Today, the CDC announced its recommendation that people wear face masks in public, the first time it has taken this position through the Covid-19 pandemic. Still a voluntary recommendation, some feel it is late coming and may not be strong enough.

Despite the official notification just coming now, many groups have already spent weeks promoting and circulating face mask designs, as this essential gear has become hard to find even for medical professionals. We’ve published a few that you can make yourself (here and here).

One person who’s been leading the endorsement of face mask use is Jeremy Howard, a distinguished research scientist at the University of San Francisco. He’s a founding researcher at fast.ai, a research institute dedicated to making deep learning more accessible. He came up with the idea for Masks4all.co, which uses promotes the benefits of everyone using face masks, even homemade ones.

We reached out to Jeremy to hear about the project.

 

Dale: What was the motivation for you to start Masks for All?

Jeremy: I didn’t mean to start anything. I was just trying to teach my students a lesson in evidence-based data analysis.

I happened across this idea that maybe universal mask wearing is a good idea, and I thought it would make a good lesson to go through the data and explain it to my students. And so, I prepared the lesson and I was kind of shocked to discover that the evidence was really strong.

Not only is universal mask-wearing a good idea, but it could actually totally stop community transmission. And so, I did this lesson, and I recorded it. That’s what I always do. And my students said, “Hey, that was actually pretty useful. Maybe you should share it publicly.” So I was like, okay. [Link]

And I did. Then much to my surprise, the Washington Post Op Ed editor sent me an email and said, “Do you want to write an article about this?” And I did. And suddenly I was on Good Morning America and ABC News’ Nightline. So it became clear that this is a thing. And so some great folks reached out to me and said, “can we help you make it a thing?”

Dale: I was watching MSNBC last night and there was a doctor saying that there’s no “compelling evidence that a facemask fashioned at home is going to protect you.” (Dr. Vin Gupta on Brian William’s 11th Hour Show.)

When many of us heard the pronouncements from the CDC, I kind of felt like our limited supply was dictating health policy. They weren’t saying, “Since we don’t have enough masks, you can’t have one but we’re trying to address that problem. But health professionals need them first.” It also meant that a lot of people that are in essential services that are not in hospitals are not wearing masks. And they’re interacting with the public.

Jeremy: Well also, a lot of hospitals were not providing or even allowing their own staff to use masks. This is just changing. Stanford’s just said that everybody at the hospital should wear a mask. So it’s not just masks for all outside of hospitals. It’s also masks for all inside hospitals.

Nurses have been reaching out and saying, we need somebody speaking up about this. They can’t go on the record. So I’ve ended up finding myself as a mouthpiece for infectious disease specialists and virologists and nurses and all these people who say, “Here’s our research,” or “Here’s our story. We can’t tell it. If we do, we’ll get fired because it’s against CDC guidelines.” So I’m trying to tell their stories at the same time as protecting their privacy.

You had mentioned that there isn’t proof, which is true. We don’t have proof that social distancing or hand-washing or masks stop the spread or slows the spread of COVID-19. But the American Statistical Association makes it very clear in their guidelines that this is not how you should do policy.

Policies should be based on: What is the evidence for? What is the evidence against? What is the upside? What is the downside? You know? So kind of the prior here is that the science shows: This thing is spread by droplets. The droplets come out of our mouth up to six feet when we talk. A cloth barrier in front of your mouth stops the droplets.

Therefore a mask stops the transmission. It’s not complex physics or complex material science. So from a statistical point of view, you’d say, okay, your null hypothesis should be “wear a mask.” And unless you can prove that you shouldn’t wear a mask, you should. But because the status quo is to not wear a mask, this kind of dated view of statistics is that this isn’t a medical intervention, like approving a drug. But actually the only downside is that people don’t get to see my face. But it’s not so bad. It’s better to stay alive.

Jo @jperla‘s modified Financial Times’ chart points to Covid-19 numbers and face mask tendencies.

Dale: There’s a signaling going on, too, that I’m aware of the problem and I’m taking action. So I think it certainly works in that regard. 

You mentioned nurses and others not being able to speak up. Have you gotten any sort of negative feedback from the medical establishment or others saying you shouldn’t be saying this, or are they acknowledging that this is the right thing to do?

Jeremy: No, like in terms of levels of support I’ve received, the highest level of support is from the scientists who are doing the primary research, because they know that this is not in doubt. One infectious diseases expert, maybe just about the best in the world that I’ve been communicating with, said that the science on this has been solid since 1956. That’s his standard citation.

Then the next level of support is coming from doctors who are working at hospitals that have a lot of COVID-19 patients. They’re basically saying, “please help us to remove the stigma around mass wearing because we all need to be wearing masks in our hospitals, and we need our community to start wearing masks so that fewer of them are coming in here and dying.” Then kind of way down at the bottom of levels of support is, there’s a few TV doctors who are going on TV and saying, “there’s no proof of this. You know, maybe if you touch your face, it’s going to spread the disease. It might give you a false sense of security.” All these kinds of post-hoc justifications.

I know they mean well. They’re trying to support our public health policy body, the CDC. And I want that too, because I don’t want anti-vaxxers and stuff winning. But unfortunately at the moment, the CDC guidelines are at best wishy-washy and at worst highly misleading. So you can’t just support a guideline if it’s not science-based.

The main thing we need at this stage is laws.

Dale: Policy changes 

Jeremy: We need laws, whether it be at city level, state level, or even federal level. I don’t think it’ll happen federally, but federal could give guidelines that would encourage states, I think.

Dale: And you obviously support people making their own masks, and there’s understanding the levels of…

Jeremy: My mother-in-law made mine for me.

Dale: That’s beautiful.

Jeremy: I did my own out of a piece of a tee shirt, but it doesn’t look great.