As a trusted node on my friends’ “nerd network” (i.e., the people who are known to dig in and research everything so others may not have to) I have been asked a few questions that I’d like to share, in the hopes that other people can add their own perspectives — and new questions!
Question: What’s up with people wearing masks? Are you?
My answer: Yes, I am starting to wear a mask when I am likely to run into groups of people or go into a store. It’s mostly to remind myself not to touch my face when I’m out, but also to remind people to keep their distance.
George Gao, director-general of the Chinese Center for Disease Control and Prevention, was asked what mistakes other countries are making. His answer? “The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks.” Read the full article in Science — it’s excellent.
Here are two Do-It-Yourself (DIY) videos for creating your own mask:
Question: If I get sick, should I keep track of my temperature? Anything else?
My answer: I’m planning to track symptoms, yes, if I or someone in my household gets sick. We have a digital thermometer and a pulse oximeter (to check oxygen level and pulse).
Here’s a COVID19 symptom diary you could use. There are also more sophisticated versions out there, particularly for people with chronic health conditions, like PatientsLikeMe’s COVID19 tracker. Disease InfoSearch is creating a patient registry to track COVID19 symptoms and long-term effects, which is a way for regular people to contribute to scientific discovery. And the Open Health Network is providing a range of tools, including a COVID symptom tracker.
Question: What is it like to have the virus?
Answer: I don’t know, but I’m reading first-hand accounts to get an idea. Here are some essays and threads written by people who are recovering, such as Kelli Dunham, Shiraz Maher and Eliza Shapiro. “Em” wrote about their experience with being on a ventilator. Everything I read makes me want to double down on my safety measures.
Here’s a video to share with anyone who scoffs at your precautions or calls you paranoid:
Question: I’m not sick yet, but I know this: If I do get the virus and have complications, I don’t want to take up an ICU bed. And I don’t want die alone in the hospital. I’d rather die at home. What should I do?
My answer: Please continue to minimize your exposure and risk. Stay home, wash your hands frequently, try not to touch your face, etc. But if you do want to have an end-of-life conversation that is specifically related to COVID19, an organization called Respecting Choices created a toolkit. This story of one woman’s death may help to bring focus to your own conversations.
If you really want to dig into this issue, read: “Pandemic palliative care: beyond ventilators and saving lives” (Canadian Medical Association Journal, March 31, 2020).
Updated on 4/3/2020: Muriel Gillick, MD, wrote two articles about COVID19 that are worth your time to read if you care for — or are — someone age 70 and older:
- Keeping Older People Safe During the Coronavirus Crisis: How caregivers can use technology to help older people minimize going to the doctor during this pandemic. (New York Times, 3/31/2020)
- Venting about Ventilators (Life in the End Zone blog, 4/1/2020)
A key quote from her blog post:
Many though by no means all people, if they know the end is likely to be near, do not want aggressive medical treatment that offers little or no benefit. This goes for people with advanced cancer, severe heart disease, or any of a variety of other conditions that are usually fatal. They’d rather receive medications such as morphine to ease their shortness of breath and medications such as lorazepam to ease their anxiety than to undergo extremely uncomfortable treatment that has only a small chance of prolonging their lives. Severe Covid-19 is another condition for the oldest Americans to consider adding to the list.
OK, your turn! What would you add to these answers? What questions are you and your friends asking each other?
For more examples of pandemic-inspired inventions for clinical and home care, see: COVID19: Peer to peer innovation.
Featured image: My home-made mask, made from an old T-shirt. Please excuse the grubby-looking running hat.
We’ve sewed a bunch of masks, for the same reason you state.
We’ve created a COVID registry because this is the perfect time to do citizen science on a large scale. We cannot Fight To End COVID without the lived experience of all of us. Our system allows people to control access to their data – the data never leaves the system, the questions come to the platform to analyze the data. We have a number of researchers looking for this information already, and we want to be sure that patient reported outcomes and the concerns of people pre- and post-COVID drive agendas. Join here – feel free to spread this far and wide: https://www.fighttoendcovid.com/
Thanks, Sharon! I love the words emblazoned on the browser tab for the site: You Are the Best Source of Vital Information.
Everyone, please also read her beautiful essay, Promise Your World Your Love. And take that minute to breathe.
Since this blog is my outboard memory, here are some additional articles I’ve read about precautions:
1) Everyone Thinks They’re Right About Masks. How the coronavirus travels through the air has become one of the most divisive debates in this pandemic. By Ed Yong in The Atlantic, April 1, 2020.
2) Keeping the coronavirus from infecting health care workers. What Singapore’s and Hong Kong’s success is teaching us about the pandemic. By Atul Gawande, MD, in The New Yorker, March 21, 2020.
3) Face mask stapled together from a folded paper towel & rubber bands – a tweet by Chuck Webster, MD.
Please add articles and how-tos if you find useful info out there!
A friend in Japan writes (quoted with her permission):
The photo of you with a school of blue-fish mask looks stylish! It reminds us of the importance of keeping our distances and contributes to slowing down the spread of infection. I have also checked Dr. Gao’s article in Science Magazine about the merit of wearing masks with photos of Chinese patients with masks.
Here in Japan, the government has decided to distribute fabric face masks to facilities for the elderly, people with disabilities and after-school programs.
They even created a 3-and-a-half-minute video in Japanese demonstrating how to hand-wash masks neatly using liquid detergent or laundry bleach. Ideally, we are to wash and let them dry after using them for a day. In reality, I wonder how many people have time for this ritual. The latest news is that the prime minister announced that 2 fabric masks will be delivered to each household nationwide to iron out the problem of mask shortages.
I will leave the discussion to the medical professionals on the effects of wearing masks. As a frequent user of masks to avoid catching flu every season, I feel it is more challenging to have a brief conversation in English with a mask covering my lips than in Japanese. It slows my communication ability especially when pursing my lips to pronounce words with plosive sounds such as “p” or ”b.” It happens that I tend to pull down my mask or take it off when I have to speak in English and then put it back again.
Our habits of unconsciously touching parts of our faces will amplify the risk of being infected. We are advised only to touch the strings or the uninfected tips of the fabric but I can easily forget it and touch the surface of the mask and then touch my face without noticing. So I decided to use masks more purposefully at crowded hours in confined settings such as trains, elevators, or stores. Now is the time for us to choose carefully when, where, and how to use masks. When I see no person around within 6 feet in open air, I tuck away my mask in a sealed plastic bag and breathe fresh air.
I hope the day will come soon when we look back and say, “Why were we seriously talking about wearing masks?” Until then, we need to use masks strategically to protect ourselves and our communities.
Phonetically, while both English and Japanese have plosive consonants, the aspiration of the English consonants is stronger than those of Japanese consonants. It’s always hard to pronounce even subtly different sounds in a language that isn’t your own! So maybe it helps to remove the obstruction of masks to more freely concentrate on the different pronunciations.
When our family lived both in Japan and China, we often remarked at how frequently the Japanese and Chinese wore masks when they were sick, in an effort to protect others, or for other reasons.
Americans are certainly less used to wearing masks. It’s interesting to consider all that is at play — linguistically or culturally — when people wear or try out masks.
Deb, thank you for the insights!
From your time in Japan and China, can you share more about how people treat their masks? Do they carefully remove them, as my friend describes above? Or do you think that caution is being added now that we are dealing with a more virulent, frightening virus?
I’m also curious to know how people handle taking a drink of water in public if they are wearing masks. But maybe that’s not relevant. It’s only Americans who walk around with water bottles like we’re all about to go on a hike.
The wearing of masks on public transportation and elsewhere in public in Asia (especially in China and Japan) took off with the SARS outbreak in 2002 and will almost certainly become even more common now, even after COVID-19 passes or a vaccine is developed and distributed widely. I was intrigued by the question about language and did a bit (very preliminary) of digging. It turns out that seeing someones lips move while speaking is very important to learning a second language (probably very important to learning your native language as well, just not as easy to study in a controlled way). So in a study of people learning Japanese, those who saw lip movement learned faster than those who did not.
The same would almost certainly be true for German, which has umlauts (that historically pushed rear throat vowels to the front of the mouth with rounded lips) that are hard to learn (or understand) if you don’t see and mimic the lips.
So while the masks are obviously important to public health, they will not help with inter-cultural understanding, certainly not at the person-to-person level. And those of us who travel (once it is safe) and want to learn or try out our limited foreign languages will find it even harder and more intimidating to do so.
An interesting read: https://www.futurity.org/lips-movement-vowel-sounds-1703692/
It was an eye opener that SARS outbreak motivated public transportation users to wear masks in Asia. In Japan, it is part of our culture from our childhood. While wearing masks may be optional in some public elementary schools, it is still a tradition for the majority of school children to use masks for the purpose of keeping the meal servers’ breath away from food.
Some parents and teenagers close to me agreed that bringing masks to school until the 6th grade was mostly for lunch-serving. As Deb has observed, masks are also used when they go to school coughing and sneezing: they wear masks to prevent their classmates from being infected while protecting themselves from the cold breeze.
Arthur, spot-on, that monitoring lip movement helps learning a foreign language in a real classroom setting, especially if the sounds do not exist or if they are phonetically distant from the speakers’ native language. Furthermore, wearing masks in class will limit the exposure of our emotional expression. This will be trickier if a teacher is checking her students’ linguistic responses before lunch when their minds start drifting towards their favorite dishes.
Thank you, Naoko!
My friend Bon Ku, MD, wrote a perspective on Twitter today about his own family history (his parents emigrated from South Korea and recently moved back there), linking to Derek Thompson’s story in The Atlantic, “What’s Behind South Korea’s COVID-19 Exceptionalism? Seven weeks ago, South Korea and the U.S. had the same number of virus deaths. Today, South Korea has fewer than 300, and the U.S. has more than 70,000.” One person asked for Bon to share any tips he is learning from his relatives in South Korea and I thought, yes! That’s what we need: More exchanges of information among people in different countries, like we are getting from you, Naoko.
Again, thank you!
Susannah, this is awesome. We are doing a post about this topic on ClearHealthCosts — may we quote from you here, and may we use your picture with the flutterbies, with attribution? If yes, thanks so much, and if not no worries, and thanks for posting – -and stay safe! xo jeanne
Sure! Please do. And thanks!
Thank you!