N95 masks for everyone!!! ...Groundhog Day mutations

 Last update: Friday 1/29/21

President Biden has issued an executive order that requires that everyone wear masks on federal properties and that everyone wear masks during interstate travel. In October 2020, as candidate Biden, he said that if elected he would mandate that all Americans wear mask during the first100 days of his administration. Although his limited executive order is more feasible politically, there is still cause for concern that he may be setting his new administration up for what might be misperceived as an early "failure".

Biden's original notion is described in the report referenced in the first citation below; his executive order is described in the second.

• "Biden’s Call for ‘National Mask Mandate’ Gains Traction in Public Health Circles", Sheryl Gay Stolberg, NY Times, 10/29/20
• "Biden Seeks Quick Start With Executive Actions and Aggressive Legislation". Michael D. Shear and Peter Baker. NY Times, 1/16/21

1) Significant virus mutations may change COVID event patterns 

Here's a chart of the seven day average for U.S. tests, infections, hospitalizations  and deaths produced by the COVID Tracking Project that covers the period from April 1, 2020 to January 23, 2021. (Note: Clicking on the chart will cause a larger, more readable, almost full screen version to appear.)

The graphs should be read from left to right, i.e., tests, infections, hospitalizations, and deaths. This sequence mirrors the usual sequence of real world COVID events, with time lags from one event to the next. Covid tests identify infected individuals; infected individuals who develop severe symptoms are hospitalized; then COVID victims who do not recover are recorded as COVID deaths. As can be seen from the red graph (second from left), the number of new COVID cases peaked and started to decline a few weeks ago. As in previous months, as can be seen from the blue and gray graphs, hospitalizations declined in the weeks thereafter, and deaths declined after hospitalizations declined. This usual pattern may hold true for a while.

However, the recent appearance of new variations of the coronavirus that are far more infectious than previous versions, and perhaps more fatal, implies that higher and longer lasting surges in hospitalizations might begin to occur if only because asymptomatic untested carriers will continue to spread the virus more rapidly for many days after the red curve for positive tests has peaked. 

It also becomes more likely that new surges in hospitalizations will begin before hospitalization levels from previous surges sink to low levels; in other words,  surges on surges will become regular occurrences. Moreover, social mitigation lapses during ordinary weekends may be followed by the kinds of huge surges in hospitalizations that previously followed major holidays.  In such a changing environment it may be difficult to demonstrate the effectiveness of any kind of social mitigation, e.g., to show that things would have been much worse had there been no mandates for masks.

• United Kingdom, "Britain Re-enters Sweeping Lockdown as Virus Variant Rages", Stephen Castle and Mark Landler, Wall Street Journal, 1/4/21
  
  
• "U.S. Is Blind to Contagious New Virus Variant, Scientists Warn", Carl Zimmer, NY Times, 1/6/21
  
  
• "As Coronavirus Mutates, the World Stumbles Again to Respond", Matt Apuzzo, Selam Gebrekidan and Apoorva Mandavilli, NY Times, 1/9/21
  
  
• United Kingdom, "Alarm in U.K. Over Virus Variant Bolsters Case for Lockdown", Mark Landler and Benjamin Mueller, NY Times, 1/24/21 ... Note: Alarm has been triggered by evidence that suggests that the new variant may be more lethal, as well as more infectious.
  
  
• "What you need to know about the coronavirus variants", Marisa Iati and Angela Fritz, Washington Post, 1/26/21

2) Better masks
Widespread wearing of face masks has substantial but limited impact on the spread of the virus.  As the virus evolves more and more powerful mutations, simple cloth masks and other low tech face covers will become less and less effective in blocking the spread of these new mutants. 

Casual browsing of Amazon's online listings for face masks discloses dozens of more complicated masks that contain multiple layers, filters, nose wires, and other design features that supposedly make them more effective in blocking the flow of the virus on inhale and exhale; but no links to studies that demonstrate the greater effectiveness of these designs are provided. How much more effective are these more complex designs? And how much protection do they provide their wearers from the people around them? Who knows. 

A recent article in the New York Times included the suggestion of Dr. Linsey Marr, an expert in virus transmission at Virginia Tech, that layering two less specialized masks (e.g. surgical masks and face-hugging cloth masks) on top of each other can provide comparable protection to N95 masks, the medical profession's gold standard. This is very encouraging, but has this claim been confirmed by other researchers? The Times does not say.

Conducting comprehensive tests of affordable designs for face covers is an ongoing research project that the CDC should have launched many months ago. By now the CDC should have published "guidance" based on their tests as to which types of  designs are more effective in protecting wearers from the people around them, as well as how effectively the masks protect the people who are near the wearers. As entrepreneurs develop new designs, the CDC should update their guidance so that the public can upgrade to the better designed affordable masks as they come to market.

• "We Need Better Masks", Ranu S. Dhillon, Abraar Karan, David Beier, and Devabhaktuni Srikrishna, Harvard Business Review, 6/18/20
  
  
• "One Mask Is Good. Would Two Be Better?", Katherine J. Wu, NY Times, 1/12/21" ... Layering two less specialized masks on top of each other can provide comparable protection.[to N95, masks]."
  
  
• "Time to double or upgrade masks as coronavirus variants emerge, experts say", Fenit Nirappil, Washington Post, 1/28/21

3) Best masks and Groundhog Day mutations
Experts say that current variants of the virus are more infectious, but will still be blocked by current vaccines. However, previous notes on this blog have considered the possible emergence of catastrophic variants that will not be blocked. "Groundhog day" would be an appropriate name for these kinds of viruses because, as in the 1993 Bill Murray movie, they would suddenly transport us back to early February 2020, before vaccines had been developed, a time wherein our only defense was social mitigation. 

Question: Would any of us really want to relive 2020 over and over again with its anxiety provoking isolation from our family and friends, chaotic school closings, and financially disastrous lockdowns as new Groundhog Day variants emerged again and again that evaded whatever new vaccines we developed?

Answer: Hell no!!! Nor would we have to if we tasked Operation Warp Speed to expand its mandate from managing the development of new vaccines to include managing the development of high tech, low cost consumer versions of these masks, producible in the hundreds of millions, that were as effective as our current N95 gold standards. Doctors wearing N95 masks will continue to get close to their patients because their masks will block the inhalation and exhalation of all mutations. 

So too everyone else would be able to get close to one another again wearing consumer N95 masks. Maintaining a prescribed social distance would no longer be required. Our schools could reopen, most businesses could resume their operations, and we could see our friends and families again. This "new normal" would not be a full return to the "old normal", but it would be close enough to put the life back into our lives no matter what kinds of mutations the virus might produce.

If the clever crew at Warp Speed could manage the development of 95 percent effective vaccines in 9 months, instead of the usual 18 to 36 months, why couldn't they manage the development of affordable N95 caliber consumer versions in three to six months? Indeed, the real question is: Why haven't they done so already?

• "Experts Call for Better Masks As Pandemic Rolls On", Jennifer Clopton, WebMD, 1/19/21  

U.S. hospitals and other medical establishments usually fit new N95 masks for their medical professionals. So the new N95 caliber consumer masks will have to have an important feature not found in current masks: they should be designed so that their wearers could fit the masks to their own faces without assistance from medical techs. We don't need to have the kinds of long lines and cancelled appointments for mask fittings, like we currently have for vaccinations. 

N95 masks for everyone!!!!!

#N95ForEveryone

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Related posts on this blog:

• "Our war against COVID-19, 2020-2021", Last update: 1/11/221

  
  

• "Will we return to normal in 2021?", Last update: 1/6/21