Can surgical masks protect you from getting the Flu?
January 26, 2020 6:28 PM   Subscribe

 
The vaccine helps too.
posted by entropone at 6:38 PM on January 26 [4 favorites]


I'm seeing some interesting facemask designs: cartoon characters, skeletal grins.
posted by doctornemo at 6:40 PM on January 26


I can’t not touch my face, all the time. Seriously. Send help.
posted by Don.Kinsayder at 6:59 PM on January 26 [42 favorites]


NYT weighed in the other day:
The masks will, however, block most large respiratory droplets from other people’s sneezes and coughs from entering your mouth and nose, said Dr. Amesh Adalja, an infectious disease physician at the Johns Hopkins Center for Health Security. Coronaviruses are primarily spread through droplets, he said.

The bigger problem is that people don’t use the masks properly. “Most people will put their hand underneath the mask to scratch their face or rub their nose,” bringing contaminants in contact with the nose and mouth, said Dr. Adalja. “You can’t take it off when you get a phone call.”
So yeah, it sounds like washing hands is more important, but masks can help if worn properly.
posted by gwint at 7:03 PM on January 26 [14 favorites]


The vaccine helps too.
I don't think there is one yet, though. And as probably-ineffective ways of dealing with disease-related panic go, face masks are pretty benign. They're cheap, and they're not going to hurt anyone.
posted by ArbitraryAndCapricious at 7:03 PM on January 26 [9 favorites]


If it's the sick folks wearing the masks, it's helping to keep them from blowing contagious droplets all over non-sick folk when they sneeze & cough. Me, I'm in favour of that.
posted by Mary Ellen Carter at 7:23 PM on January 26 [28 favorites]


And as probably-ineffective ways of dealing with disease-related panic go, face masks are pretty benign. They're cheap, and they're not going to hurt anyone

I'm always a bit squicky about that line of thinking, though. I hate slippery slope arguments, but people say the same thing abut homeopathy, and the largely flim flam nonense behind most vitamin supplements.

If they don't hurt anyone, sell them with the bolded caveat: Evidence suggests these masks may not be effective to reduce your risk of catching influenza and other viruses.

If it's the sick folks wearing the masks, it's helping to keep them from blowing contagious droplets all over non-sick folk when they sneeze & cough.

Did you read the article before commenting? Because it touches on that directly. They may not be so effective, there, either!
posted by smoke at 7:26 PM on January 26 [5 favorites]


While I'm not anti-mask, I think it's worth thinking about costs that might not be obvious, before everybody thinks masksmasksmasks and their usage expands significantly:

- Manufacturing costs
- Time finding them, buying them, storing them
- Interfering with seeing people's facial expressions, which is even more important when we have so little face-to-face time with other humans
- Adding a little extra effort to every breath, which might adjust risk factors for some things
- If they end up being made of fleece or plastic, they could contribute various unfortunate kinds of pollution if they're thrown out indiscriminately.
posted by amtho at 7:27 PM on January 26 [1 favorite]


If it's the sick folks wearing the masks, it's helping to keep them from blowing contagious droplets all over non-sick folk when they sneeze & cough.

Yes, apparently the latest coronavirus has quite a long incubation period - up to a couple of weeks, longer than the flu - and, like the flu but unlike, say, SARS, is infectious during the incubation period. So this article about the influenza virus is probably not that relevant to the question of whether wearing a mask protects other people.

According to the NYT article linked above:
There is general agreement that infected patients who wear surgical masks are less likely to spread infection to others. The Centers for Disease Control and Prevention has instructed hospitals to ask any patients who have a fever or respiratory illness, have recently traveled to Wuhan, or have come in contact with someone who has traveled there, to wear a surgical mask.
posted by A Thousand Baited Hooks at 7:36 PM on January 26 [8 favorites]


So this article about the influenza virus is probably not that relevant to the question of whether wearing a mask protects other people.

Did... did you read it? It's about how effective masks are as prophylactics, primarily. So plenty relevant.

Anyone who is sick should absolutely be encouraged to wear masks to reduce the spread of droplets; all global health authorities are recommending that. It is interesting to note, however, that wearing a mask may not be as effective as commonly supposed when it comes to stopping the spread, either (not saying it's ineffective!).
posted by smoke at 7:42 PM on January 26 [8 favorites]


Did... did you read it? It's about how effective masks are as prophylactics, primarily. So plenty relevant.

Yes, I read it. I don't see how the fact that bacteria have been found on the outside of surgical masks, and that:
...given that many people describe the flu as like being hit by a truck, it is unlikely that people will be strolling around town with a mask on when they’re at their most infectious – three to four days after symptoms begin.
...is particularly relevant to the question of whether wearing a mask prevents spreading coronavirus to other people - possibly while you're in the infectious incubation period and don't know that you're infected. What am I missing?
posted by A Thousand Baited Hooks at 7:49 PM on January 26


(not saying it's ineffective!)

No, you’re just saying masks should have a warning on them that says that.
posted by Sys Rq at 8:56 PM on January 26


I think you're confusing two different things:

1) wearing a mask as a preventative measure (not very effective, should be called out as such as the majority of current purchasing appears to be driven by this).

2) wearing masks to reduce exposure to others when you're already sick (can be effective, but perhaps not as effective as commonly supposed, due to improper use, endemic face and other touching, and potential inefficacy of filters).

Apologies if that wasn't clear. I found this and other articles interesting as pharmacies here in Australia for example, are widely sold out of face masks. Given we've had like six cases, people are obviously buying them for reason number one, not two. What they don't realise is that washing hands, and avoiding touching things is probably more effective. Additionally, our eyes catch droplets and they aren't shielded by masks.

From the BBC article:
Dr David Carrington, of St George's, University of London, told BBC News "routine surgical masks for the public are not an effective protection against viruses or bacteria carried in the air", which was how "most viruses" were transmitted, because they were too loose, had no air filter and left the eyes exposed.

...

Dr Connor Bamford, of the Wellcome-Wolfson Institute for Experimental Medicine, at Queen's University Belfast, said "implementing simple hygiene measures" was vastly more effective.

"Covering your mouth while sneezing, washing your hands, and not putting your hands to your mouth before washing them, could help limit the risk of catching any respiratory virus," he said.

posted by smoke at 9:25 PM on January 26 [7 favorites]


My understanding of surgical mask-wearing for this kind of disease was that 90 percent of the value was not so much keeping you from infecting others, or even them being much help from airborne particles, but making sure you can't touch your mouth and noise with your fingers, which is a far more likely way to transmit most viruses.
posted by tavella at 9:36 PM on January 26 [4 favorites]




So the article says research hasn't been able to show that the masks prevent flu, and ends with the conclusion that you should wash your hands...no research cited. Hmmm.

Top two Google search results for evidence that washing hands prevents flu:

Show Me the Science - Why Wash Your Hands?
Says handwashing has been shown to reduce respiratory illnesses by 16-21%. Links to two studies that seem to be the source of the two numbers. Hey, that's maybe a tiny bit more effective than the vaccine!

Hand hygiene and risk of influenza virus infections in the community: A systematic review and meta-analysis
I noticed that one of the co-authors is also a co-author on one of the two studies cited by the CDC page. The article is full of jargony jargon that I'm not going to take the requisite hours to understand, although the words "not statistically significant" jumped out at me. Skipping down to "Discussion":
We examined the efficacy of hand hygiene interventions in preventing influenza virus transmission in the community. The subgroup analysis from developed countries suggested that a combined intervention consisting of hand hygiene with facemasks is an effective strategy to prevent influenza, but we did not confirm the efficacy of hand hygiene alone for reducing influenza illness. This is consistent with evidence on the important role of aerosol transmission of influenza, such that interventions against contact transmission alone like hand hygiene may not be sufficient to control influenza transmission in the community
So of course I'm going to continue what I do every year, get the vaccine, and wash my hands...mmm sometimes...and probably not be wearing any masks. But is this paper actually saying that science doesn't (yet?) tell us that handwashing prevent flu?
posted by polecat at 9:46 PM on January 26 [1 favorite]


Additionally, our eyes catch droplets and they aren't shielded by masks.

I'm reminded of the inner meaning of "inoculate."
posted by sjswitzer at 10:39 PM on January 26 [8 favorites]


They may not be so effective, there, either!

The private medical office I use offers masks and hand sanitizer dispensers outside the elevators on each floor, and has done so for three years, now. They have signs asking that anyone with flu or other respiratory symptoms to put on a (free) mask. I'm inclined to believe medical experts on this one.
posted by They sucked his brains out! at 10:51 PM on January 26 [3 favorites]


I work in a school in Hong Kong and I have every intention of wearing a mask in class every day, when we eventually go back, for the remainder of the year. People have pretty good mask hygiene here and kids are used to asking for one if they feel ill. In a city as dense as this one every little bit helps.
posted by mdonley at 11:13 PM on January 26 [4 favorites]


I think you're confusing two different things:

Nope! Not confused at all.

The thing is, we just don't know enough about the coronavirus to be able to say whether or not the widespread wearing of masks by apparently uninfected people will be effective at preventing the virus' spread. If, in fact, the virus has a long incubation period during which people are infectious without feeling sick, which seems like it may be the case, the general wearing of masks may be quite effective at a population level. And this could be true even if masks are completely ineffective at protecting the wearer, and even if the masks are only partly effective at preventing the wearer infecting others, and even if the people wearing them are doing so for the wrong reasons. If so, "calling out" people for wearing masks prophylactically will not be helpful.

Note that the only suggestion in the original article that masks are ineffective at preventing the wearer infecting others is specific to influenza, and based on the specific infectious characteristics of influenza virus. Is this also true for coronavirus? We don't know!

Now, it's probably true that there's little point in wearing a mask in a place like Australia at the moment, unless you have some particular risk factor. But that's just because the virus probably isn't really here yet, and may change pretty quickly.
posted by A Thousand Baited Hooks at 11:29 PM on January 26 [3 favorites]


Sorry, I was talking to sys req; I think you and I are in agreement!
posted by smoke at 11:34 PM on January 26


Sorry - all good, then.

I wonder if the PM25 masks we have for the bushfire smoke work for coronavirus...
posted by A Thousand Baited Hooks at 11:42 PM on January 26


I read one study on 2.5 but again the issue always comes back to non compliant use. Theoretically they should, but hardly anyone uses masks correctly.

Worse news; long term exposure to 2.5 particles makes you more susceptible to corona viruses like flu and this one.
posted by smoke at 11:46 PM on January 26 [2 favorites]


Masks. If I look outside, almost everyone is wearing one. Shopkeepers, cleaning ladies, even people walking their dogs. But you know what I also see? People dangling them from one ear to swig water or pulling them down for a smoke break. There's a reason we don't wander around wearing masks every day.

What I don't see? Hygiene stations. Sinks with soap. Free hand sanitizer.

My concern is that masks are just a way to make people feel safe. What happens if, God forbid, Beijing was to become a new hotspot for coronavirus? All the masks will have been used. People haven't been preparing to stay indoors, so everyone still has to go out for shopping or get supplies delivered. But now we won't have any masks left.

I really hope that they're wrong about transmission when people are asymptomatic. It's hard to know what to believe.
posted by Trifling at 1:15 AM on January 27 [9 favorites]


I don't think there is one yet, though.

The article is about the flu, and there definitely is a flu vaccine. It's the thing that everybody forgets to get each year.
posted by entropone at 5:02 AM on January 27


i have to fly through several west coast airports up the to my workplace in the arctic next week.

I ordered a case of masks last week, and advised my world traveling friends to do the same, at the first news of the virus reaching beyond China, knowing they’d be panic-selling and scarce by now. I intend to wear a mask on planes and in airports.

We don’t know how effective masks are for this pathogen. If they’re marginally effective — and all evidence suggests they are at least that for most pathogens — why wouldn’t you wear one? What risk are you taking? That you might waste 30 cents on a mask? And yes, they keep you from unconsciously touching your mouth and face whether or not they filter out pathogenic organisms.

Masks are also valuable to keep in an emergency kit and they don’t go bad in storage. And they’re cheap. If you can find them.

I really won’t be reading metaanalaysis articles that argue over how many microns wide a particle has to be or point out that “most people”’ use them wrong. It’s not a choice that excludes other rational choices other than deciding to stay isolated and locked in my rural home until the situation ends.

I also apparently missed the health advisory that you can either wash your hands frequently or wear a mask but not both.
posted by spitbull at 5:05 AM on January 27 [5 favorites]


If I see someone in a mask, I'm reminded to wash my hands, so there's that
posted by eustatic at 5:22 AM on January 27 [6 favorites]


Those disposable paper masks become less effective as soon as they get wet, which can happen just from breathing into them.

I have a primary immunodeficiency and mask discussion comes up a lot in the Facebook groups for people with my condition, especially in flu season (and when some people become very frightened because of things like this coronavirus, measles outbreaks, etc.) Reusable N95 respirator masks with filters are what many folks seem to like if they're going to wear one for long periods, and the most recommended are Cambridge masks. But they're pricey and the filters aren't replaceable on the Cambridges so they are ineffective after 300 or so hours of use - the decorative patterns are a big selling point, though (they do a lot of promotion geared towards young people especially with cystic fibrosis.)

Meanwhile, the CDC recommends using disposable N95 respirator masks but provides guidelines for limited re-use (using a cover, for instance, to protect the outside).

I'm not saying masks are useless; some protection is better than none, even if mostly as a reminder to avoid touching your face and wash your hands frequently. But do at least keep an eye out for people who are obviously not using them properly (and yeah, that seems to be most people, at least in the U.S.)
posted by camyram at 5:26 AM on January 27 [3 favorites]


Reading this article has made my face feel itchy and so I've touched my face more rather than less. I need a face-plate or helmet. Maybe a fetching plague-doctor beak with some incense.
posted by slimepuppy at 5:34 AM on January 27 [10 favorites]


Being a little worried about the end-of-the-world-as-we-know-it, and not being able to do much about nukes and asteroids, I bought a pack of N95 masks after reading that they'll be selling out pretty quickly in the event of a global pandemic. No food-stockpiling or guns or other prepper stuff. Just a gesture to buy our neighbors and us a few extra days in one of my apocalyptic fantasies.
posted by kozad at 5:38 AM on January 27 [1 favorite]


The article is about the flu, and there definitely is a flu vaccine. It's the thing that everybody forgets to get each year.

There are many different strains of the flu and the vaccine doesn't cover all of them. They're constantly mutating and the vaccine is tailored to what doctors think will be prevalent that year and the latest strains. This virus is new and thus the vaccine could not have been formulated to cover it.
posted by schroedinger at 5:41 AM on January 27


But...getting the flu vaccine can LESSEN the effects of getting flu. So definitely still the smartest choice.
posted by tiny frying pan at 5:45 AM on January 27


Right, I'm just saying it won't lessen the effects of getting this particular strain. Everyone should be getting it regardless.
posted by schroedinger at 5:51 AM on January 27


Tl;dr wash your hands regularly, and try not to touch your face.
I can’t not touch my face, all the time. Seriously. Send help.

Tie strings from your belt to each wrist so you can reach just up to your shoulders, then put on an appropriate mask and gloves and walk around roaring like Tyrannosaurus rex. That should keep the infection (and infectious people) away.
posted by pracowity at 6:00 AM on January 27 [11 favorites]


Right, I'm just saying it won't lessen the effects of getting this particular strain.

This is incorrect.

Even if a year's flu vaccine winds up being a bad match for the dominant strain of flu virus that's circulating that year, getting the vaccine still lessens the severity of illness, which can save lives (tn the USA the flu kills an estimated 10,000 - 60,000 people per year).
posted by entropone at 6:03 AM on January 27 [5 favorites]


Another benefit to wearing a surgical mask is that if you suddenly find yourself needing to do surgery during your morning commute, you’re ready.
posted by oulipian at 6:09 AM on January 27 [14 favorites]


Friendly reminder that these types of vaccines are not 100% effective, so in addition to getting vaccinated be sure to also wash your hands frequently and, if you are infected and need to be out in public, wear a mask.
posted by grumpybear69 at 6:09 AM on January 27 [1 favorite]


I know it's not an option for a lot of people, but working from home is a pretty good way to dodge trouble.
posted by pracowity at 6:54 AM on January 27


I used to get sick a lot, whenever I went into places with crowds. But when I started using a wheelchair/scooter in public places, I stopped getting sick as often. Like they say, you get sick from touching things and then touching your face. But when I am in the wheelchair I don't touch nearly as many handrails, so even though I still touch my face, I don't have as much exposure.

I wonder if gloves would work better than masks, for curbing the spread of viruses? Something to interrupt all that touching.
posted by elizilla at 8:14 AM on January 27 [4 favorites]


Many years ago I asked a friend of mine who lives in Japan why Japanese tourists in San Francisco often wore masks. Did they think the US was that unhealthy? And she explained to me that they were being thoughtful because the people wearing the masks were ill themselves. Just to repeat what other folks have been saying. My dad is in a nursing home and I have a cold. If it’s not better later today I won’t go see him. But if it does get better I will be wearing one of those masks when I visit.

I have three flights to get home after my visit to the US. And I may well be wearing a mask during those flights. But probably not the entire time because I wear glasses and they always get fogged up when I am wearing a mask. If someone knows how to solve this problem, please let me know. I’m just really tired of getting a cold every single time I travel. And in both directions. So now I’m suffering through my US cold. After I leave to go home, I will get to have that cold. Bleech.
posted by Bella Donna at 8:58 AM on January 27 [5 favorites]


I wear glasses and they always get fogged up when I am wearing a mask

A proper cartridge mask should fix that, assuming it's been properly fitted. If you don't want to go all the way to a halfmask (it would probably tend to alarm those near you, as it looks like you're getting ready for chemical warfare or serious carpentry), then 3M makes disposables (eg: the 8210V) with an exhale valve that helps significantly.

NOTE, however, that the valved disposable masks are aimed at industrial-type hazards (dusts etc). If you want to step up to biological filtering with a disposable mask then you need something like the the 1860, which is rated against tuberculosis and has bacterial filtration efficiency studies, but which does not have an exhale valve and may fog your glasses unless you keep it well-fitted.
posted by aramaic at 9:11 AM on January 27 [4 favorites]


Thank you, entropone. Yes. The regular flu vaccine lessens the severity of symptoms. So it's a good try at a flu insurance policy, even against this new strain.
posted by tiny frying pan at 9:37 AM on January 27 [1 favorite]


I wonder if gloves would work better than masks, for curbing the spread of viruses? Something to interrupt all that touching.
And goggles, to keep particles out of our eyes. Maybe a veil from over a hatbrim to under my chin to keep me from touching my face... Oh hi, steampunk wins.
posted by clew at 1:44 PM on January 27 [1 favorite]


I’ve always wanted an excuse to get into steampunk. Thanks, clew.
posted by Bella Donna at 2:42 PM on January 27 [1 favorite]


This is what I meant about masks being viewed as a panacea. All students and teachers will be required to wear masks when school opens. How are we supposed to eat, drink, or go to the bathroom? My students live in dorms of ten, are they supposed to wear masks while sleeping?

Having met a child before, I can guarantee you those masks will be taken off constantly, be used as toys, and traded. Nevermind trying to teach when no one can hear you!

We will also need to check every student's temperature and have a plan in place, but that seems reasonable.
posted by Trifling at 5:37 PM on January 27


The flu is not a coronavirus. The novel coronavirus 2019 (nCoV-2019) is not a type of flu. The large family of viruses called coronaviruses includes the common cold, SARS, and MERS (and NOT influenza). "Flu-like illness" is describing symptoms, and does not mean that the illness is a type of flu.
posted by heatherlogan at 6:14 PM on January 27 [9 favorites]


Ok.
posted by tiny frying pan at 5:28 AM on January 28


The flu is not a coronavirus. The novel coronavirus 2019 (nCoV-2019) is not a type of flu. The large family of viruses called coronaviruses includes the common cold, SARS, and MERS (and NOT influenza). "Flu-like illness" is describing symptoms, and does not mean that the illness is a type of flu.

I don't think people are confusing coronavirus and the flu - I just think that some people are talking about the article (which is about the flu only) and some people are talking about the post ("As coronavirus races around the world, surgical masks are selling out..."). Slightly awkward framing that's led to some uh "mismatched conversation."
posted by entropone at 5:50 AM on January 28 [2 favorites]


Isn't a good part of the protection offered (in such places where it is the norm to wear masks when ill) just that a non-sick person will avoid people wearing masks and take appropriate additional measures such as hand-washing and so on when working or otherwise interacting with such? I've always assumed that was a large part of the practice, warning others off to prevent casual contact transmission of the disease. That, or they're actually the yōkai Kuchisake-onna, but that's a different thread.
posted by Blackanvil at 7:45 AM on January 28


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