Apparent absence of covid transmission at hair salon with face covering policy | Hacker News Reader

Apparent absence of covid transmission at hair salon with face covering policy

cdc.gov

89 pointsAlphaWeaver166 comments

I would not be at all surprised if mask use turns out to be a lot more significant a factor than western governments seem to be assuming. It seems obvious that pretty much any kind of face (mouth/nose) covering is going to be significantly better than nothing at preventing the spread of disease that spreads through droplets. Of course, we should do formal studies. But in the absence of data, masks being effective seems like a sensible default position to take.

Especially considering it being one of the cheapest (financially, legally, impact on freedom) measures we have at our disposal.

The cost / benefit analysis is so much in favor of mask wearing that I don't understand why they are not made mandatory.

Maybe some HN reader knows about some cost that I am not aware of (ie a few of pounds and a small inconvenience).

I literally just watched a youtube video that sums up the American view on masks

https://www.youtube.com/watch?v=3Q3PSISAZL8

I just.. don't get it man.

That video does not “sum up the American view on masks”. It might at most sum up one American view among many.

Where I live (which is part of the US), I’d say 100% of people wear masks inside of businesses (other than dodgy corner stores selling illegal cigarettes), and about 90% on the street.

It sums up the view of many Americans though. You can see many masks in the video, and also many not masks.

Where I live, in America, it is something like 70% of people with masks. And it is required in stores in my area. Some stores enforce, some do not. Some people wear a mask past the greeter in the store, and then take off their mask once inside.

It appears to at least sum up a (possibly non-random) sampling of non-mask-wearers' views. Certainly more than one view, since multiple people were interviewed.

Indeed it does.

I could find multiple people in France to say on video that vaccines cause multiple sclerosis - a French person could rightfully object if someone claimed that that sums up the French view on vaccines.

It’s been politicized in America. I think it’s really that simple.

In our state/county they are essentially mandatory.

You don't have to wear one outside, but if you want to use any public or private business that's located inside of a building - you are required to wear a mask.

I still feel weird when wearing a mask myself or when I see somebody with one. Before the Covid situation somebody with a mask would feel threatening. I think we should have a big public campaign promoting mask wearing and make sure public leaders set an example by wearing one.

What about sunglasses? Why doesn't that feel threatening when you see someone slip on a pair of sunglasses, and a hat? After all sunglasses are a form of a mask for the upper part of the face.

Wearing sunglasses is often viewed as impolite too. I am not arguing against masks I am just saying that there are some cultural obstacles that make people uncomfortable wearing them. It would take some leadership to get around those.

Bangalore resident here. I felt kinda embarassed wearing a mask initially. But it took about two weeks to get used, and now I feel vulnerable if I am not wearing one. I also tense up a bit if someone else not wearing a mask is within a meter from me.

Until when do you think mask wearing should be mandatory?

My biggest problem with covid interventions, including masks, is not the cost itself, but a lack of objective/quantitative criteria for deciding when to lift them, rather than “when it doesn’t feel scary anymore”.

(As for the direct costs of masks, well, they are uncomfortable, prevent me from seeing people’s faces which I enjoy doing, and make me feel depressed because they make the world look like a dystopia. Yes, the costs are relatively low, but IMO the difference in probability of death or maiming from covid with and without a mask is also quite low.)

Although not a direct answer to 'when would you not wear a mask anymore' there are objective criteria guiding some of the decision making around phased re-openings (of which some phase would be "no more masks").

Example Criteria: https://kingcounty.gov/depts/health/covid-19/data/~/media/de...

Example Dashboard: https://kingcounty.gov/depts/health/covid-19/data/key-indica...

> and make me feel depressed because they make the world look like a dystopia

Personally don’t care about people’s feelings. Normalize masks already.

That's a silly attitude. The entire movement to wear masks is predicated on caring about other people's feelings. Otherwise, people at low COVID risk (or even high risk but willing to accept it) wouldn't need to bother.

No, it's about caring about other people's health and quality of life (there are long term effects from covid-19). Feelings aren't really figured into it.

To be clear, there's not much evidence that masks _protect_ you from covid. The point is to prevent you from giving it to other people when you have it but don't know about it.

This is what I don't hear anyone talking about.

Right now, my company is saying "we're going back to the office 2 weeks after the province fully reopens". This is great! It's tied to the progression of the virus and gives me expectations about the post-covid world.

I am OK wearing a mask right now. I don't want to be wearing one in 10 years. I want an expectation similar to above, something like "mask wearing will end 2 weeks after the last known case".

I went to the dentist the other day and it was less stress than ordering from my local Thai food place. It really seems like masks are people's way of externalizing their fears, I want to see proper leadership in this area so we don't let these fears get out of hand.

In Asian countries a lot of people wear mask when they feel sick. This is to protect other around you from getting sick.

I wish this could become a new norm in the western countries.

I will stop wearing a mask outside of my home when the all cause death count falls back below the threshold for excess deaths: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

Ideally, we would have better metrics.

> and make me feel depressed because they make the world look like a dystopia

How do you feel about refrigerated trucks handling morgue overflow of dead grandparents, in terms of dystopia appearance?

> but IMO the difference in probability of death or maiming from covid with and without a mask is also quite low

The probability of death for _you_ is likely quite low, but it's not about you. If masks slow transmission even slightly (and evidence is mounting that they do), that will save lives. Possibly a lot of lives.

Mandatory but with reasonable exceptions (disabled, young children, etc).

That's why special needs schools haven't been able to re-open, even though in theory a ten-year old should be trusted to keep on a mask, due to various developmental conditions (e.g. autism, down syndrome, etc) they sometimes cannot. So we should consider edge cases when discussing mask mandates.

And I acknowledge that some able-bodied adults will abuse any exception provided, but those exceptions remain important otherwise you're just persecuting a subset of the population who are unable to comply.

> The cost / benefit analysis is so much in favor of mask wearing that I don't understand why they are not made mandatory

They have finally been made mandatory in shops and on public transport in the UK after quite a bit of public pressure. Kind of ridiculous that this wasn't done in March, but better late than never I guess.

Part of the issue is getting people to wear them--properly. People like to pull them down below their nose. Again, there isn't a whole lot of data, but it stands to reason that only covering your mouth somewhat defeats the purpose.

And it follows that using a mask exclusively as a chin brace isn't helping anyone.

I don't follow this line of argument. Theoretically the concern is exhaled droplets which I assume primarily come from your mouth. If the point of a mask is to protect others and not yourself then why would the nose need to be covered?

What if you're using your nose to exhale?

Most people sneeze out of their noses.

Your nose has the same issue as your mouth in that regard. Remember, the virus is hanging out in your respiratory system; it stands to reason that the problematic droplets don’t necessarily originate in your mouth, but rather your lungs.

Even if that isn’t the case, your nose and mouth are connected, and both contain mucosal membranes. They’re sharing the same droplets.

In general, when you cough, sneeze, or even breathe, the same droplets are coming out of both your mouth and nose.

No one wears a mask in the Netherlands. Not a recommendation, just an observation.

I wonder why nobody did any studies on COVID patients asking very simple questions such as "how often did you use a mask in public?".

A romanian doctor complained that about 70% of his COVID patients believed the dissease was a hoax before being infected themselves.

Maybe he was just trying to scare others, and by no means do I try to blame the sick, but maybe if people not wearing masks, not practicing social distancing not washing their hands are more likely to get sick, we could show this data and make the rest do it more -- if this is indeed the case and these measures significantly decrease your chances of being infected.

We do not get much information about who still gets the virus. Mostly party goers or is everyone as likely to get it?

Several weeks after the place where I live started the lockdown hundreds of people were still getting it and I was really wondering who these people were.

> I wonder why nobody did any studies on COVID patients asking very simple questions such as "how often did you use a mask in public?".

Because retrospective self-reporting surveys are not useful science.

You could be very right -- I suppose if someone thought COVID was a hoax and was asked if they wore a mask, in a hospital setting, they would be more inclined to say they did, just like how people say they voted for the winner in an election in a much larger proportion than the actual results show.

Masks are believed to be more effective for stopping an infected person transmitting than stopping an uninfected person being infected, so this probably wouldn't be especially useful.

I agree to that,but masks are still useful even for preventing, and my main reasoning was that wearing a mask is a proxy for how serious the person is for all the rest -- social distaning, avoiding crowds, avoiding interaction with people who don't wear mask themselves and so on.

But as someone else commented -- retrospective studies probably are not that useful.

You'll have seen the memes about people wearing a mask and then coughing onto an agar plate.

Here's a study where they did that properly.

It suggests that people should be changing their masks every two hours.

https://www.ijic.info/article/download/10788/7862/

> This study was conducted to check the efficacy of face masks in limiting bacterial dispersal when worn continuously in Operation Theater. A comparison was done to find out difference between fabric and two ply disposable masks. The first sample was collected prior to wearing the mask, using cough plate method holding a blood agar plate approximately 10 -12 centimeters away from the mouth. The personnel were asked to produce “ahh” phonation. Participants were then asked to don the face mask, continue routine work and report to the study center located inside the theater for further sample collections at designated intervals of 30, 60, 90, 120 and 150 minutes after wearing the fabric mask made of cotton. The study was replicated on immediate next day using two ply disposable mask keeping all the other conditions and personnel exactly the same. Bacterial counts before wearing the mask were 5.36±4.38 and 5.7±2.99 on day 1 and day 2 of study. Bacterial counts were 0.96±1.06 (P<0.001) and 0.7±0.87 (P<0.001) at 30 min; 2.33±1.42 (P<0.001) and 2.36±1.03 (P<0.001) at 60 min; 3.23±1.54 (P=0.007) and 4.16±1.78 (P=0.011) at 90 min; 5.63±4.02 (P=0.67) and 4.9±1.98 (P=0.161) at 120 min and 7.03±4.45 (P=0.019) and 5.6±2.21 (P=0.951) at 150min respectively for fabric and two ply disposable mask. Counts were near pre-wear level in about two hours irrespective of the type of mask. There was no significant difference between cotton fabric and two ply disposable masks. Face masks significantly decreased bacterial dispersal initially but became almost ineffective after two hours of use.

> Face masks significantly decreased bacterial dispersal initially but became almost ineffective after two hours of use.

That statement is logically hard to swallow as it's just as hard to breath through a face mask during minute 1 as it is during minute 121.

There are at least 5 mechanisms by which filters can filter out particles. Four of them are explained in this document [1]. Some filter materials also trap particles electrostatically. but I have no idea if that is relevant for masks filtering viruses.

For at least some of the four mechanisms covered in that document (inertial impaction, diffusion, and interception) it seems plausible that once you have a particle caught that way any other similar particle that otherwise might have been caught at the same spot the same way might either bounce off the first particle or dislodge the first particle.

This could eventually reach a steady state where as many particles are coming out as are coming in the other side, just with the individual particles being delayed.

If the particles are small enough so that sieving isn't significant, then there would probably be little change in the ability of air molecules to get through regardless of whether or not the filter is in the early, nearly clean stage or is in the steady state late stage where there are plenty of particles trapped.

[1] http://donaldsonaerospace-defense.com/library/files/document...

Among 139 client exposed to the two infected stylists only 67 volunteered for testing.

A) What if they were asymptomatic carriers? B) What about false-negatives? PCR testing work only after symptoms starts developing? C) Isn't this a rather small "sample" space to establish Universal Face Covering Policy? In this regard it'd be nice to have a countrywide comparison of infections ie. countries that required masking vs.that didn't.

As I understand it, asymptomatic carriers can still be tested and found positive just fine. It’s not the symptoms developing that lets you get a positive result, it’s the virus being found in the samples.

Honestly viral load peaks most of a day before symptoms start so the people who show up best in a PCR test are going to be asymptomatic.

PCR tests work before symptoms develop.

false negatives are more likely than false positives, which is one of the reasons people get tested multiple times if they have been exposed like the people mentioned in the article

I think this is more of an observation than a strict study. Similar to this (preprint, not peer reviewed) https://www.medrxiv.org/content/10.1101/2020.06.22.20137745v...

However, the other argument is would be that a universal face covering policy has essentially zero negative other than "it's annoying". (Except for a very small percentage of people who actually have a real medical reason). So if we find out later that masks have no effect, we didn't exactly lose much.

My sense is that it's not even that it's annoying, it's that many people just really don't like to be told what to do.

Or, to put it even less charitably, the USA is now the world COVID-19 hotspot because it turns out that "Give me liberty or give me death" is more than just a catchy slogan.

What’s even uncharitable about that? I think a lot of Americans would agree with you.

I for one will openly admit that I will accept X risk of death rather than Y affront to freedom. Of course, it depends on the magnitudes of X and Y.

(On the other hand, claiming that this is why the US is currently the hotspot seems to be cherry-picking data: the first hotspot was China and the second was southwestern Europe, all places with very different cultures. But, even if we accept your hypothesis that the US has more cases because Americans are culturally more willing to accept a risk of death in exchange for more freedom than Chinese, French, Spanish or Italian people are, there’s nothing _wrong_ with that).

A) Yes? B) Maybe? C) No.

"No" to the third one as common sense would indicate that covering your nose and mouth would slow the spread of a respiratory pathogen and the consequences are imbalanced.

There are grave consequences to the virus spreading, and no consequences whatsoever to you covering your mouth. I didn't count discomfort or fashion as reasons to not wear a mask as that would be ridiculous.

I know, I'd rather wear a mask as a protection, potential "life-saving" measure than live in constant fear of catching the virus. And I have no discomfort in wearing such,nor it's a "fashion".SEA countries quickly adopted the policy because A)Government pressure B)Pollution-people wore masks before all this; maybe only time can tell whether it's a "good" protection. In my opinion.

All and all, the data we have is still relatively new and mixed across the board. Because of obvious ethical considerations, in many cases, you can't create highly controlled studies and have to rely on retrospective data collection from situations with poor information, censored data, and a host of other issues.

When you get a situation that resembles something you might create in a controlled study (like this hair shop mask situation), you latch on to see if you can find some insight. It may be poor data and a small sample but it can give guidance for how these highly complex macroscopic situations play out.

The usefulness of studies like this is they can be used to "update your priors" so to speak. Personally, I am slightly more confident in the efficacy of masks than I was before.

There's a report of 27 clients being infected at a nail salon: https://www.cbc.ca/news/canada/ottawa/kingston-ontatio-salon...

"Inspectors found that some customers at Binh's were not wearing masks, the space was not set up to properly distance and best hygiene practices were not being followed."

Wouldn't it be more important that the staff wear masks?

Does your article touch on that?

If staff WAS wearing masks and clients still got infected, that would contradict the original article, otherwise it is in line with the current narrative that masks don't offer very much protection unless worn by infected people.

Sure, clients could infect other clients.

I'd like to see someone making nails from 2m distance.

From the article:

> Overall, 67 (48.2%) clients volunteered to be tested, and 72 (51.8%) refused

Why would anyone refuse a Sars-CoV-2 test after being exposed like that?

because you are only covid-positive if you test positive? /s

This, but unironically. I know people who were told by their bosses they'd get sacked if they tested positive on the virus. Obviously highly illegal but the only restrictions my country has on layoffs is that you have to give 3 months notice and if you lay off more than 20 people at once you need approval of the ministry of work.

Sadly, I suspect scepticism about Covid and conspiracy mongering about the medical establishment was behind at least some of the refusals. Not to mention need to get back to work

Is it a political thing?

...or even if you don't, but have a cough

The test is very invasive and uncomfortable. I can see why someone with no symptoms, especially if they're not at risk of transferring it to others, would refuse it.

A swab deep in your nose and at the back of your throat is not "very invasive".

Having seen how it's done via plenty of news reports, having a swap stuck up the back of my nose certainly looks plenty invasive, not to mention potentially painful.

I can certainly imagine someone who's asymptomatic and is more nervous about it being disinclined to voluntarily undergo testing.

If it were a finger-tip prick or cheek-swap it'd probably have a lot more acceptance.

This is true, very few would object to a finger-prick, and there was talk of a "spit test" a few weeks back; that would push testing rates to close to 100%

No. I have undergone a PCR test myself and it was no big deal at all.

It takes 5 seconds and is mildly uncomfortable. I don't even know what invasive even means in this context.

All I have to say to those people is "suck it up"

Source: I've had 8 tests now.

The guidance for the last month has been that they insert it into each nostril for at least 15 seconds out here. Curious if they do the tests differently in certain locations.

The first 2-3 I had were for 15 and I will say yes the last 4-5 seconds does get uncomfortable but not a big deal.

The more recent tests have also been 5 seconds.bone in each nostril and nothing in the throat. I've definitely had different style of tests but I do not recall the names. They are also using a better style of swab in my opinion that makes it substantially more comfortable.

Even for the more uncomfortable longer time style tests it's something you forget about pretty much immediately afterwards.

Non-invasive means that the means/method of testing effectively has zero potential of harm (although receiving the results could be a huge blow).

While nasal swabs are extremely low risk, they still are a test that people may try to avoid out of fear of medical procedures.

That's not what it means, it is invasive if it invades, enters a part of your body which is not usually probed with foreign bodies, you anus, your urethra, deep in your nose, behind your eyes. The risk associated is orthogonal.

> It takes 5 seconds and is mildly uncomfortable.

This is good to know, I've heard people say you don't want to get tested as it's rather painful.

Mildly to somewhat uncomfortable yes. Depending on the style of test, the 15 second one is obviously less fun. But it is in no way painful. I firmly believe people simply don't want to get tested for whatever selfish reason or they are wildly exaggerating the test.

> I can see why someone with no symptoms, especially if they're not at risk of transferring it to others, would refuse it.

The fact that they caught the disease tells us they are at risk of transferring it to others.

Because they stick a long cotton bud right up your nose, further than you would expect, not very pleasant. I wouldn't have one.

I have had the the test. It is really not that bad. I thought it would be worse but it was just uncomfortable, nothing more than that.

Wouldn't you want to know whether you might be infecting others you're close to?

I would assume that I could be positive and isolate myself.

It's really not as bad as everyone says. I've had to have the same swab for other reasons and it takes less than a second.

It's not a big deal at all.

At many employers, you'd be terminated if you met the criteria for getting one.

It's a pretty sad hill to die on, the discomfort level is similar to getting a shot. Really no big deal at all for a normal adult.

If you look at it from the viewpoint of the most selfish person imaginable:

If you're infected and still asymptomatic, the direct medical consequences to you are going to be the same whether you know your status now or not.

But knowing you're positive obligates you to self-isolate, track down other people you've been with contact, etc. If you don't particularly care to change your lifestyle to protect others, if you don't care that you might kill people with your carelessness, it's beneficial for you not to know.

The shame, the shame.

Given the delay (~48+hrs) associated with getting test results, it should really go the other way— after a known exposure, you are treated as infected, the isolation and contact tracing process begins, and it's only after a negative test result that you're cleared.

That's possible only if your public health system is equipped to force large numbers of people to undergo certain medical procedures. In the U.S. there exists significant opposition to that sort of capability.

Could it possibly affect health insurance costs in the future, too? Let's say that it turns out that COVID-19 carries a risk of long term lung damage. In the future a health insurer might start asking applicants if they have ever received a positive test result.

Therefore (for those in countries where this kind of thing is a problem) there is a substantial financial risk to consider too - not just the immediate financial consequences of a possible but relatively short quarantine period.

Because it takes time and you probably are not getting paid for participating. Most people have lives and obligations. Give'em $1000 and they wont refuse. And guarantee to pay for downsides if they test positive. And don't say it's just a swap and it only takes 5 minutes. Everything that involves the medical bureaucracy takes hours.

> Give'em $1000 and they wont refuse

Alternatively: free test + healthcare if you test positive; stiff fines + liable to be sued by contacts for damages if you refuse testing and later (in the next 3 weeks) turn out to be infected.

> Everything that involves the medical bureaucracy takes hours.

I'm in Waterloo Region, Canada, and I got tested back in mid-May after waking up with a fever randomly. It really was five minutes, in and out. Results were posted online two days later.

If someone went straight home after getting a haircut or had minimal contact with others before getting the call telling them about the exposure, I’d understand just waiting out 14 (or whatever the recommendation is) days while monitoring for symptoms. In all other cases, it would be pretty selfish not to get tested so that your own contacts would be able to respond accordingly if positive.

I'm not sure I would volunteer myself because, really, what information is the test going to give you? If you test negative, the instructions are still to self isolate (and rightly so, obviously). If you test positive, there's no treatment that will help you unless and until you get severely ill. I would be tempted to just refuse the test, assume I am potentially infected and self isolate for 2-4 weeks. It might be useful to get an antibody test after the isolation period, but that's a different matter altogether.

Obviously, the situation is different if for some reason you really cannot self isolate properly. In that case you would still need repeated tests to be reasonably sure and I'm not sure they offer those.

EDIT: my position assumes you don't require a test for contact tracing reasons. If I am contacted by anyone doing contact tracing and they ask me to get tested, I will follow their instructions. That said, if I'm going into isolation after an exposure event, I would notify everyone I've met since that event regardless of any testing.

There are lots of potential long-term health effects to the virus (even from asymptomatic cases), and if you were to start having health problems months down the line, you and your doctor would really want to know whether you had actually had the virus in the past. By the time months have passed it's too late to know; most people's blood antibodies have faded below detectable levels by then.

Yes, that's why I'd love to get an antibody test right at the end of the isolation period. If that's impossible, that might be a reason to do the RT-qPCR test, but in that case it's probably still optimal to do the test after a presumed incubation period rather than immediately to reduce the chances of a false negative.

You want all the kinds of tests. I'm pretty sure I had coronavirus in mid-March (I live in NYC), but seeing as how there were no tests available at all unless you were hospitalized at a minimum, I just suffered through it in home isolation. By the time antibody tests were widely available nearly two months later, my result came back negative. A swab test at the peak of my symptoms would have been more conclusive (had it been available). A lot of people who had it earlier on are already testing negative for antibodies. And now it's at the point where I'll never know for sure. I really wish the testing (all kinds) had been available in mid-March, so I'd know for sure. Now that the testing is much more available, you'd be crazy not to take advantage of it.

What would knowing for sure change for you? As you correctly noted, antibody levels seem to decline fairly quickly, so it's not like you can rely on immunity. It's true that there's a long and growing list of complications associated with C19, but I don't know of a single one where the diagnostic or therapeutic options change in any way based on whether you had C19 or not. In theory, if we actually had a thorough understanding of the mechanisms (and probabilities) of various complications after C19 it would affect the process of diagnosing them, but we're a very long way from that.

It bothers me greatly to not know things for sure. I can't even tell this story without having to put a giant caveat on it.

This really wouldn't bother you??? You really wouldn't mind not knowing?

One giant reason that knowing for sure would be helpful is knowing that you're less likely to get reinfected, and likely less likely to have serious effects if you do end up reinfected, if you previously had it (even if blood antibodies have faded, your T memory cells may still help you out). This might change your behavior going forward.

Technically, I'm in a slightly similar position to yours as I had an uncommonly annoying respiratory infection during the last week of February (I am not in a disease epicenter, however, so my Bayesian prior is much weaker). I don't believe having a positive (or negative) test would meaningfully change my behavior or medical decisions and I don't feel any significant psychological discomfort about it. That said, I respect that you feel differently, that's fair enough.

However, on the last point, I'm afraid that thinking might potentially prove quite dangerous. As far as I can tell (from closely following the medical literature, though I am not an immunologist and don't claim any authority on the subject) we really have no idea as to how quickly immunity decays, every single cellular immunity (T cell) study I've seen is extremely limited methodologically and we have no clinical evidence whatsoever to suggest that reinfections would have a milder course. If that turns out to not be the case, people who behave incautiously based on their test results might significantly endanger themselves.

>There are lots of potential long-term health effects to the virus

This has been repeated ad nauseam but there has been no proof of any long term or permanent side effects from COVID, especially for asymptomatic cases. There are a few anecdotal cases but nothing concrete. Yes, if you get a bad case of COVID with a harsh pneumonia, that will result in a lower lung capacity for a while but that's always what happens after lung damage. But to say "lots of potential side effects" is bordering on disinformation.

It's been 7 months now, we would have known by now. It makes absolutely no sense to keep pushing for the "we don't know a lot about the virus so we can just assume the worse and there's no way to prove otherwise" arguments after 5m+ infections and still no evidence even with almost every scientist and every doctor in the world being focused on COVID right now.

There is plenty of proof of long term and potentially permanent side effects, including some that are uncorrelated to disease severity. It's also true the relative prevalence of such side effects is far from well understood, but that is not a valid reason to dismiss the concerns outright. To counter your statement regarding "no evidence", here's just a few recent studies that provide such evidence (please note that this list is extremely far from being remotely exhaustive):

1) https://academic.oup.com/brain/article/doi/10.1093/brain/awa... "The high incidence of acute disseminated encephalomyelitis, particularly with haemorrhagic change, is striking. This complication was not related to the severity of the respiratory COVID-19 disease."

2) https://www.nature.com/articles/d41586-020-01891-8 (on the possibility that C19 may trigger diabetes)

3) https://medicalxpress.com/news/2020-07-physicians-comprehens... (on the systemic effects of C19, many of the acute complications have chronic effects detailed in the full study if you care to read it)

4) https://www.thelancet.com/journals/lancet/article/PIIS0140-6... (on Kawasaki-like autoimmune disease in C19-infected children)

5) https://www.thelancet.com/journals/lanres/article/PIIS2213-2... (post-C19 lung fibrosis)

Note that I've only cited evidence from highly cited and peer reviewed studies. There's a lot more if you care to follow the medical literature, but I think I've proven my point. 7 months is actually extremely little time for proper epidemiological studies on long term complications, it will take years to understand the prevalence and relative risk factors. What is clear, however, is that there is plenty of clinical evidence for different kinds of long term complications that necessitate further research.

Off topic, but it would be interesting to see political affiliation with those numbers

I'm not saying this is right, but I can imagine a few folk who probably have been going out or taking trips etc. and don't want to get tested because they fear their name being exposed somewhere with the public shaming to follow if they were to test positive.

Again, not saying it's right or that it's not selfish, but I can totally see that reasoning behind a large percentage of these folk refusing to get tested.

Where the control group of no one wearing masks had an infection rate of...?

That sounds like an unethical control test and would therefore not be considered.

That’s basically why all studies on whether masks are useful (this is not a first epidemic, not even a first coronavirus epidemic) are inconclusive.

Not really. Randomized controlled trials have been done.

The experiment isn’t unethical - it’s just that it hasn’t been done often because all of the other, less-complicated experiments, also show very little effect.

>Randomized controlled trials have been done.

Do you have any examples?

And would probably require a BSL 3 facility anyways and I don't think you could find one set up for hairdressing. The shortage of BSL 3 facilities that can do science on SARS-2 is one of the things really slowing down our understanding of many aspects of this virus.

I don't think the CDC is looking at this as some sort of controlled test requiring scientific vigor with peer reviewed results.

Instead I think the CDC is trying to understand why US COVID-19 cases are growing at 70 thousand cases a day and trying to find ways to slow that growth.

Because without some sensible control measures that daily number is going to continue to grow and the final number will be end up being much larger than it is today.

You can’t control something that requires people to cooperate if people refuse to cooperate.

I don't doubt the problem is difficult and it has only been made more difficult by the fact what is a public health issue has somehow morphed into a party political issue.

But I'm not sure just giving and not trying to do anything is the answer?

That approach will only end badly.

The state can compel cooperation.

Non-compliance == fines. Repeated non-compliance == jail or forced quarantine. Hair salons that don't comply == revocation of license.

I am not sure the US actually can, given the current legal and political landscape.

Masks are "mandatory" where I'm at, and I walked into a multi-billion dollar business the other day with a sign that literally said "if you are not wearing a mask we will respectfully assume it is due to a medical condition".

"Mandatory" in the US effectively means "strongly suggested". There's literally zero effective way to enforce it.

Some states with incompetent governance allow nonsense like that.

A local retailer was telling people that they wouldn't enforce mask use once you entered the building. Someone called the health department, and they were shut down within 3 hours.

Yes, but that is very different than the sign I posted above. Businesses generally do not have the authority nor capability to judge anyone's medical conditions.

Businesses absolutely have the authority to say "no mask, no entry", just like they can set "no shoes, no shirt, no service" policies.

The ADA requires reasonable accommodation, and has explicit exemptions to accommodations that pose a health threat to others. https://www.ada.gov/taman3.htm#III-3.8000

> III-3.8000 Direct threat. A public accommodation may exclude an individual with a disability from participation in an activity, if that individual's participation would result in a direct threat to the health or safety of others.

It is not clear that legally meets the definition of "direct threat".

> On May 26, 2020, a woman with an alleged respiratory disability filed suit under the Americans with Disabilities Act (ADA) against a supermarket chain in Pennsylvania after she was denied entry because she could not wear a face mask.

> [...] Does the risk of spreading the coronavirus (SARS-CoV-2) qualify as a “direct threat”? Cases like this may start to provide an answer to that question.

https://ogletree.com/insights/no-mask-no-service-supermarket...

The fact that lawyers can't quite agree on this, should be more than enough to evidence to show that it will also not be clear to the laypeople who are responsible for setting, following, and enforcing those policies within stores. I am sure my local news and anecdotal experiences are also not unique in showing that compliance has been spotty. This is the US; being uncooperative is basically our national past-time. Most people will avoid confrontation, and when confrontation does happen, it'll be rare that police get involved unless they escalate to violence.

If a court doesn't find "refuses to wear a mask during a global pandemic" to be a direct threat to the health of others, I'll eat my hat.

Offering something like curbside pickup is, under the ADA, a "reasonable accommodation". People who genuinely can't wear a mask should request it.

> If a court doesn't find "refuses to wear a mask during a global pandemic" to be a direct threat to the health of others, I'll eat my hat.

For a person not diagnosed with COVID-19 who is simply occupying a space and not in direct contact with another person -- I'd think that could be reasonably described as "indirect threat"

> Offering something like curbside pickup is, under the ADA, a "reasonable accommodation". People who genuinely can't wear a mask should request it.

That is a good solution to the issue and I personally wish more businesses would take this route to solve the problem, but unfortunately it is not happening.

If I call up my local gas station and tell them I want a Snickers bar, have a medical condition and can't wear a mask, the $8/hr employee on the other end is either going to argue with me or tell me to come in anyway. They're not going to contemplate the implications of the ADA and determine that curbside pickup is the best legal solution to the issue.

These are really the kinds of national conversations that should be facilitated from the top, but unfortunately that is not the perspective that our current leadership has.

The gas station cashier doesn't make a decision, they follow a policy. No sane business assumes that cashiers think.

I'm an escalation point for a not for profit that I serve on the board of. Our policy is that to be in a public space on our property, you must be masked. If you refuse to comply, the frontline worker's protocol is to ask you to leave the property. If you refuse to leave, you are trespassing, and the employee or supervisor calls the police. Supervisors are empowered to make some limited accommodations, but masks must be worn in public spaces.

If the employee ignores the policy, they are given one warning, then treated as insubordinate, usually terminated.

State regulations are very clear in our state, so if someone wants to sue, go for it. 95% percent of "health concerns" using masks are BS, and protecting our people is more important that worrying about an ADA lawsuit. Usually the people with a problem that leads to a police call flip out and act like an ass on camera, so have fun with the judge.

> The gas station cashier doesn't make a decision, they follow a policy. No sane business assumes that cashiers think.

That's part of my point -- few places have the time and money to detail policies that account for regulatory edge cases, and the boots on the ground aren't equipped to do so either. Most businesses are trying to focus on the basics, like "can we make payroll" and "are we legally allowed to be open". I expect the majority of businesses have policies that approximate the law in that they either give everyone the benefit of the doubt, or they give nobody the benefit of the doubt. Because every business has a slightly different interpretation and slightly different policy, this further degrades the public's understanding of what is legal/acceptable/reasonable. Inconsistencies like this are going to weaken the public's willingness to cooperate, and erode their belief that it actually matters.

> State regulations are very clear in our state, so if someone wants to sue, go for it. 95% percent of "health concerns" using masks are BS, and protecting our people is more important that worrying about an ADA lawsuit. Usually the people with a problem that leads to a police call flip out and act like an ass on camera, so have fun with the judge.

We're about 9 levels removed from my original comment, so a lot of context is vague by now, but my original point is more of a general statement about compliance rather than the situation inside of a given business. There are certainly some businesses operating with smart and effective management, confidence in their legal standing, a clientele that demands masks being worn, and assertive employees who will enforce policies effectively. But most businesses are missing one or more of those factors, and due to that, I think we'll see the majority of places trend towards spotty compliance in general.

They don't need to -- ADA requires accommodation, not the wild west.

In my state, emergency order requires masks in public spaces, and exempts retailers/others from any state liability. The Feds have the power to do the same.

People would prefer not to have to pay their taxes or drive the speed limit either, but the government has ways of forcing people to do so. At the end of the day it doesn't require willing cooperation, just enforcement.

It can be evidence without being conclusive evidence. The virus may have a moderately high R0 but a large majority of the spread is driven by a small minority of spreaders. Most people who have it don't end up infecting anybody else even if they don't take sensible precautions. Now, dressing the hair of 100 people is a lot worse than a normal person's not taking precautions but it might be that they just weren't shedding enough virus to infect anyone in the length of a normal appointment while only talking at a normal volume.

Again, this isn't convulsive evidence but it is evidence and generally all the evidence looks to be stacking up on the pro-mask side.

> Where the control group of no one wearing masks had an infection rate of...?

Florida?

Even if it is true, it is nothing to get excited over.

It is still a risky activity, almost anywhere in the US, given the infection rates.

I am female, so I just put a cover/wrap over my hair, in addition to wearing a mask, if I ever need to leave the house. (I have a beautiful natural strawberry blonde hair color—-but my hair has not been cut in ages!) It also keeps micro droplets (or aerosolated germs) from getting in my hair and infecting me, including when showering. I also wear long sleeved clothing too, even in the heat. Also, I don’t wear jewelry anymore and this helps me get cleaner. I often wear gloves, but not always. Sometimes it can be less safe.

When I arrive home, I slip off my shoes and I use a plastic bag to open the back door. (The shades are drawn in my house prior to leaving/entering the house) As soon as I get in the house, I strip completely, and throw my clothes in a garbage bag. I leave my phone on the counter, which I thoroughly clean later. I then wash my hands/arms, scrubbing away with a ton of soap. I then put on my robe/slippers and go to the shower, putting my robe and (washable!) slippers in a trash bag. Then I get in the shower and scrub away. I then get dressed in another room and put on my house slippers.

I then, using gloves and by cleaning knobs frequently and repeatedly, almost algorithmically, deal with the garbage bags and do laundry. Then I wash my phone with soap and water several times, using multiple pairs of gloves. I later wash the floors where I dumped off my clothes.

This routine is insane.

You'll get 99+% of the possible wins in reducing your chance of being infected simply by avoiding being indoors with others as much as possible, wearing masks when you are unable to do so (e.g. when grocery shopping), and by staying away from large crowds outdoors except when wearing masks.

So agreed, this routine is excessive. Instead of going to all of this hassle, just source N99 masks and wear them when in unavoidable close proximity to other people. Boom, you're practically guaranteed not to get it.

> You'll get 99+% of the possible wins

Can you provide hard evidence for the 99% number? It agrees with my intuition, but I don't think we have a very complete view of the effectiveness of different measures, and in the absense of such evidence it seems strange to authoritative call someone else's measures "excessive".

To be clear, I don't think what the commenter is doing is very useful, but I can't prove it either.

> Boom, you're practically guaranteed not to get it.

Not without eye protection you're not. You're also practically guaranteed to wear the respirator incorrectly. Wearing them correctly requires training, absence of facial hair and enduring a very significant degree of discomfort.

You're completely ignoring the part about not being indoors with others unless necessary. You're practically talking about dressing up in a biohazard bunny suit like you're going into a COVID ward, but that's just flat-out not necessary if you aren't remotely putting yourself into those kinds of hotspot situations to begin with. I assure you, someone taking these kinds of sanitizing precautions is already not putting themselves into close contact with other people, and is thus already getting most of the gains even being considering masks at all. Then add on wearing a good mask when necessary and you reach the 99+%.

I deliberately made no comment on the necessity of wearing the respirator in the first place - that's a separate question. I'm simply saying that if you're going to the trouble of actually wearing a respirator, do it properly.

As for the need for them - anything at or above the N95 respirator level (including eye protection) is only useful in environments with a high probability of contamination. That's mostly healthcare facilities with known C19 patients (particularly in proximity to aerosol-generating procedures), patient rooms, etc.

EDIT: I think I may have misunderstood the intent of your original post. You said "N99", so I assumed you were actually talking about respirators. If you just meant surgical masks, we're mostly in agreement.

You missed out handwashing, which is an important part of preventing the spread of infection.

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Sounds a bit excessive, put might be justified by occupation, location and personal/family risk status?

Unless you are a health care worker where you are around people that are known positive, this is extremely excessive.

In most places except Florida, Texas and California, the probability of running into someone with covid-19 is low. Unless someone coughs in the vicinity around you, the probability of getting it is even lower.

If you’re really concerned, sanitize your hands and phone when you come into the house with hand sanitizer. Leave a bottle outside if you want.

Then take off all your clothes and put it in the dryer. The dryer at 70C is hot enough to kill the virus to undetectable levels in less than 5 mins.

You don’t need to take a shower, just sanitize your hands. If you’re concerned about your hair, wear a baseball cap and put that in the dryer with the rest of your clothes.

>You don’t need to take a shower, just sanitize your hands.

This is basically my routine, if I've been out and touching things other people are likely touching then I get in, take my shoes off and go straight to bathroom and wash my hands.

Then live my life as normal.

When I get groceries delivered I wipe the stuff down I can with some wipes before putting them in fridge or cupboard.

I don't think you need to do much more than that. Mainly you want to avoid being in doors close to other people.

If it makes them feel comfortable enough to go outside, I think it's fine. Like it's not like they're donning a full hazmat suit to get groceries, it's basically just shower and wash clothes which doesn't sound that extreme you do it anyways.

I think if people are going overboard because they don’t understand the science of it, I think it’s good to point it out and present alternatives.

I don’t do it. I sanitize my hands and wear a mask, that’s about it. I don’t wear my shoes indoors so I don’t worry about my shoes.

But if I hear anyone around me cough I literally run away even though I wear a mask. If I’m in a store I will drop everything and leave. Luckily in the 6 months of this pandemic I’ve only heard people cough 2-3 times.

I live in the middle of one of the hardest hit cities and I do none of these things. I wear a mask, avoid indoor spaces and wash my hands a lot. End of list.

Kinda want to counterbalance all of the "wow, that's extreme" comments. I do have a new routine when I get groceries, though not quite as careful as yours. I think if I didn't, I'd always feel like my home was contaminated.

Before leaving, I open the washing-machine lid and cupboards and close the blinds. I drive to Target instead of the grocery store because it's less dense with people. Put on my mask as I get out of my car. Feel very contaminated in the store, hands pushing the shopping cart, touching everything, paying attention to my breathing and everyone near me. I do take off my mask in the car, and often just leave it there because it will be days before I use it again. I'm often sweating and feel like virus is dripping down my face and my hands are smearing it over my steering wheel.

When I get back home, I drop the grocery bags on the linoleum in the entry way, and use hand sanitizer. Take off my clothes and put them in the washer. Put bags with non-perishable items into a cupboard for a couple days. Put fridge/freezer bags on a particular counter. Wash my hands in the kitchen sink. Put cold items in fridge/freezer (I used to disinfect them, but stopped out of laziness). Spray counter with disinfectant, wipe and dry it; wipe down any handles/switches I touched. Wash hands again. (Sometimes I've washed them three times by then.) Start washing machine. Take a shower.

If I just go to the park, I don't wear a mask or anything. If I grab some booze at the liquor store, I wear a mask. In either case, I wash my hands when I get back, but don't necessarily shower or wash my clothes because I don't feel like the odds of contamination are very high and I probably won't put the pants on for several days anyway..

I promise you, you can't get sick from "droplets getting in my hair and infecting me". Nor can you get sick from touching something infected. Just don't put your hands in your mouth/eyes/ears/nose. Wash your hands when you get home and before you eat, don't let anyone sneeze in your face, and you'll be good.

I'm not trying to be mean, but the above seriously sounds like a kind of mental illness. You should see someone.

This article had an incredibly long title, so I had to take some liberties in shortening it. Open to suggestions for a more accurate title if anyone has one.

The site is comical on mobile, you have to scroll past the styled edge of the page several screens to read the whole title lol.

Title is good as it is. It get's the point across without mis-representing the article.

Made me think what else besides masks.. e.g. does operating hairdryers affect virus survival on suspended airborne particles? Or the chemicals they use? (Hair spray etc..) I want to believe that masks are that effective.

Does anyone have a good solution to stopping ones glasses from steaming up while wearing a mask? I enjoy being able to see when I’m walking in public

Is it any wonder? This same experiment is being run every day at hospitals and clinics across the country. Face masks diminish the risk dramatically.

Maybe masks make you shut up and with less talk there is less likelyhood you spread the virus?

We know super spreaders are the shouting-singing-outgoing types.

need comparison against infected stylist without mask, otherwise the results are meaningless not really proving anything

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