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The case for and against the effectiveness of face coverings and the mandating of their use

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Domh245

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On addition the ONS publish the death registrations every couple of weeks. In these there isn't actually any need for a positive Covid test at all - a doctor just has to decide that in their professional opinion (a professional opinion that's backed by a professional qualification and isn't given lightly) Covid was a contributing factor in the death

The registrations are published weekly with a couple of weeks lag, but there are also (since January) additional data around where covid was the underlying cause, rather than just simply being on the death certificate (for England & Wales only). It is also presented alongside similar death certificate/underlying cause for "diseases of the respiratory system" and "influenza and pneumonia". A comparison between the three (using extrapolated PHE data for before this year) on a log scale is shown below, with the 28-day metric lagged a week to try and account for registration delay.

1630092361708.png
 
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bramling

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There are two different sets of death stats. The within 28 days figures are the ones which are relentlessly trumpeted in the press. For these there is no need for Covid to be any kind of factor at all - just dying within 28 days of a test is enough. With the current high numbers of positive tests that means you'd expect something like 20 a day just on average, and more if the people getting tests skew a littoe towards people who are going to hospital for something else.

On addition the ONS publish the death registrations every couple of weeks. In these there isn't actually any need for a positive Covid test at all - a doctor just has to decide that in their professional opinion (a professional opinion that's backed by a professional qualification and isn't given lightly) Covid was a contributing factor in the death

The latter still doesn’t resolve the question of life expectancy though. What needs to be established is how many people have gone into hospital with a condition from which they would likely have passed away within a short timeframe, and then caught Covid which has contributed to their death in terms of bringing it forward by a period of time.

I realise these sorts of figures are never going to be easy to get, but there could be some proper analysis of sample datasets which ought to tell us something meaningful.

In essence, how many people are being robbed of a few days by Covid, and how many are being robbed of perhaps a year. This would greatly inform things in my view.

It’s an unpleasant subject for sure, but it’s a discourse which needs to be had, and one the politicians should have been having on our behalf, but instead they’ve been far more interested in stuff like discount meal schemes...
 

fireftrm

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If you do trust vaccines, why would a healthy vaccinated person wear a mask? It makes no sense.


OK but a standard mask is ineffective; you can choose to wear an ineffective mask if you want but it's really little more than a placebo.
Being vaccinated and healthy does not prevent anyone catching COVID-1, or having it and being asymptomatic. That some, more careful people therefore still wear a mask makes perfect sense to me.

’Standard’ (whatever that means) masks are not ineffective, however anything lower spec than FFFP3 isn’t fully effective. You are confusing less effective with ineffective. Not wearing a mask is ineffective, thereafter the effectiveness is dependant upon the quality and fit of the mask.
 

Bungle73

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RDG just put out a tweet saying "Please follow government guidance, and wear a face covering on trains and at stations (unless exempt) out of respect for others". Nothing about "if they are busy", just a blanket statement.
 

43066

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’Standard’ (whatever that means) masks are not ineffective, however anything lower spec than FFFP3 isn’t fully effective. You are confusing less effective with ineffective. Not wearing a mask is ineffective, thereafter the effectiveness is dependant upon the quality and fit of the mask.

They quite demonstrably are ineffective, and indeed this was the established scientific consensus for several decades up until this pandemic. The WHO admitted last year that it only changed its view as a result of political lobbying.

It’s now obvious that masks are a completely busted flush, which have made no statistically significant difference wherever they’ve been mandated. Anyone who suggests otherwise is either delusional or pushing a political agenda.
 

Freightmaster

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It’s now obvious that masks are a completely busted flush, which have made no statistically significant difference wherever they’ve been mandated. Anyone who suggests otherwise is either delusional or pushing a political agenda.
While I agree, I think it's a little unfair to call people who think that masks significantly
reduce transmission 'delusional' - they are simply victims of extremely persuasive and
pervasive propaganda/mass hysteria.



MARK
 

GB

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I don't care one way or the other about masks, the only real inconvenience for 99% of people is remembering to carry one...but it's pretty funny watching people on here throw their toys out the pram over them.
 

hst43102

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Looking for a church to go to tomorrow, I've come across quite a few that mandate masks "out of love and consideration". Why not show some love and consideration by giving people a safe space to forget about the troubles of these past couple of years? :frown:
 

alex397

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Just thought I’d say to people on here - if you have a problem with those continuing to wear a mask, then just keep your opinions to yourself.
 

43066

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While I agree, I think it's a little unfair to call people who think that masks significantly
reduce transmission 'delusional' - they are simply victims of extremely persuasive and
pervasive propaganda/mass hysteria.



MARK

I maintain that a belief that splash guards are effective is - by definition - delusional because they demonstrably aren’t. Agreed people might have come to that view through no fault of their own, albeit you would hope that intelligent, well educated people (not everybody is I concede) would do their own research rather than simply believing whatever guff they are told, especially by a government with a penchant for lying.


Just thought I’d say to people on here - if you have a problem with those continuing to wear a mask, then just keep your opinions to yourself.

But nobody has said that. Certainly in my view anyone wearing a mask is clearly misinformed (at best), but I respect their choice to wear one, because I’m not an authoritarian. It’s deeply ironic for pro maskers (who no doubt were in favour of masks being mandatory) to be bleating on about freedom of choice.
 

alex397

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I maintain that a belief that splash guards are effective is - by definition - delusional because they demonstrably aren’t. Agreed people might have come to that view through no fault of their own, albeit you would hope that intelligent, well educated people (not everybody is I concede) would do their own research rather than simply believing whatever guff they are told, especially by a government with a penchant for lying.




But nobody has said that. Certainly in my view anyone wearing a mask is clearly misinformed (at best), but I respect their choice to wear one, because I’m not an authoritarian. It’s deeply ironic for pro maskers (who no doubt were in favour of masks being mandatory) to be bleating on about freedom of choice.
It is not misinformed
 

yorkie

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Being vaccinated and healthy does not prevent anyone catching COVID-1, or having it and being asymptomatic.
No it doesn't; SARS-CoV-2 virus will go the same way as other HCoVs and continue to spread in a state of endemic equilibrium indefinitely.

Wearing a standard flimsy mask does not prevent transmission; if anyone feels they must avoid catching the virus (e.g. if they are immunocompromised or simply distrusting of vaccines) they could choose to wear a highly effective FFP3 mask.


That some, more careful people therefore still wear a mask makes perfect sense to me.
As I have said many times of people have a particular reason why they feel they must avoid exposure to the virus, they can choose to wear an effective FFP3 mask. Once they have made such a choice it makes no difference what other people do.

’Standard’ (whatever that means) masks are not ineffective
I refer you to the BBC article linked to numerous times previously.

By 'standard' I mean surgical masks or equivalent, which are loose fitting and flimsy and not designed to filter aerosols.
, however anything lower spec than FFFP3 isn’t fully effective.
Indeed but the difference between wearing no mask and a flimsy mask is so small (if it exists) as to be immeasurable in real world studies; in contrast the difference between a flimsy mask and an FFP3 mask is massive


You are confusing less effective with ineffective.
There is no real world evidence that wearing a standard mask offers any protection against infection.

Not wearing a mask is ineffective, thereafter the effectiveness is dependant upon the quality and fit of the mask.
Indeed it is; those who require additional protection or don't trust vaccines can get a high quality well fitted mask and be well protected.

Looking for a church to go to tomorrow, I've come across quite a few that mandate masks "out of love and consideration". Why not show some love and consideration by giving people a safe space to forget about the troubles of these past couple of years? :frown:
Unfortunately the virtue signallers driving this do not look at the bigger picture, nor do they look at things from others point of view.
RDG just put out a tweet saying "Please follow government guidance, and wear a face covering on trains and at stations (unless exempt) out of respect for others". Nothing about "if they are busy", just a blanket statement.
Yes the messaging is appalling.

It is not misinformed
In my opinion, anyone who thinks that wearing a flimsy loose fitting mask is offering any measurable degree of protection is indeed misinformed

In contrast, choosing to wear an effective FFP3 mask would be effective against SARS-CoV-2 transmission; anyone wearing one would be well informed about the effectiveness of such masks (whether or not they are well informed about the purpose and effectiveness of vaccines is another question entirely)
 

AlterEgo

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RDG just put out a tweet saying "Please follow government guidance, and wear a face covering on trains and at stations (unless exempt) out of respect for others". Nothing about "if they are busy", just a blanket statement.
Either a face covering is a worthwhile medical intervention or it is not. There is no point in wearing one “out of respect” to avoid hurting someone else’s feelings.
 

RPI

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Just thought I’d say to people on here - if you have a problem with those continuing to wear a mask, then just keep your opinions to yourself.
I doubt anyone has an issue with other people actually choosing to wear masks, my problem and many others is trying to be guilt tripped into wearing masks, particularly when the useless cloth or disposable masks worn by most people are about as effective as urinating into the wind and create a dystopian atmosphere and if nothing else I can't understand a word people are saying when they've got one on!
 

Green tractor

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I doubt anyone has an issue with other people actually choosing to wear masks, my problem and many others is trying to be guilt tripped into wearing masks, particularly when the useless cloth or disposable masks worn by most people are about as effective as urinating into the wind and create a dystopian atmosphere and if nothing else I can't understand a word people are saying when they've got one on!

Seem to be plenty of folk on this forum who have a problem with other people wearing masks, there are pages and pages of it on this one thread. You are going to have to get used to it because they will never completely go away.
 

Cdd89

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Seem to be plenty of folk on this forum who have a problem with other people wearing masks, there are pages and pages of it on this one thread.
How many organisations have you seen with signs saying “you should / must wear a mask”?

how many organisations have you seen with signs saying “you should not / must not wear a mask”?

Obviously there are individuals pressuring in both directions but one group is far louder than the other.
 

Richard Scott

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Seem to be plenty of folk on this forum who have a problem with other people wearing masks, there are pages and pages of it on this one thread. You are going to have to get used to it because they will never completely go away.
Really, could you point out those posts? I don't care if others want to wear them but have no interest in partaking in something that has no proven scientific benefit.
 

Yew

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Seem to be plenty of folk on this forum who have a problem with other people wearing masks, there are pages and pages of it on this one thread. You are going to have to get used to it because they will never completely go away.
That's sort of a non statement, as 'complete' includes situations such as only one person in the whole world wearing one.
 

farleigh

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Seem to be plenty of folk on this forum who have a problem with other people wearing masks, there are pages and pages of it on this one thread. You are going to have to get used to it because they will never completely go away.
I think the majority of people have reacted to the mandation of masks rather than people choosing to wear a mask.

That said, I do find it sad to see people cowed into wearing a piece of material over their faces. For the avoidance of doubt, I know that not all mask wearers are doing it because they feel pressured. Some people genuinely believe they work but there is also a set of people who like to wear one to signal how much they 'care' and then hector other people who choose not to wear one.
 

RPI

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Seem to be plenty of folk on this forum who have a problem with other people wearing masks, there are pages and pages of it on this one thread. You are going to have to get used to it because they will never completely go away.
Again as I said in my post, those who genuinely choose to wear one, who have done their research and wear a proper mask, rather than a piece of cloth that never gets washed and literally collects bacteria in a nice warm, moist environment I have no problem with, its when the rest of us are passively aggressively coerced into wearing one that i have a problem. As much as I hate the things I would at least understand the logic if FFP3 masks were mandated as they actually work, I never want that to happen but I would at least understand the logic behind it, but wearing a piece of cloth or a disposable mask is either virtue signalling or simply a comfort blanket.
 

Green tractor

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I wear one because I believe that it stops me spitting on things, and on the off chance that I have covid it will slightly reduce the chances of me spreading it. Not completely stop me spreading it but reduce it. I won't be wearing one forever, probably until next spring, and then after that if I have a cold, like folk in some asian countries do. I do wash mine, I have several and put them in the wash regularly. On the scale of restrictions we have had over the last 18 months masks are no bother at all to me.
 

yorkie

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I wear one because I believe that it stops me spitting on things, and on the off chance that I have covid it will slightly reduce the chances of me spreading it.
There isn't any real world evidence that wearing flimsy loose fitting masks reduces the spread of viruses; FFP3 masks in contrast are designed with this purpose in mind.

Not completely stop me spreading it but reduce it. I won't be wearing one forever, probably until next spring,
Why then? The virus won't be going away

I do wash mine, I have several and put them in the wash regularly. On the scale of restrictions we have had over the last 18 months masks are no bother at all to me.
To you, indeed.
 

Green tractor

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Why then? The virus won't be going away
Because that is what I have decided to do, it is entirely my choice, just as it is your choice not to wear one

To you, indeed.

Wearing a mask is considerably less restrictive than the shops/pubs being closed, public transport being cut back and being told to stay in my home as much as possible.

Also in terms of abuse, people getting angry I've been on the receiving end of some at work for being careful. My employer did nothing, I got abuse for sitting on my own at break times rather than sit in the non socially distanced mess-room, had people make fun of me for actually stating at home during lockdown. One chap got very angry with me shouting at me asking if I was high risk (2 members of my household are) turns out his girlfriend is at high risk for some reason, but following the crowd and putting on a macho front was more important to him than reducing his (and therefore her) risk. (This was before the vaccines had been rolled out)
 

Highlandspring

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I wear one … on the off chance that I have covid it will slightly reduce the chances of me spreading it.
Perhaps a more certain way to minimise your chance of spreading the virus would be to test yourself regularly. Knowing that you are covid-free through a daily lateral flow test before you leave the house is surely better than assuming that you might have it and that your face covering may do enough to prevent you spreading it?
 

yorkie

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Because that is what I have decided to do, it is entirely my choice, just as it is your choice not to wear one
It is but I was wondering if there was some logic/reasoning.
Wearing a mask is considerably less restrictive than the shops/pubs being closed, public transport being cut back and being told to stay in my home as much as possible.
What have those things got to do with it? If the suggestion is that mask wearing can replace those measures as a way of reducing transmission, this is an entirely false claim, not based on any real-world evidence.

Countries that went crazy for masks, such as Portugal, France and Spain have imposed strict lockdowns

In contrast Sweden didn't mandate masks and not did they impose anything close to the sort of restrictions imposed elsewhere.

I see no evidence for any such claim that mask mandating or wearing reduces any 'need' for any measures which - though highly restrictive - do actually have a clearly observable effect.


Also in terms of abuse, people getting angry I've been on the receiving end of some at work for being careful.
I wonder what you said or did to cause that.
My employer did nothing, I got abuse for sitting on my own at break times rather than sit in the non socially distanced mess-room, had people make fun of me for actually stating at home during lockdown.
People should not abuse you for this; in my opinion you have been mislead and this has been harmful to you. My issue isn't so much against people who have been mislead but against people spreading the misleading messaging as this is what is causing the harm to our mental, social and ultimately physical well-being.

I hope that the assurances provided on this forum can help you get back to normal and rebuild those relationships.

The likely harms of such fallouts far exceed those of a virus to which you now have adaptive immunity through vaccination.

One chap got very angry with me shouting at me asking if I was high risk (2 members of my household are) turns out his girlfriend is at high risk for some reason, but following the crowd and putting on a macho front was more important to him than reducing his (and therefore her) risk. (This was before the vaccines had been rolled out)
I don't think it's fair to judge him in this way
 

DustyBin

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I wear one because I believe that it stops me spitting on things, and on the off chance that I have covid it will slightly reduce the chances of me spreading it. Not completely stop me spreading it but reduce it. I won't be wearing one forever, probably until next spring, and then after that if I have a cold, like folk in some asian countries do. I do wash mine, I have several and put them in the wash regularly. On the scale of restrictions we have had over the last 18 months masks are no bother at all to me.

As far as I can tell the only “benefit” provided by surgical masks and cloth face coverings is just that i.e. they stop large droplets. However, I believe it’s now clear that surface to surface transmission simply doesn’t occur so really there’s no risk to reduce.

In regard to wearing one if you have a cold, I’d far rather see a culture where people try and avoid going out if they know they’re ill. I genuinely don’t believe we should aspire to be like (some) Asian countries in this regard.
 

Green tractor

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People should not abuse you for this; in my opinion you have been mislead and this has been harmful to you. My issue isn't so much against people who have been mislead but against people spreading the misleading messaging as this is what is causing the harm to our mental, social and ultimately physical well-being.
How have I been misled that staying at home will considerably reduce the chance of covid 19 arriving in my household? When I say staying at home I don't mean staying indoors all the time or not going out for walks etc, I just mean staying local and away from other people where possible (and I had plenty do do at home anyway.)
It is but I was wondering if there was some logic/reasoning.

I have already explained my logic.
I don't think it's fair to judge him in this way

I do, I work with the chap (hes generally a nice enough guy by the way) but he will never venture an opinion on anything until he finds out what everybody else's is
The likely harms of such fallouts far exceed those of a virus to which you now have adaptive immunity through vaccination.

If you read what I wrote this was last year, before the vaccine roll out.

However, I believe it’s now clear that surface to surface transmission simply doesn’t occur so really there’s no risk to reduce.
Cold you provide some evidence please? I would be genuinely interested to read that.

In contrast Sweden didn't mandate masks and not did they impose anything close to the sort of restrictions imposed elsewhere.
Sweden did have restrictions though, and more importantly the population largely followed them, which probably has more to do with how much they trust their politicians and how much we dont.

I wonder what you said or did to cause that.
Read my post again.... I sat on my own at lunch time
 
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DustyBin

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Cold you provide some evidence please? I would be genuinely interested to read that.


Quantitative microbial risk assessment (QMRA) studies have been conducted to understand and characterize the relative risk of SARS-CoV-2 fomite transmission and evaluate the need for and effectiveness of prevention measures to reduce risk. Findings of these studies suggest that the risk of SARS-CoV-2 infection via the fomite transmission route is low, and generally less than 1 in 10,000, which means that each contact with a contaminated surface has less than a 1 in 10,000 chance of causing an infection 7, 8, 9.

I’ll concede that my post was badly worded as I can’t provide evidence that it “simply doesn’t occur”. However, at 1 in 10,000 the risk is statistically insignificant to the point that it’s not worth mitigating against (this article agrees):


COVID-19 rarely spreads through surfaces. So why are we still deep cleaning?​

The coronavirus behind the pandemic can linger on doorknobs and other surfaces, but these aren’t a major source of infection.

When Emanuel Goldman went to his local New Jersey supermarket last March, he didn’t take any chances. Reports of COVID-19 cases were popping up across the United States, so he donned gloves to avoid contaminated surfaces and wore a mask to prevent him inhaling tiny virus-laden droplets from fellow shoppers. Neither gloves nor masks were recommended at the time.

Then, at the end of March, a laboratory study showed that the coronavirus SARS-CoV-2 can persist on plastic and stainless steel for days1. That triggered startling headlines and a slew of advice on how to decontaminate everything from doorknobs to groceries. It also seemed to confirm guidance issued by the World Health Organization(WHO) in February that the virus that causes COVID-19 can spread through contaminated surfaces, known as fomites.

By May, the WHO and health agencies around the world were recommending that people in ordinary community settings — houses, buses, churches, schools and shops — should clean and disinfect surfaces, especially those that are frequently touched. Disinfectant factories worked around the clock to keep up with heavy demand.

But Goldman, a microbiologist at Rutgers New Jersey Medical School in Newark, decided to take a closer look at the evidence around fomites. What he found was that there was little to support the idea that SARS-CoV-2 passes from one person to another through contaminated surfaces. He wrote a pointed commentary for TheLancet Infectious Diseases in July, arguing that surfaces presented relatively little risk of transmitting the virus2. His conviction has only strengthened since then, and Goldman has long since abandoned the gloves.

Many others reached similar conclusions. In fact, the US Centers for Disease Control and Prevention (CDC) clarified its guidance about surface transmission in May, stating that this route is “not thought to be the main way the virus spreads”. It now states that transmission through surfaces is “not thought to be a common way that COVID-19 spreads”.

As evidence has accumulated over the course of the pandemic, scientific understanding about the virus has changed. Studies and investigations of outbreaks all point to the majority of transmissions occurring as a result of infected people spewing out large droplets and small particles called aerosols when they cough, talk or breathe. These can be directly inhaled by people close by. Surface transmission, although possible, is not thought to be a significant risk.

But it’s easier to clean surfaces than improve ventilation — especially in the winter — and consumers have come to expect disinfection protocols. That means that governments, companies and individuals continue to invest vast amounts of time and money in deep-cleaning efforts. By the end of 2020, global sales of surface disinfectant totalled US$4.5 billion, a jump of more than 30% over the previous year. The New York Metropolitan Transit Authority (MTA), which oversees subways and buses and lost billions of dollars in passenger revenue in 2020, spent $484 million last year in its response to COVID-19, including enhanced cleaning and sanitization, according to a spokesperson.

Part of the problem is that specialists can’t rule out the possibility of fomite transmission, and the guidance from many health agencies about how to deal with surfaces has been unclear as the science has changed. In November, Chinese authorities introduced guidelines requiring disinfection of imported frozen-food packages. And the CDC directs people to a comprehensive list of agents that kill SARS-C0V-2 and says: “Frequent disinfection of surfaces and objects touched by multiple people is important.”

Experts say that it makes sense to recommend hand washing, but some researchers are pushing back against the focus on surfaces. In December, engineer Linsey Marr at Virginia Tech in Blacksburg co-wrote an opinion article for The Washington Postimploring people to ease up on cleaning efforts. “It’s become clear that transmission by inhalation of aerosols — the microscopic droplets — is an important if not dominant mode of transmission,” says Marr, who studies airborne disease transmission. Excessive attention on making surfaces pristine takes up limited time and resources that would be better spent on ventilation or the decontamination of the air that people breathe, she says.

Virus RNA can mislead​

The focus on fomites — rather than aerosols — emerged at the very beginning of the coronavirus outbreak because of what people knew about other infectious diseases. In hospitals, pathogens such as methicillin-resistant Staphylococcus aureus, respiratory syncytial virus and norovirus can cling to bed rails or hitch a ride from one person to the next on a doctor’s stethoscope. So as soon as people started falling ill from the coronavirus, researchers began swabbing hospital rooms and quarantine facilities for places the virus could be lurking. And it seemed to be everywhere.

In medical facilities, personal items such as reading glasses and water bottles tested positive for traces of viral RNA — the main way that researchers identify viral contamination. So, too, did bed rails and air vents. In quarantined households, wash basins and showers harboured the RNA, and in restaurants, wooden chopsticks were found to be contaminated. And early studies suggested that contamination could linger for weeks. Seventeen days after the Diamond Princess cruise ship was vacated, scientists found3 viral RNA on surfaces in cabins of the 712 passengers and crew members who tested positive for COVID-19.

But contamination with viral RNA is not necessarily cause for alarm, says Goldman. “The viral RNA is the equivalent of the corpse of the virus,” he says. “It’s not infectious.”

To address that part of the equation, researchers began testing whether coronavirus samples left for days on various surfaces could infect lab-grown cells. One study in April found that the virus remained infectious on hard surfaces such as plastic and stainless steel for 6 days; on bank notes, it lasted for 3 days; and on surgical masks, at least 7 days4. A later study announced that viable virus was present on skin for up to 4 days, but on clothes it survived for less than 8 hours5. And others found infectious virus on library books bound in natural and synthetic leather after 8 days6.

Unrealistic conditions​

Although these types of experiment demonstrate that the coronavirus can survive on surfaces, this doesn’t mean that people are catching it from surfaces such as doorknobs. Goldman and others caution against reading too much into virus-survival studies, because most don’t test conditions that exist outside the lab. “They were experiments that started out with humongous amounts of virus, nothing that you would encounter in the real world,” he says. Other tests have used mock saliva and controlled conditions such as humidity and temperature, all of which widen the gulf between experimental and real-world conditions, says Goldman.

Only a handful of studies have looked for viable virus outside the lab. Tal Brosh-Nissimov, who heads the infectious-diseases unit at the Assuta Ashdod University Hospital in Israel, and his colleagues swabbed personal items and furniture in hospital isolation units and rooms at a quarantine hotel. Half of the samples from two hospitals and more than one-third of samples from the quarantine hotel were positive for viral RNA. But none of the viral material was actually able to infect cells, the researchers reported7.

Indeed, researchers have struggled to isolate viable virus from any environmental samples, not just fomites. In the only study8 that has succeeded, researchers grew virus particles from hospital air samples collected at least 2 metres from a person with COVID-19.

Nevertheless, scientists warn against drawing absolute conclusions. “Just because viability can’t be shown, it doesn’t mean that there wasn’t contagious virus there at some point,” says epidemiologist Ben Cowling at the University of Hong Kong.

Human exposure studies of other pathogens provide additional clues about fomite transmission of respiratory viruses. In 1987, researchers at the University of Wisconsin— Madison put healthy volunteers in a room to play cards with people infected with a common-cold rhinovirus9. When the healthy volunteers had their arms restrained to stop them touching their faces and prevent them transferring the virus from contaminated surfaces, half became infected. A similar number of volunteers who were unrestrained also became infected. In a separate experiment, cards and poker chips that had been handled and coughed on by sick volunteers were taken to a separate room, where healthy volunteers were instructed to play poker while rubbing their eyes and noses. The only possible mode of transmission was through the contaminated cards and chips; none became infected. The combination of experiments provided strong evidence that rhinoviruses spread through the air. But such studies are considered unethical for SARS-CoV-2, because it can kill.

Although it’s probably rare, says Cowling, transmission through surfaces can’t be ruled out. “It just doesn’t seem to happen that much, as far as we can tell.”

Estimates of transmission based on levels of viral RNA persisting in the environment seem to bear this out. From April to June, environmental engineer Amy Pickering then at Tufts University in Medford, Massachusetts, and her colleagues took weekly swabs of indoor and outdoor surfaces around a town in Massachusetts. On the basis of the levels of RNA contamination and how often people touched surfaces such as doorknobs and buttons at pedestrian crossings, the team estimated10 that the risk of infection from touching a contaminated surface is less than 5 in 10,000 — lower than estimates for SARS-CoV-2 infection through aerosols, and lower than surface-transmission risk for influenza or norovirus.

“Fomite transmission is possible, but it just seems to be rare,” says Pickering, who is now at the University of California, Berkeley. “A lot of things have to fall into place for that transmission to happen.”

That might explain why a global comparison of government interventions to control the pandemic in its early months found that cleaning and disinfection of shared surfaces ranked one of the least effective at reducing transmission11. Social distancing and travel restrictions, including lockdowns, worked the best.

Messy data​

That leaves researchers sorting through messy epidemiological data about how the virus spreads. Hundreds of studies of COVID-19 transmission have been published since the pandemic began, yet there is thought to be only one that reports transmission through a contaminated surface, by what it termed the snot–oral route. According to the report, a person with COVID-19 in China blew his nose with his hand and then pressed a button in his apartment building elevator. A second resident in the building then touched the same button and flossed with a toothpick immediately after, thereby transferring the virus from button to mouth12. But without genome sequences of the viruses infecting each person, transmission through another unknown person couldn’t be ruled out.

In one other case, eight people in China are thought to have been infected after stepping in sewage containing the virus on the street and then walking the contamination into their homes13.

Despite the rarity of published examples of fomite transmission, Chinese authorities require that imported frozen food be disinfected.

The change in guidelines followed a report, which has not been released in detail, that a worker at a frozen-food business in the northern port city of Tianjin became infected after handling contaminated packaging of frozen pork imported from Germany. But the WHO and other experts have disputed claims that people can be infected through the food chain in this manner.

Cowling says that more detailed investigations are needed, carefully tracking who infects whom, and what surfaces and spaces they shared around the time of infection. “What we really, really value is epidemiological investigations of transmission patterns, whether it’s in households or workplaces or elsewhere,” he says. “I don’t think we’ve been doing enough of that.”

The greatest threat​

Armed with a year’s worth of data about coronavirus cases, researchers say one fact is clear. It’s people, not surfaces, that should be the main cause for concern. Evidence from superspreading events, where numerous people are infected at once, usually in a crowded indoor space, clearly point to airborne transmission, says Marr. “You have to make up some really convoluted scenarios in order to explain superspreading events with contaminated surfaces,” she says.

Hand washing is crucial, says Marr, because surface transmission can’t be ruled out. But it’s more important to improve ventilation systems or to install air purifiers than to sterilize surfaces, she says. “If we’ve already paid attention to the air and we have some extra time and resources, then yes, wiping down those high-touch surfaces could be helpful,” she says.

Households can also ease up, says Pickering. Quarantining groceries or disinfecting every surface is going too far. “That’s a lot of work and it also is probably not reducing your exposure that much,” she says. Instead, reasonable hand hygiene, as well as wearing a mask and social distancing to reduce exposure from close contacts is a better place to focus efforts.

The WHO updated its guidance on 20 October, saying that the virus can spread “after infected people sneeze, cough on, or touch surfaces, or objects, such as tables, doorknobs and handrails”. A WHO spokesperson told Nature that “there is limited evidence of transmission through fomites. Nonetheless, fomite transmission is considered a possible mode of transmission, given consistent finding of environmental contamination, with positive identification of SARS-CoV-2 RNA in the vicinity of people infected with SARS-CoV-2.” The WHO adds that “disinfection practices are important to reduce the potential for COVID-19 virus contamination”.

The CDC did not respond to Nature’s queries about inconsistencies in its statements about the risks posed by fomites.

The conundrum facing health authorities, says Marr, is that definitively ruling out surface transmission is hard. Authorities can be reluctant to tell people not to be cautious. “You never want to say, ‘Oh, don’t do that,’ because it can happen. And you know, we should follow the precautionary principle,” she says.

Despite the evolving evidence, the public might have grown to expect extra levels of sanitization after the early months of the pandemic. When the New York MTA surveyed passengers in late September and early October, three-quarters said that cleaning and disinfecting made them feel safe when using transport.

Goldman continues to wear a cloth mask when he leaves home, but when it comes to the possibility of catching the coronavirus from a contaminated surface, he doesn’t take any special precautions. “One of the ways we protect ourselves is by washing our hands,” he says, “and that applies pandemic or no pandemic.”
 

RPI

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Because that is what I have decided to do, it is entirely my choice, just as it is your choice not to wear one



Wearing a mask is considerably less restrictive than the shops/pubs being closed, public transport being cut back and being told to stay in my home as much as possible.

Also in terms of abuse, people getting angry I've been on the receiving end of some at work for being careful. My employer did nothing, I got abuse for sitting on my own at break times rather than sit in the non socially distanced mess-room, had people make fun of me for actually stating at home during lockdown. One chap got very angry with me shouting at me asking if I was high risk (2 members of my household are) turns out his girlfriend is at high risk for some reason, but following the crowd and putting on a macho front was more important to him than reducing his (and therefore her) risk. (This was before the vaccines had been rolled out)
And you absolutely shouldn't have to put up with that kind of s**t, its entirely your choice, maybe you should consider wearing a proper mask then that would have effect.

I think the point stills stands though that cloth masks are next to useless.
 
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