As masks come off, vulnerable Americans feel left behind
“for millions of Americans, many of whom have chronic conditions or disabilities that make them especially vulnerable to Covid-19, the pandemic is far from over.”
Tag: masks
Some hospitals ask patients, visitors to remove N95s, citing CDC
“Late last year, Laura Wing-Kamoosi visited her 79-year-old father at the hospital in northern Michigan. To her surprise, a worker asked her to remove her N95 and replace it with a surgical mask. She declined, layering the surgical mask atop her N95 instead.
She saw no staff wear N95s, among the best respiratory protection available, while they treated her father for a tear in his aorta and other medical issues, she told POLITICO. One doctor wore his surgical mask under his nose, she said. Her father, who was hospitalized for about a month, contracted Covid-19 during his stay, and while he survived, the virus slowed his recovery.
The hospital, Munson Healthcare, said it requests visitors wear the surgical masks it provides to ensure people are using quality masks and that it allows visitors to layer one over their own. The hospital is following guidance from the Centers for Disease Control and Prevention — and for many public health advocates, that’s exactly the problem.
They fear that surgical masks put the most vulnerable people at higher risk of catching Covid-19. N95s, which seal tighter to the face, offer better protection against the airborne virus, studies show. For more than a year, many have called on the Biden administration to change its guidance to offer more protection inside hospitals, even as mitigation measures have been dialed back and case counts decline.
And yet, patients across the country say they are often told to replace their N95s with surgical masks as they enter hospitals.”
There Is Little Evidence That Mask Mandates Had an Important Impact During the Omicron Surge
“Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. But as Flam notes, “the benefits of universal masking have been difficult to quantify” in the real world, where cloth models predominate and masks may not be clean, well-fitted, or worn properly.
The strongest real-world evidence in favor of general masking comes from a randomized trial in Bangladesh, which found that the use of surgical masks reduced symptomatic infections by 11 percent. That’s not nothing, but it’s a pretty modest effect, and it was achieved with surgical masks worn by adults in conditions that encouraged proper and consistent use. The same study found that cloth masks did not have a statistically significant effect.”
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“Given the situation during the omicron surge, there are additional reasons to doubt that mask mandates, even with perfect compliance, had much of an impact. While mandates required shoppers to don masks before entering supermarkets, for example, the risk of transmission in such settings is low, given the amount of time customers usually spend in them, the size of the air space, and typically wide distances between patrons. Conditions in bars and restaurants are more conducive to virus transmission, since customers spend more time there in closer proximity to each other, often while talking. But since people were allowed to remove their masks while eating and drinking, requiring them to cover their faces upon entry was more a symbolic gesture than a serious safeguard.
Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. Even if masking works, that does not necessarily mean mandates do.
An Annals of Epidemiology study published last May found that mask mandates in the United States were associated with lower transmission rates from June through September 2020. “The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening,” the researchers reported. But the study did not take into account other policies or voluntary safeguards that may have differed between jurisdictions with and without mask mandates. Nor did it look at actual mask wearing, as opposed to legal requirements.
Based on data from various countries and U.S. states from May to September 2020, a preprint study published last June found that general mask wearing was associated with a reduction in virus transmission. But the researchers found no clear relationship between mask mandates and mask use. “We do not find evidence that mandating mask-wearing reduces transmission,” the authors reported. “Our results suggest that mask-wearing is strongly affected by factors other than mandates.”
An August 2021 systematic review of 21 observational studies found that all of them “reported SARS-CoV-2 benefits” from mask mandates “in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes.” But “few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing.”
Like the debate about lockdowns, the debate about mask mandates will continue. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. But it seems clear that anyone who takes it for granted that mask mandates have played a crucial role in controlling the spread of COVID-19 is making a series of assumptions that are not justified by the evidence.”
When Is It Safe To Lift School Mask Mandates?
“pediatric hospitalizations are occurring almost exclusively among kids who are not vaccinated. Most school-age children are eligible to have been vaccinated, but most school-age children have not yet been vaccinated. Depending on what numbers you look at, only around 50 to 60 percent of kids ages 12 to 17 have been fully vaccinated, and only around 25 percent of kids ages 5 to 11.”
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“today is not the day to remove mask mandates in schools. Rather, you want to wait until case rates are much lower than they are today. Not simply for the sake of kids, but also so that children aren’t bringing the disease home. But governors are up against political pressures.
The important thing to highlight here is that many of the governors who have lifted mask mandates in the last couple of days have said that the mandates will be lifted for schools three or four weeks in the future, not today. And three or four weeks in the future, chances are that case rates will be lower, so by then it actually will be much safer to remove the mask mandates without putting kids and communities at high risk, just because there won’t be a lot of circulating COVID.”
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“There are a number of observational studies showing that communities and schools that have universal masking have lower rates of COVID-19 among kids in the school, and a couple of studies suggesting higher rates of transmission within schools that forego masking. And of course, there are many more studies in adults and kids in general — really, the preponderance of evidence supports that masks work, and they work for kids as well as for adults.”
The United States finally has free rapid tests and N95 masks – well behind many other countries
https://www.yahoo.com/news/united-states-finally-free-rapid-094937113.html
Why Covid-19 is always one step ahead of the US response
“The Biden administration’s response to the omicron variant is belatedly kicking into gear. The White House announced Wednesday that it would soon ship 400 million N95 masks to US pharmacies and community health centers to be given away. Americans can submit their bills for at-home tests to their health insurer for reimbursement, and on Tuesday, a new federal website launched that lets people order a few free at-home coronavirus tests.
Free tests and free masks are finally here — after some public health experts have been calling for them since omicron was first detected around Thanksgiving or even earlier. But the tests and masks might not arrive in Americans’ hands until the end of the month.
“By the time the masks and tests get there, the surge will probably be over,” Monica Gandhi, an infectious diseases doctor at the University of California San Francisco, told me. It’s possible — but far from certain — that the omicron wave has already peaked. The average number of daily cases has dropped by 50,000 in the last week, a 6 percent decline.”
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“Experts point to three main factors in the US government’s slow response to omicron: an over-reliance on vaccines, a failure to develop contingency plans, and the fracturing of the expert consensus on what the appropriate public health interventions would be.”
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“There are limits on what the federal government can do under our federalist system of government. Mask mandates and social distancing restrictions are largely the purviews of state and local authorities. The Biden administration did attempt to take sweeping actions, such as a vaccine mandate for large employers, that got tied up in the courts.”
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“Public health experts were never a monolith. But early in the pandemic, there was a fairly clear consensus about what to do about Covid-19: Close some businesses, ban most large gatherings, mandate masks, and develop a vaccine. A New York Times survey of hundreds of epidemiologists found in the summer of 2020 that more than half were in agreement about the timeline for resuming many activities that had been stopped because of Covid-19, such as vacationing within driving distance or eating out at a restaurant.
But as the pandemic has dragged on, expert opinions diverged. In spring 2021, the Times ran another survey of epidemiologists, asking them how long people would need to wear masks indoors, the answers varied wildly; 20 percent said half a year or less, while another 26 percent said people would wear masks indefinitely, at least in certain situations. As the Biden administration debated booster shots this summer and fall, some experts were full-throated supporters of giving everybody an additional dose, while other prominent experts argued boosters made sense only for certain people.”
Against Faucism
“Last week, the CEOs of American Airlines and Southwest Airlines told Congress that they do not think mask requirements make much sense on airplanes, where the air filtration systems are superior to what is typically found in an intensive care unit.
“I think the case is very strong that masks don’t add much, if anything, in the air cabin environment,” said Gary Kelly, CEO of Southwest. “It is very safe and very high quality compared to any other indoor setting.”
Unwilling to let anyone undermine the case for keeping a government mandate in place, White House coronavirus advisor Anthony Fauci threw cold water on the idea.
“You have to be wearing a mask on a plane,” he said bluntly on television Sunday.
When ABC News’ Jon Karl asked Fauci specifically if he thought we would ever reach the point where we did not need to wear masks on planes, he responded: “I don’t think so. I think when you’re dealing with a closed space, even though the filtration is good, that you want to go that extra step when you have people—you know, you get a flight from Washington to San Francisco, it’s well over a five-hour flight. Even though you have a good filtration system, I still believe that masks are a prudent thing to do, and we should be doing it.”
This is Faucism distilled down to its very essence. For the government health bureaucrats who have given themselves sole authority over vast sectors of American life—from travel to education to entertainment to housing—it doesn’t matter what the CEOs of these companies think. It doesn’t matter what their customers want. It doesn’t matter if maskless air travel is, for the most part, quite safe (especially for the vaccinated). It doesn’t matter if the mask mandate makes air travel impossible for families with young children. All that matters is the calculus of the most risk-averse people: unelected public health experts at the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).
Like Fauci, NIH Director Frances Collins said this past weekend that air passengers should be masked—and should think twice about large gatherings, and even about going anywhere at all.”
Lockdowns’ High Costs and Murky Benefits
“If legislators were determined to “save lives, period, whatever it costs,” they would set the speed limit at 5 miles per hour, or perhaps ban automobiles altogether, which would prevent nearly 40,000 traffic-related deaths every year. Those policies seem reasonable only if you ignore the countervailing costs. In public policy, economist Thomas Sowell famously observed, there are no solutions; there are only tradeoffs.
“Logically,” Bourne writes, “there must be some negative consequences of government lockdowns, and some point at which they might become self-defeating.” To figure out when that might be, policy makers needed to estimate the public health payoff from lockdowns and compare it to the harm they caused.
Contrary to Cuomo’s framing of the issue, this is not a matter of weighing “the economic cost” of maintaining lockdowns against “the human cost” of lifting them, as if those categories were mutually exclusive. Even in life-and-death terms, lockdowns had a downside, since they plausibly contributed to a spike in drug-related deaths, discouraged potentially lifesaving medical care, and inflicted financial and psychological distress, neither of which is good for your health. And as Bourne emphasizes, “economic welfare” goes beyond household finances or GDP, encompassing everything people value.”
Florida’s mysterious Covid-19 surge
“Toward the end of the summer, Florida became the epicenter for America’s recent Covid-19 wave — reporting more hospitalizations and deaths than any other state in the country. But there was and still is surprisingly little certainty, among experts, over one question about Florida’s surge: Why did it happen?
The most common explanation for the outbreaks in the South that we saw over the recent summer was the low vaccination rates across the region. It’s true vaccination rates are low across the South: Seven of the 10 states with the lowest vaccination rates are in the region. And lower vaccine rates do correlate with more Covid-19 cases and deaths.
But Florida defies the regional trend. The state ranks 20th for full vaccination in the US, with 56 percent of people fully vaccinated — not great, but a little above the national rate. At the peak of its outbreak in mid-August, Florida had fully vaccinated about 51 percent of its population — again, not great, but in line with the national rate.
Maybe Florida loosened restrictions too quickly and more aggressively? It’s certainly true that Gov. Ron DeSantis has taken a more hands-off approach than leaders in blue states, but it’s not clear if this actually led to differences in how the public behaved.
According to Google’s mobility data, Floridians around mid-August were about 14 percent less likely to travel to retail and recreational outlets compared to pre-pandemic times. That’s almost the same as Californians, and actually lower than New Yorkers. Neither New York (about 59 percent fully vaccinated at the time) nor California (about 54 percent fully vaccinated at the time — not much higher than Florida) saw surges anywhere as bad as Florida’s in August.
The same trend holds for other metrics that measure precaution. Based on Carnegie Mellon University’s COVIDcast, through August, Floridians were more likely to mask up than New Yorkers or residents in other states that didn’t see nearly as big Covid-19 surges.
Based on OpenTable’s restaurant reservation data, Florida was back to pre-pandemic numbers for restaurant reservations around mid-August, but that wasn’t too different from the US as a whole. Some states, like New Jersey and Connecticut, equaled or surpassed their pre-pandemic baseline for restaurant reservations and didn’t see anywhere near the surge that Florida did (although both benefited from significantly higher vaccination rates than Florida).”
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“We don’t know everything about why Covid-19 cases rise, and we don’t know everything about why they fall, either. David Leonhardt and Ashley Wu at the New York Times recently demonstrated that the coronavirus appears to follow two-month cycles in its rises and falls.”
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“This isn’t to say that nothing matters in the fight against Covid-19. We know vaccines work to protect people from severe illness, including against the delta variant. Social distancing, masking, and restrictions do, too. Chances are Florida’s surge would have been much smaller if it had done better on all these fronts.
But Florida’s example complicates any story of recent Covid-19 surges that focuses solely on reopenings and vaccinations. Something else seems to be going on, and experts aren’t totally sure what. “There are things that, to be honest, we don’t fully understand,” Ashish Jha, dean of the Brown University School of Public Health, told me.”
Rand Paul’s Criticism of Cloth Masks Was Stronger Than the Evidence Justifies
“his flat, categorical statements about cloth masks are stronger than the scientific literature supports, relying on a couple of cherry-picked studies with known limitations while ignoring countervailing evidence.
In a video responding to his YouTube suspension, Paul reiterates that “most of the masks that you get over the counter don’t work” and “don’t prevent infection.” He argues that “saying cloth masks work when they don’t actually risks lives,” describing it as “potentially deadly misinformation.” While N95 respirators are effective at preventing virus transmission, he says, “the other masks don’t work.”
Paul would have been on firm ground if he had said cloth masks offer less protection than N95 masks. But the claim that cloth masks “don’t work,” meaning they offer no protection at all, is inconsistent with multiple studies suggesting that they reduce the risk of infection, especially when worn by carriers but possibly also when worn by other people in their vicinity.”