Just the Facts, the Crown virus.

[doc henderson]

I do not do routine imms anymore, but looks like Shingrix is two shots separated by 2 to 6 months.  must of found it works better.  Zostavax is only one, but immunity declines over 5 years.  the latter is live attenuated.

[Don P]

I was just down in the shop trying to hand sharpen a set of knives I just put on yesterday, a numbnut burned up 3 sets of planer knives  >:(

Anyway, while I was in there there was a piece on the radio about a study that came out a couple of days ago from Vanderbilt. They found twice as many deaths in places without a mask mandate and higher hospitalization. My takeaway from that is if you aren't masking up and following protocols you are stressing the front line and causing harm to those around you and yourself. Aiding the enemy. I've had mixed feelings about a mandate, personally I'm over that, we hit another new high yesterday. Who gains if we are tied up with people who didn't take care, don't vaccinate, and are sick or dead, it ain't us.

Back to the grind  :D

[doc henderson]

It is bad enough, that we had to ask plant ops about the flow rate of our oxygen lines into the hospital.  had to calculate how many ventilators, bipap, and hi-flo oxygen devices we could run.  no one planned for this but we are good.  most things in hospitals are overdone, and redundant.  this is why.

[Sedgehammer]

@Don P I was just reading such a study and they said in places with mask mandates deaths and hospitalizations are lower. Then it also said that when there's mask mandates, there's restrictions on travel, gatherings and related, so there is no direct correlation, but they recommend wearing them.

The state department of health director here said the state will issue no mandate for masks. They feel they get better compliance if they ask and strongly encourage usage vs force and so many being defiant and all the problems that can cause.

I also read another study that health care providers are 3 to 4 times more likely to catch it then the general populace and family members are 2 times more likely to catch it.

In the clinic where my wife works there are 3 providers and 7 support staff. The 3 providers and the office manger wear the N95. One new mask per week, none of them have contracted it. The rest of the staff that wears the cloths masks have caught it.

Late last spring the office manager had called the state about contact tracing and she was told not to bother. That since it incubates so differently in even family members and with the state open for business, it's virtually impossible to contact trace every possible contact and where it started from. Mask usage between states with and without mandates are fairly similar, so it's most likely due too the social distancing and related. 

[Sedgehammer]

It is bad enough, that we had to ask plant ops about the flow rate of our oxygen lines into the hospital.  had to calculate how many ventilators, bipap, and hi-flo oxygen devices we could run.  no one planned for this but we are good.  most things in hospitals are overdone, and redundant.  this is why.

Feeling for ya Doc! Hang in there. Hopefully the vaccine is not to far away.

Hospitals are kinda like jet liners. Over redundancy incase something somewhere goes bad.

[doc henderson]

that is right, and once the cat is out of the bag, and not just a few cases, does not help.  the idea is to track down the exposures to quarantine incase they get it and can spread it.  we are not trying to stop it anymore, we are just trying to slow it down, and protect the frail.  i think a mask can do 2 things,  poss. protect the wearer, and protect those in proximity with an infected person who cough or sneeze.  i.e. reduce the chance of spreading the illness.

[Ricker]

I compare wearing a mask to wearing a seatbelt in a motor vehicle, except the seatbelt worn only helps the wearer.  It's pretty much standard practice to wear a sealtbelt these days for most people.  Most every state has a law on the books requiring their use.  Back in the late sixties-early seventies there were 50,000-55,000 deaths a year nowadays there are 35,000-40,000 deaths. Could be car safety engineering, could be seat belts.  But in any case 10,000-15,000 less deaths.  Don't hear many people complain about wearing the uncomfortable seatbelt anymore.

We are at 240,000 plus deaths in 9 months and asking people to wear a mask causes ire and anger in way too many people.  Even if all the stats either pro or con are wrong, if all I have to do is wear a mask when I go in the corner store to make that elderly or immune system compromised neighbor feel safer then who am I to say I don't care.

[Larry]

I compare wearing a mask to wearing a seatbelt in a motor vehicle, except the seatbelt worn only helps the wearer.

Good comparison except wearing a seatbelt also protects other people.  If your not wearing one and get thrown around you can't control the course of the vehicle.  Only took 30 years to figure out seatbelts save lives.

Took what, 30 years to figure out smoking is bad.

Our Republican governor gave a covid press conference today.  Stressed the 3 W's.  Also sat a good example.  When off to the side he put his mask on.  I was impressed, but he is a leader.

[Don P]

A historical aside  , King James, "A counterblast to tobacco"

[Ianab]

I compare wearing a mask to wearing a seatbelt in a motor vehicle, except the seatbelt worn only helps the wearer.

Possibly more like driving cars with bumper and hood designs that are less likely to kill people if you hit them. That might not be a conscious choice as all modern vehicles are designed that way. Other safety features protect the occupants, but those soft squishy plastic bumpers are there to lessen the injury to any poor individual you hit. A lot more forgiving than a big chunk of chromed steel.  

[kantuckid]

Just read in todays WSJ, "How the Swiss Cheese Model Can Help Us Beat Covid-19".
The guy that wrote the piece (balanced IMO) is a sociologist/MD and the replies are really interesting too.
Masks are one of three layers of his swiss cheese analogy to getting through this pandemic. I'll add that no matter who's talking this covid thing gets heavily politicized. The article lacks that pointing fingers politics lean but the replies go wildly towards educational levels, age, what type person voted for who and so on.  
Too bad some folks cannot focus on the prize here, which is to live a full life.    
I read the WIKI on state by state seat belt use-it still is an issue. As a motorcycle rider of many years, the larger road safety issue is failure to yield right of way, speeding and under the influence-IMO, not based on a study. In all my life red lights and stop signs and turn in front of was not whats seen everytime I enter an urban area now. Me first society. 
Probably someone's doing a PHd study now on mask wearers :D 

[Claybraker]

To keep the analogy going, how about social distancing equates to maintaining a space cushion, ie not following too close? Large crowds=traffic jams? Just throwing it out there. Kansas  tipped over into exponential growth. A microbiologist's blog I've been following thinks that is a bad thing.

[Hilltop366]

A bit of mask testing.

Testing face masks: Lab tests reveal the safest and most effective (Marketplace) - YouTube

[doc henderson]

yes. busy.  I got called in for a few hours last night.  not to see pt.s but to call around to local hospitals since we were full.  my nursing director came in, and called the icu and floor managers to get them to take more.  staff is the issue with over 30 out sick.  it is a conundrum,  they do not want to over burden ICU nurses.  they usually have a 1:1 or 1:2 patients.  So a patient that needed ICU care then sits in the ED with nurses taking what ever comes in, say 1:4.  have to change the mind set. and it is a challenge and potentially dangerous.  as I left, the life team heli was taking off moving a patient to a less busy hospital.  our usual hospitals we transfer to for higher level of care, are all full.  we were sending patients to hospitals smaller than us just to get people in a hospital  We are in it.

[LeeB]

 Saw on the news that one of our local hospitals has 50 personnel out with covid. Have not heard about the other one. both are small rural hospitals.
 I had an eye appointment next week but it has been rescheduled two weeks out. I suspect covid is why.

[Sedgehammer]

A bit of mask testing.

Testing face masks: Lab tests reveal the safest and most effective (Marketplace) - YouTube

Not a very thorough testing. Doesn't show what escapes around the face. While some of the masks stop larger droplets from exsiting the mask itself, true. Those larger droplets fall to the ground quickly. It's the aerosol particulates that are the concern and these escape around the non fitted mask very easily. They are much smaller then smoke particulates. 

If you have access to fitted masks such as the N95 or higher, use those instead.

Note how no smoke is exsiting the mask itself. This is a non fitted surgical mask. 

Your breath travels route of least resistance. Always.

[Don P]

A bit of mask testing.

Testing face masks: Lab tests reveal the safest and most effective (Marketplace) - YouTube

This is one I ran across from a couple of months ago;
Ranking the 14 face masks tested in Duke University study
I hope you get a break soon Doc but it looks like y'all better buckle up for a really rough ride for awhile.

[doc henderson]

like all equipment, you have to use it properly, and for the intended purpose.   Thanks for all the support.

[Hilltop366]

Not a very thorough testing. Doesn't show what escapes around the face.

I think the testing was quite thorough. The article didn't really concentrate on the testing of each mask, more on the general results, design /fitting and material types.

At 1:50 ish it shows the air escaping around the mask.

[Sedgehammer]

Not a very thorough testing. Doesn't show what escapes around the face.

I think the testing was quite thorough. The article didn't really concentrate on the testing of each mask, more on the general results, design /fitting and material types.

At 1:50 ish it shows the air escaping around the mask.

My bad. I missed that part. 

[Ianab]

No one has said masks are 100% effective, because obviously they aren't. The smoke escaping demonstrates why.

But what the photo shows is the wearers breath or cough isn't streaming out in a 6ft plume towards anyone nearby. That must be "some" benefit. Same as staying 6ft away from people, it greatly reduces the chances of being infected. And sanitising your hands isn't 100% effective, but it reduces your chances of being infected. That's what's meant by "Swiss Cheese" protection. No part of it is 100% effective, and even the whole system isn't 100%. But if you combine three 50% effective measures, you end up with maybe a 90% improvement.

Now if you can reduce the transmission of the virus by 90%, it's going to reduce in numbers, and gradually going to die out if you can keep up the measures long enough.

[Don P]

Or as Voltaire says "Don't let the perfect be the enemy of the good"

Our governor, a doc, clamped down yesterday, masks required with fines possible for businesses in violation, no groups larger than 25, etc. It puts the kaibosh on the local Christmas outside market but with the explosion in cases nationally ~90,000 per day to 180,000/day in one week, quite understandable.

A simple mask test on your own that I've seen is on a frosty morn exhale without the mask, then with and notice how far it travels. The droplet is the main thing you're trying to stop. Gravity is just a theory :D but it does help if you slow and drop the droplets. I have a beard and yet when I wear a respirator I can hear the valves working, yup I get wicked bad blowby but it does help immensely.

[Sedgehammer]

@Don P agree with your first sentence 100x.

Silent on second

No it's not the droplets that are the major concern. They drop pretty quickly. They are water. The aerosols are the major concern. They can stay suspended for 60 minutes in the air or longer. This is why masks that are loose around the face hardly work. 

https://www.pennmedicine.org/updates/blogs/penn-physician-blog/2020/august/airborne-droplet-debate-article#:~:text=Size%20alone%20is%20not%20the,much%20more%20difficult%20to%20avoid.

Size alone is not the only important distinction: Droplets fall to earth quickly, but aerosols can travel on air currents potentially for hours. Thus aerosolized viruses are likely to be much more infectious than viruses bound to respiratory droplets, and much more difficult to avoid.

[Sedgehammer]

Interestingly enough, the analysts analysis found that no matter the difference in statewide policies and enforcement, cases appeared to wax and wane along with changes in temperature, appearing to resist most efforts to control the viru

[Don P]

We'll see what happens here, should be an interesting experiment. It's the first time I've seen the owner of the local gas station with a mask on, maybe half the patrons today.

I imagine most have seen or heard this from the CDC in the past few days;
The Centers for Disease Control and Prevention (CDC) recently released a statement that face masks do in fact offer protection to the wearer in addition to helping prevent the transmission of COVID-19. Initially, it was thought that masks only prevented individuals from spreading the virus to others but new research shows that exposure from infectious droplets is lowered through the filtration of masks.