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Bleeding over from CE thread so masks can be discussed. I decided to collect some evidence, please discuss masks here but try to do so in a sciency way. There's a huge tension here. Proving things is hard. The rigor of evidence expected of science is much higher than the rigor used in normal decision making. It must be, or you'd never leave the house. My objectives here areas follows:
To these objectives, please make references clear: is this a peer-reviewed reference? Is this an academic source, or a popular source? Editorial, journalism, or a study? I don't make the rules, so I won't tell you you can or can't post, but if you're going to argue against mask-use in any way, you should be showing up with evidence, preferably backed by clinical trial, or you may be risking harm and that might not constitute being excellent to one another. Not sure how to read a paper? Read this: https://www.science.org/content/article/how-seriously-read-scientific-paper. If you have better advice on this, share it. Not sure if the stats match up? Ask! I'm no expert, but exploring methods will make us stronger at discerning evidence! OP recommendations welcome!
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Dec 8, 2021 21:45
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masking arguments out of the CE thread.
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| # ? Apr 19, 2024 04:03 |
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I read a few articles. Where I stand right now: based on Abaluck et al, I feel pretty confident that encouraging any mask use is good, that surgical masks are better than cloth masks. My intuition suggests N-95 masks will likely be as good or better than surgical masks against COVID-19, but evidencing that effect among casual non-professional users is a difficult task. N-95 masks are probably not worse than surgical masks, but I haven't been presented evidence that they're better. More specific thoughts below: The Impact of Community Masking on COVID-19: A Cluster-Randomized Trial in Bangladesh Authors: Jason Abaluck, Laura H. Kwong, Ashley Styczynski, Ashraful Haque, Md Alamgir Kabir, Ellen Bates-Jefferys, Emily Crawford, Jade Benjamin-Chung, Salim Benhachmi, Shabib Raihan, Shadman Rahman, Neeti Zaman, Stephen Luby, Mushfiq Mobarak, Mohammad Ashraful Haque, Md Alamgir Kabir, Ellen Bates-Jefferys, Shabib Raihan, Shadman Rahman, Neeti Zaman Publishing date: 1 Sep 2021 Publisher: Innovations for Poverty-Action (study) Peer-reviewed?: Unknown Where to access: https://www.poverty-action.org/publication/impact-community-masking-covid-19-cluster-randomized-trial-bangladesh
Pro mask wearing in general: Yes, well evidenced. Pro N-95 / KN-95: Not examined Pro surgical mask: Yes, well evidenced. Recommendations are well reasoned: cheaper than cloth masks. Not compared to N-95. Pro cloth mask: Inconclusive. May have some benefit--but cannot be disentangled from the differences due to promotion and behavioral effects of mark-wearing. Greater high-risk behaviors due to mask mandates: none evidence though, even if they were, I would only feel comfortable generalizing to the culture and people where it was studied. Other thoughts: This is an awesome study. This study tells us that promoting masks makes a difference and that surgical grade masks can make a difference. Something to be aware of is that a study recruiting 300,000 participants wasn't powerful enough to show us what effect cloth masks have, though an effect is suggested--this is difficult work and getting answers is not easy or cheap. I couldn't find a completed clinical trial, applied generally comparing N-95 masks and other masks for COVID-19, but I can for healthcare workers and influenza. Surgical mask vs N95 respirator for preventing influenza among health care workers: a randomized trial Authors: Mark Loeb, Nancy Dafoe, James Mahony, Michael John, Alicia Sarabia, Verne Glavin, Richard Webby, Marek Smieja, David J D Earn, Sylvia Chong, Ashley Webb, Stephen D Walter Publishing date: 4 Nov 2009 Publisher: JAMA (study) Peer-reviewed?: Presumably Where to access: https://clinicaltrials.gov/ct2/show/NCT00756574?term=N-95&recrs=e&draw=4&rank=2 -> https://pubmed.ncbi.nlm.nih.gov/19797474/ I don't have access to the full article, so at least this exploration will go faster: Results: "Between September 23, 2008, and December 8, 2008, 478 nurses were assessed for eligibility and 446 nurses were enrolled and randomly assigned the intervention; 225 were allocated to receive surgical masks and 221 to N95 respirators. Influenza infection occurred in 50 nurses (23.6%) in the surgical mask group and in 48 (22.9%) in the N95 respirator group (absolute risk difference, -0.73%; 95% CI, -8.8% to 7.3%; P = .86), the lower confidence limit being inside the noninferiority limit of -9%" Pro mask wearing in general: N/ Pro N-95 / KN-95: not evidenced over surgical mask, only studied influenza. Pro surgical mask: not evidenced over 95s, only studied influenza Pro cloth mask: not studied Greater high-risk behaviors due to mask mandates: not studied Other thoughts: a strong difference would have been good to see, but this study's design doesn't really tell us much of anything--all they hoped to show was that N95 masks weren't worse than surgical masks at protecting against influenza. Filtration Efficiency, Effectiveness, and Availability of N95 Face Masks for COVID-19 Prevention Authors: Caitlin M. Dugdale, MD1,2; Rochelle P. Walensky, MD, MPH1,2 Publishing date: 4 Nov 2009 Publisher: JAMA Internal Medicine (editorial) Peer-reviewed?: No, not a study Where to access: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769441 Not a study to digest, but there's some important discussion of N-95 related to other interventions here: quote:Importantly, the effectiveness of any mask also depends heavily on its real-world use; variability in mask filtration during clinical care may fluctuate more by mask adherence and fit than by marginal differences in laboratory-based filtration efficiency. In practicality, when worn properly, N95 masks are suffocating, uncomfortable, and difficult to tolerate for long durations. Best practices for N95 use require intermittent, individualized fit testing and a seal check on donning. Mask fit varies by facial shape and body habitus, and thus, once fit tested, ensuring fidelity to the same manufacturer and size is essential. Filtration efficiency of an N95 mask can also be compromised by even small amounts of facial hair in the area of the seal. Prolonged use of tightly fitting masks may result in facial bruising and abrasions, but bandages over these areas, such as the commonly seen wound barriers over the nasal bridge, interrupt the mask seal. Although a recent clinical trial6 reported similar and suboptimal self-reported adherence between outpatient health care personnel randomized to wear N95 masks vs medical masks (89% vs 90%), the study also demonstrated no difference in cases of laboratory-documented influenza—albeit a different respiratory virus—between the 2 groups. Acknowledging that adherence is likely higher amid the COVID-19 pandemic, mask efficiency observed in the laboratory likely reflects an upper bound of the effectiveness that would be observed in clinical settings. This paragraph is important because it explains the limits of N-95 masks: mainly that to reach full effectiveness, they have to be individually fit tested, seal checked and instructions must be adhered to.
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Dec 8, 2021 21:46
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I confess I'm curious what "science" would be required to advocate for the use of disposable N95 respirators or elastomeric respirators with P100 filters. The filtration standards are public record. The FUD that surrounds non-institutional respiratory PPE use is entirely overblown, as fit testing procedures are also public record and not difficult to perform in the case of elastomerics. Or is the idea that the burden of proving that e.g., a translucent Disney-branded neck gaiter is less effective than a NIOSH-certified respirator falls on the person making that claim? I've tried for almost two years now to convince people to wear at least N95s, and while some people are receptive to published safety standards a disappointing percentage just get mad and point at CDC's guidance that people strap just about anything they can find across their faces as evidence that wearing actual PPE is crazy. Anyway, I've basically given up on convincing people because the effort is usually wasted and tends to result in highly emotional backlash. If anyone is genuinely interested in maximizing protection both 3M and Honeywell make comfortable, effective elastomeric respirators that are far more comfortable than any cloth or disposable mask.
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Dec 8, 2021 22:40
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I’m going to make a not peer reviewed claim and talk about my time working around infectious diseases including a COVID ICU- simply loving washing your hands after you touch anything other people touch goes an insanely long way. I know it’s obvious but seeing it firsthand between people who followed procedure and who didn’t made something that I knew but didn’t “feel” it intuitively obvious to me. If you wear proper PPE and wash your hands before and after touching anything potentially problematic and throughout the day you almost certainly won’t catch much.
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Dec 8, 2021 23:16
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per my wife who has been treating covid patients for 2 years - there is much more concern that the newer variants are airborne. wearing a proper n95 is much more important than before.
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Dec 8, 2021 23:25
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ded posted:per my wife who has been treating covid patients for 2 years - there is much more concern that the newer variants are airborne. wearing a proper n95 is much more important than before. I'm actually switching our kids to K95s due to that and also after their school district sent out a letter saying volunteers no longer need proof of vaccination or a negative test. 
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Dec 8, 2021 23:27
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quote:I've tried for almost two years now to convince people to wear at least N95s, and while some people are receptive to published safety standards a disappointing percentage just get mad and point at CDC's guidance that people strap just about anything they can find across their faces as evidence that wearing actual PPE is crazy. The CDC’s guidance does not say this. quote:Anyway, I've basically given up on convincing people because the effort is usually wasted and tends to result in highly emotional backlash. It could be that you are misrepresenting the CDC guidance and that they noticed the misrepresentation. Or they just don’t want to buy and wear reusable half-face 3M respirators. They are affordable, if you wear N95 level protection at all times, but most people do not, and they’re not exactly kind to various hairstyles and looking “normal.” Personally, I just wear bulk-purchased KN95s from a company sample-tested by the NPPTL and keep a backup supply of surgical masks in the car. I know it would be cheaper to buy and wear a half-mask 3M reusable respirator, but it looks pretty absurd and is contrary to uniform expectations, whereas N95/KN95 is not.
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Dec 8, 2021 23:29
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mlmp08 posted:The CDC’s guidance does not say this. I urge you to Google “hyperbole.”
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Dec 8, 2021 23:33
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Loucks posted:I confess I'm curious what "science" would be required to advocate for the use of disposable N95 respirators or elastomeric respirators with P100 filters. The filtration standards are public record. The FUD that surrounds non-institutional respiratory PPE use is entirely overblown, as fit testing procedures are also public record and not difficult to perform in the case of elastomerics. Or is the idea that the burden of proving that e.g., a translucent Disney-branded neck gaiter is less effective than a NIOSH-certified respirator falls on the person making that claim? I've tried for almost two years now to convince people to wear at least N95s, and while some people are receptive to published safety standards a disappointing percentage just get mad and point at CDC's guidance that people strap just about anything they can find across their faces as evidence that wearing actual PPE is crazy. I'm sympathetic. But all of these things are tied up among surprisingly difficult moral quandaries. Determining which action fits your morals become easier with a greater understanding of fact and my hope is that, by using evidence, we can remove some of the emotion from the question. Some of this is scientific, some of this is philosophical. Whether it seems that way or not, you're asking people to weigh their moral values based on an imperfect understanding of fact. With different assumptions will come different conclusions, but they'll be enforced as norms via social isolation. We should expect some emotion. The big factor people often have to weigh is, "how much is enough?" You can always be more safe. N95 masks are probably safer than surgical masks which are probably safer than translucent Disney-branded neck gaiters. Fitted N95 masks used no more than once per patient exposure are probably safer than unfitted N-95 masks worn for several days. Self contained breathing apparatuses are probably safer. Never leaving the house, separating from and family members or friends who do go outside of the house and only receiving delivered goods after they've been left outside under sun exposure is probably even better--at least from this one particular threat. More data and better studies can help us refine these normative positions and make more convincing arguments. I've personally landed on buying a bunch of KN95 masks and reusing them. But the reason I landed on that was mostly tied to that act being easy enough--if I couldn't find them couldn't afford them, wasn't willing to take them from the market, then I might pursue cloth masks like I did in the first several months of the pandemic. If had unlimited money and no concerns, I might keep a stockpile of hundreds and change several a day--I'm fairly certain that my strategy was heavily based on access, but unless I intentionally acknowledge the bias, I'm likely to justify it post hoc with all sorts of reasons.
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Dec 8, 2021 23:54
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piL posted:More data and better studies can help us refine these normative positions and make more convincing arguments. I've personally landed on buying a bunch of KN95 masks and reusing them. But the reason I landed on that was mostly tied to that act being easy enough--if I couldn't find them couldn't afford them, wasn't willing to take them from the market, then I might pursue cloth masks like I did in the first several months of the pandemic. If had unlimited money and no concerns, I might keep a stockpile of hundreds and change several a day--I'm fairly certain that my strategy was heavily based on access, but unless I intentionally acknowledge the bias, I'm likely to justify it post hoc with all sorts of reasons. Yeah basically. I got a 100-pack of KN95s and wear them a couple days each. I wore mostly cloth masks on deployment back when supply chains were worse and mail was sometimes on hold for several weeks. When there were bad breakouts we’d maybe get a medical N95 issued and be told to wear it for weeks, until it literally fell apart. Otherwise, I avoid public spaces, eat out never (pickup/delivery sure), and I have a collection of over the top 3M gear for going to potentially high-density crowd locations if I have to. I also self-test after anything resembling a scare and all travel now that tests are more available. So collectively, I’ve spent maybe 4-500 hundred dollars on PPE and tests, which I think is worth it, but it isn’t nothing!
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Dec 9, 2021 00:07
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Loucks posted:I urge you to Google “hyperbole.” Don't post like this. It doesn't win cool points, just earns posting vacations.
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Dec 9, 2021 00:12
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McNally posted:Don't post like this. It doesn't win cool points, just earns posting vacations. No problem. I’m not sure how else to respond when someone takes obvious hyperbole and treats it like a serious argument to score their own points off of. Guess I’ll just ignore them next time.
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Dec 9, 2021 00:21
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Loucks posted:No problem. I’m not sure how else to respond when someone takes obvious hyperbole and treats it like a serious argument to score their own points off of. Guess I’ll just ignore them next time. Or presume good faith and point out that it was hyperbole. Misunderstandings happen.
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Dec 9, 2021 00:30
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I've had a couple of 3M half masks and a generous supply of p100 carts for years used for airbrushing my little robot models, but work prohibits masks with exhaust valves so I'm in fabric and disposable hell with everyone else 9-5.
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Dec 9, 2021 01:13
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Midjack posted:I've had a couple of 3M half masks and a generous supply of p100 carts for years used for airbrushing my little robot models, but work prohibits masks with exhaust valves so I'm in fabric and disposable hell with everyone else 9-5. That too. Exhaust valves are a no-go.
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Dec 9, 2021 02:21
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Posting again on the off chance that anyone in IVFW is looking for recommendations for NIOSH-certified PPE. I've tried quite a few different N95s over this thing, and the most comfortable ones I've found are the 3M Auras (models 9205 & 9210+) which retail for <$2 each and are good for at least 40 hours of use unless you're hanging out in a coal mine or something. You can wear these things for a full 8 hours without issue, at least I can. They come individually packaged, fold flat so it's easy to carry a spare, have no exhalation valve, and have a broad nose section so it's very easy to get a great seal and avoid leakage assuming willingness to shave off goony neckbeards. This last is especially helpful for those with glasses, as I at least have not found any sub-N95 (e.g., KF94, KN95) masks that don't leak enough to cause fogging problems. The 9205 model is available at some hardware stores like Home Depot, but it has rubberized straps that can pull longer hair. The 9210+ isn't available in any b&m stores afaik, but can be ordered online from quite a few vendors. Would avoid Amazon due to counterfeiting concerns.
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Dec 10, 2021 16:25
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Loucks posted:Posting again on the off chance that anyone in IVFW is looking for recommendations for NIOSH-certified PPE. I've tried quite a few different N95s over this thing, and the most comfortable ones I've found are the 3M Auras (models 9205 & 9210+) which retail for <$2 each and are good for at least 40 hours of use unless you're hanging out in a coal mine or something. You can wear these things for a full 8 hours without issue, at least I can. They come individually packaged, fold flat so it's easy to carry a spare, have no exhalation valve, and have a broad nose section so it's very easy to get a great seal and avoid leakage assuming willingness to shave off goony neckbeards. This last is especially helpful for those with glasses, as I at least have not found any sub-N95 (e.g., KF94, KN95) masks that don't leak enough to cause fogging problems. I will second this recommendation; I got a couple of boxes of 9205s at Home Depot a couple of weeks ago and have been wearing one for the last couple of weeks.
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Dec 11, 2021 03:43
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If someone could actually point me to a kn95 mask that would actually fit my drat freakishly large head I'll be more than happy to wear them. I stick with fabric because at least i can get multilayered ones that can cover both my mouth and nose at the same time.
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Dec 12, 2021 01:15
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citybeatnik posted:If someone could actually point me to a kn95 mask that would actually fit my drat freakishly large head I'll be more than happy to wear them. I stick with fabric because at least i can get multilayered ones that can cover both my mouth and nose at the same time. What's the specific challenge? Nose to mouth distance, having the Pyramid of Giza stuck to the front of your face (my issue)?
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Dec 12, 2021 01:23
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Moldex N95 is good for Italian or Serb level nose not sure it can do bigger tho
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Dec 12, 2021 01:58
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Midjack posted:What's the specific challenge? Nose to mouth distance, having the Pyramid of Giza stuck to the front of your face (my issue)? Nose to mouth distance combined with distance to my ears. It seems that I get an actual seal/coverage with fabric.
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Dec 12, 2021 02:03
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Try the Powecom FFP2 masks on amazon, they've got over the head bands instead of ear loops and I've been pleased with them despite the smallish size (for me. I have a freakishly big head, they still get a good seal)
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Dec 28, 2021 22:39
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| # ? Apr 19, 2024 04:03 |
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I got a pack of 3m Auras to try and I'm 100% sold. They're easy to breathe in, don't fog my glasses at all, and are so comfortable I don't feel the need to take it on and off outside of buildings when I'm doing stuff. I wore kn95s this entire last semester and I wish I had tried these sooner, my ears would have thanked me. Going to get a bigger box and wear them exclusively. Night and day improvement over 8210s as well (which I started the pandemic with 3 boxes of because reasons) for n95 protection.
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Dec 29, 2021 01:42
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