One of the starkest differences between East Asian and European/North American responses to the Covid-19 pandemic has been in their differing attitudes towards face masks (used here generically, and differentiated from FFP3, also known as N95, respirators) : they are common in East Asian countries such as China, South Korea, Singapore and Japan, and yet are rarely to be seen in other parts of the world. They have been part of the package of solutions recommended in East Asia, where infection and mortality rates have generally been quite low; yet they are absent in Europe and North America where rates are much higher.
World Health Organisation advice, followed assiduously by European governments and the U.S. Centers for Disease Control and Prevention (CDC) is clear:
- If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.
- Wear a mask if you are coughing or sneezing.
- Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
- If you wear a mask, then you must know how to use it and dispose of it properly.
This is frequently interepreted in an abbreviated form, as by the BBC, to imply that “Only two types of people should wear masks: those who are sick and show symptoms, and those who are caring for people who are suspected to have the coronavirus”.
The case against wearing face masks comes down essentially to the argument that they will do little to protect someone from getting infected. This is fundamentally an individualistic argument: “If I wear a mask it won’t be much good to me”. However, from a communal perspective that is absolutely not the point; what matters is that if you wear a mask and are unknowingly infected it may help to prevent you spreading the infection to many other people. Wearing a mask is about others not yourself.
A growing body of evidence is now suggesting that masks can indeed help to slow the spread of Covid-19:
- The markedly different histories of infection between countries where masks are encouraged/enforced as part of a package of measures, and those where they are discouraged, is forcing researchers and policy makers to try to explain why. Masks are an obvious possible answer.
- It is increasingly being suggested that many Covid-19 carriers are asymptomatic. They therefore don’t know that they might infect people, and so are going about their daily lives doing just that. If they had been wearing masks, it is argued, this could reduce the number of people that they infect.
- Dentists and healthcare workers in many parts of the world are encouraged or required to use masks both to provide some protection from patients, but also to protect patients from any infections that a dentist may have. If such masks are seen to be offering patients some protection, then it seems strange to suggest that they offer no protection against a coronavirus such as Covid-19 (see reviews of surgical masks and N95 masks by Loeb et al., 2009, and more recently by Long et al., 2020)
- Chinese doctors and scientists are increasingly confident that masks do make a difference. In a recent interview, George Gao (Head of the Chinese Center for Disease Control and Prevention) has thus suggested that “The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others”.
In societies such as the USA and much of Europe where the focus tends to be more on the “self” rather than the “community” it is scarcely surprising that individuals and their politicians see little value in masks; but in more communal societies, where there is perhaps more care for others, then masks are seen as an important part of the armour against Covid-19.
Many governments fear that encouraging citizens to wear face masks would mean that there would be insufficient left for medical professionals to wear. This, however, is rather a lame excuse. Such governments could readily have put in place systems in early February to prepare to expand production of protective clothing. It is not too late for them urgently to do so. The BBC thus reports that “UK clothes makers say the government has wasted time in ordering personal protective equipment for NHS staff. Fashion and textile firms believe they could have begun making gowns and masks for front-line workers 10 days ago”.
However, for those who do care about their neighbours and don’t want to disrupt the official production of masks for healthcare providers, an increasing amount of guidance is now available for making your own masks, as at:
- Business Insider: Kelly Burch on “How to make an effective face mask at home“
- Good Housekeeping: Lexis Sachs on “How to Make Face Masks for Hospitals During the Coronavirus Shortage“
- Smart Air: “What Are The Best Materials for Making DIY Masks?”
These are clearly not going to be as good as masks made by companies to stringent regulatory standards (for UK see Regulatory status of equipment being used to help prevent coronavirus (COVID-19)), but they may well offer at least some protection to reduce the communal spread of Covid-19. Pressure on demand is likely to become very much worse than it is at present, especially when imported masks are low in supply and often fail to satisfy these standards: recent reports (see for example Business Insider, 29th March) thus suggest that 600,000 masks imported from China have had to be recalled by the Dutch government because they are faulty. In countries unable even to import masks from elsewhere, domestic production in line with international standards (see Wong, A. and Wilkinson, A., 2020) can be recommended.
Above all, the discussion should not so much be about “will I be protected?” but instead “how can I protect others?“. It rather depends on what kind of society we wish to live in – especially for those who are left after this pandemic has run its course.
[Update 30th March – it is great to see that Austria has announced today, the day after I wrote the above, that it is to make wearing masks compulsory, and will distribute basic masks for free at the entrances to all supermarkets]
[Update 31st March – Tom Whipple in The Times notes comments from Prof Cheng at Birmingham University and Prof Cowling at University of Hong Kong in favour of wearing masks, although Prof McNally, also from Birmingham, expressed concern that this would be counterproductive since people would think they could still go out]
[Update 2nd April – David Shukman on the BBC News site: Coronavirus: Expert panel to assess face mask use by public. The WHO should have acted much more quickly on changing its advice]
[Update 7th April – Link to Lydia Bourouiba’s important study on turbulent gas clouds and respiratory pathogen emission: coughs and sneezes can spread #Covid19 7-8 m; CDC guidance is only 2 m; masks might help https://jamanetwork.com/journals/jama/fullarticle/2763852. We really need to rethink social distancing…]
[Update 7th July – BBC Coronavirus: Don’t leave home without a face covering, says science body – why has it taken so long for people in the UK to argue vociferously for this?]
[Update 15th December – Scientists say masks could stop coronavirus spreading in busy streets – nothing much has changed, apart from many thousands having died unnecessarily! Just goes to show what an individualistic and selfish society we live in – as many of us have said for months, masks can help protect other people. Every life saved matters]
We are all going to be affected by Covid-19, and we must work together across the world if we are going to come out of the next year peacefully and coherently. The world in a year’s time will be fundamentally different from how it is now; now is the time to start planning for that future. The countries that will be most adversely affected by Covid-19 are not the rich and powerful, but those that are the weakest and that have the least developed healthcare systems. Across the world, many well-intentioned people are struggling to do what they can to make a difference in the short-term, but many of these initiatives will fail; most of them are duplicating ongoing activity elsewhere; many of them will do more harm than good.
“A real challenge now, though, is that so many initiatives are trying to develop digital resources to support the response to Ebola that there is a danger of massive duplication of effort, overlap, and simply overload on the already stretched infrastructure, and indeed people, in the affected countries”, and
It is much easier to enjoy change if you treat it in a positive way. Think about all the good things: no need to travel to work; spending time with those you love (hopefully); doing things at home that you have always wanted to! Treat the next few weeks or months as an opportunity to do new and exciting things. Discover your home again! (Although this highlights the huge challenges facing the homeless).
If at all possible, it is absolutely essential to have separate sleeping and working places so that you remain sane. There is much evidence that trying to sleep in the same place in which you work can confuse the mind, and may tend to make it continue to work when you want to go to sleep – even subconsciously – rather than enabling you to rest. You are likely to be worried about the implications of Covid-19, and so it is essential that you do all you can to ensure a good night’s sleep. This may not be easy for many people, but you should still try not to work in your bedroom! And don’t continue working too late – give your body the time it needs to relax and rest.
It is incredibly easy to put on weight when working at home, even if you think you are not doing so! This is bad for your health, and bad for morale. It’s easy to understand why this happens: many people commute to work, and even if not cycling, they walk from their transport node to their office; homes are smaller than offices, and so you generally walk more at work than at home; and often you will go out of the office during the daytime, perhaps for lunch, but you can’t do this if you are self-isolating. There are lots of things, though, that you can do to rectify this: walk up and down stairs several times a day (never take the lift); ensure that you go for a short walk every hour (even if it is just 20 times around your home); if you have some outdoor space, take up gardening (it uses lots of muscles you never thought you had!); and even if you don’t decide to buy a stationary bike (actually much cheaper than joining a gym), you can still exercise with a resistance band, or even use bags of sugar as weights!
When you don’t have to catch public transport, or cycle/drive/walk to work it is terribly easy to be lazy, and let time slip by without focusing on the tasks in hand. Most people like to feel they have achieved something positive every day. One way to ensure this is to plan each day carefully. And don’t forget to give yourself treats when you have achieved something – whatever it is that you enjoy!
This is closely linked to planning – but don’t just spend all your time relaxing, or doing nothing but work! It’s important to maintain diversity in life. If your boss expects you to work a 10 hour day, then make sure that you do (hopefully s/he won’t). But even then you have 14 hours each day to do other things (please try and get 7 hours of sleep – it will help to keep you fit and well)! I find that having a colour coded diary with a clear schedule helps me manage my life – even though I tend to work far too much! The trouble is I enjoy my work!
Many people who now have to work at home because of Covid-19 will not have had much experience previously at doing this. It can come as a shock getting to see other aspects of a loved one’s life. Tensions are bound to arise, especially if you are trying to work when your children are at home because school has been closed. It can help to have a thorough and transparent discussion between all members of a household (including the children) to set some ground rules for how you are going to manage the next few weeks and months. This can indeed be challenging, and will frequently require revisiting, but having some shared expectations can help reduce the tensions that are bound to arise. Listening (however difficult it is) often helps to lower tension.
The clothes we wear represent how we feel, but can also help shape those feelings. It is amazing what an effect it can have if you get dressed smartly when you are feeling low. Likewise, most people like to dress in more relaxed clothing when they stop working, and we don’t usually sleep in the same clothes that we have worn during the day. Just because you are working at home, doesn’t necessarily mean that you will work well in your pyjamas (and imagine if you are suddenly asked to join a conference call without time to change!). The simple message is that we should continue to take care of ourselves, just as if we were going out to work or to a party!
Enjoy the physicality of life. Don’t always feel you have to be online in case “work” wants to get in touch. None of us are that important. The world will get by perfectly well without us! There is a lot of evidence that being online late at night can also disturb our sleep patterns. Remember that although we are increasingly being programmed to believe that digital technology gives us much more freedom in how we work, it is actually mainly used by the owners of capital further to exploit their workforces by making them work longer hours for no extra pay!
Being self-isolated at home will mean that you have vastly more time on your hands than you can ever imagine (as long as you don’t work all day and night). Use it creatively to do something that you have always thought about doing, but never had the time before. Read those books that you always wanted to. Learn a musical instrument. Learn to speak a new language (Python or Mandarin). Take up painting. Discover how to cook delicious meals with limited resources. Photograph the wildlife in your garden. Grow your own vegetables. Make beer. Even just plan your next (or first) holiday.
In Mexico and indeed in many other countries, Corona was above all else associated with beer! Produced by Cerveceria Modelo, Corona is a pale lager and one of the five top-selling beers across the world. In 2013 the 
In Pakistan, 
In Spain, Corona, or Coronas, was primarily associated with various wines. It is perhaps best known in its incarnation in the well-known Familia Torres wine 
In complete contrast, Egyptians thought that Corona was a type of chocolate biscuit (thanks so much to Leila Hassan for sharing this). 
To be fair, very few people made the above connection. However, the café takes its name from the baby elephant in the Circus Boy series (1956-58) and has persisted since the café first opened in 1967. Moreover, the Norwegian krone is pronounced in a similar way to the word corona, and as Tono Armas has pointed out in Spanish it is even called “Corona noruega“.
The 
I am never sure whether California should be seen as distinct from the USA, but for those who live there Corona is a town of about 150,000 people in Riverside County. It was originally called South Riverside, and was founded during California’s citrus boom in the 1880s. It was once called “The Lemon Capital of the World” (by USAns), and today is perhaps best known (at least by musicians) for being where the flagship factory, 
For astronomers, of course, a corona is the aura of plasma that surrounds stars including the sun. More simply, it can be considered as the outer layer of the Sun’s atmosphere that extends millions of miles into space, and generates the solar wind that travels across our solar system. It is difficult to see because it is hidden by the brightness of the sun, but is clearly visible during a total solar eclipse.
