Mask is your best defence while waiting for vaccine
Here’s a trick question that could save your life: What’s your first line of defence against COVID-19?
No, not the ever-elusive vaccine.
A shot in the arm is your last line of defence if it’s not coming anytime soon. The most medically effective (and cost effective) protection — right here, right now, not months from now — is staring you in the face.
Masks — more masks, better masks, double masks, for many months to come. All the more reason to clear the air about masks that filter the air of deadly viral particles.
The silence from our top health experts and political leaders is deafening — and contaminating. Our governments, so quick to give detailed instructions for building codes and precise measurements for passport photos, still can’t give us the straight goods on the best masks and best practices.
Under President Joe Biden, the U.S. government is overtaking us not only on vaccine distribution, but mask dissemination. The Atlanta-based Centers for Disease Control and Prevention announced Wednesday that double-masking can filter more than 95% of the COVID-19 virus if two people are wearing them at close quarters, protecting each other at one and the same time.
The story of masking in Canada is a tale of mixed messaging last year, followed by unmitigated neglect this year. We have fantasized about mass vaccinations in the moment, fetishized all those phantom fomites (countertop germs) and obsessed about elusive “iron rings” in nursing homes (predictably porous), while ignoring the most basic public health protection still under our control.
Scientists initially warned people off protective masks — reserving them for frontline medical workers and wrongly asserting they wouldn’t benefit the rest of us. Proven wrong, they later exhorted us to find our own masks, or improvised cloth coverings, for as long as the best N95 respirators were in short supply.
It made sense to update that advice in light of changing evidence early last year. It’s nonsense that all these months later we haven’t been told far more about how to properly mask ourselves.
I wrote over the weekend about the need to raise our game with masks. The response to my column, clamouring for more information, tells me that our governments are still not giving us the guidance we need.
Endless snarling about delayed vaccines or snarking about hapless politicians is little more than second-guessing from first to last — and leaves us no further ahead, as the Globe’s health policy columnist Andre Picard argued. Some critics are so busy chasing their tails they can’t see past the ends of their noses at the life-saving power of the mundane mask.
Some pundits worship at the altar of epidemiology, though its accuracy is closer to astrology — never quite wrong but rarely all that right to be much use. If the virus keeps changing — variants are the new variables — extrapolating is an endless guessing game.
Why have we elevated epidemiologists to a priesthood of expertise when the more verifiable and actionable information is coming from the physicists and engineers who understand fluid dynamics and vapour trails?
“Between SARS and the advent of COVID19, there were huge advances in our understanding of how aerosols behave,” Mario Possamai, a senior adviser to the Ontario government’s SARS Commission, told me. “Much of that research was done by physicists and engineers — and not by the epidemiologists and infectious disease experts.
“There was a professional rivalry that has led to the epidemiologists and infectious disease experts dismissing the expertise of physicists and engineers.”
The reflexive response in many workplaces was to protect workers with Plexiglas and face shields. But aerosols aren’t linear, they are insidious — going their own way in much the same way as second-hand cigarette smoke spreads indoors but dissipates outdoors.
Absent expert advice, the fearful response from many people has been to discard perfectly good masks. That makes sense in certain health-care settings, where masks are covered in aerosols from intubating or sneezing, but governments need to reassure ordinary users that good masks can be reused merely by rotating them out every few days (lying fallow while the fomites fade away).
The only certainty is that this year’s variants are more transmissible than last year’s COVID-19. We are counting on — and waiting for — the efficacy of last year’s vaccines, but what we need more than ever, sooner than ever, is better masks, and better masking, to cope with the new COVID-19.
It is a testament to Canadian compliance that so many people dutifully wear their masks outdoors, where the risk of transmission is low. It is to the discredit of Canadian deference to authority that we are not demanding more information about how to protect ourselves indoors, where the air flow is minimal and aerosols are maximal.
If an N95 respirator remains off limits to most of us, what about a Chinese-made
KN95 mask? The CDC says putting a cloth mask on top of a surgical mask ensures a snugger fit.
I argued last year that we needed to make masks mandatory. Yet all these months later, a compulsory policy is illusory.
If you buy clothing or furniture, they come with government-ordered tags attesting to new material, yet masks remain uncertified and unsanctioned.
The good news is that we now know masks are more effective and protective than we ever fathomed. The bad news is that we’re not helping Canadians get their hands on better masks — nor equipping them with the details they need to inform themselves and protect everyone else.
The NHL is adding a game-day rapid tests for players to its safety protocols in its latest bid to stem potential COVID-19 outbreaks among its teams, a source said Thursday.
Rapid tests provide results within a halfhour, and will augment daily PCR testing already in place, which is similar to the protocols the NBA introduced this season. PCR tests are considered to be more accurate, but there’s a 12-24 hour turnaround on results.
The decision comes two days after Vegas Golden Knights forward Tomas Nosek tested positive but was not quarantined until after playing the first two periods of a 5-4 win over Anaheim. And it comes on the same day the league delayed the start of Edmonton’s game at Montreal to complete contact tracing and testing after an Oilers player tested positive.
The Oilers became the first of the league’s seven Canadian team to encounter a virusrelated disturbance a little under a month into the season. Otherwise, the 35 postponed games have all involved teams in the three U.S.-based divisions in place for this season.
The NHL currently has paused the seasons of four teams: the Buffalo Sabres, Minnesota
Wild, New Jersey Devils and Philadelphia Flyers, though others have also been idled.
Golden Knights forward Mark Stone welcomed the NHL’s decision to add rapid testing.
“I think now with the reapid testing getting in place is going to help,” Stone said. “We’re to know more before the games, which is ultimately what we want.”
The NHL upgraded its safety protocols last week, too. It had teams remove glass panels from behind each bench for better air flow, while also spacing players at least 6 feet apart in their locker rooms. Teams were also told not to show up at arenas until one hour, 45 minutes before faceoff unless players need pregame treatment or preparation.
Stone said the first month of the season has been a learning experience given the disruptions caused by COVID-19.
“I think you’re a little bit naive to think we were going to go through the whole season without one guy testing positive,” Stone said. “I think everybody’s kind of learning as we go.”
DEAR DR. ROACH: I have a question about medications. I’m a soon to be 77 female. I have had Type 2 diabetes since about age 53. I am still on medication — metformin, glipizide and Actos. I previously was on glyburide and was doing well with an A1C around 7.1% or 7.2%. Then my doctor suddenly said glyburide was a dangerous drug and I must stop taking it. She substituted glipizide. This drug does not seem to work, as my A1C is now in the 7.8% range. Both of those drugs are in the same class and have the same warnings of heart failure, etc. I can’t get my doctor to relent and give me back the glyburide. She instead wants me to take an injectable, Victoza, and I’m not interested. What do you think?
— S.H. ANSWER: I think your doctor is concerned about glyburide causing low blood sugars. Glyburide not only lasts a long time, but it is metabolized by your body into other compounds that can also lower blood sugar. Especially in the elderly, those active compounds can cause a high risk of dangerously low blood sugars, and many experts do tend to avoid glyburide and use glipizide or glimepiride instead. If you have had any low blood glucose readings, I would agree with the change.
Liraglutide (Victoza) is called a GLP-1
antagonist. It is very helpful in people who need to lose weight, which includes many people with Type 2 diabetes, and in people with known cardiovascular disease. In my opinion, this class of drugs is proven to be safer than medicines like glyburide, and effective in people with those risk factors or who are at higher risk for low blood sugars.
Finally, A1C is a measurement of overall blood sugar levels, and I’m not sure additional medication is necessary for someone in their mid-70s with an A1C of 7.8%. A reasonable goal is 7.5%, and perhaps changes in diet or exercise may bring you there more safely than additional medication.
DEAR DR. ROACH:
I am curious if there is any relationship between the Asian flu in 1968-1969 and having possible immunity to COVID-19? I had the flu while pregnant in 1968. I had been in very close contact to someone in September who came down with COVID the very next day. A serious case, but not hospitalized. I did quarantine, and then tested negative after two weeks.
— J.M. ANSWER: No, I don’t think that is at all likely. The influenza virus and COVID-19 are very different viruses, as different as a pineapple and a pinecone.
I don’t know why you didn’t get infected after having been in close contact with a known case. It’s not clear why some people seem to be more infectious, and perhaps some people are more susceptible. You may have had an asymptomatic case in the past. However, it is a mistake to consider yourself possibly immune to COVID-19, and a serious mistake to think this proves COVID-19 doesn’t exist, as a few people have written me. Even after getting the illness, or the vaccine, people need to continue to take precautions. No vaccine is perfect, and it is clear that even people who have had COVID-19 can get it again.