Twitter Is A Strange Place For Global News Insights

Source: https://onemilliontweetmap.com/ as of 28 July 2020 at 3:10 PM U.S. Mountain Time (US MT)

At any given time the major cities around the globe are lit up on the Twitter activity heat map. They don’t sleep, but you’ll see after 5 PM things start to get busier for countries that run on a Monday through Friday work schedule.

For those of you losing your minds over that last statement, there are, in fact, countries that don’t run on the stereotypical Western work week. While I would love to get into how this is a detail I have yet to see a single author include while writing about these cultures, for now I will link the Wikipedia article here.

One of the great things about Twitter is that we can use it as an analytical tool to see what people are talking about across the globe and where they are having these thoughts exploding out of their brains and into a space limited to 260 characters.

So let’s go on an exploration of where the world is having deep thoughts reduced to hashtags/keywords using the free analytics tool One Million Tweet Map. I do recommend everyone to have fun and repeat this with hashtags and keywords you’ve selected. Please pick more positive/silly words than I did. I’m still questioning why I went the serious route. If you do repeat this, please tell me about it in the comments!

As a few notes before we begin, I took these map samples at a few different times to try and get the most interesting maps I could to then research what the related current events in the countries lighting up could be.

A Quick Survey

1. #covid19

Source: https://onemilliontweetmap.com/ at 3:52 PM US MT with search inclusive of all tweets using #coronavirus #covid19 #pandemic #covid #virus #socialdistancing #stayhome #corona #quarantine #lockdown

The coronavirus global pandemic is in full swing with the second wave commencing.

Top 5 countries tweeting about this are:

  1. United States – well this one makes sense. The pandemic hasn’t calmed down much here. Our case growth rate has increased to 2% (at the time of writing) from when we had it down to just under 1% for that brief glimmer of hope amount of time… before everyone who doesn’t understand how disease transmission and eradication decided it was time to “go back to normal” without sufficient social structures and a Health Belief Model in place to protect everyone – specifically the most vulnerable members of our population.
  2. India – Currently holding at a 2.3% mortality rate, India has 1.5 million cases compared to 4.5 million in the United States. To put this in perspective, the population of India is 1.35 billion and the population of the United States is 327 million. It’s coming up in the news because, much like other disease outbreaks in India, the populations most impacted are directly linked to socioeconomic stratification. This is drawing media attention.
  3. United KingdomThe UK has the highest number of coronavirus related deaths in Europe. That seems like a very legitimate reason for it to be at the forefront of people’s minds.
  4. Mexico – Mexico, like the United States and the United Kingdom, is one of the most impacted countries. Partially due to the wealthy foreigners fleeing to tourism destinations at the beginning of the global pandemic. This has lead to the closures of over 150,000 businesses as Mexico struggles with to tackle providing economic support while stopping the spread. All of this during a time when Mexico reaches near record daily death tolls.
  5. Spain – Citizens of Spain fear that it is entering its second wave as talks of a second lock down loom. At the same time, Spain is attempting to save its tourism industry – a major source of strife during this global pandemic.

2. Keyword: economy

Source: https://onemilliontweetmap.com/ at 3:30 PM US MT with search term “economy”

The Top 5 countries tweeting about this are:

  1. United States – The United States economy isn’t doing so hot. The Federal Reserve is leaving interest rates at close to zero. Some are arguing that the last financial quarter is the worst in United States history. Even Fox News is saying that the economy is only going to get worse with a second downfall expected.
  2. United Kingdom – Brexit is at the top of many minds it seems. The London School of Economics and Political Science suggests that businesses that escaped the fallout of COVID-19 will instead be destroyed by Brexit. The World Economic Forum predicts a slow recovery in early 2021 if the country can get coronavirus contained and controlled by the end of 2020. At this time it seems most of the concerns are tied to the economic impacts of the global pandemic combined with Brexit.
  3. India – It seems that economists are pessimistic about India’s recovery. The Reserve Bank of India continues to cut interest rates and India considers itself the 3rd worst economically impacted country – the first being the United States and second being Brazil. The ongoing border dispute between China and India contributes to this economic crisis. Other blame India’s economic reopening plans. Either way, for a third economic quarter, India’s GDP suffers.
  4. Australia – Economic news out of Australia tells a different story compared to the rest of the world. Expecting contraction and deflation, Australia expects only a 5% decrease in GDP. But that isn’t the whole story. Large numbers of Australians are unemployed and underemployed and others predict that Australia is approaching a fiscal cliff.
  5. South AfricaThe International Monetary Fund has provided $4.3 Billion in emergency support to South Africa. Retail sales collapsed to less than 50% of what they were a year prior in April, suggesting insufficient economic support during stringent lockdown procedures. With massive business closures in multiple industries and significant declines in spending, tax revenues have decreased. Restaurants in Johannesburg are protesting government actions while Business For South Africa (B4SA) predicts that the country is looking at a minimum of two years before any economic recovery begins.

3. Keyword: Black Lives Matter

Source: https://onemilliontweetmap.com/ at 3:35 PM US MT with search term “Black Lives Matter”

Top 5 countries tweeting about this are:

  1. United States – There is so much news. There is so much information available. I am not going to even try to provide a summary with links.
  2. Canada – The majority of news here is in discussion of what is happening within the borders of their southern neighbor or local news stories regarding racial injustices occurring within Canada – such as whether or not police should be responding to mental health crises instead of emergency medical workers. In Toronto, Black Lives Matter protestors issued a list of requests, including the removal of racist statues and restructuring of the Toronto police department, including the defunding of many of its units and resources. In the same city, over 2,000 artists signed a letter in solidarity with the movement.
  3. United Kingdom – Between Elle announcing that Women are the leaders of the Black Lives Matter movement in the UK, the announcement of a Black Lives Matter TV series, the cancelling of London Pride’s joint event with Black Lives Matter, and active youth participation across the country, the UK is not an inactive leaf in the stream of history. Statues have become a major topic, leading one man to be jailed, police departments at risk for litigation, and one museum digging in its heels over the display of a statue of a slave ship owner. These events are inspiring intense art exhibitions, with some of the art inspired by this global movement going on to be displayed in Westminster.
  4. India – The Black Lives Matter movement has sparked necessary and pre-existing controversy over the cultural relationship between social status and skin color. Skin lightener brands, such as Fair and Lovely, is one of many targets currently being called out as an example of this frustrating example of colorism found throughout the country. The problem is that discrimination based on the color of skin is more complicated in India than I, or any American, can understand. At this point, requests are for concrete and basic anti-discrimination laws – a very different concept of need compared to what the United States and United Kingdom are seeing as protesters seek to bring social injustices to light. Even the Catholic Church is getting involved.
  5. Nigeria – Between calling for museums to return stolen looted goods, pride in Opal Tometi’s role in the American Black Lives Matter movement, the Nigerian Museum confronting Christie’s over the auction of stolen, sacred ancient artifacts, and the recognition that Nigeria is becoming a fashion capital of the world, there’s no shortage on news as to why Black Lives Matter is trending there.

4. Keyword: New Zealand

Source: https://onemilliontweetmap.com/ at 3:39 PM US MT with search term “New Zealand”

The Top 5 countries tweeting about this are:

  1. United States
  2. United Kingdom
  3. Canada
  4. India
  5. Nigeria

I’m going out on a limb here and saying people are talking about New Zealand for reasons that have not that much actually having to do with events going on in New Zealand… Just a hunch… After looking at articles and deciding they were too depressing to list here.

5. Keyword: Food Shortage

Source: https://onemilliontweetmap.com/ at 4:10 PM US MT with search term “Food Shortage”

Okay, seriously, why did I think these depressing searches were a good idea?

Top 5 countries tweeting about this:

  1. United States – Conflicting information arises as I do my investigations. Despite the USDA continuing to say there are no food shortages, supply chain issues are resulting in empty grocery store shelves across America. Food manufacturers are cutting corners and changing their recipes, and with the USDA and FDA’s permissions, food allergy labeling and ingredient labeling standards are less stringent, resulting in Americans with food allergies no longer being able to trust food labeling (as an aside, I am among them and recently had a peanut allergen labeling issue in violation of FALCPA with Tillamook – read more on the FDA website here). The reasoning for these changes in labeling standards? That food shortage that the USDA claimed isn’t happening, but now the FDA is saying food manufacturers are reporting. The blame is placed on a shortage of farm workers, with those working trapped in the United States on H-2A Visas where labor violations and back-wages owed are at an all time high. At the same time, these migrant populations live in conditions putting them at the highest risk for COVID-19 transmission. With online retailers other than Walmart and Amazon not allowed to accept federal assistance programs in 33 states, the most vulnerable populations are suffering the consequences.
  2. United Kingdom – It appears that there is a national food strategy for combatting shortages. This is stirring up some conversation about the resilience of supply chains and commerce. Some are worried that Brexit will make matters worse as record numbers of individuals in the UK can no longer afford food.
  3. Nigeria – It looks like Nigeria is taking the active intervention approach after the United Nations call it and 24 other countries likely to face devastating famine as a result of COVID-19. Some experts are urging the government to do more, as it appears only 3% of current interventions are coming from the government.
  4. India – India, while producing so much food exported to the rest of the world, was ranked 102/117 on the Global Hunger Index before COVID-19 hit. Now, the problem is getting worse. The impacts extend far beyond the human population, with tiger poaching hitting all time record highs as a result of subsistence hunting. Even rhinoceroses are suffering from a food shortage. Times are so hard, India is considering passing anti-famine amendments that have not been seen in over a century.
  5. Canada – For Canadians, many are concerned about the food shortages negative impacts on the long term survival of the polar bear. Others seem to believe a silver lining to the supply chain disruption is how it is saving community supporting, local agriculture. Agri-Canada is using this opportunity to create youth focused jobs to reduce the supply chain disruption.

Why Care?

It’s helpful to think about the world beyond our own individual experiences. We cannot live in a society where we think about everything with ourselves at the center of our personal universes. It is important to instead consider the experiences of those elsewhere – places we have never seen and may never see in our lifetimes. We are all interconnected and nothing we do exists in a bubble. Nothing.

Go forth and search for more positive things. I will try to do the same.

Thank you so much for reading my post today. If you enjoyed it, please like, comment, and/or share. This helps me know which posts my readers prefer and can help me cater future content.

How Not To Feel Alone On Your 31st Birthday In 2020

Happy Birthday To Me!

Today I turn 31 in the year 2020. The world is chaotic (to say the least). But there is so much for which to be thankful. We have an opportunity in this dark time: we can use this as a pathway to finding our similarities and common ground. We can use this as an opportunity to show compassion toward our fellow human beings. Don’t believe me? I have a challenge for every person reading this.

The Google Autocomplete Challenge

Alright! So, Google Autocomplete works by predicting what phrases have the highest probability of completing your query based on the most common searches by others within your same time zone, general demographics, and country. Most of the time this is reduced to the information that can be associated with your IP address. Remember, your IP address contains a lot of information about your location.

If you’re ever feeling alone, think about the population of the country where you live. I currently live in the United States – a country with a population of 328.2 Million people. Approximately 27% of Americans report using Google as their primary search engine. That means approximately 88.614 Million Americans use Google as their primary search engine.

That means that whatever the statistically most likely predicted completion of a search phrase is results from millions of people searching that phrase.

This means you are not alone. With every crazy question you have for the internet, you are not alone. For these first fifteen, I’m going to be very general. Then, once this concept has been demonstrated, let’s go on a journey. Some of these are funny, some are depressing, some are revealing.

1. “Is it…”

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2. “What to…”

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3. “Does the…”

(If you want to know, yes, the coronavirus test hurts)

4. “Are there…”

5. “Do I…”

6. “Why is…”

7. “Who was…”

Glad to see Americans are learning history?

8. “Did I…”

9. “Where are…”

10. “Am I…”

11. “How to make…”

12. “When will…”

13. “Does the United States…”

No, the United States does not use the metric system outside of scientific laboratories.

14. “How many…”

As you can see a lack of the metric system leads to a lot of confusion.

15. “How often…”

That’s a doozy.

Okay! So 15 questions in and you’ve noticed that Americans are just as confused about our units of measure as the rest of the world and things do seem to be interesting. Plus, if you’ve been sedentary and are questioning while your bowel habits have changed, you’re not alone. Drink more water, eat more fiber, and start going for more walks. You’ll feel better.

These next questions are for those of us that recognize that search histories get a little weird when you’re writing. So, let’s start looking at some of the autocompleted questions related to writing research I’ve seen lately. These get a bit dark and others are truly revealing.

1. “What do serial killers…”

2. “Why do serial killers…”

3. “Why do wives…”

4. “Why do husbands…”

5. “Why do partners…”

6. “Do cows…”

7. “How to fake…”

The search results here made my eye twitch.

8. “How to destroy…”

9. “Why doesn’t…”

10. “Humans are…”

I warned all of you that was going to get dark.

There’s one final search I am going to show you – it leads to one of my favorite poems I had forgotten about and hadn’t read in over 10 years.

“Hope is…”

What is that first search result? See below.

“Hope” is the thing with feathers (314) – Emily Dickinson

“Hope” is the thing with feathers –
That perches in the soul –
And sings the tune without the words –
And never stops – at all –

And sweetest – in the Gale – is heard –
And sore must be the storm –
That could abash the little Bird
That kept so many warm –

I’ve heard it in the chillest land –
And on the strangest Sea –
Yet – never – in Extremity,
It asked a crumb – of me.

I hope you can hear Hope’s song, and even if you can’t right now, know that you are not alone in searching for it amongst the noise.

What were your autocomplete results like when you searched similar beginning terms? Were they the same as mine? If you have suggestions of other terms for me to search please leave them in a comment 🙂

I am so thankful for your company on this bizarre journey through search engine autocompletes on my birthday. If you enjoyed this post, please share it, like, or comment. Without you, this post would be stored quietly on a server somewhere. Have a wonderful weekend ahead 🙂 With Love – Lo.

Aversion to Masks? How Masks Make A Difference

Why Wear a Mask?

Source: https://www.maskssavelives.org/

An organization called Masks Save Lives is currently calling out a link between “low mask acceptance cultures” and how badly COVID-19 outbreaks are affecting these areas and their failures to flatten the curve once outbreaks began. Research potentially supports this division, a 2009 study in Australia found that the data could not be assessed for if cloth mask usage reduced seasonal infections in the public due to low compliance by participants.

The CDC now recommends wearing masks and numerous websites have come out with instructions on how to make a cloth one (here’s one!). [update 15 July 2020] A new study by the CDC also found significant reduction of transmission from 2 symptomatic hair stylists that tested positive for COVID-19, but all 139 exposed clients were protected by both the stylist and the clients wearing masks. With all this information available there are individuals still refusing to wear masks and the argument is that the reason for this denial is rooted in our culture.

Is there something to the cultural divide? We’re going to look at the United States, specifically (though the next Tweet is from the UK).

An example of the reaction someone gets going to the store wearing a mask in England – one of the countries accused of having an anti-mask culture by the organization.

Why Do People Not Wear Masks?

Social Acceptance

Mask acceptance is not as easy as mandates and public health advisories. Beyond the scientific and home care acceptance, it must not be seen as a threat. Previously the lack of compliance in the Australian study may have been related to an element of social acceptance, however this was not studied at that time. If someone is uncomfortable wearing a mask they won’t. One community that may feel this impact are ethnic and racial minorities in the United States. One 2010 study investigated the barriers to mask wearing among urban Hispanic households in cases of upper respiratory infection. The findings concluded that these communities required higher risk perception scores before adopting face mask usage. This led the researchers to conclude that face masks are unlikely to be effective for this community in the case of seasonal or pandemic influenza like conditions. The participants voiced concerns about social acceptability of masks within their communities – if they would be viewed as the source of illness – while others mentioned potential embarrassment.

Many have long dealt with violence related to the use of masks. Assumptions related to suspicion of crime, gang activity, and other racial profiling can making wearing a mask uncomfortable.

A recent paper in the Lancet mentioned

Consideration should also be given to variations in societal and cultural paradigms of mask usage. The contrast between face mask use as hygienic practice (ie, in many Asian countries) or as something only people who are unwell do (ie, in European and North American countries) has induced stigmatisation and racial aggravations, for which further public education is needed. One advantage of universal use of face masks is that it prevents discrimination of individuals who wear masks when unwell because everybody is wearing a mask.

At this time the adoption of universal mask usage in the United States is tenuous and has been unnecessarily politicized.

Legality

In the state of Virginia it is illegal to wear masks in public, though after the CDC’s announcement the law no longer applies.

§ 18.2-422. Prohibition of wearing of masks in certain places; exceptions.

It shall be unlawful for any person over 16 years of age to, with the intent to conceal his identity, wear any mask, hood or other device whereby a substantial portion of the face is hidden or covered so as to conceal the identity of the wearer, to be or appear in any public place, or upon any private property in this Commonwealth without first having obtained from the owner or tenant thereof consent to do so in writing. However, the provisions of this section shall not apply to persons (i) wearing traditional holiday costumes; (ii) engaged in professions, trades, employment or other activities and wearing protective masks which are deemed necessary for the physical safety of the wearer or other persons; (iii) engaged in any bona fide theatrical production or masquerade ball; or (iv) wearing a mask, hood or other device for bona fide medical reasons upon (a) the advice of a licensed physician or osteopath and carrying on his person an affidavit from the physician or osteopath specifying the medical necessity for wearing the device and the date on which the wearing of the device will no longer be necessary and providing a brief description of the device, or (b) the declaration of a disaster or state of emergency by the Governor in response to a public health emergency where the emergency declaration expressly waives this section, defines the mask appropriate for the emergency, and provides for the duration of the waiver. The violation of any provisions of this section is a Class 6 felony.

Code 1950, §§ 18.1-364, 18.1-367; 1960, c. 358; 1975, cc. 14, 15; 1986, c. 19; 2010, cc. 262420; 2014, c. 167.

Masks And Accessibility

I was unable to find documentation online of how those with disabilities that inhibit the use of masks are handling the situation or even recommendations for these individuals on how to stay safe.

Update 14 July 2020: recommendations currently stand that individuals requiring modifications to wear masks should instead self isolate and not wear the mask. These are not going to be the people attempting to show a printed off the internet ADA card while not social distancing and yelling about their rights. These individuals may have a medical letter from a doctor explaining the specifics of their condition, but this does not exempt them from wearing masks inside commercial businesses. It instead requires businesses to make accommodations, such as curbside pick up or delivery. According to the Southeast ADA Center individuals that should not be wearing masks for accessibility reasons include:

  • Individuals who have any respiratory condition (such as COPD, asthma, and cystic fibrosis) that may be worsened by wearing a mask.
  • Individuals who cannot remain calm and functional while wearing a mask due to PTSD, anxiety, claustrophobia, or other anxiety disorder. Masks have been shown to induce hyperventilation, elevated heart rate, and panic attacks in these individuals.
  • Individuals with Autism/Autism Spectrum Diagnoses (ASDs). Sensory hypersensitivity can induce panic in response to having the nose and mouth covered, fabric textures, and the feeling of masks touching their faces.
  • Mobility impairment that requires an otherwise independent individual to need assistance. Many people cannot make an assistive caregiver materialize out of nowhere and preservation of autonomy is really important.
  • Anyone using mouth or tongue control devices. This includes motorized chairs that use the sip and puff control mechanism.

Masks For Children & Caregivers

In other cases we need to consider family caregivers, and children, both needing modifications and not. Many children struggle to wear masks, particularly infants and toddlers. The primary reason most experts encourage children to wear masks is to prevent them from giving it to others, rather than to prevent them from contracting the virus themselves. But the CDC still insists that all children over the age of 2 should be wearing a mask when they leave the house. I am looking for further resources – at this time I have heard about this problem from friends that are parents.

The American Academy of Pediatrics has released the following guidelines for masks and children with special health considerations:

-If you must go outside or to a place where you are not able to practice social distancing with an infant, cover the infant carrier with a blanket, which helps protect the baby, but still gives them the ability to breathe comfortably. Do not leave the blanket on the carrier in the car or at any time when the baby and carrier are not in direct view.  

-Children who are considered high-risk or severely immunocompromised are encouraged to wear an N95 mask to best protect themselves.  

-Families of children at higher risk are encouraged to use a standard surgical mask if they are sick to prevent the spread of illness to others.  

source: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/masks-and-children-during-covid-19/

In terms of the minimum effectiveness and materials? An Experimental Study of Efficacy of Gauze Face Masks published in 1920 the researchers concluded that cloth masks had basic minimum requirements that had to be met in order for a mask to have a “restraining influence on the number of bacteria-laden droplets possible of inhalation”. Part of this involved a balance between the number of layers, thread count, and breathability. If the mask is too dense as a result of the layers and thread count then “breathing is difficult and leakage takes place around the edge of the mask”. That leakage of air is what they proposed caused the reductions in efficacy observed. Research such as this resulted in recommendations of a minimum of 300 thread count fabric still used today.

Cost Prohibitive / Unable to Obtain

We’ve talked about poverty before. This can impact obtaining supplies, time to make a mask, and many other life factors that are none of my business and we need to be understanding. Others are unable to sew or are unable to put a mask on for themselves (see “modifications” above).

Do Cloth Masks Really Help?

Yes.

[Updated 14 July 2020]

Numerous papers have been published establishing the effectiveness of masks in the control of the SARS-CoV-2 virus. One paper in the Lancet is titled “The Rational Use Of Face Masks During The COVID-19 Pandemic”. This paper took the time to thoroughly analyze public health responses from various countries, the reasoning behind their responses, and how this impacted the spread of the virus. While it explains that stigma is likely to be the biggest barrier, there’s still sufficient evidence from countries that did adopt a universal mask wearing policy and slow the spread.

A paper published in the BMJ sought to do a systematic review of the effectiveness masks. While arguing the precautionary principle is a wise choice in regards to public health measures and does not require “perfect evidence” or a full systematic review prior to implementation.

In conclusion, in the face of a pandemic the search for perfect evidence may be the enemy of good policy. As with parachutes for jumping out of aeroplanes,38 it is time to act without waiting for randomised controlled trial evidence.39 A recently posted preprint of a systematic review came to the same conclusion.40 Masks are simple, cheap, and potentially effective. We believe that, worn both in the home (particularly by the person showing symptoms) and also outside the home in situations where meeting others is likely (for example, shopping, public transport), they could have a substantial impact on transmission with a relatively small impact on social and economic life.

In a letter to the editor published in Infectious Disease Modeling a group discussed disease modeling performed on data sets from New York and Washington states. What they found suggests that the adoption of wearing masks will decrease the number of deaths significantly and reduce transmission.

Hypothetical mask adoption scenarios, for Washington and New York state, suggest that immediate near universal (80%) adoption of moderately (50%) effective masks could prevent on the order of 17–45% of projected deaths over two months in New York, while decreasing the peak daily death rate by 34–58%, absent other changes in epidemic dynamics. Even very weak masks (20% effective) can still be useful if the underlying transmission rate is relatively low or decreasing: In Washington, where baseline transmission is much less intense, 80% adoption of such masks could reduce mortality by 24–65% (and peak deaths 15–69%), compared to 2–9% mortality reduction in New York (peak death reduction 9–18%)

We began asking this question a long time ago. In a 1920 study on gauze masks looking retrospectively at the data from the 1918 influenza pandemic regarding the infections contracted by healthcare workers, authorities’ primary criticism was that the weave of the fabric was too loose. Though the study still concluded that masks did not demonstrate to have a degree of efficacy that would warrant their compulsory application during an epidemic, they argued that masks should not be abandoned entirely. I’ll leave it in their words:

Studies made in the Department of Morbidity Statistics of the California State Board of Health did not show any influence of the mask on the spread of influenza in those cities where it was compulsorily applied, and the Board was, therefore, compelled to adopt a policy of mask encouragement, but not of mask compulsion. Masks were made compulsory only under certain circumstances of known contact with the disease and it was left to individual communities to decide whether or not the masks should be universally worn.


The reason for this apparent failure of the mask was a subject for speculation among epidemiologists, for it had long been the belief of many of us that droplet borne infections should be easily controlled in this manner. The failure of the mask was a source of disappointment, for the first experiment in San Francisco was watched with interest with the expectation that if it proved feasible to enforce the regulation the desired result would be achieved. The reverse proved true. The masks, contrary to expectation, were worn cheerfully and universally, and also, contrary to expectation of what should follow under such circumstances, no effect on the epidemic curve was to be seen. Something was plainly wrong with our hypotheses. We felt inclined to explain the failure of the mask by faults in its application rather than by any basic error in the theory of its use. Consequently, Bulletin No. 31* of the Board of Health brought out the fact that where it was sought to control influenza by compulsory wearing of masks certain obstacles developed. These were:


First, the large number of improperly made masks that were used.

Second, faulty wearing of masks, which included the use of masks that. were too small, the covering of only the nose or only the mouth, smoking while wearing, etc.


Third, wearing masks at improper times. When applied compulsorily masks were universally worn in public, on the streets, in automobiles, etc., where they were not needed, but where arrest would follow if not worn, and they were very generally laid aside when the wearer was no longer subject to observation by the police, such as in private offices and small gatherings of all kinds. This type of gathering with the attendant social intercourse between friends, and office associates seems to afford particular facility for the transfer of the virus. If, as seems probable, the virus is droplet-borne, this form of contact, where people are conversing with one another, would, of course, be much more dangerous than crowd association of strangers, even under the circumstances of gathering in churches and theatres. We were not satisfied, however, with this seemingly perfectly satisfactory explanation. We felt it to be imperative, if the mask were not to be permanently discredited, that more definite information be obtained concerning its uses and limitations. If, as we believed, the gauze mask is useful as a protection against certain infections, it would be unfortunate if its uncontrolled application in influenza should result in prejudicing critical and scientific minds against it.

The American Journal Of Public Health.

A 2008 Study that came out in PLoS One found that wearing homemade cloth masks reduced hypothetical infections after spraying people with a simulated contagion.

A 2011 review of “Physical interventions to interrupt or reduce the spread of respiratory viruses” found that …

Respiratory virus spread can be reduced by hygienic measures (such as handwashing), especially around younger children. Frequent
handwashing can also reduce transmission from children to other household members. Implementing barriers to transmission, such
as isolation, and hygienic measures (wearing masks, gloves and gowns) can be effective in containing respiratory virus epidemics or in
hospital wards. The more expensive, irritating and uncomfortable N95 respirators might be superior to simple masks. It is unclear if
adding virucidals or antiseptics to normal handwashing with soap is more effective. There is insufficient evidence to support screening
at entry ports and social distancing as a method to reduce spread during epidemics.

…meaning that isolation, hygiene, and barriers like masks were effective.

On a lukewarm note, a 2013 study found that they were “better than nothing” against droplet transmission during an influenza pandemic.

Health Belief Models are one of the most mad scientist or the most Psy Ops things about public health. How do you get an entire population to participate in something that will help everyone in the long run – like washing hands? In 2014, a literature review of cloth mask usage was published in the Singapore Medical Journal taking a different approach to the use of cloth masks in the context of a Health Belief Model.

Confusingly, and commonly cited by those against wearing masks, a later 2015 study in BMJ Open found

Cloth masks resulted in significantly higher rates of infection than medical masks, and also performed worse than the control arm. The controls were HCWs who observed standard practice, which involved mask use in the majority, albeit with lower compliance than in the intervention arms. The control HCWs also used medical masks more often than cloth masks. When we analysed all mask-wearers including controls, the higher risk of cloth masks was seen for laboratory-confirmed respiratory viral infection.”

With such mixed reviews being published, why wouldn’t we be hesitant to recommend masks when they’re being advised as only a last resort? Here’s the thing. We’re there. We’re at the last resort.

When is a mask not a good idea?

Masks can lead to inhaling your own infectious droplets from a sinus infection and spread it to the rest of your airways.

Here’s an anecdote. I am having trouble finding papers to support this, but this is the current hypothesis my immunologist and I have as to how I got that month long pneumonia in March 2020.

I had a sinus infection and I was wearing a mask. Then, I aspirated droplets from my sinus infection leading to a lung infection. This lung infection eventually developed into a pneumonia. This is an instance of when a mask is not a good idea. Circumstances when you can aspirate your own droplets from a sinus infection or from an oral infection would be while exercising, crying, or dealing with temperature or humidity swings that would result in a runny nose. That’s it.

Other people who should not wear masks? The CDC recommends against masks for anyone with breathing problems, such as shortness of breath, children under the age of 2, and “Anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance.”

What About Herd Immunity

I added this section in the update because I have heard arguments against mask wearing for the purpose of increasing herd immunity. Quanta Magazine wrote a great article explaining that herd immunity is complicated and how to read an R0 . For those that don’t want to read the article, I will explain it in a way I’ve used in the past for students.

Imagine you have a bouncing ball rolling around on a pool table and every time that ball hits another ball it changes that ball’s color. This change is not reversible. The number of balls that can interact and change color at a given time depends entirely on factors such as movement, density, and the total area of the pool table versus the size of the ball. Any change in those conditions is going to change the probability of interactions, and as the balls change color there are fewer available. That said, you can always add more balls, and some of them might have already changed color. You can force the balls to not go anywhere and severely reduce their interactions.

Because herd immunity’s effectiveness is dependent on the R0 (The estimated number of people being infected by an infected person / the number of balls interacting with the balls that have changed color) and that number will vary based on the conditions previously mentioned.

Herd immunity does not protect vulnerable populations effectively due to heterogeneity of R0 within a single population. Not all humans behave the same and this vastly changes how many people they can potentially infect. With necessary herd immunity estimates requiring a range of 40-60% of the United States population to have been infected to impact and reduce the spread, and an estimated death rate range of 4-6% at this time we can quickly consider what this means for a population of 328.2 million.

This means a total of 131.28 – 196.92 million Americans will need to contract COVID-19. If this happens, we can expect 5.25 – 11.82 million deaths in total by the time herd immunity is achieved unless there is vaccine intervention, assuming the death rate does not increase beyond 6% due to lack of access to medical care as ICUs hit capacity across the United States.

TL;DR

  • Wear a cloth mask. Assume good intent for everyone wearing a mask. They aren’t doing anything suspicious. Don’t call the police.
  • Masks work. Please wear them, but wear them smartly. They do not make up for poor hygiene practices.
  • Some people can’t afford the supplies to make cloth masks, or they need modifications for their unique needs, or they cannot make the mask themselves. There are resources for that.
  • Children’s masks need consideration based on your child’s needs.
  • Masks are not always a good idea. Inhaling your own droplets can lead to pneumonia not related to COVID-19.

Thank you for reading this. Without you I am shouting into an ether. If you enjoy and want me to write more of these, please share this or comment below with what you would like to see me write next.

I started writing this article on 8 April, 2020 and stopped because I needed a break from writing about coronavirus related topics. I will be continuing to update this post-publication. Last updated on 14 July, 2020.