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Another twist in masking against covid-19: Single or double masking for all?

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By Dr B. J. C. Perera

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL) 

Specialist Consultant Paediatrician

If one looks at the history of advice regarding the wearing of masks as an effective COVID-19 control measure, it has gone through a full 180-degree swing. In the initial phases of the pandemic, even the World Health Organisation (WHO) was not convinced that wearing masks was of any benefit. Our health authorities followed suit, as they always do in any situation where the WHO pontificates. Then the research scientists showed very clearly the benefits of wearing masks and after virtually a Herculean effort on the part of the scientific community, it was agreed that all should wear masks. Now, at least in our emerald isle, it has become law and at present the police even go after people who are not wearing masks and take steps to prosecute them. It has become like a kind of a mandatory second nature for all of us to wear masks.

Masks, of course, have to be worn properly for optimal benefits. This has been said over and over, again and again. With more contagious variants of the coronavirus spreading and optimal vaccination still months away for many people, all over the world, experts agree that it is time to think even harder about how well the face masks are protecting people.

Now enter DOUBLE MASKING …In a recent statement, the Director of the National Institute of Allergy and Infectious Diseases (NIAID) of the USA, Dr. Anthony Fauci, a foremost authority on COVID-19, stated that he favours double-masking as a further measure to protect against even the new and more infectious Covid-19 variants, like the UK and South African strains, as well as other similar mutant variants that may arise with time. These new recommendations are in line with the regulations being currently imposed across Europe, where medical-grade face masks like the N95 and the FFP2/3, rather than cloth masks, are becoming mandatory in public spaces.

Why the sudden change? More importantly yet, how does one double-mask correctly? Here’s what you need to know. Why Is Double-Masking Necessary? Doubling-Up on Masks is perhaps the need of the hour. When it comes to double-masking, it all boils down to extra protection. As Dr. Fauci further stated in an interview with the Today Show, “If you have a physical covering with one layer, and then you put another layer on, it just makes common sense that it is more likely to be more effective”.

The main reason why the extra protection is necessary, now more than ever, is that the new Covid-19 variants are more contagious than the original strain of the SARS-CoV-2 virus. As has been pointed out repeatedly, it is easier for these new Covid-19 mutations to bind to human cells. Therefore, minimizing the number of novel coronavirus particles in the air that enters the human respiratory system is the key, and the easiest way to do so is to make sure that everyone is wearing masks that offer the best possible protection. One way to do this is by wearing two masks. It is of course quite important to cover our noses and mouths completely and for both masks to fit snugly. Not only will double-masking help to protect others if someone in a crowd has Covid-19, but it will also decrease every individual mask wearer’s risk of contracting the disease.

All in all, wearing two masks is a better shield between you and the novel coronavirus. But why are doctors not advising us to wear three, four, or even five masks at the same time? More layers must surely be better. However, the main reason why that is not a good idea for most people is that wearing multiple masks will make it difficult for you to breathe, depending on the material. “You can pack on 10 layers, but what you do is to lose breathability, become quite uncomfortable and you have overdone the filtering capacity that you want” states Onyema Ogbuagu, an infectious diseases specialist and the primary investigator of Yale’s Pfizer COVID-19 Clinical Trial.

How to Double-Mask correctly? There are a few things to keep in mind if you decide to start double-masking. Here are some key points: –

 

Which masks are the best to combine?

Research shows that N95 masks offer the best filtration against the novel coronavirus. That being said, these masks may not be the best choice for most people because putting on and breathing in an N95 may be quite tough, especially if you have to wear it for hours. Still, if you can handle it, wearing an N95 mask is the gold standard. It is, however, not your only option. Ideally, you just want to use masks that offer both sufficient air filtration and breathability. A worthy alternative to N95 masks is a combination of a cloth mask or a surgical mask on top of a KN95 mask, which is a modification of the N95 mask. Keep in mind that by “cloth mask”, experts mean a face mask that consists of at least two layers of tightly-knit material, and certainly not a bandana handkerchief or a neck gaiter or a scarf.

 

How should we layer the face masks?

According to infectious disease experts, the best way to wear two masks is to start with the mask that offers the best air filtration and then wear the other mask, usually a cloth mask, over it. Therefore, put on the KN95 or a surgical mask first, and then wear the cloth mask over it. Make sure there are no gaps on the sides of the masks and they provide a tight fit. That manoeuvre will ensure that no contaminated air will be able to sneak in from the sides.

All in all, the idea of double-masking is pretty straightforward, and it is definitely worth a shot, especially when you have to commute by public transportation or have to spend time in populated areas. However, experts are of the opinion that it is generally better for someone to even wear a single mask properly than to wear two masks improperly. Of course, if one could wear two masks properly, then that would probably be best. The philosophy that “one mask is good, two masks are better, is probably true”, said Dr Georges Benjamin, Executive Director of the American Public Health Association. He further stated “I would prefer that somebody wore one mask properly than two masks improperly, but if you can wear two masks properly, that’s great”.

Whether you’re doubling up, wearing an N95, or just donning your favourite fabric mask, the most important thing to do is to make sure that you are wearing it properly. Masks should cover your nose and mouth and be as tight to your face as possible, according to the Centres for Disease Control in USA.

Experts say that the coronavirus variants do not have superpowers to penetrate masks better than the older versions of the virus. But when they do get through, it is more likely that a person will get sick. There is still a lot we do not know about the variants or what makes them more contagious. It could be that they are better at entering cells, or that they produce higher viral loads, meaning that when an infected person talks or coughs, they’re spewing out more viral particles.

Yet for all this, what they do have is the ability to exploit any kind of lapses in the way you wear those masks. Therefore, if you have got a flimsy mask on or if you have got a mask that you do not wear that well … it is going to be less forgiving when you are dealing with a new variant,

Until more people are vaccinated, just keep physical distancing and wearing masks, and avoid mixing in crowds indoors. Of course, masks are just one way to reduce your risk of transmitting and spreading COVID-19, and everyone should continue distancing, avoiding crowds, limiting time indoors with people outside your household, and staying home as much as possible. There is no way in which these can be relaxed, at least not as yet.

Whatever it is, try to do a little bit better job at both the masking and all the different prevention steps that all of us have been following to try to get everybody past that finish line where we have enough people vaccinated to be able to spend less attention on these very same things. Public cooperation in that scenario is the holy grail on which we have to depend on, relentlessly.



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Tree planting along road reservations and banks of streams

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Typical View of a tree plantation along roads

Reservations of Roads & Natural Streams which extend to about 10 to 20 on either side are not actively protected in Sri Lanka though it is very common in other countries. Those reservations are owned by the government. Therefore, public use of this land can be considered as a fair use of the land. Main purpose of this proposal is to introduce an intervention to connect the Forest Patches in urban areas such as Gampaha using the reservations of roads and natural streams, by planting trees so that those strips could also act as Urban Bio Corridors while enhancing the tree cover at national level. These trees also absorb the fumes emitted by vehicles while addressing global warming caused due to lack of tree cover. It also serves as a roof top for pedestrians who use reservations along public roads while adding aesthetic value to the area. Enhancing the community awareness about BioDiversity of Sri Lanka and the importance of maintaining a clean environment along road reservations is also another objective of this type of intervention. This intervention also addresses the needs of all sectors of the local communities.

Tree Plantation along reservations of roads and natural streams

 Concept

The Green Road is a relatively new concept for roadway design that integrates transportation functionality and ecological sustainability. This project addresses the transport sector also because it facilitates Environmentally Sustainable Transport (EST) for local people. Therefore, Provincial Road Development Authority (PRDA) is the ideal institute to implement this project. It is also possible to introduce cycle tracks along stream banks as short cuts by improving the banks of natural streams as roads. This intervention would reduce vehicle congestion in main public roads while supporting Clean Sri Lanka programme because local communities themselves become watch dogs against culprits who pollute road reservations and water bodies of natural streams.

 Already implemented projects in Mahaweli Areas

In Sri Lanka, the concept of Bio Corridor was introduced in 1988 under a Project called Mahaweli Agriculture and Rural Development project implemented in System B under an USAID funded programme. Similar to highways which connect main cities, in this case the Bio Corridors were introduced as “Bio Highways” connecting fragmented forest patches (“Bio Cities”) in paddy field areas. At the same time those corridors were improved as Cycle Tracks for the local farmers.

 Figure 1 indicates the present status of a tree plantation programme implemented in Mahaweli Area (Thambuttegama) in the 1980s along newly introduced roads.

Past Experience of PRDA (WP) related to similar interventions

In 2010, similar intervention was introduced in Gampaha District in parallel with a flood mitigation project implemented by the Provincial Road Development Authority (WP). For example, while Uruwal Oya running adjacent to Gampaha Urban Area was improved to mitigate floods, riparian tree belt areas were also introduced.  Later, parts of that stream running adjacent to Gampaha Town were improved as Recreational purposes such as jogging tracks for urban communities. As an additional benefit, it was expected that the shades provided by riparian tree cover would discourage growth of invasive plants such as Japan Jabara, which clogs the drainage outlets resulting in floods in urban areas.

 by Eng. Mahinda Panapitiya

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Has Compass lost direction?

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Sri Lankan voters have excelled in the art of changing governments in executioner style, which they did in many elections including that of 1977,1994, 2015, 2019 and, of course, 2024. They did so, giving massive majorities to parties in opposition that had only a few seats, because the preceding governments were so unpopular. It invariably was a negative vote, not a positive vote-endorsing policies, if any, of the incoming governments, the last election being no exception. NPP, contesting under the compass symbol, was essentially a revamp of the JVP and their main strategy, devoid of any specific policies, was throwing mud at opponents and promising a transparent, corruption free government. They made numerous promises on the hoof. Have they stood up to the challenges?

What the vast majority of the public wanted was a significant reduction in the cost of living, which has spiralled out of control due to the misdeeds of the many preceding regimes, resulting in near starvation for many. The NPP promised to renegotiate the deal with the IMF to give relief to the masses but soon found, to their dismay, that it was a non-starter. Of course, the supporters portrayed it as a display of pragmatism! They promised that the price of fuel could be slashed overnight as it was jacked up by the commission earned by the previous minister who was accused of earning over Rs 100 for every litre! It has not happened and the previous minister has not received the apology he deserves. The cost of living remains unbearable and all that the government continues to do effectively is slinging mud at opponents.

To the credit of the NPP government, financial corruption has not set in, but it cannot be forgotten that most previous governments, too, started this way, corruption setting in later in the cycle of government. However, corruption in other forms persist contrary to the promises made. Had the government sacked the former speaker, the moment he could not justify the claimed PhD, it could have claimed high ground and demonstrated that it would not tolerate corruption in any form. For some reason, unknown to the public, he seems to have a strong hold on the party and he seems indispensable!

As for bringing to justice those previously corrupt, only baby steps have been taken. During the election campaigns AKD promised to get Arjun Mahendran from Singapore within 24 hours of his election and now they are blaming the Singapore government! It looks as if promises were made without any idea as to the practicality of implementation. According to social media posts circulated, the list of assets held by Rajapaksas would have made them richer than Elon Musk! A lady lawyer who described in detail, during the election campaign, the wealth amassed in Uganda by Rajapaksas admitted, after her election, that there was no basis. Her justification was that the NPP government ensured free speech; even to tell lies as the truth.” Government media spokesman has just admitted that she lied about the cost of new year text messages sent by previous presidents and she remains an ‘honourable’ MP!

As far as transparency is concerned, Compass is directionless. MoUs/Pacts signed with India, during the recent visit of PM Modi shines bright with opaqueness! After giving various excuses previously, including that those interested could obtain details by making requests under the Right to Information Act, the official cabinet spokesman’s latest is that it needs the permission of India to release details. This makes one wonder whether there is a lot to hide or it may be that, de facto, we are already under the central government of India and that AKD is just the Chief Minister of the 29th state!

Whilst accusing the predecessors of misuse of power, the NPP does the same thing. AKD’s statements that he would be scrutinizing allocation of funds to local bodies, if opposition parties are elected, surely is an indirect threat to voters. Perhaps, it is not an election offence as the Elections Commission has not taken any action despite complaints!

Whether the exposition of the Tooth Relic, which was done in a mighty hurry, to coincide with the mini-election campaign would backfire remains to be seen. As it was done in a hurry, there was no proper planning and even the basic amenities were not provided to the thousands who queued for days. AKD, as usual, was quick with a political gesture by the unplanned visit meeting those in the queue. What he and his government should have done is proper planning but, instead, government supporters are inundating social media blaming the public for bad behaviour!

To cap this all is the biggest faux pas of all; naming the mastermind of the Easter Sunday attack. AKD built up expectations, and the nation was waiting for the exposure on 21 April, which never materialised. His acolytes are doling out excuses. Dr Nalinda Jayatissa was as evasive as possible during his post-cabinet meeting briefing. Perhaps, there is no mastermind other than those identified by all previous investigations including that by the FBI. All that the president did was handing over the Presidential Commission of Inquiry report to the CID. The acting IGP appointed a committee of three to study, but the next day a fourth person was added, a person who is named as one of those who did not act on intelligence received!

Perhaps, as an attempt to give credence to the allegations made in the Channel 4 programme, Pillayan was arrested. Though it was on a different offence, the alleged abduction of the former chancellor of the Eastern University, Minister Wijepala had the audacity to state in the parliament otherwise. Pillayan has been detained under the PTA, which the NPP promised to abolish! The worst is the campaign of character assassination of Udaya Gammanpila who has decided to represent Pillayan. Dr Jayatissa, who has never practised his profession, took exception that Gammanpila, who has not practiced as a lawyer, is representing Pillayan. Gammanpila has corrected him by listing the cases he had been involved in. In any case, Gammanpila need not be in court but get a set of lawyers to defend, if and when, a case is filed. It begs clarification, the ministerial comment that Gammanpila should be ashamed to represent Pillayan! Has the government already decided the guilt of Pillayan?

Compass has lost direction, indeed, and far too soon!

By Dr Upul Wijayawardhana

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Canada holds its own as Americans sour on Trump

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Jubilant Carnay after Canadian elections

On Monday, April 28, Canadians gave the Liberal Party its fourth successive mandate, albeit as another Minority Government but much stronger than in the last two elections, and, more importantly, with a different Prime Minister. Justin Trudeau who had been Prime Minister from 2015 was forced to resign in January 2025 on account of his perceived electoral unpopularity. Trudeau was succeeded by Marc Carney, 60 year old former Governor of the Bank of Canada and later the Bank of England, who dramatically revived the falling fortunes of the Liberal Party and secured its fourth mandate in 10 years.

The Liberal Party and Prime Minister Mark Carney owe their good fortunes to the presidential madness that is going on south of the border, in the United States of America. With his mercurial obsession over tariff’s and recurrent musings about making Canada America’s 51st State, President Trump painted the backdrop to the Canadian election. Trump’s antics did not go down well with the Canadian public and in a rare burst of patriotism the people of Canada overarched their diversities of geography, language, culture, religion and ethnicity, and rallied round the Maple Leaf national flag with utmost determination to stick it to Trump and other Ugly Americans of his ilk.

People and businesses in Canada shunned American products, stopped travelling to US holiday destinations and even took to booing the US national anthem at sporting events involving US and Canadian teams. The threat of economic pain due to a tariff war is real, but Canadians are daring to suffer pain rather than become a part of the US. And Justin Trudeau showed his best leadership in his last days as Prime Minister. Combining diplomatic skill and splendid teamwork with eloquent defiance, Trudeau succeeded in forcing Trump into what has since become Trump’s modus operandi in implementing his idiosyncratic tariff policy: tariff, one day; pause, the next day; and uncertainty, extended indefinitely.

100 Days of Disaster

What he began with Canada and Mexico, Trump has since writ large upon the whole world. His second term is already a term of chaos not only for America but also for the whole world economy. The US economy is officially in first quarter contraction. Another four months, it could be a man made recession of what was in January an economy that was humming sound and was easily the best performing one in the world. It’s only 100 days of the second term, and what is left of it is looming as eternity. “Only 1,361 Days to Go,” is the cover page heading of the latest issue of the Economist. That sums up America’s current state of affairs and their global spillover effects.

Americans are beginning to sour on Trump but there is no way for them to channel their frustrations and anger to force an immediate executive retreat. Trump has reduced the Republican Party to be his personal poodle and with Republics holding slender majorities in both the Congress and the Senate, the Legislative Branch of the US is now wholly beholden its Executive. The traditional wait is for the midterm Congress elections in two years. But Trump has no respect for traditions and conventions, and it would be two years too much before a Democratic majority in the two houses could bestir the Congress to check and balance the runway president.

The Judicial Branch is now playing catch up after the Supreme Court had given Trump near absolute immunity and enabled his second coming. The lower courts are applying the law as they should and stymieing Trump’s palpably illegal orders on everything from deporting immigrants, to downsizing government, and gutting the country’s university system. The tariff cases are slowly making their way to courts and they will add more confusion to the running of the economy before some kind of sanity is restored. Overall, by upending a system of government that has been constitutionally evolving over 200 years, Trump is providing a negatively sobering demonstration that no system is foolproof if a capable fool is elected to take over the reins of government.

Fortunately for the world, other governments and polities have been quick in drawing the right lessons from the demonstration effects of Trump on their American cousins. Trump’s excesses have had a dampening effect on right wing populism in other countries. The Canadian elections are one such demonstration. Another is expected in Australia where national elections are scheduled for Saturday, May 3. In Europe, right wing populist parties are scaling down their rhetoric to avoid facing local backlashes to Trump’s American excesses.

No populist leader anywhere wants to go where Trump is blindly heading, and no one is mad enough like him to think that imposing tariffs is the way to grow a national economy. In Hungary, its strongman Viktor Orbán after securing super majorities in four elections since 2010, is facing the real possibility of defeat in the national elections next year. Orban is regressively anti-Eu while 86% of Hungarians want to strengthen their EU ties, and they are naturally getting tired of Orban’s smearing of the EU just like all Europeans are getting tired of Trump’s and his VP Vance’s anti-European rhetoric.

Canada Holds its Own

Canada, despite its proximity to the US, has never been a haven for Trump’s right wing populism. Yet there have always been and continue to be pockets of support for Trumpism in Canada, and they have found their sanctuary within the Conservative Party of Canada and behind its leader Pierre Poilievre, a 45-year old career politician who entered parliament in 2005 at the age of 25 and became Leader of the Conservative Party and Leader of the Opposition 18 years later, in 2023.

Clever and articulate with an ability to spin rhyming simplistic slogans, Poilievre cultivated his political base by feeding it on a diet of vitriolic and vulgar personal attacks and advertisements denigrating then Prime Minister Justin Trudeau. Poilievre identified himself with the 2022 truck convoy protest that stormed Ottawa, cheered on by MAGA America, and he came to be seen as Canada’s Trump-lite (not unlike Peter Dutton, the Leader of the Opposition in Australia). Nonetheless, Poilievre’s attacks on Trudeau worked in the post-Covid climate of economic hardships and Trudeau’s popularity sank to the point that his own MP’s started calling for his resignation.

Alas for Poilievre, Trudeau’s resignation in January took away the one political foil or bogeyman on whom he had built his whole campaign. In addition, while his attacks on Trudeau diminished Trudeau’s popularity, it did not help enhance Mr. Poilievre’s image among Canadians in general. In fact, he was quite unpopular outside his base of devotees. More people viewed him unfavourably than those who viewed him favourably. Outside his base, he became a drag on his party. He would even go down to defeat in his own electorate and lose his seat in parliament that he had held for 20 years.

Mr. Poilievre’s troubles began with the emergence of Mark Carney as the new Liberal Leader and Prime Minister – looking calm, competent and carrying the ideal resume of experience in dealing with the 2008 financial crisis as Governor of the Bank of Canada, and calming market nerves after the 2016 Brexit referendum as Governor of the Bank of England. Carnie, who had never been in formal politics before, seemed the perfect man to be Prime Minister to weather the economic uncertainties that President Trump was spewing from Washington. Almost overnight Liberal fortunes shot up and after resigning themselves to face a crushing defeat with Trudeau at the helm, Liberals were suddenly facing real prospects of forming a majority after two terms of minority government.

In the end, thanks to the quirky genius of the electorate, Liberals ended with 168 seats with 43.7% of the vote, and four seats short of a majority in the 343 seat national parliament, while the Conservative Party garnered 144 seats with 41.3% vote share. Both parties gained seats from their last election tallies, 15 new seats for Liberals and 16 for Tories, and, unusual in recent elections, the two parties garnered 85% of the total vote. The increases came at the expense of the two smaller but significant parties, the left leaning New Democratic Party (reduced from 24 to seven seats); and the Bloc Québécois (reduced from 45 to 23 seats) that contests only in the French majority Province of Quebec. The Green Party that had two MPs lost one of them in the election.

In the last parliament, the New Democrats gave parliamentary support to the minority Trudeau government in return for launching three significant social welfare initiatives – a national childcare program, an income-based universal dental care program, and a pharmacare program to subsidize the cost of prescription drugs. These are in addition to the system of universal public health insurance for hospitals and physician services that has been in place from 1966, thanks again to the programmatic insistence of the New Democratic Party (NDP).

But the NDP could not reap any electoral reward for its progressive conscience and even its leader Jagmeet Singh, a Sikh Canadian, lost his seat in the election. The misfortune of the NDP and the Bloc Québécois came about because even their supporters like many other Canadians wanted to entrust Mark Carney, and not Pierre Poilievre, with the responsibility to protect the Canadian economy from the reckless onslaughts of Donald Trump.

Yet, despite initial indications of a majority government, the Liberals fell agonizingly short of the target by a mere four seats. The Tories, while totally deprived of what seemed in January to be the chance of a landslide victory, managed to stave off a Liberal sweep under Mark Carney. The answers to these paradoxes are manifold and are part of the of reasonably positive functioning of Canadian federalism. The system enables political energies and conflicts to be dispersed at multiple levels of government and spatial jurisdictions, and to be addressed with minimal antagonism between contending forces. The proximity to the US helps inasmuch as it provides a demonstration of the American pitfalls that others should avoid.

by Rajan Philips

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