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No time for vanity, face masks save lives

The U.S. Federal, State, and/or Local governments should quickly pass laws requiring everyone to wear face masks in all public locations where there is risk of spreading the COVID-19 virus. I suggest these laws be in force immediately for all counties that have community spread of this virus.

Officials have been stating that masks do not work very well, in order to preserve masks for the healthcare workers. Healthcare workers should have priority. However, it is not reasonable to suggest that face masks do not help. If face masks do not help, why should we even worry about whether healthcare workers have masks?

Many officials have said that face masks are more effective in preventing the one wearing the mask from spreading the disease. I think the use by healthcare workers proves that masks are useful in both directions. But, even if it only works in one direction, it still works. With COVID-19, people are spreading the disease before they know they have the disease. If everyone wears a mask in public, then the masks will prevent the spread of the disease, because all those who have the disease will be wearing masks.

Consider Japan: On Jan. 31, 2020, Japan reported 14 cases and the U.S. reported 6 cases. At the time of this writing on March 28, 2020, Japan is reporting 1,499 cases and the U.S. is reporting 118,592 cases. The U.S. started this period with 43% of the cases that Japan had and ended with 7911% of the cases that Japan had. The increase in the U.S. was 185 times greater than the increase in Japan over this period. So, the measures taken by Japan reduced the amount of cases by 99.5% in those 57 days.

My wife and I happened to be vacationing in Japan visiting our son on Jan. 31, 2020. We saw that over 90% of the Japanese were wearing masks in public places. Normally, about 10% of Japanese wear masks in public, mainly those who are sick. Since they normally use masks anyway, there is no shortage of masks in Japan.

Over these 57 days, the average daily growth rate was 8.5% for Japan and 19.0% for the U.S. The most obvious reason for the difference is because almost all the Japanese were wearing masks. There are other factors. Japan is far more crowded that the U.S., which makes it worse for them. After January 31, Japan received far more visitors from China than the U.S. did, which seeded more of the virus. In Japan’s favor, they tend to be more conscientious of others and have a reputation for better hygiene.

The percentages of unreported cases are also probably different in the two countries on the two dates. The numbers are not exact, but the conclusion is overwhelming. The fact that almost all Japanese wore masks in public is probably the main reason that their growth rate was about half of what it was in the U.S. This resulted in a 99.5% reduction in cases over 57 days.

Keep in mind that COVID-19 does its reproduction in an average of around 14 days after infection. I will refer to those cases, (14 days or less since infection) as current cases. The virus has 14 days to replace itself.

Therefore, the daily break-even point for the virus is 100% divided by 14 days = 7%. You could also think of this 7% as the daily virus loss rate, since it needs that much growth just to make up for its losses. If we can get the current case spread rate below 7%, the number of current cases will decline over time.

This shows a little more why the outcomes were so different in Japan from the U.S. The U.S. daily growth rate was 12% above the virus loss rate, while the Japanese daily growth was only 1.5% ahead of the virus loss rate. The spread above break-even was eight times worse in the U.S.

Regarding the spread of the virus offspring, it is a two-step process. First, it will need to get away from the infected person (through or around their mask) into the air or surfaces in a public area. Then, it must get from the public area into the body of another person (through or around their mask).

To do some calculations, we could assume that the other positive and negative factors that differ between the U.S. and Japan offset one another, so the masks account for the 55% reduction in the rate of spread in Japan. Since 45% of the virus made it through and it is a two-step process, each side of the process would be stopping 100% minus the square root of 45%. 100% minus 67% equals 33%.

This means that the 99.5% reduction in cases in Japan was achieved with masks that were only 33% effective on each side of the spread process. This shows that even a small rate of mask effectiveness will have a huge effect on the spread of the disease.

This was done with around 90% of the Japanese wearing masks. If 100% wear masks, the spread might have been reduced by 60% instead of 55%, leading to a daily spread rate of 7.6% instead of 8.5%. 7.6% would be barely above 7% break-even point for the virus.

Availability of face masks? Face masks are rapidly being manufactured and should be available for everyone in a few weeks. In the meantime, people can make their own face masks. There are instructions on YouTube how to make a ninja face mask out of an ordinary T shirt. You simply pull the T shirt over your head and stop when the neckline is above your nose. Then, pull the back up over your head and around your forehead and tie the arms behind your neck. I put on one of these on and it was much more comfortable than a regular face mask, which tend to be itchy. Not only is it less itchy, but it covers most of your face, so you don’t have to worry so much about touching your face. Bandanas could be also used. We could cut up older clothes to make masks.

This is no time for a fashion show. We are at war with this virus. However, we could have a lot of fun with this. We could laugh at each other’s home-made masks in a variety of shapes and colors. Over time, the quality of the available masks can be improved, making this effort even more effective.

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Mark Beeksma, Koloa resident, is not a certified medical professional and this is his opinion. Please contact health care experts for further information.

16 Comments
  1. A Sewer Of Masks March 31, 2020 5:28 am Reply

    Dearest Mark Beesma. I understand you are trying to help. You were doing good for some of your letter with all of the pretty numbers. Unfortunately there are many holes in your letter. The disclaimer down below is this is your opinion. That you are not a medical doctor. That is painfully obvious. I am not knocking you for the overall tone of your letter, which is good. I am going to knock you for suggesting that a tshirt over your head is an effective mask. Sorry, that is incorrect. It is also dangerous, and will do zero to protect anyone. I am making masks now, as we speak, so let me enlighten you, since you are not a sewer either.
    For a mask to be effective, it needs a filter. There are two sorts of material that can be substituted safely, and that is stiff interfacing, and felt, double layered. A properly sewn mask is made of two or three layers of tightly woven cotton, such as the sheets you may have lying around of Egyptian cotton. The mask must be accordion pleated with a pocket, to place in the filter, aforementioned. The mask must be worn properly, and removed and disposed of properly. The mask needs a sewn in nose-clip, which can be made of various materials, the best being a metal file clip. If the mask is to be reused, it must be made of two ties that do not go over the ears, but tie behind the head, above the ears and below them. This is so it can withstand high heat in the water and the dryer in order to kill the virus. Elastic won’t and will melt. Hospitals are requiring this of sewers making them for this reason.You can use ribbon. Be sure to burn the ends. To sew masks for hospitals, they have certain guidelines. Mark, you may be better suited to trying to assemble the face shields, instead. The only place you should be getting design advice for face-masks, is at the CDC official website. There are downloadable PDF’s for both the shields, and the face-masks. The best material to make the face-masks out of, is HEPA filter bags, the kind used in HEPA vacuum cleaners that use them. This is actually recommended by the CDC. Please do not encourage people to wear tshirts over their faces, as a mask. THis is zero effective. Although tshirts can be used as the outer layer, or the inner pocket, tightly woven cotton must be used as the liner, and it needs a filter. Surgical masks are not the best to save people from infection, or spreading it. N95 Masks are. These are the ones to sew using HEPA filter bags. The best fitted masks, are round. You can also use coffee filers, or stiff interfacing, as I mentioned before. Also, our nurses and doctors are reusing masks, because there is a severe shortage in this country of medical supplies for people on the front lines. I am surprised you are suggesting that our medical personal should do without.

    The real situation is, people want to move around like before, without restrictions. Using PPE, should be done absolutely by cashiers, doctors, nurses, people on the front lines handling money, or dealing with large groups of people one after the other. If social distancing is followed, and front line people are wearing PPE, and , dare i say it oh my goodness if you just stay home for petes sake, you wont need a mask and you can save it for a nurse or a doctor who doesn’t have to die because you were out hoarding all the masks.
    I understand you meant well with this letter, and i applaud you, but numbers at this time, and percentages and speculation are really not worth it at this point. If Kauai people are not willing to stay home and social distance, a surgical mask is not going to help. Surgical masks are not the preferred mask for healthcare workers. It is just what they are using because there is a shortage of N96 masks. There is a shortage because people hoarded them.
    If you really want to help, Mark then contribute to the sewers who are making masks. These masks should be used by the general public saving the other masks for the doctors and nurses. This also, is my opinion and I am not a medical professional, but I am a sewer on the front lines, and I know what works because we have been educated by the CDC and the medical community to make effective masks.

    Thanks for playing. Now, stay home, keep 6 feet away from everyone and wash your hands.


  2. A Sewer Of Masks March 31, 2020 5:33 am Reply

    I Meant N95 not N96. Sheesh. Its early and I need coffee obviously.


    1. Mark Beeksma March 31, 2020 5:19 pm Reply

      Sewer, You did not understand my points. The Japanese are using loosely fitting surgical masks, which the math indicates only stops about 33% of the virus. Yet, stopping 33% on side and 33% on the other side means that most of the virus will be stopped. Hence, after 57 days, the Japanese have 185 times fewer cases than if they had grown the same speed as us.
      Surgical masks should be saved for surgeons, that is, just doing surgery on a non-Covid-19 patient. We can make our own masks or use paint masks or something else. Any healthcare worker that is working around people who have Covid-19 or might have it, should definitely have N-95 masks. They need at least 99% protection, or whatever those N-95 masks offer. No healthcare worker should be sent in with a 33% effective mask. But if everyone else wears 33% effective masks, we can have 185 times fewer cases, like the Japanese did.


      1. Mark Beeksma April 1, 2020 5:59 pm Reply

        I found out later that N-95 masks refer to the fact that they are supposed to stop 95% of what they are trying to stop. Frankly, I think that is rather low, for a medical worker who is working among Covid-19 patients. We should definitely try to get them N-99 masks if they want them. I guess N-99 masks are a little harder to breathe through, so maybe they don’t want those masks.

        As properly noted, I am not an M.D. However, I am a math guy. Much of the implications of virology are mathematical. Also, innovations often come from people outside the industry, because they can think outside the box, because their mind has not been boxed in too much of what the “experts” are saying. I could give you many examples of innovations by outsiders. But, my article here is not much of an innovation, because the average Japanese child already knew it and much of the Western world is coming to their senses, as we speak.


  3. Kurtis Taka March 31, 2020 5:40 am Reply

    Mark Beeksma, thank you. This is such an awesome piece. I will definitely get a mask the next time I see one.


  4. Sam Noama March 31, 2020 5:40 am Reply

    Hey Mark, like the poster above said, yeah you mean well. But you are a little off the mark. There is an article today, at CNN. It is a great article. Here is the byline:

    “WHO stands by recommendation to not wear masks if you are not sick or not caring for someone who is sick”

    Copy and paste that into any browser, and the link will come up. Know you mean well, there buddy. But I suggest you listen to the guidelines set forth by the CDC, and the WHO. A tshirt wrapped around your head? Nah, seriously, nah. The sewer above has good ideas, though. Those masks sound great. Where can I get one made for me?


  5. Bees Knees March 31, 2020 5:43 am Reply

    Hey Mark, like the poster above said, yeah you mean well. But you are a little off the mark. There is an article today, at CNN. It is a great article. Here is the byline:

    “WHO stands by recommendation to not wear masks if you are not sick or not caring for someone who is sick”

    Copy and paste that into any browser, and the link will come up. Know you mean well, there buddy. But I suggest you listen to the guidelines set forth by the CDC, and the WHO. A tshirt wrapped around your head? Nah, seriously, nah. The sewer above has good ideas, though. Those masks sound great. Where can I get one made for me?


  6. Everythingisawesome March 31, 2020 5:53 am Reply

    What about the mucus membranes in your eyes being exposed? Should we all wear safety glasses, too? Or would that be where we draw the line? Seems to imply that the masks work better at preventing the virus from leaving the personal space of the infected person than preventing the virus from reaching a new host. Are we going to be required to wear these for the rest of our lives, or until a vaccine is developed, as the death rate from common flu is on par with this virus?
    Don’t get me started on burkas….


  7. Mark Beeksma March 31, 2020 7:45 am Reply

    Having a weak mask is far better than no mask at all. But I hope people understand that a weak masks is no excuse to go out when not necessary.


  8. Michael Mann March 31, 2020 11:17 am Reply

    The World Health Organization actually says there is no evidence to suggest wearing masks when you aren’t sick helps, and that it might actually do just the opposite.

    But what they hey…if the “president” can make up rules, we all can.


    1. Mark Beeksma March 31, 2020 5:07 pm Reply

      The WHO says that only those caring for the sick should wear masks. Then, the WHO officials wear masks for their speaking engagements. Seriously? I addressed that question in my article. People are spreading it when they don’t know they have it. Even if a mask only works in one direction, everyone should still a mask because it will stop the spread.

      No evidence? I just presented one huge piece of evidence with the nation of Japan, whose climate runs from cold to warm, like ours does. Dr. Evslin offered another huge piece of evidence with the Czech Republic. You cannot get much better evidence than that.

      Michael, I know you like to pick on me, but this is not the time. Thousands of lives are at stake.


    2. Mark Beeksma March 31, 2020 6:11 pm Reply

      Here is a note my friend sent me today. “From Wall Street Journal today: U.S. public-health authorities are reviewing recommendations for wearing face masks and a wave of European governments have ordered citizens to use them outside the home, signaling a shift among Western governments on a contentious issue in the coronavirus pandemic. Much of Central Europe is now following the example set by China, Taiwan and South Korea. On Monday, Austria mandated its citizens wear masks when outside the home, after the Czech, Slovak and Bosnian governments issued similar orders.”
      The world is catching on to the truth. Let’s not be that last place on earth that still believes the lies of the WHO.


  9. Jill Friedman March 31, 2020 2:44 pm Reply

    Michael Mann and others, people are contagious with no signs or symptoms. So waiting until we’re “sick” before wearing a mask or isolating at home is poor advice, regardless of the agency being quoted. Ultimately, we each have to exercise common sense and act as if we’re all infected and contagious for at least a month.


  10. Mark Beeksma April 1, 2020 9:09 pm Reply

    I have a question here, in case there are any experts checking this. If so, please comment. What I have been hearing is that Covid-19 is a novel coronavirus that no one has any immunity to. So, if you are in good health, take vitamin C, drink lots of water, get good sleep, etc.; this will not prevent you from getting Covid-19. Obviously, all those good things will help you to survive Covid-19, but it will not prevent you from getting the disease, because your body cannot identify it as a disease. If this is true, it is one more reason to wear a mask. You cannot depend on your good health to prevent you from catching this disease. You should be as healthy as possible – it will help you survive. But to stop the disease, you must be like Bill Clinton and never inhale it. To prevent inhalation; stay at home, wear a mask, etc.


  11. Jenny Mansheim April 2, 2020 11:35 pm Reply

    i am wanting to sew masks for hospitals. what kind of material do i buy and where do i buy the hepa filters for inside the masks? Also what pattern is needed the most by hospitals?


  12. VB May 17, 2020 1:22 pm Reply

    They refer to them as mouth masks. And they do work. They wouldn’t wear them if they didn’t work. Duh.


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