Masks, Protection, Courtesy, and the Virus

I learned the custom of masks here in Japan about 40 years ago, back when it was definitely an unfamiliar sight outside Japan, and when many fellow 外人 (gaijin)  here made fun of the practice.

The first guy who explained it to me was my trainer as a missionary. As most missionaries are, he was not perfect, but his explanation was later confirmed by Japanese people I trust. This was not one of the things he misunderstood.

The mask is a custom of courtesy, less to protect the wearer than to provide partial protection for the people around him or her.

(I mention the fact of his misunderstandings because it is a fact of life, as a stranger in a strange land, that one must assume that information is, at best, incomplete, and often wrong. I guess it's even more of a fact of life when you think you are not a stranger.)

I am not an expert. I know what I'm talking about, but there are many things I don't know. Nonetheless, I think many people are operating without even this much knowledge about masks.

One, they are not, by any means, perfect protection.

Even the best masks, the ones used in surgery when the patient is immuno-compromised, are not much use long-term. Just as needles should never be re-used, the masks worn in surgery should be disposed of after finishing the surgery (and sometimes replaced periodically even during a single surgery).

[JMR202005261910 added:
I had a surgical nurse tell me I'm wrong about the above. I guess she wasn't in the operating room where I was operated on. Not every operation requires the same level of protection. But she does acknowledge washing her mask daily.
]

Why? Spattered blood or other body fluids quickly soak through the mask. Likewise, moisture, spit, phlegm, etc. from the breath of the person wearing the mask soaks through the other direction.

Faces itch under the mask, and the mask slips, so the mask tends to be touched by either the wearer's hands or an assistant's hands. This offers opportunity for transferring biologically active matter both ways across the barrier.

(Biologically active matter -- virus particles, bacteria, infected body cells, etc.)

Ordinary masks are much more porous than surgical masks, and the wearers tend not to replace them every fifteen minutes to half-an-hour. (That would be rather difficult, really, both economically and logistically -- and ecologically, come to think of it.)

[JMR202005261925 added:
I know I'm speaking in extremes in the above. The point I'm trying to make is that masks are not magic shields that block all the bad stuff and let the good stuff through no matter how long you wear them. Don't go to a rave wearing a mask and expect the mask to protect you.
]

Using terminology from information security, masks are a low wall or a speed bump.

Like the low wall and the speed bump, they can actually make problems worse when we refuse to use sense when we use them.

So why wear them at all, other than wearing true surgical masks in surgery?

[JMR202005262020 added:
Someone might bring Japan's infection and fatality rates up as empirical evidence. Yes, it is evidence, but you should understand that Japan has a long tradition with masks and other habits than help to limit the spread of aerosol spread diseases.

You do know about bowing instead of shaking hands, right? Well, even that is not that simple, but it's there. You aren't getting the whole story about Japan in the news.

Japanese people have been effectively voluntarily limiting a lot of the more dangerous activities.

Yes, there was an order, but it had, in the western mode of expression, no teeth -- other than social pressure, which is pretty powerful in Japan. Many of the less necessary businesses have been shuttered for the last couple of months, and, while there were a couple of the "live events" that Japanese entertainers, artists, comedians, etc., sometimes hold in the days after the order, people came away infected, and that fact was heavily reported and made the topic of talk shows and comedians' acts. Serious social pressure not to hold any more.

Sumo and professional baseball put on hold. The national high school baseball tournament, which is as big as the Japan Series in the fall, canceled for this year. (Probably. It might get revived if things go well now the order has been lifted.)
]

Japan is a country of mixed-mid-to-high population density.  Masks tend to be used more commonly in population centers.

Close quarters requires building walls that don't make sense in less densely populated places.

Many of Japan's differences in customs have to do with common-sense differences between low-density environments and high-density environments.

Many of the common-sense customs have been altered against reason and sense over the last three-quarters of a century, and here is one. Wearing a mask and going to work is actually a self-contradictory behavior. If you need to wear a mask, you shouldn't be going to work, whether you are trying to protect yourself or your co-workers.

Well, unless your job is important.

(Ahem.) Unless your job is especially important, because every job is important. And unless your job is not so important that passing a common cold among your co-workers would be a bad thing.

Hmm. Maybe I'm getting sidetracked, doing a bit of hand-waving at topics this post doesn't have room to tackle. Back to the point.

Okay, so the traditional use of the mask was for cases where you were a wee-bit sick, but your need to be at work or to go to the market outweighed your need for rest and isolation. (And outweighed their need for you to be getting rest and isolation.)

Wearing a mask every day, long term, was neurotic behavior, but your friends would put up with it because they had their times of paranoia and neurosis, as well.

And, here's the kicker: Even though the mask can be counter-effective if you misuse it, for such things as the common cold, the speed-bump has regularly helped slow the spread until everybody developed resistance. This is repeating in the current case.

What kinds of behavior are counter-effective?

Counter-effective mask behaviors include such things as when you fail to wash your washable mask at least once a day, or dispose of your disposable mask in an appropriate garbage pail. Or regularly take it off and set it down where it can aid in the spread of germs.

Or such as wearing a mask so you can go out when you're coughing up so much that it gets soaked by your phlegm before you get home. Or decide that, because you are wearing the mask you don't need to wash your hands or stay home from work or stay away from public places like the market.

[JMR202005262040 added:
And there is also the recent news from China about a couple of students who were made to wear masks while they were given exercise tests, who died from respiratory/circulatory failure which was likely induced by the high-filtration masks. Wearing a mask with excessive filtration is another mistake.
]

(Masks can be good while you're sleeping, to keep the throat and sinuses moist -- until the mask slips down, anyway, and if they aren't too tight to let you sleep. And if you aren't reacting to the inevitable lint. In this particular use, it's good to get the mask wet before you go to bed.)

For the individual, wearing a mask probably does not stop you from getting infected. It does slow the infection process down enough that your body can often fight it off, or you can get by with just catching a mild case.

(In surgery, if a doctor has symptoms, he or she is going to postpone the surgery or get someone else to do it, instead of depending on even surgical masks, etc.)
[JMR202005262045 added:
Related information, one medical study estimates that the rate of asymptomatic infection of SARS-CoV-2 in Kobe is probably 3%.
]

In groups (in the calculus of social behavior), having many speed-bumps and low walls helps slow the rate of spread down enough to prevent an epidemic. (Or slow down an epidemic to prevent it becoming a pandemic.)

If people behave sensibly.

If and only if people behave sensibly in the aggregate.

Aside from such things as cancelling raves and other high-attendance, close-encounter activities, what kinds of behavior are the common-sense behaviors I'm talking about?
Well, I've posted twice on this, if you want some more light reading:

• talking about learning from the virus that competition is not a good excuse to forget to live, 
• and discussing some specific measures to take.

[JMR2020052055 added:
For what it's worth, I wear a mask when I'm out working. (I'm currently working as a long-term temporary postal delivery person for Japan Post.) It is required for the job, but I do not wear it because of the requirement, and I do not wear it because of social pressure.

I wear it for courtesy.

I recommend wearing masks for the duration, in general. I do not recommend trying to force everyone to wear them. Too many people have problems with masks that they are unable to express or explain.

If masks cause you problems, I recommend restricting your close-quarters contacts as much as you can.
]

In summary, masks are an example of the fact that individual behavior does matter, and that being courteous does come back to you.

War And Where I Grew Up (West Texas)

(I'm not really sure this is a wise rant to post, but this is close to home for me, too. I wrote a more reasoned post on the main subject, here: https://joel-for-president.blogspot.com/2019/08/we-are-at-war-with-ourselves-and-not-in.html. If you only have time to read one of my posts, I'd rather you read that. This one is much less lucid.)

When the mass shootings in El Paso hit the news, I knew it was a matter of time.

I grew up in west Texas. I spent a lot of time driving I-20 and US-80. I knew parts of Odessa like the back of my hand.

I made a comment to a FB friend that he may have misinterpreted.

If we keep killing the shooters, how are we going to find out why?

It's an easy comment to misinterpret, I imagine, especially for people who, like me, grew up where a mass shooting has occurred. This hits close to home, and it feels like I am saying there is an acceptable level of collateral damage or something.

But walk with me on this.

If there were a sudden epidemic of bird flu, we'd want to pin down where it was coming from.

If there were a sudden uptick in rabid animal cases, again, we'd want to look for a source so we could eradicate it.

But we are not looking for the cause of the sudden epidemic of mass shootings.

No, calls for getting rid of the guns is not looking for the cause. It's assuming the cause, because, you know, guns are dangerous.

But guns have been around for a lot longer than the sudden epidemic of mass shootings. Hundreds of years longer, unless you count wars as mass shootings.

Even without a surviving killer to talk to, we can still think about possible causes.

Odessa is a relatively violent town. It has several times been highest in the number of murders per capita, not just in Texas or the US, but in the world. There have been, in the past, shootings we might now call mass there before, but they only made local news.

Most of the city is relatively safe, but, yeah. Bar shootings on the weekends. Eruptions of the war on drugs. Certain parts of town you really should avoid on weekend nights.

At times, part of the violence has been the town's dependency on the oil industry. Boom cycles always attracted lots of temporary workers and often caused serious shortages of housing, and made it difficult for the temporary workers to get access to necessities.

Boom economics is like that. The people who come for the work find that maybe they should have stayed where they were, and get frustrated, have money in their pockets, go to the bars, and let their frustrations boil over. Arguments happen. Fists, bar stools, knives, and guns come out, whatever weapon is handy. People get hurt and sometimes die.

Another part of it is probably the desert heat and the mineral level in the tap water, making it easy for people to be irritated.

But the biggest constant factor since before I was in middle school was that Odessa was the first big town after El Paso on one of the primary traffic routes that drug runners took from Mexico to the eastern seaboard.

Violence has a reason.

The spate of mass shootings in the US that began sometime after the turn of the millenium must have a cause.

The kinds of mass killings that occurred within the US until recently were cases of one killer gone over an edge and committing a string of murders over a period of time, cases of fighting between organized crime organizations, a few cases of bombings by organized violent political groups, a few cases like Charles Manson, and so on. Random shootings were rare in non-war conditions, and we haven't had war within the borders of the US since about 1865 (according to conventional wisdom).

Violence has been with us for a long time. It is not going to magically go away any time soon.

Taking one weapon away will only turn those who think they have reason to become randomly violent to other weapons -- knives, poisons, arson, makeshift bombs. (I'd add a few more to the list, but that would make this rant even more insensitive than it already is.)

You can see this in Japan. There's been a recent spate of knife attacks in which several people die before the attacker is brought to bay, and there have been a spate of deadly arson cases recently, as well. Looking back only a little ways in the past, there have been a case of arsenic in the curry and of poison gas in the subway that stand out.

If you are seeing one specific weapon, or of weapons in general as the cause, you are missing something really important.

When a shooter is dead, we can guess from his recent history what his motives might have been. He can't defend himself, but he also can't make a fool of himself. We cannot know what actually pushed him over the edge, to go to war against society, and we leave his motives in a darkness that invites glorification by rumor.

And this is what it is. We are at war. Death by violence is a glorious rebellion against some form of oppression. These mass shootings are evidence that the madness of war has leaked back into the parts of our society where we have lazily thought that violence had been put away.

Compare the deaths from mass shootings in the US to deaths from other causes. Drunk driving? Suicides? Working (and living) conditions among the undocumented workers? ...

Compare the deaths from mass shootings and such all over the world to death from other causes. What is going on in Africa, the Pacific Rim, and the less known parts of China?

We are at war.

But we keep killing the best sources of information about the enemy, in the cases of mass shootings. And dead shooters tell no tales, leaving us without the best source of information on why the rash of killings occurs.

If I can surmise, I can offer this: If you aren't reaching out with what extra you have to help those who have less than you have, you potentially contribute to the complaints they have.

Having complaints is not always the complainer's fault.

Self-righteous anger is as likely a cause as any I can think of, coupled with the mirage of becoming a martyr in the cause against an inequitable society.

If you want to help reduce the number of mass shootings, reach out to the people near you.

If you have extra time, money, or other resources, reach out to help those who need help.

If you have needs that you don't know how to meet, keep reaching out to the people around you, even if they don't seem to care. Or look for people who do care to reach out to, who don't recommend violence. Please don't just give up. Giving up puts you in the position where violence no longer seems unreasonable.