Buying facemasks in the hope of avoiding becoming permanently disabled due to long COVID
There is mounting evidence the long-term effects of continuously getting re-infected with COVID-19 is something you would very much want to to avoid.
For this reason I wish to purchase a well-fitting facemask with replaceable filters. I managed to find two but none of them have economically feasible delivery options to Europe (shipping, import duties):
Is there a mass-produced alternative to these boutique COVID-specific face masks offering replaceable filters? I don't mind looking like a non-conforming weirdo or someone from a building site.
If anybody would like to weigh in with their considerations I would appreciate it a lot. Personally I find it very weird that the mounting evidence from the mainstream scientific community for the prevalence and seriousoness "long COVID" is not reflected in official COVID-19 guidelines, even in the relatively well-functioning European (by todays standards) country I inhabit. I understand the economy is considered sacred and that it takes precedence over human life but still ... ?!?
Your thoughts on masks and in the situation in general is much appreciated.
Risk of developing long COVID-19 is accumulative, meaning the virus persists in your body like HIV/AIDS:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883497/
All internal organs are impacted by COVID-19:
https://www.nejm.org/doi/full/10.1056/NEJMe2400189
Immune system is permanently damaged:
https://www.nature.com/articles/s41590-023-01601-2
https://www.science.org/doi/10.1126/science.adg7942
https://www.nature.com/articles/s41590-021-01113-x
Write-up from American doctors association with less science-heavy language:
https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-covid-19-reinfection
I want to be clear that I'm not here to provide a voice counter to your concern. I think masking and doing what you can to stop the spread of any illness, especially COVID, is an altruistic and morally good thing to do, even if it comes from a place of self-concern. With that being said, however, I did want to address the AMA article you linked and the research it references (from Washington) about reinfection and long COVID risks.
The most glaring issue with this paper, and one which unfortunately is not addressed by the authors in the conclusion, is there is no attempt to adjust for patient complexity. People who are less healthy are more likely to get infections, and those with multiple reinfections of COVID may simply be patients who are less healthy. If these patients are less healthy, they're also more likely to suffer from more complex conditions as well as to suffer for a longer period of time after any infection. In general, there's poor control of many factors in this study, which is to be expected of a retrospective done on a large data set. Of note it's mostly elderly men in the data set (~10% female which the authors do note), only includes information from the US Department of Veterans Affairs (does not capture non-VA sources of healthcare, such as urgent care clinics).
All of this is to say that long COVID is still something we don't understand super well and being reinfected with COVID likely does contribute to the overall risk factors of long COVID but may not be a particularly strong contributor. Most studies I've seen on long COVID seem to suggest that other risk factors are likely much more important (pre-existing conditions, such as COPD). But it's hard to classify something we struggle diagnosing in the first place, because without a mechanism of action it's hard to say what might contribute to the creation of this disease state. I say this because I'd like to address this statement you made:
I disagree in that I think the mainstream scientific community has been pushing an appropriate level of risk/caution/warning with regards to the risks of COVID and long COVID. The feeling of a mismatch between their guidelines and your feelings could come from a state of assessing it as a higher risk than the scientists can currently determine, or having a lower risk tolerance than the average person for this particular issue.
Appreciate this very thoughtful comment. Thank you Gaywallet.
I don't know about your personal health and history, so please don't construe this as health advice. That said, one of the greatest predictors of long COVID is needing significant health interventions during the initial infection. I.e., the sicker you get initially, the greater your chance of long term damage, including the constellation of symptoms we call long COVID.
It's unlikely this is unique to COVID. Recent studies have shown a similar effect from influenza. In general, anytime you are hospitalized, your chance of long term damage and ill effects goes up.
Likewise, the healthier you are during the initial infection, the less likely you are to become seriously ill, and thus the lower your risk of long COVID.
So tailor your mitigations to your risk and comfort level. Though it is likely not necessary for most healthy people to mask in their daily life based on the data we have. And since it seems that there has been a long flu, long COVID doesn't seem a unique danger. Rather, any serious infection has the potential to permanently damage your health, and that risk existed pre COVID.
This makes a lot of sense to me.
Anecdotally, I was hit hard by the swine flu epidemic. I was bedridden for two weeks and very sick for a couple more weeks after that, and I ended up with lingering long-covid-like symptoms for something like a year afterwards.
Yet a couple years before that, I caught mono. It gave me severe pharyngitis that required treatment, but apart from that, it was no worse than a bad cold. I was sick for a couple weeks, but I was still able to go about my daily life; in fact, I had my final exams about a week after I caught it, and I aced them. Mono is famous for lingering fatigue up to year later, but I had nothing of the sort. I think it's because it just didn't make me that sick to begin with.
The swine flu comparison is apt, thanks for bringing that up. I hadn't thought about it for years, but as a kid I remember being absolutely thrashed by swine flu. I have asthma and I think I wound up with a cough for a solid 6 months afterward.
Fortunately COVID hasn't been as awful for me; I've had it thrice and it only took me out for about a week the first two times. But it's comforting to think that "long covid" is less of a special COVID thing and more of a general flulike illness thing.
3M 7500 half-face respirator. Pricey and ugly, but it works. Should be able to get it from a hardware store or an industrial supply store. I sprung for the P100 cartridges that also had acid gas filters. Useful for fires or industrial accidents as wel if you need to evacuate somewhere.
Seconding the 3M 7500 series.
I've been wearing one of these since the start of COVID. Not all the time, mind you, just when I need to be indoors with other people except when at home. Grocery shopping and such. I've only taken outdoor work since the Pandemic began.
They are comfortable, cleanable, have standard replaceable filter cartridges which (for me) last over 6 months before I swap them out, and are easy on/easy off while hanging on your neck when not in use but ready to put back on fast and easy.
The mask itself lasts years if not rough-handled.
I typically get either the 60923 or 60926 cartridges. Either give you a combination of P100 electrostatic pre-filters with an activated carbon base second stage rated for a bunch of different stuff including OV (organic vapors). The P100 is the rating you need to filter out COVID, the OV rating also does an excellent job of filtering out smells.
I STRONGLY ADVISE NOT TRUSTING EBAY OR AMAZON TO BUY FILTER CARTRIDGES. BUY FROM INDUSTRIAL SUPPLY HOUSES. BUYING COUNTERFEIT (AND USELESS) CARTRIDGES CAN COST YOU EVERYTHING. BUYING FROM A GUARANTEED SOURCE ONLY COSTS YOU EXTRA MONEY.
If you just want P100, there are a bunch of options, some much cheaper in terms of filters such as the pink fabric disk filters, though since they don't have a hard shell they will get (physically) worn out faster just by handling and bumping stuff.
Be aware: these masks have inlets and outlets with one-way valves. This is a plus and a minus both. It is a major plus for your breathing comfort: you don't get the 'breath in your exhaled breath' feeling of having the first bit of air you breathe in be stuff you just exhaled. Downside is that THESE MASKS WILL NOT FILTER YOUR EXHALED BREATH - IF YOU HAVE COVID, THESE MASKS WON'T SHIELD OTHERS.
For me, that downside hasn't been an issue, I have gone to... rather inhuman lengths to ensure I do not get COVID and have thus far has a 100% success rate. At the cost of many other things, a social life and mental health among them.
Thanks for all the detail. If you don't mind me asking, what makes all of the sacrifice worth it just to not get covid? It sounds like quite the toll, so I'm guessing you must have a preexisting condition that makes the risk profile especially nasty.
I have asthma and I took covid really seriously for 3ish years, but eventually the social and mental costs just weren't worth it. I have felt a lot better since then, it honestly felt like I was trapped in a bubble for 3 years or something. But I completely understand that for some people the calculus will never change.
I live with and take care of my girlfriend. She is immunocompromised and has a long list of medical conditions - even vaccinated we worry that getting COVID for her would either kill her or leave her with enduring effects that would make her life worse and never go away.
As a lesser risk for myself personally, I really don't want to risk long term / permanent effects that would reduce both my physical and cognitive capacity. The potential cognitive reduction is a personal nightmare for me - even with all my neurological flaws, and wow do I have some, I still really like my brain.
You may want to try asking over at
https://www.reddit.com/r/Masks4All/
I’ve found them to be very helpful.
Ohhhh yes back to reddit. Thanks for recommending.
I try to avoid going back, but it can be helpful in certain situations, and this seems fairly complex/specific.
Same here. Briefly visiting reddit now and then just reminds me how great the tildes community is becoming. Without having the breadth of reddit (yet!).
So as someone who is high risk (heart failure, recovered), I masked both at work and in public right up until this summer. I used cotton fabric masks I made myself with a pocket for an N95 filter. I'm also fully vaccinated. Never got covid that I'm aware of.
Now I'm in a very small community, (moved from a large metro area to a town of under 2000). I no longer feel the need to mask all the time, but I will if I feel I'm in a risk situation. My advice is to be proactive, yet realistic. I think the mask you are considering might be overkill.
Tangentially related, years later, I am baffled and frustrated that we still lack testing that proves the presence of Long COVID.
Well, that goes into the mystery of "does long covid actually exist" - there are so many symptoms, of such breadth, and the particular symptoms of each person who claims to have seems like a random subset of those. There's no clear sign on what would even be damaged inside the body, by what, to cause these symptoms.
As someone who's had chronic fatigue syndrome for over a decade triggered either by EBV infection or by damaging my gut microbiome: welcome.
CFS and long covid seem to be similar, so my hypothesis is that the illness is actually several sub-illnesses with different markers, some of which we still either don't know how to check or checking them is way too expensive to be practical so nobody has done the research yet.
Example: chronic fatigue syndrome generally brings gut dysbiosis, but it's not one specific type, so you're going to encounter patients who have zero detectable amounts of (what used to be called) lactobacillus, but also patients who have more lactobacillus than 99% of population, because some lactobacillus species act as opportunistic pathogens which can create or exacerbate cfs-like symptoms.
Some very early research suggests that there are likely going to be some common issues between different types of dysbiosis, like different types of bacteria overproducing similar metabolites that become toxic in high amount and causing a change in intestinal permeability. So eventually we may find that these different configurations of microbiomes are different, but when you look at their metabolomes, they're all going to have one specific issue in common. But we cannot accurately measure and analyze that yet.
Another example: Some research found that all tested CFS patients, of which there were like 7, had specific clear and clearly problematic issue with calcium metabolism on a cellular level. The way to detect it is to watch calcium channels on an individual cell. And the reason why they only tested a small sample of people and why it's still not used as a biomarker is because this test is incredibly expensive and impractical.
This is probably silly since I don't know very much about the topic, but would probiotics help with your issues if they're potentially caused by a disrupted gut microbiome?
Probiotics can influence one's gut microbiome, but if it's caused by a variety of different types of issues with the gut microbiome that are different from each other, it's likely that the ideal treatment is going to vary significantly from person to person.
It's impossible to really explain why in a short comment, but it's basically what the other person said.
The tl;dr is that apart from needing a different treatment for each person there are other problems: for example most probiotics do not colonize your gut, so they're only effective as long as you're taking them. This can still be useful because they often affect the abundance of other bacteria in your gut (positively or negatively) and this change may persist. But it seems that often targeted prebiotics and changing your diet in general are more effective. And sometimes antibiotics are the best course of action.
I think the situation is going to change a few years (to accumulate data) after accurate nextgen sequencing of the gut microbiome becomes financially viable enough for both common people and scientists, and we're quite close to that.
There's a ton of things like this in health where we're on the cusp of achieving true understanding and being able to treat the cause instead of the effect, which is exciting and probably one of my biggest sources of optimism.
What I've read is that the cluster of symptoms that are long covid are only attributable by negation, meaning you have to rule other causes of for instance neausea and red eyes out. I could be wrong.
I suspect that’s because long covid isn’t really a single thing, it’s a shorthand for a variety of long term effects. Fatigue, shortness of breath, brain fog, insomnia, narcolepsy — these might all feel kinda related to each other, but they’re all distinct issues and everyone will experience them in different ways.
If long covid was a singularly defined symptom or collection of symptoms, with similar severity across all populations of long covid sufferers, it would be much easier to point at, and therefore test and research and find solutions for it. Alas, the universe is not so kind as to give us such a tidy reality.
The one (and possibly only) advantage of long covid is that people are taking other cases of post-viral long-term effects more seriously than they did prior to covid.