Why Mask?

On the sixth month anniversary of the largest national shutdown linked to Covid-19, the pandemic scenario ends; strange night curfews, Ukalo state approved distribution, color-coded India in red, yellow and green dots on nothing, the Covid-busting apps that were supposed to liberate the nation, and even blind faith in the panacea, hydroxychloroquine, are losing momentum.

But the pandemic does not and continues to destroy lives and livelihoods. While quarantine, isolation, and treatment are essential for those exposed or infected, at this late stage, when the contagion has spread across the country, there seems to be less and less attention to the two vital but simple interventions that still remain can help mitigate the spread; masking and hand washing.
Last month, a network of volunteer medical students from around the country came out of their homes to watch a few hundred fellow citizens dress up while shopping at the local market.
They found out if customers and suppliers were properly masked by visiting 30 local markets in 19 cities on nine different occasions.
Of the nearly 4,500 people observed, nearly one in four did not wear a mask, and among those who did, nearly a third to half did not use them properly.
In fact, almost 2,528 of the 4,548 people (more than half) were not effectively masked.
This should concern us all. Masking is one of the last arrows left in our quiver, as long as an effective vaccine arrives.

Why Mask?

A few months after the pandemic started, it became clear that we were not dealing with a virus that spreads as easily as measles or Ebola.
Covid-19 is transmitted mainly by an infected person, whether symptomatic or asymptomatic, when he speaks, coughs, sneezes or even when he eats, in company.
We also know that inoculum (dose) plays an important role; the amount of viral particles that an infected person sprays into the air is important and, more importantly, the amount of those particles that we inhale.
Of course, age and underlying health will greatly affect the ability to fight the virus; Most Indians are in their 20s and although they have not died from the infection despite millions of people.
They have contracted it, they continue to transmit it to others who can more sensitive.
Transmission by contact with contaminated surfaces appears to be less of a concern than originally anticipated, although the abandonment of precaution is not justified.
A recent article in the New England Journal of Medicine even suggested that masking, by reducing inoculum, may in fact inadvertently lead to asymptomatic infections and subsequently immunity.
We in India should know that, after all, the Shitaladevi story is not a myth. For centuries, ‘tika’ has been practiced in India, where a smear of fluid from pustules (boils) of smallpox patients was applied to the pitted skin of a healthy person under the watchful eye of the patient.
“Goddess of cooling”, with the effect – then unknowingly – of unleashing a milder form of infection and consequently immunity! Exposure to an altered dose explains why unprotected family members, nurses, doctors, or coworkers are more likely to become infected and sick.
After the initial cost of healthcare providers in New York City, other cities in the United States that had time to prepare for the outbreak, such as Boston, did not experience the same mortality among healthcare providers of health.
They had time to ensure not only that doctors were properly protected on the job, but also that the public was in disguise at all times.

How to Mask?

There are literally hundreds of videos on what types of masks to wear. It’s not rocket science – the first goal is to avoid inhaling the virus, eliminate direct inhalation, and minimize any chance that we will get a large amount on our face by touching it with our virus-covered hands. The second, and perhaps even more important, is to prevent infected people from spreading the infection by exhaling.
A little blanket is better than no blanket, a tight fitting surgical mask with no side spaces is even better, and an N95 respirator may be best, but over the top in most cases and it’s not possible to wear it all the time.
N95 is essential for any close exposure between nurses and patients or between doctors and patients, and preferably with eye or face protection such as glasses or a screen.
Putting the mask on your chin frequently is a bad idea, as you can inhale what the mask has just filtered effectively.
It is a common practice among my colleagues to remove the mask completely and hang it on a hook, or place it outside, upside down, when it is necessary to remove it.

So why not hide us?

People get tired especially when nothing seems to have worked. Scientists warned of the danger of pseudoscience; While the pandemic required urgent interventions, there was no room, no, for no intervention.
The “something is better than nothing” attitude may be an acceptable philosophy of life, but a terrible public health strategy has resulted in a variety of prediction models and applications based on incomplete test data and poor judgment understanding of transmission dynamics.
Frightening and draconian isolation strategies and construction of hospitals when there have never been enough doctors to even staff the facilities we have.
When one intervention after another fails, public health authorities run the risk of eroding one of the most critical elements of an effective response; trust.
However, blaming the state does not relieve us of individual responsibility.
How many middle-class Indian households that have been so impatiently awaiting the return of the maids have gone to the trouble of providing an extra box of masks or disinfectants or even soap for their families or employees?
All of these products are prohibitively expensive with the meager wages our domestic workers earn, but they cost a fraction of the cost of ventilators.
It has always been convenient to blame the ills of India on its illiterate masses.
But Covid-19 did not hatch in our slums or inland, it was brought to India by flights and spread to our cities, then across India due to miscalculations colossal forces of the urban elite.
Leaving everyone to fend for themselves is not only cowardly but amoral.
Wearing masks in hot and humid India is not easy. What is needed is an aggressive and thoughtful ‘mission mode’ media campaign to show how to cover your face at home and highlight why they remain important, despite the oppressive realities of living in a poor country and densely populated: travel on crowded buses and trains, overcrowded living conditions and working in hot, stuffy spaces with poor ventilation. Billionsocialmasks.org, which brings together scientists and women’s empowerment groups, is one of many examples.
Grand gestures are not entirely unjustified; sometimes theatricality is needed to galvanize public attention. But having lost the trust of the public, now asking people to mask themselves, is a communication nightmare.
However, the greatest successes in public health have very modest origins. Advances in sanitation in London led to some of the biggest increases in life expectancy in the 19th century.
In the 20th century, in the cholera fields of Bangladesh, mixing a pinch of salt and a teaspoon of sugar with a glass of water brought back the lives of cholera patients, while he was impossible to provide fluids to thousands of patients intravenously.
Those of us who grew up in the days of One-Channel Doordarshan remember the television campaigns in which women went door-to-door to advise neighbors on how to prepare oral rehydration solutions at home.
This simple and unrecognized intervention remains a highly effective treatment for millions of people around the world, as it ensures that the correct concentration of ingested glucose and sodium activates specific cells in the gut to absorb water, thereby compensating for the problems. threatening water losses of blood. life caused by bacteria. Vibrio cholera.
The parade of leaders that made people stay home, quit their jobs, and download apps must now resurface, acknowledge the state we are in (widespread community broadcast) and explain why the only effective way, until the vaccine arrives, is to continue social distancing (for the few who can afford it) and masking and hand washing for all.
Surveillance is not the only way to ensure compliance; It would be prudent to revitalize our largely flexible population to make masking the norm and to expose it socially as unacceptable.
A wide distribution of effective soaps and masks will be exponentially more beneficial than the distribution of potions.
How incredibly powerful it would be if the highest office in the country inspired people to take collective action, this time in the service of science.