The Bridge with Peter Mansbridge - Everything You Need To Know (or at least should consider) about MASKS!

Episode Date: July 28, 2020

The promised special on masks is here. How effective are they, which is best and how do you maintain them?

And hello there, Peter Mansbridge here with the latest episode of The Bridge Daily. Well, as I've mentioned a number of times in the past few podcasts, we wanted to do kind of a special just on masks and kind of bring you up to date with the latest thinking on masks, about their effectiveness, and about how best to use them and reuse them. So we're going to try and do that today. It reminds me of when I first bought a mask during this pandemic. And surprisingly enough, it was in January, literally just

days after the first reports started coming in about the coronavirus, COVID-19, and what was happening in China, and whether or not we should be concerned of it coming our way. Well, I happened to be at my pharmacy on that particular day, picking up a prescription that I needed renewed. And as I was waiting for it to be readied, I was walking around the pharmacy and I saw this little, very small area

where there were some masks. There were the basic kind and there were also a few, maybe half a dozen N95s. Now, I didn't know the difference between

these, but I'd heard this report earlier in the day and I thought, you know what, maybe I should just buy some and we'll have them in the house just I thought, you know what, maybe I should just buy some and we'll have them in the house just in case. So I picked them up and I took them over to the counter where my pharmacist had got my prescription ready. And he's a good friend and I've known him for many years. And he looked at me and he's looked after me on my various international travels and the different things that I'd needed at different times.

And he looked at me and he said, you don't need these. And I said, yeah, but you know, there's this story about this virus. And oh, he says, you're not going to need a mask. And I thought, wow, this is like, it's like pharmacist. He must know what he's talking about. And I assume he's trying to make some money, and he's telling me I don't need to buy these. Now, I bought them anyway, and, you know, a couple of each kind. And, you know, I'm not trying to suggest that somehow my pharmacist is an incompetent pharmacist,

because he's absolutely not. He's terrific. But he was not dissimilar to many of the people who were talking about the situation then and for another month or so after that, that you're not going to need to wear masks and don't spend your money on masks. And it would be better if masks were just kept for those healthcare professionals who were at the front line, who would need these if things got out of control. So all those who are, you know, suggesting,

oh, everybody's screwed up and they didn't know what they were talking about and Fauci's this, that, or the other, and Fauci once said you don't need to wear a mask. Well, you know, that was the common thinking of all health care people, and I shouldn't say all, but absolutely most of them, and certainly those in positions of authority. Even as little as, you know, a couple of weeks ago, some were saying,

you know, masks are helpful, but we don't need them right now. Well, now everybody's saying we need masks. And it could be the front line of fighting this pandemic, especially in areas where it seems to be on fire and raging out of control. And you know where I'm talking about, the southern United States. and that masks should be worn even in areas where it seems things are under control to prevent them from getting out of control. So given all that, that's why I want to talk a little bit about masks today. And to do that, I'm relying primarily on two articles that I've read in the last week or so.

Both of them I found really good and really informative, very helpful. I'm going to read a bit from the first article, which was from National Public Radio in the U.S., NPR. And you can find it in their health section. And it's basically headlined, Can Widespread Mask Use Prevent Lockdowns Where the Virus is Surging? Now, aside from answering that question, it does give a lot of general information that is useful for us when we're having this discussion about masks. So one of the first things it talks about is a fairly widespread study that's been done on the effectiveness of masks.

And the study is actually a compilation of a series of studies in different parts of the world, mainly from China, Germany, and a variety of states within the United States. Ali Mokdad is on a research team that has tried to make sense of a large number of these studies. Mokdad and colleagues with the University of Washington's Institute for Health Metrics and Evaluation did what's called a meta-analysis. So I'm reading here from this piece now.

You take every study that has been published on the protective effect of masks, and then you reanalyze all the data, says Mokdad. Their bottom line estimate, okay, and this is starting to get right into the hard numbers of effectiveness. Their bottom line estimate, if 95% of people wear cloth masks when they're outside and about interacting with other people, it reduces transmission by at least, at least 30%. In other words, each infected person will go on to infect 30% fewer people. Mokdad stresses that this is a conservative finding. It uses the lower bound within the range of estimates, and it assumes all the masks are cloth rather than surgical masks or N95 respirators, which are even more effective. Widespread mask use, says Mokdad, could be even more powerful because some portion of people would likely be using those

more protective versions. Yet even with a 30% reduction in transmission, the cumulative impact on a community can be massive. To understand why, it helps to consider some math. The coronavirus spreads exponentially. For example, let's say in a place where no one is wearing masks. No one. Each infected person is currently passing the virus to 1.03 others. This means 100 infected people will go on to infect 103 others, who in turn infect 106 others, who infect 109, and so on. The result is that in, say, seven five-day cycles of infection, a total of 889 people will have contracted the virus.

Okay, you follow that? A lot of numbers there, but the math is pretty simple, really, and it shows how rapidly things can increase. But if you curb the transmission rate by 30%, as the study shows, what would happen if 95% wear cloth masks? These are not even the good masks, you know, the really good masks. It's just your basic cloth mask. If you curb the transmission rate by 30%, this means that instead of infecting 1.03 others,

each infected person passes the virus on to only 0.72 others. So now 100 infected people go on to infect only 72 people. These 72 go on to infect just 52. By the seventh cycle, only 10 new people are infected and only a total of 332 people have contracted the virus altogether. Essentially, instead of exponential growth, you've triggered what's called exponential decay. So there's some basics with very basic mask use.

So you say, yeah, okay, prove it to me. Where has it worked? So the study, and Ali Motdad, note that a number of places have already achieved high levels by increased mask use or near universal mask use. They are Singapore, South Korea, Taiwan, Japan. All right, all obviously in Asia. Now, it is worth noting, and Mokdad does note,

that while many countries in Asia with high mask use have managed to keep the virus controlled, two countries in South America, where mask use is also high in some parts, they are Chile and Brazil, have seen raging outbreaks. Mokdad says one reason may be that those countries are in the southern hemisphere, so their outbreaks coincided with cold weather, which seems to

correlate with higher transmission of the virus. But if true, that could diminish the benefit that mask wearing could have in the United States come autumn. And that would be similar to here too. All right, that's the first article. And that gives you some sort of basic overview. I found this article actually the most interesting because I think for most of us who are using masks, the issue becomes supply.

And is there a way of reusing masks? What should we be thinking about on that front? Well, the Atlantic, Atlantic.com to be specific, has a great Q&A section with kind of their resident doctor, Dr. James Hamblin. Now, he got an email in the last couple of weeks from a Canadian, from Linda Veland or Wieland in Ottawa. And her question, I'll read her question, because it prompted a lengthy and terrific answer from Dr. Hamblin. Here's her question.

We've been told that washing our hands with soap and water for 20 seconds kills the virus, and that the virus doesn't stay viable on surfaces for more than a couple of days. So why are we told that masks need to be washed with hot water? Isn't simply not using a mask for several days before wearing it again, sufficient for any virus to expire before reuse. These recommendations don't seem to rationally fit together. What a terrific question. And, as a result, a really interesting answer. Now, it's very lengthy. I'm not going to read it all,

but I am going to read quite a bit of it because it'll give you lots of things to think about and perhaps lots of things to follow. So here's how Dr. Hamblin starts off. There's no such thing as a perfect mask. Every type involves trade-offs. A loosely wrapped bandana may be barely better than nothing. N95s dig into your face and bruise you. Gas masks are clunky and scare your neighbors. You know, when I read that, it reminded me that when I went to Iraq in 2003, just on the days or weeks before the Americans invaded,

we had to be prepared for anything, including a chemical attack. And so they gave me all kinds of stuff that I had to take with me. And I still have it all because it was all fitted for me and used for me. So it was kind of personal in its nature. And so when all this started, I thought, geez, whatever happened to that stuff?

And I went down to my basement and I found the container. It was all in and I opened it up. And there was this gas mask that looked like, you know, something out of World War I. And I put it on and I walked upstairs to show Cynthia and Will what I was wearing and they went, no, you're not going outside wearing that. If you go outside wearing that, we really are at the end of the world. So it's still downstairs.

And as Dr. Hamblin says, gas masks are clunky and scare your neighbors. I'll say. Surgical masks, back to his article, come closest to perfect for this moment. They are feather-light, breathable, and electrostatically charged to catch viruses without blocking air. They seal tightly around your face, but not so tightly that they can cause injuries when worn all day. I think most of us would agree with that. Doctors and nurses who typically discard masks after a single use have now been instructed by the FDA, the Food and Drug Administration, this is an American-based article, obviously,

to take the risky step of rationing and reusing them. New guidelines are being invented for this moment, and they don't necessarily make sense. In normal times, the use of homemade masks is actively discouraged because they can be contaminated. They encourage touching your face, and they don't clearly protect people unless they're made well and worn assiduously. But since we clearly can't count on government helicopters dropping surgical masks on us anytime soon, cloth face coverings are going to be with us for a while. So we've had to put our trust in clothing

brands, Etsy sellers, or our own ability to create medical devices. And it's becoming clear that not all of the end products we call masks are functionally the same. Those in popular use right now run the gamut from plausibly effective public health intervention to theatrics, depending on what they're made of and how they're used and maintained. And we all know that, I mean, you just have to go out on the street or go to the grocery store and you're going to see all kinds of different masks, some homemade, some commercially made. I mean, I may, I wear what appear to be very well made Toronto Raptors

and Toronto Maple Leaf branded masks, among others. And I wear the basic surgical mask. When I can get my hands on one. An interest, back to the letter, an interesting study of the effectiveness of cloth facial coverings

appeared last month in a physics journal. Researchers at Florida Atlantic University compared what happened when coughs and sneezes were blasted into various materials. They found that most any half-hearted attempt at a mask can catch large viral droplets spewing forth from your mouth and nose, though the droplets will still fall onto nearby surfaces if the mask isn't tight around your chin.

But when it came to stopping airborne viruses from penetrating the mask, some materials were better than others. Bandanas and similarly thin cotton face coverings provided minimal blockage of the aerosolized particles that can shoot through the cloth in a respiratory jet. Such jets are created when you speak loudly or cough or sing, and the viral particles can hang in the air and conceivably fill a poorly ventilated room. The underlying takeaway from the study was that the density of fibers in the cloth makes a big difference in how many tiny droplets travel from your mouth into the air. Surgical masks can be thin because their fibers are arranged to filter out particles.

But when it comes to cotton, creating density means layering. Short of running your own physics experiment, a fair rule of thumb is that the blocking power of a cloth mask can be approximated by how hot and suffocating it is. There's a reason a bandana is more pleasant to wear than a t-shirt folded over 12 times. Once you've calibrated your mask, still reading here, I told you this is really interesting. The layering part is really important in terms of, you know, your cotton masks, including the commercialized ones.

There's sports ones put out by Maple Leaf Sports and Entertainment that I just mentioned, the Raptors and the Leafs. They're layered, you know, they have more than one layer to them. Back to the article. Once you've calibrated your mask to balance safety and livability, then it's time to worry about it falling apart. This brings us to washing. Any material degrades with washing as the fibers grow slightly thinner and farther apart. Avoiding over washing is especially relevant to masks because the tightness and integrity of the fibers is essential to their function. I'm just going to read a little more of this because I think it's really important. So in our ramshackle approach to self-masking, there is good reason to think outside the box. One of the things we could be using more to our advantage during the pandemic is time. The virus can hang around for a few days on some surfaces, but it lives longer on hard surfaces, such as metal

doorknobs, than soft ones, such as cardboard or cloth. If you waited a week to reuse a mask, I see no reason, this is Dr. Hamblin speaking, I see no reason that you shouldn't feel certain it was free of the virus. Bacteria and fungi can grow on all sorts of mediums, but viruses need a host. Without one, their days are numbered. Light is also your friend. The Centers for Disease Control and Prevention recommends washing your mask like you would any other piece of laundry, by machine or hand, and then leaving it to dry in direct sunlight. Don't put it in the automatic dryer.

Take it outside, put it in the sunlight. This latter part may deserve more emphasis than the former. Intense UV rays can kill the virus in less than an hour. This doesn't mean you're safe from infection simply because you're outside, but it does mean that surfaces and materials exposed to direct sunlight will carry the virus for less time than they would in the dark. Sunlight is a tool worth keeping in mind for specific uses, like disinfecting makeshift masks. In sum, and here's the conclusion, in sum, this may be the surest way to get the safest, longest life out of your mask.

Have several masks, made to fit well around your nose and mouth. Make them as heavily layered as you can tolerate. After wearing them for a day or so, or in a high-contact scenario, let them sit for a few days in a sunny, out-of-the-way place. Between the effects of time and light, there should be little need for running a washing machine or going through the hassle of hand-washing your masks. Well, unless they just smell terrible.

In that case, maybe it's your teeth that need cleaning. Ah, yes. I can laugh at that. So, as I told you, a lot to consider there, a lot to think about in terms of masks, from their effectiveness or lack of it to maintaining them. Remember, every time you put a mask in a washing machine, it's probably becoming a little less effective

because you're wearing down some of that material. But at the same time, you can put it in there with everything else, your dirty socks, your jeans, your whatever. But when you bring it out of the laundry, take it outside. Put it in the sunlight. Let it dry there. And it's even possible in some cases,

if you haven't really got the mask dirty, that you can just air it out and sun it out for three or four days and wear it again without even putting it in a washing machine. Those are the lessons from Dr. Hamblin's answer to Linda Whelan of Ottawa, Ontario. Okay, so I promised you a special on masks. I have just delivered you a special on masks.

It'll be interesting if two months from now we have another special on masks that says, remember all that stuff I told you back in July? Well, actually, things have changed. I don't know. I don't think they will. I think this is all pretty good stuff. And I hope it's given you some food for thought. All right. We're approaching hump day.

But not before tonight's big game. The Leafs, the Habs, Toronto, Montreal, exhibition game. But oh my gosh, it's going to be good to see hockey. If you like hockey, that is. I do, and I'm looking forward to it. All right, folks, that's this special mask edition of the Bridge Daily. I'm Peter Mansbridge, and I'll be back in 24 hours. Thank you.