The 1918 Spanish Influenza taught us the life-saving value of wearing a face mask to slow rates of community transmission

Heavy Death Tolls in Italy and Spain: Coronavirus deaths in Italy and Spain rose above 17,000, keeping Europe focused on further restricting people’s movements and avoiding a health-care collapse. Italy, the country with the most reported deaths, recorded 756 new fatalities on Sunday. Spain’s Health Ministry said 838 people died from the virus over the last 24 hours, its highest daily number yet. Both countries together have more than five times the deaths reported in China, where the outbreak began.

Spain’s patients in intensive care surpassed the national capacity of some 4,400 beds, forcing health-care workers to decide whom to treat first. While officials say the increases in deaths and infections are leveling off, that focuses attention on the suffering and risks in hospitals. “It seems the evolution has stabilized and could even be starting to fall, but the fundamental problem now is to ensure that our ICUs aren’t saturated,” Health Ministry spokesman Fernando Simon said at a briefing in Madrid. Italy’s death toll rose to 10,779, with the number of infections approaching 100,000. Spain has recorded 6,528 deaths linked to the virus.

In a small glimmer of hope, the pace of increases in deaths slowed for a fourth day in Spain, deaths in Italy fell for a second day and new infections are rising more slowly in both countries. Officials warned against complacency. The human toll is a reason to “be even stricter,” Luca Richeldi, an Italian government medical adviser, told reporters. “We must be even more determined in complying with the measures.” The economic costs of the crisis continue to mount. Spanish Prime Minister Pedro Sanchez on Saturday repeated his call for a European “Marshall Plan,” a reference to the U.S. aid program credited with pulling Western Europe out of its post-World War II devastation. European Union member states remain at odds over how best to buttress their economies as the costs of countering the pandemic and supporting workers and companies rise.  –Bloomberg

Face or Gauze Masks used in the Spanish Flu of 1918: The gauze mask was another prevention method using similar ideas of contagion and germ theory. In the United States it was widely accepted for use in hospitals among health care workers. The face masks consisted of a half yard of gauze, folded like a triangular bandage covering the mouth, nose and chin (BMJ, 11/2/19118). These gauze masks acted to prevent the infectious droplets from being expelled by the mouth and from the hands, contaminated with microbe from being put to the mouth.

The barrier from the hands was thought to be more important than the barrier from the air. The mask was also worn in some regions by the general population. In San Francisco the gauze masks were made a requirement of the entire population in a trial ordinance. This was later expanded to include San Diego in December. This rhyme was a popular way to remind people of the ordinance. They found that the mask wearing led to “a rapid decline in the number of cases of influenza.” (JAMA, 12/28/1918).  –Virus Stanford

PARIS — Luxury fashion group Chanel said on Sunday it would launch production of face masks to help bolster supplies in France, as the coronavirus sweeps across the country. Prototypes were being worked on and would roll off production lines once they received the approval of French authorities.

Dr. Alfred Wong in Hong Kong says face masks work in slowing down transmission rates

“Today we are mobilizing our workforce and our partners … to produce protective masks and blouses,” Chanel said in a statement. On Saturday, Health Minister Olivier Veran said the government had ordered more than a billion face masks, mostly from China, to be supplied in the weeks and months ahead. France was using 40 million face masks per week, he said. Doctors, nursing home careers and police have complained of shortages. –NY Times