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In this Trilogy, I began by taking from powerhouses of new ideas, namely, INSEAD, McKinsey’s and Harvard Business School. In this blogpost, I am taking from an article published in HBR on June 18, 2020, with the title and authors given below. I chose this article because wearing mask is the current hot topic, is relevant everywhere, is close to everyone and is extremely important. Our policy makers and opinion leaders are usually focusing on so-called important areas. This being the most basic and workable protection needs attention at all levels. I have done some editing to keep it more relevant to our situation. [quote]
We Need Better Masks
by Ranu S. Dhillon, Abraar Karan, David Beier, Devabhaktuni Srikrishna
With 21 U.S. states experiencing a rise in Covid-19 cases just weeks after reopening, it’s clear that maintaining control of the pandemic without lockdowns is proving to be a challenge. To not only stay open but also really revive the economy — to get people back to work, traveling, attending sporting events, eating at restaurants, and so on — they will need to feel confident that they and their loved ones are at low risk of getting infected.
Testing remains an order of magnitude short of what is needed, and a vaccine won’t be available until at least early next year. But we could potentially achieve control and confidence now if better masks were available for the general public that are more protective than the cloth ones worn now and closer in caliber to the N95 and high-filtration surgical masks used by health workers.
Scientists believe that Covid-19 is largely transmitted via virus-containing particles that people emit when they breathe, speak, cough, or sneeze. N95 masks, if worn correctly, can block nearly all of this spread. High-filtration surgical masks, which are a cut below N95s, can block much of this transmission but are not as effective against smaller particles, known as aerosols. There is debate about how much Covid-19 spreads through aerosols and whether the added protection N95s provide against them is necessary. While we need to better understand the level of protection required, what is clear is that if we had better masks than current cloth and homemade ones, transmission could be substantially and quickly curbed. The problem is N95s are uncomfortable to wear for long periods of time, and both surgical and N95 masks remain in short supply even for health workers, making neither an option for the general population.
Models suggest that the widespread use of even cloth masks, bandanas, or scarves could dramatically reduce transmission. But their effectiveness varies, and they primarily function as “source control”: They provide the person wearing it with some protection from particles coming in, but mainly reduce how much the wearer expels. That means that your personal safety from infection is not in your control and largely depends on how reliably those around you are wearing masks.
Consequently, we need masks for the general population that block the virus from coming in and going out similar to what high-filtration surgical or N95 masks do for health workers. Masks like this would give people control over their own safety, a greater incentive to wear them, and the confidence to resume economically important activities.
If worn widely enough in crowded and indoor settings where most transmission seems to occur, these masks could potentially stop the epidemic altogether. Better masks may be the most effective way to counter Covid-19 in low-income countries where testing is limited and the social and economic damage caused by lockdowns is more severe.
These masks should meet five parameters:
The level of necessary protection depends on how important it is to defend against aerosols. Protection results from deflection and filtration(how well particles are blocked going through the mask) and fit (how well the mask seals around the face and prevents particles from coming around it). There are increasing examples of how these characteristics might be achieved. A recent study showed that filtration just shy of N95s could be achieved with combinations of cotton and other common fabrics like silk, flannel, and chiffon. Other research has demonstrated how the fit can be enhanced by lining the inside of masks with material from a nylon stocking or creating a brace using rubber bands. Another researcher is experimenting with fabrics that deploy low-level electric charges and can be inserted into masks to neutralize viral particles.
Any design must use commonly available materials that commercial manufacturers can purchase in massive quantities. Multiple designs using different materials may be necessary so we are not reliant on any single set of materials that could run out. One reasons masks are such an attractive option is that, unlike testing and contact tracing, they can be scaled more readily and widely.
Masks must be comfortable enough for people to wear them for long periods of time without needing to touch them or take them off too frequently. There may be ways to do this while still preserving protection.
To preclude a constant need for new masks, it would have to be possible to easily clean them or only have to replace certain parts (e.g., filters) so they could be repeatedly used.
Widespread adoption of masks will require a significant cultural shift so they become a seamless part of a “new normal.” They should be fun, cool, and fashionable. For instance, they might exhibit the colors or logos of individuals’ favorite sports teams or brands.
Designing and producing such masks and persuading large numbers of people to wear them is not straightforward and poses engineering, manufacturing, and marketing challenges that may ultimately require tradeoffs. There are already some efforts to overcome them.
Given the stakes, the federal government should convene companies and forge public-private partnerships to expedite the process of developing, validating, and scaling effective designs. Grand challenge prizes could help accelerate this effort, and the Defense Production Act could be used to rapidly scale up manufacturing.
However, we don’t need to wait for federal action to move forward. Academic institutions, companies, and private citizens can start creating and testing designs and mass manufacturing effective ones. Industries imperiled by the epidemic — such as airlines, sports leagues, and hotels — have every incentive to see this happen and should use their resources and know-how to push this forward.
Once an effective design is in hand, the challenge will be getting enough people to actually wear them in crucial situations. It is difficult for people to wear masks — no matter how comfortable — for hours on end. However, not all situations carry equal transmission risk and wearing masks when performing some activities, such as walking alone outdoors, is less important. It is most critical that masks are worn when indoors, in crowded or tight spaces (e.g., public transportation, bars), in prolonged close contact with others (e.g., sitting across the table at dinner), or engaged in activities that involve heavy breathing (e.g., exercise, singing). Concerted promotional campaigns waged by governments and companies could persuade large numbers of people to wear masks in such places.
Although expanding testing or contact tracing remain crucial, designing, producing, and getting people to wear more protective masks is more feasible and more quickly achievable. It may be the single most important low-hanging opportunity for slowing Covid-19’s spread and giving people the security they need to bring our societies back to life. [unquote]