Good to see an article calling this out. Temperature-screening might catch a few people who know that they have a temperature (or are just not feeling well) and are going to "tough it out".
Here in the Portland, OR area I've noticed a definite change in how many people are wearing masks. At the grocery store, 2 months ago there were about 5% of the people not wearing masks and they all tended to be men in their 30s and 40s. At convenience stores in more suburban area, I was the only one in a mask. Now it seems like 100% of the people are wearing masks.
Wearing masks, not temperature checks, is what seems to be our best option.
> Temperature-screening might catch a few people who... are going to "tough it out".
And cause others with symptoms to stay home in the first place with the fear that they'll be caught, wasting the trip (e.g. to LAX in LA traffic), keeping them out of the secured area & also off transportation to that area.
Because it IS the best option. Temperature checks are theatre, and don't matter when it only takes one asymptomatic, maskless person to spread a deadly respiratory illness.
Are you reacting to somewhere that was doing temperature checks, but not requiring masks? Relying on temperature checks alone is clearly foolish.
In my experience, I've only ever seen temperature checks at doctor's offices and hospitals, where they also have mask policies so "thorough" that I sometimes have to argue to keep my P100 non-glasses-fogging respirator on.
I agree completely on masks being preferable to this, but I wonder whether it may have some utility anyways, because even if it does not catch many asymptomatic people, if it is widely deployed and it catches _some_ people, those people don't go on to spread the virus, and then if you deploy those measures broadly, you have managed to halt a few potentially exponential sources of spread.
I should hasten to add that I'm not an epidemiologist, so I don't know whether this is true. But my intuition suggests that even if this is just partially effective it might still be worthwhile in the context of national efforts to control the spread, which is a numbers game.
I think this is a crucial distinction between "security theater" and "hygiene theater" -- security risks are not contagious and don't have the same potential for exponential growth that virus transmission does.
As a doctor, I really do think this is ‘hygiene theatre’ (that is, forehead/IR temperature checks).
Last week I rocked up to operate at a hospital I irregularly work at which has recently introduced checks (as opposed to all public hospitals which have had this in place since March).
In theatres we were talking about how useless it was. One of the nurses said someone tested high last week. They made the person sit in a chair for half an hour and then re tested them and granted them entry.
To some degree I get it. I mean, my state is only recording 15-20 positives a day across almost 20,000 tests so the pre-test probability is small. On the other hand, what’s the point of a policy if it doesn’t change anything.
Another aspect of ‘hygiene theatre’ - when the apple stores reopened in sydney I happened to be one of the first back in (by coincidence). I visited late on the first day. I was initially impressed - security guard scanning, handing masks out.
Inside the sales rep who served me had a mask continually falling down his face and kept grabbing at his face and readjusting.
I eventually capitulated and told him he was wearing it upside down (metal bit across bridge of nose needs to be squeezed).
Mask hygiene is important but pretty much everyone is so slack with them that, whilst they may be decreasing aerosolisation, they would be actively increasing spread of body fluids on surfaces, since so many people put a mask on and then immediately give up hand hygiene.
> One of the nurses said someone tested high last week. They made the person sit in a chair for half an hour and then re tested them and granted them entry.
While 30 minutes seems excessive, this makes sense. Your surface temperature is heavily biased by your environment’s temperature. Letting one settle in a controlled environment to test is reasonable to see if it’s really a fever (temperature will stay elevated) or due to environmental factors.
An issue is that anyone could ice their forehead in advance and beat the test. Dunno if too low of a temperature triggers a fail. In theory, everyone should have to sit in a controlled environment before forehead testing, but at that point, may as well do tympanic checks.
(Among many other issues, like the massive variance that’s probably accepted because of unreliability of surface temperatures as a proxy for internal temps)
It’s winter here now.
It’s not true that a ‘true fever’ will keep temperature high. On night shifts when I am called to patients that are febrile (using more sensitive tympanic or sublingual thermometers) I often ask them to check again in half an hour to kick it down the road (at which time they are generally non-febrile) provided they have a known cause and are on adequate treatment. Although the Pathogenesis of hyperthermia in this instance is usually from a slightly different cause (ie bacterial rather than viral)
I biked to a non-doctor appointment in 80+ degree heat recently. A guy thermometer-gunned my forehead before coming in. I was outside and visibly sweaty, but I still had to warn him that given the circumstances, my temperature might appear a bit high. I don't know if people are really thinking through any of this.
Did it read high? I have been checked by IR thermometers hundreds of times and have never tested above 36.9C which seems to be the gate temp around here. I too have sometimes been hot and sweaty and it didn't seem to affect the results much. I cannot even enter my own apartment building without passing an IR thermo check.
I wonder how much of a difference biking made. Generating your own breeze may balance things out.
Right now where I am, air conditioning isn’t common, but it was slightly above body temperature at the peaks of each day (I guess 100F). I wonder how that worked out with scans.
From what I have read, you are most infectious in the 24-72 hour period before experiencing any symptoms.
Given that the time from infection to symptomality is as short as 48 hours, this means it may be possible to be infected by someone before either they or the person that infected them has started to show any symptoms.
There's a subtle distinction between being most infectious and infecting the most people.
You may be very infectious when symptomatic, but you're likely bedridden and the few people around you are taking some precautions.
On the other hand you may be less infectious while presymptomatic, but live a normal life, effectively infecting more people right before you "get sick" yourself.
Not to mention that OTC analgesics do a pretty good job at controlling fever. Don't feel well? Pop a tylenol and your fever will come down significantly for a few hours.
Now that likely won't work if you're in the throws of a Covid infection, but in the first few days when you're not sure if you're really sick? It probably does a great job of masking fever.
If you're reasonably healthy in general a fever(under 42°C) might be worth enduring for the health boost. Treating influenza by lowering a fever with antipyretics increases the odds of death in animal studies and in humans similar treatment has been shown to prolong recovery time.[0]
That's awfully high: You should be seen well before that, child or adult. [1] I have only had such a fever once in my adult life - and I had serious cognitive defects. I couldn't drive. I fell asleep while while waiting for the doctor, who proceeded to have me take 800mg of children's liquid ibuprofen and kept me there to make sure my fever started to go down, otherwise they were going to send me to the ER. My fever was 103.1 (39.5C). I'd think at 42C, I'd be in serious, serious trouble.
All that said, a low-grade fever isn't all that harmful. I still tend to take something. I used to try to tough it out before the experience above, but also found that without the body aches and headache that comes with the fever, I slept better while sick, even though I still would sleep for hours. I also tended to feel better a little sooner. Of course, this isn't data, and I've read the stuff about the beneficial fever before, but until general medical advice tells me to do differently, I'll stick to comforts.
I just transited through an airport, and it saddened me seeing how many people wasted perfectly good N95 and equivalents by poor fitness.
They’re no better than a surgical mask if you have a lot of gaps: they’ll filter nothing but your coughs. So little inhalation will be filtered because of the path of least resistance.
How's the actual mask use? The majority of people I see reuse the same one over and over, frequently touch it and adjust it, and then touch other things. I don't see how they're achieving much more than safety theater that way.
Does that matter? I thought the point of having the entire public wear masks is to stop the wearer's breath from spreading germs, not stop the wearer from coming in contact with germs.
Obviously medical professionals or other people who come in close contact would be better off using medical-grade masks in a hygienic and consistent way- but for the majority of grocery shoppers and such, I thought the purpose was simply reducing your ability to spread the germs.
How does it not matter? If their breath contains something that shouldn't be spread and they're actively touching the damp mask containing it and then touching other things, how does that not spread it?
you said that if people touch their mask or adjust it, "I don't see how they're achieving much more than safety theater that way." Covid is primarily airborne. If you prevent your breath and your coughs and your speech from spreading the germ and making it airborne, you're accomplishing a lot. And I feel like "damp mask" is a bit of an exaggeration. A hell of a lot more than "safety theater".
That's fine from a theoretical standpoint, but the reality is far, far different. People in general do easy, token gestures. They're not following proper procedures for mask use.
Citation needed. Reusing a mask that is already loaded with exactly the stuff you don't want to breathe will cause the material to dry as soon as the user stops wetting it with their exhale, and then pass through on re-use because it's under the filter size, even for an N95 which practically nobody is using.
There are good reasons they are called disposable masks.
Viruses don't live forever, and the current coronavirus is no exception. Current estimates for surfaces vary a bit, but I believe it's no more than 1-3 days for fabric. And of course, the decay is exponential. Finally, why would it matter if you inhale stuff you just exhaled? If you're already sick, it doesn't matter anyway. The mask is about you preventing others from getting sick; it only marginally protects you from other people.
The exhaled air does not go through the disposable fake mask.
Disposable masks that the majority of people are using are are not for reuse, and it says right on the box "not for viruses". The "oh but large particles they (aerosol experts) didn't think of that" thing is surreal to see people say with a covered face.
Yet those same masks are reused multiple times per day. Taken on and off. The multi-day exponential hand wave fails on reuse, the exhale re-hydrates the medium. Masks have a finite capacity before they are a net negative, and cloth IRL insanity is a growth medium.
The psychology of "wear a fake mask for others" is next level propaganda. It's right in line with the drastically more dangerous social contagion that person X knows better than person Y and therefore is righteous to force their ideas (medical procedures) on person Y.
Conditioning people to make medical decisions for others is too obvious, but here we are, fake masks and all.
It's a deadly religion, which repeats over and over in human history.
Every single claim you make here requires scientific evidence as in actual studies that demonstrate such effects. Are you seriously trying to argue that not wearing a mask at all is the optimal way to handle a highly infectious respiratory pathogen? You should be advocating increased availability of N95 or better rated masks instead. I believe the US has made a serious error in only allocating N95 masks to hospitals. The gamble is that surgical masks or cloth masks are enough, but they don't filter very well. Cloth masks are woven and have large holes everywhere making them only somewhat better than nothing. Surgical masks were never intended for serious filtration and don't even form a decent seal. BTW manufacturer claims or disclaimers are not evidence for anything in particular and are irrelevant.
> Good to see an article calling this out. Temperature-screening might catch a few people who know that they have a temperature (or are just not feeling well) and are going to "tough it out".
The article says that 30000 people were tested. 4 people were false positives, 0 people were true positives. This is called ‘many false positives’. Yet the people who actually had high temperatures were supposed to be at home anyway, right?
4 out of 30000 is not many, they are not real false positives and the design is flawed anyway because people are going to self select, as stated. So the article is just bullshit. Let’s not even go into the rest which tells some unrelated anecdotes about Ebola and other diseases that are not the same diseases and serve nothing but to indicate vague trends under the guise of evidence.
> Here in the Portland, OR area I've noticed a definite change in how many people are wearing masks. At the grocery store, 2 months ago there were about 5% of the people not wearing masks and they all tended to be men in their 30s and 40s. At convenience stores in more suburban area, I was the only one in a mask. Now it seems like 100% of the people are wearing masks.
This is a completely unrelated tangent. According to this anecdotal non evidence mask use has increased among some stereotyped group and in some establishments. Even if taken at face value this tells nobody anything about the effect of the masks.
> Wearing masks, not temperature checks, is what seems to be our best option.
That’s an opinion, based on nothing, which even if assumed true means nothing. To the writer something seems to be the best option.
That’s fine and maybe it even is the best option.
But does it really help to announce they jumped on the mask bandwagon before ‘men in their 30s and 40s’ and people in ‘convenience stores in more suburban area’?
The fake masks accumulate and concentrate particles in the users airstream. The large aerosols they do catch are dried and the contents can easily then pass through. They are not designed for viruses, and there is no strong evidence they do anything positive. I suspect they are a strong net negative.
At the very least they provide false sense of protection. If people want to be protected, they should use a real mask designed for viruses.
In situations where 100% mask compliance exits, they are still not effective.
Fort Benning: "according to Elizabeth Howe of Connecting Vets. About 640 recruits from the 30th AG Battalion and 2nd Battalion, 29th Infantry Regiment arrived at Fort Benning in May for training and were immediately tested for COVID-19. Four recruits tested positive and were removed from the group while the remaining soldiers were placed in isolation for 14 days without any training exercises. After the 14-day quarantine, they were all retested and every single one was negative.
Only then did the training commence – with the full panoply of obsessive social distancing measures, including mask wearing. You can imagine that there will never be greater compliance to these rules than during military training. Yet, just eight days later, after one recruit exhibited symptoms, 142 of the trainees tested positive. That is 22% of the entire group isolated and quarantined together. As they were young, none of them were hospitalized and most were asymptomatic."
And then there is the psychology, which is... more troubling to say the least. To the people promoting this pseudoscience, why not wear the fake masks forever?
Here in the Portland, OR area I've noticed a definite change in how many people are wearing masks. At the grocery store, 2 months ago there were about 5% of the people not wearing masks and they all tended to be men in their 30s and 40s. At convenience stores in more suburban area, I was the only one in a mask. Now it seems like 100% of the people are wearing masks.
Wearing masks, not temperature checks, is what seems to be our best option.