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August 15, 2020: The Real Story Behind the Mask Controversy in the United States

Duke University released a study on face masks 8 days ago, but this information has been available to the public for months.

I need to make a confession — I am embarrassed. In the wake of drama in the United States, we missed the big picture. We have been distracted in a new, polarizing way. Politics crept its way into our country and homes like never before and many of us were more focused than ever on either supporting or impeaching our President. Hindsight is always 20/20, but now we can see how ridiculous we look to other countries. We were having a bedroom fight while the house was on fire. As of this very moment, the United States of America has 5,150,407 confirmed cases. The next closest country, Brazil, has 2 million less. The World Health Organization has been preaching very specific and clearly outlined protocols from the beginning, all of which the United States government has chosen to disregard.

We were having a bedroom fight while the house was on fire.

I shared an article on my Instagram account a few days ago and it caught a fair amount of traction: “14 Face Masks tested in Duke University study, ranked from best to worst.” People around the country were shocked and disappointed that just as they were willing to embrace face coverings, they have come to learn that a gaiter is not sufficient protection for themselves nor others. Results showed that those cute cotton masks aren’t nearly as effective as a surgical mask. Although fourteen masks were tested, the n95 remains the gold standard and it has been encouraged to save these for health care professionals and immunocompromised individuals. Cotton masks all tested with the same insufficient efficacy and are generally not recommended.

Someone re-shared my post in a mocking way and it caught my attention:

“’A very useful study conducted by Duke University came out this week,’ as in 2020 August???? China had this information in Early February and we shared it with WHO and many countries including the U.S. Why is this news now? Why didn’t you inform your citizens?!”

I looked into the account and saw that it is based in Shanghai. Then I started looking into the information that the World Health Organization (WHO) and other leading organizations around the globe have been providing compared to what the U.S. has been advising its citizens. What I found left me feeling sick, ashamed, and disappointed in our country. I knew government leadership has been rocky, but I didn’t know it was this bad.

Here’s a timeline of COVID-19 relative to mask type and use recommendations.

U.S. recommendations are bold and all other recommendations are keyed in as reported.

December 31, 2019: “Pneumonia of unknown cause” was identified in Wuhan, China

January 5, 2020: First disease outbreak news report was released to the public.

January 10–12, 2020: Countries were given a comprehensive package with recommendations related to proper management of the novel COVID-19. Public health recommendations at that time for Infection and Prevention guidelines included:

— Offer medical mask for suspected novel COVID-19 infection for those who can tolerate it

[— Cover nose and mouth during coughing or sneezing with tissue or flexed elbow for others — Perform hand hygiene after contact with respiratory secretions]

January 20, 2020: First case of COVID detected in the U.S.

January 24, 2020: France detected 3 novel cases and the Americas were urged to be prepared to detect early, isolate, and care for patients.

January 29, 2020: A very clear outline from WHO was released, “Advice on the use of masks in the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak.”

— Medical Masks were the recommended mask for — symptomatic individuals — those around symptomatic individuals — those in a healthcare setting

January 30, 2020: CDC says it doesn’t recommend masks for the general public

February 3, 2020: WHO finalizes its Strategic Preparedness and Response Plan, which improved capacity to detect, prepare, and respond to outbreaks

February 24, 2020: A collective “mission” formed by WHO involving The Pandemic Supply Chain Network and World Economic Forum] stressed that “to reduce COVID-19 illness and death, near-term readiness planning must embrace the large-scale implementation of high-quality, non-pharmaceutical public health measures”, such as case detection and isolation, contact tracing and monitoring/quarantining and community engagement…Success was presented as dependent on fast decision-making by top leaders, operational thoroughness by public health systems and societal engagement.”

February 26, 2020: Trump states in response to concerns for acquiring proper PPE, “Well, we can get a lot of it. In fact, we’ve ordered a lot of it just in case we need it. We may not need it; you understand that. But in case — we’re looking at worst-case scenario. We’re going to be set very quickly.”

February 27, 2020: WHO outlines rational use of PPE and other protective procedures, this includes charts for all citizens, not just healthcare workers:

— Medical Mask — Social Distancing — Hand-washing

February 29, 2020: U.S. Surgeon General Tweets that masks are not effective.

March 2, 2020: U.S. Surgeon General and Dr. Fauci (Director of the National Institute of Infection Disease) advise against masks due to lack of PPE.

March 3, 2020: WHO issued a call for industry and governments to increase PPE manufacturing by 40% to meet rising global needs.

March 11, 2020: The Director-General of WHO advised countries to take a whole-of-government, whole-of-society approach, built around a comprehensive strategy to prevent infections, save lives and minimize impact.

April 1, 2020: It was discovered that people can be symptomatic, pre-symptomatic, and asymptomatic and all can be carriers.

April 2, 2020: New York City Mayor De Blasio urges all NYC residents to use masks: “It doesn’t have to be fancy to work. It can be real homegrown,” he said. “When you put on that face covering, you’re protecting everyone else. A lot of people out there, right this minute, don’t even know they have it…You can create a face covering with anything you have at home right now, a piece of cloth,” he said. “You can create your own version and put on your own decoration. That’s what we want you to do. Something homemade, not something professional.”

April 3, 2020: The Center for Disease Control and Prevention in the U.S. tells citizens to wear “cloth face coverings fashioned from household items or made at home from common materials … as an additional, voluntary public health measure.” This is only a recommendation, masks can still be worn on a voluntary basis.

April 4, 2020: U.S. Surgeon General on Twitter does a video on how to make a mask at home. “Here’s how you can make your own face covering in a few easy steps with items you can find around the house, like an old scarf, a bandana or a hand towel, or you can make a face covering out of an old T-shirt.”

April 6, 2020: Public advice was released by WHO on use of masks. Medical masks are recommended but in light of the PPE shortage, non medical masks could be used but the following 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

April 15: An executive order was issued by Governor Cuomo: masks made mandatory for New Yorkers

May 29, 2020: Leaders in government, science, academia, industry, and civil society came together and issued a “Solidarity Call to Action” with the goal of keeping all information with regards to COVID-19 transparent for use by all.

June 5, 2020: An update of advice for use of masks and types that are effective was released by WHO.

For healthcare professionals — n95 or medical mask

Non medical masks are only recommended for the general population in:

— Areas with known or suspected widespread transmission and limited or no capacity to implement other containment measures such as physical distancing, contact tracing, appropriate testing, isolation and care for suspected and confirmed cases

— Settings with high population density where physical distancing cannot be achieved; surveillance and testing capacity, and isolation and quarantine facilities are limited

— Settings where a physical distancing cannot be achieved (close contact) without increased risk of infection/negative outcomes

July 22, 2020: U.S. President Trump willingly wears a non medical mask in public for the first time.

August 7, 2020: Duke University releases the study, “Low-cost measurement of face mask efficiency for filtering expelled droplets during speech.” They ranked different types of face masks (same types of masks tested and presented as WHO guidelines released on June 5, 2020). The goal of the study was to show inexpensive ways to measure mask effectiveness, but social media and reporters around the U.S. did not make that clear. The scientists went on to write, “The required hardware for these measurements is commonly available; suitable lasers and optical components are accessible in hundreds of research laboratories or can be purchased for less than $200, and a standard cell phone camera can serve as a recording device. The experimental setup is simple and can easily be built and operated by non-experts.”

I’d venture to say that most Americans had no idea that this information was not only readily available but being recommended since the onslaught of this pandemic.

This timeline sheds light on how reliant Americans are on our government and news outlets to provide all of the information efficiently and accurately. Duke University may have known the prior WHO information existed, but there is no mention of it. The scientists state that “The work we report here describes a measurement method that can be used to improve evaluation in order to guide mask selection and purchase decisions.” To make matters worse, major publications picked up the study and have been sharing it widely for the past several days and sending the wrong message regarding the point of the study. I’d venture to say that most Americans had no idea that this information was not only readily available but being recommended since the onslaught of this pandemic. Taking a look back on this timeline of conflicting information, no wonder we are here.

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