Germany goes into month long lock down. I’m so old, I remember …. oh hell

I’m sold old, I remember when Germany did everything right.

Mask wearing was mandatory on public transport and in retail shops since April. Two weeks ago, wearing masks outdoors in public spaces became mandatory.

Yet another example of a region that did everything right to great success – until it was no longer successful.

This – repeated in numerous countries – points to public health mitigation strategies that do not work because they are not sustainable, not effective, or do not work. Public health must re-think its response to pandemics. What worked 300 years ago for isolated agricultural and small port cities no longer works today – but public health is doing exactly what they did back then with bad outcomes.

The public health mitigations that appear to work are:

  • Social distancing measures
  • Lockdowns work but are not sustainable for more than a few weeks, lead to massive unemployment, mental and physical health problems, destroy the economy and people usually begin resuming their lives by about week 3.
  • Compliance with mask mandates is very high but masks likely work in limited situations of close in, extended contact, and only when proper masks are worn and used correctly.

Mandatory face masks have failed: Who knows why? Perhaps because the transmission mechanism is not understood, perhaps because home made masks made of random bits of cloth are not effective, perhaps because many use the wrong kind of mask (N95 with exhalation valves), perhaps because people stop social distancing when wearing a mask, perhaps because people wear and use masks improperly (failure to cover the nose, mishandling the mask creating contamination).

No one knows why but masks are not meeting their original claims. In the U.S. the CDC Director said in August this would all be over with in weeks if everyone wore a mask – and in the majority of the country were mask were already mandating, compliance was 80 to 95%. Yet in many of those high compliance areas, new cases have since skyrocketed.

Why are face masks not working?

My very general thoughts are because:

  • Many face masks used are not using effective filtration materials.
  • Many people are not using the masks properly. Yesterday I saw a news photo of a crowd at a public event where face masks were mandatory for all adults. More than half of the adults had their noses uncovered, their mouth and nose uncovered, or the mask pull down around their necks!
  • Social distancing behavior changes when wearing a mask. We see this at many events where the six foot guidelines seem to vanish when people are wearing a face mask.
  • Finally, it may be because we are required to wear masks where they would have little impact in reducing the spread of the disease -and not required where they would have an impact. Specifically, 40% of new Covid-19 cases come from close household contacts; but no one wears a face mask in their own home. Another 20% or so come from close social contacts, often when meeting in someone’s home. Again, few wear a face mask in their own homes.
  • THIS IS PROBABLY WHY FACE MASKS ARE NOT HAVING MUCH EFFECT – WE WEAR THEM WHERE RISK ARE LOW – AND DO NOT WEAR THEM WHERE RISK ARE HIGH (INSIDE OUR HOMES). There is little chance I will catch Covid-19 while shopping at my local mega building supply store – everyone is spaced apart, and if not, its only for a very brief passage in an aisle. There is no extended close contact.

The effect is that while masks work in theory, they do not do much in the real world.

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