Let's talk medical masks, plague history, culture, and fashion!

Let's start around the 17th century with everyone's favorite iteration of medical mask- The plague doctor!

Now that I have your attention, we're actually going to start at the tail end of the 16th century and talk about the very first, clumsy prototypes brought about by the final sweeps of bubo with the Great Plague of London.

These masks were inelegant, herb stuffed teabags.

Rosemary, posies, thyme were all used to stuff masks as it was thought to be carried on tainted air. The idea was that the herbs purified the air as it came through the mask and removal of the bad smells meant the air was filtered and pure. It obviously wasn't, but we learned.

What did these early iterations of masks NOT do? Prevent incoming pathogens was mainly what they DIDN'T do. So how the heck could those have been even slightly useful when bubo was mainly passed from flea bites and exposure?

Source Control! They kept YOU from spreading germs!

Okay, let's take a quick look at some culture disparity to explain what's going on here in America RIGHT NOW about wearing masks and people who refuse to consider the herd.

In Western cultures we emote with our lips and mouth the most. Many Eastern cultures use the brows/eyes.

Let's start with the funfact about the dentistry industry driving Western cultures into lip driven emoting!

So we Westerners used wide lipped, toothy smiles as a status symbol. It was showing off how beautiful your teeth were, meaning you were showing off your /wealth/.

This is why people of many Western cultures feel restricted with anything over their mouths and inversely people of most Eastern cultures tend to feel restricted with hats and sunglasses instead.

So that's a bit of the sociological WHY for Americans rejecting mask use.

Keeping up so far? Great! So while we're on the subject of sociological structure and impact let's look at the divide between- (forgive the obvious example) America and Japan.

MANNERS. American manners are rooted in rugged individualism, whereas Japan has a culture that is-

rooted in politeness and consideration of what others think. This difference is striking to anyone who has been to both countries or studied cultural manners.

American lifestyle is exceptionally selfish and self serving. This is part of why we see so many billionaire stans.

In America specifically the attitude is quite often centered on the individual. This self-centralized approach to individuality leads to the "Fuck you, I got mine" mindset we see so often here in America and several other Western cultures.

But Tyrion, you promised us PLAGUE DOCTORS!

Okay, I hear you! Let's switch back to the medical history again for a second here and trail back around to 17th century masks shall we? Excellent, so we know herbs were used ineffectively to filter pathogens. Let's talk transmission.

DROPLET TRANSMISSION!

"Droplet transmission is usually defined as "respiratory droplets carrying infectious pathogens [that] transmit infection when they travel directly from the respiratory tract of the infectious individual to susceptible mucosal surfaces of the recipient,-

generally over short distances, necessitating facial protection." Close contact involves hand transfer of surface contamination to mouth, nose or eyes, hand washing and gloves being common controls."

So back to Source Control for a second? Plague Doc masks did nothing to keep-

pathogens out- what they did facilitate however, in conjunction with their accompanying outfit and gloves, was a fairly sterile surgeon who was less likely to contaminate you as a patient!

Surgical masks and cloth face masks as we know them didn't evolve until the late 1800's. The first known use comes from French Surgeon Paul Berger who was famous for his skill with amputations.

What he SHOULD be known for is his exacting standards toward sterilizing equipment-

and demanding higher quality requirements in his industry's tools. He was one of the first to advocate for the cloth surgical masks we see and use today due to Droplet Transmission. Dr. Berger noticed that other surgeons talking often allowed saliva to drip or splatter on-

the patients. Realizing that this likely increased the transmission of communicable diseases he advocated vehemently for the use of surgeon's masks even when it was considered laughable that a SURGEON could possibly be a source of infection!

"For several years I have been worried as to the part that drops of liquid projected from the mouth of the operator or his assistants may exercise on the outbreaks of infection which one still sees from time to time under conditions of surgical asepsis which are apparently-

satisfactory."- The beginning of Dr. Berger's paper on cloth masks. Did you know that Dr. Berger even fell ill because a droplet of blood from a patient's blood splatter landing in his mouth? Imagine what he'd have to say about the current standards we have- it'd be an earful.

"It is exactly because I realize that perfection in the carrying out of operations aseptically must not concern itself with any one point but with all, and must neglect no detail, that I have been so anxious to insist on a precaution, the use of which has contributed not a-

little to improve my operative results. I do not blind myself to the fact that this is too great a shock to custom for it to receive a much more favourable welcome than that accorded by the German surgeons to an analogous communication by Professor Mikulicz."- Dr. Paul Berger

Moving on, cloth masks were in use as late as the 1960's when modern marketing brought us disposable masks!

These were intended as Source Control, made to collect saliva, mucus, and to reduce the air transmission of pathogens from breathing, coughing, and sneezing.

So if the regular surgical masks are merely Source Control and only contain the pathogens you have, what do you need to filter out pathogens as a preventive measure then? A respirator of course!

Let's swing back to social structures and manners again for a bit yeah?

So, social good vs individualism! Let's take a quick look at that.

In some cultures it is impolite to so much as blow your nose in public because of the potential spread of germs. If you have allergies you know how near impossible that can be sometimes!

"About one-fourth of the Japanese population suffers from kafunsho, or hay fever. There are about 60 types of plants and trees that cause hay fever in Japan, but the pollen from the Japanese cedar, sugi, and Japanese cypress, hinoki, is most common." https://matcha-jp.com/en/2245 

So, Japan has some excellent reasoning here for allergen filtration, but there's more to it than that! Allergies are one thing, but if you're sneezing around someone sick or elderly with hayfever there's STILL a chance of Droplet Transmission for something the vulnerable person-

may not be able to fight off, even if the person who is *only* suffering allergies is not ill! Ergo, wearing face masks in public is not only polite, it is CONSIDERATE of communal health in all instances.

Why do American struggle with this concept? That's a whole dissemination.

Let's switch gears a bit and examine what's going on in current events then. New York is our closest model of a similar population density to several other countries, why is New York hit so hard? Lack of Source Control is a huge part of that.

So backing up a bit to American individualism and how that translates to the "Fuck you, I got mine" mindset that's currently the baser reason most Americans REFUSE to wear masks- Americans and many Western cultures do not *care* so deeply about preventing the spread of germs.

You need look no further than the antivax movement which has crippled America and Britain's herd immunity and overburdened our healthcare systems and even caused old plagues and diseases to resurface with a newfound virulence. Western cultures teach us to worry about-

"You and yours." Okay, let's break this thought process down for the audience abroad who has no concept of this piece of Western ideation. "Me and mine." is basically slang for "the people directly involved in my life long term." Anyone outside this does not require empathy.

In essence this means anyone outside your family, long time friends, and colleagues are not 'your concern'. Western cultures teach us that WE the individual are the most important thing, not our place amidst many others like or unlike us, we the individual stands above all else.

Oh, but wait, there's much more to this stigma of masks in America and Western cultures! What are masks associated with most often in Western cultures? BANDITS AND BANK ROBBERS OF COURSE!

Hiding the facial features is disturbing to Americans, you can't read someone's face-

We have this cultural paranoia involving masks to the point that up until recently it was legitimately illegal to wear masks at ALL in public in many places over here. This includes for fashion. There are several city and local ordinances throughout the American Midwest-

that classifies surgical masks, bandannas, and face coverings worn in public as "reasonable suspicion", "party paraphernalia", and in some cases have even been a fineable or jailable offense!

America has a cultural problem here that is deeply rooted in antiblackness and steeped-

in racist stereotypes involving face masks and covering one's mouth/identity. While I am no expert on the intersectionality of this particular point, I will say that this does tie heavily into bandannas and hoodies being instantly associated with criminal activity.

Covering your mouth should not be so stigmatized, and especially not weaponized against vulnerable populations. We are watching in real time now as our own hubris and vehement approach to individualism destroys our communities while the harmful tropes of yesteryear give us pause.

What do *I* gain from wearing a face mask? You gain control, autonomy, you gain some peace of mind, you gain safety, you gain keeping your health.

More than anything you give others peace of mind.

Let's wrap this up with the various other reasons we should destigmatize medical masks in public!

1. Allergies! Allergies are everywhere, it makes life easier for those of us who can hardly breathe the air for the floating plant snot making our sinuses drown us in them.

2. Social Autonomy! Blemishes, shyness, lack of make up, not wanting the world to judge you by your resting bitch face that could crack a mountain in half because you're just fucking tired of people asking if you're okay. All should be acceptable reasons to wear masks socially.

3. FASHION! If you need me to explain this one just look at the images below.

Masks like these are common at concerts to prevent the spread of communicable illness! That's metal af imho.

Let's pivot back to respirators for a second shall we? Why are the N95 masks so indispensable right now? They make an airtight seal and are named for their standard, they block out 95% of airborne particles while common surgical masks block about 8% of that.

N95's do not work-

effectively at all if you get oil on them including skin oils! This is *important* to know and understand. DO NOT HANDLE YOUR N95 WITH YOUR GREASY, BARE HANDS! OKAY? Okay!

N95's are however excellent Source Control AND Prevention however.

Did you know they were industrial products first and medical products second?

The industrial variant I'm most familiar with is the P95- the model I was gifted by my brother who works landscaping. I will genuinely recommend these before an N95 for public use! Here's WHY-

"P95 respirators are designed to provide the wearer with respiratory protection against contaminants that contain oil while providing 95% filtering proficiency. These factors make this type of respirator ideal for a number of work environments since P95 respirators can also-

be used for protection against non-oil based respiratory irritants."

So what does this mean for you the individual? It means this model is going to last you a LOT longer in an every day environment with dust, oils, and allergens!

P95's are used for painting and mining.
They are exceptionally great at filtering airborne pollution, smog, and other harmful particulates that may be in the air AS WELL as the majority of easily communicated airborne pathogens!

Circling back to cloth face masks in response to earlier plagues- In 1910 China used face masks to protect against, can you guess? Bubonic plague!

This directly inspired their use against the outbreak of Spanish Flu later in 1918 and then later on they inspired WWII GAS MASKS!

Gas masks were later adapted for mining use, however being big and bulky meant miners hated them and thus the masks began getting refined and adapted to better suit needs! The standard was first developed in the United States creating single use respirators. Neato right?

The construction of these is actually similar to the construction of surgical masks, and involves a polymer that was developed by 3M. The first commercial n95 mask came out in 1972 and was designed by Sara Little Turnbull. M
https://en.wikipedia.org/wiki/Sara_Little_Turnbull

So here's where the socio-economics of all this gets super interesting and we get to highlight one of the largest problems the world is facing during this latest plague-

The N95 was invented in the US, produced in the US, so why aren't they commonly available in the US anymore?

The answer is cost cutting and avoiding lawsuits. People started using less effective materials, they require fitting, and other things. But a lot of the production of them ended up in countries with a heavier mining industry who could also afford to produce them at a greater

scale(because of the above industries). Competition resulted in a lot of American companies stopping production of them in the early 2000s. Where were most of them made after that? Why *China* of course.

But that only explains the shortage, not how they became a medical thing. Why did they take off in the medical community? Drug Resistant Tuberculosis. OOF! Anyone remember tuberculosis wards? It was NOT pretty and it drove the US medical industry forward without mercy.

The US shortage of N95 masks comes from 3M, the inventors of it, outsourcing operations to China. Also, their prioritization of places that were willing to pay more. There are only a few placing in the US still producing them.

Surgical masks and N95 masks are made with the same process and roughly the same equipment btw!
https://en.wikipedia.org/wiki/Melt_blowing

This process is why they are so highly effective at filtering out particulates, vapors, and airborne pathogens!

Alright folx, this thread is an absolute UNIT now and I'm going to wrap this lesson up with some links and love.

Fam is trying to organize creation and distribution of face masks! Please hit them up and if you're making masks maybe consider volunteering! https://twitter.com/hachx0/status/1249044834150727682?s=20

Helpful links!
https://masks4all.co/  "Find out how to make masks, learn about the science, and please share to save lives."

https://twitter.com/J0hnnyXm4s/status/1248363768658243585

https://smartairfilters.com/en/blog/best-materials-make-diy-face-mask-virus/?fbclid=IwAR0aTvIzNrjpoSh1s40OyAUO7B6thnkya_7kQg2Ufz28_Nq7D7_zxcWQrR4

https://www.peakprosperity.com/forum-topic/covid19-diy-mask-tutorial/

In closing, Please be safe, learn from our history of plagues and pandemics.

Plagues, diseases, and the medical masks created in response to them is a special interest for me- I understand that these topics can be difficult for others to cope with however. Especially now.

I would like to thank and credit my beloved @FourmyleCircus for helping me organize my thoughts and letting me directly quote them in several places. Without them this thread would not have been so well organized or possible.