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PANDEMIC ALERT LEVEL
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Tracking the next pandemic: Avian Flu Talk

The mask debate

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    Posted: March 21 2006 at 3:18pm
Tuesday, Mar 21, 2006
Experts struggle with issue of what medical masks to stockpile for a pandemic

ATLANTA (CP) - The issue of medical masks - who should use them, and what types should be stockpiled - is one of the vexing and potentially explosive questions facing public health experts working to prepare for a possible flu pandemic.

With precious little science to go on and in the face of the strong probability of a global mask shortage, they are struggling to craft recommendations that strike the best balance between the ideal and the feasible - without a clear picture of what either will be when the next pandemic hits.

Speaking on the wings of an international conference on emerging infectious diseases, experts readily acknowledge a global wave of illness could place modern day standards of infection control out of reach.

"If this thing rages for a year, all of this is academic, all of these stockpiles. Because we're going to burn through all of that. So we have to have plans," said Stewart Simonson, assistant secretary of the U.S. Department of Health.

"Health care may end up looking, for a little while . . . more like the '50s. And we may run out of rubber gloves. So we're going to have to have some way for people to sterilize their hands so they can safely do things. We've got to start thinking that way, I think."

Weighing on the minds of those deliberating is the fear that, while health-care workers will be desperately needed during a pandemic, some may refuse to show up for work if they feel they are not adequately protected.

Ontario nurses are already raising the issue, complaining that the federal government is stockpiling inexpensive surgical masks rather than the more costly N-95 respiratory masks.

The World Health Organization and the U.S. Centers for Disease Control currently recommend N-95 masks for health-care workers treating the rare but dangerous human cases of H5N1 avian flu. But neither group has issued recommendations on what they think should be the standard when the next pandemic hits.

Coming up with those policy recommendations is challenging.

There is almost no scientific evidence on whether wearing a mask cuts transmission during a flu pandemic. Pandemic strains of influenza are rare, they are different from annual flu strains, and they are different from one another. And modern protective devices weren't available during the last pandemic in 1968.

"It's just not settled the role that small particle aerosols" - the form of transmission best protected against with an N-95 mask - "will play in terms of a pandemic strain," said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine.

Policy makers who are accustomed to issuing evidence-based recommendations are in the uncomfortable position of trying to find novel ways to devise guidance that is more than mere guess work.

Some are scouring medical histories, original source material from past disease outbreaks and even historical fiction looking for clues about how effective measures like the wearing of cloth masks across the face were during earlier outbreaks of infectious diseases.

"I find it very useful, not as a case control study, but as a historical reference point to study some of the original records from the various pandemic experiences and see: What did societies do?" Cetron said.

The Institute of Medicine, experts who advise the U.S. government, has been asked to investigate whether it would be feasible to develop reusable cloth masks, made of muslin, for use in a flu pandemic.

And those involved in discussions over the use of masks recognize their advice has to cover both what might be best if it is workable, and what might be an acceptable alternative if best isn't available.

"It's going to be important to establish the ideal and then plan for the real event," said Dr. Michael Osterholm, an infectious disease expert who has been warning of the amplifying effect the global just-in-time distribution system will have during the next pandemic.

"And the real event, we'll be seriously short of many of those essential goods and even some services that we count on on a routine basis," said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

The WHO faces the additional challenge of making recommendations for the world - for the wealthy G-7 countries, for mid-level economies and the poorest of the poor.

Under those circumstances, recommending health-care workers be protected by the Cadillac of medical masks is ensuring the poorest countries can't follow the WHO's advice.

"If you take that perspective, it means that a lot of practical considerations have to be on the table as well as scientific considerations. And then you take some mix of those factors to come up with the best guidance that you can come up with," said Dr. Keiji Fukuda, acting director of the WHO's global influenza program.

"You don't want to make recommendations that are simply the ideal. You want to make recommendations which are practical. They're usable. They're feasible."

© The Canadian Press, 2006
 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:03pm
This is the most distrubing thing that I've read in a very long time.

Please go back and read it again.

Does anyone think that it's a good idea for policy makers to even think of this as a source of  info.....


Some are scouring medical histories, original source material from past disease outbreaks and even"historical fiction looking for clues about how effective measures like the wearing of cloth masks across the face were during earlier outbreaks of infectious diseases.

"I find it very useful, not as a case control study, but as a historical reference point to study some of the original records from the various pandemic experiences and see: What did societies do?" Cetron said."


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    Ont. nurses want better masks for avian flu

Updated Sun. Mar. 19 2006 11:33 PM ET
CTV.ca News Staff

Ontario nurses say the federal government wasted money by purchasing
standard surgical masks incapable of blocking avian flu.
"It was two of our nurses who died during the (SARS outbreak)," Lesley
Bell, of the Ontario Nurses Association, told CTV News. "We're just saying
we don't want to go through that again. Let's make sure that the nurses
and health care workers who are on the front lines are protected."

The government bought 4.5 million standard masks for
about 10 cents each. Ontario nurses say the masks are inadequate
protection against avian flu, and the government needs to buy N95
surgical masks at about 10 times the cost. Nurses demanded and
received N95 masks three years ago during Toronto's SARS outbreak.


The World Health Organization recommends the N95 mask as protection
against both SARS and avian flu.

The mask has become popular in the United States, where they are mailed
to relatives living in countries affected by the virus.

"They came in a bought cases at a time, and they would ship them home
to their families," Home Depot worker Jake Zacharias said.The
government says there is no evidence to show N95 masks are more
effective at blocking the virus than standard surgical masks.

"There is certainly confusion, in the health care community, and globally,
about how this disease is transmitted, and what the optimal method of
protection is," said Dr. Arlene King, a microbiologist at the Public Health
Agency of Canada.

The N95 masks are manufactured in Quebec, but have to be pre-fitted for
every user and can only be worn for a few hours.

Dr. Donald Low, a microbiologist, said that N95 masks also become
useless if the user touches them, adding another problem.

"In some circumstances they may be no better than a surgical mask, and
in some cases they may even be worse," she said.

However, Ontario's nurses say the government is simply interested in
saving money, not which mask is more effective.Meanwhile, Israel
confirmed its first outbreak of the H5N1 strain Sunday – the worst
mutation of the virus.




http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060319 /
bird_flu_060319/20060319?hub=Health
    
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heheheheh
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:29pm
Subject:WHO Pandemic RR&C protocol

Mar 17 draft "elimination of any reference to masks"


-----Original Message-----
From: xxxxxxo@xxx.xxx.ca
[mailto:xxxxxx@lxxx.xxx.ca>
On Behalf Of Dr. xxxx xxxxxx, ROH
Sent: March 17, 2006 8:12 PM
To: xxxx@xxxxx.ca

Subject: OccHygPro: WHO Pandemic RR&C protocol Mar 17
draft

This evening, WHO posted the latest iteration of its
Rapid Response and Containment protocol resulting from
the deliberations at the Global Technical Meeting, Mar 6-8.

http://www.who.int/csr/disease/avian_influenza/guidelines/draftprotocol2006_03_17/en/index.html

Progress includes:

- clarification that the considerations could apply not only to H5N1, but also to other viruses with pandemic potential

- assignment of responsibility for national plans to
"be updated frequently to take account ofinternational developments"

- elimination of any reference to "masks".

The matter of PPE is deferred to the parallel document
Avian influenza ... WHO interim infection control guideline for health care facilities Revised 9 February 2006

http://www.who.int/csr/disease/avian_influenza/guidelines/infectioncontrol1/en/index.html
.

Further work is in order.

In keeping with the 2nd bullet above, you may want to
reconcile your corporate / municipal / provincial-territorial plan with the latest WHO guidelines; hopefully, our national authorities will
be similarly diligent.

Regards,

xxxxxxxx
____________________________
xxxx xxxxMEng,PhD,CIH,ROH
Environmental Hygienist / Toxicologist


    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:30pm
Originally posted by Rick Rick wrote:

    Dr. Donald Low, a microbiologist, said that N95 masks also become
useless if the user touches them, adding another problem. 

    
 
How on earth are you supposed to put it on without touching it?!?!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:40pm
Originally posted by justme justme wrote:

Originally posted by Rick Rick wrote:

    Dr. Donald Low, a microbiologist, said that N95 masks also become useless if the user touches them, adding another problem.     


How on earth are you supposed to put it on without touching it?!?!


Yes I watched the same report. Excuse my Latin but what a bunch of Crxpxla !

This is the same fellow that worked in a hospital that was telling nurses to put their used N95 masks in a plastic bag so that they could be re-used by co-workers during the SARS epidemic, according to Barb Wahl president of the Ontario Nurses union, who testified to this during an 2003 public inquiry. I know someone that worked in this hospital.

This same hospital told nurses that they were dealing with SARS,
2-weeks after doctors were informed. Once the nurses were aware, they were double-gowned and double masked. Mmmm.......
    
    


Fudge! I gotta move this thread. I'll do it when I regain cons.....
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:45pm

That is shameful of him to tell them to re-use the masks especially if he believes touching them makes them useless.

Is it true that touching them makes them useless?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:50pm

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:56pm
Regarding the point about touching the masks...my understanding is that you do not want to transfer the oils from your skin to the breathing surface of the masks because it reduces effectiveness.  I was advised be some medical folks to either glove and put on or to try and be careful ot just handle the edges.  Any medical provider types out there have other input?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 4:58pm
masks are for the sick,to reduce  viral spreading,they are not for protection.
real masks are the one with the photo
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:01pm
    
However, Ontario's nurses say the government is simply interested in
saving money, not with mask is more effective.


http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060319 /
bird_flu_060319/20060319?hub=Health


"Face masks offer the best protection in the fight against SARS,
reveals a new hospital-based study from Hong Kong.

Wearing a mask can give a person dealing with SARS patients in hospital
up to 13 times more protection compared with not wearing one, says
Wing Hong Seto, study lead and chief microbiologist at the Queen Mary
Hospital in Hong Kong."

http://www.newscientist.com/article.ns?id=dn3692

---

For masks to be effective in the filtering function, air must pass through,
and not around the masks. They should be fitted tightly and changed
when wet or soiled. One must not assume that a high efficiency mask like
N95 is capable of providing 100 percent protection to the user. Proper
skills and precaution in using masks, together with adequate hand
hygiene, may determine the efficacy of the protection provided by the
masks.

http://www.joannabriggs.edu.au/pacesetters/1_2a_sarshk.php


* A study of Hong Kong nurses working with infected patients everyday,
concluded, those that took the proper precautions, did not contract the
disease, or had a very low incidence. My 2-cents.

    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:02pm
eyes must be protected,they are an easy entry too
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:03pm
Originally posted by justme justme wrote:

<FONT style=": #222222">That is shameful of him to tell them to re-use the masks especially if he believes touching them makes them useless.


Is it true that touching them makes them useless?

    

No.



    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:05pm
[QUOTE=Hermes] eyes must be protected,they are an easy entry too    


If you are nursing someone and you are close to them, yes. A quick trip to an ATM, no. My 2-cents.

    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:22pm
"masks are for the sick,to reduce  viral spreading,they are not for protection."
This is a joke, right?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:29pm
no.
 no joke.very serious
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:34pm
Would you please explain why you say that masks aren't for protection?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 5:34pm
this will help you
.real masks cost money dear

A gas mask, also known as a respirator, is a mask worn on the face to protect the body from airborne pollutants and toxic materials. The mask forms a sealed cover over the nose and mouth, but may also cover the eyes and other vulnerable soft tissues of the face.

Airborne toxic materials may be gaseous (for example the chlorine used in WWI) or particulate (such as many biological agents developed for weapons such as bacteria, viruses and toxins). Many gas masks include protection from both types. Unlike other breathing devices, gas masks do not require the user to carry an air supply as in the use of scuba gear. However, this means that the wearer depends on the air in the atmosphere, the same medium of the toxic materials. Thus, the mask must remove them and relay clean air to the wearer.

There are three main ways of achieving this: filtration, absorption and adsorption, and reaction and exchange.

Contents

[hide]

< =text/> //

Filtration

A filter works by having holes that are smaller than the particles to be removed. Since many pollutant molecules and particles are larger than oxygen and nitrogen molecules, this works for many applications. Filtration thus lends itself to defense against particulate hazards.

Gas-masked US Navy member in a MILES combat exercise
Enlarge
Gas-masked US Navy member in a MILES combat exercise

However, the smaller the gap through which the air has to pass, the greater the pressure the wearer's lungs must exert to draw the air through, hereby limiting the porosity of these passages. Thus to extract many toxic gases, masks use other methods.

Absorption and adsorption

Absorption is the process of being drawn into a (usually larger) body, or substrate, and adsorption is the process of deposition upon a surface. This can be used to remove both particulate and gaseous hazards. Although some form of reaction may take place, it is not necessary; the method may work by attractive charges (for example, if the target particles are positively charged, use a negatively charged substrate). Examples of substrates include activated carbon, and zeolites. This effect can be very simple and highly effective, for example using a damp cloth to cover the mouth and nose whilst escaping a fire. Most of the harmful vapours and smoke will be dissolved in the water on the cloth, giving you vital extra seconds to escape.

Reaction and exchange

Gas mask used by the French military
Enlarge
Gas mask used by the French military

This principle relies upon the fact that substances that can do harm to humans are usually more reactive than air. This method of separation will use some form of generally reactive substance (for example an acid) coating or supported by some solid material. An excellent example is resins. These can be created with different groups of atoms (usually called functional groups) that exhibit different properties. Thus a resin can be tailored to a particular toxic group. When the reactive substance comes in contact with the resin, it will bond to it, removing it from the air stream. It may also exchange with a more harmless substance at this site.

There are two main difficulties with gas-mask design:

  • The user may be exposed to many different types of toxic material. Military personel are especially prone to being exposed to a diverse range of toxic gases. However if the mask is for a particular use (such as the protection from a specific toxic material in a factory), then the design can be much simpler and the cost lower.
  • The protection will wear off over time. Filters will clog up, substrates for absorption will fill up, and reactive filters will run out of reactive substance. This means that the user only has protection for so long, and then they must either replace the filter device in the mask, or use a new mask.

History and development of the gas mask

Contrary to some modern day opinion, there is no single inventor of the "gas mask". In fact, there were patents for such devices as early as 1887. A first gas mask to be used by miners was introduced by Alexander von Humboldt already in 1799, when he worked as a mining engineer in Prussia.

Early gas mask designed by A. von Humboldt in 1799 for underground mining
Enlarge
Early gas mask designed by A. von Humboldt in 1799 for underground mining

In the early days of World War I, the Canadian Army made field expedient gas masks to protect themselves from the deadly chlorine gas used by the Germans by urinating on rags and holding them to their faces.

One such design began as a "Safety Hood and Smoke Protector" invented by African American inventor, Garrett A. Morgan in 1912, and patented in 1914. It was a simple device, consisting of a cotton hood with two hoses which hung down to the floor, allowing the wearer to breathe the safer air found there. Morgan won acclaim for his device when in 1916 he, his brother, and two other volunteers used his device to rescue numerous men from the gas and smoke-filled tunnels beneath Lake Erie in the Cleveland Waterworks.

Dr. Cluny MacPherson of The Royal Newfoundland Regiment, while serving in Gallipoli in 1915, where he acted as an advisor on poisonous gas, used a helmet taken from a captured prisoner to fashion a canvas hood with transparent eyepieces that was treated with chlorine-absorbing chemicals.

Gas masks development since has mirrored the development of chemical agents in warfare, filling the need to protect against ever more deadly threats, biological weapons, and radioactive dust in the nuclear era. However, where agents that cause harm through contact or penetration of the skin occurs, such as blister agent or nerve agent, a gas mask alone is not sufficient protection, and full protective clothing must be worn in addition, to protect contact from the atmosphere. For reasons of civil defense and personal protection, individuals often purchase gas masks in the belief that they prevent against the harmful effects of an attack with nuclear, biological, or chemical (NBC) agents; this is not the case, as gas masks protect only against respiratory absorption. Whilst most military gas masks are designed to be capable of protection against spectrum of NBC agents, they can be coupled with filter canisters that are proof against those agents (heavier) or just against riot control agents and smoke (lighter, and often used for training purposes); likewise there are lightweight masks solely for use in riot control agents and not for NBC situations.

Although thorough training and the availability of gas masks and other protective equipment can render the casualty-causing effects of an attack by chemical agents nullified, troops who are forced to operate in full protective gear are less efficient in completing their given tasks, tire easily, and may be affected psychologically by the threat of attack by these weapons. During the Cold War era, it was seen as inevitable that there would be a constant NBC threat on the battlefield, and thus troops needed protection in which they could remain fully functional; thus protective gear, and especially gas masks have evolved to incorporate welcomed innovations in terms of increasing user-comfort, and in compatibility with other equipment (from drinking devices to artificial respiration tubes, to communications systems etc). The gas mask has thus now arrived at a 'fourth generation' of development.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 6:31pm
Originally posted by aurora aurora wrote:

"masks are for the sick,to reduce  viral spreading,they are not for protection."
This is a joke, right?
 
Relative to us and the Avian Flu, there are TWO types of masks:
 
Those that keep the germs IN the PERSON
 
Thost that keep the germs OUT of the PERSON.
 
A surgeon wears a mask not to avoid getting something from the patient, but to avoid infecting the patient.  These are the cheap "surgical masks" and they are pretty effective at keeping airborne infectious particles inside the wearer for a short period of time.
 
The "N95" or better masks, right up to all those rubber masks, are designed to keep the infectious particles out, for varying periods of time. 
 
That's why you can say that masks are for the sick, not the healthy.  It depends on the mask and the application.
 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 6:34pm


"Face masks offer the best protection in the fight against SARS,
reveals a new hospital-based study from Hong Kong.


Wearing a mask can give a person dealing with SARS patients in hospital
up to 13 times more protection compared with not wearing one, says
Wing Hong Seto, study lead and chief microbiologist at the Queen Mary
Hospital in Hong Kong."

http://www.newscientist.com/article.ns?id=dn3692

    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 6:37pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gricha56 Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 6:41pm
Originally posted by aurora aurora wrote:

This is the most distrubing thing that I've read in a very long time.

Please go back and read it again.

Does anyone think that it's a good idea for policy makers to even think of this as a source of  info.....


Some are scouring medical histories, original source material from past disease outbreaks and even"historical fiction looking for clues about how effective measures like the wearing of cloth masks across the face were during earlier outbreaks of infectious diseases.

"I find it very useful, not as a case control study, but as a historical reference point to study some of the original records from the various pandemic experiences and see: What did societies do?" Cetron said."


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 6:42pm

No, dear, I’m not asking how a respirator works – I just bought four North Half Masks.


What I was asking is why are you saying that a N95 isn't for protection. It's obviously not as adequate as a full mask or half mask or even P95, but it's better than a surgical mask and certainly better than nothing.

 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote daddog36 Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 7:01pm
I got my n95 masks and nobody is going to tell me not to wear mine.
daddog36
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gricha56 Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 7:01pm
I think it is a good idea for policy makers to consider fiction during sessions that are brainstorming in nature.  There are many valid ideas that might be considered better suited to science fiction than policy formulation.  But we seem to have a situation that calls for thinking outside of the box.  Or does it?  Perhaps we need to apply some basic infection control techniques, such as religious handwashing and insisting that PATIENTS wear masks  ( to control the spread of droplets containing viruses )  and that staff wear some form of mask  to furthur reduce transmission of the illness.  The goal would be not to protect an individual ( which is our goal ) but to reduce the number of infections and reduce morbidity.  The only thing that will insure your safety as an individual is to live in a bubble.  That level of security is not achievable.  Even the N-95 mask has serious flaws as a respirator and will not provide you absolute protection.    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 7:22pm
Originally posted by gricha56 gricha56 wrote:

That level of security is not achievable.  Even the N-95 mask has serious flaws as a respirator and will not provide you absolute protection.    



The only two sure things in life are death and taxes. I can't prevent these things, but sure as heck I'm going to try and delay them.

If I'm going to gamble, I'm going to play the game where the house does not have the advantage and I'll use a mask. Being ignorant gives the house the advantage. My 2-cents.



    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mtn. Man Quote  Post ReplyReply Direct Link To This Post Posted: March 21 2006 at 7:43pm
I you got'em, smoke'em.
 
If you have masks, wear'em.
 
'nuff said.
 
 
Business is great, People are terrific, Life is wonderful!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kirby Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 5:34am
 My 2 cents...
 
 In the same thought as Bannor said, the surgical masks are intended for the sick person, the respirator mask are intended for the care giver. 
 
Seasonal influenza guidelines call for a surgical mask when withiin 3 feet of the sick person if the sick person cannot tolerate a mask.  Normal flu virus is heavy and when expelled, goes about 3 feet and falls to the surface.  Surgical masks filter only large particles and are suitable for this.
 
Airborne particles are light and can float high, travel distances and hang for long periods of time and easily inhaled.  TB is a good example of another airborne illness.  The guidelines for TB is to put a surgical mask on the patient.  It stops the bacteria (TB is not a virus) at the point of exhalation or from the mouth/nose when sneezing/coughing if the mask is worn by the sick person.  However; once the bacteria is out into the enclosed area like the room, the care giver must wear a more protective filtered mask to filter out the bacteria before they inhale it. 
 
Problem is that the person who is SUPPOSED to be wearing the SURGICAL mask is generally TOO sick to tolerate a mask or too non-compliant to use it properly, thus we ALL need to assume the bacteria (in the case of AI, virus) is there and wear the N95 mask.
 
IMHO, the filks deciding to order 50 million sugical masks should be scrapping that order and adding another 50 million N95 masks which can double as a more efficient surgical mask (tighter fit, less gaping, more secure than tie-on masks) when not fit-tested and as a respirator mask when it has been fit-tested.  But then we are talking a few more pennies and that makes a difference.....
 
Perhaps the 50 million SURGICAL masks are for the anticipated 50 million they anticipate DYING so it LOOKS like they made an effort??
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RicheeRich Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 6:11am
My 3 cents:
 
-- Buy the best particle respirator masks you can for yourself and your family
 
-- Buy lots of cheap ones for sharing with people who aren't prepping
 
-- If buying surgical masks will make you feel better, then have at it.
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kirby Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 6:22am
 Great advice.
 
 And don't forget the tuna...
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 6:53am
I do not think a patient with severe bilateral pneumonia who is potentially bleeding from the nose and coughing up blood will be able to keep any type of mask on.  People with lung problems have trouble enough getting air into their lungs and are weak.  These patients will also be running fevers and masks are hot and uncomfortable to use for long periods of time.  Patients will take those masks off as fast as they can so they can breathe easier.  My 2 cents.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 7:59am

Originally posted by Sniffles Sniffles wrote:

I do not think a patient with severe bilateral pneumonia who is potentially bleeding from the nose and coughing up blood will be able to keep any type of mask on.  People with lung problems have trouble enough getting air into their lungs and are weak.  These patients will also be running fevers and masks are hot and uncomfortable to use for long periods of time.  Patients will take those masks off as fast as they can so they can breathe easier.  My 2 cents.

    
It's difficult to anticipate how the different forms of the H5N1 virus will effect people and how individuals will react. There is no harm in having an extra surgical mask around in case the patient can wear one and help protect the caregiver.



    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 8:10am

Rick,  the problem will be that it will only take one patient to refuse or to be unable to wear a mask for the virus to spread.  Patients will also need to eat and cannot be moved to another isolated location in order to take off the mask to eat.  In my personal opinion, I do not think having patients wearing masks would be a feasible option to reduce the spread of the virus.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Fiddlerdave Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 10:13am
Wearing a cheaper, lighter surgical maskwould have one large potential benefit - it would keep you from touching the mucous membranes of your nose, and your mouth with your hands. Plus, whatever blocking is provided of water droplets (which carry the virus) would make a surgical mask WAY better than nothing, and 13 times better protection doesn't sound unreasonable as an estimate.
 
Having worn fitted respirators for workdays in mines, I would be concerned about my own complance over time for wearing a more cumbersome fitted mask.  And the lower price and convenience means you might wear it more often in lower risk situations when the $5 N95 would seem like too much. Have both!
Dave
"Ask not for whom the bell tolls, it tolls for us"!
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