Face masks cut disease spread in the lab, but have less impact in the community. We need to know why


Paul Glasziou, Bond University and Chris Del Mar, Bond University

In controlled laboratory situations, face masks appear to do a good job of reducing the spread of coronavirus (at least in hamsters) and other respiratory viruses. However, evidence shows mask-wearing policies seem to have had much less impact on the community spread of COVID-19.

Why this gap between the effectiveness in the lab and the effectiveness seen in the community? The real world is more complex than a controlled laboratory situation. The right people need to wear the right mask, in the right way, at the right times and places.

The real-world impact of face masks on the transmission of viruses depends not just on the behaviour of the virus but also on the behaviour of aerosol droplets in diverse settings, and on the behaviour of people themselves.

We carried out a comprehensive review of the evidence about how face masks and other physical interventions affect the spread of respiratory viruses. Based on the current evidence, we believe the community impact is modest and it may be better to focus on mask-wearing in high-risk situations.




Read more:
How a 150-year-old experiment with a beam of light showed germs exist — and that a face mask can help filter them out


The evidence

Simply comparing infection rates in people who wear masks with those who don’t can be misleading. One problem is people who don’t wear masks are more likely go to crowded spaces, and less likely to socially distance. People who are more concerned often adhere to several protective behaviours — they are likely to avoid crowds and socially distance as well as wearing masks.

That correlation between mask wearing and other protective behaviours might explain why studies comparing mask-wearers with non-mask-wearers (known as “observational studies”) show larger effects than seen in trials. Part of the effect is due to those other behaviours.

The most rigorous, but difficult, way to evaluate the effectiveness of masks is to take a large group of people and ask some to wear masks and others not to, in a so-called controlled trial. We found nine such trials have been carried out for influenza-like illness. Surprisingly, when combined, these trials found only a 1% reduction in influenza-like illness among mask-wearers compared with non-mask-wearers, and a 9% reduction in laboratory-confirmed influenza. These small reductions are not statistically significant, and are most likely due to chance.




Read more:
13 insider tips on how to wear a mask without your glasses fogging up, getting short of breath or your ears hurting


None of these trials studied COVID-19, so we can’t be sure how relevant they are to the pandemic. The SARS-CoV-2 coronavirus is a similar size to influenza, but has a different capacity to infect people, so it is possible masks might be more or less effective for COVID-19. A recently published trial in Denmark of 4,862 adults found infection with SARS-CoV-2 occurred in 42 participants randomised to masks (1.8%) compared to 53 control participants (2.1%), a (non-significant) reduction of 18%.

The most comprehensive between-country study of masks for COVID-19 infection is a comparison of policy changes, such as social distancing, travel restrictions, and mask wearing, across 41 countries. It found introducing a mask-wearing policy had little impact, but mask policies were mostly introduced after social distancing and other measures were already in place.


The Conversation, Author provided

What might diminish the effect of masks?

Why might masks not protect the person wearing them? There are several possibilities. Standard masks only protect your nose and mouth incompletely, for one thing. For another, masks don’t protect your eyes.

The importance of eye protection is illustrated by a study of community health workers in India. Despite protection by three-layer surgical masks, alcohol hand rub, gloves, and shoe covers, 12 of 60 workers developed COVID-19. The workers were then supplied with face shields (which provide eye protection) — in addition to the personal protective equipment (PPE) described above — and none of the 50 workers became infected despite higher case load.

Why masks might fail to clearly protect others is more complex. Good masks reduce the spread of droplets and aerosols, and so should protect others.

Things that might make masks less effective.
Paul Glasziou, Author provided

However, in our systematic review we found three trials that assessed how well mask wearing protects others, but none of them found an obvious effect. The two trials in households where a person with influenza wore a mask to protect others in fact found a slight increase in flu infections; and the third trial, in college dormitories, found a non-significant 10% relative reduction.

We don’t know if the failure was the masks or participants’ adherence. In most studies adherence was poor. In the trials very few people wear them all day (an average of about four hours by self-report, and even less when directly observed). And this adherence declined with time.

But we also have little research on how long a single mask is effective. Most guidelines suggest around four hours, but studies on bacteria show masks provide good protection for the first hour and by two hours are doing little. Unfortunately, we could not identify similar research examining viruses.

Is it better to focus masks on the 3 Cs: covered, crowded and close contact?

In addition to the completed Danish trial, another ongoing trial in Guinea-Bissau with 66,000 participants randomised as whole villages may shed more light as it tests the idea of source control. But given the millions of cases and billions of potential masks and mask wearers, more such trials are warranted.

We know masks are effective in laboratory studies, and we know they are effective as part of personal protective equipment for health care workers. But that effect appears diminished in community usage. So in addition to the trials, new research is urgently needed to unravel each of the reasons why laboratory effectiveness does not seem to have translated into community effectiveness. We must also develop ways to overcome the discrepancy.

Until we have the needed research, we should be wary about relying on masks as the mainstay for preventing community transmission. And if we want people to wear masks regularly, we might do better to target higher-risk circumstances for shorter periods. These are generally places described by “the three Cs”: crowded places, close-contact settings, and confined and enclosed spaces. These would include some workplaces and on public transport.

We are likely to be better off if we get high usage of fresh masks in the most risky settings, rather than moderate usage everywhere.




Read more:
How should I clean my cloth mask?


The Conversation


Paul Glasziou, Professor of Medicine, Bond University and Chris Del Mar, Professor of Public Health, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

As Victoria’s COVID-free streak continues, it’s probably time to consider changing the rules around masks


Lara Herrero, Griffith University and Eugene Madzokere, Griffith University

After a devastating second wave, Victoria yesterday recorded its twelfth straight day of zero new COVID cases.

In light of the state’s progress, Premier Daniel Andrews announced the easing of several COVID restrictions on Sunday, including removing travel limits within Victoria, reopening gyms and cinemas, and allowing greater numbers in hospitality venues. Restrictions are set to ease further on November 23.

But one of the notable measures to remain is face masks. Every Victorian must still wear a mask in public — whether indoors or outdoors — and they risk a A$200 fine if they don’t.

Is it time this rule was relaxed? After all, Victoria’s COVID situation is beginning to look more and more like other Australian states and territories, which have seen prolonged stretches of zero community transmission. Yet it remains the only state where mask-wearing is compulsory.

What does a mask do anyway?

A highly contagious virus called SARS-CoV-2 causes COVID-19. We believe the virus most commonly spreads when we breathe in tiny contaminated droplets which a person infected with SARS-CoV-2 has released into the air when coughing, sneezing, or talking.

The virus may also spread when we touch our eyes, nose or mouth after coming into contact with surfaces viral droplets have settled onto.

Face masks primarily target that first route of transmission, appreciating many people with COVID-19 won’t display symptoms. By preventing both inward and outward flow of virus-carrying droplets, masks can protect both the wearer and other people.

It’s also possible that if our hands become contaminated with the virus, wearing a mask may stop us touching our face and becoming infected that way.




Read more:
Which mask works best? We filmed people coughing and sneezing to find out


The effectiveness of any mask depends not just on its type, but also on wearing it correctly — so it covers your mouth and nose — and handling it carefully to avoid cross-contamination.

Widespread use of masks, together with sticking to other COVID-safe strategies, very likely helped Victoria to control its second wave. The use of similar approaches has been effective in other parts of the world, such as China, Italy and the United States, where the burden of COVID has been high.

Are masks as important outside as they are inside?

Wearing masks inside, or outside where physical distancing is difficult, helps to slow the spread of SARS-CoV-2. It’s especially important in areas where many people congregate including in shops, elevators, public transport, or at outdoor sporting venues.

There are a couple of factors that make wearing masks less important outdoors, particularly when we’re not near other people. First, the high airflow outside means any virus-carrying droplets are more readily dispersed, and so we’re less likely to breathe them in, compared with poorly ventilated indoor environments.

Second, evidence suggests outdoor environmental conditions such as higher heat or humidity can reduce the survival of SARS-CoV-2.

Taken together, the risk of transmission outdoors where physical distancing is in place remains low.




Read more:
How to talk to someone who doesn’t wear a mask, and actually change their mind


Is it time to change the rules?

Victoria is one of numerous states and jurisdictions around the world that have mandated masks during the pandemic. Of course, many of these places are experiencing significant community transmission, which Victoria isn’t.

Other Australian states recommend masks — particularly where it’s difficult to maintain physical distancing — but don’t mandate them.

While the continuation of the mask rule may be confusing and disappointing for many Victorians, the rationale is to keep the population safe and to safeguard the state’s strong progress.

A woman wears a mask in the supermarket.
It’s more important to wear a mask indoors than outdoors.
Shutterstock

That said, if Victoria’s zero community transmission streak continues for more than 14 days altogether (which is enough time for most people to develop symptoms if infected) the state should start considering transition to an “indoors only” mask strategy.

This approach would require masks to be worn indoors, particularly in crowded and possibly poorly ventilated environments like shops and restaurants, and in transit, such as on public transport or in taxis.

Wearing masks outdoors would be recommended if physical distancing is difficult or if a person is more vulnerable to COVID. But the decision would be up to the individual.

Hopefully in time for summer

Masks become less tolerable as the weather gets warmer. There’s little doubt Victorians would be glad to be free from masks when going out walking, or for a picnic, or to the beach.

If Victoria remains on the path of no new cases — or at least none with an unknown source — we would think, and hope, that the current mask rules will be eased in time for the summer holiday period.

The challenge for Victoria’s health department will be to ensure the transition occurs safely. Venues need to maintain strong COVID-safe plans, including hand hygiene, distancing, regular sanitising, and “check ins” for easy contact tracing.

The success of an “indoors only” strategy or any relaxing of mask rules would likely depend on both residents and visitors to Victoria strictly adhering to remaining COVID restrictions. It would be important for people to use their judgement, and if they’re in a crowded place where it’s difficult to maintain physical distancing, to put on a mask.




Read more:
Melbourne is almost out of lockdown. It’s time to trust Melburnians to make their own COVID-safe decisions


The Conversation


Lara Herrero, Research Leader in Virology and Infectious Disease, Griffith University and Eugene Madzokere, PhD Candidate in Virology, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

From scary pumpkins to bridal bling, how masks are becoming a normal part of our lives in Australia



http://www.shutterstock.com

Deborah Lupton, UNSW; Ash Watson, UNSW; Clare Southerton, UNSW, and Marianne Clark, UNSW

On Halloween this Saturday, it won’t be just trick-or-treating children who are wearing spooky costumes. Adults handing out sweet treats may also be sporting Halloween-themed face masks, which are now readily available online.

Come the festive season, you will also be able to wear a Christmas-themed face mask as you unwrap gifts with family and friends. You may even find some handmade cloth masks as part of your present haul.




Read more:
Friday essay: vizards, face gloves and window hoods – a history of masks in western fashion


As social researchers completing a book on face masks during COVID, we are keeping a close eye on the social trends and popular culture related to these simple objects.

We have observed increasing evidence masks are becoming normalised and part of everyday life, noting they are currently compulsory in Victoria. They are now commonly seen in public places around Australia and a thriving industry has sprung up to cater for every possible face mask need.

Before coronavirus, masks were a rarity

Pre-COVID, face masks are commonly worn in parts of Asia for a variety of reasons — including protection from pollution and the sun, personal privacy, and warding off seasonal flu and the common cold.

But in countries such as Australia, masks were rarely seen. A year ago, few Australians would not have given much thought to the humble surgical face mask, or ever considered buying, much less wearing one. Face masks were only for healthcare professionals.

Woman wearing a mask, walking her dog at Brighton Beach.
Masks have become a sign of how much COVID has changed Australian society.
James Ross/AAP

But with the arrival of the COVID-19 pandemic, the face mask has taken on a new significance. Even though we were initially advised against wearing them to reduce the spread of coronavirus, state health authorities in NSW and Queensland now recommend face masks should be used in situations where physical distancing is not possible.

The Victorian government has also mandated the use of face coverings for its citizens since the second lockdown in August. Earlier this month, fitted face masks (not bandanas or scarves) were made compulsory every time people leave their homes.

As Victoria opened up earlier this week, Premier Daniel Andrews noted, “masks need to be with us across the whole state for some time to come”.




Read more:
Which mask works best? We filmed people coughing and sneezing to find out


In Australia, we haven’t seen the intense political debates and activism around face masks that have emerged in the United States. Compared with the US, Australians tend not to see preventive health as a political issue. In fact, there is evidence of a growing acceptance face masks are becoming part of our everyday lives.

Steady increase in Australians wearing masks

Australian Bureau of Statistics figures show the proportion of Australians wearing face masks has steadily increased over the past few months.

Back in April, only about 17% of Australians reported wearing a face mask as part of their precautions against COVID-19.

By September, this number had increased dramatically. In total, 66% of Australians reported wearing a face mask “in the past week”.

Not surprisingly, the figures were much higher for people in Victoria, with 97% of reporting they wore a face mask. Even in New South Wales, where there have been sporadic but well-controlled outbreaks of COVID-19, most people (78%) were masking up.

It is notable that in all other states and territories, 23% reported wearing a mask in the past week at the time of the survey. This shows significant normalisation of mask-wearing, even when it’s not recommended by health authorities.

Woman wears a mask during a Lions AFL game at the Gabba in Brisbane.
An increasing number of people around Australia are wearing masks.
Darren England/AAP

Other surveys have also shown significant levels of support for mask wearing.

An ABC survey conducted in September found two-thirds of Australians agreed mask use should be mandatory in all public places. Meanwhile, an August Australian National University study revealed some interesting findings when it comes to different social groups.

It found 39% of surveyed Australians said they mostly or always wore masks indoors in public places, while 37% did so outdoors in public places. Younger Australians (aged 18 to 24 years) and older Australians (aged 75 years and over) were more likely to be mask wearers, as were those who spoke a language other than English at home, had a university education, and lived in a capital city.

A mask for every occasion

In the course of writing our book, we have noticed some fascinating developments in how face masks are portrayed in popular culture. In addition to being available in a range of prints and fabrics (including Australiana themes), there are face masks for every occasion and milestone.

Masks are promoted as a new form of bridal wear, with luxury face masks embellished with beads, diamantes and lace. Wedding guests may also find customised face masks as gifts to wear as part of the celebrations.

Bride wearing a white bridal face mask.
Customised face masks and now being marketed to brides.
http://www.shutterstock.com

There is also a wide range of customised masks on offer for footy matches, birthdays, baptisms, bar and bat mitzvahs, first communions and even funerals (“in loving memory…”).

These new ways of presenting and decorating masks demonstrates they are becoming not only part of everyday life, but also central elements of special occasions during COVID times.

Wearing a mask is more than showing the wearer is taking a responsible, caring approach to protecting others’ health. Masks are now also part of a culture of decoration and fashion. So they are not just a preventive health device but a mode of self-expression.

Are face masks here to stay?

Of course COVID and its path through our society is unpredictable. But it is highly likely COVID outbreaks will continue to occur well into 2021 and possibly beyond, and mask wearing will continue to be promoted as one of the key measures to contain the spread in these situations.




Read more:
Millions of face masks are being thrown away during COVID-19. Here’s how to choose the best one for the planet


In some countries pre-COVID, face masks had already become part of everyday life. Our research suggests the widening meanings, purposes and diversity of face masks could support a normalisation of masking in Australia, even once the critical phase of the pandemic has passed.

This will not necessarily mean that people will automatically wear them every day. But they are likely to have a selection of different styles waiting, ready to be used for higher-risk public activities or even special occasions.The Conversation

Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, UNSW; Ash Watson, Postdoctoral Fellow, Vitalities Lab, UNSW; Clare Southerton, Postdoctoral Fellow, Vitalities Lab, UNSW, and Marianne Clark, Postdoctoral Fellow, Vitalities Lab, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Does a face shield protect against COVID-19? We’re not sure — so a mask is probably a safer bet for now


Philip Russo, Monash University and Brett Mitchell, University of Newcastle

For several weeks, Victorians have been required to wear a face covering when they leave home. And while we now have a clearer path out of lockdown, it’s likely masks will be around for a while.

Meanwhile, people in other states with outbreaks have been encouraged to wear masks, and some people are simply choosing to wear one as a precaution.

But some people in the community, instead of opting for a traditional mask, are instead wearing a face shield.

This might offer some degree of protection — but it’s probably not as good as a mask in preventing the spread of COVID-19.

What is a face shield?

A face shield is a film made from plastic or other transparent material designed to be worn like a visor. It’s attached using a band that goes around the top of your head.

Think of a visor a welder wears to protect themselves from sparks and injury. Health-care workers use face shields to block bodily fluids from coming into contact with their face, and potentially causing infection.

It’s likely many people are choosing face shields during COVID-19 because they’re experiencing discomfort wearing a mask — whether glasses fogging up, irritation around the ears, or just that extra layer.

The term “face covering”, as per the Victorian government’s guidelines, is notably vague. It can include a face mask, a face shield, or a scarf or bandana.

The department of health does however recommend a mask over a face shield.




Read more:
How should I clean my cloth mask?


How effective are face shields?

A letter, published recently in the journal Physics of Fluids, reported on a laboratory experiment where scientists put face shields to the test.

They simulated coughing by connecting the head of a mannequin to a fog machine, and then using a pump to expel the vapour through the mannequin’s mouth.

They found that while face shields stopped the droplets being propelled forwards, aerosolised droplets — those much smaller in size — lingered at the bottom of the shield and floated around at the sides. They eventually spread approximately 90 centimetres from the mannequins.

A health-care worker looking out the window. She wears full PPE, including a face shield.
Health-care workers may wear face shields to prevent splashes of bodily fluids.
Shutterstock

This is an interesting laboratory experiment, but not conclusive evidence face shields offer less protection than masks in the community.

A lack of research on the effectiveness of face shields means it’s not possible to make any strong recommendations for or against their use.

Where does this leave us?

There’s a lot we still don’t know about this virus and how it spreads.

At present, we believe the virus is spread generally through close contact with an infectious person, contact with the droplets emitted when they sneeze or cough, or contact with surfaces these droplets have contaminated.

To establish an infection the virus enters your body through portals of entry: the mouth, nose and eyes.

Wearing a mask is intended to protect others if you have the infection, by blocking the droplets coming out of your mouth and nose. We call this source control. To a degree — though we have less evidence on this front — it’s also likely to protect you, the wearer, by providing a physical barrier to your portals of entry.




Read more:
Which face mask should I wear?


A face shield may offer an advantage in that it provides a physical barrier over all your portals of entry — your eyes as well as your mouth and nose. Shields may also reduce the frequency of the wearer touching their face, and have the added benefit of allowing the person’s face to be seen (if they’re not wearing a mask as well).

However, as they’re not tight fitting, aerosols may still enter and exit around the outside of a face shield, where it’s not fitted in the same way a mask is. And we’re continuing to accumulate evidence about the possible role of aerosolised transmission in the spread of COVID-19, which the World Health Organisation is closely monitoring.

Correct use is important too

Whatever face covering you choose, you must use it properly, and it must fit correctly.

Having masks slung under the chin, hanging off one ear, or your nose poking out over the top of the mask will make them markedly less effective. And of course frequently touching and re-adjusting the mask means we’re possibly contaminating our hands too.

If you don’t intend to wear a mask properly or you’re unable to, then a face shield is a better option. You can also wear mask and a face shield together, should you wish to.

Like masks, there are a variety of face shields available, varying in quality and size. The department of health advise if you wear a face shield it should cover “the wearer’s forehead to below the chin area and wrapping around the sides of the wearer’s face”.

You should not share a face shield. If they’re labelled disposable, don’t reuse them. And if they are reusable you need to clean them regularly following the manufacturer’s instructions.

The upshot

Masks worn correctly are the best option. When wearing a mask is not possible, then a face shield is better than nothing. Neither will work well if not used properly, and importantly, they don’t replace physical distancing and hand hygiene.




Read more:
How to talk to someone who doesn’t wear a mask, and actually change their mind


The Conversation


Philip Russo, Associate Professor, Director Cabrini Monash University Department of Nursing Research, Monash University and Brett Mitchell, Professor of Nursing, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Face masks and facial recognition will both be common in the future. How will they co-exist?



Pixabay, CC BY-SA

Paul Haskell-Dowland, Edith Cowan University

It’s surprising how quickly public opinion can change. Winding the clocks back 12 months, many of us would have looked at a masked individual in public with suspicion.

Now, some countries have enshrined face mask use in law. They’ve also been made compulsory in Victoria and are recommended in several other states.

One consequence of this is that facial recognition systems in place for security and crime prevention may no longer be able to fulfil their purpose. In Australia, most agencies are silent about the use of facial recognition.

But documents leaked earlier this year revealed Australian Federal Police and state police in Queensland, Victoria and South Australia all use Clearview AI, a commercial facial recognition platform. New South Wales police also admitted using a biometrics tool called PhotoTrac.




Read more:
Your face is part of Australia’s ‘national security weapon’: should you be concerned?


What is facial recognition?

Facial recognition involves using computing to identify human faces in images or videos, and then measuring specific facial characteristics. This can include the distance between eyes, and the relative positions of the nose, chin and mouth.

This information is combined to create a facial signature, or profile. When used for individual recognition – such as to unlock your phone – an image from the camera is compared to a recorded profile. This process of facial “verification” is relatively simple.

However, when facial recognition is used to identify faces in a crowd, it requires a significant database of profiles against which to compare the main image.

These profiles can be legally collected by enrolling large numbers of users into systems. But they’re sometimes collected through covert means.

Facial ‘verification’ (the method used to unlock smartphones) compares the main image with a single pre-saved facial signature. Facial ‘identification’ requires examining the image against an entire database of facial signatures.
teguhjatipras/pixabay

The problem with face masks

As facial signatures are based on mathematical models of the relative positions of facial features, anything that reduced the visibility of key characteristics (such as the nose, mouth and chin) interferes with facial recognition.

There are already many ways to evade or interfere with facial recognition technologies. Some of these evolved from techniques designed to evade number plate recognition systems.

Although the coronavirus pandemic has escalated concerns around the evasion of facial recognition systems, leaked US documents show these discussions taking place back in 2018 and 2019, too.

This clip shows how fashion designers are outsmarting facial recognition surveillance / YouTube.

And while the debate on the use and legality of facial recognition continues, the focus has recently shifted to the challenges presented by mask-wearing in public.

On this front, the US National Institute of Standards and Technology (NIST) coordinated a major research project to evaluate how masks impacted the performance of various facial recognition systems used across the globe.

Its report, published in July, found some algorithms struggled to correctly identify mask-wearing individuals up to 50% of the time. This was a significant error rate compared to when the same algorithms analysed unmasked faces.

Some algorithms even struggled to locate a face when a mask was covering too much of it.

Finding ways around the problem

There are currently no usable photo data sets of mask-wearing people that can be used to train and evaluate facial recognition systems.

The NIST study addressed this problem by superimposing masks (of various colours, sizes and positions) over images of faces, as seen here:

While this may not be a realistic portrayal of a person wearing a mask, it’s effective enough to study the effects of mask-wearing on facial recognition systems.

It’s possible images of real masked people would allow more details to be extracted to improve recognition systems – perhaps by estimating the nose’s position based on visible protrusions in the mask.

Many facial recognition technology vendors are already preparing for a future where mask use will continue, or even increase. One US company offers masks with customers’ faces printed on them, so they can unlock their smartphones without having to remove it.

Growing incentives for wearing masks

Even before the coronavirus pandemic, masks were a common defence against air pollution and viral infection in countries including China and Japan.




Read more:
I’ve always wondered: why many people in Asian countries wear masks, and whether they work


Political activists also wear masks to evade detection on the streets. Both the Hong Kong and Black Lives Matter protests have reinforced protesters’ desire to dodge facial recognition by authorities and government agencies.

As experts forecast a future with more pandemics, rising levels of air pollution, persisting authoritarian regimes and a projected increase in bushfires producing dangerous smoke – it’s likely mask-wearing will become the norm for at least a proportion of us.

Facial recognition systems will need to adapt. Detection will be based on features that remain visible such as the eyes, eyebrows, hairline and general shape of the face.

Such technologies are already under development. Several suppliers are offering upgrades and solutions that claim to deliver reliable results with mask-wearing subjects.

For those who oppose the use of facial recognition and wish to go undetected, a plain mask may suffice for now. But in the future they might have to consider alternatives, such as a mask printed with a fake computer-generated face.The Conversation

Paul Haskell-Dowland, Associate Dean (Computing and Security), Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

With rights come responsibilities: how coronavirus is a pandemic of hypocrisy



Shutterstock

Luke Zaphir, The University of Queensland

It’s after work and you’ve gone to the supermarket to grab some ingredients for dinner. You’re tired, anxious and pretty hungry. Plus you have to put on a mask because a thousand other people are there, and social distancing is hard to enforce at this moment. Now you’re uncomfortable, on top of everything.

We all feel this way sometimes. But we tolerate it because there’s a pandemic and we all have to do our part to keep everyone safe.

Except that one person.

There’s that one person at the front of the line being asked to step out and put on a mask before coming into the shop. And they’re putting on a scene, yelling about their rights to go unmasked, to be able to breathe, to be free of oppression.

“Everyone else can wear a mask if they choose but not I,” says the person. “I have rights and I will be free.”

This is hypocrisy.

Hypocrisy is when we are inconsistent in our morality. We commonly refer to it as “saying one thing and doing another”.

Anti-maskers believe they have rights. But in refusing to wear a mask, they are denying other people the right to live in security. Article 3 of the United Nations Universal Declaration of Human Rights says “everyone has the right to life, liberty and security of person”. These rights are inextricably interwoven. Freedom without safety is arguably not freedom at all.

The primary way we become hypocrites, strangely enough, is being too flexible in our thinking — a cognitive flexibility called abstraction. Flexible thinking can be about keeping an open mind, but the capacity to warp one’s thinking processes can also make double standards acceptable.




Read more:
How to talk to someone who doesn’t wear a mask, and actually change their mind


We create loopholes in the application of the rules because we’ve created those rules much too theoretically, which doesn’t gel with real world settings.

Why is hypocrisy so bad?

When we are hypocritical, we create injustices. We may fail to do the right thing, which might hurt people or even make them sick. But the biggest problem with hypocrisy is that it causes a complete breakdown of our own personal truth.

If we believe in a principle, but don’t apply it ourselves, that principle is essentially meaningless.

Many dictatorships and fascists are fantastic hypocrites. They often say they are defending some theoretical value – like national security, cultural tradition or even freedom — but there’s no value or meaning in an abstract notion of security or freedom if you murder and oppress your people.

Man pulling a mask of his face off his head.
How can you trust someone who says one thing, but acts differently?
Shutterstock

Not all hypocrisy ends with bloodshed but we can have some pretty poor outcomes regardless. One of the more fundamental hypocrisies comes from ignoring the responsibility that comes with every right.

You want the right to live? Then you have a responsibility to the rights of others to live.

You want to own stuff? You have a responsibility to respect the property rights of others.

You want to use a public space? You have a responsibility to share that space with others.

To believe you have a right without a corresponding responsibility is hypocritical — a double standard where you’ve likely considered the abstract principle but not the specific situation.

Why is it bad, particularly now?

Hypocrisy erodes the value behind rights and truth, so they’re essentially worthless. Democracy is fundamentally about consent of the governed — we give our informed consent through voting and political participation. Informed consent requires accurate information though. Without being able to know the truth, we have no ability to give consent.




Read more:
Post-truth politics and why the antidote isn’t simply ‘fact-checking’ and truth


Our democracy erodes away with every hypocrisy and lie told to undermine expertise. It’s a well-known arguing tactic to discredit opposition to win a debate but we simply don’t have the luxury of this kind of sophistry during a pandemic.

We may not agree on what we need to do but right now we can’t afford to ignore evidence and truth.

Take public goods. These are shared spaces and qualities we all benefit from: education, clean air and water, health and the environment.

Letter tiles spelling 'truth' being covered up by sand.
Hypocrisy can erode truth.
Shutterstock

Without the public good of health, we get sick, the economy shuts down, we lose loved ones to disease. Our quality of life drops dramatically without good public health.

A hypocritical viewpoint says: “I’m willing to benefit from good public health but I’m not willing to maintain it”.

Hypocrites never would directly think or say this. Instead, they would see the issue as a fulfilment of a different abstract right. This might look like “I have a right to be unmasked in public”.




Read more:
How not to fall for coronavirus BS: avoid the 7 deadly sins of thought


This right may exist, or it may not. However, if you think public health is a good thing but you aren’t willing to take a basic measure of responsibility for it — like wearing a mask — that’s hypocrisy. It can make a disaster worse for everyone.

What can we do to check ourselves for hypocrisy?

One of the best ways to avoid hypocrisy is to make our own moral principles far more specific. Put that abstract principle into context.

Say your principle is

I have a right to live unmasked.

That’s not too contentious but it is vague enough to be abused.

Applying context to that principle could look like this:

I have a right to live unmasked even when I’m possibly an asymptomatic carrier of the worst disease to hit our country in a century.

It’s a lot harder to defend a belief like this one.

We don’t have to share common ethics from person to person, but we do have to be consistent with ourselves. If we’re charitable and authentic in how we interpret a situation, we gain the ability to construct much stronger, much more consistent moral beliefs.The Conversation

Luke Zaphir, Researcher for the University of Queensland Critical Thinking Project, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Mask or no mask? This simple ethical approach can help with your pandemic etiquette



http://www.shutterstock.com’

Elspeth Tilley, Massey University

Feeling torn about wearing a mask? Me too. I don’t want to look like I’m virtue signalling or get funny looks. But I also want to be responsible about public health. I’ve ended up conflicted, wearing a mask one day but not the next.

The statistics suggest this isn’t my dilemma alone. While mask sales have skyrocketed in New Zealand since COVID-19 reemerged, public mask wearing (even in Auckland) is still the exception.

This is where understanding ethical decision making can be useful. Ethics breaks down values-based decisions, helping us see when our ego is ruling us, and when our rationality is in control.

Ethical analysis can’t make the decision for us, but it can make dealing with ethical decisions clearer and more conscious.

What kind of person do I want to be?

Scholars divide the study of ethics into three main branches: virtue, deontological and consequential. All three can us help think about wearing a mask.

Virtue ethics is about developing good character. Our virtues come from our upbringing, experiences and education. We can change them by redefining what sort of person we want to be.




Read more:
3 moral virtues necessary for an ethical pandemic response and reopening


Simple virtue checks include:

  • The front page test – would you feel comfortable seeing your behaviour on the nightly news?

  • The significant other test – would the important people in your life be proud of you?

(There are several recently disgraced politicians who probably wish they’d run the front page and significant other checks before acting.)

However, virtue ethics are individualistic: values differ by gender, age, culture and other factors. Our ego can help us moderate our behaviour, but it can also convince us we are right just because we sincerely hold a strong moral belief.

The “no win” debates we see on social media often reach a stalemate because people are relying on personal values as their only moral compass.

Also, prioritising reasonableness can result in apathy. While Aristotle praised the “reasonable man” as virtuous, George Bernard Shaw pointed out that “all progress depends on the unreasonable man”.

Currently mask wearers are the exception rather than the rule, and some have even been mocked. Shaw’s approach would suggest the courage to show ethical leadership deserves praise rather than mockery. But we can only make a robust ethical judgement if duties and outcomes are also considered.




Read more:
Why New Zealand needs to focus on genome sequencing to trace the source of its new COVID-19 outbreak


What are my duties?

Deontologists try to identify rules for good behaviour that will hold true in every situation. They advise us to obey the law and any codes of conduct or standards that apply to our job or other group membership.

There is currently no law in New Zealand mandating mass masking, so that can’t guide us. But many workplaces have conduct or health and safety codes, which can simplify decision making, and there are clear public health recommendations.

Deontology gives clarity – rules define what can be done without penalty – and is less muddy or personal than virtue-based ethics. It can also provide accountability. If we breach the rules of a group, often we can be removed from that group.

On the other hand, deontological ethics is inflexible. Codes and rules can’t cover every situation, can date rapidly, and are usually made reactively. They mostly punish breaches rather than guiding good behaviour.

Nonetheless, considering laws and rules is an important ethical step, alongside thinking about our values and the impact of our actions.

What kind of world do I want to live in?

Consequentialists judge actions by their outcomes: who is affected and how. They aim to maximise benefit and minimise harm.

When weighing consequences, it is useful to ask:

  • Would you be happy for your action to affect you in the same way it does others (reversibility)?

  • Would the outcome be acceptable if everyone behaved this way (universalisability)?

  • What don’t we know today that might be true tomorrow (unknowability)?




Read more:
Don’t stand so close to me – understanding consent can help with those tricky social distancing moments


Consequentialists try to act ethically towards all groups of people, not just the group they currently occupy, because they know circumstances can change. If a friend was diagnosed with an unexpected respiratory condition tomorrow, for example, would we be happy with how we behaved today?

But, on their own, consequentialist approaches can be vague and complex. Most usefully, consequentialism adds depth to other approaches.

Ask yourself these questions

So, I run all three ethics checks: what values are important to me, what are my duties, and what are the potential impacts of my choice? To help, I can ask other questions:

  • What would mum say? (Be compassionate.)

  • What does my workplace code of conduct say? (It prioritises manaakitanga or care for others.)

  • What does the reversability test imply? (That I can show solidarity with, and reduce anxiety for, people at risk, even if I am at less risk.)

  • If someone I’m in contact with got sick tomorrow, how would I feel about my behaviour today? (I’d rather not be sorry in hindsight.)

Asking a range of questions from all three ethical angles helps me arrive at an ethically measured decision: that I should be consistently wearing a mask when I go out. And a careful decision is much easier to stick to, even if it means I still get the odd funny look.The Conversation

Elspeth Tilley, Associate Professor of English (Expressive Arts), Massey University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How do I know if my mask actually works? What about the ‘candle test’?



Shutterstock

C Raina MacIntyre, UNSW

With mask wearing in public compulsory in Victoria and recommended in New South Wales, many Australians are buying, wearing or making face masks for the first time.

Reports of counterfeit or potentially substandard masks on the market may lead some people to question whether their surgical or cloth mask actually works.

So what can you look out for when buying a mask to make sure it does what it’s supposed to do?

And how can you test one you’ve bought or made?

What do I look for in a surgical mask?

Surgical masks (also known as medical masks) are usually made of three or four layers, most commonly polypropylene.

Ideally, they should meet Australian standards for how well they filter and how resistant they are to water.

Only masks the Therapeutic Goods Administration (TGA) approves as medical products (officially known as medical devices) can be used in hospitals.

If a mask meets Australian standards as a medical device, you will see a label on the packaging, plus a code indicating the standards it has met, such as:

  • AS/NZS 4381:2015

  • ASTM F2101-14 or EN 14683:2014

  • ISO 22609 or ASTM F1862/F1862M-13.

If your surgical mask says “not for medical use”, it doesn’t necessarily mean it’s useless. It just means it has not been submitted to the TGA for approval as a medical device.

If that’s the case, you can assess it using one of the methods below.

What do I look for in a cloth mask?

Cloth masks are non-medical devices. But they can be designed to be reasonably protective.

If you’re buying one online or making one yourself, check how many layers it has. A single-layered mask is better than no covering, but two layers are better than one, and three layers are better than two. More than three layers are better still.

Look for a fine weave, high thread count and dense material. Flimsy or see-through material, or material with large gaps, is not adequate because droplets and aerosols can pass through the gaps.




Read more:
Which mask works best? We filmed people coughing and sneezing to find out


For a cloth mask, pure cotton is not a good choice for the outer layer, as it is absorbent. If someone else is coughing and sneezing near you, you want your mask to block those droplets rather than enable them to pass through the mask and infect you. A polyester or cotton-polyester blend is a better choice for this outer layer.

So for cloth masks, aim for at least three layers, including a water-resistant outer layer. The inner layer can be cotton, as that makes it more comfortable to wear, because it will absorb moisture from your breathing.

Check also that your mask fits well around your face. If you have gaps around the edges of your mask, you can breathe in unfiltered, contaminated air.

Look to see if there’s a nose bridge piece or other adjustable edge to help mould the mask around your nose and the top of your cheeks. If your mask is loose-fitting, a nylon stocking over the top can improve the fit and seal.

And remember to wash your cloth mask daily.




Read more:
13 insider tips on how to wear a mask without your glasses fogging up, getting short of breath or your ears hurting


How can I test my mask at home?

Test for good filtration and fit

For filtration and fit, you can do some rather time-consuming experiments at home.

But a much simpler method is the candle test, popularised by US science educator Bill Nye. If you can blow out a candle while wearing your mask, that’s a fail.

It means your mask doesn’t adequately stop the flow of air. If you can blow air out, air can also leak inward just as easily.

Put on your mask, light a candle, then try to blow out the flame.

Test for water resistance

The virus is carried on water droplets expelled when infected people talk, cough and sneeze. If these droplets land on your mask, you want the outer layer to repel them.

A TGA-approved mask will be water resistant. But not all other masks are. So you can test a non-approved surgical mask or cloth mask at home.

If a drop of water on the outside surface is absorbed straight away, that’s a fail. If the drop forms a bead, the mask is water-resistant.




Read more:
How should I clean my cloth mask?


Whether you go for a surgical mask that’s an approved medical device, an unapproved surgical mask, or a cloth mask, these simple tips should help you assess it before leaving the house.

Masks are a simple method for helping reduce transmission of the virus that causes COVID-19, alongside physical distancing, hand-washing and other infection control measures. If enough people wear them, they may even help avoid a lockdown.The Conversation

C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How should I clean my cloth mask?



Shutterstock

Brett Mitchell, University of Newcastle and Philip Russo, Monash University

Face coverings, such as cloth masks, are mandatory for all Victorians and are being recommended for public use in some other parts of the country.

Wearing a face covering helps prevent the spread of COVID-19 by providing a physical barrier. In saying that, they don’t replace the need to keep up physical distancing, hand hygiene, and staying at home when feeling unwell (as well as any other government restrictions). They should also be worn correctly.

Importantly, they should also be washed properly. If you come into contact with an infected person while wearing a mask, virus particles could land on your mask and contaminate it. If you don’t handle and wash your mask correctly, you may infect yourself or others by touching the contaminated mask.

When to clean

Cloth masks should be cleaned after each use. Importantly, if your mask gets wet, moist or visibly dirty, it’s time to take it off, put on a new one and wash the old one. A supply of masks will help you manage the cleaning process, so you always have one to hand. The number of masks you want to have in supply will depend on how frequently you leave the house and use them.

Remember the mask may be contaminated, so don’t touch the front of it when taking it off. Instead, use the loops or ties to take it off, then store it in a plastic bag or dedicated area, ready to be washed. And wash your hands immediately afterwards.

If you happen to have a surgical or medical mask, these are single-use only, so should not be laundered, cleaned or reused.

How to clean

Washing cloth masks is pretty straightforward. You can add them to your normal laundry wash. Make sure to use a detergent and to use the warmest temperature setting your clothes and cloth can handle.

There is no need to use disinfectant in your wash. For the detergent, you may want to use a non-scented detergent if you are sensitive to the smell.

If you want to wash your cloth mask by hand, use a bucket of hot water with a detergent. Just use hot water from the tap, no need to boil water. Let the cloth mask soak in the water, give it a hand wash and rinse. If your mask remains visibly dirty, try washing it in the washing machine.

As always, ensure you wash your hands after you put the mask in the washing machine or bucket, and after handling your mask in general.

A person washing their mask in a bucket with water and deterganet
You can wash your mask in a machine or by hand. Either way, the most important thing is to use a detergent.
Shutterstock

Drying them is important

A wet cloth mask is not effective to use, so your cloth mask must be dry before using it again. You can dry your cloth mask in any number of ways.

You can use a dryer (using a heat setting) or lay it flat to air-dry. Direct sunlight is also another way to dry your cloth mask. You can hang it, but it’s best to dry it flat so it doesn’t lose its shape.

When you have washed and dried your mask, store it in a clean, dry place where it won’t get contaminated again.

How often do I need to make or buy a new mask?

Cloth masks are all very different. You may have purchased one or made one yourself. As a result, there is no set “life” of a cloth mask.

But here are some indications you may need a new one:

  • it doesn’t fit snugly on your face anymore, or has lost its shape

  • there are tears or holes, or the material is wearing thin

  • it frequently falls down or you need to keep adjusting it.




Read more:
Which mask works best? We filmed people coughing and sneezing to find out


And don’t forget

When putting on a fresh mask, make sure you wear it properly, ensuring it covers your mouth and nose. Do not wear a mask slung under your chin, or have your nose protruding over the top. Avoid fiddling with your mask, moving it around unnecessarily, or excessively touching it.

Finally, masks used alone will not prevent infection. Used together with physical distancing and hand hygiene will offer the most protection.


This article is supported by the Judith Neilson Institute for Journalism and Ideas.The Conversation

Brett Mitchell, Professor of Nursing, University of Newcastle and Philip Russo, Associate Professor, Director Cabrini Monash University Department of Nursing Research, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Two weeks of mandatory masks, but a record 725 new cases: why are Melbourne’s COVID-19 numbers so stubbornly high?


Erin Smith, Edith Cowan University

Melburnians have now been wearing mandatory face coverings in public for two weeks. Yet Premier Daniel Andrews yesterday announced another grim milestone in Victoria’s second wave of COVID-19 infections: 725 new cases, a record daily tally for any Australian state since the pandemic began.

Four weeks after Melbourne reintroduced stage 3 restrictions, logic suggests the coronavirus curve should have flattened and begun heading downwards by now. And on July 27, Victoria’s chief health officer Brett Sutton suggested the plateauing figures could represent the peak of the state’s daily case numbers.

But on August 2, Andrews announced Melbourne was moving to even stricter stage 4 restrictions, imposing a night-time curfew and shutting down a swathe of Victorian businesses for a further six weeks.




Read more:
Which mask works best? We filmed people coughing and sneezing to find out


Why haven’t masks made a difference?

The premier announced on Tuesday a new deterrent aimed at those who continue to disregard the self-isolation restrictions: a fine of A$4,957, the largest on-the-spot fine applicable in Victoria. People who repeatedly breach the rules can also be taken to court, where the maximum penalty is A$20,000.

Meanwhile, proper, widespread use of masks by the public should have made a big dent in coronavirus numbers. So why hasn’t there been a drop in cases?

It can’t be blamed entirely on the government’s response. A portion of the blame also lies with the public.

Philip Russo, president of the Australasian College of Infection Prevention and Control, last week lamented the “really obvious disoedience” displayed by some people, and speculated masks may also have created a false sense of security among the wider public who may view masks as more effective than they truly are.

Andrews said “far too many people” were going to work while sick, labelling this behaviour “the biggest driver of transmission” in the state. The stage 4 restrictions will clamp down heavily on this.

Julie Leask, a social scientist at the University of Sydney, said workers’ reluctance to call in sick is linked to how financially stable they feel, explaining that for casual workers:

isolation after a test could mean no work, less chance you will get a shift in future, and considerable financial stress. In that situation, it’s easy to rationalise a scratchy throat as just being a bit of a cold.

Another difficulty is the lag time between when someone is infected and when they start showing symptoms.

What we are seeing now is actually infections from 5-10 days ago. And any public health interventions implemented now will take 5-10 days to show an effect.

Taking this time lag into account, the full effect of mandatory mask wearing will start to be seen this week.

We also know COVID-19 thrives in environments where it can quickly infect large numbers of people – and the recent uptick in cases has largely been driven by workplace transmission which occurred before the stage 4 restrictions came into effect.




Read more:
‘Far too many’ Victorians are going to work while sick. Far too many have no choice


Prime Minister Scott Morrison has announced a A$1,500 disaster payment available to workers in Victoria who do not have sick leave and who need to self-isolate for 14 days.

Lax lockdown?

During July’s stage 3 lockdown, Melburnians were under the same restrictions as the original lockdown in March and April. Yet vehicle traffic was almost 20% higher than during the earlier lockdown (albeit well below normal, pre-pandemic levels).

Victorian government epidemiologist James McCaw said people generally haven’t changed their behaviour as much during the second lockdown as they did the first time around.

Nevertheless, there are early signs the stage 4 lockdown is markedly reducing the number of Melburnians who are out and about. On Monday, the first day of the new strictures, pedestrian numbers in the CBD plummeted. Typically, 1,300 people walk across Sandridge bridge during morning peak hour – on Monday it was just six.




Read more:
Mapping COVID-19 spread in Melbourne shows link to job types and ability to stay home


The persistently high numbers may also be partly explained by infected people transmitting the virus to their families, partners or housemates – something that’s hard to avoid even in lockdown.

The government will presumably not attempt enforce mask wearing or social distancing within our own homes, yet this has profound implications for disease transmission.

It is helpful to consider your household as a single unit; if one person puts themself at risk, perhaps by not wearing a mask, they put their entire household at risk.

Masks have slowed “sharp upward trend”

While it’s frustrating that Victoria’s numbers have not trended downwards, it’s also true the state has successfully avoided the kind of exponential increase in cases seen in many other countries. An analysis published this week in the Medical Journal of Australia estimates that Victoria’s restrictions have averted between 9,000 and 37,000 coronavirus infections.

Masks are a crucial part of this, and the state government is distributing more than 1.37 million free reusable masks to those most in need.




Read more:
A $200 fine for not wearing a mask is fair, as long as free masks go to those in need


It’s also possible Victoria is partly a victim of bad luck and unfortunate timing. The case clusters that spurred the second wave arose just as social distancing rules were easing after months of restrictions.

Regardless of how Victorians got here, it is clear what they must do next. It’s vital for people in Melbourne to diligently follow the stage 4 restrictions, and that all Victorians maintain physical distancing, stay at home if unwell, get tested if they have symptoms, and self-isolate if they test positive.The Conversation

Erin Smith, Associate Professor in Disaster and Emergency Response, School of Medical and Health Sciences, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.