Wildfires are Increasing Along with Air Pollution

Taiwan Produces Nearly One Surgical Mask per Day per Person

Taiwan Donates Mask Making Machinery to the Czech Republic

Delta Installing MERV 14 Filters in Jet Bridges

Arvind Limited to Produce 30 million N95 Masks per Year

3M Still Not Producing Enough Surgical and N95 Masks

N95 Masks for General Public are  an Important Option

Efficient Masks are the Low Hanging Fruit to Mitigate COVID

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Wildfires are Increasing Along with Air Pollution

As early as 2016, researchers were already noting stark patterns around the length and severity of wildfires.

A June 2016 report by Climate Central found that the average length of wildfire season in the western U.S. was 105 days longer  than in the 1970s – from under 150 days in 1970 to over 250 days in 2016.

The report also found that the average size of fires in the western U.S. grew from less than half a million acres in 1970 to nearly 2 million acres in 2016. Researchers discovered that rural wildfire smoke drifts farther from its source than was previously thought. Examining satellite data to track the movement and dispersal of smoke plumes, they found that wildfire smoke drifts at a very high altitude, eventually reaching distant urban centers and interacting with other pollutants to create elevated ozone levels far from the fire source.

Previous studies had found that wildfires release nitrogen oxide and hydrocarbons that contribute to elevated ozone levels, but those effects were seen mostly in rural areas, not distant urban centers far removed from the fires. Elevated ozone levels are a major health concern, particularly in urban areas. Breathing ozone can trigger a variety of negative health effects, including coughing, throat irritation and congestion in healthy people. Furthermore, ozone can also worsen symptoms of bronchitis, emphysema and asthma.

A study published in the Journal of the American Heart Association reported evidence of a connection between wildfire smoke particles and acute heart disease, including cardiac arrest. Smoke particles that are 2.5 microns or less in diameter (known as “fine” particles) in particular were found to be associated with a short-term increased risk of cardiac arrest. The study also found an increase in emergency-department hospital visits associated with exposure to fine smoke particles from wildfires.

Although other studies have previously established the link between fine smoke particles and respiratory problems such as asthma, this study clarifies the link between wildfire smoke and heart disease. Specifically, the study reported a 6.9% increase in cardiac arrests during a two-month period as a result of exposure to wildfire smoke particles near Victoria, Australia. The increase was most strongly associated with men and with people more than 65 years old. Increases were also found in other forms of heart disease.

Taiwan Produces Nearly One Surgical Mask per Day per Person

The evidence is mounting that cloth masks are aerosol generators and are therefore not effective in mitigating COVID. The fact that Taiwan has only registered seven deaths from COVID is in no small part due to the fact that it supplied its citizens with surgical masks at the critical stages.  Today it has the highest surgical mask production per capita of any country in the world.

Despite being close to China, Taiwan has stopped the COVID-19 with general screening strategy and encouraging people in Taiwan to wear a mask. Taiwan reported the first COVID-19 case on January 21, 2020. About 850,000 of Taiwan's 23 million citizens live and work in mainland China,. There were 2.71 million visitors from Mainland China in Taiwan in 2019. The narrowest point between Taiwan and mainland China is just 130 km. Taiwan is one of the areas with the highest risk of the COVID-19 pandemic, but it did not happen. Taiwan has recorded just 443 cases and 7 deaths on June 04, 2020, including 55 local cases and 352 imported cases and 36 navy crew members aboard the Panshi fast combat support ship, respectively.

In European and American countries, it is generally believed that only infected patients need to wear a mask and that wearing a mask implies an admission of disease. In Asian countries, on the other hand, it is common for people to wear masks to prevent COVID-19.

The daily production capacity of face mask manufacturers in Taiwan before the outbreak was 1.88 million face masks with a maximum production capacity of 2.44 million face masks per day. To ensure sufficient domestic resources for the prevention and control of epidemics, the Government of Taiwan imposed a ban on exports of face masks on January 24th, followed by the requisition and rationing of all domestically-produced face masks (about 4 million pieces per day) by the National Health Command Center and Central Epidemic Command Center.

Starting from February 6th, each person was allowed to purchase two surgical masks (priced at NT$5 each, equivalent to USD 0.17 each) every seven days. Starting from March 5th, the purchase limit was increased to three masks for adults and five masks for children every seven days. To ensure an adequate supply of face masks, Thailand, South Korea, and France announced the implementation of export controls on face masks starting from February 4th, February 26th and March 3rd, respectively. Germany and Russia also announced a ban on exports of face masks on  April 4th. Besides, the World Health Organization (WHO) also called for all countries to boost their production of face masks on April 4th.

Currently, Taiwan is capable of producing 20 million face masks per day and will boost its production capacity to 25 million face masks per day. The purchase limit has also been revised to nine masks for adults or 10 masks for children every 14 days starting in April. Now that the government has lifted a ban on the commercial sale of masks, convenience stores and supermarkets have began to sell face masks on June 3rd.

Taiwanese people who suspect they may have been infected with COVID-19 can go to the emergency department of the nearest hospital for relevant medical examinations (including sampling and testing for COVID-19, blood tests, and X-ray imaging test) with out-of-pocket medical expenses of less than NT$ 600 (USD 20). People with high suspicion of COVID-19 infection will be admitted to isolation wards, and those who have tested positive for COVID-19 can only be discharged home after three consecutive respiratory specimens test negative for the virus. In that case, patients will have to pay less than NT$ 3000 (USD 100) out-of-pocket for medical services.

Most of the medical expenses incurred by Taiwanese people are covered by the National Health Insurance program. As of May 5th, there were a total of 443 confirmed COVID-19 cases out of 72,871 screening tests under surveillance with a positive rate of 0.61%. Of the confirmed cases, seven patients died from the disease and 428 patients (98.2%) have been released from quarantine.

Taiwan Donates Mask Making Machinery to the Czech Republic

As Czech Senate speaker Milos Vystrcil leads an 89-member delegation in Taiwan, Taiwanese firm and machinery industry leaders have raised funds to donate five "fully automated 3D high-end mask production lines" to the Czech Republic as a token of their appreciation for the eastern European country's friendliness toward Taiwan.

Autoland Technology Co., Ltd. (東建安公司) General Manager Kuo Li-lin (郭立霖) was cited by SET News as saying that these five production lines are being donated by his company and a group of machinery industry leaders in southern Taiwan to the Czech Republic to help them produce masks for 120,000 front-line medical staff. One production line can produce 30 medical-grade masks and N95 respirators per minute, according to Kuo.

Kuo estimated that the mask production lines will generate 200 million euros (US$236 million) in economic benefits for the Czech Republic per year. Therefore, he asserted that the equipment will not only help prevent the spread of the Wuhan coronavirus (COVID-19), but it will also increase job opportunities for Czech citizens.

 

Delta Installing MERV 14 Filters in Jet Bridges

Delta, the Atlanta-based airline announced two new safety and sanitization initiatives at airports this week as airlines prepare for a stall in demand recovery between the summer and holiday travel seasons.

Delta said it would replace the air filtering systems on the jet bridges that passengers use to walk from the gate onto their planes, and announced new anti-microbial bins at security checkpoints at five of its hubs. The moves come as travel demand remains severely depressed over the same period in 2019. Airlines are desperate for demand to grow as they continue to bleed cash.

Although airplanes recirculate some cabin air, almost all aircraft are outfitted with High Efficiency Particulate Air, or "HEPA" filters, which are highly effective at removing the SARS-CoV-2 virus and other microbes from the air.

On the jet bridge, however, and on parked planes, air typically isn't filtered. Delta said that it would add MERV-14 filters to those air systems at 31 airports by mid-September, and at more airports in the coming months.

Although MERV-14 filters are not as effective as HEPA filters — they reduce air particles by 40%, according to Delta, instead of the 99.7% filtration that HEPA filters provide — it's still a significant improvement over having no filters at all. It was not immediately clear why Delta did not use HEPA filters, although those more effective products are in high demand as schools and universities reopen.

The airline also said it would offer the anti-microbial security bins at five airports: Atlanta, Minneapolis-St. Paul, Los Angeles, New York LaGuardia, and New York JFK. It has several hubs and focus cities (think mini-hubs) that did not make the list and said that it "will evaluate opportunities for expansion to other markets following the launch in these cities."

The new bins, according to the airline, come with antimicrobial technology that "prevent[s] the growth of a broad spectrum of bacteria." While COVID-19 is a virus, not bacteria, the new bin design also "continuously minimizes the presence of microbes throughout the bin's lifecycle."

Arvind Limited to Produce 30 million N95 Masks per Year

Arvind Limited, one of India’s largest textile-to-retail conglomerates and ACT Grants have partnered to produce 30 million N95 masks in the next 12 months.

Arvind Limited has received ₹100 million from ACT Grants, the non-profit coalition of VC funds and start-up founders, and will employ its manufacturing expertise on Medical Products and Working Capital to create a large, integrated facility for N95 mask production and distribution.

Through this partnership, Arvind and ACT Grants will jointly donate 9 million masks over the next year to charitable institutions, government bodies, and other organizations, focusing on medical and non-medical professionals with the highest risk of contracting the virus.

Upon complete scale-up, the daily N95 mask production capacity will be approximately 2 lakh units which would be operated, owned and managed by Arvind.

The N95 masks will be available through Arvind Advanced Material Distribution partners, direct sales channels to Government, hospitals, and other corporates.

“Arvind has been manufacturing PPEs for various industries for over a decade and we believe we can use this expertise to produce N95 masks," Punit Lalbhai, Executive Director, Arvind Limited, said. 

“A detailed Quality Management System including product and process has been implemented, to ensure quality and consistent manufacturing. ACT upfront supported Arvind in setting up this project in record time and Arvind appreciates having a likeminded partner in this journey," Lalbhai added.

Arvind Advanced Materials is a large, pioneering manufacturer of PPE Coveralls and Face Masks which are certified by BIS and Global agencies. 

“ACT and its partners have already provided over 3 lakh PPE and over 15 lakh masks to hospitals, police and frontline workers across 20 states of India. This partnership with Arvind will allow us to make ten times the impact in protecting our front-lines and provide high quality, locally manufactured BIS certified N95 masks in India. ACT will work with partner NGOs & Foundations to make these N95 masks available free of cost," said Apurv Bansal, Spokesperson from ACT Grants.

 

3M Still Not Producing Enough Surgical and N95 Masks

Like millions of other U.S. businesses, the pandemic has not been easy on 3M. The Saint Paul, Minnesota-based corporation has seen demand for most of its products plummet in a rapidly contracting economy, crushing its revenues. But while many of those other companies are seen as victims, the mask fiasco has left 3M with a big dent in the golden reputation it’s been building for more than a century. The reality is masks are barely a line item on 3M’s balance sheet. Up until the pandemic, N95s only accounted for less than 1% of the public company’s $32 billion in annual revenues. But when you take on the risk of having a product in your portfolio that has the potential to become the lifeline for the country overnight, you better be ready to step up to the occasion. It might only be a fraction of your business, but it’s your entire reputation on the line.

In mid-January, Michael Osterholm, a University of Minnesota researcher who heads the school’s Center for Infectious Diseases Research and Policy, contacted 3M to urge them to start making more N95 masks. There were no known U.S. cases of Covid-19 at the time and only dozens of known cases anywhere in the world outside of China.

To gear up for the next potential health crisis after SARS, 3M purchased the “melt-blown polypropylene” material and the huge, complex machines required to produce the masks, and put it all in mothballs. It also trained more technicians on the equipment and processes. While almost all other U.S. manufacturers of N95 masks were shifting their N95 production to China, India, and other countries where costs were lower, 3M kept its biggest N95 manufacturing lines in the U.S., in South Dakota and Nebraska, recognizing that in a serious outbreak, overseas pipelines might dry up.

So when Covid-19 started to have the makings of a pandemic, 3M was ready to hit the gas. It added shifts and overtime to its plants worldwide to get to 24/7 operation on its lines, pulled the tarps off its extra equipment and materials, and moved hundreds of employees over to mask production. When it started running out of people it could shift over or hire, it began purchasing robots to pitch in. Its researchers studied ways to sterilize masks for reuse. It even successfully pushed the federal government for fast changes to regulations that would have prevented the company from diverting shipments of N95 masks earmarked for industrial use to hospitals.

When the pandemic exploded in New York City and other hot spots in March, the company began airlifting and hand-delivering mask shipments to hard-hit hospitals, moving as many as half a million masks per day. But it wasn’t enough. As the crisis sharply worsened, more hospitals started running out of the masks, and of other protective gear. There was nothing else 3M could do to make masks any faster. The machines that make them are complex and getting more of them would take months. The world’s supply of melt-blown polypropylene, difficult to obtain on short notice in the best of times, dried up overnight.

In the past six months, the mask-manufacturing industry has steadily ramped up N95 output, with the sector expected to continue to grow its revenue by 23% per year over the next five years, according to one estimate. 3M alone is on track to produce 2 billion masks this year, more than half of which will be made in, and thus will be sure to stay in, the U.S.

Honeywell is building up to a 250-million-masks-a-year capacity. And new manufacturers, like Miami-based Maskco Technologies, are springing up.

Along with partners, Maskco has bought 56 Chinese N95-like mask-making machines capable of producing nearly a billion masks per year (they can’t be called N95 masks until they’re thoroughly tested by NIOSH and approved by the FDA). “I already have purchase orders in hand for my first two years of production,” says CEO Scott Weissman, an investment banker who founded the company in April in response to the pandemic.

The enormous ramp-up in mask production may not do all that much for 3M’s bottom line, but far more important, the resulting higher capacity from all this activity should be enough to see most hospital workers through the pandemic. Unless that is, there’s a massive, sharp spike beyond any we’ve seen so far, which unfortunately remains a distinct possibility, given the U.S.’s track record.

N95 Masks for General Public are  an Important Option

Experts sang the praises of N95 masks while their supply remained dangerously short of what health care desperately needs. But as the shortages ease, more are speaking out about what a plentiful supply of N95 masks could do to keep people safe as they mingle with the mask less masses.

Writing in the Harvard Business Review in mid-June, two Harvard Medical School physicians and two other health and policy experts explained that N95 masks “would give people control over their own safety, a greater incentive to wear them, and the confidence to resume economically important activities. If worn widely enough in crowded and indoor settings where most transmission seems to occur, these masks could potentially stop the epidemic altogether.” In a July opinion piece in USA Today, two intensive-care specialists put it this way: “How should individuals protect themselves from infection in areas where near universal indoor mask use is not the norm? In such a situation, the best option is to wear an N95.”

Efficient Masks are the Low Hanging Fruit to Mitigate COVID

Models suggest that the widespread use of even cloth masks, bandanas, or scarves could dramatically reduce transmission. But their effectiveness varies, and they primarily function as “source control”: They provide the person wearing it with some protection from particles coming in, but mainly reduce how much the wearer expels. That means that your personal safety from infection is not in your control and largely depends on how reliably those around you are wearing masks — a major problem given that only half of Americans wear masks consistently and some adamantly refuse to wear them as a political statement. All it takes is one “superspreader” not wearing a mask to infect numerous others who are.

Consequently, we need masks for the general population that block the virus from coming in and going out similar to what high-filtration surgical or N95 masks do for healthcare workers. Masks like this would give people control over their own safety, a greater incentive to wear them, and the confidence to resume economically important activities.

If worn widely enough in crowded and indoor settings where most transmission seems to occur, these masks could potentially stop the epidemic altogether. They would also reduce flu transmission and the chance of a dreaded “double epidemic” in the fall. Better masks may be the most effective way to counter Covid-19 in low-income countries where testing is limited and the social and economic damage caused by lockdowns is more severe.

These masks should meet five parameters:

Protection

The level of necessary protection depends on how important it is to defend against aerosols. Protection results from deflection and filtration (how well particles are blocked going through the mask) and fit (how well the mask seals around the face and prevents particles from coming around it). There are increasing examples of how these characteristics might be achieved. A recent study showed that filtration just shy of N95s could be achieved with combinations of cotton and other common fabrics like silk, flannel, and chiffon. Other research has demonstrated how the fit can be enhanced by lining the outside of masks with material from a nylon stocking or creating a brace using rubber bands. Another researcher is experimenting with fabrics that deploy low-level electric charges and can be inserted into masks to neutralize viral particles. Some infectious disease experts propose that face shields — which also stop particles from entering a person’s body through the eyes — might also provide sufficient mouth and nose protection.

Scalability

Any design must use commonly available materials that commercial manufacturers can purchase in massive quantities. Multiple designs using different materials may be necessary so we are not reliant on any single set of materials that could run out. One reasons masks are such an attractive option is that, unlike testing and contact tracing, they can be scaled more readily and widely.

Comfort

Masks must be comfortable enough for people to wear them for long periods of time without needing to touch them or take them off too frequently. There may be ways to do this while still preserving protection. For example, Stanford researchers are experimenting with wearable devices that pump oxygen into masks to make them more breathable.

Reusability

To preclude a constant need for new masks, it would have to be possible to easily clean them or only have to replace certain parts (e.g., filters) so they could be repeatedly used. (Some hospitals have started using elastomeric masks typically worn in industrial plants and construction sites that meet this requirement.)

Style

Widespread adoption of masks will require a significant cultural shift so they become a seamless part of a “new normal.” They should be fun, cool, and fashionable. For instance, they might exhibit the colors or logos of individuals’ favorite sports teams or brands.

Designing and producing such masks and persuading large numbers of people to wear them is not straightforward and poses engineering, manufacturing, and marketing challenges that may ultimately require tradeoffs. There are already some efforts to overcome them. J Labs, a unit of Johnson and Johnson, presciently ran a contest last year to develop better masks; the winner and other entrants created designs along the lines of what we need now. A nurse executive in San Antonio created N95-caliber masks using materials found in local hardware stores. And a Stanford team designed a similarly effective version that adapts off-the-shelf snorkeling masks.

Given the stakes, the federal government should convene companies and forge public-private partnerships to expedite the process of developing, validating, and scaling effective designs. Grand challenge prizes could help accelerate this effort, and the Defense Production Act could be used to rapidly scale up manufacturing.

However, we don’t need to wait for federal action to move forward. Academic institutions, companies, and private citizens can start creating and testing designs and mass manufacturing effective ones. Industries imperiled by the epidemic — such as airlines, sports leagues, and hotels — have every incentive to see this happen and should use their resources and know-how to push this forward.

Once an effective design is in hand, the challenge will be getting enough people to actually wear them in crucial situations. It is difficult for people to wear masks — no matter how comfortable — for hours on end. However, not all situations carry equal transmission risk and wearing masks when performing some activities, such as walking alone outdoors, is less important. It is most critical that masks are worn when indoors, in crowded or tight spaces (e.g., public transportation, bars), in prolonged close contact with others (e.g., sitting across the table at dinner), or engaged in activities that involve heavy breathing (e.g., exercise, singing). Concerted promotional campaigns waged by governments and companies could persuade large numbers of people to wear masks in such places. Approaches from behavioral economics and anthropology that use “nudges” to encourage healthy behaviors could also play a role. While laws mandating that masks be worn in high-risk settings appear to increase their use, similar decrees have been enforced in ways that discriminate against Black Americans. So they would need to be applied carefully to avoid biased enforcement.

Although expanding testing or contact tracing remain crucial, designing, producing, and getting people to wear more protective masks is more feasible and more quickly achievable. It may be the single most important low-hanging opportunity for slowing Covid-19’s spread and giving people the security they need to bring our societies back to life.

https://hbr.org/2020/06/we-need-better-masks