Masks, ventilation, vaccination: 3 ways to protect our kids against the Delta variant


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Katrina McLean, Bond University and Natasha Yates, Bond UniversityLast year in the COVID-19 pandemic, children were not catching or spreading the virus much. The main focus was on protecting our elderly and vulnerable.

But the Delta strain has changed things. Children around the world are contracting Delta in high numbers and some frontline doctors believe they may also be getting sicker from this strain.

Many parents and schools have concerns about how to best protect children from COVID-19. There’s also the worry children will catch the virus at school and take it back to their families and communities.

While many children are now well-accustomed to washing and sanitising their hands, this is simply not enough to tackle the spread of COVID-19, especially now we know the virus is airborne. We need a whole toolbox of strategies.

There are three key areas to focus on that we believe are evidence-based, easy to implement and will help protect our children: masks, ventilation and vaccination.

1. Masks

In certain Australian states, children aged 12 and above are currently required to wear a mask in public areas (schools included).

Meanwhile, Victoria’s chief health officer Brett Sutton has recommended children aged five and up wear masks in the face of rising Delta transmission among children.

As GPs, parents often ask us if it’s safe for children to wear masks. While we understand concern from parents, we reassure them masks have been found to cause no harm in children over the age of two. When children wear masks it doesn’t affect their breathing or reduce their oxygen levels.

Importantly, when worn properly, masks are effective at reducing the spread of COVID-19, for adults and children alike.




Read more:
Under-12s are increasingly catching COVID-19. How sick are they getting and when will we be able to vaccinate them?


A few quick tips. Fabric masks should be treated like underwear: wash them regularly, ensure they cover everything, and don’t share. These are a better option for the environment.

Label fabric masks like school hats — they will go missing!

Surgical/disposable masks are single use. Like using a tissue to blow your nose, make sure it goes in the bin once used and then wash your hands.

And masks should fit snugly — the less gaps there are the better they will work.



Like anything new, getting used to masks can take time. Children may initially be anxious, especially if their parents are too. Though most kids adapt really quickly (much quicker than adults, in our experience).

While the majority of children will adapt quickly there will be some who have specific and legitimate concerns, for example disabilities and sensory issues. GPs and paediatricians can help work out what the safest approach is for these children.

2. Ventilation

SARS-CoV-2, the virus that causes COVID-19, can float in the air like smoke. If you’re inside in a small enclosed room with other people and the ventilation is poor, it will only be a matter of time before you’re all breathing in each other’s air.

Schools have lots of children inside enclosed classrooms, often for hours, so what can be done?

Ventilation is something schools can and should address. Some simple strategies include:

  • get outside as often as is practical. Call children into the classroom only once the day has started. Hold some lessons outside the classroom. During breaks and lunch time children should be outside whenever possible too
  • open doors and windows
  • set air conditioning or heating systems to bring in as much outdoor air as possible
  • check the air with carbon dioxide monitors. This is occurring overseas.

Why do we care about CO₂? Well, we breathe in oxygen and breathe out CO₂. In confined spaces with lots of air that has been “breathed out”, monitors will detect higher levels of CO₂.

All that “breathed out” air could be full of viral particles, so if the monitor is measuring high, airflow needs to be improved immediately by opening a door or window.

In stuffy rooms, or rooms that measure high for CO₂ (indicating the ventilation is poor), a longer-term plan to clean the air should be considered. What’s encouraging is that the technology already exists to address this.

Air cleaners, also known as air purifiers, scrubbers, or HEPA filters, can actually help to “clean” the air we breathe. Lots of schools around the world are now actively improving ventilation systems and air quality monitoring.

Improving the air quality in schools may also prevent some of the other colds and flus kids pick up at school, and reduce asthma and allergy symptoms.

3. Vaccination

At this stage in Australia the Pfizer vaccine is recommended for vulnerable children aged 12-15, including those registered on the National Disability Insurance Scheme.

Vaccinations for all children 12 and over are now under way in New Zealand.

New Zealand GP Dr Sarah Hortop shared this photo of her daughters who received their first dose of the Pfizer vaccine recently.
Sarah Hortop, Author provided

Many other countries have been giving vaccines to children for several months now. For example, in the United States, more than one-third of 12 to 15-year-olds are fully vaccinated and nearly 50% have had at least one dose.

We know the vaccines work well in this age group and just like in adults, there is very close monitoring of adverse events from these vaccines in children. It’s reassuring to see very few serious reactions, and even those that are (for example myocarditis — inflammation of the heart) are treatable.

Vaccine trials are under way in children under 12 in the US (for Pfizer and Moderna), and once we have the safety and efficacy data we can start making decisions around vaccinating them too.




Read more:
We should install air purifiers with HEPA filters in every classroom. It could help with COVID, bushfire smoke and asthma


The Conversation


Katrina McLean, Assistant Professor, Medicine, Bond University and Natasha Yates, Assistant Professor, General Practice, Bond University

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

Can’t get your kid to wear a mask? Here are 5 things you can try


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Rebecca English, Queensland University of Technology and Karleen Gribble, Western Sydney UniversityLet’s face it, none of us actually enjoys wearing a mask. And it’s even harder when you’re a parent trying to get your kids masked up, as well as yourself.

Victoria, New South Wales and the Australian Capital Territory now require everyone over the age of 12 to wear a mask whenever they leave their home, unless they are exercising. This mandate includes in high schools in NSW and Victoria.

In parts of Queensland and South Australia, children 12 to 17 years also need to wear a face mask if they’re indoors and can’t socially distance.

Children should not wear masks while exercising. And children under two years old should also not wear masks, as they are a choking and suffocation risk.

Parents can decide if children between the ages of five and 12 should wear a mask. But, the World Health Organization says children under five years old should not be required to wear masks.

There is ample evidence showing masks help keep children and young people safe. Plus, unlike the earlier stages of the pandemic when kids weren’t contracting or transmitting the virus as much as adults, we are now seeing many cases in children of the Delta variant. Although, thankfully, serious disease among young people is still rare.




Read more:
Under-12s are increasingly catching COVID-19. How sick are they getting and when will we be able to vaccinate them?


Here are five things you can do to encourage your kids to wear a mask.

1. Model wearing one

One of the best things you can do to encourage your kids to mask up is to model mask wearing. Show your child it is OK to wear a mask; it is “normal”.

Mother and daughter listening to music and wearing a mask while waiting for train.
Show your child it’s normal, and not scary to wear a mask.
Shutterstock

2. Empathise with their feelings

If your child is reluctant to wear a mask, you can empathise with their feelings. Nobody likes wearing masks. Children rely on facial gestures to communicate, and many have sensory issues that can make wearing masks uncomfortable. Reflecting back to your child that you know this is hard for them helps them feel understood.

Find out why they don’t want to wear a mask. It might be they get sore ears or a headache. If so, masks that tie behind the head can be helpful. If it’s fogged glasses, a better fitting mask, or a mask clip, may help.

The internet is full of mask hacks to help make masks more comfortable. Some are as simple as using hair clips in the loops to extend the length of the mask.




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


3. Help them understand the science

Kids may be more willing to wear a mask if they understand why they need to. When children understand why a behaviour is important to their health, they are more likely to comply. Older children may be interested in the science of mask wearing.

There are many resources — including easy to understand YouTube videos — that can help.

You could get your kids to watch a video, like this one.

Remind your kids that doing things they want, like seeing their friends at school, relies on them wearing a mask.

4. Make it a game

Younger children may be helped by making the mask wearing a bit of a game, which can include making up silly poems about wearing masks. Or you could encourage your child to see themselves as a superhero protecting others by wearing a mask.

Younger children can imagine they’re a superhero helping others.

You could also give your child the chance to choose a mask or decorate their own, turning it into a craft activity. This will make the child comfortable with the mask and give them a sense of ownership over it.




Read more:
Tinker Bell, Batman, Ben 10… if your kids are in character, they’re more likely to help around the house


5. Ask others for help

Children require good fine motor skills to put on, and keep on, a mask. If you want your child to be wearing a mask at school, you could talk to the teacher, teacher aide or guidance officer to see if they can help.

Teachers can make sure the mask is on properly, and help your child to adjust the mask as needed.

For children with a disability

If your child has a learning disability, developmental delay or is on the autism spectrum, asking them to wear a mask, and keep it on, may be harder.

Making it a game or making it fun may also work for these children. And there’s evidence that tolerance training, where you gradually expose your child to mask wearing providing praise when the child is able to complete a step, can help.

But it may be impossible to force compliance and it may be dangerous in some circumstances. There are exemptions for people who have any medical condition that makes wearing masks unsuitable.

Students in class wearing masks.
You could ask a teacher to help your child wear their mask properly at school.
Shutterstock

Lastly, ask yourself these questions

If your child isn’t legally required to wear a mask, but you’re still wondering, ask yourself these questions:

  • are there high levels of virus in my community?
  • is my child going to be indoors with poor ventilation and lots of people?
  • does my child have a medical condition that might make COVID-19 more risky for them or are they going to be around people who have a medical condition that makes them more susceptible to COVID-19?

If the answers to any of these questions are “yes”, that would lend weight to encouraging mask wearing.

If the answers to any of these questions are “no”, this would lend weight towards not requiring mask wearing.




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But if your child is under 12, or has a developmental or another kind of disability, it’s also important to consider whether they can put the mask on and take it off safely by themselves, and whether you or someone else can supervise them while they are wearing a mask. If not, it may be better they don’t wear one.The Conversation

Rebecca English, Senior Lecturer in Education, Queensland University of Technology and Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University

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

View from The Hill: Barnaby Joyce repudiates Christensen’s COVID misinformation


Michelle Grattan, University of CanberraNationals leader Barnaby Joyce has dissociated himself from the views of his maverick backbencher George Christensen, who on Tuesday flatly rejected measures to contain COVID and played down the seriousness of the disease.

“I don’t agree with him,” Joyce said. “Just because someone has a view, it doesn’t mean it’s my view.” Joyce is personally close to Christensen.

Joyce drew on the experience of his father, who he said had been very involved in the eradication of brucellosis and bovine tuberculosis in northern NSW.

This had been done by large scale vaccination, quarantine, prosecution of people who did not comply with measures, and explanation, Joyce told The Conversation.

“I’m not going to step away from growing up having to deal with those things at an agricultural level. This is how you deal with diseases,” he said.

In a speech delivered just before question time, Christensen asked rhetorically, “How many more freedoms will we lose due to fear of a virus, which is a survivability rate of 997 out of a 1000?”

He said masks didn’t work and lockdowns didn’t work.

“Domestic vaccine passports are a form of discrimination,” he said.

“Nobody should be restricted from everyday life because of their medical choices, especially when vaccinated people can still catch and spread COVID-19.”

“Our posturing politicians, many over there [on the Labor benches], the sensationalist media elite and the dictatorial medical bureaucrats need to recognise these facts and stop spreading fear.

“COVID-19 is going to be with us forever, just like the flu and just like the flu, we will have to live with it, not in constant fear of it. Some people will catch it. Some people will tragically die from it.

“That’s inevitable and we have to accept it. What we should never accept is a systematic removal of our freedoms based on a zero risk health advice from a bunch of unelected medical bureaucrats. Open society back up. Restore our freedoms. End this madness.”

During question time Anthony Albanese, in a neat tactical strike, moved a motion calling on all MPs to “refrain from making ill-informed comments at a time when the pandemic represents a serious threat to the health of Australians”.

The motion also condemned “the comments of the member for Dawson prior to Question Time designed to use our national parliament to spread misinformation and undermine the actions of Australians to defeat COVID”.

Albanese suggested Christensen was able to wag “the National party dog” because Joyce was “quite happy” to let him.

Morrison was in an awkward corner. The government’s usual instinct would be to move to shut Albanese down. But that would have it effectively backing Christensen.

By the same token Morrison did not want to risk giving Christensen the big whack he deserved.

Christensen is a man who enjoys making threats, even if he doesn’t carry them out, and he is not running at the election so has nothing to lose. If he “walked” to the crossbench the government would lose its one seat majority. It has already lost its majority on the floor of the House – when Craig Kelly, another recalcitrant on matters-COVID, defected from the Liberals to the crossbench. .

So the government let the Albanese motion proceed and in his reply to the opposition leader, the PM waved just the smallest of reproving feathers in Christensen’s direction.

After going through what had been done in the pandemic, Morrison said the government “will not support those statements, Mr Speaker, where there is misinformation that is out and about in the community, whether it’s posted, Mr Speaker, on Facebook, or it’s posted in social media, or it’s written in articles or made [in] statements. Whether in this chamber, Mr Speaker, or anywhere else.”

But he wasn’t going to “engage in a partisan debate on this. I am not, Mr Speaker, because what I know is Australians aren’t interested in the politics of COVID.”

Queensland Liberal Warren Entsch wasn’t reluctant to go in hard against Christensen. He told the ABC: “That is the sort of nonsense that I see in protests outside my office from time to time for those with conspiracy theories”. In the parliament “it was resoundingly rejected right across the whole political spectrum – when the motion was put up it was supported, there was not a single dissenter”.

Federal Communications Minister Paul Fletcher repeatedly refused to be drawn when pressed on the ABC on Christensen’s views. But NSW Environment Minister Matt Kean didn’t hold back, saying on the ABC that Christensen “is as qualified to talk about health policy as he is to perform brain surgery”.

Joyce wasn’t in the parliament – he went home at the end of last week and now, with COVID in his electorate of New England, he is confined there.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

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

We’ve become used to wearing masks during COVID. But does that mean the habit will stick?


Holly Seale, UNSW; Abrar Ahmad Chughtai, UNSW, and C Raina MacIntyre, UNSWMask mandates are in place in Victoria and New South Wales as these states continue to see COVID cases in the community. And public health experts have argued face masks will continue to be an important measure in our fight against the virus for some time to come.

Evidence shows masks are effective at reducing the spread of COVID-19 in the community.

However, masks won’t always be compulsory, particularly outside outbreak situations. In most Australian states and territories at present, masks are not mandatory but are recommended in certain settings, such as where physical distancing is difficult.

But moving forward — as more people get vaccinated and outbreaks hopefully become fewer and smaller — is mask use likely to stick?

Leaving it up to the public

In recent weeks, we’ve seen announcements from the United Kingdom and Singapore that they’re shifting their approach to COVID-19 restrictions, moving to a new way of “living with the virus”.

In the UK, along with the reopening of all businesses, and lifting of attendance caps at events, social distancing and mask wearing will become matters of personal responsibility.

Select authorities may still require people to wear masks in certain settings, such as in hospitals or on public transport. For example, masks will remain compulsory on London’s public transport network.

But from July 19, the national legal requirement to wear a face covering in shops, on public transport and in other enclosed spaces will end.

Cloth masks on a table.
Masks effectively reduce the spread of COVID-19 and other respiratory viruses.
Shutterstock

In Singapore and the UK, the governments have noted the community’s behaviour will be part of the solution.

Authorities hope that even without mandates, people will continue to wear masks in high-risk situations, such as crowded and enclosed spaces.

Will discretionary mask use work?

While we know mandates increase mask use substantially, the decision to wear a mask is influenced by many factors beyond whether or not there are penalties in place for non-compliance. A person’s age, level of income, where they live and cultural norms can all play a role.

A review on mask use to prevent respiratory infections, conducted before COVID-19, found people are more likely to wear a mask when they feel at increased risk of infection, or when they think the outcome of getting sick is severe.

Wearing a mask is also motivated by a shared sense of responsibility and by perceived social norms (those unwritten rules or beliefs we consider acceptable in our community). We often take cues from people we’re close to, especially in uncertain times.

Our research found perceived pressure from different avenues including employers, mass media, government and family can all play a role in increasing mask use.




Read more:
Living with COVID: is now the right time for England to lift all restrictions?


It’s difficult to know whether as countries move away from mandates, and leave it up to individuals, we’re likely to see ongoing mask use in the community.

But it’s worth looking to the Asian experience. Some Asian countries have a longer history of wearing masks, both for protection against pollution and for protection against infection, especially since SARS in 2003.

In Hong Kong after the outbreak, the proportion of people who reported wearing a mask when experiencing flu-like symptoms declined sharply from 74% in June 2003 to 39% in September 2003. But self-reported health-related behaviours, including mask use, were still much greater in the period after SARS compared to before it.

Researchers tracking these trends noted that in the face of SARS, people in Hong Kong came to accept mask use as part of their “civic responsibility”.

One study looking at photographs of settings such as grocery stores and markets in six different countries in early 2020 mapped huge variations in mask use. This ranged from a high of 97% in Phnom Penh, Cambodia (in Asia) through to 4% in Kinshasa, in the Democratic Republic of Congo.

In some of these countries the level of mask use may have been influenced by government recommendations or mandates in place at the time.

There is an element of doubt as to whether masks will continue to be used in countries with more individualist cultures such as the US and Australia (“I often do my own thing”), as opposed to collectivist cultures like those found more often in Asia (“My happiness depends very much on the happiness of those around me”).

Vaccination status could also affect mask use in the community. People who are vaccinated against COVID-19 — as a high proportion are in countries like the UK and Singapore — may be less inclined to wear a mask, compared to those who are unvaccinated.

The new normal?

If we’re trying to shift the social norm around masks, and encourage their ongoing use (without mandates), it’s important we evolve our messaging. This includes relevant reminders around times when masks would be most beneficial, such as:

  • encouraging people to put a mask on straight away if they’re out in public and start to feel unwell
  • encouraging mask use in higher-risk locations such as on public transport and especially when visiting people in aged care and hospitals.

Continuing to frame the use of masks as a social behaviour is critical. We don’t send our kids to school with peanut butter sandwiches in case there’s someone with an allergy. Likewise, wearing a mask is a simple action we can take to protect those who may be vulnerable.




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The Conversation


Holly Seale, Associate professor, UNSW; Abrar Ahmad Chughtai, Epidemiologist, UNSW, and 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.

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.




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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.




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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.




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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.




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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.




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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.




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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



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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.




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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”.




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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.




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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.




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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.




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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.




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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.




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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.




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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



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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.




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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.




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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”.




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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.