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.
