If You Saw A Rabid Dog You Might Shoot It, But You Can't Shoot Someone Who Refuses To Wear A Mask

I doubt Senor Trumpanzee and his Death Cult are going to be happy about this, but in a JAMA interview yesterday, CDC Director, Dr. Robert Redfield said and wrote that universal masking would stop the pandemic. "I really do believe that if the American public all embraced masking now... rigorously... over the next 4-8 weeks we could bring this epidemic under control.

Covering mouths and noses with filtering materials serves 2 purposes: personal protection against inhalation of harmful pathogens and particulates, and source control to prevent exposing others to infectious microbes that may be expelled during respiration. When asked to wear face coverings, many people think in terms of personal protection. But face coverings are also widely and routinely used as source control. For instance, if given the choice between having surgery performed by a team not wearing some covering over their mouths and noses vs a team that does, almost all patients would reject the former. This option seems absurd because it is known that use of face coverings under these circumstances reduces the risk of surgical site infection caused by microbes generated during the surgical team’s conversations or breathing. Face coverings do the same in blocking transmission of SARS-CoV-2.

Early in the pandemic, the Centers for Disease Control and Prevention (CDC) recommended that anyone symptomatic for suspected coronavirus disease 2019 (COVID-19) should wear a face covering during transport to medical care and prior to isolation to reduce the spread of respiratory droplets. After emerging data documented transmission of SARS-CoV-2 from persons without symptoms, the recommendation was expanded to the general community, with an emphasis on cloth face coverings that could be made more widely available in the community than surgical masks and to preserve personal protective equipment such as N95 respirators to the highest-risk exposures in health care settings. Now, there is ample evidence that persons without symptoms spread infection and may be the critical driver needed to maintain epidemic momentum.

While community use of face coverings has increased substantially, particularly in jurisdictions with mandatory orders, resistance continues. Some have raised concerns that homemade face coverings made from household fabrics may be inferior compared with commercially manufactured products. Cloth face coverings can substantially limit forward dispersion of exhaled respirations that contain potentially infectious respiratory particles in the 1- to 10-μm range that includes aerosol-sized particles, and recent research of household textiles’ performance when used as source control suggests cloth face coverings may be able to do so with acceptable efficiency and breathability. Others may think it is premature to promote community masking until research has been completed that measures the effectiveness of cloth face coverings to prevent exposure specifically to SARS-CoV-2. Laboratory studies will be difficult and costly because they require capacity to safely manage this biosafety level 3 pathogen. Any type of community-based randomized trial will be complex to deploy in the right setting (a community with active infection) at the right time (when infections are increasing) to produce actionable results quickly. In the absence of such data, it has been persuasively argued the precautionary principle be applied to promote community masking because there is little to lose and potentially much to be gained. In this regard, the report by Wang et al provides practical, timely, and compelling evidence that community-wide face covering is another means to help control the national COVID-19 crisis.

Other than to walk in the lonely Griffith Park hills in my neighborhood, I haven't been out of the house without an N-99 mask since February. [And when I walk in the hills I wear a surgical mask.] In February, when I first started going to stores to stock up, with my mask-- and other paraphernalia-- on, people looked at me strangely, some giving me aggressive looks, others just running away from me (which was even more than I could have hoped for). But I told Roland that it wouldn't be more than a month or so that everything would change and the aggressive looks would be directed at people not wearing masks. I've since seen two men beaten up for not wearing masks on lines in front of two different grocery stores. I don't like violence or vigilantism but I'd be lying if I were to tell you these two assholes didn't deserve what they got.

All the videos you can see of Trumpist imbeciles idiots-- some elected officials-- screaming about not wearing masks makes my blood boil. They're prolonging the pandemic and endangering the rest of us. I suppose that eventually they will be shot down like rabid dogs as a last ditch effort to save the country. I won't be shooting anyone; nor will I cry.

America isn't the only country with violent right-wing anti-social idiots refusing to wear masks. Last week, in Bayonne, France, near the Spanish border, two men in their 20s murdered a bus driver who asked passengers to wear masks on the bus, which is the law. Both assailants were arrested as were others on the bus who didn't help the driver. In the U.K. masks will become mandatory in all indoor businesses as of July 24, which will bring England into line with Scotland and other European nations like Spain, Italy and Germany. Those who fail to comply with the new rules will face a fine of up to £100, which is not an effective deterrent  Foolishly the new rule does not apply to retail staff. A far right-wing member of Parliament from southern England, notorious racist, Sir Desmond Angus Swayne, described the rule as a "monstrous imposition" that would make him less likely to go shopping. That probably makes retailers happy since the only thing Swayne is known for-- other than his racism-- is that he's a thief and has been caught repeatedly stealing money on his expenses.

Yesterday, L.A. Times reporters Rong-Gong Il and Maura Dolan wrote that Masks offer much more protection against coronavirus than many think. They noted that many people have been led to believe that masks don't protect the wearer; they protect other people from the wearer's germs. And many selfish people don't care about protecting others, only themselves. Well, as anyone with two brain cells to rub together figured out, by April, the government-- hoping to protect the mask supply-- was lying and that masks do protect the weare. "If you're unlucky enough to encounter an infectious person," they wrote, "wearing any kind of face covering will reduce the amount of virus that your body will take in. As it turns out, that's pretty important. Breathing in a small amount of virus may lead to no disease or far more mild infection. But inhaling a huge volume of virus particles can result in serious disease or death."

That's the argument Dr. Monica Gandhi, UC San Francisco professor of medicine and medical director of the HIV Clinic at Zuckerberg San Francisco General Hospital, is making about why-- if you do become infected with the virus-- masking can still protect you from more severe disease.

"There is this theory that facial masking reduces the [amount of virus you get exposed to] and disease severity," said Gandhi, who is also director for the Center for AIDS Research at UC San Francisco.

The idea of requiring mask-wearing in public has become an increasingly pressing and politicized issue as California and the rest of the nation see a surge in new cases as the economy reopens.

...[E]xperts say masks are essential for people to wear when they go out in public, such as to shop or go to medical appointments, and to get exercise like heading to the beach or park.

California has mandated face coverings in public settings since June 18, and a growing number of communities say they will ticket people who disobey the rules. But there remains resistance to the government mandating wearing masks in some corners of the state, including Orange County.

Some leaders in Orange County have pushed back against requiring students to wear masks should they return to classrooms in the fall.

In policy recommendations approved by the Orange County Board of Education on Monday, a document stated that "requiring children to wear masks during school is not only difficult-- if not impossible to implement-- but [is] not based on science. It may even be harmful." Individual districts will have the final say on how schools open.

Some health experts were appalled by that language.

"This anti-mask rhetoric is mind-blowing, dangerous, deadly and polarizing," said Dr. Peter Chin-Hong, professor of medicine and an infectious diseases specialist at UC San Francisco. "There is no evidence that it is dangerous."

In fact, wearing masks can help prevent children from being infected and suffering serious consequences of infection, such as multisystem inflammatory syndrome, a rare condition that has been seen in children who have been infected with the coronavirus. "Kids not only transmit, but they can get sick as well," Chin-Hong said.

While children are less likely to develop severe illness from the coronavirus than adults, they can still be infected, be contagious and transmit the virus to other people, Gandhi said.

Wearing a mask at school would not only reduce their ability to transmit the virus to other classmates, teachers and administrators, but also protect the students from getting infected with a large dose of virus from infected people.

Transmission rates for coronavirus have been rising across the state. Nearly 1,000 of San Francisco's nearly 4,600 cases have been diagnosed in just the last two weeks, said Dr. Grant Colfax, the city's director of public health.

In San Francisco, nearly half of all those who have tested positive in the city are Latinos, he said, even though Latino residents make up just 15% of the city's population. Overall, the city has seen 7.8 new infections per 100,000 residents over the last seven days, far above its goal of no more than 1.8 new infections per 100,000 people.

"This, again, indicates that the virus is spreading throughout the city, particularly ... in the southeast part of the city,” Colfax said.

For every one person who contracts the virus, another 1.25 people on average are now infected, he said. “We really need to drive that down to 1 or below as quickly and as soon as possible.”

The transmission rate also rose above 1 in L.A. County in June, but has fallen back to 1. “The virus currently rages on in our community," Public Health Director Barbara Ferrer said.

The reason why masks are so important in controlling the spread of the coronavirus is that it can be widely spread by people who are not visibly sick-- either because they haven't yet shown signs of illness, or they will spend the entire course of their infections with little or no symptoms at all.

...Masks don't filter out all viral particles, Gandhi said. But even cloth face masks filter out a majority of viral particles.

And even if a person wearing a mask gets infected, the mask-- by filtering out most of the viral particles exhaled by the infected person-- probably leads to less severe disease, Gandhi said.

The idea that a lower dose of virus when being infected brings less illness is a well-worn idea in medicine.

...So what happens if a city dramatically masks up while in public?

If Gandhi is right, it may mean that even if there's a rise in coronavirus infections in a city, the masks may limit the dose people are getting of the virus and result in them more likely to show less severe symptoms of illness.

That's what Gandhi said she suspects is happening in San Francisco, where mask wearing is relatively robust. Further observations are needed, Gandhi said.

There's more evidence that masks can be protective-- even when wearers do become infected. She cited an outbreak at a seafood plant in Oregon where employees were given masks, and 95% of those who were infected were asymptomatic.

...The protective effects are also seen in countries where masks are universally accepted for years, such as Taiwan, Thailand, South Korea and Singapore. "They have all seen cases as they opened ... but not deaths," Gandhi said.

The Czech Republic moved early to require masks, issuing an order in mid-March, Gandhi said; that's about three months before Gov. Gavin Newsom did so statewide in California. But in the Czech Republic, "every time their cases would go up ...their death rate was totally flat. So they didn't get the severe illness with these cases going on."

By May, the Czech Republic lifted its face mask rule. "And they're doing great," Gandhi said.

Israel is in the midst of a disastrous second wave they brought on themselves. On Sunday, Israel reported 1,206 new cases, 23rd highest in the world and Monday it was another 1,962 (17th highest in the world) bringing the national total to 40,632-- 4,418 cases per million Israelis, even worse than hard-hit European countries like the U.K. and Italy. Writing from Jerusalem yesterday, Noga Tarnopolsky noted that "Of 1,400 Israelis diagnosed with COVID-19 last month, 657 (47 percent) were infected in schools. Now 2,026 students, teachers, and staff have it, and 28,147 are quarantined.



NPR: Daniel, in Israel, it's been a little bit more of a complicated picture. School shut down because of the virus, and then it reopened. They did go back in May, and now it's out again. What happened?

Daniel Estrin: Well, what happened in Israel is quite a cautionary tale, I think. At first, the Israeli health professionals here urged the government, yes, let school resume again, but only let kids under the age of 9 go back to school, and keep it in small groups. And they said data around the world show that younger kids have a very low rate of infection and transmission.

But instead of just letting the younger kids go back to school, there were these last-minute negotiations. Ultra-Orthodox Jewish schools wanted the older kids to go back to religious studies, and so they did. And then 11th- and 12th-graders also went back to school. And so very, very quickly, everyone was back. And then very quickly after that, there was a heat wave, so the government said, well, kids don't need to wear masks anymore during this heat wave. And then we just saw big outbreaks in schools, and a lot of schools shut down for several weeks...

I think the lessons to be learned from Israel are listen to the health experts. The government here did not follow the health experts' guidelines to just open the younger grades and to have kids in small groups. They opened very fast, and there was no coherent policy. So listen to your health experts. Have a coherent policy.

This video is for Trump supporters because I have never met an intelligent Trump supporter. There may be intelligent Trump supporters-- though I doubt it-- but I never met one. So this is for you, who are, after all, Americans too: