Interview with Mask a Hero NY

Really excited to have both of you join me here today. So just to set the context a little bit for the conversation.

We're very much still in the midst of the COVID -19 pandemic.

And one of the challenges, I think, especially in the early days that came up as a result of it was shortages of PPE and personally protective equipment.

So I'm excited to have Dr.

Levin come talk to us about Masca here in New York, which is a nonprofit organization that helps connect doctors with those resources, as well as Matt Weinberg, the president of Happy Cog, who has helped from the technical side, facilitate that.

So I will let you guys introduce yourselves and your own words as well.

So I am Dr. Emily Levin. I'm an anesthesiologist in New York.

I co-founded Masca Hero New York with a good friend and colleague, Dr. Michelle Kars.

We work together. And we both are working as full time anesthesiologists and running Masca Hero New York together.

And I'm Matt Weinberg.

I am, as you mentioned, the president of Happy Cog. We're a digital agency, and I just, you know, build the website and do some of the tech stuff for the platform.

I also use Cloudflare for a whole bunch of other projects with work.

So, Emily, could you tell us a bit about what inspired you to start Masca Hero New York?

So back in March, I guess it was probably the beginning of March, the second week in March, we were starting to hear reports coming out from China and from Italy, and then in Washington about many physicians who are taking care of these patients with the novel coronavirus disease and needing equipment to protect themselves, and they did not have that equipment.

It's called personal protective equipment, or PPE.

And there were starting to be a shortage that these doctors taking care of the patients, putting themselves at risk, did not have masks, did not have face shields, did not have gowns to protect themselves while taking care of these patients.

And we were connecting with other physicians and first responders on social media, hearing how scared they were that they were not able to protect themselves while taking care of these other patients.

And we as physicians take an oath to take care of patients.

And it's becoming a major problem to not be able to take care of yourself while taking care of patients.

So in preparing for the coronavirus to come to New York, for a major surge, we started speaking to other physicians who were in the midst of it, talking about their needs of PPE and masks, and started thinking it would be a great idea to see what we can get donated to us, what masks we can get donated from, say, construction workers, people in their house, for example, have what we call N95 masks that filter out tiny particles, including the virus, to be able to start collecting those masks to be able to donate to physicians in need, so the physicians could protect themselves while helping other people.

So we started talking about this one day, and it sort of snowballed over the next few days, that, and the ways that we could ask who needs masks and find out who has masks to donate and connect those people.

So in discussion, we started reaching out to friends, we reached out to one of my closest friends, Matt Weinberg, to help us get a website up and running to be able to have a place where people could go in and say they have masks to donate, and then we can connect them with people signing up saying they are in need of masks to protect themselves, the hospital, and we could connect people and start donating masks to those in need so we can protect each other.

And just so I understand correctly, so in the beginning, I think, of the pandemic, one of the things that was talked about quite a bit was this idea of flattening the curve, right?

And is the, is the, the idea of flattening the curve is kind of due to, like, we have a limited amount of supplies and a limited capacity, right, to be able to treat patients.

So the intention is to keep the number of patients that we have, like, under the amount of the supplies that we have, right?

Correct, correct. So in the beginning, the flattening the curve was to try to decrease the amount of people that were infected.

We don't have a cure for this virus. We don't have a treatment for this virus.

We don't have a way to prevent the virus, except for staying home quarantining.

And if you have to go out, if you have to go somewhere to protect yourself and others, meaning, put the mask on, wash your hands a million times, to decrease any risk of you having the virus and transmitting it to others.

So exactly what you're saying, flattening the curve.

There was a bunch of memes going around saying that it wasn't to, not to get rid of the virus, it was to make space in the ICU.

So during the surge at many hospitals in the New York area, we were exploding at the seams.

They were making hospital beds and auditoriums and cafeterias and tents outside and boats in New York that came to make beds for all the people that were suddenly infected with COVID-19.

And that was the hardest part is at that time, we don't have enough supplies, including workers, people who are working in the hospital, physicians, nurses, techs, and supplies, as you're saying.

Masks, gowns, face shields, drugs.

I can go on and on about the things that you don't have in a surge when your capacity is overflowing.

So flattening the curve was to spread out when people are getting sick.

If everyone's out all at once, and this disease is so rapidly spreading and contagious, everyone gets infected.

But if you're staying home, then eventually go out.

It's less and less people. Yes, there will still be some people who get infected, but then there are capabilities in the hospitals to take care of you.

And the need for personally protective equipment for doctors as a result, then, is we already have a limited capacity of doctors.

So if anyone gets sick, it just makes the situation worse. Correct. At the beginning, there were too many physicians, nurses, techs, people in the hospital getting sick.

And unfortunately, many died from COVID-19, partially because they didn't have the equipment to protect themselves.

They didn't have masks. They didn't have face shields.

We as anesthesiologists, which I am, are one of the highest risk professions doing procedures called intubations, which is if someone needs help breathing, we put breathing tubes in, and you're aerosolizing the virus.

You're having respiratory secretions. The virus is coming out at you.

And there's extremely high risk of the virus getting onto your face, your hands, into your mouth, and then you contracting the virus and getting sick.

So protecting yourself is really the best and only option during those procedures, which we have to do to save other people, which again, we took an oath to take care of people.

So it's great that you took upon yourself the initiative to help out, I'm sure, your colleagues and so many others in crisis.

What was it like actually getting Mask a Hero off the ground?

It was very much a work in progress. It's nothing I had ever done before, nothing my colleague, Dr.

Kahrs, had ever done before. We were learning as we were going, and we called upon a lot of friends, Matt, to help us and do the website and all the technical things we needed.

Another friend who's in public relations to help us with that side of things.

We kind of called upon our network to help get everything going, which is super important to have people who can help you and everyone work together.

We coordinated with other colleagues in other states who helped as well to get everything up and running to make this work.

But it's definitely interesting and exciting to be a part of this, and we really just wanted to help people and seeing all the people that were helping and hearing from them.

When people just, even if we're donating 10 masks to someone, they're so grateful just to have something to protect themselves when they can't get anything.

We have people emailing saying, we can't buy anything online, everything is backordered or just unavailable, and they still need to take care of patients no matter what.

So they're grateful for having a mask donated to them.

You said that it was very much a work in progress.

What was the very core MVP, minimum viable product like?

Did you try to do anything before the website, or was the launch of the website kind of the beginning of it?

The launch of the website was the beginning.

The thing that we needed at first, or just the idea that we had in our head, was having a form where if someone needs a mask, they fill out a form and it comes to us.

And if someone has masks to donate, they fill out a form and it comes to us.

That was as far as my head got, which is where I reached out to Matt for help.

And I think the whole thing was able to evolve because of him, and he put the whole thing into play.

So maybe Matt, you can speak about how you took our ideas and visions and made it into reality.

Sure. So they called me, and Emily and I are very close friends, and they said they had this idea, as Emily just said, we just want to connect people.

We want a form. And I was like, okay, well, what does that mean?

What information do you need? And they hadn't thought through a lot of that from what we might, when building websites, what we might call the user stories or requirements and all of that.

And that's fine, right?

That's not their job to do that. And also, we were at kind of a crisis situation.

In other words, in New York, especially, there were thousands of people getting this virus.

Many of them were dying. This was very early on. So the lockdowns were just starting, or the closings were just starting.

So they reached out.

They said, here's what we need to do. I said, okay, well, what about this, this, and this?

And they were like, we don't know. We just need to, you know, we just know that there's this issue.

Again, we might call it a business problem, but not really, right?

There's no, this is all volunteer run. But with this business problem of, there are people that absolutely need PPE very badly.

Hospitals, nursing homes, fire departments, anybody else.

And there are people that have PPE that they can donate.

And there are hospitals that it hasn't hit as hard yet that maybe can donate.

And there's this matching problem that you have.

And we need to coordinate those. And also, other people might have similar ideas.

And you don't want a situation where there's some conversation happening on one Facebook group and some conversation happening on another Facebook group.

You really need a central clearinghouse for all of this, because that's how you coordinate.

Make sure you have the best, like the most amount of donators and the most amount of recipients so we can make the most efficient matches.

Honestly, we just decided to do something super simple and quick.

We used Google Forms to just collect the information.

We decided we would have a small website. The website only needed, really only had a couple of requirements, right?

The number one requirement is let people self-select into being a donator or recipient and then fill out a Google Form with the appropriate information.

We wanted to gain a little bit of trust.

Like, unfortunately, there's a lot of scams out there now with people selling, you know, selling PPE.

It's not really safe PPE or you don't know where it's going to come.

This site isn't selling anything. It's just connecting donations.

We wanted to gain a little bit of trust, show people that this is legit, and also help explain what it was doing.

So I just spent some time on the phone.

Were you concerned at all? You mentioned that there were kind of disparate efforts in terms of Facebook groups and things like that.

Were you worried that maybe there was another Masky Hero NYC?

I think I lost you there, Rita.

Emily, did you lose Rita too? She froze for a second. Okay.

Rita? I'll answer what I think the question was, which was, are we concerned that there was another Masky Hero NYC or something?

I don't necessarily want to speak for you, but it didn't seem like that would be a big problem.

In other words, if other people were doing similar type things, I guess the worst case scenario is it gets more visibility to the cause.

If anything, this would help the situation, right?

Because people are already having those discussions on Facebook groups and everything else.

So is that your take also? Yes. I mean, there are other groups doing similar things.

One difference I noticed with your idea though, Emily, was that you were focused more on mass donations, right?

Like I feel like I saw a lot of people doing single donations.

Oh, I have a box of like five things, a box of 10 things. But it felt like your idea was more like for the industrial uses or like commercial type uses, right?

Like bigger donations and bigger amounts. Yeah. I mean, that's what we were hoping for and we still hope for.

We also off the bat said, we're not going to take anything that's open.

So a lot of people said, oh, I have a box and I used a few, but here are the other five that are in the box, which is great.

But we also wanted to maintain cleanliness and make sure we weren't giving someone, we didn't know where those masks were.

We wanted to keep everything sterile and uncontaminated as best we could.

I guess I'll just keep asking questions.

Do you, there's Rita. Do you want to talk a little bit about the matching process maybe?

Because like at first, I mean, you got hundreds and hundreds of submissions.

Well, I think it had changed, it changed like throughout.

Hi, Rita. Hello. Don't worry, we continued on. That's great. The show must go on.

My computer decided that it shouldn't, but I'm glad we're back. I'm sorry, you were asking about the matching process, which I think is really interesting.

So at first we were trying to match, you know, someone would say, okay, I have a box of masks on the Upper West Side.

And then we would try to look for someone who wrote in saying, I live on the Upper West Side, I need masks.

And we were trying to get the two of them together.

Which would be lovely if I had all the time in the world to be able to match that and coordinate and be available 24 hours a day to figure that out.

But I think it quickly grew that we had many requests to donate as well as many people who needed, and it just wasn't feasible.

So we sort of ended up saying, okay, we have pick up and drop off locations.

My partner lives in Manhattan and I live on Long Island.

And if you have something that's fabulous, and you could drop it off at our locations.

And if you need something, come and pick it up at either her apartment or my house.

So two different locations. So we were, you know, and we are masking here in New York, which we've taken to mainly New York City, Long Island, Staten Island, Brooklyn, Bronx, Westchester, the area.

We do have affiliates in other parts of the country.

For the people who were asking, we have affiliates in six states.

And North Carolina is main Maski Hero in Ohio, Wisconsin, Tennessee, California, other people doing Maski Hero and connecting people in those states so that we're, you know, focused here where we can hand off the masks.

So if someone has masks at home, is the best thing for them to do?

Just see which masks are kind of nearest to them? Are you familiar with other organizations doing a similar thing?

There are a lot of organizations. We had started talking about this a little bit.

There are other organizations doing similar things.

And that's great. We just want to help people and have whoever needs the mask to be able to get masks, however they can.

How do you prioritize who ends up getting the masks?

Because I'm sure the demand is huge.

Yes, yes. We've had over 250 requests for masks, for face shields, for gloves, for hand sanitizer, Lysol.

I would love if I had extra Lysol or hand sanitizer to give out to people.

But your question was, how do we prioritize? So I think that's one of the harder things that we do.

At first, we're prioritizing to the departments in the hospital that are most effective and most affected and most at risk, meaning anyone in the emergency room, whether that be physicians or nurses, anesthesiologists such as us, other specialties at high risk, ENT, ear, nose and throat doctors are also at high risk from their procedures.

But we also have expanded to first responders are high risk.

EMS, policemen, firemen are going into people's houses.

So we really wanted to give out to them. We also expanded into nursing homes, which everyone saw in the news how that was a huge place of spread.

Elderly people at risk, immunocompromised, and everyone living in the same quarters with the same people taking care of them.

With this very contagious disease, it was spreading.

So we were able to donate to many nursing homes, rehab centers, similar places like that.

You mentioned a few types of PPE that you guys ended up receiving.

So different masks and face shields. Could you explain the difference, I guess, between the different types of masks?

And I think a lot of people listening as well, I know, especially earlier on, there was a question of people felt guilty wearing masks because they knew there was a shortage and wanted to make sure that doctors had a priority.

So what kind of masks should people be wearing and what's the difference between everything that's available?

Definitely, definitely.

I know a lot of people felt that. With reason, too, because we didn't have enough in the hospitals and people going to the grocery store were wearing the type of mask that we needed in the hospitals for higher risk situations than it was going to the grocery store.

So, I mean, starting the basic, there are cloth masks, which is the recommendation for anyone to cover their face.

So you can use a cloth mask, you can use a bandana to cover your face.

It's really wearing the mask is to protect you from, if you don't know you have a disease, from giving it to other people.

So as long as you're covering your nose and your mouth, that is what the CDC and the WHO and the health organizations are recommending to decrease the spread.

So a person going outside to a store or just outside to the park, you're going to be close to other people, wear a mask.

A surgical mask is the next step, which is the kind of mask that previously you'd see people wearing in the hospital or in the operating room, just a regular mask that we would wear.

I don't have, oh, I can show people.

This is a surgical mask that you can wear, which is a regular mask.

The problem with this mask is it doesn't, it lets in particles get through, which is why we came to the N95 mask, which is, this is an N95, which can filter much smaller particles, which the virus is very small.

So this is an N95, which we as anesthesiologists now wear all the time for everything that we do.

And these are the masks that are, were hard to come by that were in demand, in short supply throughout the state, throughout the country, throughout the world.

And we will continue needing this mask, the N95 mask, as long as COVID continues on.

The other PPE that we were talking about that as things have evolved is face shields, which at first, I think, were not readily available.

People weren't wearing them. It's not something we normally wear. What is a face shield?

A face shield is a plastic covering. And many different factories have now started manufacturing them.

If they were manufacturing something before, and now they switched to that to help out.

Really just a band around your head or however you do it, and plastic covering, just as another layer of protection of having particles go into your nose, your mouth, your eyes, anything that could possibly infect you.

So now at the hospital, I wear an N95 and then another mask over it, and a face shield all the time to protect myself for any procedure that I'm doing, taking care of any patient for the most protection.

The other thing that we also have some of is Tyvek suits or full body suits.

When you see the images from Wuhan, China, and even from Italy, you'd see people wearing these full body gowns covering with a hood over their head, really covering everything.

And then you'd see images of people in the United States physicians not wearing any of that because we didn't have that available.

And it might not be as necessary as we thought it was before, but during some procedures in a patient with known COVID-19, I will wear one of those suits if available to protect myself.

So you're not, for the most part, wearing those all day?

No, I would not wear the full body suit all day.

I do wear the N95 all day long, as do most people in the hospital where I am.

And I have to say where I work, I'm very lucky that we have been able to have appropriate PPE throughout, which is great and be able to be protected.

In the hospital, you mentioned that everyone wears N95s where you are.

How is the hospital split up in terms of, is there any separation between COVID-19 patients and everyone else to make sure that others don't get infected?

There are.

There are specific floors for COVID-19 patients. And as we were talking about before, when the surge happened and the hospitals were overflowing, there were many, many, many floors with all COVID-19 patients.

It's now down to maybe one floor, one area.

But COVID-19 patients need surgeries, just like any other patient, and might need to go have a CAT scan or get a test done where they would have to go around.

But we are getting better and better at having separate areas for those patients, keeping everyone separate to minimize any risk of anyone else getting sick.

One thing that's been, I've seen talked about is COVID kind of coming and going in waves.

So people have been talking about, you know, the possibility of a second wave.

Do you feel like we'll be better prepared since we've kind of gone through it before?

I hope so. I really hope so. I mean, I think that it was a learning process for everyone involved.

And everyone did a great job in this horrible time.

Everyone, doctors, nurses, administrators, everyone who works in the hospital came together to support each other and help out.

And, you know, things were changing every day, every hour, every, you know, week, there was, we found something new, we learned something new, we, you know, dress differently, we took off our clothes, whatever we were doing differently, that we found worked or didn't work.

Same thing with, you know, how we take care of patients with COVID -19.

So I would hope that if there is a second wave, or even waves in other parts of the countries, you know, we had our peak last month and now in other parts of the country, for example, Arizona right now, is having a huge surge of patients that they can learn from what we did and what we went through to be better prepared for next time.

You said you guys were trying out different things and then correcting things along the way.

What are some interesting learnings that you had that maybe you didn't expect?

I think, you know, I think what we learned is that we have to keep our ears open, our eyes open for what works and what doesn't.

And it's okay to change, for example, the way we treat patients.

At the beginning, a lot of the patients who were having trouble breathing, that was one of the main issues with COVID is that people were having trouble breathing.

And right away, people were getting intubated or having the breathing tube put in, which is something that we as anesthesiologists do.

And it evolved that later on, people were just being treated with oxygen, rather than having a breathing tube and letting them recover.

So things like that, whether they were at first they were getting antibiotics, and then that sort of changed, you don't need those antibiotics.

There's a bunch of different treatments that had been talked about in the news.

I know that some people thought worked, and then maybe studies showed it didn't work.

But we're all, this is the importance of research and medicine and studies so that we can see what works and what doesn't work.

And a lot of it is anecdotal. But a lot of what we've been doing as physicians is discussing on social media.

So we were talking before about the importance of the Internet now.

And now, every day, there's conversations with physicians from China, from Italy, from Washington, talking to people in New York, talking to the people in other states, saying this worked, this didn't work, because we really we don't know.

There are no textbooks saying what to do. Yeah, that makes sense.

And I think, from our side, we're constantly thinking about the pandemic has really shown just how dependent we are on the Internet to spread this kind of information.

And I know we have more time, but I just want to say one more time, how grateful that you were able to join us, because we really are sitting at home.

And the only feed that we have into the rest of the world is kind of seeing what doctors and other professionals are doing.

Yeah, absolutely.

I know there were a lot of surgeries that were put on hold for months because they couldn't come in.

But it is interesting to see all these other surgeries that people were doing that they needed to do are not happening.

For example, you know, people who used to have all these heart attacks, where did those people go?

Where did they go?

And I think it's really interesting to see how people are able to come in and be able to do that.

Yeah, absolutely.

Do you feel one thing that I think people are also worried about is, as you mentioned, many surgeries were paused or other treatments are paused to make space in the hospital for COVID-19 patients.

Are you guys able to address some of that backlog now?

Or are you worried about there being kind of a huge overload afterwards of things that were paused?

So I think that there is a huge overload. And I think that people are working really hard now, 24 hours a day to get these surgeries done, working during the day, working on weekends, working on holidays, to address the backlog of all these surgeries that are more on the urgent side.

You know, people who have cancers that need to be operated on, people who have other pressing issues that need to get done.

So I know we are working really, really hard to get that all done in a timely manner right now.

One thing that's been happening in the past couple weeks in parallel as well, right, is many of the protests after the murder of George Floyd.

I was wondering if you've, first of all, seen any changes in the hospital as a result of that, such as patients coming in?

I know some of the protests, most protests are really, really peaceful, but obviously a few have escalated and we've all seen violence as a result of those.

Is that something that you've seen as well? I haven't personally seen anything myself.

I do have a good friend who is an ophthalmologist in Minneapolis, and he had taken care of a patient who had some eye damage from the protests, from the not very peaceful protests at the time, and he was taking care of that.

I will say I went to a peaceful protest this weekend and luckily it was peaceful and there was nothing happening.

But I will say not everyone was wearing masks, which is disappointing because they were all standing next to each other not wearing masks.

So I could see, you know, spreads happening from that.

And it's great. I'm very happy for people to go out and speak to this and participate.

But I would suggest that people do it in a smart way with a mask, not standing on top of each other and maintain social distance while still having a voice.

Well, I think you touched on something that I thought was pretty interesting to me kind of earlier on in our conversation about the role of masks.

And I think people are very accustomed to thinking of masks as something that protects them.

But most of the masks that people wear outside are less so to protect yourself and more so to protect others, right?

So unless everyone is wearing a mask, it's really hard to...

The altruistic thing that you need to protect other people from you if you may not know you're sick or, you know, before you're sick or if you don't even get sick, but you are a carrier of the virus to protect other people from the disease.

For Mask a Hero, what do you guys see it turning into in the future?

And do you have any plans for it?

Matt, can you tell us what's on the roadmap? I don't know if it's got a traditional like JIRA backlog roadmap thing.

I mean, in a way, you want this whole thing to go away and nobody ever goes to the site again because no one ever needs it, right?

I'll take it. I'll definitely take that. That would be great. I do think it's interesting to note that as the response to the virus has evolved, I think the way the site is handling the response has evolved as well.

So just even, you know, Emily and Michelle and some of the other people that helped do the matches, originally they were doing it in more of a manual way.

Now it's very based on like Google Sheets with, you know, certain filters and labels and kind of automated things there as well.

As the kind of, I don't know, the types of the traffic you're getting and as the places that they're getting them from and as some hospitals get the PPE they need and some other types of environments don't.

So it's been interesting to see that and have the site adapt to that.

I don't know that we have like a backlog or roadmap or anything in terms of plans for the future.

We did add a press page because suddenly we got all these partners.

This one fashion designer created a shirt and all the proceeds were donated to this purpose.

Emily, what was her name?

That's awesome. Yeah. Do you know who the designer was? Rebecca Minkoff made a shirt.

Right. Rebecca Minkoff made a shirt. You know, the site's been featured on all these sites.

Katie Couric featured it. A couple other well-known people.

And again, the site isn't monetized, right? Like nobody's making money, but we like the visibility because it obviously helps just get more donations and get more people that need masks to see it.

So I think we just have to understand, you know, is this thing going to be like a horseshoe, like where it kind of kicks up and then goes down in terms of people?

It's spiking in certain areas.

Is there just going to be this kind of slow tail off with the PPE need kind of catch up with the supply?

That's what we're trying to figure out as we understand the roadmap.

Got it. And in terms of I know with a lot of the press you received, you ended up getting a lot of traffic.

Did you have to go in and modify anything to be able to support that?

Kind of a leading question. It is kind of a leading question.

When we first launched this, you know, the number one thing we wanted to care about was helping people.

And we absolutely did not want to care about servers, server management, scaling, databases.

It's just we didn't have time for that.

You know, again, you know, thousands of people were getting infected every day when we started this, when Emily and Michelle started this.

It was really early and a lot of people were hurt.

So we just needed to get it up quickly.

Ultimately, the site is a couple of pages, right? It's the homepage, it's the forms, it's the press about us and about masks.

So, you know, as I was thinking through the technical architecture, what I kind of thought was, you know, this is a perfect static site.

We don't need a content management system. There's so little content on the site that it would be easy to just manually change.

We don't need a database.

We don't need any of that. So we ended up building it in Jekyll, which is a static site generator.

And then when looking for places to host it, again, I didn't want to have to deal with servers.

I didn't want to have to deal with FTPing, crazy deployments or anything.

So we decided on Cloudflare workers, Cloudflare worker sites specifically, right?

Because Cloudflare worker sites we can do is do our build process.

It's a couple of templates, maps, I think, you know, a shared header, a shared footer and a couple of just quick Jekyll templates, a couple of markdown pages.

Build it. It's a, I don't know, five second build because it's less than that.

It's a couple of pages. There's no SAS, CSS compilation.

And then with Wrangler, we just upload it to Cloudflare worker sites.

Honestly, we've seen big traffic spikes, especially after some of those press hits from Vogue and from Katie Couric and from some of the others, but we haven't even needed to worry about it.

We didn't sweat it. It's a static site running on Cloudflare worker sites.

It's on all of the Cloudflare points of presence kind of around different countries.

So it's honestly just it's literally the very last thing we want to think about.

We haven't had to think about the hosting since we put it up.

We do deploys. That's it. We don't have to worry.

And that's fine because we want to concentrate on the magic. That's awesome. That makes a lot of sense.

This I know this wasn't your first workers project, Matt.

You presented at our Cloudflare Connect Day as well. Could you tell us a bit about some of the other projects maybe that you've built on workers?

So we in my in my real life day job, I run this interactive agency called HappyCog and we use workers for a number of different things.

One thing we did recently was we built a caching system based on workers for one of our very high traffic publishing news clients.

So this is a client that they publish a lot of breaking news, a lot of really important stories.

They get these huge traffic spikes whenever they publish something that's super popular.

And they were getting even though they had varnish in front, they were getting cached.

It's just killing the origin servers.

So we built a workers based caching system. It uses workers KB, which is the kind of key value storage.

And effectively, when anybody does a request for the site before it even hits the origin, Cloudflare worker intercepts it and checks workers KB to see if we already have a cached copy of the serialized HTML inside of KB.

If we do, the worker just serves it right there. It never touches the origin.

Our backend servers never see that request at all. If it doesn't, the worker actually issues a queue job to like a backend process that ends up generating HTML in the backend and then using the workers REST API to save it.

So that was really technical. I may have lost some people there. But the net is that we were able to stop cached leads and significantly decrease the amount of origin servers we have because we kind of control that.

And at this point, I want to say, I don't know, 99.5 or 99.9 percent of requests are served directly from workers and workers KB without ever touching the backend.

That was one. We also use workers in our old office.

We had a, it wasn't a person in the front. It was like a buzz up and you hit the buzzer and the buzzer would ring our phone and we'd have to answer the phone, hit zero to let them in.

And it got super annoying during lunch delivery hours.

So we ended up hooking it up with Twilio and a worker that would kind of like automatically answer the phone from Twilio, dial back zero and kind of let people into our door.

It was all controlled with Slack, Slack bot that kind of pinged workers to determine if the door should be allowed to open or not.

So that was really cool as well.

That was more of a fun internal project. I think you could build a similar mechanism for informing whoever is managing the stations for the pickup of PPE to get notified when someone's there to pick them up.

That'd be cool to like tie it into like text messaging, like automated text messaging or something like that.

You could have it totally serverless, right? You could have it all running on workers tied into Twilio.

Yeah, that'd be really interesting to do.

You could, you could even tie it to the Google sheets they use to manage everything when they like check a box and a column or something that triggers some kind of webhook to the worker.

Right. Yeah. Keep better track of stock as a result.

One of the things that I thought was really interesting in the beginning of COVID was in my Twitter, which is primarily I follow a lot of tech people.

And so some people are making the comparison of COVID is like DDoS, a distributed denial of service system on our medical system, which I thought was so interesting because most of the time when we try to explain distributed denial of service attacks in layman's terms to people, we kind of use the real life equivalent of it, right?

Which is something like, oh, imagine like a virus overwhelms the hospitals or, yeah, those types of analogies.

So I thought it was very interesting that it got reversed.

I mean, it's exactly like a DDoS, just my understanding from Emily and from others.

It's exactly like a DDoS. If you had that same amount of traffic on a server, but spread across a month, almost any server could handle it, right?

But if you kind of do that volumetric type request in a short period of time, the server gets overloaded.

It seems like that's the same issue with the hospitals.

Emily, I'm interested from your perspective with Throne, the word workers around so many times, do you feel like you know what that is?

No idea. That's great.

You got to teach us about so much about the medical field. So maybe I don't know.

Matt, do you want to take this one, maybe? Yeah, I think. Is there an analogy?

Is there a hospital analogy I can use? All right. So the best analogy I can use here is most websites are like if there was one hospital just in New York City and every single person needed to travel to New York City, do whatever they needed to get done and go back.

But 99% of those requests are going to be similar. And so imagine if you had a physician's assistant or an N.P.

or something in every city around the world.

And they're not just I mean, they know what they're doing, right?

They're not just kind of like guessing people. But imagine if the vast majority of medical requests could be kind of handled by those N.P.s kind of distributed around the world.

And yes, every so often, maybe you need to go back to New York City for some very difficult request or something.

That's what workers really gives you, right?

That is happening now. So that is what happens now with urgent care centers and facilities being staffed by N.P.s and P.A.s, if I'm understanding that right.

Actually, yeah, it is like urgent care centers. That's exactly right.

Because I go to urgent care all the time for like little things. He's laughing because you do go to urgent care all the time.

I know, my son has to go to urgent care all the time.

But it's exactly like that. It lets you kind of push logic out to the edges, out to all these kind of different localized areas.

Run that logic without necessarily overwhelming or running it all in your kind of one central hospital or one central database system.

Rita, what did you think of that metaphor? I thought that was awesome.

I guess it's up to Emily to tell us whether she ‑‑ Emily, do you have a better understanding of what workers is as a result of that?

Still no.

Still no. I feel like we've actually tried to discuss this before. We spent four hours last night.

I explained it so many times. All right.

Let me have another stab at it. I don't know if I have a good metaphor. But basically when you go to a website, right, it's hosted on a server somewhere.

And most of that time it's a physical server and it's literally placed in a location in a data center somewhere.

If you live on the east coast of the United States, you're pretty lucky because a lot of the time these like server farms are in Virginia somewhere.

But if I live on the west coast or I live in Europe or somewhere else, we haven't figured out a way to beat the speed of light.

So websites are going to be slower.

But even more importantly in this case, what also can happen is if the server gets a ton of requests, which is what happens when a ton of people visit it, it might crash.

Just like the hospital. And so what workers is is Cloudflare has a network of data centers around the world.

So instead of like a single centralized data center, there's a data center in New York and there's a data center in Boston and there's a data center kind of all over the U.S.

and all over the globe. And so that way requests can kind of get handled, I guess, in their regional care centers or by NPS as Matt mentioned before.

Occasionally they might have to go to the central location, but most of the time they can get served directly from the data center that's nearby.

Does that make more sense?

Sure. I have an idea in my head. Was this on Silicon Valley? I think what's interesting is that even if you went back a couple of years, like those kind of points of presence around the world, they were only able to handle static content.

So imagine in this medical world that, you know, if you had urgent care centers, but it was just they really couldn't handle anything.

So you go in and they tell everybody that comes in, oh, take Advil.

Like that was it. And if take Advil was the right move, that's fine.

But for everybody else, it couldn't do that logic.

I think what Cloudflare is really building with workers is smarter points of presence.

That they don't just say take Advil, but they can actually do some of that logic and some of that treatment and some of that analysis on the edge.

So it's more and more efficient after there.

Maybe our metaphor is getting a little stretched, but I feel like...

I get that. That sounds good to what you're explaining.

If you could do that in health care, that would be great too. That's what Mask of Heroes should be next.

We should invent. We should do that. Cloudflare workers for health care.

The next step is the robot who takes my job in the operating room, giving propofol for procedures.

So if you can, you know, figure that out on Cloudflare also.

Hopefully Cloudflare doesn't take my and your jobs.

I don't think that... Remember me.

If you try to take my job, just remember me from way back when. Remember when we...

Emily, you got 30,000 masks distributed. That's true. So you're good. We'll remember that.

Yeah, we'll definitely remember that. It's not in our plans to displace you guys.

Although I do find it a little funny that the name of the product is called workers.

And yeah, they are definitely, as much as I like to talk about them and work on them every day, they're the least essential probably of the workers that we have out there helping us out and getting us through this.

Emily, you and your coworkers are saving lives. We're just building websites.

But websites are important to help us save lives.

So thank you for that. All right. Well, we have a few more minutes left.

So I'm going to see if there are any questions that have come in.

There were no questions until we started the metaphor.

You have a lot of questions. No one has questions.

We explained everything so well. Yeah, really great job.

I was hoping people would have some medical questions.

I know for me, one of my friends is a doctor in San Antonio.

So every time we get to chat, I'm just like, my world is staring at a computer screen every day.

So any details about the medical world and what exactly is going on there day to day, I find really, really interesting.

So if you have any anecdotes to share with us, we will really gladly accept that too.

I mean, I'll just add in that I think that, and I touched on it before, but in a hard time, people really came together, especially in my department and hospital and the state and the country.

Everyone really came together to help each other out in the trying time.

It's very emotional in the hospital, especially a few months ago where patients were dying left and right.

And there were patients everywhere and there were emergencies all the time.

And it was extremely stressful physically and emotionally.

Physically, wearing PPE all day long is exhausting and dehydrating.

And wearing the mask and the whole thing, it really takes a toll on you.

And then emotionally seeing these people, not to mention all the patients are by themselves in the hospital.

And you as physicians, nurses, anyone else in the hospital, really the only ones they get to speak to and see.

And you really take a big role in them. And you see people reaching out and sitting with patients and giving their phones so that they can FaceTime with their loved ones.

And helping each other when you're just having a hard day or a hard patient or something bad just happened.

And you just need to take a moment, go back and you see everyone comforting each other and being there for each other.

And helping each other out is really heartwarming in a terrible, awful, awful time in our world.

To look at one silver lining of everyone coming together to support each other and be there for each other.

I feel like such an important part of patient care is building that interpersonal relationship and making the patient feel comfortable in their most vulnerable moment.

Has that been harder? I feel like so much of communication is your facial expressions.

Is it harder with a mask on?

Yeah, no, you have a really good point. It's hard to see. I actually had suggested a few times with all the things, you have no idea what the person looks like.

So some people have taken to printing out pictures, making kind of a big ID so that you can see who you are underneath all the gear.

I know there were some images, I think, of physicians in Israel who were doing that.

And I have seen some people around the hospital do that.

But I agree, it is super important to be able to see your face and facial expressions.

I know I had seen some things online of masks that were clear so that you can see your mouth.

But it definitely is a different relationship that you have.

It's also extremely hard to hear anyone in a mask if you've tried to have a conversation.

So it does make communication and having that relationship more difficult.

And not being able to touch people, you know, we just put your hands on their shoulder, even shake hands, we don't do anymore.

But sometimes I forget, you know, you'll stick your hand out to introduce yourself.

Oh, wait, I would, you know, can't do that anymore. It is, it's less personal.

It's comforting to hear the doctors do the, try to shake your hand.

I do it sometimes. You forget sometimes. And I mean, I wish I could, you know, get rid of what's going on now.

But you forget what's happening and just say, oh, wait, I can't do that.

I can't put my arm around you or hug you or the things that we used to do.

Is there anything else other than donating masks that people at home can do to help?

We have a couple of minutes to wrap up. What would be the message that you send out to everyone that's watching this?

Well, if anyone wants to go to our website, it's maskaherony.com to visit our website.

You can follow us on Instagram at help mask a hero and why or hashtag mask a hero.

If you have anything to donate, that would be great.

If you want to donate money, maskahero.com, which is a parent organization centered in North Carolina, run by Dr.

Lakeisha LeGray. You can donate money. But I think otherwise really work on protecting yourself and others to stop the spread.

Wear a mask, wash your hands. Be smart.

Definitely we'll do our best.

All right. Well, I think we are exactly at time. So thank you both so, so much again for joining us.

This is super informative for me and I'm sure so many people at home watching.

And I think that what you guys have done is incredibly inspiring.

Yeah. So thank you. Thank you for having us. Thank you.

Thank you.