掩蓋事實 - 口罩的配帶
掩蓋事實 - 口罩的配帶！ - 準備轉變 / 2020年8月30日
curated by Marilyn M.Singleton,M.D.,J.D.
由瑪麗蓮·m·辛格爾頓博士和法學博士共同策劃。
Transmission of SARS-CoV-2
SARS-CoV-2的傳播
Note:A COVID-19(SARS-CoV-2)particle is 0.125 micrometers(μm);influenza virus size is 0.08–0.12μm;a human hair is about 150μm.
注：一個新型冠狀病毒肺炎(SARS-CoV-2)顆粒為0.125微米，流感病毒大小為0.08-0.12微米，人類頭髮約為150微米。
* 1 nm=0.001 micron;1000 nm=1 micron;Micrometer(μm)is the preferred name for micron(an older term)
* 1納米=0.001微米；1000納米=1微米；微米(m)是微米(一個較早的術語)的首選名稱
1 meter is=1,000,000,000 nm or 1,000,000 microns
1米=1,000,000,000 nm 或1,000,000微米
Droplets
液滴
Virus is transmitted through respiratory droplets produced when an infected person coughs,sneezes or talks.Larger respiratory droplets(>5μm)remain in the air for only a short time and travel only short distances,generally<1 meter.They fall to the ground quickly.
病毒通過感染者咳嗽、打噴嚏或說話時產生的呼吸道飛沫傳播。較大的呼吸飛沫(大於5微米)在空氣中停留的時間很短，而且飛行距離很短，一般小於1米。他們很快就倒在地上
This idea guides the CDC's advice to maintain at least a 6-foot distance.
這個想法指導CDC的建議保持至少6英尺的距離
Virus-laden small(<5μm)aerosolized droplets can remain in the air for at least 3 hours and travel long distances.
攜帶病毒的霧化小液滴可以在空氣中停留至少3個小時，並且可以飛行很長的距離
Air currents
氣流
In air conditioned environment these large droplets may travel farther.
在空調環境中，這些大液滴可以飛得更遠
However,ventilation—even the opening of an entrance door and a small window can dilute the number of small droplets to one half after 30 seconds.(This study looked at droplets from uninfected persons).This is clinically relevant because poorly ventilated and populated spaces,like public transport and nursing homes,have high SARS-CoV-2 disease transmission despite physical distancing.
然而，通風ーー即使是打開入口門和小窗戶，也可以在30秒後稀釋小水滴的數量，使其減少一半。 (這項研究觀察了來自未感染者的飛沫)。這具有臨床相關性，因為儘管物理距離較遠，但通風不良和人口密集的空間，如公共交通和療養院，有較高的SARS-CoV-2疾病傳播
Objects and surfaces
物體和表面
Person to person touching
人與人之間的接觸
The CDC's most recent statement regarding contracting COVID-19 from touching surfaces:"Based on data from lab studies on Covid-19 and what we know about similar respiratory diseases,it may be possible that a person can get Covid-19 by touching a surface or object that has the virus on it and then touching their own mouth,nose or possibly their eyes,"the agency wrote."But this isn't thought to be the main way the virus spreads.
疾病防治中心最近關於接觸表面感染新型冠狀病毒肺炎病毒的聲明中寫道："根據對新型冠狀病毒肺炎病毒的實驗室研究數據和我們對類似呼吸道疾病的了解，有可能一個人通過接觸表面或物體上的病毒，然後觸摸自己的嘴、鼻子或者可能是他們的眼睛而感染新型冠狀病毒肺炎病毒"。 "但這並不是病毒傳播的主要方式
Chinese study with data taken from swabs on surfaces around the hospital
中國一項研究的數據來自醫院周圍表面的拭子
The surfaces where tested with the PCR(polymerase chain reaction)test,which greatly amplifies the viral genetic material if it is present.That material is detectable when a person is actively infected.This is thought to be the most reliable test.
表面測試的 PCR(聚合酶鍊式反應)檢測，這大大增強了病毒的遺傳物質，如果它是存在的。當一個人被主動感染時，這種物質是可以檢測到的。這被認為是最可靠的測試
Computer mouse(ICU 6/8,75%;General ward(GW)1/5,20%)
電腦鼠標(ICU 6/8,75%;普通病房(GW)1/5,20%)
Trash cans(ICU 3/5,60%;GW 0/8)
垃圾桶(ICU 3/5,60%;GW 0/8)
Sickbed handrails(ICU 6/14,42.9%;GW 0/12)
病床扶手(ICU 6/14,42.9%;GW 0/12)
Doorknobs(GW 1/12,8.3%)
門把手(GW 1/12,8.3%)
81.3%of the miscellaneous personal items were positive:
81.3%的雜項個人物品是正面的：
Exercise equipment
運動器材
Medical equipment(spirometer,pulse oximeter,nasal cannula)
醫療器械(肺活量計、脈搏血氧計、鼻腔插管)
PC and iPads
個人電腦和 ipad
Reading glasses
閱讀眼鏡
Cellular phones(83.3%positive for viral RNA)
手機(83.3%的病毒 RNA 陽性)
Remote controls for in-room TVs(64.7%percent positive)
室內電視的遙控器(64.7%為陽性)
Toilets(81.0%positive)
廁所(81.0%正面)
Room surfaces(80.4%of all sampled)
房間表面(80.4%的採樣)
Bedside tables and bed rails(75.0%)
床頭櫃和床扶手(75.0%)
Window ledges(81.8%)
窗台(81.8%)
Plastic:up to 2-3 days
塑料袋：最多2-3天
Stainless Steel:up to 2-3 days
不銹鋼：最多2-3天
Cardboard:up to 1 day
硬紙板：最多1天
Copper:up to 4 hours
銅：長達4小時
Floor–gravity causes droplets to fall to the floor.Half of ICU workers all had virus on the bottoms of their shoes
地面引力導致水滴落到地面。一半的重症監護室工作人員的鞋底都有病毒
Filter Efficiency and Fit
過濾器的效率和適應性
* Data from a University of Illinois at Chicago review
* 數據來自美國伊利諾大學芝加哥分校協會審查
HEPA(high efficiency particulate air)filters–99.97–100%efficient.HEPA filters are tested with particles that are 0.125μm.
高效微粒空氣過濾器-99.97-100%有效率。高效微粒空氣過濾器的測試粒子為0.125米
Masks and respirators work by collecting particles through severalphysical mechanisms,including diffusion(small particles)and interception and impaction(large particles)
口罩和防護口罩通過幾種物理機制收集粒子，包括擴散(小顆粒物)和攔截和阻塞(大顆粒物)
N95 filtering facepiece respirators(FFRs)are constructed from electret(a dielectric material that has a quasi-permanent electric charge.An electret generates internal and external electric fields so the filter material has electrostatic attraction for additional collection of all particle sizes.As flow increases,particles will be collected less efficiently.
N95過濾面罩式呼吸器(FFRs)由駐極體(一種具有準永久電荷的介質材料)構成。駐極體產生內部和外部電場，因此過濾材料具有靜電吸引力，可以收集所有粒徑的額外粒子。隨著流量的增加，顆粒的收集效率會降低
N95–A N95-aproperly fitted
合適的裝配
N95 will block 95%of tiny air particles down to 0.3μm from reaching the wearer's face.
N95可以阻擋95%的微小空氣顆粒到達0.3微米以下的佩戴者的臉部。
But even these have problems:many have exhalation valve for easier breathing and less moisture inside the mask.
但即使這些也有問題：許多人有呼氣閥，以便於呼吸，減少口罩面膜內的水分
Surgical masks are designed to protect patients from a surgeon's respiratory droplets,aren't effective at blocking particles smaller than 100μm.
醫用口罩是為了保護病人免受外科醫生的呼吸道飛沫的傷害而設計的，對於100微米以下的顆粒無效
Filter efficiency was measured across a wide range of small particle sizes(0.02 to 1µm)at 33 and 99 L/min.
在33和99l/min 的範圍內，測量了不同粒徑(0.02ー1 m)的過濾效率
N95 respirators had efficiencies greater than 95%(as expected).N95
呼吸防護口罩的效率高於95%(如預期)
T-shirts had 10%efficiency,
T 恤衫有10%的效率,
Scarves 10%to 20%,
圍巾10%到20%,
Cloth masks 10%to 30%,
布口罩10%到30%
Sweatshirts 20%to 40%,and 20%至40%，
運動衫20％至40％，以及20％至40％
Towels 40%.
毛巾40%
All of the cloth masks and materials had near zero efficiency at 0.3µm,a particle size that easily penetrates into the lungs.
所有的布口罩和材料在0.3微米處的效率接近於零，這種粒子大小很容易穿透到肺部
Another study evaluated 44 masks,respirators,and other materials with similar methods and small aerosols(0.08 and 0.22µm).
另一項研究評估了44種口罩、呼吸器和其他使用類似方法的材料以及小型氣溶膠(0.08米和0.22米)
N95 FFR filter efficiency was greater than 95%.
N95 FFR 過濾效率大於95%
Medical masks–55%efficiency
醫用口罩 - 效率55%
General masks–38%and
一般口罩 - 38%及
Handkerchiefs–2%(one layer)to 13%(four layers)efficiency.
手帕-2%(一層)至13%(四層)效率
Conclusion:Wearing masks will not reduce SARS-CoV-2.
結論：戴口罩不會減少 SARS-CoV-2
N95 masks protect health care workers,but are not recommended for source control transmission.
N95口罩保護醫護人員，但不推薦用於源頭控制傳播
Surgical masks are better than cloth but not very efficient at preventing emissions from infected patients.
外科口罩比布料的好，但在防止受感染病人排放物方面效果不是很好
Cloth masks will be ineffective at preventing SARS-CoV-2 transmission,whether worn as source control or as personal protective equipment(PPE).
無論是作為源頭控制還是作為個人防護設備(PPE)佩戴，口罩在防止 sarsーcov-2傳播方面都是無效的
"Masks may confuse that message and give people a false sense of security.If masks had been the solution in Asia,shouldn't they have stopped the pandemic before it spread elsewhere?"
"口罩可能會混淆信息，給人們一種錯誤的安全感。如果口罩在亞洲是解決問題的辦法，難道他們不應該在大流行傳播到其他地方之前阻止它嗎?"
* The first randomized controlled trial of cloth
* 第一個戴面具的隨機對照試驗 masks.
Penetration of cloth masks by particles was 97%and medical masks 44%,3M Vflex 9105 N95(0.1%),3M 9320 N95(<0.01%).
粒子滲透率為97%，醫用口罩為44%，3M Vflex 9105n95(0.1%)，3M 9320n95(<0.01%)
Moisture retention,reuse of cloth masks and poor filtration may result in increased risk of infection.
保濕、重複使用布面具和過濾不良可能會增加感染的風險
The virus may survive on the surface of the face-masks
病毒可以在口罩表面存活
Self-contamination through repeated use and improper doffing is possible.A contaminated cloth mask may transfer pathogen from the mask to the bare hands of the wearer.
重複使用和不當落紗可能造成自身污染。受污染的布質口罩可能會將病原體從口罩傳播到配戴者的手上
Cloth masks should not be recommended for health care workers,particularly in high-risk situations,and guidelines need to be updated.
不建議醫護人員使用口罩，特別是在高危情況下，並且需要更新指南
* A study of 4 patients in South Korea
* 一項有關韓國四名病人的研究
Known patients infected with SARS-CoV-2 wore masks and coughed into a Petrie dish."Both surgical and cotton masks seem to be ineffective in preventing the dissemination of SARS–CoV-2 from the coughs of patients with COVID-19 to the environment and external mask surface."
已知感染 SARS-CoV-2的病人戴著口罩，咳嗽時使用 Petrie 盤。"外科口罩和棉質口罩似乎都不能有效防止 SARS-CoV-2病毒的傳播，這種病毒是由新型冠狀病毒肺炎患者的咳嗽傳播到環境和口罩表面的。"
* Singapore Study–Few people used mask correctly
* 新加坡研究ー很少有人正確使用口罩
Overall,data were collected from 714 men and women.About half the sample were women and all adult ages were represented.Only 90 participants(12.6%,95%CI 10.3%-15.3%)passed the visual mask fit test.About three- quarters performed strap placement incorrectly,61%left a"visible gap between the mask and skin,"and about 60%didn't tighten the nose-clip.
總的來說，數據收集自714名男性和女性。大約一半的樣本是女性，所有的成年年齡都有代表。只有90名參與者(12.6%，95%置信區間10.3%-15.3%)通過了視覺口罩匹配測試。大約四分之三的人沒有正確地放置皮帶，61%的人"在口罩和皮膚之間留下了可見的縫隙"，大約60%的人沒有收緊鼻夾。
* A 2011 randomized Australian clinical trial of standard medical/surgical masks
* 2011年澳大利亞標準醫用/外科口罩隨機臨床試驗
Medical masks offered no protection at all from influenza.
醫用口罩對流感一點保護作用都沒有。
Conclusions from Organizations
各組織的結論
The World Health Organization(WHO):
世界衛生組織：
"Advice to decision makers on the use of masks for healthy people in community settings
"就在社區環境中為健康人士使用口罩向決策者提供諮詢
As described above,the wide use of masks by healthy people in the community setting is not supported by current evidence and carries uncertainties and critical risks."
正如上文所述，健康人士在社區環境中廣泛使用口罩並沒有現有證據支持，而且帶有不確定性和關鍵風險。”
"Medical masks should be reserved for health care workers.The use of medical masks in the community may create a false sense of security,with neglect of other essential measures,such as hand hygiene practices and physical distancing,and may lead to touching the face under the masks and under the eyes,result in unnecessary costs,and take masks away from those in health care who need them most,especially when masks are in short supply."
"醫用口罩應該留給醫護人員。在社區使用醫用口罩可能造成一種虛假的安全感，忽視其他基本措施，如手部衛生習慣和身體距離，並可能導致觸摸口罩下面和眼睛下面的面部，造成不必要的費用，並奪走最需要口罩的醫護人員的口罩，特別是在口罩供應不足的情況下
"Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water."
“口罩只有在與經常用酒精搓手液或肥皂和水洗手相結合時才有效”
WHO acknowledges that most people do not use masks properly.
世衛組織承認，大多數人沒有正確使用口罩。
Dr.Nancy Messonnier,director of the Center for the National Center for Immunization and Respiratory Diseases:
南希梅森尼爾博士，國家免疫和呼吸系統疾病中心主任：
"We don't routinely recommend the use of face masks by the public to prevent respiratory illness,"said on January 31."And we certainly are not recommending that at this time for this new virus."
"我們不建議公眾經常使用口罩來預防呼吸道疾病"，1月31日表示。 "我們當然不建議在這個時候對這種新病毒採取這種做法。"
The Centers for Disease Control and Prevention(CDC)
美國疾病控制與預防中心
In March 5,2019 regarding the flu:"Masks are not usually recommended in non-healthcare settings;however,this guidance provides other strategies for limiting the spread of influenza viruses in the community:
2019年3月5日，關於流感："在非醫療機構通常不建議使用口罩，但是，這份指南提供了其他策略來限制流感病毒在社區的傳播：
cover their nose and mouth when coughing or sneezing,
咳嗽或打噴嚏時，應掩蓋口鼻,
use tissues to contain respiratory secretions and,after use,to dispose of them in the nearest waste receptacle,and
用紙巾包住呼吸道分泌物，並在使用後將其丟棄在最近的廢物容器中，以及
perform hand hygiene(e.g.,handwashing with non-antimicrobial soap and water,and alcohol-based hand rub if soap and water are not available)after having contact with respiratory secretions and contaminated objects/materials.
接觸呼吸道分泌物和受污染的物件/物料後，應注意手部衞生(例如用沒有抗菌劑的肥皂和清水洗手，以及在沒有肥皂和清水的情況下用酒精搓手)
From the New England Journal of Medicine
摘自《新英格蘭醫學雜誌》
"We know that wearing a mask outside health care facilities offers little,if any,protection from infection.Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes(and some say more than 10 minutes or even 30 minutes).The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal.In many cases,the desire for widespread masking is a reflexive reaction to anxiety over the pandemic."
"我們知道，在醫療機構外面戴口罩對於防止感染幾乎沒有任何保護作用。公共衛生當局定義與有症狀的新型冠狀病毒肺炎患者在6英尺內的面對面接觸，持續至少幾分鐘(有些人說超過10分鐘甚至30分鐘)。因此，在公共空間裡，通過一個經過的互動來捕捉新型冠狀病毒肺炎的機會是很小的。在許多情況下，渴望廣泛的掩飾是對大流行的焦慮的反射性反應。"
Final Thoughts
最後的想法
Surgical masks–loose fitting.They are designed to protect the patient from the doctors'respiratory droplets.The wearer is not protected from others airborne particles
醫用口罩 - 寬鬆配件。它們的設計是為了保護病人免受醫生的呼吸道飛沫的傷害。佩戴者不受其他空氣傳播粒子的保護
People do not wear masks properly.Most people have the mask under the nose.The wearer does not have glasses on and the eyes are a portal of entry.
人們不會適當地戴口罩。大多數人都把口罩戴在鼻子底下。佩戴者不戴眼鏡，眼睛是入口
The designer masks and scarves offer minimal protection–they give a false sense of security to both the wearer and those around the wearer.
設計師的口罩和圍巾提供了最低限度的保護——它們給穿戴者和周圍的人一種虛假的安全感
**Not to mention they add a perverse lightheartedness to the situation.
**更不用說他們給這種情況增加了一種反常的輕鬆
If you are walking alone,no mask–avoid folks–that is common sense.
如果你獨自行走，不要戴口罩——避開人群——這是常識
Remember–children under 2 should not wear masks–accidental suffocation and difficulty breathing in some
記住 - 2歲以下的兒童不應該戴口罩 - 意外的窒息和呼吸困難
If wearing a mask makes people go out and get Vitamin D–go for it.In the 1918 flu pandemic people who went outside did better.Early reports are showing people with COVID-19 with low Vitamin D do worse than those with normal levels .Perhaps that is why shut-ins do so poorly.
如果戴口罩會讓人們出去攝取維生素D，那就去吧。在1918年流感大流行，走出家門的人表現更好。早期報告顯示，維生素D含量低的新型冠狀病毒肺炎患者比維生素D含量正常的人情況更糟糕。也許這就是為什麼自閉症患者表現如此糟糕的原因
If you are sick,stay home!
如果你生病了，就呆在家裡！
Additional Resource:Healthy People Wearing Masks,Should They or Shouldn't They?This ER nurse with over two decades of experience took a deep dive into the science to find out:https://jennifermargulis.net/healthy-people-wearing- masks-during-covid19/
附加資源：健康的人戴口罩，他們應該還是不應該？這位有著超過20年經驗的急診室護士深入研究科學，找到了答案：https://jennifermargulis.net/healthy-people-wearing-masks-during-covid19/
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