Post #942, Masks, part two: Please update the US mask initiative using N95 respirators

Posted on January 7, 2021

Source:  Carnegie-Mellon Delphi Group Covidcast.  This is based on an ongoing Facebook survey of mask use.

Based on the above, it looks like the wear-a-mask message finally seems to be getting through to most people.

In Post #935, I made yet another plea not just to wear a mask, but to wear a good mask.

Upon reflection, I think this ought to be Federal policy.  And I think the Feds ought to re-purpose the original plans for a U.S. mask initiative to accomplish that.

And so that’s what this posting is about.  I’ll start by recapping where we were, back in April of 2020 when the CDC first said “wear a cloth mask”.  Remind you of the first Federal mask initiative, the one that was spiked by the Trump administration.  I’ll note  what has changed (the shortage of N95 masks), and what hasn’t (the ban on retail sales of N95 masks to the general public).  Remind you of how vastly better N95s are compared to commonly-used masks.  And end by suggesting that the Federal government should start mailing good masks — N95 respirators — directly to U.S. households, starting with Southern California.  Because this is one instance in which the marketplace will not adequately serve our needs.

Really, there’s just about nothing here that I haven’t said before.  But I think it’s worth saying again.  Policies designed to keep N95s out of the hands of the public made sense in light of a critical shortage of those respirators.  A shortage that ended months ago.  Now, those same policies are worse than useless.  Those outdated policies shouldn’t just be eliminated, they should be reversed, with a goal of getting N95s into the hands of the public.


As briefly and logically as possible.

A:  We actually did have a national mask policy for U.S. citizens in the works.

Post #816: We actually did have a rational, national plan for mask use?

When the CDC changed its advice to “wear a cloth mask”, on 4/3/2020, Health and Human Services was already primed to promote that.  They were going to mail five cloth masks to every residential address in the U.S.  What a great and relatively cheap way to get people focused on using masks.

That was, of course, killed by the Trump administration.  You can read the details by clicking the link to an earlier post, above.

B:  N95s haven’t been available to citizens through normal retail channels since early in the pandemic.

We had a severe shortage of N95 respirators.  The shortages of N95s are well enough documented that you don’t need references from me.

One way or the other, those N95s got reserved for healthcare workers, first responders, and similar.  They were pulled from all legitimate retail channels.  (But only after panic buying and hoarding wiped the shelves clean (Post #535).  N95 respirators were long gone by the time the toilet paper aisles started to empty out.)  I have a series of posts pointing out the lack of retail access to N95s, ending with the very first cracks showing in the retail N95 ban, last month (Post #918).

C:  N95s provide vastly better protection than ear-loop surgical masks or most cloth masks.

I just went through this, in my 10-cent lungs post (Post #935).  If you stop and do the math, the viral load that you face when wearing a common ear-loop surgical mask is about 14x higher than you would face wearing an N95 respirator.  (Why?  Because the surgical mask is roughly an N30, so you breathe in roughly 70% of the particles in the air.  An N95 means you only breathe in 5% of the particles in the air.  And 70/5 = 14).

And most cloth masks perform similarly to an ear-loop surgical mask, based on the JAMA-published test that formed the basis for that posting.  With one notable exception (Post #938).

So mask rating numbers are modestly misleading.  They are factually correct, but they really don’t force you to focus on how much better an N95 is than (say) something equivalent to N30.

Just do the math:  Right now, we could cut the viral load that the mask-wearing population faces by a factor of 14, if we could just swap out those cheapo masks for proper N95 masks (respirators). 

Does anybody else have any proposed policy that even remotely comes close to that, for overall effectiveness?  I guess we could all go into total lockdown.  But short of that, putting the circulating US public in N95s would do more than any other single proposal for reducing the amount of COVID-19 that the public is exposed to.

D:  There is no longer a shortage of N95 masks.

 There’s no longer a shortage of N95s, thanks in part to US manufacturers, and in part to partial removal of the FDA ban on use of Chinese KN95s in health care settings (discussed in Post #601).

Certainly isn’t one in Virginia, at present.  And when I look for one, via Google, for California, all I see is references to the situation half a year ago.  But nothing today.  Because that problem has been solved.

This may not be obvious to you, if you haven’t been tracking it, but an entire genre of news articles and posts is no longer present. Remember back in the spring of 2020, when you could see articles on how to sew masks and donate them to your local health care provider?  You don’t see those any more.  And my inference is, that’s because that’s part-and-parcel of the lack of a shortage of genuine FDA-approved masks for healthcare providers.

E:  And yet, the informal ban on sales of N95s through normal retail channels remains.

Just go on Amazon and look for 3M N95 masks.  All the legit ones are marked as reserved for health care providers.  Got to the Home Depot website and try to buy a decent N95 or P95 dust/paint mask.  No such thing is available.

F:  But how can you get a few N95 masks into the hands of everyone, without having hoarders snap them up off the shelves?

Those masks were the first thing to fly off the shelves, at the start of the Great Panic Buying Episode of 2020.  Before toilet paper, even.  (See Post #535).

If you put them back on the shelf, you know what’s going to happen.

Which means that if you want to get a few, into the hands of every citizen, you’re going to have to bypass the markets.  Because, in this case, the markets aren’t serving your needs.  Panic buying and hoarding make the markets dysfunctional for this particular purpose.

The whole rational-econonomic-man thing just kind of flies out the window in the face of panic buying.  And I have a more-than-lifetime-supply of single-ply toilet paper to prove it.

And so, speaking as a classically-trained economist, former small-business owner, and fervent capitalist:  It’s time for a little socialism.  But just a little.  Let the President-elect demonstrate his socialist cred by using the U.S. mail to provide a few high-quality masks to every household. 

(But if you were paying attention, Biden would only be plowing the socialist ground that was broken by the Trump administration.  The Trump administration overrode market forces with their (informal) ban on sales through normal retail channels.  For the greater good, meaning, so that health care workers would have N95s.  Bypassing market forces to achieve a social goal — that’s socialism.)

And so, if the irrationality of panic buying prevents a normal, capitalist, market-based solution — just repurpose the original U.S. mask initiative from this spring.

Back then, people needed access to some cloth mask — there weren’t enough of those to go around.  And that’s what the original policy would have done.

Now, the markets freely and cheaply supply those cloth masks.  There’s no need for a socialist policy of distributing cloth masks.  But there is a crying need for such a policy for distributing N95 respirators.  So, update the policy to meet the current need.

As with the initial proposal, start with the hardest-hit areas.  So start by mailing N95s (with instructions) to households in Southern California.  And see how it goes.  Given the costs being incurred now, and the economic losses from further shutdowns, the cost of mailing out a few tens of millions of N95 masks is more-or-less rounding error.

G:  Summary.

Once upon a time, we had a critical shortage of N95 respirators, and so we developed a policy of keeping those out of normal retail channels.  That interference in the marketplace reserved the U.S. supply for healthcare workers.  And that was a good thing, because people would simply have panic-bought and hoarded them if they’d been on the shelves.  (Because that’s exactly what they did when the cleared the shelves of them in the first place.)

Putting those N95s back on the shelves isn’t smart.  They’ll just get snapped up as fast as you can supply them, until all the hoarders are satisfied.  Instead, the Federal government should, in this one case, bypass the markets once again, but this time to provide a modest supply of those masks directly to U.S. households.  Starting in the hardest-hit areas.

It wouldn’t cost much.  And it beats the heck out of just waiting around to see what happens next.

As a final addendum, the Kimberly-Clark N95s that I recently bought on Amazon (Post #918) fold flat for shipping.  So you really could stuff five in an envelope and mail them.  Or splurge for a box, and send proper 3M N95s.

Source:  A plausibly legitimate N95 mask that was recently for sale on Amazon.com