So a Person Is Vulnerable to the Virus; What’s Their Responsibility?

 

There’s a letter to the editor published in the Fairbanks News Miner by an elderly individual with bad lungs, which makes her (the name is Robin; could be a guy) vulnerable to the virus.

She was on a rant that the in the store she entered, Fred Meyer, one of the brands that the Kroger chain runs, had many people running around without masks.  I go into that store every few days, and I confirm that roughly half the customers aren’t wearing masks.  I’ll add that the vast majority of those, are wearing cloth masks, which the CDC says is better than nothing (which equals a false sense of security).

I did reply in the comments section that the store she went into has a program where you can order their stuff online, park at the store in a designated spot, and they will deliver the items to your car (or for a lot of us in Fairbanks, your pickup truck). I also said that they also have a phone number, and you can talk to a real person. (I think; I hope that the local number isn’t a digital menu.) Fairbanks is a smallish town.  I posit that there probably isn’t a business here that won’t deliver purchases to the parking lot if you call and ask, especially if you explain you are vulnerable if you catch the virus.

The big point I wanted to make is that she has to take responsibility for her own health, and that includes asking for help if she needs it.

In a town like Fairbanks, with a low population density, a person can walk outside and easily maintain the 6ft social distance when they encounter people here and there.  And you can get the essentials of life, and also non-essentials, without entering a store. You can do it with a dumb phone, though it helps to have a smartphone, tablet, or computer to go online.

People talk about protecting the vulnerable as if they have to be coddled, and they have to be isolated.  Well, it depends.  A lot don’t need coddling, and the isolation need not be restricted to their own homes.  They can still get about, and not depend on everyone to wear masks.

It’s probably that way in the suburbs too.  But they have to take responsibility too.

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  1. Steven Seward Member
    Steven Seward
    @StevenSeward

    Kozak (View Comment):

    Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis

    Vittoria Offeddu, Chee Fu Yung, Mabel Sheau Fong Low, Clarence C TamClinical Infectious Diseases, Volume 65, Issue 11, 1 December 2017, Pages 1934–1942, https://doi.org/10.1093/cid/cix681Published:07 August 2017

    I skimmed over this study and it doesn’t look all that convincing to me, though in fairness I didn’t give it a critical look.  Here are some of their conclusions that make me unconvinced of the efficacy of wearing masks in public as a protection against the Covid Virus:

    “Continuous Respiratory Personal Protective Equipment Use vs No Respiratory Personal Protective Equipment

    Two RCTs compared respiratory infection risk in HCWs (health-care workers) wearing rPPE continuously to convenience-selected controls wearing no rPPE [24] or following routine care [23]. Wearing a medical mask or N95 respirator throughout the work shift conferred significant protection against self-reported clinical respiratory illness (CRI) (RR = 0.59; 95% CI: 0.46–0.77) (Figure 2A) and influenza-like illness (ILI) (RR = 0.34; 95% CI: 0.14–0.82) (Figure 2B). Meta-analysis suggested a protective, but nonstatistically significant, effect against laboratory-confirmed viral infections (VRI) (RR = 0.70; 95% CI: 0.47–1.03) (Figure 2C).”

    [Bold emphasis – mine]

    And this:

    “Meta-analysis indicated statistically significant superiority of N95 respirators over medical masks against laboratory-confirmed upper respiratory tract bacterial colonization (BRI) (RR = 0.46; 95% CI: 0.34–0.62) (Figure 4A) but not laboratory-confirmed influenza (RR = 0.84; 95% CI: 0.36–1.99) (Figure 4B) or other viral infections (RR = 0.78; 95% CI: 0.54–1.14) (Figure 4C).”

    [Bold emphasis – mine]

    And then this:

    “With one exception [30], case-control studies consistently reported a protective effect of medical masks against SARS [31, 32, 34] (Appendix B, Table 2). Compared to “no rPPE” controls, N95 respirators conferred protection against confirmed SARS-CoV infection in 2 of 3 case-control studies [32, 33]; no protective effect against SARS was reported for disposable [29, 34], cotton [35], or paper [32] masks (Appendix B, Table 2).”

    [Again, bold type is my emphasis.

    Now it does say that specifically wearing medical masks or N95 respirators  reduced the risk of SARS by approximately 80%, but the above statement makes it clear that all other such masks are pretty much ineffective against SARS.

    Am I missing anything?

    • #61
  2. Steven Seward Member
    Steven Seward
    @StevenSeward

    I should add a part of the “Conclusions” of the study:

    “The confirmed effectiveness of medical masks is crucially important for lower-resource and emergency settings lacking access to N95 respirators. In such cases, single-use medical masks are preferable to cloth masks, for which there is no evidence of protection and which might facilitate transmission of pathogens when used repeatedly without adequate sterilization [8].

    We found no clear benefit of either medical masks or N95 respirators against pH1N1 (Flu – Steven S.). However, current policies mandating standard and droplet precautions when performing routine care for influenza patients are reasonable. RCTs conducted in community settings have demonstrated protective effects of medical masks in combination with hand-hygiene and other infection control interventions [53].”

    They go on to say:

    Overall, the evidence to inform policies on mask use in HCWs is poor, with a small number of studies that is prone to reporting biases and lack of statistical power.

    • #62
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