Masks-no discussion needed. Just vote and see where we really are.

[JettaKnight]

You'll be shocked (I was), but they hardly do.

Guideline for the prevention of surgical site infection, 1999 (CDC):
1) the wearing of surgical masks is a tradition,
2) their efficacy is questionable,
3) but they may protect against splashes of blood and fluids.

They protect the wearer from splashes, that's the extent of their utility.
https://stacks.cdc.gov/view/cdc/7160

Ewww.

 

[Expat]

The mask MAY be useful, so I voted with the voluntary option. Masks do help in the surgerical theater, so I accept there may be a rationale for its use; but in the real world its use should be optional.

ditto
I doubt they are helpful, but i was wearing one to protect against bringing anything home if at all possible.

 

[HoughMade]

You'll be shocked (I was), but they hardly do.

Guideline for the prevention of surgical site infection, 1999 (CDC):
1) the wearing of surgical masks is a tradition,
2) their efficacy is questionable,
3) but they may protect against splashes of blood and fluids.

They protect the wearer from splashes, that's the extent of their utility.
https://stacks.cdc.gov/view/cdc/7160

There's a 2017 Guideline, but neither of them deal with the passing of a viruses from one respiratory tract to another. That is vastly different from a surgical site issue. I've been spending a lot of time on surgical site infection research lately due to some things I've been working on.

At the risk of discussing, the Infectious Disease Society of America has published COVID 19 Guidelines.

https://www.idsociety.org/practice-guideline/covid-19-guideline-infection-prevention/

These guidelines have their own language and terms of art, so pulling out a single quote without context is of limited use, but here goes:

Recommendations

In CONVENTIONAL settings:

Recommendation 1: The IDSA guideline panel recommends that health care personnel caring for patients with suspected or known COVID-19, use either a surgical mask or N95 (or N99 or PAPR) respirator compared with no mask as part of appropriate PPE*. (Strong recommendation, moderate certainty of evidence)

In CONTINGENCY or CRISIS CAPACITY settings:

Recommendation 2: During contingency or crisis capacity settings (respirator shortages), the IDSA guideline panel recommends that health care personnel caring for patients with suspected or known COVID-19 use a surgical mask or reprocessed respirator instead of no mask as part of appropriate PPE*. (Strong recommendation, moderate certainty of evidence)

*Appropriate personal protective equipment includes, in addition to a mask or respirator, eye protection, gown and gloves.

Summary of the evidence

Direct evidence from the early stages of the COVID-19 pandemic provide information about the risk of infection among HCP and the effectiveness of N95 respirators and surgical masks. According to these studies, approximately 30% of unprotected HCP (wearing no masks) exposed to COVID-19 patients developed infection [15]. In a retrospective cohort study comparing HCP wearing N95 respirators (N=278) caring for high risk COVID-19 patients compared with unmasked HCP (N=213) caring for low risk patients, 10/213 unmasked HCP became infected compared with 0/278 who wore N95 respirators [16]. Overall, rates of infections in HCP were three times higher compared to the general population, likely due to inadequate PPE practices, although the most frequent failure mechanism (lack of proper masks, face shield or contact precautions such as hand washing) remains unclear [17].

Indirect evidence from the SARS epidemic was used to inform the question about the effectiveness of masks. Based on an existing systematic review of five observational studies in health care personnel, wearing any mask (surgical mask or N95 respirator) demonstrated a large reduction in the risk of developing infection (surgical masks: OR 0.13; 95% CI: 0.03,0.62) or (N95 respirator OR 0.12; 95% CI: 0.06,0.26) [18] (Table 1). Studies comparing N95 respirators to surgical masks on rates of SARS infection failed to show or exclude a beneficial effect (OR 0.86; 95% CI: 0.22, 3.33) on rates of SARS infections. Four studies compared N95 respirators with surgical masks for prevention of viral respiratory infections (VRI) also failed to show or exclude a beneficial effect (OR 0.94; 95% CI: 0.80, 1.11) [19] (see Table 2 below and Figure s2 in Supplemental Materials.

Other Considerations

Evidence to support the use of N95 respirators or surgical masks (as compared with no masks) was based on observational studies that showed a very large reduction in the risk of infection during the SARS outbreak. The overall certainty of evidence was moderate. The data on use of N95 respirators compared to surgical masks for SARS or other VRI was low or very low. The limitations of the evidence included small numbers of events, recall bias, and data on all viral infections (not limited to coronavirus).

Conclusions and research needs for this recommendation

The guideline panel recommends that in conventional settings, HCP caring for confirmed or suspected COVID-19 patients use a surgical mask or a N95 or higher-grade respirator (such as an N99 or PAPR). Use of masks or respirators must be in conjunction with other recommended PPE and appropriate hand hygiene. Because of the risk of serious harm, the panel recommends that health care personnel not be exposed to suspected or confirmed COVID-19 patients without a mask or respirator.

 

[JettaKnight]

There's a 2017 Guideline, but neither of them deal with the passing of a viruses from one respiratory tract to another. That is vastly different from a surgical site issue. I've been spending a lot of time on surgical site infection research lately due to some things I've been working on.

That sounds incredibly boring.

 

[HoughMade]

That sounds incredibly boring.

How much could I pay you per hour to do something incredibly boring?

This will give you a clue as to why I do incredibly boring things.

(it is indeed boring, but somehow exciting enough to make the national news)

 

[idkfa]

There's a 2017 Guideline, but neither of them deal with the passing of a viruses from one respiratory tract to another. That is vastly different from a surgical site issue. I've been spending a lot of time on surgical site infection research lately due to some things I've been working on.

At the risk of discussing, the Infectious Disease Society of America has published COVID 19 Guidelines.

https://www.idsociety.org/practice-guideline/covid-19-guideline-infection-prevention/

These guidelines have their own language and terms of art, so pulling out a single quote without context is of limited use, but here goes:

Yes, there is a 2017 Guideline, and it does not mention masks at all.
I was specifically addressing the point about the application of masks in surgery.

In regards to the IDSA Guideline, it is (1) also vastly different from the topic being discussed here (use of cloth masks, especially mandated by the government) by general public, (2) its focus is shifted somewhat to the N95 respirators (which undeniably have a substantial barrier effect), and (3) they acknowledge that the sample size is very small (albeit the power is apparently sufficient to make conclusions).

In terms of a rigorous assessment, I found a very curious study: essentially a mechanical simulation of the virus spread under different scenarios. Surgical masks have a protection degree (PD) between 30 and 50% (i.e. how much the body exposure is reduced, the higher the better).
The kicker? Max distance they used was 60 cm (under 2 feet).
So yeah, I can see how a surgical mask (or even better, an N95 mask) would prevent a nurse from getting the virus when she attends to the sick patients and likely spends a significant amount of time in the vicinity of their mouths and noses.

 

[idkfa]

How much could I pay you per hour to do something incredibly boring?

This will give you a clue as to why I do incredibly boring things.

(it is indeed boring, but somehow exciting enough to make the national news)

˄˄˄THIS

 

[HoughMade]

Masks used in surgery are irrelevant to COVID 19 altogether.

 

[Bapak2ja]

You'll be shocked (I was), but they hardly do.

Guideline for the prevention of surgical site infection, 1999 (CDC):
1) the wearing of surgical masks is a tradition,
2) their efficacy is questionable,
3) but they may protect against splashes of blood and fluids.

They protect the wearer from splashes, that's the extent of their utility.
https://stacks.cdc.gov/view/cdc/7160

Interesting. Since our medical personnel still vote by their actions, I will accept there is some value in wearing a mask. I know several who work in the medical profession and all affirm it is wise to wear the mask in medical situations—surgery; ER treatment of wounds, breaks, gunshots; doctor offices when suspected contagious cases go in for treatment; etc. Even "protecting the wearer from splashes" demonstrates the mask does have some value, even if minimal.

Since I will not be in any of those situations, unless disaster befalls me and I suddenly appear in the ER, I will not wear the mask unless forced to do so. I will also extend the same freedom of choice to my fellow Hoosiers——even if they do think Glocks are better than FNH firearms.

 

[Flingarrows]

I vote: wear it if you want, don’t if you don’t want


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[JCSR]

Praise the Lord!!!!! We needed another mask thread................

 

[dusty88]

 

[hoosierdoc]

after someone dislocates their hip we put them in a knee immobilizer. it makes it more difficult to get your hip into a position to dislocate if your knee is straight. plus it's a reminder to pay attention to what you're doing

this is what I see masks doing for people. reminding them to not touch everything. keep distance. I don't believe it's significantly reducing viral shedding. and I don't believe asymptomatic people are significant spreaders. so why mask an asymptomatic person?

lots of meandering comments

 

[KJQ6945]

after someone dislocates their hip we put them in a knee immobilizer. it makes it more difficult to get your hip into a position to dislocate if your knee is straight. plus it's a reminder to pay attention to what you're doing

this is what I see masks doing for people. reminding them to not touch everything. keep distance. I don't believe it's significantly reducing viral shedding. and I don't believe asymptomatic people are significant spreaders. so why mask an asymptomatic person?

lots of meandering comments

Purely for the feelz Doc.

 

[dusty88]

after someone dislocates their hip we put them in a knee immobilizer. it makes it more difficult to get your hip into a position to dislocate if your knee is straight. plus it's a reminder to pay attention to what you're doing

this is what I see masks doing for people. reminding them to not touch everything. keep distance. I don't believe it's significantly reducing viral shedding. and I don't believe asymptomatic people are significant spreaders. so why mask an asymptomatic person?

lots of meandering comments

Truly asymptomatic people may account for a small number of cases, but presymptomatic appear to account for a significant #. I think the current total of presymptomatic and asymptomatic transmission appears to be about 40% of the total transmission. Many of the "superspreader" were not symptomatic at the time they spread it (perhaps obvious in a way, because they felt well enough to be out around large groups of people and active at the time).

Some references

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30113-4.pdf (viral load during different phases of infection)

https://www.medrxiv.org/content/10.1101/2020.03.24.20042606v1 contact tracing includes some asymptomatic cases

https://pubmed.ncbi.nlm.nih.gov/32412896/ a cluster at fitness classes from a presymptomatic (or asymptomatic, not sure in this case)

https://www.nejm.org/doi/full/10.1056/NEJMoa2008457 presymptomatic transmission in a nursing home

https://pubmed.ncbi.nlm.nih.gov/32067043/ a cluster indicating possible transmission during the incubation period

https://www.acpjournals.org/doi/10.7326/M20-3012 a review paper on asymptomatic transmission

One of the presenters in this webinar (from UCSF) gave several references during her presentation for mask effectiveness, though IMO she is a bit overenthusiastic with her extrapolations. I hope she's proven right though. It would make things a lot easier.
https://www.youtube.com/watch?v=Cio3rh6ta3w&list=WL&index=71&t=246s

 

[Rookie]

this is what I see masks doing for people. reminding them to not touch everything. keep distance.

Maybe I'm the only one, but I mess with my face a lot more when I have to wear a damn mask.

 

[Tombs]

I'm of the mindset that the right rating of mask does what it's rated to do. And that cloth is nothing more than signaling virtue.

Look at what people use who do this stuff professionally, for the specific situation. That's what you should always be noting when ever you're trying to decide on the right gear to get.

If it's being used professionally, there's usually a process it went to for them to arrive at the decision to use it.

 

[MnemonicMonkey]

Here's an article that sums it up nicely.

Masks work.

Cloth is better than nothing.

https://www.ucsf.edu/news/2020/06/4...-heres-science-behind-how-face-masks-prevent.

Sent from my Pixel XL using Tapatalk

 

[churchmouse]

Here's an article that sums it up nicely.

Masks work.

Cloth is better than nothing.

https://www.ucsf.edu/news/2020/06/4...-heres-science-behind-how-face-masks-prevent.

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And there are 10 other articles in these sub forums that prove they either don't work or the efficiency is not what that say it is.

For every pro article we can fins at least one or more con articles. Pick your poison.

 

[churchmouse]

Good lord we have 3 posting members in a gun forum that believe the Gov. should mandate masks.........The ice is cracking peoples.