A friend of mine made a very convincing case on LessWrong for widespread usage of high quality masks. I am reposting here because we expect greater knowledge of affecting change through public health campaigns etc.:
“Surgical masks do not form an airtight seal to the face and thus can’t reliably prevent transmission. Achieving a tight fit with FFP masks is tricky and at least requires some practice. A recent post on LessWrong suggested the use of reusable masks with replaceable filters and body made out of silicone...”
“These masks (also sometimes called respirators) are available in different sizes and can be equipped with filters of N99 / P3 standard. Safe usage should be much easier to achieve than with FFP masks due to the mask body having a flexible silicone edge that can form a tight seal with the face. [...] They are more expensive than the other mask types (~50$), but can be easily mass-produced using injection molding. Thus, widespread use of such masks seems highly desirable and might play a big part in reducing effective transmission rates without requiring severe social-distancing measures. Compared to the economic costs of these measures, the cost of providing these masks to everyone, at least in industrialized countries, seems to be negligible. ”
Call to action
“Given the plausibility and potential benefit of the idea described above, it is urgent that we take action to promote it or figure out if it is wrong. I strongly encourage the readers of this post to:
Share the idea widely and try to convince influential people.
Buy a mask for yourself, friends, and family; wear them when you’re in public (or generally close to people that you don’t live with) to protect yourself and others and increase social acceptance.
Use 3D printers and share potential designs; distribute self-made masks to people in need of protective equipment.
Reach out to groups which are at high risk of infections and with an interest in protecting themselves (e.g. nurses in nursing homes).
Suggest further ideas and point out potential problems in the comments.”
I agree with the approach of individuals controlling spread through cheap effective masks. If the portal of entry and exit of this virus is the mouth, nose and eyes, (fecal is debateable) then if everyone contained transmission through these openings, the pandemic would be over.
There is a lot of talk about vaccines and treatments and seclusion, but these are complex, prone to failure, and have very clear negative/unintended consequences.
Effective masks are simple, can be implemented rapidly, confer benefits at the margin, and the negative consequences are harder to see, although certainly worth considering (ie- making it harder for healthcare workers).
Therefore, we should look hard for cheap effective masks, or demonstrate why it’s a bad idea.
I also agree that the seal is important as well as reusability.
My hospital uses full face snorkel masks with N-99 filter, though this is extremely uncomfortable for significant periods of time and difficult to talk. These masks exist in large affordable quantities on Amazon/Walmart. I’m working on making adjustments to this for comfort, but not making a lot of progress. https://www.pneumask.org/
The benefit appears to be that it covers the eyes as well as the mouth nose, but the cost of comfort is not worth it long term.
Another challenge is fashion. It just feels weird to wear an intense-looking mask in public. It may be worthwhile to spend some time pushing on this area, especially because there is some stigma to not wearing a mask at all.
I appreciate you coming up with innovative ideas to stop C19, but I strongly downvoted this for the following reasons:
1. See Greg Lewis interview on the 80k podcast (https://80000hours.org/podcast/episodes/greg-lewis-covid-19-global-catastrophic-biological-risks/) especially the last 25 mins on EA community mistakes on the c19 response (he mentions that facemasks in particular can actually be net negative—I realize this is slightly different, yet still applies to this post).
2. especially here you have a direct call to action to spread this aggressively on social media.
3. There does seem to be a cost-effectiveness analysis and so we don’t know whether this is worth anyone’s time.
But I think it’s important for people to come up with innovative ideas. I think what would be better is to send this directly to junior people in this field (say junior authors of this paper: https://www.cam.ac.uk/research/news/study-identifies-275-ways-to-reduce-spread-of-coronavirus-following-lockdown and ask them whether this might be something interesting—the ideas being that they’re in a better position to judge whether it’s really effective policy and worth more senior people’s currently very precious time and pass it on to them.
I didn’t vote either way, but I’m sympathetic to Hauke’s view because I think some EAs are distracted by COVID-19 stuff that they don’t have a lot of expertise right now when they could be doing higher impact work.
(There are also some EAs who should be working on COVOD-19! I’m just not sure what the balance is.)
EDIT: Okay, if I’m honest, it’s because I keep getting distracted by COVID-19 volunteer efforts when I would have more impact focusing on my job.
80000 Hours says the ~4% with greatest comparative advantage should work on COVID-19.
I think the idea of effective mask use has withstood sufficient criticism to warrant spreading aggressively, both to the public as well as experts in the field. It may be a mistake, but compared to no mask at all (risk of infection, barriers to reentering society) it is hard to see it being a significant mistake. The potential upside is significant. We may have a relatively cheap and safe countermeasure within reach.
Point 2 is fair, but do note that I did post this under question, so some degree of uncertainty is implied.
Point 3 seems like addressing a standard that is at the very least not consistently applied. I went back through all question posts of the last 6 months; this seems to be fairly similar in form to this question and does not contain a cost-benefit analysis either. And as already mentioned, it is still part of the question category.
Hauke, have you written up a postmortem somewhere that I can find? Here’s one by David Manheim if you happen to need a template.
(Retracted because I think I could’ve conveyed this in a nicer manner)
I’m sorry if I’m being ignorant because I haven’t followed C-19 very closely recently, but can you point out what you take offense with?
1) I was aware of this podcast, and actually contemplated not posting because the superficial similarity between the topics might be a problem. First of all Lewis’ criticism is not just slightly different, it’s all about EA’s discussion of cloth masks. About medical masks, which this post is about, he specifically says “medical masks are pretty good for the general population which I’ll just about lean in favor of, although all of these things are uncertain.”. Furthermore I am uncertain whether one very recent expert’s opinion should promote a huge shift in EA’s consensus on this topic.
I see your point, yet still think the central argument and the other points I made still stand. I also think there are more than superficial similarities between what you suggest and what Greg criticizes, but not because both proposals are about masks, but rather because both proposals are hobbyists ideas for an intervention of dubious effectiveness.
I agree with Hauke, as well as being quite unlikely that hobbyist will have better ideas and recommendations than groups of public health experts. These specific ideas also have clear potential to cause harm through taking away PPE from those that most need it, and plausibly causing an increase in transmission through touching inside of masks and risk aversion behaviour. Even ideas that would have small expected EV in transmission, have the potential to cause harm overall in expectation as they could diminish trust of future public health pronouncements.
Well, when comparing a typical price for these masks (was ~50$, nowadays they are mostly sold out) times number of people with the damage to the economy caused by lockdowns and social distancing, you don’t relly need a calculator, do you? :)
I’ve also pointed out that they can be mass-produced, so distributing mask to everyone, at least in industrialized countries, should obviously be cost-effective.
I would be really curious to know how a mask like this could have a negative effect. Risk compensation should obviously considered, but otherwise I’m coming up blank.
“I would be really curious to know how a mask like this could have a negative effect. Risk compensation should obviously considered, but otherwise I’m coming up blank.”
I’m pretty sure that’s exactly what a whole bunch of rationalists with no qualifications in epidemiology were saying about cloth masks before the Greg Lewis interview too...
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