Welcome to Plugging the Gap (my email newsletter about Covid-19 and its economics). In case you don’t know me, I’m an economist and professor at the University of Toronto. I have written lots of books including, most recently, on Covid-19. You can follow me on Twitter (@joshgans) or subscribe to this email newsletter here. (I am also part of the CDL Rapid Screening Consortium. The views expressed here are my own and should not be taken as representing organisations I work for.)
Globally, the pandemic ebbs and flows. Countries that were doing well — e.g., Israel or Ireland — suddenly find themselves at the top of the pack in cases per day. And then they fall back and something else takes over. It is now Ontario’s turn to be among the worst — not just in Canada but globally. (Last week Canada as a whole overtook the US for the first time). And with new measures being the same old same old, there is very little chance of this being abated before summer. What is more, we are faced with the over-run of hospital facilities and the life-death triage choices looming with them that first got me motivated to start working in this area over a year ago. I can’t believe the issue is back. What is more, there is a simple solution to counter it: mandate N95 masks in workplaces.
The Ontario rocket of doom
For those that don’t know, here is the picture in Ontario.
And it is all being driven by new variants; pretty much all B.1.1.7 or the UK variant.
This time, the hospitals are ready and have been expanded into car parks.
Fortunately, over 84% of those aged 80 or above have received one dose. This will likely help but the numbers in ICUs are a problem.
This outbreak is currently raging out of control. No measures have tempered the rate which appears to have an effective reproduction number around 1.2 at the moment. That is very high. The overall rate is 34 new cases for every 100,000 people per day.
Why is this happening? First, the new variants. Their basic reproduction number is likely around 5 (twice that of Covid Classic). What that means is that it is a coronavirus on steroids. The virus binds more quickly and generates a much higher viral load. That is why people are showing more symptoms and those are occurring in younger people.
Second, the spread is originating almost entirely in workplaces that remain open. Manufacturing factories and distribution centres. The data isn’t great but the pattern seems to be that workers infect each other at work and then bring the virus home.
This paints a picture. The new variants, as I have written about before, are successful precisely because they work around our current methods of mitigation. The one thing the Ontario government has not moved to do anything about is workplaces like these. Two and two sometimes do add up to four.
What we need to do RIGHT NOW!
You might be expecting me to say — rapid screening. Of course, that would be great but it takes 3-4 weeks to stand up facilities on that and we don’t have the time.
Another option is to shut everything down. And it may come to that.
But the thing we can do immediately is right before us: give every worker a new N95 mask every day. It is time to get serious about masks. This is not an area for theatrics.
We have come a long way in the West on masks. They are now routine. But the masks that are routine are cloth masks or cheap disposable masks. Zeynep Tufekci and Jeremy Howard called for this in January specifically against the new variants. In hospital settings more serious attire is worn. This matters.
This may not look like a huge advantage but if you are with people in a workplace for over 8 hours a day, it really adds up. There’s more:
The Journal of American Medical Association, Internal Medicine, published a study in December 2020 that examined how well different masks protect the person wearing them. The fit filtration efficacy (FFE) of various masks was measured using a device that detects particles behind the mask, with the following results:
Three-layer cotton mask: FFE 26.5 per cent
Non-woven polypropylene mask with fixed earloops: FFE 28.6 per cent
Medical procedure masks (surgical mask): FFE 38.5 per cent
N95 respirator: FFE 98.4 per cent
The study also found that the FFE of cloth and surgical masks can be increased with modifications that improve fit, such as double masking or tucking and knotting a surgical mask.
We no longer have a shortage of such masks in Canada and they can be made locally. You can get them for less than $1 per unit.
We need to mandate N95 or better masks in all currently open workplaces in Ontario with more than 20-30 people employed. This will be costly but I’m an economist, I can make it budget neutral for you.
To save money, we can now abandon the disinfection theatre that pervades workplaces. Covid is spread in the air and not on surfaces. Stop the cleaning. Take the money and buy some f**king masks.
And Ontario government: turn your attention to these workplaces and do what it takes to keep people in them safe. When those cases go above their project 10,000 per day, people, even if you stop paying them, will stop coming into work. Eventually, if the government does not mitigate real risk, people take it into their own hands to protect themselves.