Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

The Centers for Disease Control and Prevention says it may be time for you to think about wearing two masks. That will be a stretch for tin foil hat types who can’t find the fortitude to wear one, but the CDC says the virus variants present us with new threats and we have to double our efforts.

The CDC’s new guidance is based on an assessment of 10 different methods of wearing masks. Researchers found two ways of improving the fit:

• Fitting a cloth mask over a medical procedure mask. The CDC assessment says, “The results indicated that when fitters are secured over a medical procedure mask, they can potentially increase the wearer’s protection by ≥90% for aerosols in the size range considered to be the most important for transmitting SARS-CoV-2.”
• Knotting the ear loops of a medical procedure mask and then tucking in and flattening the extra material close to the face. The CDC assessment says, “New CDC studies found that knotting and tucking a medical procedure mask or placing a sleeve made of sheer nylon hosiery material around the neck and pulling it up over either a cloth or medical procedure mask also significantly improved the wearer’s protection by fitting the mask more tightly to the wearer’s face and reducing edge gaps.”

“Each modification substantially improved source control and reduced wearer exposure,” the assessment says.

The CDC provides a graphic to show you how to modify your mask-wearing:

(CDC)

These are photos from the new lab experiments. Photo A shows the typical gap that allows the virus to escape from medical masks. Photo B shows a cloth mask over the mask in Photo A. Photo C shows how to make the medical mask in photo A fit better by tightening it with knots. (CDC)

There is a potential downside to wearing two masks. Linsey Marr, a professor of civil and environmental engineering at Virginia Tech, told Time, “You have to be careful once you start adding more and more layers because it can be hard to breathe through, and then then you’re going to end up pulling in more air through any gaps around the sides. So there’s definitely a point of diminishing returns. I wouldn’t really go more than two layered on top of each other.”

The CDC’s guidelines are ever-evolving. 11 months ago, experts told us that there was no need for an otherwise healthy person to wear a mask. Now they say we should wear two. No doubt, that evolution will be an issue of contention for people who do not want to wear any mask, much less wear multiple layers. But that is the nature of science. New evidence should lead us to new practices.

The CDC guidelines remind us that the way you wear a mask is almost as important as what kind of mask you wear.

Will multiple mask layers trap CO2?

A favorite conspiracy among anti-maskers is that wearing a mask will trap carbon dioxide and poison you. It is, of course, nonsense. 

Dr. Greg Schmidt at the University of Iowa explains why in this video. He shows us how physicians can measure both oxygen saturation levels and carbon dioxide levels. When they test with and without masks, the levels are unchanged. (95-100 for oxygen saturation and 35-45 for CO2 levels)

The reason that masks can block droplets contaminated by viruses but not block oxygen and CO2 is that droplets are bigger. You would have to have an airtight mask — think of something as tight as a scuba mask — to trap carbon dioxide. That would be way more restrictive than a cloth mask or even a professional N95 mask.

Are there standards for cloth masks?

At present, there are no national standards established for cloth masks, although such standards are under consideration by ASTM (formerly known as the American Society for Testing and Materials). In some ways, that is part of the problem.

Time recently asked whether we are being way too lax about the quality of the masks we are wearing.

Experts say the best face coverings are respirator-style masks, like N95s. These masks are approved by the U.S. National Institute for Occupational Safety and Health (NIOSH); the “95” means the mask filters at least 95% of particles out of the air the wearer is breathing in.

There are some problems with N95 masks. One problem is that they are, a year after the pandemic began, still in short supply. A resurgence of the virus could put us in a real supply pinch.

Another problem is that, in order to get the protection that N95 masks are designed to deliver, you have to be fit-tested annually to make sure the mask provides a good seal around your face. And different N95 masks come in different styles.

But what about U.S. Food and Drug Administration-approved surgical masks? If they wear them in surgery, shouldn’t they help you? Time explains:

Other potentially effective medical masks include U.S. Food and Drug Administration-approved surgical masks (disposable masks which fit more loosely) and foreign-made respirator masks, including KN95s (from China) and KF94s (from South Korea) — but they also come with a few caveats. Surgical masks are more likely than respirator masks to have gaps big enough to allow air to leak through the side. KN95s and KF94s, meanwhile, can be hit or miss. While they work similarly to N95s, such masks have not been fully approved by NIOSH (although some KN95s manufacturers have received emergency use authorization from the agency). Meanwhile, the U.S. Centers for Disease Control and Prevention warns that most products that claim to meet European or Chinese standards provide “well below 95%” filtering efficiency. Furthermore, at least some of the N95s, KN95 and KF94 masks on the market are likely counterfeit and provide inadequate protection, and it’s difficult for most buyers to tell a counterfeit mask from a real one, especially when shopping online.

CDC and DOT are considering requiring COVID-19 tests for all flights

Theresa Zoller, left, gets a rapid COVID-19 test before a United Airlines flight to Hawaii at San Francisco International Airport in San Francisco, Thursday, Oct. 15, 2020. (AP Photo/Jeff Chiu)

Federal Department of Transportation Secretary Pete Buttigieg told Axios that the CDC is considering whether passengers on all flights, not just international flights, should have to provide negative COVID-19 test results.

“There’s an active conversation with the CDC right now,” he said. “What I can tell you is, it’s going to be guided by data, by science, by medicine, and by the input of the people who are actually going to have to carry this out.”

The Washington Post says airlines cannot hate this idea enough:

Ed Bastian, chief executive of Delta Air Lines, said Tuesday on CNN that a testing requirement is a “horrible idea” and argued it would not make domestic travel safer.

He is backed by a coalition of aviation groups, which released a four-page document outlining reasons requiring travelers in the United States to test negative before they board a flight would be ill-advised.

The coalition, which includes the trade group Airlines for America and unions representing pilots and flight attendants, said a requirement is not “scalable, feasible or effective” and would lead to “further job losses without producing meaningful public health benefits.”

‘The Pandemic Wall’: when you are worn the hell out

It was sometime in March last year when somebody mentioned that they thought we would be dealing with the pandemic into the fall and the thought of it stunned me. Here we are, a year later, and a phrase is making the rounds that may describe exactly what you are feeling: “The Pandemic Wall.”

It is when you cannot stand one more night at home watching people on a cable channel renovate a cabin in Maine and when buying an RV suddenly seems like a sound investment.

New Year’s Eve had all of the promise of some kind of reset. We were going to kiss 2020 goodbye and start over. Except we didn’t start over.

The Washington Post notes all of this:

“I guess my mentality was, everyone’s going to get vaccinated, and everything’s going to be fine,” says Paula Tomlinson, 60, who lives outside of Tampa and received both doses of her vaccine. “But I don’t see that happening at all.”

A survey by the National Center for Health Statistics found that 41 percent of Americans showed some symptoms of an anxiety disorder or a depressive disorder in January, up from 34 percent in May.

“There’s a lot of disappointment in January, a lot of depletion,” says psychiatrist Lori Plutchik, co-founder of Caring for Caregivers, a New York organization that offers therapy to front-line doctors (whose burnout has only increased in the past month, Plutchik says).

Chronic uncertainty is bad for our mental health. When we’re stressed or anxious, finding something we have control over can make us feel a little bit better. For all the hope vaccines have brought in theory, uncertainty reigns. “Getting vaccinated, in most places, does not feel like something you have a whole lot of control over,” Lynn Bufka, senior director of practice transformation and quality at the American Psychological Association says.

How are we supposed to power through the wall?

Therapists often say that one of the ways to get through tough times is to cultivate gratitude. Many of the people hitting the wall are employed, fed and healthy. That doesn’t diminish their suffering — everyone is struggling in a different way — but Bufka encourages them to try to look at all they have.

This business about the healing power of gratitude is not just hyperbole. When my wife (who is a licensed therapist) and I do workshops for newsrooms about stress and trauma, she points to research, real clinical research, that says gratitude is good for your health. The Harvard Medical school newsletter says, “In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.”

Dr. Michael Craig Miller, senior editor of Mental Health Publishing at Harvard Health Publishing, offers a handful of ways to express gratitude. It doesn’t just help you, but might also give somebody else a lift right now, right when everybody needs it:

Write a thank-you note. You can make yourself happier and nurture your relationship with another person by writing a thank-you letter expressing your enjoyment and appreciation of his or her effect on your life. If this seems corny, then seize opportunities to go beyond a perfunctory thank you email — after having been invited to dinner or after spending time with a friend, write a heartfelt note. Every so often, write one to yourself.

Thank someone mentally. No time to write? It may help just to think about someone who has done something nice for you, and mentally thank him or her.

Keep a gratitude journal. Make a habit of writing down thoughts about the gifts you’ve received each day. Sharing these thoughts with a loved one is even better.

Count your blessings. Pick a time every week to sit down and think about your blessings. Reflect on what went right or what you are grateful for. Sometimes it helps to pick a number — say three to five things — you will identify each week. Be specific and think about the sensations you felt when something good happened to you.

Pray. People who are religious can use prayer to cultivate gratitude. If you pray, try to do so with intention — thinking carefully about what you are communicating through prayer rather than reciting the words automatically.

Meditate. Mindfulness meditation involves focusing on the present moment without judgment. Although people often focus on a word or phrase (such as “peace”), it is also possible to focus on what you’re grateful for (the warmth of the sun, a pleasant sound, etc.).

Maybe it is also helpful to assure people who feel that they have hit a wall that they are not alone. Maybe that is also the value of The New York Times’ “Primal Scream” project, which set up a phone line for mothers to call in and vent for a minute. This quote really struck me:

(The New York Times)

And when I read and listened to those stories in the “Primal Scream” project, it was my turn to feel gratitude for the work that you journalists are doing.

Mall owner sees reason for optimism

When is the last time you heard a mall owner saying anything that didn’t sound like it came from Eeyore? Simon Property Group says more mall retailers are paying their rent and the migration to America’s suburbs is good news for mall retailers.

All of the optimism has to fit next to pretty awful 2020 earnings. But for all of the news about mall retailers closing, Simon’s occupancy rate at the end of the year was 91.3%, which is barely below 95.1% a year ago.

Hate crimes against Asian Americans

Hate crimes against Asian Americans have been rising and still are. Fortune reports:

Hollywood stars began calling out the racist violence early in the pandemic. By mid-summer, Stop AAPI Hate, an alliance of three organizations serving AAPI communities, began documenting the incidents. They quickly found that bullying, assaults, and verbal abuse were “becoming the norm” across the U.S. By September, it seemed that one in four young Asian American adults had been bullied or otherwise harassed.

Analysis conducted by Stop AAPI Hate found that one in ten tweets about Asian Americans contained racist or stigmatizing language related to China in the months preceding the 2020 election.

By midyear last year, one group documented 2,100 hate incidents focused on Asian Americans.

Some examples and resources:

• New Data on Anti-Asian Hate Incidents Against Elderly and Total National Incidents in 2020 – Feb. 9
• Stop AAPI Hate Statement on Memorandum Against AAPI Hate – Jan. 26
• Georgia Report – Dec. 28
• Los Angeles County Report – Dec. 3
• Youth Incidents Report – Sept. 17
• Youth Campaign: They Blamed Me Because I Am Asian – Sept. 17
• National Report – Aug. 5

People ‘barred from buying guns’ bought them anyway

On Friday, I told you that gun sales soared in 2020. Now the group Everytown for Gun Safety adds a footnote to that story. They say that an unprecedented number of people who are legally barred from owning guns managed to buy them in 2020 through the so-called “Charleston loophole.”

CBS News explains:

The “loophole” allows gun dealers to complete sales after three days if a buyer’s background check has not been completed by the FBI. If the agency later determines that the buyer should not have been allowed to get the gun, it refers the case to the Bureau of Alcohol, Tobacco, Firearms and Explosives, which is tasked with recovering it. There were 5,807 cases in which gun purchases should have been prohibited last year through November 3, 2020, on pace to roughly double the 3,139 total for all of 2019.

Each year, the FBI flags thousands of “Charleston loophole” cases to the ATF, but the true number of cases is not known. Hundreds of thousands of background checks each year are never completed because the agency is required to purge records after 90 days. Everytown estimates that in 2020, more than 438,000 background checks were purged without being completed, more than doubling 2019’s roughly 207,000.

It’s unclear how many background checks go through as sales after three days because some major retailers like Walmart, on their own accord, won’t complete the sale unless the check is finished.

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