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A Kurdziel  
#41 Posted : 12 January 2021 12:45:12(UTC)
Rank: Super forum user
A Kurdziel

It is increasingly obvious that the covid regulations, at least how they are being used in England need to be reviewed. They were knocked up nearly a year ago on the assumption that would only be imposed for a few months at most after which any issues with them will have disappeared into history.  There are several issues that need to be looked at if we are going to apply rules which might actually reduce the spread of COVID-19.

Firstly, the use of face shields, for which there is no evidence that they actually stop the spread of the virus. they Scots do not allow them but insist on a cloth covering.

The issue of exemptions to wearing face coverings. As people have said it is really easy for anybody to claim an exemption based on the legal criteria and there is no need to provide proof that the exemption is valid: anybody can claim that a face covering causes them “severe distress;”. Somebody needs to evaluate these exemptions (not a GP they are not “medical exemptions”) with the burden of proof being on the person claiming the exemption to establish that they need one. Each exemption should be registered and an official card or permit issued to that person with a photograph. I know that this sounds bureaucratic but I think it will become part of the new normal. We should be working on the assumption that life will never back to exactly what it was like before March 2020.

There is more but we need to look at these as long term issues and the general consensus at WHO etc, is even after covid 19 is back under control, there are other new diseases waiting in the wings.  

John Murray  
#42 Posted : 12 January 2021 14:53:07(UTC)
Rank: Forum user
John Murray

Plenty waiting, and if not waiting, then being made.

Unfotunately, the economy of this society cannot cope with a national lockdown for much longer, so if the vaccine/s do not work well enough, it will be back-to-normal-and-hope-for-the-best (pretty much like what happened after the last lockdown). Pictures of snake-like queues waiting for vaccination in the rain and cold do not inspire confidence. My GP practice, which is large, will not be doing vaccinations. They're being done in a large hall (or a civic centre) (or both) (or neither).

As for exemptions, as I said...I could easily have one (as could any of 65 million residents of the UK). You think a national exemption-card-centre would work? Only by having access to each applicants medical record. And since that list of people who can has access is already large, and increasing every day, it is a possibility (which includes the police, who may request information about you if you are supposed to be self isolating). GPs' won't do it, they're snowed-under, and it isn't in their contract. Just in case you forgot the majority are self employed. I decided not to go the route of walking around a shop without a [proper] facemask....self preservation. Didn't help my breathing much, but at least it makes it more likely I will continue to breathe !!

Roundtuit  
#43 Posted : 12 January 2021 15:28:04(UTC)
Rank: Super forum user
Roundtuit

We have all bemoaned getting appointments during Covid.

Before last March the local well being service had a waiting list of two years to get a "first" appointment towards an assessment - so no medical record to access. Would a place in the queue count as evidence for exemption?

Roundtuit  
#44 Posted : 12 January 2021 15:28:04(UTC)
Rank: Super forum user
Roundtuit

We have all bemoaned getting appointments during Covid.

Before last March the local well being service had a waiting list of two years to get a "first" appointment towards an assessment - so no medical record to access. Would a place in the queue count as evidence for exemption?

Pandatank  
#45 Posted : 13 January 2021 04:35:41(UTC)
Rank: Forum user
Pandatank

Regarding positive pressured masks, in an environment requiring FFP3 levels of passive RPE, HSE allows you to downgrade to FFP2 filtration because of the elimination of face fit and contamination issues. and the added protection against infection through the tear ducts.

There are 2 things we need to clarify here,

1) an aerosol is a water droplet small enough that gravitational acceleration is completely negated by the brownian motion of the gases in air and by air currents. In countries with better track and trace than we employ, they have found aerosol infection at a distance of 6metres. The couple that contracted the virus were seated under the air extraction unit and the infected couple that dined at the restaurant were seated 6m away inline with the extraction airflow.

2) I don't recommend face visors because they are any more effective at blocking viron travel than, say,a 3ply surgical mask, I recommend face visors because of the reduction in risk of contact transfer of viral (and other hazardous) contamination from the forehead or neck to the nose, mouth and eyes.

Also, contamination of the inner surface of a visor presents far less of an inhalation risk than it does with a tight fitting mask holding the virus against the breathing passages. Issues of fibre friability and (potentially contaminated) microfibre inhalation are eliminated with a visor. Touching anywhere on the face is prevented by the visor and the ease of maintaining the visor in a sterile condition is why I would favour a visor over a mask. 

The 3D visualisation studies modelling aerosol and small droplet distribution are flawed in one aspect and the results have been cherry picked.

If we are wearing masks to protect others from our pre-symptomatic and asymptomatic viral shedding, why are we looking at models based on coughing and sneezing, which are smptoms? Surely asymptomatic spreading is mainly by small droplet and aerosol spread by talking and breathing etc? 

If they can show you the clips of the face visor result, why do you not see the video clip of a mask for comparison? They tested all the current types of face covering available to the general public, so they could have easily published a video of the best performing mask to compare. I saw some stills from the original study that showed around 1m diameter "clouds" of aerosol hanging around people's heads.

The only protection against inhalation of viral aerosol is FFP3 level of protection. Reduction of exposure by dilution of viral aerosol with air is higher up the hierarchy of control than PPE and a face visor achieves this, unlike a mask.

Edited by user 13 January 2021 04:38:48(UTC)  | Reason: misspelling

Kate  
#46 Posted : 13 January 2021 07:55:37(UTC)
Rank: Super forum user
Kate

As to why coughing and sneezing are relevant, people without Covid symptoms do still cough and sneeze.  Not every cough is a Covid-type cough and sneezing isn't even one of the main symptoms.

People cough or sneeze because their throat or nose is irritated, because their food or drink goes down the wrong way, because they have allergies, because they need to clear their throat, or because they have some other illness such as a lung disease or a common cold, and probably for other reasons I haven't even thought of.

A cough is only treated as a Covid symptom if it is new and continuous.  If it is due to an existing condition or is just occasional then it is not treated as a Covid symptom.  Sneezing isn't treated as a Covid symptom at all.

So Covid-asymptomatic people do cough and sneeze and if they are carrying the virus, this is clearly far more of a transmission risk than when they are just breathing or talking.

thanks 1 user thanked Kate for this useful post.
chris42 on 13/01/2021(UTC)
Holliday42333  
#47 Posted : 13 January 2021 08:40:48(UTC)
Rank: Forum user
Holliday42333

Pandatank, you may beright you may be wrong.  I for one certainly cannot definitively argue for or against the points you make.

But here is the thing; right now the WHO, English Guidance and Scottish law is that close fitting face covering and not visors are appropriate.  We collectively could fully agree with you but as of right now (much like if we agreed that 70mph was an innapropriate speed lmit for a motorway) it makes no practical difference.  The guidance not to wear visors (on their own) as a face covering still stands.

At best you are right and should share your opionions whigh whichever SAGE subgroup are looking at this issue, but as things stand we should follow the guidance until this is confirmed.

At worst, your opionion is (whilst potentially well intentioned) is wrong.  In which case you are doing what Sir Simon Stevens got so passionate about in one of last weeks press conferences; spreading information that influences people to do the wrong thing.

I like a good intelectual debate as much as anybody but all this 'why Government advice is wrong' is getting more and more futile in the face of the current state of the pandemic.  Much of legislation/guidance is fundamentally flawed (RIDDOR, DSE, CDM) and we still have to follow those too.  

thanks 4 users thanked Holliday42333 for this useful post.
Kate on 13/01/2021(UTC), CptBeaky on 13/01/2021(UTC), chris42 on 13/01/2021(UTC), Alan Haynes on 13/01/2021(UTC)
Holliday42333  
#48 Posted : 13 January 2021 09:25:12(UTC)
Rank: Forum user
Holliday42333

Originally Posted by: Pandatank Go to Quoted Post

1) an aerosol is a water droplet small enough that gravitational acceleration is completely negated by the brownian motion of the gases in air and by air currents. 

Pandatank, there is one point that I do disagree with you on the basis of my experience as an aerosol development chemist for over a decade.  The definition you have given of an aerosol is correct in specific circumstances but far too restrictive, in my opinion, and appears to have been given to support your argument rather than an objective descriptor.

An aerosol is merely a suspension of liquid droplets in a gas.  This covers a whole range of scenario's.  Indeed the products of most 'aerosols' from a can or mechanical pump spray are liquid droplets suspended in the atmosphere due to the kinetic energy of the propulsion mechanism and Brownian motion or air currents do not normally have a relevent effect.

Brownian motion only really overcomes gravity where very small droplets are concerned.  It is only my opinion but if there is an aerosol of virus carrying droplets small enough to be suspended by Brownian motion, then an FFP3 respirator would be very unlikely to offer protection as these droplets would pass staight through.  As far as I am aware FFP3 respirators/filter cartridges have never been claimed to offer this protection.  They are used in the health service as the best mass produced equipment available that reduce the risk to a broadly acceptable level.

Edited by user 13 January 2021 09:38:03(UTC)  | Reason: Terrible grammar correction

thanks 1 user thanked Holliday42333 for this useful post.
Kate on 13/01/2021(UTC)
Pandatank  
#49 Posted : 26 January 2021 01:00:47(UTC)
Rank: Forum user
Pandatank

"Evidence showed that the surgical mask might not be enough to protect the person from air-borne pathogens and might also be the soutrce of air-borne or droplet infection" https//www.thoracic.org/statements/resources/eoh/resp1-13.pdf

"Medical masks were not protective and may in fact increase the risk of viral co-infections.....it is further possible that the physical conditions of a medical mask may increase moisture or other parameters to increase the risk of co-infection"       MacIntyre CR, Wang Q, Cauchemez S, et al. A cluster randomized clinical trial comparing fit‐tested and non‐fit‐tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers. Influenza and other respiratory viruses 2011;5(3):170-79.

https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data

achrn  
#50 Posted : 26 January 2021 07:45:49(UTC)
Rank: Super forum user
achrn

Originally Posted by: Pandatank Go to Quoted Post

"Evidence showed that the surgical mask might not be enough to protect the person from air-borne pathogens

Yes, we did all that discussion months ago.  The face covering 'mandate' is not intended to protect the person wearing it, so the fact that there is some evidence that it doesn't do so is not very interesting.

You may as well post scientific studies demonstrating that wearing safety glasses doesn't protect your toes.

Brian Hagyard  
#51 Posted : 26 January 2021 08:23:27(UTC)
Rank: Super forum user
Brian Hagyard

Read on the news yesterday that Austria now require FFP2 masks in public places - i wonder if they bother with face fit tests to ensure people are wearing the right size - and what about people with beards? We are not the only country where strange decisions are made.

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