This is sadly true, but that same ideology also reduces compliance with mask wearing. And make no mistake, the biggest problem with mask is not efficiency of filtration but compliance with best practices. The medical grade, single use masks are pretty damn effective at protecting the wearer (witness the fact that I am still uninfected!) but they have to be used properly, and are designed to be single use. 380 million people going through multiple masks in a day is not a sustainable plan, even if there were good compliance. On the other hand, reusable cloth masks are quite effective at decreasing the risk of transmission, which is a somewhat different measure, and relies on fairly universal compliance to work. Unfortunately, in our current environment, I despair of anything that depends on people thinking of others. My advice? Get your vaccine as soon as you can to protect yourself, wear a mask to protect others. Just do it. A very important lesson taught during my ICU days was to never let perfect become the enemy of good, and we are a long way from “good” here.
I am in Japan. (To clarify, you can get N95 masks online from exporters in China or Korea, but it is pricey…)
I live in one of the major cities in Japan, so I will invariably see hundreds of people whenever I go shopping, and it is very rare to see somebody who is not wearing a mask (really, fewer than one in one-hundred). The government here has never had to mandate masks; people just do it.
I have relatives back in the States, though, so I worry…
I don’t have a crystal ball, but I’m oddly optimistic on this one. The anti-vaxxers will still be around doing their thing. But while Trump sneered at masks, he was quite proud of “his” vaccine. I don’t have numbers, but I suspect there are more people who trust Trump than there are anti-vaxxers.
Just a guess, of course.
You seem to be conflating protection to the individual wearer, in which case yes, mask quality makes a big difference, and impact on community transmission, where compliance is a far more important factor. Under current conditions, I would far rather have decent compliance with cheap, reusable cloth masks than a few folks wearing unvented N95’s, let alone the vented ones that are the most common I see around here. The cost of acquiring a supply of really good masks puts them out of reach for the very people who need protection the most, and cheap, washable and reusable cloth masks, with good community compliance, absolutely will drop community transmission. This has been documented in a number of studies, intentional and unintentional.
Thank you for phrasing that so succinctly. As an individual, I wear higher filtration level masks in high risk areas, like hospitals and airplanes (both for work). As a policy, there is no objective evidence that I have found that shows that the compliance trade off of high-filtration masks nets an epidemiological benefit.
I mean, from the testing data I’ve seen, unfitted or improperly worn N95 respirators are worse than cloth masks, since the higher filtration efficiency causes more resistance to flow and results in a lot of exhalation bypassing the filter entirely. Hospitals have been fitting clinicians with respirators for months and training them on proper wear, and yet I still see a small group of people who wear them too loosely. Now apply that to the jack hole at Home Depot chinstrapping their two-week old paper mask.
I’ve not seen anyone post evidence there is a “compliance trade off” with use of better masks.
I do agree that bypass can be an issue, however that is already true, and more so, of procedural masks which are not designed to fit tightly and aren’t made to be respirators. KF94s, in contrast, have much lower bypass than procedural masks because they are made to fit tightly. But I’ve not seen any data that in general that people get worse filtration from filtering face piece respirators on average than from cloth masks.
And I have seen people wearing respirators wrong (primarily, using just one of the two head straps, or not fitting the nose bridge wire securely).
It is true that I’m being a little unclear about when I’m talking about source control vs personal protection, and when I’m talking about the population vs. individuals. But in all of those cases, I think a better mask like a KF94 will be more effective than random cloth masks. But I also agree that emphasizing compliance in general has to be the first priority.
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