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Medical Workers Should Use Respirator Masks, Not Surgical Masks Medical Workers Should Use Respirator Masks, Not Surgical Masks
(about 11 hours later)
A new analysis of 172 studies, funded by the World Health Organization, confirms what scientists have said for months: N95 and other respirator masks are far superior to surgical or cloth masks in protecting essential medical workers against the coronavirus.A new analysis of 172 studies, funded by the World Health Organization, confirms what scientists have said for months: N95 and other respirator masks are far superior to surgical or cloth masks in protecting essential medical workers against the coronavirus.
The results, published on Monday in The Lancet, make it clear that the W.H.O. and the Centers for Disease Control and Prevention should recommend that essential workers like nurses and emergency responders wear N95 masks, not just surgical masks, experts said.The results, published on Monday in The Lancet, make it clear that the W.H.O. and the Centers for Disease Control and Prevention should recommend that essential workers like nurses and emergency responders wear N95 masks, not just surgical masks, experts said.
“It’s been disappointing that both the W.H.O. and the C.D.C. have suggested that surgical masks are adequate, and they’re clearly not,” said David Michaels, a professor at George Washington University who headed the Occupational Safety and Health Administration under President Obama.“It’s been disappointing that both the W.H.O. and the C.D.C. have suggested that surgical masks are adequate, and they’re clearly not,” said David Michaels, a professor at George Washington University who headed the Occupational Safety and Health Administration under President Obama.
“Reliance on surgical masks has no doubt led to many workers being infected,” he said.“Reliance on surgical masks has no doubt led to many workers being infected,” he said.
N95 masks offered 96 percent protection, the analysis found, while the figure for surgical masks was 67 percent. The findings are particularly important as the United States moves to reopen the economy, Dr. Michaels said.N95 masks offered 96 percent protection, the analysis found, while the figure for surgical masks was 67 percent. The findings are particularly important as the United States moves to reopen the economy, Dr. Michaels said.
Workers in health care settings are not the only ones at high risk of coronavirus infection: employees in meatpacking plants and some farms are all also at high risk of coronavirus infection and could benefit from N95 masks, he said.Workers in health care settings are not the only ones at high risk of coronavirus infection: employees in meatpacking plants and some farms are all also at high risk of coronavirus infection and could benefit from N95 masks, he said.
The W.H.O. has not endorsed universal wearing of masks, although most of its member governments adopted the practice months ago. The organization’s stance has frustrated many public health experts who see masks as a simple, inexpensive and highly effective strategy to help contain the pandemic, especially given that the virus can be transmitted by people who do not know they are ill.The W.H.O. has not endorsed universal wearing of masks, although most of its member governments adopted the practice months ago. The organization’s stance has frustrated many public health experts who see masks as a simple, inexpensive and highly effective strategy to help contain the pandemic, especially given that the virus can be transmitted by people who do not know they are ill.
“When there is uncertainty and you don’t know everything about a disease, you have to be precautionary, which means you have to assume the worst and provide the best for health care workers,” said Dr. Raina MacIntyre, an epidemiologist at the University of New South Wales in Sydney, Australia, who wrote a commentary accompanying the paper.“When there is uncertainty and you don’t know everything about a disease, you have to be precautionary, which means you have to assume the worst and provide the best for health care workers,” said Dr. Raina MacIntyre, an epidemiologist at the University of New South Wales in Sydney, Australia, who wrote a commentary accompanying the paper.
“This kind of denial, what purpose is it serving — except to harm health care workers?” she said.“This kind of denial, what purpose is it serving — except to harm health care workers?” she said.
Previous studies have shown that the universal wearing of masks is effective. If anything, the new study does so based on poorer evidence, said Jeremy Howard, a distinguished research scientist at the University of San Francisco, and a co-founder of the global #Masks4All movement.Previous studies have shown that the universal wearing of masks is effective. If anything, the new study does so based on poorer evidence, said Jeremy Howard, a distinguished research scientist at the University of San Francisco, and a co-founder of the global #Masks4All movement.
“This is probably what the W.H.O. needs to change their guidance, even though it shouldn’t be,” Mr. Howard said. “Such is life. It will save lives, so that’s good.”“This is probably what the W.H.O. needs to change their guidance, even though it shouldn’t be,” Mr. Howard said. “Such is life. It will save lives, so that’s good.”
The new analysis also suggests that covering the eyes with face shields, goggles and glasses may provide additional safeguards for health care workers and people in the community.The new analysis also suggests that covering the eyes with face shields, goggles and glasses may provide additional safeguards for health care workers and people in the community.
The report is among the first to lay out evidence specific to coronaviruses, rather than extrapolating from data on other respiratory viruses.The report is among the first to lay out evidence specific to coronaviruses, rather than extrapolating from data on other respiratory viruses.
The coronavirus is thought to spread primarily through droplets expelled when an infected person coughs, sneezes, sings, talks or even breathes. Some infections may also be caused by people touching a contaminated surface and then their mouth, nose or eyes.The coronavirus is thought to spread primarily through droplets expelled when an infected person coughs, sneezes, sings, talks or even breathes. Some infections may also be caused by people touching a contaminated surface and then their mouth, nose or eyes.
Study after study has indicated that the virus can also spread via tiny droplets less than 5 microns, called aerosols. (A micron equals one millionth of a meter.)Study after study has indicated that the virus can also spread via tiny droplets less than 5 microns, called aerosols. (A micron equals one millionth of a meter.)
But the W.H.O. has so far not acknowledged this risk and has not backed the universal use of masks. “There’s this fear around saying airborne — but that’s what it is,” Dr. MacIntyre said.But the W.H.O. has so far not acknowledged this risk and has not backed the universal use of masks. “There’s this fear around saying airborne — but that’s what it is,” Dr. MacIntyre said.
A recent review in the journal Science took direct aim at the W.H.O.’s reluctance on this issue, saying the organization’s recommendations for physical distancing and hand washing were based on studies “carried out in the 1930s.”A recent review in the journal Science took direct aim at the W.H.O.’s reluctance on this issue, saying the organization’s recommendations for physical distancing and hand washing were based on studies “carried out in the 1930s.”
The C.D.C. did not recommend masks till April 3. Even now, its guidance says surgical masks offer enough protection for health care workers unless they are involved in procedures that produce aerosols.The C.D.C. did not recommend masks till April 3. Even now, its guidance says surgical masks offer enough protection for health care workers unless they are involved in procedures that produce aerosols.
The C.D.C. initially recommended N95 masks for all health care personnel. Dr. MacIntyre said the agency later downgraded its recommendations because of a shortage of N95 masks and personal protective equipment.The C.D.C. initially recommended N95 masks for all health care personnel. Dr. MacIntyre said the agency later downgraded its recommendations because of a shortage of N95 masks and personal protective equipment.
“Guidelines should be based on evidence, not on supplies,” she said. “It’s like telling an army, ‘Oh sorry, we’ve run out of guns, just take these bows and arrows and face the enemy.’”“Guidelines should be based on evidence, not on supplies,” she said. “It’s like telling an army, ‘Oh sorry, we’ve run out of guns, just take these bows and arrows and face the enemy.’”
She noted that N95 masks were inexpensive to produce and that other countries, including Australia, had repurposed existing manufacturing facilities to make the masks.
Updated June 22, 2020Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
She noted that N95 masks were inexpensive to produce and that other countries, including Australia, had repurposed existing manufacturing facilities to make the masks.
“We’re not talking about making a space shuttle,” she said. “We’re talking about making a straightforward piece of equipment that’s quite cheap to manufacture.”“We’re not talking about making a space shuttle,” she said. “We’re talking about making a straightforward piece of equipment that’s quite cheap to manufacture.”
A C.D.C. spokesman was unable to address the Lancet study but said the agency is constantly evaluating new science and “adjusts its guidance accordingly.”A C.D.C. spokesman was unable to address the Lancet study but said the agency is constantly evaluating new science and “adjusts its guidance accordingly.”
No precaution is a guarantee against infection. But the new report estimates how effective some of them seem to be.No precaution is a guarantee against infection. But the new report estimates how effective some of them seem to be.
Standing more than three feet away cuts the risk of transmission to 3 percent from 13 percent, the analysis found. Use of masks reduces the odds of infection to 3 percent from 17 percent, and eye protection to 6 percent from 16 percent. The researchers emphasized that people should also continue to wash their hands frequently.Standing more than three feet away cuts the risk of transmission to 3 percent from 13 percent, the analysis found. Use of masks reduces the odds of infection to 3 percent from 17 percent, and eye protection to 6 percent from 16 percent. The researchers emphasized that people should also continue to wash their hands frequently.
The review also offers some practical information for disease models. For example, it suggests that contact tracing for people who are potentially exposed should include anyone who has been within six feet of an infected person.The review also offers some practical information for disease models. For example, it suggests that contact tracing for people who are potentially exposed should include anyone who has been within six feet of an infected person.
The analysis is based on observational studies conducted during the coronavirus pandemic, as well as the SARS and MERS epidemics. It can offer only moderate certainty — although the study “underplays the results,” Dr. Michaels said.The analysis is based on observational studies conducted during the coronavirus pandemic, as well as the SARS and MERS epidemics. It can offer only moderate certainty — although the study “underplays the results,” Dr. Michaels said.
The evidence is strong enough to warrant changes to recommendations for essential health care workers and to plan for mass production of N95 masks, Dr. Michaels said.The evidence is strong enough to warrant changes to recommendations for essential health care workers and to plan for mass production of N95 masks, Dr. Michaels said.
“The Trump administration needs to be less worried about producing meat, and more about producing N95s and other P.P.E. needed to save the lives of essential workers,” he said.“The Trump administration needs to be less worried about producing meat, and more about producing N95s and other P.P.E. needed to save the lives of essential workers,” he said.