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I disagree. I think the CDC did actually perform a cross-benefit analysis on masks during the initial segment of the outbreak. Given the not-incontrovertible, y

I disagree. I think the CDC did actually perform a cross-benefit analysis on masks during the initial segment of the outbreak. Given the not-incontrovertible, yet positive, efficacy of masks, combined with the implications of a PPE shortage for healthcare workers meant that there probably was a calculated decision made to not recommend masks. Though at this point, without some more transparency, I'm not sure what we can say about the CDC's decisionmaking here.

polemic 7y ago
Potentially, but then surely a Cost/benefit analysis would strongly encourage the CDC to stockpile them in advance too? Perhaps nations need strategic PPE reserves.
roenxi 7y ago
> not sure what we can say about the CDC's decisionmaking here. We can say "gee, we should appoint more truthful bureaucrats". It isn't a crazy guess that (for this pandemic) a useful mask for a normal everyday person is anything that puts something in front of their face that makes it a little harder to breath and baffles the air currents. There may be a shortage of proven face masks but there is no shortage at all of things that could be sewn up to cover faces and deaden air currents. The cost is tiny vs the risk of it not working. Officials who are more worried about preventing a response to the potential crisis than the potential crisis should not be in charge if there is a potential crisis. We want people to change their behaviors if there is a crisis. Ideally even before the evidence in overwhelming that there is a problem.
- kd5bjo 7y ago
  The cost of recommending masks is that a large minority of people will decide they need the best mask to protect themselves, and buy them up thus depriving the healthcare workers of them. Yes, in an ideal world, the entire situation would be spelled out and only those people who are truly at higher risk would acquire some of the limited supply of more-effective masks. For that to work, however, requires a sense of community and level of trust in government that has been in short supply in the US in recent years. These factors were also in play for swine flu and the other potential pandemics the article examined CDC rsponses for. In a crisis, officials have to base their decisions on current conditions, not on what they should ideally be. Restoring trust in government is extremely important, but can’t be accomplished in the timescale necessary to be useful for this crisis.
- lonelappde 7y ago
  There isn't a coach and team in the world, real or hypothetical, who could win a football game down by 10 goals with 5minutes on the clock. The mask stuff was deck chairs on the Titanic.
wnoise 7y ago
They didn't just "not recommend" masks, they affirmatively said "don't".
- dboreham 7y ago
  They also said "and don't tell anyone that masks might be beneficial"
- nullc 7y ago
  I missed the word don't. I did see them use "not effective" which is CDC muckmuck for hasn't been proven by multiple rigorous studies to work.
  - lonelappde 7y ago
    The CDC and Surgeon General ran a campaign with the slogan "STOP buying masks". It doesn't simpler than that.
    - stevenwliao 7y ago
      Agreed. There's a difference between "stop buying masks because we need to save them for nurses" and "stop buying masks because they don't help at all*". Lying erodes public trust.
mattmanser 7y ago
They cover this argument in the article.
breischl 7y ago
TFA actually mentioned that point specifically, if you read it... > I went into it thinking they’d lied to us, hoping to prevent hoarders from buying up so many masks that there weren’t enough for health workers. Turns out that’s not true. The CDC has been singing the same tune for the past ten years. Swine flu, don’t wear masks. SARS, don’t wear masks. They’ve been really consistent on this point. But why? Quoted text included this link: https://slatestarcodex.com/blog_images/masks_cdc.png https://slatestarcodex.com/blog_images/masks_cdc.png
- Karrot_Kream 7y ago
  That's very weak reasoning, and I felt it was more musing than anything else. What evidence do we have for it not to be true? Why do we think consistency with previous advice trumps scientific evidence here? It feels like a cop-out to rule out a cost-benefit analysis simply because this advice mirrors advice in the past.
  - Noumenon72 7y ago
    It's actually the strongest form of logical reasoning, a formally valid argument. This argument is true no matter what you substitute for A and B: * You said X did A only because of situation B. * But X does A even in situation not-B. * Therefore, situation B is not a necessary condition to cause A. The only way to rescue "mask shortage" as causing the WHO's advice is if you can show that whatever caused the advice last time was missing this time, so the WHO was primed to reverse the advice until "mask shortage" brought it back to do the same advice again.
    - Karrot_Kream 7y ago
      > It's actually the strongest form of logical reasoning, a formally valid argument Garbage In, Garbage Out. You are making several assumptions in order to apply this "logical" (which logic? This isn't FOL, since FOL has no concept of time, so I'm guessing you're invoking some Temporal Logic) argument, you need to assume that the CDC is a static, homogeneous organization that, for the purposes of this statement, continues to be a valid X between the past and the present. This seems naive to me; the CDC has changed in funding, priorities, membership, and leadership over time, and it's unclear to me how you can use past behavior as an indicator of future communication.

polemic 7y ago

Potentially, but then surely a Cost/benefit analysis would strongly encourage the CDC to stockpile them in advance too? Perhaps nations need strategic PPE reserves.

roenxi 7y ago

> not sure what we can say about the CDC's decisionmaking here. We can say "gee, we should appoint more truthful bureaucrats". It isn't a crazy guess that (for this pandemic) a useful mask for a normal everyday person is anything that puts something in front of their face that makes it a little harder to breath and baffles the air currents. There may be a shortage of proven face masks but there is no shortage at all of things that could be sewn up to cover faces and deaden air currents. The cost is tiny vs the risk of it not working. Officials who are more worried about preventing a response to the potential crisis than the potential crisis should not be in charge if there is a potential crisis. We want people to change their behaviors if there is a crisis. Ideally even before the evidence in overwhelming that there is a problem.

kd5bjo 7y ago
The cost of recommending masks is that a large minority of people will decide they need the best mask to protect themselves, and buy them up thus depriving the healthcare workers of them. Yes, in an ideal world, the entire situation would be spelled out and only those people who are truly at higher risk would acquire some of the limited supply of more-effective masks. For that to work, however, requires a sense of community and level of trust in government that has been in short supply in the US in recent years. These factors were also in play for swine flu and the other potential pandemics the article examined CDC rsponses for. In a crisis, officials have to base their decisions on current conditions, not on what they should ideally be. Restoring trust in government is extremely important, but can’t be accomplished in the timescale necessary to be useful for this crisis.
lonelappde 7y ago
There isn't a coach and team in the world, real or hypothetical, who could win a football game down by 10 goals with 5minutes on the clock. The mask stuff was deck chairs on the Titanic.

wnoise 7y ago

They didn't just "not recommend" masks, they affirmatively said "don't".

dboreham 7y ago
They also said "and don't tell anyone that masks might be beneficial"
nullc 7y ago
I missed the word don't. I did see them use "not effective" which is CDC muckmuck for hasn't been proven by multiple rigorous studies to work.
- lonelappde 7y ago
  The CDC and Surgeon General ran a campaign with the slogan "STOP buying masks". It doesn't simpler than that.
  - stevenwliao 7y ago
    Agreed. There's a difference between "stop buying masks because we need to save them for nurses" and "stop buying masks because they don't help at all*". Lying erodes public trust.

mattmanser 7y ago

They cover this argument in the article.

breischl 7y ago

TFA actually mentioned that point specifically, if you read it... > I went into it thinking they’d lied to us, hoping to prevent hoarders from buying up so many masks that there weren’t enough for health workers. Turns out that’s not true. The CDC has been singing the same tune for the past ten years. Swine flu, don’t wear masks. SARS, don’t wear masks. They’ve been really consistent on this point. But why? Quoted text included this link: https://slatestarcodex.com/blog_images/masks_cdc.png https://slatestarcodex.com/blog_images/masks_cdc.png

Karrot_Kream 7y ago
That's very weak reasoning, and I felt it was more musing than anything else. What evidence do we have for it not to be true? Why do we think consistency with previous advice trumps scientific evidence here? It feels like a cop-out to rule out a cost-benefit analysis simply because this advice mirrors advice in the past.
- Noumenon72 7y ago
  It's actually the strongest form of logical reasoning, a formally valid argument. This argument is true no matter what you substitute for A and B: * You said X did A only because of situation B. * But X does A even in situation not-B. * Therefore, situation B is not a necessary condition to cause A. The only way to rescue "mask shortage" as causing the WHO's advice is if you can show that whatever caused the advice last time was missing this time, so the WHO was primed to reverse the advice until "mask shortage" brought it back to do the same advice again.
  - Karrot_Kream 7y ago
    > It's actually the strongest form of logical reasoning, a formally valid argument Garbage In, Garbage Out. You are making several assumptions in order to apply this "logical" (which logic? This isn't FOL, since FOL has no concept of time, so I'm guessing you're invoking some Temporal Logic) argument, you need to assume that the CDC is a static, homogeneous organization that, for the purposes of this statement, continues to be a valid X between the past and the present. This seems naive to me; the CDC has changed in funding, priorities, membership, and leadership over time, and it's unclear to me how you can use past behavior as an indicator of future communication.