Why we really should wear masks

By Andrew Polmear, our intrepid wine and cheese man – it’s OK kids, he’s a retired doctor

Most of us are pretty good at wearing a mask in a public place, possibly because we’d get thrown out if we don’t. But have a look round on a bus or train and you’ll often see someone whose mask is useless – either below the nose or even round the chin. There are people, of course, who are exempt, but they wouldn’t be wearing one at all. Does it matter? How good is the evidence that wearing a mask saves lives?

Comparing different countries. The first sort of evidence is from countries where almost everybody wears a mask when they leave home. One careful study showed that transmission of SARS-CoV-2 (the virus that causes Covid-19) is 7.5 times higher in countries where mask wearing is not universal compared to those where it is. That’s not proof, of course – the difference may have been due to something else; they may also have been hand-washing, or distancing, or just not shaking hands, for example. But the masks probably help. A study of US states found that states in which mask-wearing was compulsory had slower disease growth rates than states where it wasn’t.

Studies that asked contacts of coronavirus cases whether they wore a mask or not, then checking whether or not they caught the disease. It’s not a reliable technique – it all depends on people’s memory and honesty. Roughly, wearing a mask seemed to result in half the risk of catching coronoavirus disease. But almost all of these cases were SARS or MERS, not Covid-19.

Lab studies. The final sort of study is done in a laboratory where they measure particles the size of the water particles that carry coronavirus. Researchers have looked at the different situations that arise. I’ll focus on where the contagious person is coughing:

  • The person coughing is masked: a mask roughly halves the number of particles getting out. (Warning – different studies come up with different figures, according to what size particles were measured and how far away from the person being tested.) A 3-layer homemade cloth mask does as well as a surgical mask. An N95 mask may do a bit better but it’s quite a bit more expensive. Whether it fits properly may be more important than what it’s made of.
  • The person with the mask is in the same room as the person coughing (who is not masked): there is benefit but it’s much less.
  • If both are masked the benefit is much greater at about 80%. But what really makes a difference is if both wear double masks – that is, a surgical mask with a fabric mask over the top. That reduces particle transmission by 95%. It may be that the double masking works more by ensuring a close fit, than by the ability of the extra mask to filter more particles. Try it, it’s quite comfortable!

Where should we wear those masks? Obviously in public enclosed spaces. Keeping 2 metres apart isn’t enough. Those masking studies I mention above were done 6 feet apart. I think masks should also be worn out of doors. If there are no crowds and a good breeze you would probably be all right, but you can never protect yourself against the panting jogger who pushes past you, or against bumping into someone as you round a blind corner. If you can smell the cigarette smoke of a smoker you are inhaling their breath.

Finally, what about in the home if a family member becomes ill or is a contact. There’s just one study on this, from Beijing. Transmission of Covid-19 was reduced by 79% if everyone in the household was masked. But there’s a catch. Masking has to be all the time, including before the person who becomes ill develops symptoms. That’s partly why Covid-19 is such a problem. The time when a person is most contagious is from 2 days before symptoms begin until 1 day after they start. If the person you live with is a contact you have time – mask up straight away, don’t wait for them to become ill. If they develop symptoms out of the blue you’ve probably missed the boat, but mask up anyway.

PS. You may be wondering whether higher quality masks would do better than the fabric and surgical masks described above. After all, an FFP2 mask is, by EU definition, one that filters out 94% or more particles (roughly the same as an N95 mask (the US equivalent) and a KN95 (the Chinese equivalent)). An FFP3 mask filters out 98% or more particles. The answer is no, not necessarily. They were designed for industrial use, not specifically for viral protection. Also, those EU tests do not attempt to mimic the human situation, with one person coughing, or talking, or even just breathing out, and another person breathing in. They may still be better than fabric or ordinary surgical masks, especially if properly fitted, but don’t expect 94% or 98% reduction in transmission. And, of course, don’t wear a mask with a valve in it – that would allow out any virus you are exhaling.

PPS. Those who wear glasses find masks a problem. Their moist breath fogs up the inside of the lenses. From all the people who have commented on this it is clear there’s only one solution: wear the mask high up on your nose and perch the glasses on top of it. One eye surgeon, who needs to wear glasses while operating, tapes the top of his mask to his nose, so it can’t slip down below his glasses.

This is an area of science where new information is coming out every day. By the time this article is published it may already be out of date. And please bear in mind that it is the opinion of one retired GP, not a leading scientist. Andrew regrets that he cannot enter into correspondence with individual readers.

Dirt Royal tell Mick Robinson about their Great Expectations

I’ve been a big fan of this Brighton band since they started a few years ago, and we’ve done some superb gigs together at The Prince Albert, Hotel Pelirocco, two landmark gigs at the Concorde and the 100 Club in London supporting punk legends Sham 69. They also played the new band stage at Rebellion and have toured Germany.

You have just released your second album, Great Expectations. How long did it take to record, where did you record it and what’s your connection with Germany?

Char – We recorded the album in Horsham at Ignite studios it was very cold, we did nine songs there then we did three songs at Russell Church’s Sea Side Studios. The tracks were mastered at Gatehouse studios. We didn’t have time to record a song called Outsiders which is shame because it’s a rip off another song I really love.

Leon – We had plenty of time Char, me and Loz just decided it was out. Did you not get the memo?

Char – We work with Time for Action records that are based in Germany – it’s just a shame we can’t tour and get out to Germany, they treat us really well out there.

What is the main inspiration behind your songwriting?

Char – On this album lyrically I was inspired by a lot of the uncertainty and repetitiveness you start to notice in the people around you once you get  past 25. I feel compared to the first album it’s a lot more pessimistic. But I’ve been told we sound a lot more vulnerable at parts.

Leon – I think with this album I wanted it to sound bigger than the rest, but when it came to the writing I wanted it to be as honest and raw as possible. The first album we wrote songs based around characters mostly with some self-reflection, but this time I wanted it to feel personal and more relatable.

When & how did the band form?

Char – I met Loz in a bar called PR6 he was playing Blink with his mate Harry. Then I met Leon at the Jurys Out open mic night – he was wearing a Libertines T shirt.

Leon – No comment. I prefer to keep this shrouded in mystery 

Who’s your biggest influence & why?

Char – The Clash of course. So many reasons but for now I’ll say because they are the best band that there ever was.

Leon – Well this is a big one, what does one look for in ones influences? Raw talent, musical prowess, cutting truthful lyrics? I dunno. I like a catchy tune, I’m well into Polka at the minute – it’s the next punk take it from me.

You met Mick Jones (from the Clash) when he was in Brighton in 2015, what did he say? 

Char – He said ‘Nice set boys. You’ll be hearing from my lawyers’. He was beyond cool and had a lot of time for creepy fans like me.

Leon – He didn’t speak to me. I saw Matt Cardle at Westfield once. That was pretty cool.

What’s been your favourite gig you’ve played so far?

Char – That’s really hard. Playing Concorde 2 with Sham was amazing. Our first gig in Germany was incredible, but all the gigs we played at 12 Bar in Soho hold a special place in my heart. I miss that place, but right now I’d be happy to play a gig at a bus stop.

Leon – I do love the Concorde 2 gigs, but we’ve done some great gigs at the Albert over the years, they can be very sweaty and lively. It was also the first stage we ever graced so it has a special place among the many venues we’ve played.

Where do you see live music going, post lockdown?

Char – Going to be a big hit I think which is bad because it wasn’t getting much support before, maybe people will want to go out more after being caged for a year.

Leon – I think there’s a lot of DIY stuff coming out now so I’m hoping the decline of the stadium show will give space for small grass roots venues to make a comeback. Instead of going to see old bastards headline the Brighton Centre, maybe people will watch a new band down the street.

What’s your fave film?

1.Star Wars (empire)

2.Toy Story

3.Rocky 1

4.Clockwork Orange

5.Batman 1989

6.The Fly

7.Drop Dead Fred

8.One Flew Over The Cuckoo Nest

9.On The Beat


How are you keeping busy in the lockdown?

Char – Writing a lot and Leon has taught me how to record demos at home, so we’re just trying to get all the ideas down ready for when we can practice again. Got a lot of new songs between us, over 20.

Leon – I’ve been reading them books.

Any other contemporary bands you like, especially in Brighton ?

Char – Teenage Waitress I’m all over at the moment, The Lathums, Bite The Buffalo, and I’m loving the new Strokes album. And my mate I was in a band with at school recently showed me Cloud Nothings.

Leon – I’ve been getting into the new post punk thing, bands like Squids, Sports Club and Yak, there’s also some cool stuff coming out of Australia like the Chats and Viagra Boys

And what are your plans for 2021?

Char -Get the new songs together and ready to record. But also we were planning to record a new single so we will be getting that together ASAP I would like to get that out this year, all depends on when we can get back in a practice room together again.

Leon – Shake my tail feather, I just wanna go dancing.

If you could play anywhere in the world where would it be?

Char – New York!

Leon – San Francisco all the way.

Any advice for a band starting out right now?

Char – Write, rehearse, gig, record.

Leon – Don’t do it, get a trade or learn how to code or something.

Where can we buy the album?

Char – The physical copies of the album have sold out, but it’s still up on iTunes, Amazon, Spotify and a load of other streaming sites I’ve never heard of. Actually, we did a few Dirt Royal bundles with the album, t-shirts and previous singles and stuff. There might be one or two still available at www.pipandpine.com…. quick go now

Cor blimey, guv, strike a light

Me old China Peter Batten goes off searching for the East End he knew

Brick lane

My father’s family came from the Isle of Dogs, more politely known as Millwall. This is the area of London portrayed in the TV Soap, EastEnders. Several of my relatives were involved in amateur or professional boxing, a sport rarely mentioned in the BBC’s Albert Square.

That omission leads me to a question I am often asked, “How true to the East End is the BBC Soap. I should certainly be able to answer that question. I grew up in a house which looked out on a very substantial street market.

On the other side of the road there were market stalls and behind them a row of shops. Just at the end of the row was a pub called, The Queen Victoria. As in the soap my grandmother would meet her cronies there most evenings. Just before closing time she would toddle home clutching her nightcap, a small jug of brown ale. On our corner, two houses away, was a fish and chip shop. I can almost recapture the smell as I write these words…

Just a few yards away the market became denser, with stalls on both sides of the road and many different shops. One feature I recall immediately, which EastEnders does not recreate, is the lighting. In 1938 our road had been electrified, so the stalls had been linked to electric lighting.

One of my earliest memories (I was born in 1933) is of the warm attractive glow, in winter months, around the stalls early in the morning and again in the evening. Activity began at about 6am, when some stalls had to be brought out – lots of noise – and ended after 6pm.

There is just one problem with my description. When my mother and father married (they met in Greenwich Park) they lived in my grandmother’s flat in Southwark Park Road in Bermondsey, south of the river.

It suited my father because he worked at the Surrey Commercial Docks in Rotherhithe, just over a mile away. This is the road which I have been describing. It is certainly not in the East End.

The Street Market which I have begun to describe is typical of many throughout those inner London suburbs which grew up post 1850. They were active from Monday to Saturday. Then on Sunday huge special markets took over, like the amazing Petticoat Lane near Liverpool Street Station or the one I often visited just off the Walworth Road. One of their special attractions was the sale of animals, which took up one or two side streets.

My memories of our market are based on the years 1938-1958. I think they make an interesting contrast with the market which has been created for EastEnders, but I do not intend that as a criticism of the soap. Each of the smaller local markets had a character of its own, but they all offered a diversity of goods and characters which EastEnders cannot hope to recreate. Our market was known as “The Blue Anchor” after the pub which was at the heart of the market area.

It was older than the Queen Vic, a late Victorian pub, and an even younger pub, the Colleen Bawn. As a nosey child this name always irritated me. What did it mean? Only in the 1970s did I discover that it was the title of a very successful Victorian play by the Irish playwright Dion Boucicault.

We had a small fleapit cinema, the Rialto, a small Woolworth’s, a bank, and a Co-op supermarket, built on part of the road which had been destroyed by bombs. The variety of the stalls and shops was amazing, with all kinds of goods, groceries and foodstuffs on sale. Immediately opposite our house was a greengrocer’s stall, so it was very easy to nip across if we needed some extra veg for a meal.

Right behind him was a German bakery called Griesbach. A little further away was a German pork butcher offering some delicious specialities. Sadly, that closed in 1940.

Among the more unusual offerings was Sarsparella, a red cordial sold by the glass from a barrel. As in Ben Jonson’s Elizabethan play, “Volpone” there was usually someone offering some miracle cure for all ailments. Sometimes there would be a crockery stall where you were encouraged to make an offer for plates or a tea service, An allegedly ex-boxer stood with a set of scales offering to tell your weight. Someone called Prince Monoloulou might come by offering to sell you betting tips.

Which reminds me of something else. There is no illegal betting in EastEnders. In my childhood it was going on all around me. “Runners” as they were called were quietly taking bets and handling money in every pub and every factory. Our elderly neighbour, Mr Westcar, found a handy way to add to his pension by running a small “Book”, as it was called. Just in case the police came calling, my mother explained to me, all his betting slips were pinned to the underside of his large kitchen table.

OK EastEnders, so there’s no illegal betting these days. But what happened to our jellied eels??  

What’s Going On?

In the second of Andrew Polmear’s Covid reports, he looks at the Oxford AstraZeneca vaccine and the over 65s.

A friend has just emailed to say that she’s delighted that she’s had her first Covid vaccination – but disappointed that it was the Oxford/AstraZeneca version. She’s in her 70s and I guess she’s heard that a number of European countries will not be using the Oxford/AZ vaccine in people over 65. Indeed, President Macron of France has been the most outspoken, saying that “it’s quasi-ineffective in the over 65s” Yet our own Medicines and Healthcare Products Regulatory Agency, and the EU equivalent, have approved its use in all adults. So what’s going on?

The problem is that the Oxford study began with patients under 55 years old. They wanted to prove that it was safe in younger patients before giving it to the elderly. Once it was clear that it was safe they included adults of all ages. But when they reported their first results only 2 patients over 65 had the disease. Neither had been given the vaccine but the numbers were too small to say that that proved that the vaccine worked in the older patient. They could, however, say that President Macron was wrong to say it didn’t work. All that can be said is that they hadn’t proved it did work.

So why has the Oxford/AZ vaccine been approved for all ages? There are two reasons:

  1. The researchers measured the antibodies in the blood following administration of the vaccine. Subjects over 65 had a strong immune response, as measured in the lab. It was not quite as strong as in younger subjects but it was plenty strong enough.
  2. All other studies so far reported have shown that older people are protected by the other vaccines. Especially reassuring is the vaccine made by J&J which uses the same technology as the Oxford/AZ vaccine. It would be very odd if the Oxford/AZ vaccine didn’t behave in the same way.

My belief is that, like President Macron, politicians in those countries have confused ‘no evidence of benefit’ with ‘evidence of no benefit’. If the Oxford/AZ vaccine isn’t shown to be effective at all ages in the next few weeks, I’ll eat my hat.

This is an area of science where new information is coming out every day. By the time this article is published it may already be out of date. And please bear in mind that it is the opinion of one retired GP, not a leading scientist. Andrew regrets that he cannot enter into correspondence with individual readers.

Covid-19 and vaccines – a (retired) doctor writes…

Not only is Andrew Polmear our intrepid wine and cheese man, he’s also a retired doctor and asks… Does delaying the second dose till 12 weeks after the first put us at risk?

One of the joys of being a retired doctor is having the satisfaction of responding to people’s concerns about medical matters without the worry of being responsible for them. So I enjoy queries from friends; and of all the questions I’ve been asked about Covid-19, the commonest is about the 12 week delay between jabs. Is it safe?

The short answer is yes, but, of course, it’s a bit more complicated than that.

The first bit of the answer is the straightforward one that Matt Hancock, Health Secretary, gave when he announced the change. If you have a vaccine that’s in short supply it’s better to give everyone at risk a first dose rather than give some a second dose and others nothing at this stage. The first dose gives a better “bang for your buck”. That means Matt Hancock made the right choice for the country; but it doesn’t stop us, as individuals, wanting that second dose.

But does delaying that second dose reduce our protection?

Things are easiest to understand with the Oxford/AstraZeneca vaccine, because there’s published information about this. The Oxford researchers had intended to test a single dose. But after they’d started the trials they found that, when they gave a second jab to a small group, they got a better antibody response. They went back to the regulator and got permission to change the trial, so they could give a second jab 28 days after the first. However, by the time they gave their subjects the second dose, some were at least 90 days after the first. So they could compare the effect of early and late second jabs:

  • second dose given early (between 22 and 90 days after the first) – 76% of cases of Covid were prevented, with no sign that protection was tailing off towards the end (and none of those who did get Covid were bad enough to go to hospital).
  • second dose given late (more than 90 days) – 82% protection. What’s more, subjects had higher antibody levels than those who had an earlier second dose.

So, with the Oxford/AZ vaccine, we can say that a 90 day gap is fine, possibly even better than a 28 day gap.

With the Pfizer vaccine it’s more difficult because all of those taking part in the trial got the second dose at between 19 and 42 days after the first. So Pfizer are correct to say that there’s no evidence that delaying the second dose until 90 days is safe. The World Health Organisation hedges its bets by recommending that the gap go up to 6 weeks. So why does our own, highly regarded, Joint Committee on Vaccination and Immunisation recommend 3 months? There are two reasons:

  • The first is that most, possibly all, vaccines give better long-term immunity if the second dose is delayed. The HPV vaccine, for instance, given to girls and boys to protect against certain types of cancer, works best if the second dose is given between 6 months and two years after the first. Immunity from vaccination doesn’t fall off rapidly. It takes 2 – 3 weeks after a jab to develop. It doesn’t then suddenly disappear, at least not for months or years.
  • The second reason is a detailed look at the Pfizer trial. Patients in the week before the second jab were 89% protected against Covid-19. After the second jab they were 95% protected. Such a small improvement in protection from an early second dose isn’t statistically significant.

 So, the chances are that a delay in receiving a second dose of the Pfizer vaccine will do no harm. And it’ll certainly mean that more people will get their first jab sooner; which is good for everybody.

This is an area of science where new information is coming out every day. By the time this article is published it may already be out of date. And please bear in mind that it is the opinion of one retired GP, not a leading scientist. Andrew regrets that he cannot enter into correspondence with individual readers.