What to do with anti-maskers? Punishment has its place, but can also entrench resistance


Meg Elkins, RMIT University and Robert Hoffmann, RMIT University

What’s driving “Bunnings Karen” and others to film themselves arguing with shop assistants about face masks and human rights? And how should we respond?

Victorian premier Daniel Andrews has called their behaviour “appalling” and advised us to ignore them, because “the more you engage in an argument with them, the more oxygen you are giving them”.

Others are taking a more confrontational approach.

On Australia’s morning television Today show, presenter Karl Stefanovic cut off an interview with an anti-masker after telling her she had “weird, wacko beliefs” and “I can’t listen to you anymore”. And that’s relatively tame, compared with what’s being said about the “covidiots” on social media.

Our desire to condemn and punish non-cooperative behaviour is strong. One of the key insights from behavioural econonomics over the past few decades is that people are willing to punish others at a cost to themselves, and this helps increase cooperation – to an extent.




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But condemnation and punishment can also reinforce resistance among the uncooperative. We must also try to understand the complex emotional motivations of those refusing to wear masks.

Anti-masker motivations

It’s hard to say how many people are opposed to mandatory mask wearing. But the evidence suggests social media channels such as YouTube and Facebook have increased the popularity of conspiratorial theories that governments want people to wear masks as some form of mind control.

The COVID conspiracy movement is a broad church, but there appear to be two fundamental traits among its adherents.

First, a belief in their own intuitive ability to know the truth.

Second, a deep and cultivated distrust of government and other institutions. They do not believe the mainstream media, and there is no shortage of alternative media narratives to sustain them.

A popular conspiracy theorist meme. Ironically the quote from George Orwell is a fabrication.

Trust or distrust in authority, and whether one is more obedient or rebellious, has been shown to be an innate tendency, shaped by experience and culture. It is very difficult to shift. As social psychologist Jonathan Haidt notes in his 2012 book The Righteous Mind: Why Good People Are Divided by Politics and Religion, our minds were designed for “groupish righteousness”:

“We are deeply intuitive creatures whose gut feelings drive our strategic reasoning. This makes it difficult – but not impossible – to connect with those who live in other matrices”

Distrust in authority is easily reinforced by any perceived mixed messages from official souces. In the case of masks, health officials initially advised against wearing them. We know the main purpose of this message was to safeguard limited supplies for health workers, but the change in tune has helped entrench anti-masker beliefs the government isn’t truthful.

Cooperation and punishment

So what to do?

The important issue is not whether we can change anti-masker beliefs but whether we can change their behaviour.

Traditional economic theory, which assumes people are rational and follow their self interest, would emphasise carrots and sticks.

Behavioural economics, which understands that decisions are emotional, would also recognise that people are quite ready to take a hit just to express their disgust about being treated unfairly.

This has been repeatedly demonstrated by a staple experiment of behavioural research – the “ultimatum game”. It involves two players and a pot of money. One person (the proposer) gets to nominate how to split that money. The other (the responder) can accept or reject the offer. If it’s a rejection, neither gets any money.

A “rational” responder would accept any offer over nothing. But studies have consistently shown a large percentage opt for nothing when they consider the money split unfair.

This sense of fairness is a deep evolutionary trait shared with other primates. Experiments with capuchin monkeys, for example, have shown that two monkeys offered the same food (cucumber) will eat it. But if one monkey is given a sweeter treat (a grape) the other will reject the cucumber.

Other types of games show this innate sense of fairness leads to a desire to penalise “selfish” people in some way. Most of us are “conditional cooperators”, and punishment of non-cooperative behaviour is important to maintain than cooperation.




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But punitive measures may paradoxically reduce compliant behaviour.

Economists Uri Gneezy and Aldo Rustichini, for example, conducted an experiment in Israel to discourage parents picking up their children from day care late by introducing fines. The result: lateness actually increased. Fines became a price, used by parents as a way to buy time.




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Need to express dissent

If a rule jars with one’s beliefs, following it can cause huge emotional turmoil. Particularly if disobedience is the only way to express disagreement.

Could anti-maskers express their feelings in another way?

Economists Erte Xiao and Daniel Houser demonstrated this possibility in a variation of the standard ultimatum game.

Normally the game only allows responders to express their feelings through accepting or rejecting a proposer’s offer. Xiao and Houser allowed responders to express their feelings about an unfair offer by sending a simple message. The result: they became much more likely to accept an unfair offer.

Some enterprising types seem to have cottoned on to this idea by selling face masks enabling wearers to signal their conspiracy convictions.

Qanon-themed masks available on Amazon.

So if we want to anti-maskers to cooperate, we will need to tolerate them expressing their dissent in other ways.

Ostracism and ridicule will just increase their resistance and resentment, and reinforce the “us versus them” mentality.The Conversation

Meg Elkins, Senior Lecturer with School of Economics, Finance and Marketing, RMIT University and Robert Hoffmann, Professor of Economics and Chair of Behavioural Business Lab, RMIT University

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

It’s easy to judge. But some people really can’t wear a mask



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Holly Seale, UNSW

Victoria’s chief health officer Brett Sutton said recently there were good reasons why some people can’t wear a mask:

A number […] are legitimately not able to wear masks so please don’t vilify individuals or don’t make the assumption they are simply stubborn. There will be people with medical, behavioural, psychological reasons […] certainly don’t make an assumption that they should be the subject of your ire.

He commented on the first day wearing a mask in public in Greater Melbourne and Mitchell Shire became mandatory, except for those without a valid reason.




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It’s easy to jump to conclusions

As wearing a mask in public becomes more common in Australia, either because it’s mandatory where you live or because you choose to wear one, it might be tempting to assume people who don’t wear masks are irresponsible, misguided or selfish.

You might also question why you need to wear a mask when others don’t.

But some people find wearing a mask difficult or distressing. So, to reduce the risk of inflammatory or inappropriate comments being made, we need to understand some of the reasons why:

  • autism — some people with autism spectrum disorders find covering the nose and mouth with fabric can cause sensory overload, feelings of panic, and extreme anxiety

  • disability — some people with a disability can find wearing a mask difficult if they cannot remove one from their face without help. For example, someone with cerebral palsy may not be able to tie the strings or put the elastic loops of a face mask over the ears, due to limited mobility

  • post-traumatic stress disorder, severe anxiety or claustrophobia — people with these conditions can find wearing a mask terrifying and may not be able to stay calm or function while wearing one

  • hearing impairment — people who are deaf or hard of hearing, or those who care for or interact with someone who is hearing-impaired, rely on lipreading to communicate. So wearing a face mask can be a challenge

  • facial deformities or physical trauma — may be incompatible with wearing a mask.

There are legitimate safety concerns

This is not a list of exemptions. Nor should we assume all people who fall into these categories can’t wear masks.

In some situations, wearing a face covering may worsen a physical or mental health condition, lead to a medical emergency, or be a significant safety concern.

In the United States and United Kingdom there have been reports of people with disabilities being challenged, threatened with arrest, or excluded from retail and food outlets for not wearing a mask.

Conversely, there have been incidents in which anti-mask activists have feigned disability to avoid having to wear a mask in public. This could magnify scepticism and mistrust of people with legitimate, but potentially not obvious, reasons for not having to wear a mask.

While there are people who genuinely cannot wear masks, for others, it may just take extra time, resources, adaptions, alternatives and support to feel comfortable wearing one.




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That might involve a bit of trial and error before finding a mask that fits well or is made from a comfortable fabric. Others may be able to wear a mask, but for only a short time.

There are online resources with useful tips and strategies to reduce the stress and challenges associated with using a mask or face shield. However, governments also need to ensure these resources are accessible to the people who need them, their family and carers.

How about breathing problems?

The Victorian government includes people with breathing problems on its list of valid medical exemptions for not wearing a mask in public.

But this is a grey area. We don’t have evidence-based guidelines for judging these various medical exemptions. Each country is currently taking a slightly different approach in this area.

In any case, given the types of masks the public are wearing (cloth masks or surgical/face mask), some experts say it’s unlikely these masks will cause problems.

For instance, the chief medical officer of the American Lung Association said recently:

People with underlying chronic lung disease, such as [chronic obstructive pulmonary disease] or asthma, should be able to wear a non-N95 facial covering without it affecting their oxygen or carbon dioxide levels.

The World Health Organisation also says face masks of breathable material, worn properly, will not lead to oxygen deficiency or carbon dioxide intoxication.

For most of us, wearing a mask is new

While we all adjust to wearing masks in public, it is important we try to assume as little as possible about others based on whether they’re wearing one.

Remember, the goal of the public wearing a mask when leaving the house is to reduce the risk of community transmission. If we can do that without vilifying people who genuinely can’t wear masks, or need a bit of extra support to do so, we all benefit.




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The Conversation


Holly Seale, Senior Lecturer, UNSW

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

‘Living people’: who are the sovereign citizens, or SovCits, and why do they believe they have immunity from the law?



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Kaz Ross, University of Tasmania

You might have seen articles or comments on social media lately alluding to “sovereign citizens”, or “SovCits” for short, with some reports suggesting COVID-19 government restrictions have driven a surge of interest in this movement.

So, who are these self-styled sovereign citizens, and what do they believe?

Sovereign citizens are concerned with the legal framework of society. They believe all people are born free with rights — but that these natural rights are being constrained by corporations (and they see governments as artificial corporations). They believe citizens are in an oppressive contract with the government.

SovCits reportedly believe that by declaring themselves “living people” or “natural people”, they can break this oppressive contract and avoid restrictions such as certain rates, taxes, and fines — or particular government rules on mandatory mask-wearing.

The SovCit movement arose in America decades ago, with roots in the American patriot movement, some religious communities, and tax protest groups. It has also been known as the “free-man” movement.




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Re-interpreting the law

SovCits see themselves as sovereign and not bound by the laws of the country in which they physically live. Accepting a law or regulations means they have waived their rights as a sovereign and have accepted a contract with the government, according to SovCit belief.

The SovCit movement doesn’t have a single leader, central doctrine or centralised collection of documents. It is based on their reinterpretation of the law and there are many legal document templates on the internet for SovCit use to, for example, avoid paying fines or rates they see as unfair.

SovCits tend not to follow conventional legal argument. Some have engaged in repeated court action and even been declared vexatious litigants by the courts.

The SovCit movement has many local variations but there are some key commonalities across the Australian SovCit movement.

Key beliefs and phrases

A central belief, according to news reports, is that the Australian government, the police, and other government agencies are corporations. Believers feel they must be on guard to avoid entering into a contract with the corporation. They often do this by stating, “I do not consent” and trying to get the police officer or official to recognise them as a “living” or “natural” being and therefore as a sovereign.

SovCits are often careful to avoid showing ID such as driver’s licences or giving their name and address. Saying “I understand” also risks being seen to agree to the contract so SovCits will repeat the phrase “I comprehend” to show they are refusing the contract.

Many reject their country’s constitution as false and reportedly refer to the Magna Carta of 1215 as the only true legal document constraining arbitrary power.

SovCits often come to the attention of authorities due to driving offences. It is a core belief of the movement that “sovereigns” have the right to travel freely without the need for a drivers licence, vehicle registration, or insurance.

Until COVID-19, the main threat seems to have been in committing road offences. More recently, actions protesting measures aimed at limiting the spread of COVID-19 have been linked to the sovereign citizen movement.The Conversation

Kaz Ross, Lecturer in Humanities (Asian Studies), University of Tasmania

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

Does your homemade mask work?



Ti Vla/Shutterstock

Simon Kolstoe, University of Portsmouth

If a surgeon arrived at the operating theatre wearing a mask they had made that morning from a tea towel, they would probably be sacked. This is because the equipment used for important tasks, such as surgery, must be tested and certified to ensure compliance with specific standards.

But anyone can design and make a face covering to meet new public health requirements for using public transport or going to the shops.

Indeed, arguments about the quality and standard of face coverings underlie recent controversies and explain why many people think they are not effective for protecting against COVID-19. Even the language distinguishes between face masks (which are normally considered as being built to a certain standard) and face coverings that can be almost anything else.

Perhaps the main problem is that, while we know that well-designed face masks have been used effectively for many years as personal protective equipment (PPE), during the COVID-19 outbreak shortages of PPE have made it impractical for the entire population to wear regulated masks and be trained to use them effectively.

As a result, the argument has moved away from wearing face masks for personal protection and towards wearing “face coverings” for public protection. The idea is that despite unregulated face coverings being highly variable, they do, on average, reduce the spread of virus perhaps in a similar way as covering your mouth when you cough.

But given the wide variety of unregulated face coverings that people are now wearing, how do we know which is most effective?

The first thing is to understand what we mean by effective. Given that coronavirus particles are about 0.08 micrometres and the weaves within a typical cloth face covering have gaps about 1,000 times bigger (between 1 and 0.1 millimetres), “effectiveness” does not mean reliably trapping the virus. Instead, much like covering our mouths when we cough, the aim of wearing cloth coverings is to reduce the distance that your breath spreads away from your body.

The idea is that if you do have COVID-19, depositing any virus you may breathe out on either yourself or nearby (within one metre) is much better than blowing it all over other people or surfaces.

So an effective face covering is not meant to stop the wearer from catching the virus. Although from a personal perspective we might want to protect ourselves, to do so we should be wearing specially designed PPE such as FFP2 (also known as N95) masks. But, as mentioned, by doing so we risk creating mask shortages and potentially putting healthcare workers at risk.

Instead, if you want to avoid catching the virus yourself, the most effective things to do are avoid crowded places by ideally staying at home, don’t touch your face, and wash your hands often.

Two simple tests

If effectiveness for face coverings means preventing our breath travelling too far away from our bodies, how would we go about comparing different designs or materials?

Perhaps the easiest way, as demonstrated by several increasingly shared pictures or videos on social media, is to find someone who “vapes” and film them breathing out the vapour while wearing a face covering. One glance at such a picture dispels any suggestion that these face coverings stop your breath escaping.

Instead, these pictures show that your breath is directed over the top of your head, down onto your chest, and behind you. The breath is also turbulent, meaning that although it does spread out, it doesn’t go far.

In comparison, if you look at a picture of someone not wearing a face covering, you will see that the exhalation goes mostly forward and down, but a significantly further distance than with the face covering.

Such a test is probably ideal for examining different designs and fits. Do coverings that loop around the ears work better than scarves? How far under your chin does a covering need to go? What is the best nose fitting? How do face shields compare to face masks? These are all questions that could be answered using this method.

But, in conducting this experiment, we should appreciate that “vaping” particles are about 0.1 to 3 micrometres – significantly bigger than the virus. While it is probably fair to assume that the smaller virus particles will travel in roughly the same directions as the vaping particles, there is also the chance that they may still go straight forward through the face covering.

To get an idea of how much this might happen, a simple test involving trying to blow out a candle directly in front of the wearer could be tried. Initially, the distance coupled with the strength of exhalation could be investigated, but then face coverings made from different materials and critically with different numbers of layers could be tried. The design of face covering that made it hardest to divert the candle flame will probably provide the best barrier for projecting the virus forward and through the face covering.

Trying to blow out a candle using different masks.

Without any more sophisticated equipment, it would be difficult to conduct any further simple experiments at home. However, combining the above two tests would provide wearers with a good idea about which of their face coverings would work the best if the aim was to avoid breathing potential infection over other people.The Conversation

Simon Kolstoe, Senior Lecturer in Evidence Based Healthcare and University Ethics Advisor, University of Portsmouth

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

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



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Craig Lockwood, University of Adelaide and Zoe Jordan, University of Adelaide

After midnight tonight, wearing face masks will be mandatory for people in Melbourne and Mitchell Shire when they leave home. It’s also recommended in New South Wales when physical distancing isn’t possible.

This means many Australians will be wearing a face mask for the first time.

Yes, wearing a mask can be uncomfortable or frustrating, especially if you’re not used to it. People who wear glasses, those anxious about being able to breathe properly, or who wear masks for extended periods of time face particular challenges.

But health workers, who have long used face masks as part of their everyday work, have developed a number of useful workarounds we’d like to share.




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How do I stop my glasses fogging up?

For people with glasses, wearing a mask can lead to their lenses fogging, reducing their vision. As you breathe out, your warm breath shoots upwards out the top of the mask. When it hits the colder lens, it cools down, forming condensation, or fogging.

Having to keep on taking off your glasses to wipe them clear, and putting them back on again, is an infection risk. So preventing or minimising fogging is the key. Here are some tips:

1. Soap and water — wash your glasses with soap and water (such as regular washing up liquid), then dry them with a microfibre cloth. This type of cloth typically comes free with each pair of glasses. You can also buy cheap microfibre cloths from most optometrists. Facial tissues may leave lint, which attracts moisture to the lenses. Soap reduces surface tension, preventing fog from sticking to the lenses.

A surgeon shows us how to keep our glasses fog-free while wearing a mask.

2. Shaving foam — apply a thin layer of shaving cream to the inside of your glasses, then gently wipe it off. The residual shaving cream will protect the lenses from misting up.

3. De-misting spray — you can use a commercial de-misting spray that dries clear. But make sure this is compatible with your lens type or existing coatings on your lens. You can buy demisting spray online or from your optometrist.

4. Close the gap on surgical masks — mould the nose bridge at the top of your surgical mask to your face to reduce the gap that allows warm moist air up to the glasses.

5. Twist ties and pipe cleaners — if you make your own cloth mask, add a twist tie (for instance, from a loaf of bread) or pipe cleaner to the top seam of your homemade mask and mould that to your nose for the same effect.

6. Tape — some health professionals apply a strip of tape that’s specially designed for use on skin to the top edge of the mask to close the gap. You can buy a roll online or at the pharmacy.

7. Damp tissue — slightly moistening a tissue, folding it and placing it under the top edge of the mask also does the trick.

8. Nylon stocking — Victoria’s health department says you can also get a snug fit across the cheeks and bridge of the nose by wearing a layer of nylon stocking over a face mask.

Sadly, there is no magic trick, such as putting the mask or glasses on first that will stop fogging. Improving the fit around the curve of the nose and cheeks is the best approach.

I feel anxious about wearing a mask. What can I do?

Putting on a mask may make you feel anxious or you may find it hard to breathe normally, especially if you’re new to wearing a mask.

Fortunately, the World Health Organisation and others say there is no evidence a face mask will cause either a drop in blood oxygen or an increase in blood carbon dioxide levels for normal everyday activities.

The World Health Organisation busts a common myth.
WHO

If you do feel anxious about wearing a mask, here are some tips:

9. Practise at home — take a few minutes before leaving the house to get used to the feel of wearing a mask. Slow your breathing, breathe gently, with a slower, longer inhale and exhale while focusing on the fact that air is getting to your lungs, and safely out again.

10. Try another mask — if you still feel breathing is difficult, try a different mask, use a commercially available design, or use different materials in your next home mask project.




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What can I do to stop my ears hurting?

Once you have been wearing a face mask for several hours, you may notice discomfort around the ears as the ear loops can chafe the skin. Here’s what you can do:

11. Wear a headband with buttons… — one solution is to wear a headband with two buttons sewn onto it. Sew the buttons so they sit behind the ears. Rather than looping the mask around your ears, loop it around the buttons instead. This takes the pressure off the skin, increases comfort and helps you keep the mask on longer.

12. …or a paper clip — unfold two paper clips and wrap them around a headband, again positioning them behind the ears. Leave enough paperclip exposed to hook your earloops over, then press down to clamp down the loops in place.

13. 3D printing — freely available 3D printer templates allow you to print your own ear shields.

It’s worth getting this right

It may take a few attempts to get used to wearing a mask. But with a bit of trial and error, your glasses should remain fog-free, your ears comfortable and any anxiety about wearing a mask should reduce.

Wearing a mask in public is another thing we can do to help keep ourselves and the community safe, alongside social distancing and hand hygiene.




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The Conversation


Craig Lockwood, Associate Professor Implementation Science, University of Adelaide and Zoe Jordan, Executive Director, JBI, University of Adelaide

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

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



from www.shutterstock.com

C Raina MacIntyre, UNSW; Abrar Ahmad Chughtai, UNSW; Charitha de Silva, UNSW; Con Doolan, UNSW; Prateek Bahl, UNSW, and Shovon Bhattacharjee, UNSW

If you’re not sure whether wearing a face mask is worth it, or you need to wear a mask but are unsure which type, our new research should help you decide.

We took videos of what happens when you talk, cough and sneeze in different scenarios — while not wearing a mask, wearing two different types of cloth masks, or wearing a surgical mask.

The results, published today in the journal Thorax, are clear.

A surgical mask was the most effective at blocking droplets and aerosols from talking, coughing and sneezing. But if you can’t get hold of one, a cloth mask is the next best thing, and the more layers the better.

How different types of mask work to block droplets from talking, coughing and sneezing (Thorax).

Here’s what we did and what we found

You can be infected with the coronavirus, but not show symptoms. So you cannot identify an infected person just by looking at them. And you may be infected (and infectious) but not know it.

So we wanted to compare how effective different types of masks were at preventing outward transmission of droplets while talking, coughing and sneezing. These are the types of masks the public might use to reduce community transmission.

We compared using no mask with two different types of cloth masks made from DIY templates provided online (one mask had a single layer of cloth; the other had two layers), and a three-layered surgical mask.




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To visualise the droplets and aerosols you may not otherwise see, we used an LED lighting system with a high-speed camera.

We confirmed that even speaking generates substantial droplets. Coughing and sneezing (in that order) generate even more.

A three-ply surgical mask was significantly better than a one-layered cloth mask at reducing droplet emissions caused by speaking, coughing and sneezing, followed by a double-layer cloth face covering.

A single-layer cloth face covering also reduced the droplet spread caused by speaking, coughing and sneezing but was not as good as a two-layered cloth mask or surgical mask.

We do not know how this translates to infection risk, which will depend on how many asymptomatic or mildly symptomatic infected people are around. However, it shows a single layer is not as good a barrier as a double layer.

Using sewing machine to make face mask
The more layers the better when it comes to making your own cloth mask.
from www.shutterstock.com

What does this mean?

With mandated mask use in Greater Melbourne and the Mitchell Shire, we may face shortages of surgical masks. So it is important to understand the design principles of cloth masks.

We did not test more than two layers, but generally, more layers are better. For example, a 12-layered cloth mask is about as protective as a surgical mask, and reduces infection risk by 67%.

We acknowledge it’s difficult to sew together 12 layers of fabric. But there are steps you can take to make cloth masks more effective. You can:

  • increase the number of layers (at least three layers)

  • use a water-resistant fabric for the outer layer

  • choose fabric with a high thread count (so a tighter weave, for instance from a good quality sheet is generally better than a fabric with a looser weave that you can clearly see light through)

  • hybrid fabrics such as cotton–silk, cotton–chiffon, or cotton–flannel may be good choices because they provide better filtration and are more comfortable to wear

  • make sure your mask fits and seals well around your face

  • wash your mask daily after using it.

The evidence is mounting

In practice, we don’t yet know which has a greater effect — wearing masks to prevent infected people spreading to others or protecting well people from inhaling infected aerosols. Probably both are equally important.

In Missouri, two infected hairdressers kept working while infectious, but wore a mix of cloth and surgical masks, as did their 139 clients. No client was infected.

However, one hairdresser infected her household family members, as she did not wear a mask at home, and neither did her family.

This is reassuring evidence that infection risk is reduced when everyone wears masks.




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How to make your own cloth mask

During widespread community transmission, a mask or homemade face covering can make a difference — both by protecting well people and blocking infected aerosols and droplets from an infectious person.

So, as many Victorians start living with mandated face masks, research from our group and others suggests throwing a scarf over your face is not as protective as a well designed cloth mask with several layers.

The Victorian government provides instructions on how to make a good cloth mask. There are many videos showing how, including a no-sew method. There are also community groups making cloth masks and providing helpful information.The Conversation

How to make a mask out of a t-shirt. No sewing required.

C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW; Abrar Ahmad Chughtai, Epidemiologist, UNSW; Charitha de Silva, Lecturer, UNSW; Con Doolan, Professor, School of Mechanical and Manufacturing Engineering, UNSW; Prateek Bahl, PhD Candidate, School of Mechanical and Manufacturing Engineering, UNSW, and Shovon Bhattacharjee, PhD Candidate, The Kirby Institute, UNSW

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

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


Francesco Paolucci, University of Newcastle; Doowon Lee, University of Newcastle; Laura Wall, University of Newcastle; Madeleine Hinwood, University of Newcastle, and Marcello Antonini, University of Newcastle

As we reach the two-week mark since the reinstated restrictions for Melbourne, and are yet to see a decline in new daily cases, it is not surprising the Victorian government has now made face masks mandatory.

From midnight tonight, residents in metropolitan Melbourne and Mitchell Shire must wear a face covering whenever outside the home, or face a A$200 fine. The state government has also ordered 1.37 million reusable masks for public distribution, and says schools will be among the first to receive them.

With some people arguing the measures will unfairly penalise poorer Victorians, Health Minister Jenny Mikakos has pledged to provide more information about which groups will also be receiving free masks.

Will mandatory masks help stop the virus?

There are certainly many benefits to wearing masks or similar face coverings in reducing the spread of coronavirus, especially in closed or confined environments. With rising case numbers and a growing recognition that the coronavirus can be transmitted even without symptoms, numerous health advisory bodies – including the US Centers for Disease Control and Prevention and the World Health Organisation – now recommend masks for the general public.

When it comes to mandatory enforcement of mask wearing, the benefits have to be weighed against other questions, such as whether everyone will be able to obtain masks, and whether the fines unfairly discriminate against people with less money.

Given that even low rates of mask-wearing can deliver significant benefits, it would be tempting to conclude there is no need for mandatory enforcement. Not all members of the public are likely to embrace the use of face masks equally, so it might make sense simply to rely on those who are more willing.

However, the fact that face masks are cheap (or can be given out for free) and highly effective means the corresponding public health benefits are huge. According to one US estimate, each additional cloth mask worn by a member of the public would lower the death risk enough to save US$3,000-6,000 in reduced health costs.

Put simply, the more people wear masks, the faster we can potentially resume normal activity. It thus becomes easier to justify stringent measures to deliver universal mask-wearing. The low cost and high effectiveness of masks means even a harsh fine of A$200 becomes justifiable, given the crucial need to suppress COVID-19.

How much do masks cost?

The Victorian government has mandated that any type of face-covering material is suitable, meaning residents could potentially minimise their expenses by making their own masks at home.


Shovon Bhattacharjee/The Kirby Institute/UNSW

One sensible option would be to give free masks to people living in hotspots or who have less financial means – Melbourne’s public housing towers would tick both of these boxes. Free masks could also be given to people who are more likely to use public transport, or who work in jobs that necessitate close contact with the public.

For those buying their own, disposable masks retail for about A$1 each, meaning someone who works five days a week would need to spend about A$30 on masks during the six-week lockdown.

Another prudent move would be to prevent stockpiling or profiteering by capping the price (as South Korea did) or the number of masks that can be purchased at one time (as in Taiwan, which limited purchases to ten masks per person every two weeks) instead of relying on retailers to apply restrictions.

So why the outrage?

Some Australians have reacted with anger to the mask mandate, despite widespread community support for other, arguably more disruptive, measures such as social distancing, travel bans and quarantines.

As is clearly evident in the United States, it seems there is something unique about face masks that has many people up in arms. As one Australian Twitter user wrote:

Like a good citizen, I’ve stayed home. I’m more than willing to wear a mask publicly indoors but I take my kids for a walk/bike to the park once a day for “FRESH AIR” to relieve some anxiety and stress at government shambles, now he takes the air we breathe?

After weeks of social distancing and hand sanitising, are face masks simply the straw that broke the camel’s back for some people? One theory, called the strength model of self-regulation, suggests the more behavioural changes an individual is required to make (such as quitting smoking or refraining from touching their face) the less success they will have at each.

There are many possible explanations for mask refusal: physical discomfort, inconvenience, denial of the benefits, mixed messaging, lack of role modelling, fear of judgement or stigma, or a desire to rebel against authority. But there is little published research on why people might be more willing to accept one disease prevention tactic over another.




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Coronavirus spike: why getting people to follow restrictions is harder the second time around


Public health measures work best when they balance the needs of individuals with those of the public at large. Providing free masks to those who can’t afford them, and trying to understand the points of friction that might make some people less likely to wear them, will both increase the overall levels of mask-wearing.

Mandates and punishments, although justified by public health objectives, can only work for so long. In all likelihood, we will be living with COVID-19 until a vaccine is developed. This means we need sensible and pragmatic strategies to help everyone fight this and future pandemics together.The Conversation

Francesco Paolucci, Professor of Health Economics, University of Bologna, University of Newcastle; Doowon Lee, Assistant Dean, International – Strategy and Programs Office PVC – Business and Law, University of Newcastle; Laura Wall, Postdoctoral Research Fellow, University of Newcastle; Madeleine Hinwood, Research Academic, School of Medicine and Public Health, University of Newcastle, and Marcello Antonini, PhD, University of Newcastle

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

Single-use masks could be a coronavirus hazard if we don’t dispose of them properly



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Saniyat Islam, RMIT University and Kate Kennedy, RMIT University

From midnight tomorrow, it will become mandatory for anyone in Melbourne and Mitchell Shire leaving their homes to wear a mask. Many people have already been wearing masks for some time in a bid to protect themselves and others from COVID-19.

Evidence has shown masks likely do reduce the spread of COVID-19, so wearing them is a good thing – particularly as Victoria continues to grapple with a second wave.

But one conversation we’re not having enough is around how to safely dispose of single-use masks. Disposing of used masks or gloves incorrectly could risk spreading the infection they’re designed to protect against.




Read more:
Victorians, and anyone else at risk, should now be wearing face masks. Here’s how to make one


A convenient choice

While reusable cloth masks are an option if you’ve been able to buy one or even make one yourself, disposable, single-use surgical masks appear to be a popular choice. They provide protection and they’re cheap and convenient.

It’s estimated the global use and disposal of masks and gloves will amount to 129 billion face masks and 65 billion plastic gloves for every month of the COVID-19 pandemic.

The effect on the environment is an important but separate issue to the health risks we’re discussing here.

Alarmingly, from what we’ve observed, people are discarding masks in communal rubbish bins and even leaving them in empty shopping trolleys.

Incorrectly disposing of masks could create a risk of infection for others.
Kate Kennedy, Author provided

People should know better than to leave used masks lying around. But they can’t be expected not to discard them in public bins when there’s no other option, and when they’re not given any advice on how to dispose of them properly.

Importantly, while there are clear guidelines on the disposal and separation of medical waste within health-care settings, guidelines for disposal of surgical masks in public settings are unclear.

The Victorian government simply advises they be disposed of “responsibly in the rubbish bin”, meaning they will be mixed with ordinary waste. This is in contrast to personal protective equipment (PPE) used in health-care settings, which is disposed of separately to regular waste, transported to sealed landfill, and in some cases incinerated.




Read more:
Which face mask should I wear?


Why could this be a danger?

We don’t yet know a whole lot about the survival of SARS-CoV-2, the coronavirus that causes COVID-19, on textile materials.

One study published in the medical journal The Lancet found no infectious SARS-CoV-2 could be detected on textile materials after 48 hours.

A review study which looked at the survival of a range of pathogens on textiles found viruses could survive longer than 48 hours, though not as long as bacteria.

Masks have been mandated in Victoria. But we’re offered little guidance on how to dispose of them safely.
Shutterstock

Although we need more research on this topic, it seems there is potential for cross-contamination, and therefore possibly COVID-19 infection, from disposed masks.

In all likelihood, other people, such as supermarket staff collecting trolleys, or waste handlers, will come into contact with discarded masks well within that 48 hour window.

In addition, if the discarded mask is carrying infectious particles, it may be possible for these to cross-contaminate the surfaces they come into contact with, such as shopping trolleys. And we know SARS-CoV-2 survives more readily on hard surfaces than porous ones, so this is a worry.




Read more:
Are you wearing gloves or a mask to the shops? You might be doing it wrong


Who needs to act?

This issue is a potential biosecurity concern, and we need segregation of used masks from ordinary waste immediately. We urge attention from the Victorian government and local councils to act on this issue, including in the following ways:

  • create general awareness of this problem, potentially by including messaging around how to properly dispose of masks in directives on their use

  • install pop-up secured bins in public places such as shopping centres for used masks and gloves

  • workers collecting the waste should follow biohazard protocols similar to those used to manage waste collected from health-care settings.

What you can do

In the first instance, please don’t leave your used masks and gloves in a shopping trolley, or lying around anywhere else.

The safest thing to do is to put used masks and gloves into a plastic bag when you take them off, and seal it. Then, when you’re back at home, throw the bag away into a closed bin.

Hopefully we will have further directions on how to dispose of these items soon.




Read more:
Is the airborne route a major source of coronavirus transmission?


The Conversation


Saniyat Islam, Lecturer, Fashion Entrepreneurship, RMIT University and Kate Kennedy, Lecturer, School of Fashion and Textiles, RMIT University

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

Can Australian businesses force customers to wear a mask? Here’s what the law says



Loren Elliott/AAP

Rick Sarre, University of South Australia and Juliette McIntyre, University of South Australia

Many Victorians are now being asked to wear a mask in public if they can’t socially distance.

It is possible this practice may be encouraged more widely across Australia, amid a push from health professionals to increase mask-wearing.




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Victorians, and anyone else at risk, should now be wearing face masks. Here’s how to make one


People will of course still want to visit private spaces, including offices, GP clinics and churches. They will want to go shopping and visit cafes.

So, can businesses refuse entry to customers who are not wearing a mask? Similarly, can they refuse entry to anyone not sanitising their hands?

What are our rights and obligations when it comes to mask wearing?

Business owners can set the rules

Australian law, quite simply, says that private landowners or occupiers can take reasonable steps to protect themselves, their employees and people on their property.

So it would be legal for businesses – including cafes and supermarkets – to make it a condition of entry that customers wear a mask and sanitise their hands.

Supermarkets and other shops can take ‘reasonable steps’ to keep people safe on their premises.
Loren Elliott/ AAP

It makes little difference whether the business is a GP clinic rather than, say, a greengrocer, in establishing their right to exclude patrons. However, in practical terms, people should realise the increased potential for catching/transmitting COVID-19 in a healthcare facility makes it even more important for the business owner to exclude those failing to wear a mask.

Entry conditions are nothing new

Entry rules and safety requirements are concepts we are already very familiar with in Australia.

We know and accept that nightclubs and private bars can enforce dress codes without fear of running afoul of the law. Indeed, you cannot board a plane or enter big public arenas without a bag check.

Schools have been instructing students’ families to accept “no hat, no play” for years due to the dangers of children being sunburnt.




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Which face mask should I wear?


Moreover, the law mandates seatbelts in cars and helmets for cyclists. These infringements on personal liberty are seen as acceptable – in both practice and law – because they protect both individuals and community safety.

It’s also about occupational health and safety

When it comes to businesses making customers wear a mask, there are important occupational health and safety considerations as well. The International Covenant on Economic, Social and Cultural Rights notes employees have a right to “safe and healthy working conditions”.

Victorians under ‘stage 3’ restrictions have been encouraged to wear a mask in public.
Scott Barbour/ AAP

The United Nation’s 2011 Protect Respect and Remedy Framework also emphasises the need for businesses to take adequate preventive measures to ensure the health and safety of workers.

Following a major 2002 report to the federal government on negligence law reform, civil liability amendments were enacted in all jurisdictions across Australia.

South Australia’s Civil Liability Act provides a useful example of the scope of the reforms. It says when examining “standard of care”, a court must take into account, among other matters,

the measures (if any) taken [by the building occupier] to eliminate, reduce or warn against the danger; and the extent (if at all) to which it would have been reasonable and practicable for the occupier to take measures to eliminate, reduce or warn against the danger.

We don’t need ‘mask rage’ here

In the United States – where the political and COVID-19 situations are admittedly quite different from Australia’s – there is a heated debate about mask wearing. This has involved multiple cases of “mask rage”, featuring full-on scuffles in shops over people’s refusal to wear a mask.




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Mask resistance during a pandemic isn’t new – in 1918 many Americans were ‘slackers’


This ongoing mask conflict recently gave rise to a sign, reportedly put up by a Portland bar, that was then shared widely on social media. It captures the essence of the legal position here in Australia, too.

We can also use common sense

It is also important to note that that businesses, in setting their rules, cannot act in a discriminatory way. The law protects us against a range of discriminatory behaviours. The potential for, say, disability or religious discrimination might allow a person to legitimately refuse to wear a mask.

In that event, the shop would need to make alternative arrangements for that customer.

Ultimately, however, when it comes to taking protective action, as a community we need to rely as much on commonsense and common courtesies as anything else.The Conversation

Rick Sarre, Adjunct Professor of Law and Criminal Justice, University of South Australia and Juliette McIntyre, Lecturer in Law, University of South Australia

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

Which face mask should I wear?



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Abrar Ahmad Chughtai, UNSW

Australia’s chief medical officer Paul Kelly today recommended people in Melbourne and the Mitchell Shire wear masks when leaving the house:

[…] If people have symptoms and they need to go for a test, for example, which we would definitely encourage, they should wear a mask. Other people, where physical distancing cannot be guaranteed, they should also wear a mask in Melbourne and Mitchell Shire.

However, Kelly did not say wearing masks in public in these areas would be mandatory.

Kelly’s recommendation comes after growing concern it was time for people in affected parts of Victoria to wear masks in public, when physical distancing was not possible, and with rates of community transmission rising.




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Victorians, and anyone else at risk, should now be wearing face masks. Here’s how to make one


The different ways to cover your face

There are many different ways to cover your face to protect against infectious diseases, whether that’s with a bought surgical mask, one you make yourself out of cloth, or with a scarf or bandana. Each type has its pros and cons.

The idea is not only to protect other people if you have the coronavirus, but also to protect yourself from catching the virus from other people.

A surgical mask can do both, with the latest evidence coming from a major review of evidence so far of the effectiveness of a range of masks, including surgical and cloth masks.




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The evidence prompted the World Health Organisation to strenghthen its advice on people wearing masks in public where physical distancing wasn’t possible and where community transmission was high.

No type of mask provides perfect protection. How well a mask filters out droplets from coughs and sneezes carrying the coronavirus depends on a variety of factors, including the nature of the mask itself and how it’s used.

For the public, the two major options are a surgical mask (also known as a medical mask) or a cloth mask. While you can buy respirators (known as N95 masks), these should really be reserved for health professionals.

Surgical masks

Surgical (or medical) masks are the ones to aim for. But there are other options.
from www.shutterstock.com

This is the type you not only see surgeons wear in hospital, but are being worn by the public in the community. They are generally blue or green. Put them on by holding by the ear loops and hooking over the ears. Make sure you cover the nose, and pull them down under the chin (see diagram below for the correct procedure of putting on and taking off a mask). Pinch the bridge to ensure a good seal around the top of the nose.

You can buy these online, or from a pharmacy, and are relatively cheap.

Many studies show surgical masks are better filters of particles from coughs and sneezes than cloth masks. You’re also less likely to get infected when wearing a surgical mask compared with a cloth mask.

Cloth masks

Cloth masks are the next best thing and you can make them at home.
from www.shutterstock.com

If you cannot find a surgical mask, then you can use a cloth mask, which people have used throughout history to protect themselves from various respiratory infections. You can either buy one ready made or make one yourself.

While it’s generally accepted cloth masks don’t do as good a job at filtering out particles from coughs and sneezes as surgical masks, new evidence shows there are several things to look out for when choosing or making a cloth mask:

  • use two or three layers of fabric

  • choose fabric with a high thread count (so a tighter weave, for instance from a good quality sheet is generally better than a fabric with a looser weave that you can clearly see light through)

  • fabrics made with more than one type of thread (for instance cotton–silk, cotton–chiffon, or cotton–flannel) may be good choices because they provide better filtration and are more comfortable to wear

  • make sure any cloth mask fits well and seals around the face.

While in an ideal world, we should wait for high quality evidence from robust trials before implementing public health measures, we also need to be pragmatic.

During the current COVID-19 pandemic, not a single country was able to manage the supply of face masks. That’s why cloth masks are an option for the public.

Cloth masks have the added advantage of not depleting stocks meant for health workers and can be re-used. You can wash them with soap and water or household detergents, or preferably in a washing machine (at 60℃). Put the mask somewhere isolated until you can wash it.

Wearing a scarf or bandana

Wearing a bandana around your face should be a last resort.
from www.shutterstock.com

Wearing a bandana or scarf around your face should be a last resort. That’s because it’s hard to get a good fit around your face and the cloth they are usually made from tends to have a loose weave. There have also been no studies to show they work.

But with many cases of COVID-19 arising without symptoms, a bandana or scarf may provide some protection and prevent spread of infection from sick people.




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Coronavirus: how worried should I be about the shortage of face masks? Or can I just use a scarf?


How to put on and take off a mask

Whichever mask you use, it’s important you put it on, take it off and dispose of it correctly, otherwise you risk contaminating your hands and spreading the virus further.




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Yes, this is a major shift

Wearing a mask in public is more common in Asia, and it’s compulsory in other parts of the world during the COVID-19 pandemic.

But for most Australians, wearing a mask in public will be a major shift in how they go about their daily lives.

Remember, this latest advice is only for parts of Australia where there are high rates of community transmission. And this needs to be combined with other interventions, like physical distancing and washing your hands.

There is no need for everyone to wear masks in public in other parts of the country where there are only a few locally transmitted cases, most cases are imported, and the risk of catching the virus is low.The Conversation

Abrar Ahmad Chughtai, Epidemiologist, UNSW

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