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Where Are All the Masks? Where Are All the Masks?
(32 minutes later)
As the heath care system strains to accommodate the unprecedented challenge of the coronavirus outbreak, many medical professionals on the front lines do not have adequate protection.As the heath care system strains to accommodate the unprecedented challenge of the coronavirus outbreak, many medical professionals on the front lines do not have adequate protection.
Some are reusing masks and gloves. Others have taken to social media with public pleas for help using the hashtag #GetMePPE, an acronym for personal protective equipment. Without proper covering, every new bedside visit might prove fatal, especially for older physicians and their families.Some are reusing masks and gloves. Others have taken to social media with public pleas for help using the hashtag #GetMePPE, an acronym for personal protective equipment. Without proper covering, every new bedside visit might prove fatal, especially for older physicians and their families.
And already, dozens of health care workers across the country have fallen ill. Hundreds more have been forced into quarantine.And already, dozens of health care workers across the country have fallen ill. Hundreds more have been forced into quarantine.
“The sky is falling,” one doctor wrote in an opinion piece for The New York Times.“The sky is falling,” one doctor wrote in an opinion piece for The New York Times.
“We’re heading into the abyss,” wrote another.“We’re heading into the abyss,” wrote another.
The short supply of masks in particular is dire.The short supply of masks in particular is dire.
The coronavirus is transmitted by droplets from coughing or contaminated surfaces, so properly applied protective gear can go a long way toward keeping doctors safe.The coronavirus is transmitted by droplets from coughing or contaminated surfaces, so properly applied protective gear can go a long way toward keeping doctors safe.
At minimum, doctors should be wearing gloves, gowns, eye gear and masks. But for weeks, hospitals have been running dangerously low on essential supplies.At minimum, doctors should be wearing gloves, gowns, eye gear and masks. But for weeks, hospitals have been running dangerously low on essential supplies.
Many doctors said they were being given just one mask, to use indefinitely. Between patients, they spray it down with a disinfectant or wipe it off, hoping for the best. But they feared that being forced to reuse a mask might infect patients who did not yet have the virus.Many doctors said they were being given just one mask, to use indefinitely. Between patients, they spray it down with a disinfectant or wipe it off, hoping for the best. But they feared that being forced to reuse a mask might infect patients who did not yet have the virus.
In part, a widespread buying of masks by anxious citizens limited commercial supply. Experts say masks and respirators are not effective for protecting the general public, but are crucial for health care workers.In part, a widespread buying of masks by anxious citizens limited commercial supply. Experts say masks and respirators are not effective for protecting the general public, but are crucial for health care workers.
Also, the prolonged outbreak in China dwindled supply. Even before the coronavirus emerged, China produced about half of the world’s masks. During the outbreak, it expanded its mask production by nearly 12-fold.Also, the prolonged outbreak in China dwindled supply. Even before the coronavirus emerged, China produced about half of the world’s masks. During the outbreak, it expanded its mask production by nearly 12-fold.
(The outbreak also comes after a particularly mask-intensive few months. Wildfires in California and in Australia had already diminished the supply of some humanitarian organizations.)(The outbreak also comes after a particularly mask-intensive few months. Wildfires in California and in Australia had already diminished the supply of some humanitarian organizations.)
On Friday, President Trump said at his daily White House briefing that the Centers for Disease Control recommended that all Americans use basic “non-medical, cloth” masks on a voluntary basis.On Friday, President Trump said at his daily White House briefing that the Centers for Disease Control recommended that all Americans use basic “non-medical, cloth” masks on a voluntary basis.
“You can do it. You don’t have to do it. I’m choosing not to do it,” Mr. Trump said. “It’s only a recommendation.”“You can do it. You don’t have to do it. I’m choosing not to do it,” Mr. Trump said. “It’s only a recommendation.”
The federal C.D.C., like the World Health Organization, had advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. (The New York Times and other news outlets had been reporting the C.D.C.’s previous guidance.)The federal C.D.C., like the World Health Organization, had advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. (The New York Times and other news outlets had been reporting the C.D.C.’s previous guidance.)
The C.D.C. now recommends that everyone wear face coverings in public settings, like pharmacies and grocery stores, to avoid unwittingly spreading the virus. Public health officials have continued to stress, however, that N95 masks and surgical masks should be saved for front-line doctors and nurses, who have been in dire need of protective gear.The C.D.C. now recommends that everyone wear face coverings in public settings, like pharmacies and grocery stores, to avoid unwittingly spreading the virus. Public health officials have continued to stress, however, that N95 masks and surgical masks should be saved for front-line doctors and nurses, who have been in dire need of protective gear.
Ideally, clinicians would be using a new, tightly-sealed respirator, like the N95, with each patient. These are thicker than standard surgical masks, and are designed to fit more tightly around the mouth and nose to block out much smaller particles. The Food and Drug Administration said that neither surgical masks nor N95s should be shared or be reused.Ideally, clinicians would be using a new, tightly-sealed respirator, like the N95, with each patient. These are thicker than standard surgical masks, and are designed to fit more tightly around the mouth and nose to block out much smaller particles. The Food and Drug Administration said that neither surgical masks nor N95s should be shared or be reused.
As the outbreak worsened and there were shortages in medical supplies across the country, the C.D.C. updated its recommendations for optimizing the supply of protective gear.As the outbreak worsened and there were shortages in medical supplies across the country, the C.D.C. updated its recommendations for optimizing the supply of protective gear.
Now, except in the case of intubations, which involve inserting a breathing tube, the agency says standard surgical masks are acceptable when examining or treating a coronavirus patient. (This aligns more closely with the W.H.O., which advises that surgical masks can be used in some situations, but warns that they are not sufficient on their own.)Now, except in the case of intubations, which involve inserting a breathing tube, the agency says standard surgical masks are acceptable when examining or treating a coronavirus patient. (This aligns more closely with the W.H.O., which advises that surgical masks can be used in some situations, but warns that they are not sufficient on their own.)
Updated June 12, 2020 Updated June 16, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Some medical professionals suggested that the C.D.C.’s new recommendations are borne of political expediency instead of science.Some medical professionals suggested that the C.D.C.’s new recommendations are borne of political expediency instead of science.
“We are concerned that C.D.C. recommendations are based solely on supply chain and manufacturing challenges,” the American Nurses Association said in a public letter.“We are concerned that C.D.C. recommendations are based solely on supply chain and manufacturing challenges,” the American Nurses Association said in a public letter.
Now, the C.D.C. also outlines a crisis strategy for wearing the same mask for repeated encounters with different patients. It suggests medical professionals may need to use masks beyond the manufacturer-designated shelf life date, and to prioritize the use of masks for activities in which there may be sprays, splashes or prolonged exposure.Now, the C.D.C. also outlines a crisis strategy for wearing the same mask for repeated encounters with different patients. It suggests medical professionals may need to use masks beyond the manufacturer-designated shelf life date, and to prioritize the use of masks for activities in which there may be sprays, splashes or prolonged exposure.
“As a last resort,” the C.D.C. says “homemade masks” like a bandanna or a scarf can be used, although their protective ability is unknown.“As a last resort,” the C.D.C. says “homemade masks” like a bandanna or a scarf can be used, although their protective ability is unknown.
At a news conference in March at the White House, Vice President Mike Pence said the federal government had ordered “hundreds of millions” of N95s for health care centers across the country, but he did not say precisely when they would be delivered to workers.At a news conference in March at the White House, Vice President Mike Pence said the federal government had ordered “hundreds of millions” of N95s for health care centers across the country, but he did not say precisely when they would be delivered to workers.
The White House also signaled that American companies have been increasing efforts to restock hospitals, citing that Hanes and General Motors will make masks. But it again stopped short of discussing in detail any sort of fulfillment of the more assertive demands coming from some state and local leaders.The White House also signaled that American companies have been increasing efforts to restock hospitals, citing that Hanes and General Motors will make masks. But it again stopped short of discussing in detail any sort of fulfillment of the more assertive demands coming from some state and local leaders.
Some doctors in Oregon and in Washington have recently received gear from the Strategic National Stockpile, a federal repository of critical medical supplies for public health emergencies. But officials in both states said it was far less than what they had requested.Some doctors in Oregon and in Washington have recently received gear from the Strategic National Stockpile, a federal repository of critical medical supplies for public health emergencies. But officials in both states said it was far less than what they had requested.
There have been other efforts to donate masks. In New York, the Federal District Court in Manhattan donated and delivered 1,000 N95s that were in storage to the Hospital for Special Surgery. On Wednesday, some N95s reserved for construction work were temporarily approved for medical use by the F.D.A.There have been other efforts to donate masks. In New York, the Federal District Court in Manhattan donated and delivered 1,000 N95s that were in storage to the Hospital for Special Surgery. On Wednesday, some N95s reserved for construction work were temporarily approved for medical use by the F.D.A.
Individual doctors are looking out for one another, too. Some are shipping supplies to colleagues across the country. Others are just grateful for people leaving donations outside their doors.Individual doctors are looking out for one another, too. Some are shipping supplies to colleagues across the country. Others are just grateful for people leaving donations outside their doors.
Abby Goodnough, Margot Sanger-Katz, Benjamin Weiser and Sanam Yar contributed reporting.Abby Goodnough, Margot Sanger-Katz, Benjamin Weiser and Sanam Yar contributed reporting.