To read Bret Stevens in the New York Times (“there should be no big-pharma haters in pandemics”), you’d think that remdesivir, the promising covid treatment, was the result of Big Pharma’s big R&D budgets. You’d be wrong. Remdesivir was publicly funded.
The U.S. Army, the Centers for Disease Control and Prevention and the National Institutes of Health/National Institute Allergies and Infectious Diseases subsidized the preclinical and clinical development of remdesivir - helped along by public universities.
Actual pharma R&D spend goes to things like figuring out how to repatent an old heart med as a boner pill (Viagra), or how to reformulate a public domain opioid and repatent it (Oxycontin).
The risky spending that saves lives? That comes from the government.
Why would the private sector spend money that it could divert to shareholder buybacks and executive salary on high-risk ventures to improve patients’ lives, when the can just appropriate publicly funded research, patent it, and charge unlimited sums for access to it?
It didn’t used to be this way. In 1989, the Bush NIH adopted a rule limiting how much pharma companies could charge Americans for products derived from publicly funded research. In 1995, Bill Clinton struck down the rule.
What’s more, as David Sirota notes, the Clinton HHS czar who oversaw the change, Donna Shalala, was just appointed to oversee trillions in stimulus funds by Nancy Pelosi.
If remdesivir turns out to be an effective covid treatment, it will be a huge, publicly subsidized windfall for Gilead, the pharma company that gouged the public on Hepatitis C treatments, tripled the cost of publicly funded HIV meds, dodged tax by offshoring its profits.
Gilead is also the company that secured “orphan drug” status for remdesivir, giving it 7 years’ worth of extra exclusive rights to it (this status is for drugs that treat rare diseases that no one else is addressing).
The right has fretted for decades about the “moral hazard” of government handouts, warning that giving poor people enough money to house and feed themselves will tempt them to be lazy and greedy.
But the only welfare queens driving Cadillacs and getting fat on government pork are the donor class in exclusive ZIP codes, not people living in Section 8 housing and risking their lives working for Doordash.
Remember when the stimulus was first proposed, and there was a lot of concern that the GOP would us it as an excuse to put billions more into the pockets of, you know, billionaires?
Unsurprisingly, Mitch McConnell’s version of the CARES Act included swingeing tax-breaks for the richest people in America, eliminating the Tax Scam’s modest limits to how much individuals earning $250K or more could claim.
All told, the Joint Committee on Taxation calculated that this change will cost $195B over ten years: more, even, than the US is showering on the airlines who so unwisely incinerated their cash reserves in an orgy of stock-buybacks, leaving them to beg for corporate welfare.
It’s hard to overstate much much money this will give to the richest people in America. EIGHTY PERCENT of the 195 BILLION DOLLARS will go to 43,000 people.
These are literally the richest people in the country.
As Matt Taibbi explains so masterfully, this is a trickle-down bailout, with seemingly unlimited budgets to lift asset prices, but a mere $1200 to help low-waged workers survive for ten weeks (Treasury Secretary Mnuchin calls this a “liquidity bridge”).
The Fed is stepping in with billions for junk bonds issued by “fallen angel” companies whose credit ratings have fallen through the floor. They’re buying from banks like Citibank, who buy bonds them at steep discounts, then sell them at full face value to Uncle Sucker.
Okay, I am going to put myself out here: we need masks for all. If you live in a country that doesn’t have widespread use of masks in public, this one is for you.
Here is a graph of coronavirus trajectories by country. All those countries in blue have widespread public use of masks, in addition to other measures.
Obviously I am not basing all of this on a few countries that have managed to slow the spread. Here is a link to a summary of 33 scientific papers that show that masks (even handmade ones, we’ll get to that) reduce spread of infection for the general population. Many of these studies are themselves meta-analyses of data. The evidence is mounting that public mask usage is an important strategy to reduce COVID-19 transmission. I want to highlight this paper in particular which modeled that public mask usage could slow or even stop the spread of an influenza pandemic.
(The CDC and WHO still maintain that healthy people should not wear masks. Preserving them for healthcare workers is important, but that is a separate question from whether they work or not. It seems likely from the evidence presented above that they do help at least somewhat)
Of course, there is a nationwide shortage of masks in most countries. Medical grade masks must be reserved for healthcare workers (if you have some, look for local ways to donate them, many hospitals are accepting donations). So where do we get the masks for the public? We follow the lead of the Czech Republic and Taiwan and make our own.Here is a great summary of how the Czech Republic went from 0 to 100% public mask usage, in less than two weeks.
A person makes masks and a “mask tree” where neighbors could donate handmade masks to others. Note that masks (or anything really) can be effectively sterilized by heating above 70C (158F) either in the oven for paper masks or using regular cycle in your washer and dryer for cloth masks.
Studies have shown even basic household materials like t-shirts can be effective at blocking droplets that contain viruses.
Are they as good as n95 respirators? No. But outside of certain medical procedures, the disease mainly spreads through droplets, and these homemade masks are still pretty good (though not perfect) at blocking those. This goes both ways: the masks provide a layer of protection to protect you, but ALSO contain a lot of the droplets you could be spreading. Some people with the disease don’t have any symptoms at all, so wearing masks is also important to reduce the chance of infecting others.
Masks, like social distancing, don’t have to be 100% effective in order to help flatten the curve.
Here is a model from the Seattle area, which shows how small changes in social contacts can effect total case numbers. You can see that even reducing contacts 25% has a profound effect on case numbers after a few weeks. The same thing would be true if wearing masks reduced transmissions by just 25%.
I want to point out that as long as you don’t take risks you wouldn’t take otherwise and keep your hands off the mask, there is very little risk to doing this now as we wait for further scientific evidence. And the evidence is mounting that simple masks reduce risk and slow spread.
In the Czech republic, they went from no one wearing masks to 100% (it is now mandatory in public) in about 10 days. While the mandatory order to cover your mouth and nose is only a week old, they have seen a slower growth of cases than the rest of Europe despite lots of testing.
Basic masks can be made with just a t-shirt and scissors, no sewing required. This video shows you how, just wear your mask higher on your face than this guy. (Video is changed from original post to one that doesn’t require Facebook login)
Simple mask that can be made with a sewing machine, from Craft Passion
If you get good at making homemade masks, especially the ones with HEPA filters, some hospitals are now accepting donations of homemade masks as well. Check to see what is going on in your local area.
If the papers cited above are correct, wearing a mask now when you need to leave the house for essential chores will reduce the time it takes to bring our cases down, and public use of masks could be invaluable in keeping cases low when people start to go back to work.
We can change our culture from stigmatizing masks to expecting people wear them. It happened in the Czech Republic in less than two weeks. We can do it too.
If you have the time, please watch this video. It was the thing that really made all of this click for me, and it has a ton of great information. Here is a shorter video from the Czech youtuber who started the movement in his country which I also recommend watching & sharing.
Please reblog & add resouces, tutorials, or mask selfies! There are three main things you can do to help spread the word and normalize mask wearing: 1) share videos & other information on the topic; 2) take a selfie of you wearing a home-made mask; 3) spread the message, with hashtag #masks4all.
March 30th updates:
A lot has happened in the four days since I wrote the post. Some news:
“The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.”
President of Slovakia, Zuzana Chepalova has been matching her masks to her outfits this week. Slovakia has also made masks mandatory in public.
A team of public health experts at American Enterprise Institute included public use of masks a key part of their strategy:
There is emerging evidence that asymptomatic and presymptomatic transmission of COVID-19 is possible, which complicates efforts to pursue case-based interventions. To reduce this risk during Phase I, everyone, including people without symptoms, should be encouraged to wear nonmedical fabric face masks while in public
(Link - it’s worth reading the whole section on masks if you are interested)
US Senator Pat Toomey calls for the public to wear homemade masks to prevent the spread of covid-19.
Not news, but important, here is the conclusion of a study that evaluated homemade masks against surgical and n95 respirators for protection against respiratory infection:
“Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection. Masks worn by patients may not offer as great a degree of protection against aerosol transmission.”
A great new summary video to share, featuring experts from the Czech medical community and the Minister of Health of the Czech Republic:
In addition to the t-shirt method in the original post, here are three more face-covering tutorials that do not require a sewing machine:
This one is disposable!
Here is how to turn a t-shirt into an impromptu face covering, no cutting or sewing required.
5 more new sew styles. Could potentially be reinforced with a paper towel, or additional cloth.
I want to end with a plea not to treat the masks as a substitute for quarantine, social distancing, hygiene and other measures. The biggest fear in recommending masks to the public is that people might get a false sense of security from them. If people use masks as an excuse to take these other precautions less seriously, it could undo any benefit they have and even make the situation worse. If you wear a mask, you MUST continue with all the social distancing and hygiene measures as before. Don’t think of the mask as permission to do risky things: think of it as a constant reminder of how careful we must be.
Mask or not: isolate yourself when sick, stay home as much as possible, keep a safe distance from others when you must go out, avoid touching your face, and wash your hands frequently and well.
Stay safe y’all. These are wild times
Takes some adjusting to avoid steaming up my glasses
