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Why face masks are going viral
As the new coronavirus epidemic spreads, more and more people are wearing surgical masks—despite their questionable effectiveness. An anthropologist explores the reasons why.
On the day the first case of the new coronavirus was confirmed in the Philippines, a surreal sight greeted me on the streets of Manila.
Half the people were wearing face masks—from the disposable surgical variety to heavy-duty N95 respirators, which many had purchased just weeks before to protect themselves from ash erupting out of the Taal volcano.
Traveling to Thailand the same week, I was met by a similar scene. All the flight attendants and half the passengers on the plane from Manila to Bangkok had donned masks.
On January 30, the World Health Organization declared that the “unprecedented outbreak" of the novel coronavirus (2019-nCoV) was a global health emergency. As of that date, 7,834 cases of the flu-like disease had been confirmed, and 170 people had died. Nearly 99 percent of cases occurred in China, where the virus first appeared in December before rapidly spreading to 18 other countries.
As a result, masks are selling out around the world, making them one of the most sought-after commodities of our time. A recent cover of The Economist depicts a giant surgical mask wrapped around the Earth.
However, the science on how well masks protect the public is complicated.
Surgical masks are designed to protect health care providers and patients from cross-transmitting large droplets such as blood and saliva. So, they can be somewhat effective when worn by sick people to prevent spreading disease through coughing. But surgical masks provide minimal protection from contracting viruses. And they offer little to no protection from air pollution, since gases such as nitrogen dioxide from vehicles easily pass through, while poor fit and movement allow larger particles to leak in.
Filtering facepiece respirators such as N95s are highly effective in protecting people from inhaling viruses and environmental pollutants. But respirators can make it very difficult to breathe, and they're only effective if worn properly.
People's motivation for wearing these masks goes far beyond simple considerations of medical efficacy. Cultural values, perceptions of control, social pressure, civic duty, family concerns, self-expression, beliefs about public institutions, and even politics are all wrapped up in the "symbolic efficacy" of face masks.
Face masks first became widespread during the 1918 influenza pandemic, which infected 500 million people and killed an estimated 50 million worldwide. The public was advised, and in some places required, to wear gauze face masks. "Obey the laws and wear the gauze," Americans were warned. Masks became "an emblem of public spiritedness and discipline" that helped boost morale, wrote historian Nancy Tomes. However, the masks were typically homemade (some women even fashioned them out of chiffon), so, not surprisingly, studies on their efficacy were mixed.
After the 1918 pandemic abated, use of the masks subsided in many parts of the world. Yet they remained part of the hygiene culture in Japan, where they became increasingly common due to a succession of epidemics and disasters, including severe acute respiratory syndrome (SARS) in 2003, avian flu in 2004, swine flu in 2009, and the Fukushima Daiichi nuclear disaster in 2011.
Scholars have proposed various additional explanations for the popularity of face masks in Japan. Some say the practice conforms with the country's notions of cleanliness and purity. One study suggested Japanese society has lost trust in public institutions in recent decades, prompting people to become more self-protective. In another survey, Japanese people said they primarily used masks to protect themselves but that the practice also demonstrates consideration for others and a respect for etiquette. For many, masks are a kind of "safety blanket," and the simple act of putting them on is a "risk ritual" that provides comfort and quells anxiety.
In a sign that the culture is constantly evolving, young Japanese people today are sporting masks as fashion statements, expressing their personal style through anime designs or army camouflage patterns. (Ditto in Australia, where bushfires have inspired companies to fashion attractive respirator masks infused with eucalyptus scent.) Some people are even strapping on masks to prevent others from bothering them or to hide their emotions.
In China, too, people's motivations for wearing masks are muddled with culture. When SARS broke out in Hong Kong, wearing a face mask expressed collectivist values, and declining to do so was met with public censure, noted sociologist Peter Baehr. By putting on a mask, "people communicated their responsibilities to the social group of which they were members," he wrote. "By disguising an individual's face, it gave greater salience to collective identity."
Peer pressure certainly plays a role in some people's decision to don a mask. When two researchers flew to Bangkok during the SARS epidemic, they observed travelers who, after encountering the sight of masked crowds, rushed to buy their own masks. This was despite the fact that no cases of SARS transmission had been reported in Thailand, they had received no clear information on mask wearing, and the surgical masks offered minimal protection. What's more, many people who wore masks practiced poor hygiene, taking them off to cough, sneeze, wipe their nose, and rummage through the communal bread basket. (Many experts say washing hands is the best way to fend off viral illnesses.)
Nevertheless, these scholars stated that mask wearing "can assist the management of major communicable disease incidents by empowering the general public and strengthening perceptions of personal control."
Perhaps this is what Singapore's government had in mind in its response to the novel coronavirus outbreak. On January 30, Prime Minister Lee Hsien Loong simultaneously announced that "we only need to wear a mask if we are sick" and that all 1.37 million households in Singapore will be given four masks each. On the day of the announcement, only 13 cases of the disease had been confirmed in Singapore.
Perhaps the perception of control also informs the narratives of Filipino people I have spoken with about their decision to wear masks. "I don't want to infect my children," Fely (a pseudonym), a mall worker in Quezon City, told me. "Even if doctors say it's not necessary, I will wear it anyway because my family is at stake."
"I feel uneasy when I see others wearing masks and I'm not," said Justine (a pseudonym), a college student in Manila, adding that "there's nothing to lose" by wearing them.
"When [people] saw me, they began to discreetly wear masks. They think all Chinese are contagious," a Filipino Chinese colleague told me.
There may be nothing to lose, but that doesn't mean face masks are always a neutral or benign device.
As concerns over the new coronavirus are spreading around the world, face masks are playing a role in the act of "othering." A Filipino Chinese colleague recently recounted to me: "When [people] saw me seated in the restaurant, they began to discreetly wear masks. They think all Chinese are contagious."
Disease epidemics set off an "epidemic of explanation," in which societies search for a cause of the contagion, according to medical sociologist Philip Strong. At the same time, outbreaks heighten preexisting fears of societal dangers, which can cause flare ups of racial, social, and economic prejudices. The subsequent symptoms can include stigma, exclusion, and what cultural anthropologist Mary Douglas calls a politicized "blaming system."
In late January, news broke out that 3 million face masks had been shipped from a Philippine factory to China, at a time when Filipinos were struggling to buy masks due to shortages and overpricing. The public response was mixed—and telling.
Some Filipinos were outraged and criticized the Chinese for a variety of related and unrelated harms, saying that their own people must come first. Some pointed out that China had previously offered aid to the Philippines, so it was right to return the favor. Others focused purely on the fact that China needed the masks more.
Anthropologists have explored these varying responses. In times of scarcity, some groups become more selfish. Others uphold reciprocity, a powerful and universal human value. And many communities practice "need-based transfer"—based on the idea that, in times of trouble, people help because they assume others would do the same for them.
Following the eruption of the Taal volcano in the Philippines, face masks became the currency not just of greed but also of goodwill. One of the most iconic images of the crisis is a photo of a man distributing free masks to help protect people from inhaling ashfall.
Face masks are likely to become increasingly common as the climate crisis exacerbates wildfires and other natural disasters, as air pollution worsens in many cities, and as global connectivity heightens the risk of pandemics. As masks become more integrated into everyday life, they will continue to reveal facets of human cultures as much as they conceal our faces.
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Certain water beetles can escape from frogs after being consumed.
- A Japanese scientist shows that some beetles can wiggle out of frog's butts after being eaten whole.
- The research suggests the beetle can get out in as little as 7 minutes.
- Most of the beetles swallowed in the experiment survived with no complications after being excreted.
In what is perhaps one of the weirdest experiments ever that comes from the category of "why did anyone need to know this?" scientists have proven that the Regimbartia attenuata beetle can climb out of a frog's butt after being eaten.
The research was carried out by Kobe University ecologist Shinji Sugiura. His team found that the majority of beetles swallowed by black-spotted pond frogs (Pelophylax nigromaculatus) used in their experiment managed to escape about 6 hours after and were perfectly fine.
"Here, I report active escape of the aquatic beetle R. attenuata from the vents of five frog species via the digestive tract," writes Sugiura in a new paper, adding "although adult beetles were easily eaten by frogs, 90 percent of swallowed beetles were excreted within six hours after being eaten and, surprisingly, were still alive."
One bug even got out in as little as 7 minutes.
Sugiura also tried putting wax on the legs of some of the beetles, preventing them from moving. These ones were not able to make it out alive, taking from 38 to 150 hours to be digested.
Naturally, as anyone would upon encountering such a story, you're wondering where's the video. Thankfully, the scientists recorded the proceedings:
The Regimbartia attenuata beetle can be found in the tropics, especially as pests in fish hatcheries. It's not the only kind of creature that can survive being swallowed. A recent study showed that snake eels are able to burrow out of the stomachs of fish using their sharp tails, only to become stuck, die, and be mummified in the gut cavity. Scientists are calling the beetle's ability the first documented "active prey escape." Usually, such travelers through the digestive tract have particular adaptations that make it possible for them to withstand extreme pH and lack of oxygen. The researchers think the beetle's trick is in inducing the frog to open a so-called "vent" controlled by the sphincter muscle.
"Individuals were always excreted head first from the frog vent, suggesting that R. attenuata stimulates the hind gut, urging the frog to defecate," explains Sugiura.
For more information, check out the study published in Current Biology.
Are "humanized" pigs the future of medical research?
The U.S. Food and Drug Administration requires all new medicines to be tested in animals before use in people. Pigs make better medical research subjects than mice, because they are closer to humans in size, physiology and genetic makeup.
In recent years, our team at Iowa State University has found a way to make pigs an even closer stand-in for humans. We have successfully transferred components of the human immune system into pigs that lack a functional immune system. This breakthrough has the potential to accelerate medical research in many areas, including virus and vaccine research, as well as cancer and stem cell therapeutics.
Existing biomedical models
Severe Combined Immunodeficiency, or SCID, is a genetic condition that causes impaired development of the immune system. People can develop SCID, as dramatized in the 1976 movie “The Boy in the Plastic Bubble." Other animals can develop SCID, too, including mice.
Researchers in the 1980s recognized that SCID mice could be implanted with human immune cells for further study. Such mice are called “humanized" mice and have been optimized over the past 30 years to study many questions relevant to human health.
Mice are the most commonly used animal in biomedical research, but results from mice often do not translate well to human responses, thanks to differences in metabolism, size and divergent cell functions compared with people.
Nonhuman primates are also used for medical research and are certainly closer stand-ins for humans. But using them for this purpose raises numerous ethical considerations. With these concerns in mind, the National Institutes of Health retired most of its chimpanzees from biomedical research in 2013.
Alternative animal models are in demand.
Swine are a viable option for medical research because of their similarities to humans. And with their widespread commercial use, pigs are met with fewer ethical dilemmas than primates. Upwards of 100 million hogs are slaughtered each year for food in the U.S.
In 2012, groups at Iowa State University and Kansas State University, including Jack Dekkers, an expert in animal breeding and genetics, and Raymond Rowland, a specialist in animal diseases, serendipitously discovered a naturally occurring genetic mutation in pigs that caused SCID. We wondered if we could develop these pigs to create a new biomedical model.
Our group has worked for nearly a decade developing and optimizing SCID pigs for applications in biomedical research. In 2018, we achieved a twofold milestone when working with animal physiologist Jason Ross and his lab. Together we developed a more immunocompromised pig than the original SCID pig – and successfully humanized it, by transferring cultured human immune stem cells into the livers of developing piglets.
During early fetal development, immune cells develop within the liver, providing an opportunity to introduce human cells. We inject human immune stem cells into fetal pig livers using ultrasound imaging as a guide. As the pig fetus develops, the injected human immune stem cells begin to differentiate – or change into other kinds of cells – and spread through the pig's body. Once SCID piglets are born, we can detect human immune cells in their blood, liver, spleen and thymus gland. This humanization is what makes them so valuable for testing new medical treatments.
We have found that human ovarian tumors survive and grow in SCID pigs, giving us an opportunity to study ovarian cancer in a new way. Similarly, because human skin survives on SCID pigs, scientists may be able to develop new treatments for skin burns. Other research possibilities are numerous.
The ultraclean SCID pig biocontainment facility in Ames, Iowa. Adeline Boettcher, CC BY-SA
Pigs in a bubble
Since our pigs lack essential components of their immune system, they are extremely susceptible to infection and require special housing to help reduce exposure to pathogens.
SCID pigs are raised in bubble biocontainment facilities. Positive pressure rooms, which maintain a higher air pressure than the surrounding environment to keep pathogens out, are coupled with highly filtered air and water. All personnel are required to wear full personal protective equipment. We typically have anywhere from two to 15 SCID pigs and breeding animals at a given time. (Our breeding animals do not have SCID, but they are genetic carriers of the mutation, so their offspring may have SCID.)
As with any animal research, ethical considerations are always front and center. All our protocols are approved by Iowa State University's Institutional Animal Care and Use Committee and are in accordance with The National Institutes of Health's Guide for the Care and Use of Laboratory Animals.
Every day, twice a day, our pigs are checked by expert caretakers who monitor their health status and provide engagement. We have veterinarians on call. If any pigs fall ill, and drug or antibiotic intervention does not improve their condition, the animals are humanely euthanized.
Our goal is to continue optimizing our humanized SCID pigs so they can be more readily available for stem cell therapy testing, as well as research in other areas, including cancer. We hope the development of the SCID pig model will pave the way for advancements in therapeutic testing, with the long-term goal of improving human patient outcomes.
Adeline Boettcher earned her research-based Ph.D. working on the SCID project in 2019.
Satellite imagery can help better predict volcanic eruptions by monitoring changes in surface temperature near volcanoes.
- A recent study used data collected by NASA satellites to conduct a statistical analysis of surface temperatures near volcanoes that erupted from 2002 to 2019.
- The results showed that surface temperatures near volcanoes gradually increased in the months and years prior to eruptions.
- The method was able to detect potential eruptions that were not anticipated by other volcano monitoring methods, such as eruptions in Japan in 2014 and Chile in 2015.
How can modern technology help warn us of impending volcanic eruptions?
One promising answer may lie in satellite imagery. In a recent study published in Nature Geoscience, researchers used infrared data collected by NASA satellites to study the conditions near volcanoes in the months and years before they erupted.
The results revealed a pattern: Prior to eruptions, an unusually large amount of heat had been escaping through soil near volcanoes. This diffusion of subterranean heat — which is a byproduct of "large-scale thermal unrest" — could potentially represent a warning sign of future eruptions.
Conceptual model of large-scale thermal unrestCredit: Girona et al.
For the study, the researchers conducted a statistical analysis of changes in surface temperature near volcanoes, using data collected over 16.5 years by NASA's Terra and Aqua satellites. The results showed that eruptions tended to occur around the time when surface temperatures near the volcanoes peaked.
Eruptions were preceded by "subtle but significant long-term (years), large-scale (tens of square kilometres) increases in their radiant heat flux (up to ~1 °C in median radiant temperature)," the researchers wrote. After eruptions, surface temperatures reliably decreased, though the cool-down period took longer for bigger eruptions.
"Volcanoes can experience thermal unrest for several years before eruption," the researchers wrote. "This thermal unrest is dominated by a large-scale phenomenon operating over extensive areas of volcanic edifices, can be an early indicator of volcanic reactivation, can increase prior to different types of eruption and can be tracked through a statistical analysis of little-processed (that is, radiance or radiant temperature) satellite-based remote sensing data with high temporal resolution."
Temporal variations of target volcanoesCredit: Girona et al.
Although using satellites to monitor thermal unrest wouldn't enable scientists to make hyper-specific eruption predictions (like predicting the exact day), it could significantly improve prediction efforts. Seismologists and volcanologists currently use a range of techniques to forecast eruptions, including monitoring for gas emissions, ground deformation, and changes to nearby water channels, to name a few.
Still, none of these techniques have proven completely reliable, both because of the science and the practical barriers (e.g. funding) standing in the way of large-scale monitoring. In 2014, for example, Japan's Mount Ontake suddenly erupted, killing 63 people. It was the nation's deadliest eruption in nearly a century.
In the study, the researchers found that surface temperatures near Mount Ontake had been increasing in the two years prior to the eruption. To date, no other monitoring method has detected "well-defined" warning signs for the 2014 disaster, the researchers noted.
The researchers hope satellite-based infrared monitoring techniques, combined with existing methods, can improve prediction efforts for volcanic eruptions. Volcanic eruptions have killed about 2,000 people since 2000.
"Our findings can open new horizons to better constrain magma–hydrothermal interaction processes, especially when integrated with other datasets, allowing us to explore the thermal budget of volcanoes and anticipate eruptions that are very difficult to forecast through other geophysical/geochemical methods."