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Yep - when I questioned my local health authorities guidance that if "healthy" I should take off my mask on crowded public transit and when working with the ver

Yep - when I questioned my local health authorities guidance that if "healthy" I should take off my mask on crowded public transit and when working with the very elderly (adult day health) I was told to avoid "disinformation" (in writing) and to follow surgeon general and their guidance and take off my mask on public transit and while working with the elderly. A month later they flip-flopped on that ironically. I wonder if they started to believe some of the "disinformation" that wearing masks is a low cost though imperfect way to reduce spread. I've found actual scientists working with these diseases are pretty on it for logic, but folks like epidemiologists are sometimes totally horrendous. Is epidemiology less rigorous then other infectious disease educational tracks?

Enginerrrd 6y ago
Honestly, the answer to the question "is field x less rigorous" is almost universally no. Some fields tend to attract smarter people than others, but that doesn't mean there aren't very smart people in pretty much every field who are doing good work and exploration at depth. For this question I think that beyond the politics and what was a deeply ill-advised strategy for managing a limited resource (masks), it may also have to do with the type of studies they tend to use and give authority to. The scientists you're talking about probably are looking at smaller scale things where plausible mechanisms are investigated and confirmed. Epidemiologists though have many examples in their toolkit where such common sense findings don't extrapolate to population level interventions. For whatever reason, epidemiology doesn't seem to embrace a more bayesian approach where you operate with a good guess and try to revise it as you learn more. They tend to stick to confirmed models.
dmurray 6y ago
Epidemiology during a pandemic is about one part science to three parts PR. Sending a consistent message to the public and getting them to change their behaviour at all is more important than getting the details right. In the case of masks, the WHO decided early on that masks for the public were of limited use in slowing coronavirus spread: they'd stop some infections but could be detrimental if misused and could threaten the supply to medical professionals. This was a reasonable conclusion at the time. To communicate that to the public, the party line was: masks no good. Many national organisations took their cue from the WHO. Now the risk/reward tradeoff has shifted: better research shows that masks, even ersatz ones, are good and the supply lines for professionals have improved. So the message has to change: masks good. The actual scientists know that it's not black and white, but pretending it is is a useful tool for health organisations. At some point I expect we'll see a flip-flop on the party line that "there is no evidence that covid-19 infection confers immunity against future infection". It's nonsense - there are hundreds of years of circumstantial evidence - but it's just about defensible in that there haven't been any sufficiently powerful blinded trials to directly demonstrate it specifically for Covid-19. Once it's deemed to be in the public good, they'll accept some study showing exposure does indeed confer immunity.
- pyuser583 6y ago
  Is it reasonable to ask the public to believe absolute messages that contradict themselves? Maybe what the boy who cried wolf meant was “I am not sure whether a wolf is in the forest. But the potential damage from a wolf a attack, combined with the increased likelihood of a wolf presence due to the observation of fresh wolf droppings, exceeds the damage from sheltering in place.” But the like the epidemiologists, simply said “There’s a wolf in the forest! Run away!”
  - dmurray 6y ago
    That's a question for the PR experts. I expect the majority of people are swayed by the absolute advice and the flip flopping doesn't damage the message too much. After all, we have always been at war with Eastasia.
    - thoraway1010 6y ago
      The flip flopping from folks who keep on saying "believe the science" is ridiculous. How can science be trusted if it has these huge flop flops within a week with really no change in underlying research?
- Tomte 6y ago
  It's not just that. In the beginning the assumption was that asymptomatic people aren't (very) contagious. That meant that contagious people would know about their status (from the symptoms) and mostly stay at home. When we found out that you can be contagious and not have a clue about it, the recommendation to wear simple "community masks" changed. The scarcity of "real masks" and the wish to save them for the health sector played into the public statements that authorities made (partly because it was a true concern, partly because it's an explanation that people understand easily). In hindsight, those statements were a mistake, because many people now think the authorities flip-flopped. They did, but because there was new information.
- mercer 6y ago
  I wouldn't be surprised if in various post-mortems we will conclude that advising against face masks even though they do 'work' was a mistake. It's understandable that our governments might advise against their use because of limited availability, but I think 'doing PR' on this issue hasn't really helped when it comes to our trust in said government in our information age. Perhaps it would have been better for the government to be honest from the start, explain that they believe masks are crucial for care workers and of relatively limited use to the rest of us, and either leave it at that, or actively disallow ownership and usage if necessary. Lying about the whole thing just feeds the flames of a public that already has a large amount of skeptics.

Enginerrrd 6y ago

Honestly, the answer to the question "is field x less rigorous" is almost universally no. Some fields tend to attract smarter people than others, but that doesn't mean there aren't very smart people in pretty much every field who are doing good work and exploration at depth. For this question I think that beyond the politics and what was a deeply ill-advised strategy for managing a limited resource (masks), it may also have to do with the type of studies they tend to use and give authority to. The scientists you're talking about probably are looking at smaller scale things where plausible mechanisms are investigated and confirmed. Epidemiologists though have many examples in their toolkit where such common sense findings don't extrapolate to population level interventions. For whatever reason, epidemiology doesn't seem to embrace a more bayesian approach where you operate with a good guess and try to revise it as you learn more. They tend to stick to confirmed models.

dmurray 6y ago

Epidemiology during a pandemic is about one part science to three parts PR. Sending a consistent message to the public and getting them to change their behaviour at all is more important than getting the details right. In the case of masks, the WHO decided early on that masks for the public were of limited use in slowing coronavirus spread: they'd stop some infections but could be detrimental if misused and could threaten the supply to medical professionals. This was a reasonable conclusion at the time. To communicate that to the public, the party line was: masks no good. Many national organisations took their cue from the WHO. Now the risk/reward tradeoff has shifted: better research shows that masks, even ersatz ones, are good and the supply lines for professionals have improved. So the message has to change: masks good. The actual scientists know that it's not black and white, but pretending it is is a useful tool for health organisations. At some point I expect we'll see a flip-flop on the party line that "there is no evidence that covid-19 infection confers immunity against future infection". It's nonsense - there are hundreds of years of circumstantial evidence - but it's just about defensible in that there haven't been any sufficiently powerful blinded trials to directly demonstrate it specifically for Covid-19. Once it's deemed to be in the public good, they'll accept some study showing exposure does indeed confer immunity.

pyuser583 6y ago
Is it reasonable to ask the public to believe absolute messages that contradict themselves? Maybe what the boy who cried wolf meant was “I am not sure whether a wolf is in the forest. But the potential damage from a wolf a attack, combined with the increased likelihood of a wolf presence due to the observation of fresh wolf droppings, exceeds the damage from sheltering in place.” But the like the epidemiologists, simply said “There’s a wolf in the forest! Run away!”
- dmurray 6y ago
  That's a question for the PR experts. I expect the majority of people are swayed by the absolute advice and the flip flopping doesn't damage the message too much. After all, we have always been at war with Eastasia.
  - thoraway1010 6y ago
    The flip flopping from folks who keep on saying "believe the science" is ridiculous. How can science be trusted if it has these huge flop flops within a week with really no change in underlying research?
Tomte 6y ago
It's not just that. In the beginning the assumption was that asymptomatic people aren't (very) contagious. That meant that contagious people would know about their status (from the symptoms) and mostly stay at home. When we found out that you can be contagious and not have a clue about it, the recommendation to wear simple "community masks" changed. The scarcity of "real masks" and the wish to save them for the health sector played into the public statements that authorities made (partly because it was a true concern, partly because it's an explanation that people understand easily). In hindsight, those statements were a mistake, because many people now think the authorities flip-flopped. They did, but because there was new information.
mercer 6y ago
I wouldn't be surprised if in various post-mortems we will conclude that advising against face masks even though they do 'work' was a mistake. It's understandable that our governments might advise against their use because of limited availability, but I think 'doing PR' on this issue hasn't really helped when it comes to our trust in said government in our information age. Perhaps it would have been better for the government to be honest from the start, explain that they believe masks are crucial for care workers and of relatively limited use to the rest of us, and either leave it at that, or actively disallow ownership and usage if necessary. Lying about the whole thing just feeds the flames of a public that already has a large amount of skeptics.