User:Yiyi Dai/Face masks during the COVID-19 pandemic

Surgical masks: Surgical masks are disposable. Surgical masks should be used tightly against the nose and mouth. The correct use of surgical masks can prevent large droplets containing viruses and bacteria and body fluids from splashing and scattering, thereby preventing them from reaching the mouth and nose of others.

A policy memo to: US Defense Logistics Agency(US DLA)

From: Yiyi Dai

RE: Solve the shortage of masks during the epidemic

Date:11/27/20

Executive Summary

In 2019, COVID-19 broke out in Wuhan, China, and spread to the world in just a few months. On January 12, 2020, this virus was officially named by the World Health Organization. Coronavirus is a large virus family, known to cause colds and more serious diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).[1] As the epidemic continues to spread, most countries are facing the problem of insufficient supply of masks, and the shortage of masks has become a global focus issue. According to a report in the Elsevier Public Health Emergency Collection, the frightened public in the United States has recently been snapping up masks and other medical equipment, resulting in an extremely limited supply of medical personnel who need these equipment the most. Health experts, including experts from the US Centers for Disease Control and Prevention, in the early stages of the virus, only recommend that personnel from relevant medical institutions who must be exposed to the virus wear medical masks and N-95 respirators. However, people are still buying facial masks, and the purchases are so large that the WHO is worried that those who need the facial masks the most will not be able to buy them.[2]

The study by Tso et al. illustrates the benefits of wearing masks for controlling the pandemic. Tso et al. (2020) Prior to this, the stigmatization of masks constituted the reason why the crowd did not trust masks and some people would not wear masks, which was aggravated by relevant news reports. Tso’s team mentioned that in order to encourage the public to treat masks in a fair and rational manner, after the World Health Organization relaxed its stance on the use of masks, people gradually realized the importance of masks and began to engage in self-protecting behaviors in order to block the spread. Tso gave a case study in China, claiming that the low infection rate in China is related to the government's rapid response to the epidemic and the mandatory policy for people to wear masks.[3] Social isolation and personal protection have strictly blocked the outbreak of the virus in communities and collectives. Therefore, the necessity of wearing masks cannot be ignored on the grounds of shortage of supplies.

Based on current research, from the consideration of the interests of the public, the government, and enterprise, I have provided three solutions to the shortage of masks in the United States during the epidemic. In general, companies should use the government as a channel to order self-imported semi-finished masks of a certain scale and reprocess them for sale. The government gives companies certain preferential policies (such as tax cuts) to stimulate factories to expand the production scale of masks, the government and companies jointly import large-scale orders for semi-finished masks, and encourage people to use basic living materials such as sewing, non-woven fabrics and rubber band, etc. make masks at home. This will help solve the shortage of masks in the United States.

Background

WHO estimates that during the raging COVID-19, medical staff need 89 million facial masks a month, as well as 76 million pairs of gloves and 1.6 million goggles. Mask supply demand during the pandemic has far exceeded the number of masks used in a year when there was no virus spread in the past. The Secretary of the Department of Health and Welfare of the United States, Alex Azar, said that the United States has a strategic reserve of 30 million masks, which should be reserved for medical institutions. The United States still needs 270 million masks. It can be seen that the inventory of masks in the United States was seriously insufficient while the pandemic broke out.[4] The WHO calls on factories to actively manufacture masks and increase the output of masks by 40% to meet the growing global demand. Even so, the supply is quickly running out.[5] Meanwhile, the market has also experienced supply chain cannot be well connected to improve the matching of supply and demand. It usually takes several months for the masks manufactured by the factory to be delivered to the relevant agencies, which leads to people's normal health needs and life safety not fully guaranteed in a short time. Buying low and selling high is another problem. Due to the price effect of the market, the suppliers generally sell products to the highest payer, causing organizations to compete with each other to buy masks, resulting in high mask prices and neglecting the flow of masks into the hands of real demanders. The general public can hardly afford to sell expensive masks, so they can only use some inferior substitutes.

'''With continuous changes in WHO recommendations, there are more and more discussions around the labeling and needs of public masks. According to the current CDC's release of mask wearing requirements, it is found that masks that meet the role of blocking the virus must meet the following conditions: have two or more layers of washable, breathable fabric, masks made of tightly woven fabrics ( That is, a fabric that does not let light pass through when maintaining a light source), and a mask with an internal filter bag. [6]Non-medical disposable masks are the best choice for ordinary people. Disposable masks have the advantage of reducing the probability of secondary infection, and the disposable nature is convenient for people to use. In the process of wearing a mask, the mask needs to cover both sides of the face and extend to the chin to ensure the maximum effect. It should be noted that CDC does not recommend the use of masks with exhalation valves or vents, because the holes in the material may cause bacteria in people's respiratory tract to escape with small molecular particles and reach other places. The use of inferior substitutes may cause the virus to enter the mouth and nose through the side, causing safety hazards. Some people may not be suitable to use traditional cloth masks. Deaf-mute persons with disabilities and those who need to see the shape of their mouths to obtain information can choose a transparent mask with a transparent plastic panel.'''

Options

Option 1 - Government gives companies certain preferential policies, requiring factories to increase the productivity of masks and then purchase masks at reasonable prices.

Option 2 - Government acts as a channel, and the company imports semi-finished masks through the government,then reprocesses and sells them.

Option 3 -People use materials that are easy to purchase and supplement to make low-cost household masks.

Analysis of Options

Option 1: In order to ensure the greatest possible solution to the shortage of masks, increasing the production of masks in the United States is a top priority. The government cannot afford a large budget deficit, therefore the government needs to put pressure on enterprises to promote factories to accelerate the productivity of masks. Although the US government cannot directly control companies, the government can give companies some appropriate incentives, such as tax cuts, and urge companies to achieve the goal of increasing the output of masks. The government then buys masks at reasonable prices, sells them through pharmacies, post offices and other specific institutions or distributes them to the public for free. Increasing production capacity can fundamentally solve the problem of shortage of masks. Meanwhile, enterprises are also controlled to a certain extent by the government. Because of the preferential policies, companies will actively cooperate with the government in large-scale mask production instead of following the company's own wishes.

Option 2:'''My second proposal is that government acts as a channel, and the company imports semi-finished masks through the government,then reprocesses and sells masks. Given our current state of economic globalization,''' if the United States wants to produce more masks, it may face insufficient raw materials for masks. The US Department of Health pointed out that many of the raw materials used to produce related products need to be imported from Asia. [7] At the same time, even if American factories are willing to resume operations and speed up production, it will take a certain amount of time from manufacturing models to transportation. Therefore, the government should provide certain channels to allow US factories through the government to import semi-finished masks from other countries, and reprocess the masks for sale. The advantage of this is to shorten the delivery time in order to meet the Americans' demand for standardized masks as soon as possible. At the same time, the government will not bear a serious economic burden. Semi-finished masks already have prototypes, as long as they are partially reprocessed and quality tested on this basis, they can be sold normally. Generally speaking, the cooperation between the government and enterprises will be a mutually beneficial method. Buying semi-finished masks for reproduction can also avoid directly importing masks that do not meet US standards, provided that US factories need to manufacture masks in accordance with industry standards.

Option 3: '''My third roposal is that people can use materials that are easy to purchase and supplement to make low-cost household masks. Eikenberr et al. [8]described in his article that although N95 and professional masks have better protection against viral infections, and homemade masks are not as effective as surgical masks, they are still significantly better than no masks. （Eikenberr et al. 2020）'''Due to the long duration of the fight against the epidemic and the huge consumption of masks, many medical supplies have been declared urgent. CDC encourages people to make their own masks at home to deal with COVID-19 while leaving medical masks and N95 respirators for medical staff and other emergency personnel.[9] '''Although many people think that it is possible to buy disposable masks, disposable masks are very expensive when masks are in short supply. Therefore, homemade masks have become one of the people's choices'''. '''Hilder briefly listed the methods and costs of making household masks in the Creative Bloq news section.(Hilder, 2020)[10] He showed that if people need to make a bandana-style face mask, they only need to use spare cotton cloth, rubber bands, and coffee filter paper. The easiest way is to fold the headscarf in half to the proper size, tighten the sides with a rubber warp, and fold it again so that the cloth can be fixed by the rubber band. People can also add a piece of coffee filter paper with a suitable shape to the mask to block droplets.Filter paper can be replaced at any time. If people want to buy new fabrics, the price on Browse fabric at JOANN is only $3.99. Fabrics can be purchased on JOANN, Fabric.com, Etsy and other websites. Masks made from old T-shirts can also use above method. Before that, the T-shirt may need to be cut into a suitable shape similar to a headscarf. If you don’t want to use a sewing machine to make a cloth mask, you can use needles, scissors, pins and cotton to make a simple mask. Use a disc-shaped template to cut the fabric into a circle, fold it in half and cut a crack in the middle with scissors and then stitch it together. The purpose of this is to make the mask into an arch to better fit the shape of the face. The next step is to sew the edges of the mask. Note that you need to leave a small gap at one end to allow the rubber band to pass through the mask. Now, you should basically have a shaped mask, and then you only need to tie the rubber band tightly and confirm the tightness on your face, and you are done.''' Homemade masks are low-cost and simple to make. Masks of suitable size can be made according to the individual's face shape. Meanwhile, individuals can choose the pattern and material of the fabric according to their own preferences, which makes their customized masks comfortable and pretty.

'''The artivle by Sunjaya explains that one of the benefits of homemade masks is that they are easy to clean and maintain.[11] (Sunjaya, 2020) Although there is no research to show how different cleaning mechanisms remove virus particles, CDC recommends using 70-80°C hot water to wash the homemade cloth masks with detergent for 10 minutes. Even if no detergent is used, above 50°C The temperature can also significantly reduce microorganisms. Also, exposing homemade masks to a temperature higher than 56°C for 15 minutes can also effectively eliminate the virus on the mask.'''

Recommendation

'''Through analysis, I found that the three options have their advantages and disadvantages. My final recommendation is the option 1, that is increasing the productivity of masks.''' Option 1 is the most common way to solve the problem of material shortages. One of the benefits of mass production is that it can lower the price of masks so that more people can afford basic prevention expenditures. But there may be limited companies capable of large-scale production. In addition, if the company needs to be equipped with advanced production machinery and needs to spend a certain amount of budget, the funding of this amount may become a problem'''. Option 2 can reduce the time to produce masks but the issue with option 2 is that semi-finished masks may not be imported on a large scale.''' According to the current international situation, some countries are still suffering from severe epidemics, and these countries need to consider their own citizens before thinking about exports. '''Option 3 allows almost everyone to have the opportunity to have a mask, and the mask is also easy to clean and reuse. However, the disadvantage of option 3 is that the masks made by the people may not meet medical standards. General consensus is that wearing a homemade mask can only block basic droplets, but cannot effectively prevent Covid-19 infection.''' According to chemical safety expert Neal Langerman, people cannot ignore social distancing and other epidemic prevention measures because they wear masks. In addition, people should understand the risks behind each measure in order to truly protect themselves and others.[12] '''People can make their own masks, but they should not rely too much on them. If possible, they should use medical masks with stronger antivirus capabilities.''' [1] Coronavirus disease (COVID-19) pandemic. (2019). Retrieved from

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

[2] Zhai, Z. (2020). Facial mask: A necessity to beat COVID-19. Building and Environment, 175, 106827. https://doi.org/10.1016/j.buildenv.2020.106827

[3] Tso, R. V., & Cowling, B. J. (2020). Importance of Face Masks for COVID-19: A Call for Effective Public Education. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciaa593

[4] U.S. Has 30 Million Masks, Needs 300 Million for Coronavirus. (2020). Retrieved from

https://www.newsweek.com/alex-azar-coronavirus-masks-30-million-have-need-30-million-fight-america-senate-committee-1489058

[5]  Shortage of personal protective equipment endangering health workers worldwide. (2020). Retrieved fromhttps://www.who.int/news/item/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwid

[6] COVID-19 and Your Health. (2020, February 11). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html#recent-studies

[7] U.S. Pandemic Could Severely Strain Face Mask, Other PPE Supply Pipeline. (2020). Retrieved from https://www.infectioncontroltoday.com/view/us-pandemic-could-severely-strain-face-mask-other-ppe-supply-pipeline

[8] To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic. (2020, January 1). ScienceDirect. https://www.sciencedirect.com/science/article/pii/S2468042720300117

[9] CDC on Homemade Masks. (2020). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-make-cloth-face-covering.html

[10] Hilder, R. (2020, September 21). How to make a face mask: 4 easy ways to make DIY face coverings at home. Creative Bloq. https://www.creativebloq.com/news/how-to-make-a-face-mask

[11] Sunjaya, A. P. (2020). Evidence Review and Practice Recommendation on the Material, Design, and Maintenance of Cloth Masks | Disaster Medicine and Public Health Preparedness. Cambridge Core. https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/article/evidence-review-and-practice-recommendation-on-the-material-design-and-maintenance-of-cloth-masks/0630CEE32CCD97E85CC7931062308B7A

[12] Why the best material for a homemade coronavirus face mask is hard to identify. (2020). Retrieved from https://cen.acs.org/biological-chemistry/infectious-disease/cn-Why-the-best-material-for-a-homemade-coronavirus-face-mask-is-hard-to-identify/98/i14