tons of horseshit regarding face-masks

Pentagon gives a million masks to IDF for coronavirus use
JPost, Apr 8 2020

A plane carrying over a million surgical masks for the IDF landed in Ben-Gurion airport Tuesday night, in an operation run by the Israeli Department of Defense’s Delegation of Procurement. Limor Kolishevsky, head of the New York Purchasing and Logistics Division said:

In the past two weeks we have purchased and flown to Israel tens of thousands of swabs, masks, protective suits for medical staff and more. A million masks, procured in China, were quickly flown to Israel with the intention that the IDF will be using them within the next few days.

The New York delegation, part of Israel’s national procurement effort for medical equipment to fight the coronavirus, works with a with a wide range of international suppliers to purchase essential medical equipment for the IDF, according to Kolishevsky. The IDF has been playing a central role in the fight against coronavirus in Israel. According to an IDF spox, within the last week, soldiers have packed approximately 1,610,000 food and holiday food packages for Israelis; distributed food packages to 118,635 citizens; and distributed a further 15,000 relief boxes to residents of Bnei Brak, which included dry goods, fruit, vegetables and toilet paper. 18,000 IDF commanders and soldiers are involved in the efforts against the coronavirus in Israel, continuing to assist civilians as required. One of the ways in which they have been helping has been by turning their hands to running residential complexes under the restrictions put in place by the government to slow the rate of the spread of infection. So far, soldiers have been helping at 192 housing groups across the country, and are taking on the management of retirement homes as the residents are particularly vulnerable to the disease. In addition, 12 hotels have been opened, of which eight are for the care of patients with COVID-19, and four for keeping people in isolation. Four of the hotels are for the orthodox population, with 1,044 patients drawn from that group, and a further 578 people from the orthodox community are in isolation. 10,169 blood donations have also been collected from members of the IDF.

Hospitals say feds are seizing masks and other coronavirus supplies without a word
Noam Levey, LA Times, Apr 7 2020

Although Trump has directed states and hospitals to secure what supplies they can, the federal government is quietly seizing orders, leaving medical providers across the country in the dark about where the material is going and how they can get what they need to deal with the coronavirus pandemic. Hospital and clinic officials in seven states described the seizures in interviews over the past week. The FEMA is not publicly reporting the acquisitions, despite the outlay of millions of dollars of taxpayer money, nor has the administration detailed how it decides which supplies to seize and where to reroute them. Boxtops who’ve had materials seized also say they’ve received no guidance from the government about how or if they will get access to the supplies they ordered. That has stoked concerns about how public funds are being spent and whether the Trump administration is fairly distributing scarce medical supplies. Dr John Hick, an emergency physician at Hennepin Healthcare in Minnesota who has helped develop national emergency preparedness standards through the National Academies of Sciences, Engineering and Medicine, said:

In order to have confidence in the distribution system, to know that it is being done in an equitable manner, you have to have transparency.

The medical leaders on the front lines of the fight to control the coronavirus and keep patients alive say they are grasping for explanations. In Florida, a large medical system saw an order for thermometers taken away. And boxtops at a system in Massachusetts were unable to determine where its order of masks went. A boxtop said:

Are they stockpiling this stuff? Are they distributing it? We don’t know. And are we going to ever get any of it back if we need supplies? It would be nice to know these things. We can’t get answers.

PeaceHealth, a 10-hospital system in Washington, Oregon and Alaska, had a shipment of testing supplies seized recently. Richard DeCarlo, the system’s chief operating officer, said:

It’s incredibly frustrating. We had put wheels in motion with testing and protective equipment to allow us to secure and protect our staff and our patients. When testing went off the table, we had to come up with a whole new plan.

Although PeaceHealth doesn’t have hospitals in the Seattle area, where the first domestic coronavirus outbreak occurred, the system has had a steady stream of potentially infected patients who require testing and care by doctors and nurse in full protective equipment. Trump and Kushner have insisted that the federal government is using a data-driven approach to procure supplies and direct them where they are most needed. In response to questions from the LA Times, a FEMA representative said:

FEMA, working with the DHHS and the DoD, has developed a system for identifying needed supplies from vendors and distributing them equitably, which factors in the populations of states and major metropolitan areas and the severity of the coronavirus outbreak in various locales. High-transmission areas were prioritized, and allocations were based on population, not on quantities requested.

FEMA has refused to provide any details about how these determinations are made, or why it is choosing to seize some supply orders and not others. Admin boxtops also will not say what supplies are going to what states. Using the Defense Production Act, which allows the president to compel the production of vital equipment in a national emergency, Trump last month ordered General Motors to produce ventilators to address shortfalls at hospitals. The law also empowers federal agencies to place orders for critical materials and to see that those get priority over orders from private companies or state and local governments. Experts say judicious use of this authority could help bring order to the medical supply market by routing critical material, such as ventilators, masks and other PPE, from suppliers to the federal government and then to areas of greatest need, such as New York. Yet there is little indication that federal boxtops are controlling the market, as hospitals, doctors and others report paying exorbitant prices or resorting to unorthodox maneuvers to get what they need. Hospital and health officials describe an opaque process in which federal officials sweep in without warning to expropriate supplies. Jose Camacho, who heads the Texas Assn. of Community Health Centers, said his group was trying to purchase a small order of just 20,000 masks when his supplier reported that the order had been taken. Camacho was flabbergasted. Several of his member clinics, which as primary care centers are supposed to alleviate pressure on overburdened hospitals, are struggling to stay open amid woeful shortages of protective equipment. Noting Trump’s repeated admonition that states and local health systems cannot rely on Washington for supplies, Camacho said:

Everyone says you are supposed to be on your own. Then to have this happen, you just sit there wondering what else you can do. You can’t fight the federal government.

Israeli govt makes masks in public compulsory, tightens travel restrictions
RT Newsline, Apr 7 2020

Israeli government issued orders on Tuesday making the wearing of masks in public compulsory. Trying to stem the spread of the coronavirus, it also approved a timeline for tightened travel restrictions for the Passover holiday, which begins on Wednesday.  PM Netanyahu has said that this year the festive dinner should be a small affair, limited to household members. Last week, the PM urged Israelis to wear masks while in public. The government says this measure will become compulsory as of Sunday. Children under the age of six, the mentally disabled or those alone in vehicles or workplaces are exempted. Masks could be homemade. From Tuesday evening until Friday morning, a ban on unnecessary out-of-town travel will be in place, effectively preventing large gatherings of family and friends. Israel has more than 9,000 confirmed cases of the coronavirus, with sixty people having died, Reuters said.

Marine Corps says Marines won’t be allowed to wear N95 or surgical masks, even if they own them
Paul Szoldra, Task & Purpose, Apr 7 2020

The Marine Corps on Monday ordered all its personnel to start wearing cloth face coverings to help prevent the spread of the novel coronavirus (COVID-19), but restricted Marines from wearing masks with higher levels of protection, such as surgical and N95 masks. In an administrative message that followed a Pentagon order to wear face coverings, the Corps directed all individuals on its property and installations to wear cloth face coverings that are “conservative in appearance, not offensive, and conform to CDC guidance.” Marines are encouraged to make their own face coverings, but are not allowed to “procure or wear” surgical masks or N95 masks, the message said, since those are “reserved for appropriate personnel.” Among the do-it-yourself masks the Corps recommends are issued balaclavas, neck gaiters, or uniform green t-shirts fashioned into face coverings. Full masks, which the message said included surgical masks, N95 respirators, ski masks, and issued gas masks, “are not authorized.” the message said:

Cloth face covers shall NOT be substituted with surgical masks or N-95 respirators. Surgical masks and N-95 respirators are personal protective equipment (PPE) and must be reserved for use in medical settings. Cloth face covers and PPE are integrated into a larger system of non-pharmaceutical interventions (NPIs) to limit transmission of infection.

The message did not include exceptions for people who may have previously purchased their own surgical or N95 masks. A Marine official told Task & Purpose the order indeed restricted Marines from wearing masks that could potentially better protect them from the virus, even if they had been purchased before the outbreak. A Marine Corps spox told Task & Purpose in an emailed statement:

The Marine Corps considers N95 masks to be prioritized for medical personnel or first responders on the front lines of the pandemic response. The guidance outlined in the MARADMIN is intended to assist with the optimization strategies of the PPE supply chain published by the CDC. To the extent practical, the Marine Corps will support these strategies. The intent is to avoid Marines attempting to procure these supplies and further interrupting the supply chain.

Surgical masks can block large-particle droplets, splashs and sprays that may contain germs from reaching the mouth and nose, according to the FDA. Even better protection comes from N95 respirators, which fit closer to the face and can block at least 95% of very small particles. Pindostan has seen a shortage in masks and other personal protective gear in the wake of the COVID-19 outbreak. FEMA has nearly exhausted its own strategic reserve to supplement states’ dwindling stockpiles of protective equipment, while the Trump administration has used the Defense Production Act to mobilize private industry to make additional masks. The Marine Corps had 78 confirmed cases of COVID-19 within its ranks as of Tuesday. There have been 2,449 total cases across the DoD, and seven deaths.

Turkey hopes to become first country to distribute free masks to entire nation
Borzou Daragahi, Independent, Apr 7 2020

Turkey has launched an ambitious programme to get free surgical masks into the hands of all the nation’s 82 million residents in an effort to combat the spread of coronavirus while allowing the country’s tattered economy to recover. This week Turkey launched a website where both citizens and official residents can register to receive five free surgical masks per week delivered by the national postal service. On Friday, Erdogan announced new rules requiring all those in workplaces or markets to wear masks. He later banned the sale of the masks amid accusations of price-gouging. Videos posted on social media showed bus drivers handing out free masks to passengers as they boarded. Turkey’s parliament in Ankara convened on Tuesday to discuss a coronavirus prisoner release law with lawmakers, journalists and council staff all wearing masks. Erdogan was quoted as saying late Monday:

We have enough mask stock and production plans for all of our citizens until the outbreak ends. As the state, we are determined to provide free masks to all our citizens.

COVID-19 has killed at least 725 people in Turkey, a death toll second only to Iran in the Middle East. At least 34,000 people have tested positive for the virus. Strong anecdotal evidence suggests three-ply surgical masks that include a layer of bonded material reduce the rate of coronavirus infection in Asian cities such as Hong Kong and Singapore. Austria ordered all shoppers to wear masks, and Morocco recently made it mandatory to wear masks in public, selling them at a subsidised rate. Turkey has shut down schools and ordered all residents over 65-years-old or under 20 to remain confined to their homes. But Erdogan has vowed to keep the wheels of production turning, and many businesses, factories and construction sites remain operating, to the chagrin of some opposition politicians who have demanded a more stringent lockdown. Erdogan said on Monday:

Every factory that can work will continue to work. Our farmers will not leave their land uncultivated.

The ban on sales of the masks potentially kills off a lucrative source of income for pharmacies and medical supply companies which have jacked up prices for the products amid unprecedented global demand. Turkey is one of the world’s leading producers of medical personal protective equipment. Erdogan has also announced the construction of two 1,000-bed hospitals to treat pandemic patients in Istanbul, the city hardest hit by the virus. Opposition figures claimed credit for both the free masks programme and the hospitals, but nonetheless praised the government for taking up the ideas. Canan Kaftancıoglu, head of the Istanbul branch of the opposition People’s Republican Party, wrote on Twitter that the country’s 13,000 to 14,000 postal delivery people weren’t enough to distribute the masks.

Vietnam donates 550,000 masks to 5 EU states to support coronavirus fight
RT Newsline, Apr 7 2020

Vietnam donated 550,000 face masks to five European countries on Tuesday to support their fight against the coronavirus. The masks, made of antimicrobial fabric, were handed to the ambassadors of France, Germany, Italy, Spain and Britain in Hanoi, the Foreign Ministry said in a statement. Vietnam has reported 245 coronavirus cases in the country, with no deaths, Reuters reports. Hanoi has also donated masks and other medical equipment to other countries, including China, Cambodia and Laos. Last week, Vietnam asked its mask producers to step up their production to make five million masks a day.

Pindostan denies hijacking Chinese medical supplies meant for Brazil
Lisandra Paraguassu, Reuters, Apr 7 2020

BRASILIA – The Pindo ambassador to Brazil on Tuesday denied reports that the Pindo government took over Chinese supplies of medical equipment that were ordered by Brazil to fight the coronavirus pandemic. Brazilian Health Minister Mandetta said last week China had ditched some Brazilian equipment orders when the Pindo government sent more than 20 cargo planes to the country to buy the same products. Local media also reported that a shipment of supplies destined for the Brazilian state of Bahia was diverted for use in Pindostan during a stopover in Miami after suppliers were offered higher prices. Ambassador Todd Chapman told reporters in a conference call:

The Pindo government did not buy or block any material destined for Brazil. Those reports are false. We have investigated this.

Chapman, who arrived in Brasilia last week, said suppliers around the world were taking advantage of the huge demand for medical equipment such as personal protective equipment, gloves and masks. Mandetta said last week Brazilian states are well stocked for now, but Brazil had to turn to several countries before it China accepted its $228m order to restock. Brazil’s education minister has also accused Chinese suppliers of profiteering on the pandemic, but later said he would apologize if China agreed to sell Brazil 1,000 ventilators. While Pindostan has rapidly become the epicenter of the global pandemic, the number of confirmed cases of the disease caused by the new coronavirus, COVID-19, in Brazil has doubled in the last six days to 12,056, with 553 related deaths. Chapman, who served as deputy head of the Pindo embassy in Brasilia from 2011-2014, said the Trump administration is considering suspending all flights to Brazil, but no decision has been taken yet. he said:

It is important to protect our country and it is important for Brazil too. We are evaluating this constantly in talks with Brazilian authorities.

Pindo airlines have drastically cut back operations in Latin America, but Chapman said there are still 16 flights a week to Brazil. Brazilian authorities last week banned entry of Pindo citizens who are not residents of Brazil.

Advice on the use of masks in the context of COVID-19
WHO, Apr 6 2020 (pdf, abridged by moi – RB)

This document provides advice on the use of masks in communities, during home care, and in health care settings in areas that have reported cases of COVID-19. Current information suggests that the two main routes of transmission of the COVID-19 virus are respiratory droplets and contact. Respiratory droplets are generated when an infected person coughs or sneezes. Any person who is in close contact (within 1 m) with someone who has respiratory symptoms (coughing, sneezing) is at risk of being exposed to potentially infective respiratory droplets. Droplets may also land on surfaces where the virus could remain viable. Thus the immediate environment of an infected individual can serve as a source of transmission (contact transmission). Current evidence suggests that most disease is transmitted by symptomatic, laboratory-confirmed cases. The incubation period for COVID-19, which is the time between exposure to the virus and symptom onset, is on average 5-6 days, but can be as long as 14 days. During this period, also known as the “pre-symptomatic” period, some infected persons can be contagious and therefore transmit the virus to others. In a small number of reports, pre-symptomatic transmission has been documented through contact-tracing efforts and enhanced investigation of clusters of confirmed cases. This is supported by data suggesting that some people can test positive for COVID-19 from 1-3 days before they develop symptoms. Thus it is possible that people infected with COVID-19 could transmit the virus before symptoms develop. Pre-symptomatic transmission still requires the virus to be spread via infectious droplets or through touching contaminated surfaces.

In this document medical masks are defined as surgical or procedure masks that are flat or pleated (some are shaped like cups); they are affixed to the head with straps. They are tested according to a set of standardized test methods that aim to balance high filtration, adequate breathability and optionally, fluid penetration resistance. Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including COVID-19. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted. The use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets. There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure. There is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19. Medical masks should be reserved for health-care workers. The use of medical masks in the community may create a false sense of security, with neglect of other essential measures such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take masks away from those in health-care who need them most, especially when masks are in short supply.

Persons with symptoms should wear a medical mask, self-isolate and seek medical advice as soon as they start to feel unwell. Symptoms can include fever, fatigue, cough, sore throat, and difficulty breathing. It is important to note that early symptoms for some people infected with COVID-19 may be very mild. Persons with symptoms should follow instructions on how to put on, take off, and dispose of medical masks, and follow all additional preventive measures, in particular, hand hygiene and maintaining physical distance from other persons. All persons should avoid groups of people and enclosed, crowded spaces; maintain physical distance of at least 1m from other persons, in particular from those with respiratory symptoms, such as coughing, sneezing; perform hand hygiene frequently; cover their nose and mouth with a bent elbow or paper tissue when coughing or sneezing, dispose of the tissue immediately after use, and perform hand hygiene; refrain from touching their mouth, nose, and eyes. In some countries masks are worn in accordance with local customs or in accordance with advice by national authorities in the context of COVID-19. In these situations, best practices should be followed about how to wear, remove and dispose of them. The wide use of masks by healthy people in the community setting is not supported by current evidence and carries uncertainties and critical risks. WHO offers the following advice to decision makers so they apply a risk-based approach. Decisions makers should consider the following:

  1. Purpose of mask use: the rationale and reason for mask use should be clear, whether it is to be used for source control (used by infected persons) or prevention of COVID-19 (used by healthy persons);
  2. Risk of exposure to the COVID-19 virus in the local context: current epidemiology about how widely the virus is circulating (clusters of cases versus community transmission), as well as local surveillance and testing capacity (contact-tracing and follow-up, ability to carry out testing).
  3. ­Whether the individual is working in close contact with public, such as community health worker or cashier;
  4. Vulnerability of the person/population to develop severe disease or be at higher risk of death, e.g. people with co-morbidities such as cardiovascular disease or diabetes mellitus, and older people;
  5. Setting in which the population lives in terms of population density, the ability to carry out physical distancing (on a crowded bus), and risk of rapid spread (closed settings, slums, camps/camp-like settings);
  6. Availability and costs of the mask, and tolerability by individuals;
  7. Type of mask: medical mask versus non-medical mask.

In addition to these factors, potential advantages of the use of mask by healthy people in the community setting include reducing potential exposure risk from infected persons during the “pre-symptomatic” period. However, the following potential risks should be carefully taken into account in any decision-making process:

  • self-contamination that can occur by touching and reusing contaminated mask;
  • depending on type of mask used, potential breathing difficulties;
  • false sense of security, leading to potentially less adherence to other preventive measures such as physical distancing and hand hygiene;
  • diversion of mask supplies and consequent shortage of mask for health-care workers;
  • diversion of resources from effective public health measures, such as hand hygiene.

WHO stresses that it is critical that medical masks and respirators be prioritized for health-care workers. The use of masks made of other materials such as cotton fabric, also known as non-medical masks, in the community setting has not been well evaluated. There is no current evidence to make a recommendation for or against their use in this setting. Decision-makers may be moving ahead with advising the use of non-medical masks. Where this is the case, the following features related to non-medical masks should be taken into consideration:

  • Numbers of layers of fabric/tissue;
  • Breathability of material used;
  • Water repellence/hydrophobic qualities;
  • Shape of mask;
  • Fit of mask.

For COVID-19 patients with mild illness, hospitalization may not be required. Persons with suspected COVID-19 or mild symptoms should self-isolate if isolation in a medical facility is not indicated or not possible; perform hand hygiene frequently; keep a distance of at least 1 m from other people; wear a medical mask as much as possible. The mask should be changed at least once daily. Avoid contaminating surfaces with saliva, phlegm or respiratory secretions. Improve airflow and ventilation in the living space by opening windows and doors as much as possible. Care-givers or those sharing living space with persons suspected of COVID-19 or with mild symptoms should perform hand hygiene frequently; keep a distance of at least 1 m from the affected person when possible; wear a medical mask when in the same room as the affected person; dispose of any material contaminated with respiratory secretions (disposable tissues) immediately after use and then perform hand hygiene. Improve airflow and ventilation in the living space by opening windows as much as possible.

Health-care workers should wear a medical mask when entering a room where patients with suspected or confirmed COVID-19 are admitted, and use a particulate respirator at least as protective as N95, EU standard FFP2 or equivalent. One study that evaluated the use of cloth masks in a health-care facility found that health-care workers using cotton cloth masks were at increased risk of infection compared with those who wore medical masks. Therefore, cotton cloth masks are not considered appropriate for health-care workers. As for other PPE items, if production of cloth masks for use in health-care settings is proposed locally in situations of shortage or stock out, a local authority should assess the proposed PPE according to specific minimum standards and technical specifications. For any type of mask, appropriate use and disposal are essential to ensure that they are effective and to avoid any increase in transmission. The following information on the correct use of masks is derived from practices in health-care settings. Place the mask carefully, ensuring it covers the mouth and nose, and tie it securely to minimize any gaps between the face and the mask. Avoid touching the mask while wearing it. Remove the mask using the appropriate technique: do not touch the front of the mask but untie it from behind. After removal or whenever a used mask is inadvertently touched, perform hand hygeine. Replace masks as soon as they become damp with a new clean dry mask. Do not re-use single-use masks. Discard single-use masks after each use and dispose of them immediately upon removal.

Jared Kushner Faces Backlash for Saying ‘Our Stockpile’ Is Not Meant to Be ‘States’ Stockpiles’
Meaghan Ellis, IJR, Apr 3 2020

White House Senior Advisor Jared Kushner is facing backlash for his remarks about the federal government’s stockpile of medical supplies. Kushner discussed during Thursday’s press conference how he has been working with FEMA to ensure supply chain management for the coronavirus response efforts. While discussing the supply chain, Kushner offered details about the federal stockpile, insisting that supply is not to be the “states stockpiles.” Kushner said:

The notion of the federal stockpile was it’s supposed to be our stockpile. It’s not supposed to be states’ stockpiles that they then use.

He went on to say that the coronavirus crisis has shed light on the leaders that are “better managers than others,” and to criticize some of the governors as he questioned if they are aware of the medical supplies they already have in their states. He said:

When you have governors saying that the federal government hasn’t given them what they need, I would encourage you to ask them, have you looked within your state to make sure you haven’t been able to find the resources?

Kushner’s stockpile remarks have drawn criticism and confusion from many Twitter users who disagree with his stance on who should be allowed to use supplies in the federal stockpile. On multiple occasions, Trump has also blamed states for supply shortages. Despite the federal government having a stockpile, Trump and Kushner both agree local health departments should look to their state officials for supplies first, not the federal government. During a previous coronavirus press briefing, Trump criticized governors, saying:

Governors are supposed to be doing a lot of this work, and they are doing a lot of this work. The Federal government is not supposed to be out there buying vast amounts of items and then shipping. You know, we’re not a shipping clerk.