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There are clearly potential upsides (in terms of saving lives) of mandatory public mask wearing. What are the potential downsides (in those same terms)?

redis_mlc 6y ago
That's your opinion. I haven't seen anything proven yet. And "saving lives" has become the new "think of the children" excuse for irrational public policy and laws. All public policy requires a cost-benefit analysis. For example, banning cars would reduce automobile fatalities by 30,000/year in the US. But we aren't banning cars.
- seesawtron 6y ago
  We aren't banning cars because we understand the cause of automobile fatalities. There are well defined laws and regulations implemented to curtail those fatalities. But people still choose to drive irrationally, they choose to disobey those regulations, violate the speed limits, so on and so forth putting their and other's lives in danger. Going by this analogy, implementing mandatory masks is one such regulation to prevent covid infections and deaths as is implementing traffic rules to prevent automobile fatalities. Since we have not had enough time to deeply understand the spread of this virus and its affect on all of us (unlike automobile fatalities), the state has no choice but to follow the safest policy that seems to work. But, of course, you are right to question whether this policy is the best we can do or not which remains to be seen as we witness the coming months.
  - redis_mlc 6y ago
    > implementing mandatory masks is one such regulation to prevent covid infections Again, we don't know that. "Doing something, anything" is not better than doing nothing.
- blub 6y ago
  The fact that you haven't seen anything proven is not a meaningful statement. The data's there of you look. The most successful countries at fighting the pandemic are also champions at wearing masks. There's plenty of studies from the flu and SARS times showing that certain masks reduce the risk of an individual infection and any mask worn by an infected individual will reduce risk of transmission. What we don't have is a peer reviewed study that masks stop a pandemic, because such a study is incredibly hard to set up and we didn't have enough pandemics yet.
  - rurban 6y ago
    No. Masks don't explain the dramatic differences in the IFR. That's the Infection Fatality Rate. Masks only explain the R differences. Most countries are around 0.2% IFR, which you call successful, some are at around 1%. Masks just prevent infections (by about 5%), but does not influence the percentage to die when you got infected. The biggest factors (called comorbidities) for the differences are the age curve (significant drop at around >75), pre-existing conditions like diabetes, obesity, ... the effectiveness of the healthcare system, air pollution, but it could also be just two different kinds of strains. The 0.2% strain, and the 1% strain, because there's a clear geographical line between the two. At the beginning it was the 45° parallel north latitude, at the end it was the Germany/France border, 10° east longitude. The R differences on the other hand are clearly influenced by the measures: social distancing, travel restrictions, hygiene, lockdown, masks,...
    - blub 6y ago
      No... what? Because you seem to be agreeing with me that masks prevent infections. No infections, no pandemic. But I wonder where you got the 5% from, because Hong Kong, South Korea and others are doing spectacular at preventing infections compared to e.g. the US or Europe, much better than 5%.
- tonyedgecombe 6y ago
  The difference is there would be a significant cost to banning cars. The only apparent downside to masks is a little embarrassment.
vikramkr 6y ago
Not sure what terms you're talking about but in terms of a health risk of mandatory public mask wearing - the backlash from crazy people protesting with guns is a safety thread and a public health threat as those motivated to stroll up to Capitol buildings with guns by mandatory mask laws could spread the disease. More generally, anything mandatory is going to generate some personal freedom backlash. It's a big political risk.
DanBC 6y ago
Masks _might_ cause some people to reduce distancing, and they might cause some people with symptoms to stop isolating and leave home. We don't know if they do. We have good evidence that distance is important. We have poor evidence that masks work. We think masks work. They have a plausible mechanism of action, but we struggle to find benefit from the RCTs that have been done, and we have to use other statistical methods on existing data to find a benefit. We need better data for masks. https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)31142-9 https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)3...
seesawtron 6y ago
I have read arguments that unsanitary masks, for example, resuing masks without cleaning them properly (which I have been told is at +90 degees Celsius) is not a healthy practice. But to make a policy, one has to measure the risks from not wearing masks (eventual Covid infection) vs risks of wearing masks (bacterial infection). At the time of peak infection rates, it was sensible that the former risk was higher hence the policy for mandatory masks was necessary. But during current low infection rate period, policy might need to be reformed after calculating the two risks again. Hence the dissatisfactory mood of the public "For how long will this go on?" Of course then there are non-physical risks like social perception, social relationships, discomfort and so on and so forth which are more difficult to quantify.

redis_mlc 6y ago

That's your opinion. I haven't seen anything proven yet. And "saving lives" has become the new "think of the children" excuse for irrational public policy and laws. All public policy requires a cost-benefit analysis. For example, banning cars would reduce automobile fatalities by 30,000/year in the US. But we aren't banning cars.

seesawtron 6y ago
We aren't banning cars because we understand the cause of automobile fatalities. There are well defined laws and regulations implemented to curtail those fatalities. But people still choose to drive irrationally, they choose to disobey those regulations, violate the speed limits, so on and so forth putting their and other's lives in danger. Going by this analogy, implementing mandatory masks is one such regulation to prevent covid infections and deaths as is implementing traffic rules to prevent automobile fatalities. Since we have not had enough time to deeply understand the spread of this virus and its affect on all of us (unlike automobile fatalities), the state has no choice but to follow the safest policy that seems to work. But, of course, you are right to question whether this policy is the best we can do or not which remains to be seen as we witness the coming months.
- redis_mlc 6y ago
  > implementing mandatory masks is one such regulation to prevent covid infections Again, we don't know that. "Doing something, anything" is not better than doing nothing.
blub 6y ago
The fact that you haven't seen anything proven is not a meaningful statement. The data's there of you look. The most successful countries at fighting the pandemic are also champions at wearing masks. There's plenty of studies from the flu and SARS times showing that certain masks reduce the risk of an individual infection and any mask worn by an infected individual will reduce risk of transmission. What we don't have is a peer reviewed study that masks stop a pandemic, because such a study is incredibly hard to set up and we didn't have enough pandemics yet.
- rurban 6y ago
  No. Masks don't explain the dramatic differences in the IFR. That's the Infection Fatality Rate. Masks only explain the R differences. Most countries are around 0.2% IFR, which you call successful, some are at around 1%. Masks just prevent infections (by about 5%), but does not influence the percentage to die when you got infected. The biggest factors (called comorbidities) for the differences are the age curve (significant drop at around >75), pre-existing conditions like diabetes, obesity, ... the effectiveness of the healthcare system, air pollution, but it could also be just two different kinds of strains. The 0.2% strain, and the 1% strain, because there's a clear geographical line between the two. At the beginning it was the 45° parallel north latitude, at the end it was the Germany/France border, 10° east longitude. The R differences on the other hand are clearly influenced by the measures: social distancing, travel restrictions, hygiene, lockdown, masks,...
  - blub 6y ago
    No... what? Because you seem to be agreeing with me that masks prevent infections. No infections, no pandemic. But I wonder where you got the 5% from, because Hong Kong, South Korea and others are doing spectacular at preventing infections compared to e.g. the US or Europe, much better than 5%.
tonyedgecombe 6y ago
The difference is there would be a significant cost to banning cars. The only apparent downside to masks is a little embarrassment.

vikramkr 6y ago

Not sure what terms you're talking about but in terms of a health risk of mandatory public mask wearing - the backlash from crazy people protesting with guns is a safety thread and a public health threat as those motivated to stroll up to Capitol buildings with guns by mandatory mask laws could spread the disease. More generally, anything mandatory is going to generate some personal freedom backlash. It's a big political risk.

DanBC 6y ago

Masks _might_ cause some people to reduce distancing, and they might cause some people with symptoms to stop isolating and leave home. We don't know if they do. We have good evidence that distance is important. We have poor evidence that masks work. We think masks work. They have a plausible mechanism of action, but we struggle to find benefit from the RCTs that have been done, and we have to use other statistical methods on existing data to find a benefit. We need better data for masks. https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)31142-9 https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)3...

seesawtron 6y ago

I have read arguments that unsanitary masks, for example, resuing masks without cleaning them properly (which I have been told is at +90 degees Celsius) is not a healthy practice. But to make a policy, one has to measure the risks from not wearing masks (eventual Covid infection) vs risks of wearing masks (bacterial infection). At the time of peak infection rates, it was sensible that the former risk was higher hence the policy for mandatory masks was necessary. But during current low infection rate period, policy might need to be reformed after calculating the two risks again. Hence the dissatisfactory mood of the public "For how long will this go on?" Of course then there are non-physical risks like social perception, social relationships, discomfort and so on and so forth which are more difficult to quantify.