, the city lost only 300 people during that crisis.
Experts say that instilled a sense among the people of Hong Kong that masks are vital to thwarting a pandemic. That sense was reignited when the coronavirus hit. Now they’re everywhere.”
“Despite Hong Kong’s mask ban officially remaining in place, some of the government’s health officials now praise the citizenry for organically putting the coverings on without being told to do so.”
“It’s worth noting that Hong Kong also implemented a strong testing, tracing, and isolation program, in addition to strengthening travel rules and closing bars at the end of March. Those moves, perhaps just as much as masks, have helped keep Hong Kong’s coronavirus death toll low.
But the masks, research shows, are still very important.”
“Certified N95 respirators are special. Unlike a conventional surgical mask, N95 masks are built so that 95 percent of very small airborne particles can’t get through. These masks also need to be approved by the CDC’s National Institute for Occupational Safety and Health and, depending on the type, the Food and Drug Administration. In order to fulfill those requirements, N95 masks must be constructed so that they seal tightly around one’s mouth and nose, unlike surgical or cloth masks which are loose-fitting.
The United States is now confronted with a shortage of N95 masks for a number of reasons. The masks themselves are difficult to make, in part because they require specialized equipment to meet stringent regulatory standards. Many of the companies that can make the masks are also in China. That supply chain wasn’t prepared for a pandemic, especially one that originated in the same country where many of these masks are produced. And as the novel coronavirus spread throughout China, the country’s government bought its domestically produced masks, ensuring they weren’t exported. That’s made the gap between supply and demand in the US much larger.
In the absence of a pandemic, the US has typically not produced enough of these N95 masks to meet the needs of its own workers. Prestige Ameritech and 3M are the two primary companies that do end-to-end production of medical-grade N95 masks in the US, and both are both ramping up production. Another American company, Honeywell, recently started producing N95 masks at its Rhode Island and Phoenix facilities. Still, these three companies won’t solve our mask shortage.”
“America is suffering from a shortage of almost everything it needs to combat the spread of COVID-19. Hospital beds, ventilators, gloves, and gowns are all in short supply.
That’s particularly true of the N95 masks that help medical professionals avoid catching and spreading the virus as they tend to patients. The N95 designation refers to the ability of these masks to filter out 95 percent of airborne particles.
In early March, the U.S. Department of Health and Human Services (HHS) said that the country’s stockpile of N95 masks was enough to meet about 1 percent of the three billion masks we would need during a true pandemic.”
“government regulations are stifling the ability of manufacturers to set up new N95 mask production facilities—handicapping the private sector’s ability to respond to the current crisis.”
“The production of N95 masks is regulated by the CDC’s National Institute for Occupational Safety and Health (NIOSH). Prospective makers of N95 masks must submit detailed written applications to NOISH, and send finished products to its Personal Protective Technology Laboratory for testing. NIOSH staff must also personally inspect new manufacturing sites before they’re allowed to start pumping out masks.
Chisholm says regulators have told the Open PPE Project that getting agency approval could take anywhere from 45 to 90 days.”
“3M, one of the largest makers of N95 masks, says that it is producing 35 million respirators per month in the U.S. and that within 12 months it plans to double global production capacity to 2 billion masks a year. It also says it is exploring coalitions with other companies to expand mask production further.
Honeywell, another major mask manufacturer, claims it has more than doubled its mask production, according to The New York Times.
That’s a lot of masks, but nowhere near enough to meet the current demands of the country’s medical sector, let alone the demands of other essential workers and volunteers who are out in public right now, potentially dealing with sick people.”
“The world is experiencing a shortage of surgical masks and respirators. Countries around the globe are scrambling to bulk up their mask supplies to help curb the spread of the novel coronavirus and allow medical professionals to safely treat infected patients. It’s crucial for health care workers, doctors, and nurses on the front lines of the disease to have the proper protective gear to lower the risk of contracting Covid-19, but America’s mask supply is being so rapidly depleted that even the Centers for Disease Control and Prevention has suggested homemade masks, like bandanas or scarves, “as a last resort” for health care providers in “settings where face masks are not available.”
Public health officials warned about a strain in the supply chain for masks and other equipment in late February, when the pandemic started to spread in the US, which prompted regular people to snatch up medical supplies. By hoarding masks and respirators, civilians have contributed to the shortage of personal protective equipment (PPE) for health workers. (The US government is also partly to blame for overwhelming the health care system by not taking fast enough action to test citizens.)”
“So why is it so hard to produce new masks? The New York Times reported that China made half of the world’s masks before the outbreak, and while factory production has increased nearly twelvefold, the country has kept most of its inventory as it sought to control the virus. US mask manufacturers are also seeing unprecedented demand for masks, with Prestige Ameritech, the country’s biggest producer, aiming to make 1 million masks a day, compared to an average 250,000 before the pandemic.
Despite these efforts, the short-term future appears grim.”