Kiwi in China Joseph Judd says there’s enough evidence available to warrant an urgent review and change in New Zealand’s current stance on the use of face masks

Kiwi in China Joseph Judd says there’s enough evidence available to warrant an urgent review and change in New Zealand’s current stance on the use of face masks

By Joseph Judd*

On my flight back from Auckland to China two weeks ago, the family sitting next to my wife and I were all wearing hazmat suits, goggles, masks and gloves.  

We both wore masks too. In fact, everyone including flight attendants on our China Eastern flight wore masks. When we arrived in Shanghai, all the airport staff were in full protective gear.

By contrast, as we walked through Auckland airport none of the customs or security staff wore masks or any other protective gear. Nor were any of the staff on our domestic flight to Auckland.

The widespread use and availability of face masks in China, Korea, Singapore, Hong Kong and Taiwan is only one of the many intensive measures used by these governments in their successful battles against COVID-19, but it has been a critical one, and one that people and leaders in the West seem to overlook or misunderstand.

On February 1, when Singapore had recorded just 13 cases of the coronavirus, the government ordered the Armed Forces to deliver 5.2 million masks to 1.3 million households across the city. In Korea, television broadcasts, subway station announcements and smartphone alerts provide endless reminders to wear face masks.

Taiwan responded immediately by ramping up face mask production, now at 10 million per day. And it’s notable that Hong Kong, the densest city in the world where hundreds of thousands travel to China every day, has almost totally curbed community spread of COVID-19, despite a recent rise in imported cases. Officials in Hong Kong credited universal mask wearing as part of the solution and recommend it in fighting the virus.

In New Zealand the government is only now beginning to focus on providing masks and other protective gear for some of our frontline workers (after outbreaks in hospitals, among the police and airline staff), but still fails to understand the key role widespread mask wearing can play in saving lives.

Fundamental to that is grasping the fact that masks can protect other people from you if you unknowingly have the virus. COVID-19 can spread through asymptomatic transmission: people with the virus don’t show symptoms for 5 to 6 days, and fit, younger people with mild symptoms may not know they are sick or infectious. There is also evidence that masks can help by reducing the amount of virus taken in, since the immune system is more effective if infection starts with a low dose.

Another significant misunderstanding is a cultural one. People in the West often associate face masks in Asia with air pollution, and there’s a negative stigma attached to wearing them. But in places like China, Hong Kong and Taiwan, wearing face masks is a practical, unspoken social contract about being considerate to others when you think you may be sick.

I am not a scientist or medical professional, but seeing the data and studies on what’s worked in China and other parts of Asia, and what’s happening in much of the West, I believe there’s enough evidence available to warrant an urgent review of New Zealand’s current stance on the use of face masks.

The Ministry of Health website says: “For most people in the community, face masks are not recommended. For people with symptoms of an acute respiratory infection, the World Health Organization recommends that there may be benefit in wearing a face mask.”

This is the basic advice of the WHO and the CDC in the US, which has the highest number of COVID-19 cases globally. The CDC is now saying it’s reviewing its advice on masks, and the Ministry of Health said it’s “keeping a close watch” on that.

But experts and commentators in the US are raising the alarm that advice from the WHO and CDC on masks has been well off the mark.

There are in fact dozens of studies that show masks are very effective in reducing transmission of viruses like COVID-19, along with other measures like social distancing and handwashing.

Face masks were the most consistently effective intervention for reducing the contraction and spread of SARS, according to research in a Cochrane Review. One study following community transmission of SARS in Beijing found that wearing a mask in public was associated with a 70% reduction in the risk of catching the virus. This is why the governments of Hong Kong, Singapore, Korea, Taiwan and China –– who learned from SARS –– made widespread face mask use a central part of their strategies.

A few of Europe’s leaders are catching on. In the Czech Republic, citizens have mobilised in a national effort to make home-made masks following government orders to make face-wear mandatory in public. The Czech Republic and Slovakia are the only two countries in Europe to make mask-wearing mandatory, while Austria and Germany appear to be moving in the same direction. As of Wednesday, the Czech Republic had recorded thirteen COVID deaths, much lower than neighboring Germany and many of its other European counterparts, while Slovakia remained at zero deaths.

The truth is, many governments in the West, along with the WHO, have been hesitant to recommend masks because of concerns of a shortage, public hoarding and healthcare workers missing out. These concerns are valid: healthcare and other frontline workers should absolutely be the top priority for all PPE, including masks, and especially N95 masks.

But the blanket message to the public that “You don’t need them” is misleading and wrongly suggests there’s no urgency in making masks widely available as this crisis unfolds.

A study by Cambridge University showed that even simple homemade masks can be effective. There are many articles that explain how to make them, and lots of information about how to put them on safely.

We pride ourselves on being a nimble, forward-thinking country. Let’s live up to that by urgently catching up with the curve on masks, insisting on their use and making them universally available.


*Joseph Judd is a New Zealander who has been living and working in Taipei and Shanghai for the past seven years. Judd is strategy director at ad agency Bartle Bogle Hegarty in Shanghai.

We welcome your help to improve our coverage of this issue. Any examples or experiences to relate? Any links to other news, data or research to shed more light on this? Any insight or views on what might happen next or what should happen next? Any errors to correct?

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53 Comments

Peak Prosperuty Guy

https://youtu.be/NkN8yCWSGus

Masking making should be the social media craze.

Peak prosperity guy is annoying.

Not as annoying as this guy (Forbes article): 3M Blasts Back At Trump: Company Says Not Selling Masks To Canada Could Spark Retaliation. "3M issued a warning regarding the Trump Administration’s request to cease exports to markets in Latin America and Canada, saying it would not only bring up “significant humanitarian implications,”
"Trump, meanwhile, had criticized 3M Thursday night, saying the company “will have a big price to pay,” apparently for exporting the masks".

https://www.forbes.com/sites/carlieporterfield/2020/04/03/3m-blasts-back...

11
up

"Send your kids to school, they're safe there" - 17 March Chris Hipkins
"but not to worry because being at home is the safest place to be" - 23 March Chris Hipkins

Next up face masks. Then asymptomatic transmission. Then aerosolisation.

It's almost as if this is a dynamic and changing situation and ministers are reacting to those changes. Unlike other countries.

Damn our competent politicians!

Competence huh. If someone says don't walk with that tray of eggs in the kitchen because the floor is wet, and you walk in the kitchen, slip over, break the eggs, wipe half of them up with paper towel and say you'll put it in the bin later, is that competence too?

It's almost as if this is a dynamic and changing situation and ministers are reacting to those changes. Unlike other countries.

Damn our competent politicians!

Do not wait for our 'three weeks too late' government to do the right thing... wear a mask whilst out and about, its the new normal for a while.

It won't help you says Dr Chris Smith, consultant clinical virologist at Cambridge University.

https://www.rnz.co.nz/national/programmes/saturday/audio/2018741498/chri...

Yes I learnt this from peak Prosperity in January and the information is all verifiable. The Govt seems to be 2 months behind the curve on Knowledge which is dangerous and makes this lock down wasted time and money. Populations will only tolerate being locked down for so long so you have to make the best of that time. I think the WHO maybe a big problem with the misinformation. The sooner govts stop listening to that corrupt organisation the better.

I have been wearing N95 or P2 masks in public since visiting Sing at the end of Jan.
It just makes sense. Sneezers and coughers are minimised, these guys/gals according to the news today (Midday TV1) can throw 6m/8m respectively in a still wind so in Wellington you would have to be a football field away.For those nose pickers amongst us (most of NZ from observation) again the sense is obvious. Yes there is a lot of discomfort but so it is with the virus apparently and you do adjust the mask a lot but away from the openings (mouth, nose). The eyes and ears also have to be protected.

I think a lot of the negativity about the masks is from the fact that there just are not a lot of them around, especially after the Chinese diaspora stripped the world early March. The few new ones I had in the cupboard were from projects I had been on involving dust. I cycle them with a spray of disinfectant and a couple of days on the clothesline.

Why would ears need protection? They don't have mucous membranes, do they?

Dp

https://www.verywellhealth.com/what-are-mucous-membranes-1191862

".....Because they are exposed to the outside world, mucous membranes are found in your ears, nose, and throat.@

Peak Prosperity for goverment at next election and yes the wasted time and money for this lock down is going to be huge.
They should have sourced masks in Jan/Feb and made them compulsory at the supermarket etc as that is where the virus will keep spreading.
If you sneeze in the supermarket it can travel up to 60 metres and remain airborne for hours.
https://www.aljazeera.com/indepth/features/doctor-note-coronavirus-sprea...

They barely have enough for hospital staff.
They know they work but not enough for everyone so they play dumb otherwise people will be demanding them.
Give it a week or 2 and they will change tact again if they manage to source a few hundred million and it will become the law to wear in public.

Masks are already available- buy cloth ones online, sew them yourself or just fold a bandana. We just need JA to make them compulsory.

Do they filter well

What happened to the 18million masks that Jacinda said we had in one of her first speeches? Was that a lie, or are they stockpiling? Beats me. Oh, may be they sold them back to China? Who knows....it's a fiasco. And like a few on here, I followed Peak Prosperity from January. The facts were all out there. If we could find them, you would think the MOH could. But alas, they missed the boat.

Common sense suggests wearing a mask is preferable. I dont need some govt hack deciding for me. I was wearing a mask in high risk places from early Feb. The fact there is even debate on the issue is laughable.

In Feb were you wearing it to reduce the risk to others, or just for yourself? This seems to be the part that derails any 'common sense'.

Imagine if everyone wore face masks allll the time. Hooking up would be like Russian roulette. Kind of like the family guy big coats gag

https://www.youtube.com/watch?v=so2FsA9G7cI

That the government have a definite plan about handling this virus, is pretty clear. Whether or not it is the right plan, only time will tell. With regards to masks, there is obviously a shortage, so the plan is to communicate to the public that masks are ineffective, and there is no need for them.
The government has taken a huge risk in asking the public to trust them, and only them.
Reading through global media, it would seem that the agreed social language is to place an emphasis on, "those that have recovered".
The way the testing was approached, by limiting testing to those returning from overseas, or had direct contact with someone having returned from overseas, lasted for a little while. Perhaps because of a lack of resources to test? Then all of a sudden, "yes we need to test more, especially those with symptoms ". Next we get reports of swab test supplies running low. Unless the public are actually educated about the virus itself, it will remain this "thing", which if you get it, well you just get it.
Perhaps the government could do better by sharing the actual problem, as this attempt to pretend they are in the know, is really preventing the nation being able to explore the problem from a rational viewpoint, with valuable info, or lack of info, as there is still a lot not known about this virus.
Aren't we all in this together? Or does the government have such little faith in it's own education system, that it has to treat everyone like children? What's the point of a 4 week lockdown, at huge cost and effort, unless the effort is inclusive, and every attempt is made to cleanse NZ of this virus. In other words, what's wrong with saying we have limited testing kits, at the moment, and will prioritise in this manner. Yes, masks are great, yet we have a shortage. That way the public can participate in addressing, and or, understanding the issues.
Perhaps the government would like the situation to persist, by the end of a prolonged period, the govt would own all national assets of importance, everyone would be being paid by the govt, and everyone can just carry on with their lives, waiting for the occasional instruction from the beehive.
Over the top, of course, yet the point is relevant, because what happens when the majority middle class stop trusting, and listening to the govt ? Get masks, make masks and use masks. Is that too difficult?

Without asymptomatic testing [ ie everyone] the stats for Clovid cannot possibly be right for actual current infected cases.
That is, there will be far more cases coming out there. Also means it is hard to see who is and where the cases come from, if there are no symptoms. Can JA really know when to cease lockdown? Unlikely.
Can docs test all when only symptomatic ones fill the current testing criteria? No.
It is essentially an invisible illness in 50%. Challenging therefore for non believers for this wrecking ball politics.
Here is the read:
A podcast interviews Andrea Crisanti, a professor of microbiology, who gives a pre-publication report of the results of testing the entire population of the Italian town of Vo, Veneto, for Covid-19. Veneto adjoins Lombardy, the worst hit province in Italy.
Vo recorded the first case of Covid19 in Italy.
Results
3300 residents, all were tested
3% found to be infected
45% completely asymptomatic (cf estimates of 30% in China and 50% in Iceland)
link; https://player.whooshkaa.com/episode?id=600939

Great comment Lark. The government has been treating us like children. The face mask debacle has been appalling, like telling us all a fairy story to keep us calm while the Titanic sinks. "There, there, dear, you don't need masks, masks actually make it worse don't you know? Just be kind".

This four week lockdown should be used to suppress the virus as well as get us all kitted up with masks, eye protection and gloves so that we can fight this and get back to keeping the economy going.

Massive screw up.
Jacinda stated that we have 5 million facemasks and then later announced we were getting another 7 million. Not to worry we have plenty.
5 million people 2 day and change.
Jancinda screwed it badly at the start, ind of caught up fast and now falling behind again.

The government needs to startup a factory and stop wasting our money as masks are going to be a hot product for a longtime and give some people a job and possibly save a lot by slowing down spread.

Maybe for once they could deliver on their action-focussed mantra of 'Let's Do This!'....

There already is a factory in NZ that can produce (and are) 80,000 masks per day.
https://www.qsisafety.com/

It's all bullocks. The 4 000 here there etc.

We need know how many masks are needed.
How many we got. = short fall
And when sufficient will be available.

Exactly! This article hit the nail on the head.

Seems absolutely crazy to me that the NZ Ministry of Health guidelines do not specify N95 masks for healthcare staff whenever working with COVID-19 patients. Currently they are only required when doing certain procedures. Simple surgical masks are known to not be good enough.

I think Lanthanide would call that competence in a dynamic and changing situation.

I wore a mask to the supermarket on Tues night. Pleasantly surprised to see about 1/3 of the people shopping had a mask on. Several different styles, including homemade. We can change the culture ourselves if we all just start doing it. In Asia the culture is 'do the right thing', i.e keep your bugs to yourself.

The supermarket workers love mask wearers!

That is a point worth thinking about if you feel a bit awkward about wearing a mask. I'm sure the checkout person would appreciate you wearing a mask.

Yeah I found the same and people are starting to take mask wearing a bit more seriously out in more populated public places. I'm not sure about the mask helping to prevent you from touching your face, it was kind of the opposite for me perhaps I'll get use to them.

Used to work for the NHS Wards and Theatres, the problem with people wearing masks is they don't use them correctly. New Zealand should be proud of its response to this pandemic. Buy surgical masks if you can just don't expect free ones or take them away form people at most risk. If your sick stay home. If you care for a loved one who is vulnerable google Siouxsie Wiles. Be kind.

Masks.
A distraction from testing.
No wait
A distraction from swiss cheese borders
No wait
A distraction from ICU beds and medic teams.
No wait
A distraction from numbers of ventilators
No wait
A distraction from No Plan B.

masks can help protect people from you

Agreed! However, the fancy N95 masks with a one way exhaust valve may be less effective at capturing expelled virus compared to simple masks like the one in the article photo. I hope some basic research gets done before widespread recommendations are made. Mask protocols for healthcare workers would understandably be more stringent.

BBC Number of daily US deaths reaches new peak.
* US records world's highest daily toll with 1,169 deaths
* US unemployment figures hit a record high of 6.6 million
https://www.bbc.com/news/live/world-52146227

Did the 1st shop since lockdown yesterday.
Some obvious failures.
Lots of touching / rejection of fruit, veges, meat and milk. Oldies staring at shelves for ever before making up their mind. Some young ones having their catch up meeting in the middle of aisles. They might not of heard of a recent invention called the telephone

Yes, Fritz. Sweden.We have lost transparency. The most precious thing in the most severest of times.
Therefore trust.Goodwill soon too?
"money vs lives is a false choice. Rising unemployment hits pensions directly," she says. "What's more, the tax base disappears - then we have to start cutting welfare." And Swedes should be proud that "we have not extinguished the entire society, as many other countries have done".
https://i.stuff.co.nz/national/health/coronavirus/120805778/coronavirus-...

We've already destroyed our economy, we're not going to change our way of life for this overhyped virus.

Wearing masks is not the Kiwi way.

The first casualty in any war is the truth, ie by design as in 'You can't handle the truth,' or as in they are, we are making major decisions based on poor data, but don't tell them that.'

The evidence on why you should wear a mask has always been there.

If you want to see what happens when you sneeze, cough or even talk -check out the latest video here:

https://www.youtube.com/watch?v=vBvFkQizTT4

Watch to the end.

This is particularly relevant in low humidity indoor environments as we get into winter and it becomes colder as the virus loses moisture and shrinks in size enabling it to act more like a microdroplet and stay airborne for longer.

As the video says you can partially mitigate this with good ventilation which doesn't happen enough specially in wintertime, and if you did, then your heating cost rises dramatically. There are enough people in fuel poverty situations as it is.

A lot of this would be solved by having warm, dry healthy affordable housing, like Passive House which uses heat recovery ventilation systems.

The way we build houses in NZ is killing people.

https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-nov...

Asians make up 15.3% of the population.
Based on 950 confirmed and possible cases at this point in NZ they should then have around 145 of these 950. (Data taken from link above)

I know it's a small data set but they only have 76. Ask yourself if you have been out which race wears masks predominantly.?

Coincidence????.

We banned travelers from China several months ago, three weeks before NZs first coronavirus case arrived. That seems somewhat relevant when 47% of cases are directly travel linked.

Praggers is that tongue in cheek, not sure.

First of all Chinese Kiwis are big travellers. They set up the bolt hole in NZ during keys years for a reason and that reason is now. They flooded "home" in Feb and March due to the Wuhan nightmare. These could be part of the 47% you referred to but they seem underrepresented in the infected. Take out the 4.9% Chinese and the 0.75% S Koreans plus another 0.25% for regular mask wearers from Japan & Singapore you have about 9.4% from the rest of Asia. That would give you an expected infection rate for the rest of Asia of about 90, closer to the 76 reported. Yeah small data sample but watch this space.
Secondly even though direct flights were curtailed Chinese kiwis still came "home" in Feb/Mar via a second Asian airport. Our neighbour, a Chinese Kiwi came home in March via Hong Kong. He said the flight was chokka with Chinese kiwis. People also commented on this site how direct flight continued all through March by Chinese Airlines. I did a couple of trips out to the airport picking up people in March and was amazed at the number of Chinese coming in, all wearing face masks. The rest thought they were bullet proof apparently...

As an aside I note on today's arrivals into AKL there is a flight by Chinese Southern from Guanzhou and another from neighbouring HongKong by Cathay. (Cargo only I hope but doubt it.)

https://www.aucklandairport.co.nz/flights

If you can get a N95 or P2 face mask wear it in public. The evidence is getting clearer every day.

"But in places like China, Hong Kong and Taiwan, wearing face masks is a practical, unspoken social contract about being considerate to others when you think you may be sick."

No, this practice has been social etiquette in Japan for decades and only really became common place in China and HK after SARS when folks feared catching something or the air pollution was particularly bad. Perhaps a few people wore masks to prevent the spread of something but this would have been a single digit minority.

Having lived in HK, China and Japan for the past 25 years I can tell you that you are talking through your ar*e.

I dont disagree with the point about wearing masks however. The WHO is now recommending it ~ if a disease is airborne its airborne, covering up of your face makes as much sense as regularly washing your paws.

"Perhaps a few people wore masks to prevent the spread of something but this would have been a single digit minority... I can tell you that you are talking through your ar*e."

Disagree: it's very much a cultural norm to wear masks when sick in East Asia. Even if it did start with SARs, that's not the point.

https://www.visiontimes.com/2017/06/16/why-do-chinese-wear-masks.html

"In many Asian countries, it is a common occurrence for people to wear masks if they feel like they’re getting sick, even it is just a slight cold. They do this as a courtesy to prevent spreading their own infection on to others."

https://www.bbc.com/news/world-52015486

"For many of these countries, mask-wearing was a cultural norm even before the coronavirus outbreak... In East Asia, many people are used to wearing masks when they are sick or when it's hayfever season, because it's considered impolite to be sneezing or coughing openly."