Journal

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3 Feb 2020

It’s the end of the world as we know it – No doubt you, dear reader, have heard of the novel coronavirus (2019-nCoV) by now. Depending on who you listen to, it is either a public health emergency of international concern or the beginning of the end of the world. We know it is serious, but just how serious is it? Let me start by saying that I am not a medical professional. So if somehow you’ve come here seeking sound medical advice on 2019-nCoV, you’re probably in the wrong place. I will be linking to some reliable sources (like the link to the WHO above), but those sources are the only expert information you will find here.

“...you are far more likely to become infected by touching an infected surface than through airborne pathogens.”

With those disclaimers out of the way, let’s get on with it. As of this morning, there were 15 reported cases in Korea, although it is likely that this number will already be out of date by the time you read this. By that same time, there were 14,557 cases in China (the WHO considers Taiwan to be a part of China, incidentally), which means that we have seen slightly more than 0.1% of the number of cases China has seen. (These figures come from the WHO report for 2 February.) Even if you keep in mind that South Korea has less than 4% of China’s population, that’s still not too bad.

As more cases are being reported daily, though, I’m finding that people around me are starting to become more concerned. In the past few days, three conferences that were scheduled for the next few weeks have been postponed, and a department trip to Jeju was also canceled. It kind of feels like people are being excessively cautious, but I suppose the idea is to be better safe than sorry. I’m also seeing a lot more people wearing masks as they are out and about. It’s not uncommon to see people wearing masks at this time of year, due to both the poor air quality and the common cold, but I’m definitely seeing more of them. This has been especially true in areas where people congregate, such as the subway. We also saw a lot of people wearing masks at church this past Sunday, which is something I’ve never seen before.

I have to admit, though, that I do wonder about the efficacy of masks when it comes to preventing transmission of 2019-nCoV. A mask may prevent the majority of airborne particles from coming into contact with the mouth and nose, if the mask is of sufficient quality and forms a seal against the face. These are some big “if”s. I have a cotton mask that I wear when the air gets really bad, but I know for a fact that it doesn’t form a proper seal around my nose because I end up with condensation in my eyebrows (hot air escapes through gaps next to my nose and shoots upward toward my eyebrows). This makes it fairly ineffective, but I will still sometimes wear it because I figure it is better than nothing. Honestly, though, it often just feels like theater.

In terms of preventing me from being infected with pathogens, I suppose it might help if someone sneezed or coughed directly in my face. How often does this actually happen, though? I can count on one hand the number of times someone has sneezed or coughed in my face over the past year (incidentally, it was one of my nieces every single time). It may be more likely to happen in a crowded subway, but we’re still talking about something that doesn’t happen very often. Still, if it reduces our risk of being infected by an airborne pathogen—even if by only a little—we should do it, right? Well, there is some logic in that. But I think there is a danger of being overconfident in the protection offered by a mask and thus being lax in taking other precautions to keep ourselves healthy. And if the wearing of a mask changes the behavior of the wearer in such a way as to put that person at greater risk, than the wearing of a mask actually becomes dangerous. The wearing of a mask should never take the place of normal care and caution.

To give a specific example of what I consider to be “dangerous behavior,” I often see people wearing masks around their chins, as if they were chinstraps—in fact, I saw a number of people doing this at church on Sunday. You may wonder why people do this, since the point of masks is to protect the mouth and nose, not the chin. Well, you might not be aware of this if you’ve never worn a mask before, but they are not very comfortable. So what people will do sometimes is wear their masks properly when they feel they need to, then pull the mask down around their chin when they feel they don’t. This isn’t quite as ridiculous as it sounds if you’re wearing the mask to protect your respiratory organs from the sometimes horrible air in Seoul, but it is patently ridiculous if you are wearing the mask to protect yourself from airborne pathogens; if there are any pathogens on the outside of the mask, you risk spreading them to your face or hands every time you pull the mask down or back up again. Taking off the mask completely and then putting it on again isn’t much better. If you’re going to do this, I honestly think you’re better off just not wearing a mask at all.

The bottom line, I think, is that if you are going to wear a mask, you either have to do it right or you run the risk of canceling out any benefits and possibly even making things worse. This means that you need to get a mask that will actually keep out pathogens (N95, basically, which filters out 95% of airborne particles), make sure that it forms a proper seal on your face, and then leave your mask in place until you do not need it anymore—no pulling it down or anything—and then throw it away (if it is a disposable mask) or wash it (if it is a reusable cotton mask). So if you are going out to dinner, you should have two masks: one for the journey out, and then one for the journey home once you’ve finished dinner. If that sounds like a hassle, well, you’re beginning to understand why I am a little skeptical of masks when it comes to disease prevention.

I left out one step above in proper mask procedure, though: Once you’ve taken off the mask, WASH YOUR HANDS WITH SOAP AND WATER. Sorry for the all caps, but this is the single most important piece of information I have for you in today’s entry. This is because you are far more likely to become infected by touching an infected surface (and then touching a mucous membrane, like the membranes found around your eyes, nose, mouth, etc.) than through airborne pathogens. Still, I think it’s worth coming right out and saying, because I don’t think people do it nearly as often as they should. In our house, when we come home after having been in public—and especially after a ride on the subway—the first thing that we do is wash our hands with soap and water. And I don’t mean just now that the coronavirus is a thing, I mean always. This is something you should be doing all the time if you want to reduce your chances of getting sick.

I know it feels like I am lecturing here, but if you knew how many people I’ve seen on a daily basis use the toilet and then walk out without even a glance at the sink, you would understand. Seriously, what is up with that? How do you stand there in a public restroom with your hands on your messy bits, spraying urine and/or fecal matter all over the place, and then not wash your hands before you leave? A lot of people do exactly this, though, and it blows my mind (and also makes me glad that shaking hands isn’t the normal method of greeting here). It might be just a guy thing, for all I know, since I obviously don’t frequent women’s restrooms. My point, though, is that if you’re not washing your hands after using the toilet, than you’re probably not washing your hands in other situations, either. And that is just a recipe for disaster when it comes to disease transmission.

So, in closing, I will once again remind you that I am not a medical professional, but I am also not alone in stressing the importance of washing your hands to prevent the spread of disease. I’m also not the only person to question the efficacy of face masks in preventing the contracting of disease. As the TIME article notes, what masks are good for is reducing the risk that you will spread your germs to other people if you are sick, and it is in fact common practice for people with colds to wear masks here in Korea. But don’t rely on a mask to protect you from 2019-nCoV or any other communicable disease. Instead, make it a habit to wash your hands regularly (or use hand sanitizer if soap and water are not available, although soap and water are ideal), and you’ll be on your way to a healthier life.

Send me your thoughts.

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