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Online Discussion: Tracking new emerging diseases and the next pandemic.

The mask debate

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"I find it very useful, not as a case control study, but as a historical reference point to study some of the original records from the various pandemic experiences and see: What did societies do?"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