Face Masks - technical, non-political issues

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Pauldog
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Face Masks - technical, non-political issues

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The story so far: Last time the issue of face coverings came up, I had mentioned my use of a face shield. Since it has a foam pad sealed against my forehead, it offers a fair amount of eye protection from above. Chris shared his practical medical experience about their usual use, and I also found this article:

https://scitechdaily.com/visualization- ... -covid-19/
["Visualization Shows How Face Shields (and Some N95 Masks) Fail to Stop the Spread of COVID-19"]

Also, many places near me are now preferring or requiring masks rather than shields, anyway.

I thought the oddest thing was that some people on Youtube claiming to be doctors were saying that using a mask would cut down your oxygen intake too much, but my oximeter shows no change over several minutes. And I'm sure that if mask-wearing surgeons were screwing up operations from lack of oxygen, it would have been noticed long ago.

I stumbled onto an article mentioning masks with a nano-coating of titanium dioxide, which is supposed to be antiviral (and probably antibiotic), so I'm looking for more information on that. Apparently this is not yet available for sale.

I'm hoping for a happy public health side effect of mask wearing this winter - a noticeably reduced incidence of colds and flu.
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Re: Face Masks - technical, non-political issues

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People wear surgical masks all day long and have no issues with hypoxia. That's nonsense.

Face shields hinder the deposition of macro-droplets from sneezes and coughs from going in your eyes, but unless combined with a mask, offer no protection from those in the air you inhale around the sides of the mask. Remember, unless it's a N95 mask, you will still breathe in small droplets and aerosolised droplets. The mask that protects you is the mask worn by the other person. Your mask is principally to protect them.

Titanium dioxide? Sounds impressive, as we all know titanium metal is expensive, hard to work with, and made the SR-71. The dioxide is cheap and widely used in pigments, and was the original sunscreen before UV-blocking chemicals. You applied a white (or coloured if other pigments added) paste to your nose and looked stupid. Very effective though. I know of no antiviral activity from titanium dioxide. Many people are aware that some metals have a mild antibacterial property (copper, brass), but that anti-bacterial, not anti-viral.

A hypothesis has been floated in the NEJM that masks may assist us to achieve herd immunity with a larger proportion of asymptomatic cases, as those who catch Covid-19 through a mask get a smaller viral load infecting them, which is associated with less symptoms. No evidence for this, just a hypothesis. Suggestive evidence includes studies on cruise ships where all passengers wore surgical masks, and all crew wore N95. The rate of asymptomatic infection was 81%, whereas on other cruise ships without universal masking the rate was 20%. One wishes the researchers in that study had been able to compare passengers and crew for development of antibodies at the end of the cruise; one suspects N95 masks would lessen the development of herd immunity.

Whatever these details turn out to show, there is no doubt that universal masking in public crowded indoor spaces will lessen transmission, and the transmissions that do occur are probably going to result in less serious disease. This is not open to reasonable doubt by anyone with half a brain and no political axe to grind.
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Re: Face Masks - technical, non-political issues

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drmoss_ca wrote: Thu Sep 17, 2020 7:21 am I know of no antiviral activity from titanium dioxide. Many people are aware that some metals have a mild antibacterial property (copper, brass), but that anti-bacterial, not anti-viral.
Ah. An important distinction.
Good to know.
A hypothesis has been floated in the NEJM that masks may assist us to achieve [herd] immunity with a larger proportion of asymptomatic cases, as those who catch Covid-19 through a mask get a smaller viral load infecting them, which is associated with less symptoms. No evidence for this, just a hypothesis.
That's interesting, if true. It's like the opposite of "no such thing as a little bit pregnant".
The mask that protects you is the mask worn by the other person. Your mask is principally to protect them.
Which is why it drives me crazy to hear anti-maskers say "they're willing to take the chance". It's not their own health they're risking.
Suggestive evidence includes studies on cruise ships where all passengers wore surgical masks, and all crew wore N95. The rate of asymptomatic infection was 81%, whereas on other cruise ships without universal masking the rate was 20%.
Just to make sure I understand what you're saying there...
On the ships without universal masking, 20% of the cases were asymptomatic, and 80% of the cases were symptomatic.
The wrong interpretation being that "a mere 20% of all the people (crew plus passengers) tested positive" with universal masking.

One thing that concerns me are the number of people you see on TV that have masks with circular markings on one or both sides. I hope those are merely logos and not exhalation valves.
I gather that even with these valves a mask can be considered to be rated as N95, for the purpose of protecting the wearer only. Is that so?
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Re: Face Masks - technical, non-political issues

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John Rose wrote: Thu Sep 17, 2020 8:56 pm
drmoss_ca wrote: Thu Sep 17, 2020 7:21 am Suggestive evidence includes studies on cruise ships where all passengers wore surgical masks, and all crew wore N95. The rate of asymptomatic infection was 81%, whereas on other cruise ships without universal masking the rate was 20%.
Just to make sure I understand what you're saying there...
On the ships without universal masking, 20% of the cases were asymptomatic, and 80% of the cases were symptomatic.
The wrong interpretation being that "a mere 20% of all the people (crew plus passengers) tested positive" with universal masking.
Correct. Universal masking results in 81% of infections being asymptomatic. Without masks, 20% of infections are asymptomatic. Presumably, but not stated in the linked article, there would be a lot more infections on the unmasked ship too.
John Rose wrote: Thu Sep 17, 2020 8:56 pmOne thing that concerns me are the number of people you see on TV that have masks with circular markings on one or both sides. I hope those are merely logos and not exhalation valves.
I gather that even with these valves a mask can be considered to be rated as N95, for the purpose of protecting the wearer only. Is that so?
Those will be the exhalation valves, and that does mean they don't protect others as any viruses you exhale are free to go out through the valve. Unlike surgical masks, though, N95 masks do offer more protection to the wearer, as when fitted properly all inhaled air has come through the microfilter. So:

-N95 with exhaust valve - the selfish mask. Maximum protection for me and none for you
-N95 without valve - maximum protection for both of us, but maybe less chance to develop herd immunity with asymptomatic infections
-surgical/cloth masks - decent protection for others against your exhalations, some protection for you against theirs (works fine if both parties wear them)
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Re: Face Masks - technical, non-political issues

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This is great information. Masks in public are mandatory here, and have been for quite some time. The mask quickly becomes second nature. We're constantly washing ours, we - the wife and I - have a sizeable rotation that includes a supply of clean backups in our cars. I keep one or two backups in my pocket. Time will pass and we'll eventually be able to put 2020 behind us. Fortunately, the shield isn't something immediately foreseeable for us, but time will tell. Also looking forward to a vaccine.
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Re: Face Masks - technical, non-political issues

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This is similar information to what I was reading about a month ago:

https://www.express.co.uk/news/science/ ... stant-mask

"The coating is a Japanese patented molecular nano-technology is proven to destroy 99.9 percent of viruses, bacteria and fungi. The active ingredient is Titanium Dioxide which no other disinfectant has incorporated in their solution."


Chris, from what you wrote, my impression is that getting occasional very low doses of the virus from mask-wearing (as opposed to higher doses from not wearing one) could be competitive in safety and efficacy with the upcoming "warp speed fast tracked" vaccines.

I'm also looking into the anti-microbial effects of negative ion generators, since I have a few older ones already. (These claim to produce almost no ozone, which is good.) They do help keep dust out of the air. It can be a problem getting that dust off the wall when it deposits there instead of floating around, but at least I'm not breathing it.
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Re: Face Masks - technical, non-political issues

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Pauldog wrote: Fri Sep 18, 2020 10:13 pm This is similar information to what I was reading about a month ago:

https://www.express.co.uk/news/science/ ... stant-mask

"The coating is a Japanese patented molecular nano-technology is proven to destroy 99.9 percent of viruses, bacteria and fungi. The active ingredient is Titanium Dioxide which no other disinfectant has incorporated in their solution."
Yup, snake oil.

Pauldog wrote: Fri Sep 18, 2020 10:13 pmChris, from what you wrote, my impression is that getting occasional very low doses of the virus from mask-wearing (as opposed to higher doses from not wearing one) could be competitive in safety and efficacy with the upcoming "warp speed fast tracked" vaccines.
That's the hypothesis, and even if true, it comes with a price tag; you have to catch the disease and hope you come through it. Maybe you have a better chance with a low dose of pathogens instead of a large one. You'll see the word 'variolation' in the article, which refers to the practice of deliberately infecting people with smallpox (variola) in the hope it would be safer than catching the disease naturally. It was risky, and certainly killed people, but was safer than natural infection. When it was discovered by Jenner that relatively harmless cowpox (vaccinia) would provide antibodies that also protected against smallpox, we had invented vaccination. Using imperfect masks to get controlled doses of infection with Coronavirus is thus akin to variolation.
Pauldog wrote: Fri Sep 18, 2020 10:13 pmI'm also looking into the anti-microbial effects of negative ion generators, since I have a few older ones already. (These claim to produce almost no ozone, which is good.) They do help keep dust out of the air. It can be a problem getting that dust off the wall when it deposits there instead of floating around, but at least I'm not breathing it.
Lots of claims over many years for ionisers, but no real evidence they make good on the claims. Yes, they do precipitate dust from the air, and it has to go somewhere, usually clogging and destroying the machine itself if it actually makes ions. How you do that without making ozone is beyond me. In theory they might help asthmatics, but I don't think anyone has studied asthmatic symptoms when the subjects don't know it the device is switched on ot not. Inhaling fewer germs carried on dust particles? Pretty tenuous, and coronavirus is carried as an aerosol, and I don't know that aerosol droplets will acquire a charge and drop from the atmosphere.
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Re: Face Masks - technical, non-political issues

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https://www.newscientist.com/article/dn ... nfections/

"Repeated airborne infections of the bacteria acinetobacter in an intensive care ward have been eliminated by the installation of a negative air ioniser.

"In the first such epidemiological study, researchers found that the infection rate fell to zero during the year long trial. “We were absolutely astounded to find such clear cut results,” engineer Clive Begg at the University of Leeds, UK, told New Scientist."


It seems to depend on which ionizer is being used. Some are junk, and some produce more than what's considered a safe (extremely low) amount of ozone. Amount of ozone and production depends on voltage. If I remember right, ozone machines use voltages over 10,000 volts, and ionizers use about 5000 volts. (The US FDA limit on ozone production from medical devices is 0.05 ppm.)

As far as getting less exposure from a mask, is it possible to get a low enough dose where you produce antibodies, but never show symptoms? Then the question would be whether such a person would still be contagious.

As far as cowpox vs. smallpox, has anyone investigated if exposure to some other coronavirus (e.g., one associated with colds) would give you more resistance to this new one?
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Re: Face Masks - technical, non-political issues

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The problem with coronaviruses is that we don't make good lasting lifelong antibodies against them. Actually, 'lifelong' is a misleading word here, as it doesn't mean what it used to mean when we all died at 30. Smallpox immunity wanes after 30-40 years, and mumps after about 20. The best known subset of coronavirus, the rhinovirus or most frequent cause of the common cold illustrates it well. You catch them all the time as a kid when you have no immunity to any of them, and then they get less frequent as an adult as you've had most of them and maybe get some crossover immunity from one strain to another, but you never stop catching a cold now and then.

The other close relatives of the Covid-19 virus are the SARS and the MERS virus. There was a huge effort to make a vaccine against SARS, but two problems emerged, one was that the antibodies did not last. Worse still, since it was the body's own immune response that killed people (the cytokine storm), improving the immune response by priming the immune system simply made the response against the virus more vigorous. The vaccine increased mortality from the disease, rather than reducing it. To avoid that, you have to find an antigen on the surface of the virus that you can make antibodies against that will be protective, but an antigen that isn't part of triggering the cytokine storm. And just for added difficulty, this is an RNA virus, which for various reasons means it isn't so easy to take and purify the protein antigen desired and inject it. We end up taking the part of the RNA from the virus genome that codes for the antigen, wrap it in a fatty membrane so the body doesn't destroy it, inject it and hope it gets taken up into some cells that will unwrap the present, stick the RNA into a transcriptase enzyme and then make the virus protein antigen right there inside your cell, which will then trigger a response from the immune system. RNA vaccines are new, and this will be the first for human use if successful. And if successful, how long will it protect for? There seem to be reliably identified cases of re-infection within months of the original infection. It might be that it has to be given every six months or yearly, or we could be lucky enough that there is lasting T-cell immunity (not an antibody mediated part of the immune system) and doses can be spread further apart.
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Re: Face Masks - technical, non-political issues

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drmoss_ca wrote: Wed Sep 23, 2020 5:18 am The problem with coronaviruses is that we don't make good lasting lifelong antibodies against them. Actually, 'lifelong' is a misleading word here, as it doesn't mean what it used to mean when we all died at 30. Smallpox immunity wanes after 30-40 years, and mumps after about 20. The best known subset of coronavirus, the rhinovirus or most frequent cause of the common cold illustrates it well. You catch them all the time as a kid when you have no immunity to any of them, and then they get less frequent as an adult as you've had most of them and maybe get some crossover immunity from one strain to another, but you never stop catching a cold now and then.

The other close relatives of the Covid-19 virus are the SARS and the MERS virus. There was a huge effort to make a vaccine against SARS, but two problems emerged, one was that the antibodies did not last. Worse still, since it was the body's own immune response that killed people (the cytokine storm), improving the immune response by priming the immune system simply made the response against the virus more vigorous. The vaccine increased mortality from the disease, rather than reducing it. To avoid that, you have to find an antigen on the surface of the virus that you can make antibodies against that will be protective, but an antigen that isn't part of triggering the cytokine storm. And just for added difficulty, this is an RNA virus, which for various reasons means it isn't so easy to take and purify the protein antigen desired and inject it. We end up taking the part of the RNA from the virus genome that codes for the antigen, wrap it in a fatty membrane so the body doesn't destroy it, inject it and hope it gets taken up into some cells that will unwrap the present, stick the RNA into a transcriptase enzyme and then make the virus protein antigen right there inside your cell, which will then trigger a response from the immune system. RNA vaccines are new, and this will be the first for human use if successful. And if successful, how long will it protect for? There seem to be reliably identified cases of re-infection within months of the original infection. It might be that it has to be given every six months or yearly, or we could be lucky enough that there is lasting T-cell immunity (not an antibody mediated part of the immune system) and doses can be spread further apart.
Thanks for sharing this detailed insight into the challenges and complexities surrounding coronaviruses, especially in the context of vaccine development. The comparison to other viruses like smallpox, mumps, and rhinovirus adds valuable historical context, highlighting the varied patterns of immunity over time.

The information about the challenges faced during the development of a vaccine for SARS, including the issue of antibody longevity and the risk of an overactive immune response, is particularly interesting. The explanation of RNA vaccines and their innovative approach sheds light on the intricacies of creating effective immunization against a virus like COVID-19.

The uncertainty regarding the duration of protection and the possibility of reinfection, as well as the potential need for repeated vaccinations, raises important considerations for ongoing public health efforts. The quest for lasting T-cell immunity presents both challenges and hopes for the future.

Your insights offer a comprehensive understanding of the complexities involved in combating coronaviruses and developing effective vaccines. Thank you for sharing this detailed perspective.

Jim
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Re: Face Masks - technical, non-political issues

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You're welcome. I have never read so much medical misinformation online as I have about vaccines since 2019. And for those convinced that mRNA vaccines cause a multitude of ills, I give you the case of the German man who had 217 covid vaccines over a 27 month period (about one every four days):
https://www.thelancet.com/pdfs/journals ... 0134-8.pdf
He suffered no ill-effects, but nor did he have any improvement in his antibody levels over those from a normal vaccine schedule. For some reason prosecutors are looking at charging him, instead of sending him to a psychiatric unit, which is where he probably belongs.
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Re: Face Masks - technical, non-political issues

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Thanks for sharing the information. The case of the German man who received a remarkably high number of COVID-19 vaccines without suffering ill-effects is indeed intriguing. It's a unique scenario that sheds light on the resilience of the human body in the face of multiple vaccinations.

The mention of the abundance of vaccine-related misinformation online is a significant concern, and your contribution to providing accurate and well-documented sources is valuable. The need for reliable information is crucial, especially in the context of public health.

Jim
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