19 ms·

The science of mask-wearing hasn’t changed, so why have our expectations?

107 points by hooloovoo_zoo 6y ago

TACIXAT 6y ago
This seems like it is casting uncertainty when there is really good evidence that wearing masks is effective. https://www.theguardian.com/commentisfree/2020/apr/04/why-wear-a-mask-may-be-our-best-weapon-to-stop-coronavirus https://www.theguardian.com/commentisfree/2020/apr/04/why-we...
- aahhahahaaa 6y ago
  It's effective but it sounds like the fear is that the effectiveness is overhyped (says this specifically in the article)... and I think that's a valid concern. If everyone thinks they can go out wearing a mask and forget about distancing and other measures, then that complicates things. Wearing a mask to go grocery shopping for 20 minutes is also different than say, wearing a mask and sitting in a theater or bar for 2 hours.
  - watwut 6y ago
    The actual fear should be from people who dont wear masks, dont wash hands and generally act like covid-19 is a hoax. It does not even matter whether the non-mask wearer is not wearing it because he believes mask is not effective, mask is not needed due to covid not existing or mask is sign of being fearful and one gotta project bravery. Mask wearer who skipped washing hands once or approached someone 1.5 meters is still good.
    - timr 6y ago
      "The actual fear should be from people who don't wear masks" I don't understand this. The actual fear should be any form of scientific misinformation. Eventually, the truth will be known, and if "scientists" are deemed to be advocating for policies that aren't supported by science, it will hurt science in the long run. On top of this, there is decent reason to believe that there's a down-side to mask laws: too many people think that they can behave normally if they're wearing a mask, when the evidence simply doesn't support it.
      - BolexNOLA 6y ago
        >On top of this, there is decent reason to believe that there's a down-side to mask laws: too many people think that they can behave normally if they're wearing a mask, when the evidence simply doesn't support it. I have seen this repeated many times but have not seen any evidence that really supports it. It just sounds like a common behavior. I would imagine the cross-section of people who are already going to act like it wasn’t a big deal and people who wear a mask that act like it’s not a big deal is already substantial. And while I also don’t have any data, I think it is as common sense as the other assumption and thus illustrates my point.
        noodlesUK 6y ago
        Anecdotally, people give you a fair bit more space when you’re wearing a mask and clearly taking precautions than if you aren’t. I’d argue that in the current political climate, mask wearing might actually improve distancing measures. The people who aren’t wearing masks just don’t seem to give a shit. It’s a social signal about if you care about covid these days. I’m saddened that we can’t just make tonnes of melt blown and make n95s (that imo are more comfortable than normal masks cause they aren’t touching your lips) for anyone who wants them.
        runnr_az 6y ago
        For what it’s worth, thus seems correct in my experience. I expected people to just throw on masks and behave “normally,” but the opposite seems to have happened - it serves as a reminder of the seriousness of the situation.
        Wowfunhappy 6y ago
        Also an anecdote, but I know many people IRL who have said "The reason we should be able to open back up is everyone knows to wear a mask now." That doesn't mean people shouldn't wear masks, but... it's definitely the wrong takeaway.
      - watwut 6y ago
        > On top of this, there is decent reason to believe that there's a down-side to mask laws: too many people think that they can behave normally if they're wearing a mask, when the evidence simply doesn't support it. But you are just making that one up. You don't have studies showing people wearing masks taking more risk than non-masks wearing people. Also, the scientists talk about effectiveness of masks it is not like I had seen a single one claiming it is perfect. This whole argument is just being manipulative. Trying to pretend it is all about science and precision, when it is nothing like that.
  - bitexploder 6y ago
    Also, well fitted N95 style masks are very different from a loose mask around the face.
    - BolexNOLA 6y ago
      Still makes a world of difference though, especially because your mask (unless N95) isn’t for you as much as it’s for others. If two people interacting are both wearing - even loose fitting - cloth masks over their nose and mouth, the chance of spreading disease is orders of magnitude less.
      - gridlockd 6y ago
        We do not actually know that. That is the point.
        cjbenedikt 6y ago
        We actually DO know that
        gridlockd 6y ago
        Well, then where is the scientific evidence that simple masks reduce chance of spread by an order of magnitude, as described? There is none, because the science hasn't been done. There's a viral JPEG on the internet that claims this, it's just that. If we don't have that evidence, the we don't really know, plain and simple. That's not to say people should stop wearing masks. It's plausible that they help. It's just that we don't know the extent to which they help.
        cjbenedikt 6y ago
        Widespread Use of Face Masks Could Save Tens of Thousands of Lives - https://www.npr.org/2020/07/03/886905055/widespread-use-of-face-masks-could-save-tens-of-thousands-of-lives-models-projec https://www.npr.org/2020/07/03/886905055/widespread-use-of-f...
  - Spooky23 6y ago
    Masks have always been controversial, but I think what we have seen in terms of outcomes in the NY/NJ/CT area shows that they likely have some effect. Usually the studies that knock masks compare them against people following good hand washing protocol. Mask vs. person with good hygiene is different than the typical slob you find on the street.
- superkuh 6y ago
  There's no uncertainty that unfit around the nose masks have giant centimeter squared open gaps. For protection of the wearer they're not good. Objectively in tests with similar gaps the rating is N30-N40. There needs to be a strong and lasting push for increased N95 mask production or at least purchasing. Pretending that ineffective unfit masks (of any material!) can fill the role of real masks does real damage and needs to stop. If everyone could rotate a set of N95 masks when indoors then spread could really be stopped. Even a synthetic/cotton/synthetic mask would be quite effective if they'd just incorporate metal nose bridge with foam.
  - SpicyLemonZest 6y ago
    Better-fitting masks made of non-woven cloth might help, but the focus on N95 and the confidence that "spread could really be stopped" by wearing them is exactly the kind of overconfidence the article warns against. There's no known evidence supporting the idea that good masks are a silver bullet.
    - watwut 6y ago
      N95 is what doctors wear to generally not get sick while working. Had there been enough of them, it would likely do a lot. But back to real world, cloth masks is what we got.
      - perl4ever 6y ago
        I think I've read that N95 masks are in fact inferior to other kinds for "civilians" and I don't altogether believe this is propaganda to conserve them. It makes sense, doesn't it, that N95 masks filter air coming in, not out? My impression is the valve in masks that have them is a sign that it's not protecting others from you - the point is to let air out easily. There is an asymmetry between healthcare workers and the public - in a hospital, you have one non-infected person surrounded by a lot of infected people, while elsewhere, it's the opposite. I see a lot of people wearing surgical masks, and having just googled and read a page on 3M's site, it mentions: "Surgical/procedure or “medical” facemasks are designed to help keep spit and mucous generated by the wearer from reaching a patient or medical equipment. Some surgical/procedure masks do contain filter media but as they may not be designed to form a seal to the face, and have not been certified to meet all of the performance standards of a respirator, they should not be used to help reduce exposures to airborne particles" I feel like this is a simple difference that people can't comprehend due to a very primitive equation of protecting oneself and protecting others. There is a difference and it should inform our behavior. Edit: to clarify, I meant to contrast the N95 masks with a valve, that seem to make more sense for health care workers, with the surgical masks that seem to make more sense for the public.
- timr 6y ago
  On the contrary, there's actually very little evidence that masks are effective for the general public. Particularly for cloth masks, the evidence is essentially non-existent. You're citing an article by Jeremy Howard, who is quoted in the OP, and whose opinion is directly rebutted. Michael Osterholm of CIDRAP has written a rather scathing summary of the data for cloth masks, and the political and social machinations that have gotten us where we are. He calls out Jeremy Howard as a particularly vocal spreader of scientific misinformation on the topic: https://www.cidrap.umn.edu/covid-19/podcasts-webinars/special-ep-masks https://www.cidrap.umn.edu/covid-19/podcasts-webinars/specia... (edit: how can you possibly downvote a link to a factual source that is cited in the article? Consider your bias.)
  - cmiles74 6y ago
    In my opinion, it's unreasonable to expect that there would be studies on the effects of cloth masks. Up until the quarantine began the reasonable assumption was that if you needed a mask you wore the one appropriate to your task. I don't think cloth masks were in widespread use until these masks became scarce. Maybe some studies are happening now. Even so, it probably makes more sense to encourage people to purchase more reliable masks.
    - timr 6y ago
      "In my opinion, it's unreasonable to expect that there would be studies on the effects of cloth masks." That's fine, but there are lots of plausible interventions that have little/no evidence, and we don't mandate those by law. Why this one? For example, the Lancet study commissioned by the WHO found that eye protection is about as supported by the available literature as surgical masks. Why aren't we all required to wear goggles? I believe that "science" should not be used to mandate actions that have no scientific data backing them. "it probably makes more sense to encourage people to purchase more reliable masks." The issue there is still shortages. I don't buy surgical or n95 masks, because other people need them more than I do.
      - ceejayoz 6y ago
        > For example, the Lancet study commissioned by the WHO found that eye protection is about as supported by the available literature as surgical masks. Why aren't we all required to wear goggles? Because masks are being recommended to work on outgoing virus. Unless you've evidence respiratory viruses spread significantly via jets of air emitted via your eyeballs, this is a weird argument.
- jph00 6y ago
  Thanks for sharing that article - I wrote it months ago, and there's been plenty more papers that have come out since, but there's really not much I'd change in it today. The science has only become more clear. I think the 538 article really under-states the evidence. I'm quoted in it, but only about my thoughts on the political situation. I actually pointed out to the author that the science is stronger than any other intervention we have.
  - YeGoblynQueenne 6y ago
    So you're Jeremy Howard? Hi. Someone on this thread recommended this article by yourself, on The Conversation, that I managed to miss a couple of months ago (I can't find again the post where the link to the article was given, apologies): https://theconversation.com/masks-help-stop-the-spread-of-coronavirus-the-science-is-simple-and-im-one-of-100-experts-urging-governors-to-require-public-mask-wearing-138507 https://theconversation.com/masks-help-stop-the-spread-of-co... From what I can see in the article, you were first convinced that masks should be worn after watching a youtube video. Then, having been convinced by the video you found more evidence to support your conviction. I quote from the article: The research that first convinced me was a laser light-scattering experiment. Researchers from the National Institutes of Health used lasers to illuminate and count how many droplets of saliva were flung into the air by a person talking with and without a face mask. The paper was only recently published officially, but I saw a YouTube video showing the experiment in early March. The results are shockingly obvious in the video. I have to say, this rings all manner of alarm bells. For example, a video on youtube cannot be seen as evidence of anything, even if it's from the NIH; that video could at best be seen as evidence of a likely mechanism for the spread of the virus, but evidence of a mechanism that could produce an effect is not evidence that the mechanism produces that effect; etc. In short, all this is not "strong science", even if it led to strong convictions. In any case, we all have to remember -data scientists first of all- that "data science" is not a "science" in the sense that e.g. epidemiology is a science and in a time of a public health crisis, the stage should be left clear for the relevant experts.
davesque 6y ago
What confuses me is why so much scrutiny is being placed on the practice of wearing a mask. It just hardly seems like much of an inconvenience. And common sense dictates pretty convincingly that it must have some benefit, however small. So then why so much effort into deciding if it works or not? I suppose there are two answers to that question. One, health officials want to know if masks give a false sense of security so they can spend their time promoting measures that will actually make a difference. Two, folks just want a reason to avoid the minor inconvenience or, worse, have been led to believe that mask mandates seriously impinge upon their rights. My concern is that the most common answer is the second and articles like this only serve to confuse people at a time when we need to accept that we must make small sacrifices to solve this problem.
- kencausey 6y ago
  Just in response to your comment "It just hardly seems like much of an inconvenience.": I suspect that means you are not out of shape or live in a hot humid place. I wear a mask on those very few occasions when I leave my home but it takes a while to acclimate to it each time and often when I take it off my face is wet. And don't even get me started on the pain of wearing both a mask and glasses in a humid environment. Is it a valid excuse for not wearing one? No it isn't. Edit: logic correction, I think... Edit 2: I proofread poorly.
  - lkxijlewlf 6y ago
    I'm in Fl. When I walk out of a grocery store my glasses fog up. Is that a big enough inconvenience to ask them to turn off the AC? Nah... My glasses don't fog up nearly so much as that by simply wearing a mask; little bit on some exhales. So, given the benefits to others, I'm okay with it.
- krapp 6y ago
  >So then why so much effort into deciding if it works or not? FUD around masks and their effectiveness is being deliberately spread by people and groups with a political agenda, primarily through disinformation campaigns on social media. This isn't an entirely organic phenomenon.
prox 6y ago
So what is needed to get to that certainty? What research is being done or must be done?
- cmiles74 6y ago
  Should we even bother, now that masks are becoming easier to purchase?
  - lolc 6y ago
    Given that we're heavily inconvenienced by the masks and other measures, we should find out how well they work so we can focus on the stuff that helps the most.
- jjgreen 6y ago
  No need, mask wearing is not a matter of science, it is theology; would you ask for a proof of God's existence?
- cma 6y ago
  Crowded Brooklyn bridge and other areas during during Floyd protests: lots of mask usage, no uptick in cases. It could just be that outdoors in sunlight is relatively safe though and that had a bigger effect than the masks. Or just even though it looked like huge packed crowds it was still tiny relative to NYC population.
deleted 6y ago
[deleted]
stri8ed 6y ago
I would like to see more discussion around, if the initial viral load is related to the severity of the infection[1]. If yes, then in theory, a mask could provide large benefits, even in absence of a perfect seal around the face. [1] https://www.lesswrong.com/posts/3ArEA7tHDXQxE6PED/taking-initial-viral-load-seriously https://www.lesswrong.com/posts/3ArEA7tHDXQxE6PED/taking-ini...
- credit_guy 6y ago
  Absolutely. The initial disinformation campaign by the western governments (and the CDC and the WHO) that masks are useless for their wearer (due to the shortage of masks, and the fear they won't be enough for the health care personnel) has long lasting effects. That was an abject lie, and people have paid with their life for that. The governments now don't know exactly how to turn around and communicate that yes, masks are useful, we've been lying to you all this time, sorry for that, now you can go ahead and wear some. You can't do an 180 like that, can you? So for now it's "masks are good for the others, but they won't help you. but don't you want to be a good team player?".
  - nefitty 6y ago
    What is stopping individuals from holding a nuanced understanding of politics similar to this comment?
    - JMTQp8lwXL 6y ago
      Indoctrination to their social circle (family, friends, etc). You'll become an outsider by expressing opposing opinions.
lurquer 6y ago
Fluids flow through the path of least resistance. A loose-fitting mask is uttterly worthless, as the air you are breathing does NOT go through the cloth. (Of course, even if it did, it wouldn't 'filter' out a virus.) Sneezing and coughing? That's not what the masks are for. If you are sneezing through your mask -- and continuing to wear it -- you're a sick pig. And, if you claim you carry around enough masks to change it whenever you sneeze, you're a liar. Looose-fitting masks are nothing more than a virtue-signaling placebo
- augustt 6y ago
  Just wear the fucking mask. Ever been hit by spittle in the face? When you’re talking you’re spraying your mouth juices all over the place. Masks undoubtedly help reduce that.
  - jjgreen 6y ago
    This unpleasant bullying is increasingly common in these discussions.
    - mindslight 6y ago
      When 130k Americans have died due to gross ignorance and selfishness, it should be no surprise that those who are following sensible precautions have dwindling patience. Sooner or later, the US is going to have to actually buckle down and work to confront COVID-19.
  - drvdevd 6y ago
    This is actually a very important point in lieu of the linked article. In the absence of evidence, we have sometimes have to resort to common sense. The old phrase "say it don't spray it" comes to mind. We've all been there. Also, as for sneezing or coughing, I suggest actually trying it with a mask on if you doubt the efficacy of whatever mask you're wearing. I have and can tell you my shitty cloth mask blocks a significant percentage of particles from entering the air around me. I don't need science to inform me about that, I can literally just feel it with my own face.
arminiusreturns 6y ago
I just want to point out all the people who say "It's about protecting others, not yourself" or some variation are part of the problem! That can be said about the random diy cloth masks, but for everything else: The science of masks hasn't changed... N95 – Filters at least 95% of airborne particles. Not resistant to oil. Surgical N95 – A NIOSH-approved N95 respirator that has also been cleared by the Food and Drug Administration (FDA) as a surgical mask. N99 – Filters at least 99% of airborne particles. Not resistant to oil. N100 – Filters at least 99.97% of airborne particles. Not resistant to oil. R95 – Filters at least 95% of airborne particles. Somewhat resistant to oil. P95 – Filters at least 95% of airborne particles. Strongly resistant to oil. P99 – Filters at least 99% of airborne particles. Strongly resistant to oil. P100 – Filters at least 99.97% of airborne particles. Strongly resistant to oil. I've been wearing a p100 respirator that makes a good seal to protect myself, and been changing out a small piece of cloth on the out-valve to protect others. Please, stop perpetuating the myth that masks don't protect you. Of note is that while many of the higher rated masks tend to be tested at .3 microns, this is often a buffer and real world they tend to filter about .1... and the virus is said to be .12+ micron. So if you can, I would suggest getting your hands on n100 or p100, preferable use an oximeter to make sure you have the physical fitness needed to force the air through, but if you are doing very small timeframe adventures this becomes less of an issue. Something that makes a good seal is ideal. Guys, you should heavily consider shaving. There is a reason in the military NBC training they started requiring with only a few exceptions, shaves... and no, the military gas masks will not work for this application unless you get the specific filters for this application (if you do, they would be great since they integrate the eyepro), which have a much wider ranger to select from than the above I reference... note: it is also very important to verify you haven't been sold a fake product https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/default.html https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part...
- nickthemagicman 6y ago
  Airflow follows the path of least resistance. Air and the particles in it will go around the edges of the mask where there is zero resistance.
  - 6y ago
woodandsteel 6y ago
This article has some interesting points, but overall it is click-bait. The recommendation at the end is, “We don’t know how well cloth masks work, so distancing should come first, but masks are likely to work to some extent and not everyone can distance themselves.” But for most of the article it talks as if the whole matter is so uncertain no recommendation can be made. Anyway, the whole idea that we should wait until the science is all settled before we make policy decisions is quite impractical. We are learning as we are fighting the epidemic, and so we have to make decisions before we have full evidence. Indeed, the only way we can learn if masks work to help stop the epidemic is to have some countries mandate them and compare the results with countries that don't. Epidemics are very different than individual diseases. You have to make decisions at the group level, and when it is a new disease you have to do so without really good understanding. And we know that the countries that have pursued a whole set of rigorous policies that includes face masks have been successful, while countries that are lax, include face masks, have failed. So the smart thing to do is pursue the set of policies that includes face masks, and later on find analyse the data and find out exactly how important they are.
whoopdedo 6y ago
When is a mask not a mask? The CDC does and does not recommend: -- A filtered breathing apparatus. -- or A sterile medical mask. -- or A disposable paper mask. -- or A reusable cloth face covering. Each of those serves a different purpose. Some are meant to protect a healthy wearer from sick people around them. One of the others is for a sick person to avoid spreading their disease to others. Or a combination of protecting both wearer and nearby people, but with different risk factors. Add to it that they have different costs and conditions of use. But we cover all these use cases under one broad description of "mask". Is there any wonder people are confused?
drummer 6y ago
Not only do masks not protect you but they are also a potential health hazard. Oxygen levels behind the mask are lower which results in shortness of breath and headaches for many people. A quick duckduckgo search shows what the impact of low oxygen is on the brain. Apart from that people keep touching their masks and handling them in the wrong way which might even increase their risks of getting sick. If you've ever seen a surgeon putting on his masks and gloves, you'll note that assistants put those on for him; touching it himself would risk contamination. So the whole masks thing is just a false sense of security in the worst possible way.
- lkxijlewlf 6y ago
  I was at the grocery store earlier and, man, within 10 minutes I started seeing people dropping to the floor struggling to breath! It was cra-cra! I ran around tearing their masks off, yelling, "Breath! Breath!" Some, sadly, I was too late.
- ceejayoz 6y ago
  > Oxygen levels behind the mask are lower which results in shortness of breath and headaches for many people. This is false; anyone with a $30 pulse oximeter can disprove it. I've checked my oxygen levels; there are a bunch of videos of healthcare workers demonstrating it has no impact. > If you've ever seen a surgeon putting on his masks and gloves, you'll note that assistants put those on for him; touching it himself would risk contamination. If you're not slicing into the interior of a human, this is significantly less of a concern.
- drummer 6y ago
  Might want to check this https://m.youtube.com/watch?v=hyENddY1NbM https://m.youtube.com/watch?v=hyENddY1NbM
nateberkopec 6y ago
It's been really interesting to watch this pandemic from Japan, where I've been for the last ~3 months. I am an American citizen. Walking around Tokyo this week I'm still seeing mask rates of >95%. Lockdown ended about 2 weeks ago. In America, mask-wearing carries a different set of social signals. It seems that not wearing a mask is perceived, by some, as a signal of one's virility and freedom. The article makes this all pretty clear, but the comments here are getting bogged down in "but the data says masks are/aren't effective". The point is that the data doesn't matter. Mask-wearing is determined by social/political expectations and signaling, not by data. If a study came out tomorrow that said mask-wearing reduces transmission by 95%, Trump still wouldn't wear one. Looking for a silver bullet study to prove a point either way is a waste of time at this juncture. Apparently, asking Americans to show that they care about the health of another American via a very low-impact signal (the $10 it costs to get/make a mask, the minor inconvenience of wearing one) is too much. How can a society solve any size of a problem when it cannot be bothered to put a piece of paper or cloth on their face for the possible benefit of another? If your political climate makes such a minor gesture controversial, how will you solve any meaningful issue where your factions disagree? How do you get Americans to care about the health and welfare of other Americans?
- trynewideas 6y ago
  since "looking for a silver bullet study to prove a point" is the only thing fivethirtyeight has left, it should probably just stop now
- aliante 6y ago
  > How can a society solve any size of a problem when it cannot be bothered to put a piece of paper or cloth on their face for the possible benefit of another? A friend's mother will tell anyone she encounters who is wearing one that they are a ninny and a coward. So for some people it is also an indicator of courage/weakness.
- HeyZuess 6y ago
  > Walking around Tokyo this week I'm still seeing mask rates of >95%. Lockdown ended about 2 weeks ago. I currently live in Asia and have been for many years, I am from a western country. I think in Asia, face masks are just a fact of life, including pre-covid. There is/was an expectation that if you are sick, then you should probably wear a mask. Given that a lot of cities are crowded, many wear masks also not to get sick. As a westerner, I understand the negative connotations of wearing a mask, it is not a part of "normal life" in many countries. But life has changed, people should get used to it. Americans should just look at the stats to know that there is a problem. This isn't an attack on their freedoms, it is an attempt not to save their life, but the life of a fellow American, by preventing the spread. While China may have been the epicenter of the virus, the spread is the responsibility of the citizens of the secondary country.
corny 6y ago
From an outsider perspective (I'm Canadian), the politicalization of wearing a mask seems like a huge distraction from action that can make a much bigger difference: * staying home when even a little bit sick * physical distancing (esp. indoors) * hand washing * don't touch your eyes, nose, mouth with unclean hands * getting tested if having symptoms * if physical distancing is not possible, then wearing a mask (esp. indoors) I kind of worry that in a desperate attempt to improve the economy, US governments will continue to ignore the advice of experts and embrace mask-wearing as a panacea.
- SpicyLemonZest 6y ago
  US governments have to deal with the fundamental problem that the US public doesn't want to physically distance anymore. They want to gather with friends and family, eat in restaurants, drink in bars, even hold large public gatherings for their political causes. If the government doesn't offer advice on how to do these things safely, that'll just mean they get done unsafely.
  - closeparen 6y ago
    Was it ever the plan to maintain physical distancing for the next several years? As lockdowns started, the most alarming projections had us cycling it on and off periodically. Not going cold turkey on all human interaction for the long haul.
    - SpicyLemonZest 6y ago
      Those projections called for a long initial period, long enough to drive transmission to near-zero, which hasn’t yet happened in the US.
    - dragonwriter 6y ago
      > As lockdowns started, the most alarming projections had us cycling it on and off periodically. Not going cold turkey on all human interaction for the long haul. The projected initial period of lockdown before going into cycling was longer than even the places that locked down early and reopened late had it, and that was assuming coordinated national response not many places not initially participating in the lockdown.
deleted 6y ago
[deleted]
trhway 6y ago
The CDC best estimate is that US has 20M+ covid cases right now ( https://www.nbcbayarea.com/news/coronavirus/cdc-says-covid-19-cases-in-us-may-be-10-times-higher-than-reported/2315636/ https://www.nbcbayarea.com/news/coronavirus/cdc-says-covid-1...) . That number has beem reached with all the masks wearing and lockdowns. So, what is the difference between the expectations in case of mask wearing vs. not wearing by the end of the year? Even with masks wearing and lockdowns we're probably talking about high tens of millions or even 100M for US. Can it be higher without masks and lockdowns? Spanish flu infected just under one third of total population. For covid, New York had probably reached about 2M cases (~20% of population) and the infection rate went down after that. Using that model of 20% (and NY has much higher population density) it means 70M infections for the whole US. Given how we've already reached 20M+, i think that number will be reached no matter what in a few months (give or take a bit depending on masks, lockdowns, etc.), well before wide availability of vaccine. So, it is really not about whether masks work, it is about whether it makes any noticeable difference in the current situation. I personally was for total population mask wearing, temp checking, etc. back then in Dec/Jan/Feb because back then we had a chance to stop the spread. These days i just don't see any arithmetically consistent way to avoid the described above scenario and stop the current flooding/tsunami.
- mennis16 6y ago
  The places surging right now in the US are all places where mask wearing was a controversy and many people did not wear masks. So I don't think it is fair to say that the case numbers are "with mask policy".
- adjkant 6y ago
  You assume here that NYC's numbers went down via some property of the disease, not a lockdown being observed by the whole city along with high mask usage. Letting this "run its course" would spike NYC and the whole US far above 70M cases. We would easily be looking at 500,000 dead at least even with how we've learned to decrease the death rate. That death rate would also go up as we stop flattening the curve, as we saw happen quickly with Texas. NYC has had decreasing numbers despite large outdoor protests, which had high mask usage. In a week or two there will be some numbers on how Phase II reopening is going in an area with high mask usage as well which should be another good data point. Here are some actual interesting scenario tools for controlling the virus even as it runs its course: https://ncase.me/covid-19/ https://ncase.me/covid-19/ As a note, a big factor here is that it appears that antibodies may only last for 2-3 months which breaks some of those recovery models. If that is true, without any mitigation and even with most at-risk people dying off earlier, we could still end up losing .1% - 1% of the population every 3 months until we have a treatment or vaccine. I don't like how those numbers look even if we manage to get a vaccine in 12 months.
ljlolel 6y ago
https://medium.com/p/4ef05aa357c5?source=linkShare-72308c464041-1586107578 https://medium.com/p/4ef05aa357c5?source=linkShare-72308c464...
SonnyTark 6y ago
Here in NZ, masks were never required. The rationale is that when people wear masks no matter how you explain it they believe they themselves are safe, which makes them get closer to other people (I can't give them the disease) and be less cautious in general (I'm protected). Take the mask away and the only things they have is social distancing and being obsessive about touching surfaces. Which in my experience works very well and it's what the community here focused on. In the meantime my folks in Maine wear masks and gloves and think now everything is fine we can do anything and go anywhere.
hassancf 6y ago
This is a good read “The Masks Masquerade” by Nassim Taleb of Black Swan fame: “First error: missing the compounding effect” ... “Third Error: Mistaking Absence of Evidence for Evidence of Absence” ... https://medium.com/incerto/the-masks-masquerade-7de897b517b7 https://medium.com/incerto/the-masks-masquerade-7de897b517b7
- justnotworthit 6y ago
  I liked his point that if you believe in "cause no harm" (non-agression), you should wear the mask. It raises issues in what counts as real harm/aggression (wearing clothes someone in society dislikes is technically "harm", but not a harm considered real or aggressive or... I forget the terms). Then he insults everyone who disagrees with him multiple names and accusations of bad faith (which makes serious discussion undesirable and difficult). I think that's a thing Taleb does (online).
giardini 6y ago
As timer notes in another post below, the episode "Special Episode: Masks and Science" talks about the history of masks vis-a-vis Covid-19: https://www.cidrap.umn.edu/covid-19/podcasts-webinars/special-ep-masks https://www.cidrap.umn.edu/covid-19/podcasts-webinars/specia... In this episode, Dr. Osterholm and host Chris Dall discuss the current science on COVID-19 and cloth masks. Transcript available at https://www.cidrap.umn.edu/revised-mask-transcript-6220 https://www.cidrap.umn.edu/revised-mask-transcript-6220
johndoe42377 6y ago
The "science" of mask wearing is plagued by redundant and irrelevant abstract mathematical concepts. A mask is a membrane (not perfect, of course) and this is how it must be properly modelled. It is that simple - just use proper (right) abstractions. All the sophisticated statistical extrapolations is just flawed bullshit.
deleted 6y ago
[deleted]
jakeogh 6y ago
The virus is in the same class as some common colds. It's not "going away". If people are concerned about it they should use a real mask designed to filter viruses[1]. Instead, the population is being conditioned to force medical procedures on other people. Forever. The "flatten the curve" thing was predictably re-goalposted. There are strong financial incentives to keep people irrationally in a state of fear. After this, there will be the next. This keeps getting ignored: What is the non-COVID-19 pneumonia # for 2019-2020? CDC Influenza and pneumonia deaths by influenza season and age: United States, 2008–2015: https://www.cdc.gov/nchs/data/health_policy/influenza-and-pneumonia-deaths-2008-2015.pdf https://www.cdc.gov/nchs/data/health_policy/influenza-and-pn... (these are not estimates, see the footnote) CDC #'s 2015-2016 Flu: 7,961 Pneumonia: 131,858 All: 1,769,940 [1] https://news.ycombinator.com/item?id=22232633 https://news.ycombinator.com/item?id=22232633
- corny 6y ago
  > If people are concerned about it Until more is learned about covid-19 people should be concerned. Where the disease is out of control, hospitals are filling up and many people in need of health care are suffering as a result. BTW, at least in Canada, the number of deaths due to covid-19 has been concentrated most in long-term care homes. These are also places where deaths due to pneumonia and flu are common. We're learning now that the quality of care in these homes has been insufficient to deal with covid-19. All of the measures that are now in the works to improve the quality of care in those homes should have the side-effect of reducing deaths from other infectious diseases in the future.
  - jakeogh 6y ago
    The excess death stats are accessible to us all. What's the non-COVID-19 pneumonia # for 2019-2020 so far? It's nonsensical to expect everyone to agree, those that want a mask, should use one for viruses. This is like pretending the cold is going away, and we must all obey until that happens. Wont happen. As you mention, fixing the situation of the vulnerable is the way. Quite possibly would have been better response in the first place. Viruses are only getting easier to engineer. Shutting down the country only makes them _more_ valuable.
pabe 6y ago
"Martin worried that wearing masks might lead people to feel more safe than they actually were — and make choices that increased their risk of contracting or transmitting COVID-19." - I don't see people wearing masks jumping into my face. It's people who're feeling safe for other reasons, that do. People who don't see there's a pandemic. People who think it's all made up. People who feel invincible or who're thinking they can show-off as invincible to impress others. Those people don't wear masks and throw one Corona Party after another. I'd assume that most people wearing a mask care more deeply about others than those who don't. So, wearing a mask is also a statement. And it's got almost nothing to do with politics.
xtiansimon 6y ago
> “... a public health and disease expert who is worried that mask effectiveness is being over-hyped...” Medical professionals have their own sources of information (just talk to a doctor about hand washing vs. hand sanitizer). Then I assume the concern is some members of the public are taking risks while wearing masks, thinking they are more safe than they really are? I don’t understand the concern, because if you’re really concerned about the virus you’re staying home. If you’re cavalier about the whole thing, then you’re likely standing <6feet and doing other “risky things”. And finally, for everyone else there are the simple rules. This seems totally different than, say, the controversy about the anti-malarial drug, which had severe potential side effects. What am I missing?
wdr1 6y ago
I wear a mask. I encourage all my friends to wear a mask. It's a very low cost, with large potential upside. There's no good reason not to wear a mask. But I am also interested in the pure science & am asking strictly from that point of view. Again, I am not suggesting we don't need to wear masks. I found this report on the CDC website that states: "Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza" (emphasis mine) https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article I'm aware it's for influenza & not COVID-19, but most research, including evidence suggesting we should wear masks, is based on research done on influenza. I think it's reasonable, given the paucity of COVID-19 data and we have to do something, and given they're both RNA viruses, experts feel it's reasonable as well. My conclusion from above is that while we should still definitely wears masks, it's unlikely wearing them will see a noticeable change in R0, which is what we need to really open up. I.e., opening with mask compliance probably isn't going to work, and we need people to stay home. I'm not an expert, so would to love to learn if I've got anything wrong. Thanks in advance.

107 points by hooloovoo_zoo 6y ago

This seems like it is casting uncertainty when there is really good evidence that wearing masks is effective. https://www.theguardian.com/commentisfree/2020/apr/04/why-wear-a-mask-may-be-our-best-weapon-to-stop-coronavirus https://www.theguardian.com/commentisfree/2020/apr/04/why-we...

aahhahahaaa 6y ago
It's effective but it sounds like the fear is that the effectiveness is overhyped (says this specifically in the article)... and I think that's a valid concern. If everyone thinks they can go out wearing a mask and forget about distancing and other measures, then that complicates things. Wearing a mask to go grocery shopping for 20 minutes is also different than say, wearing a mask and sitting in a theater or bar for 2 hours.
- watwut 6y ago
  The actual fear should be from people who dont wear masks, dont wash hands and generally act like covid-19 is a hoax. It does not even matter whether the non-mask wearer is not wearing it because he believes mask is not effective, mask is not needed due to covid not existing or mask is sign of being fearful and one gotta project bravery. Mask wearer who skipped washing hands once or approached someone 1.5 meters is still good.
  - timr 6y ago
    "The actual fear should be from people who don't wear masks" I don't understand this. The actual fear should be any form of scientific misinformation. Eventually, the truth will be known, and if "scientists" are deemed to be advocating for policies that aren't supported by science, it will hurt science in the long run. On top of this, there is decent reason to believe that there's a down-side to mask laws: too many people think that they can behave normally if they're wearing a mask, when the evidence simply doesn't support it.
    - BolexNOLA 6y ago
      >On top of this, there is decent reason to believe that there's a down-side to mask laws: too many people think that they can behave normally if they're wearing a mask, when the evidence simply doesn't support it. I have seen this repeated many times but have not seen any evidence that really supports it. It just sounds like a common behavior. I would imagine the cross-section of people who are already going to act like it wasn’t a big deal and people who wear a mask that act like it’s not a big deal is already substantial. And while I also don’t have any data, I think it is as common sense as the other assumption and thus illustrates my point.
      - noodlesUK 6y ago
        Anecdotally, people give you a fair bit more space when you’re wearing a mask and clearly taking precautions than if you aren’t. I’d argue that in the current political climate, mask wearing might actually improve distancing measures. The people who aren’t wearing masks just don’t seem to give a shit. It’s a social signal about if you care about covid these days. I’m saddened that we can’t just make tonnes of melt blown and make n95s (that imo are more comfortable than normal masks cause they aren’t touching your lips) for anyone who wants them.
        runnr_az 6y ago
        For what it’s worth, thus seems correct in my experience. I expected people to just throw on masks and behave “normally,” but the opposite seems to have happened - it serves as a reminder of the seriousness of the situation.
      - Wowfunhappy 6y ago
        Also an anecdote, but I know many people IRL who have said "The reason we should be able to open back up is everyone knows to wear a mask now." That doesn't mean people shouldn't wear masks, but... it's definitely the wrong takeaway.
    - watwut 6y ago
      > On top of this, there is decent reason to believe that there's a down-side to mask laws: too many people think that they can behave normally if they're wearing a mask, when the evidence simply doesn't support it. But you are just making that one up. You don't have studies showing people wearing masks taking more risk than non-masks wearing people. Also, the scientists talk about effectiveness of masks it is not like I had seen a single one claiming it is perfect. This whole argument is just being manipulative. Trying to pretend it is all about science and precision, when it is nothing like that.
- bitexploder 6y ago
  Also, well fitted N95 style masks are very different from a loose mask around the face.
  - BolexNOLA 6y ago
    Still makes a world of difference though, especially because your mask (unless N95) isn’t for you as much as it’s for others. If two people interacting are both wearing - even loose fitting - cloth masks over their nose and mouth, the chance of spreading disease is orders of magnitude less.
    - gridlockd 6y ago
      We do not actually know that. That is the point.
      - cjbenedikt 6y ago
        We actually DO know that
        gridlockd 6y ago
        Well, then where is the scientific evidence that simple masks reduce chance of spread by an order of magnitude, as described? There is none, because the science hasn't been done. There's a viral JPEG on the internet that claims this, it's just that. If we don't have that evidence, the we don't really know, plain and simple. That's not to say people should stop wearing masks. It's plausible that they help. It's just that we don't know the extent to which they help.
      - cjbenedikt 6y ago
        Widespread Use of Face Masks Could Save Tens of Thousands of Lives - https://www.npr.org/2020/07/03/886905055/widespread-use-of-face-masks-could-save-tens-of-thousands-of-lives-models-projec https://www.npr.org/2020/07/03/886905055/widespread-use-of-f...
- Spooky23 6y ago
  Masks have always been controversial, but I think what we have seen in terms of outcomes in the NY/NJ/CT area shows that they likely have some effect. Usually the studies that knock masks compare them against people following good hand washing protocol. Mask vs. person with good hygiene is different than the typical slob you find on the street.
superkuh 6y ago
There's no uncertainty that unfit around the nose masks have giant centimeter squared open gaps. For protection of the wearer they're not good. Objectively in tests with similar gaps the rating is N30-N40. There needs to be a strong and lasting push for increased N95 mask production or at least purchasing. Pretending that ineffective unfit masks (of any material!) can fill the role of real masks does real damage and needs to stop. If everyone could rotate a set of N95 masks when indoors then spread could really be stopped. Even a synthetic/cotton/synthetic mask would be quite effective if they'd just incorporate metal nose bridge with foam.
- SpicyLemonZest 6y ago
  Better-fitting masks made of non-woven cloth might help, but the focus on N95 and the confidence that "spread could really be stopped" by wearing them is exactly the kind of overconfidence the article warns against. There's no known evidence supporting the idea that good masks are a silver bullet.
  - watwut 6y ago
    N95 is what doctors wear to generally not get sick while working. Had there been enough of them, it would likely do a lot. But back to real world, cloth masks is what we got.
    - perl4ever 6y ago
      I think I've read that N95 masks are in fact inferior to other kinds for "civilians" and I don't altogether believe this is propaganda to conserve them. It makes sense, doesn't it, that N95 masks filter air coming in, not out? My impression is the valve in masks that have them is a sign that it's not protecting others from you - the point is to let air out easily. There is an asymmetry between healthcare workers and the public - in a hospital, you have one non-infected person surrounded by a lot of infected people, while elsewhere, it's the opposite. I see a lot of people wearing surgical masks, and having just googled and read a page on 3M's site, it mentions: "Surgical/procedure or “medical” facemasks are designed to help keep spit and mucous generated by the wearer from reaching a patient or medical equipment. Some surgical/procedure masks do contain filter media but as they may not be designed to form a seal to the face, and have not been certified to meet all of the performance standards of a respirator, they should not be used to help reduce exposures to airborne particles" I feel like this is a simple difference that people can't comprehend due to a very primitive equation of protecting oneself and protecting others. There is a difference and it should inform our behavior. Edit: to clarify, I meant to contrast the N95 masks with a valve, that seem to make more sense for health care workers, with the surgical masks that seem to make more sense for the public.
timr 6y ago
On the contrary, there's actually very little evidence that masks are effective for the general public. Particularly for cloth masks, the evidence is essentially non-existent. You're citing an article by Jeremy Howard, who is quoted in the OP, and whose opinion is directly rebutted. Michael Osterholm of CIDRAP has written a rather scathing summary of the data for cloth masks, and the political and social machinations that have gotten us where we are. He calls out Jeremy Howard as a particularly vocal spreader of scientific misinformation on the topic: https://www.cidrap.umn.edu/covid-19/podcasts-webinars/special-ep-masks https://www.cidrap.umn.edu/covid-19/podcasts-webinars/specia... (edit: how can you possibly downvote a link to a factual source that is cited in the article? Consider your bias.)
- cmiles74 6y ago
  In my opinion, it's unreasonable to expect that there would be studies on the effects of cloth masks. Up until the quarantine began the reasonable assumption was that if you needed a mask you wore the one appropriate to your task. I don't think cloth masks were in widespread use until these masks became scarce. Maybe some studies are happening now. Even so, it probably makes more sense to encourage people to purchase more reliable masks.
  - timr 6y ago
    "In my opinion, it's unreasonable to expect that there would be studies on the effects of cloth masks." That's fine, but there are lots of plausible interventions that have little/no evidence, and we don't mandate those by law. Why this one? For example, the Lancet study commissioned by the WHO found that eye protection is about as supported by the available literature as surgical masks. Why aren't we all required to wear goggles? I believe that "science" should not be used to mandate actions that have no scientific data backing them. "it probably makes more sense to encourage people to purchase more reliable masks." The issue there is still shortages. I don't buy surgical or n95 masks, because other people need them more than I do.
    - ceejayoz 6y ago
      > For example, the Lancet study commissioned by the WHO found that eye protection is about as supported by the available literature as surgical masks. Why aren't we all required to wear goggles? Because masks are being recommended to work on outgoing virus. Unless you've evidence respiratory viruses spread significantly via jets of air emitted via your eyeballs, this is a weird argument.
jph00 6y ago
Thanks for sharing that article - I wrote it months ago, and there's been plenty more papers that have come out since, but there's really not much I'd change in it today. The science has only become more clear. I think the 538 article really under-states the evidence. I'm quoted in it, but only about my thoughts on the political situation. I actually pointed out to the author that the science is stronger than any other intervention we have.
- YeGoblynQueenne 6y ago
  So you're Jeremy Howard? Hi. Someone on this thread recommended this article by yourself, on The Conversation, that I managed to miss a couple of months ago (I can't find again the post where the link to the article was given, apologies): https://theconversation.com/masks-help-stop-the-spread-of-coronavirus-the-science-is-simple-and-im-one-of-100-experts-urging-governors-to-require-public-mask-wearing-138507 https://theconversation.com/masks-help-stop-the-spread-of-co... From what I can see in the article, you were first convinced that masks should be worn after watching a youtube video. Then, having been convinced by the video you found more evidence to support your conviction. I quote from the article: The research that first convinced me was a laser light-scattering experiment. Researchers from the National Institutes of Health used lasers to illuminate and count how many droplets of saliva were flung into the air by a person talking with and without a face mask. The paper was only recently published officially, but I saw a YouTube video showing the experiment in early March. The results are shockingly obvious in the video. I have to say, this rings all manner of alarm bells. For example, a video on youtube cannot be seen as evidence of anything, even if it's from the NIH; that video could at best be seen as evidence of a likely mechanism for the spread of the virus, but evidence of a mechanism that could produce an effect is not evidence that the mechanism produces that effect; etc. In short, all this is not "strong science", even if it led to strong convictions. In any case, we all have to remember -data scientists first of all- that "data science" is not a "science" in the sense that e.g. epidemiology is a science and in a time of a public health crisis, the stage should be left clear for the relevant experts.

davesque 6y ago

What confuses me is why so much scrutiny is being placed on the practice of wearing a mask. It just hardly seems like much of an inconvenience. And common sense dictates pretty convincingly that it must have some benefit, however small. So then why so much effort into deciding if it works or not? I suppose there are two answers to that question. One, health officials want to know if masks give a false sense of security so they can spend their time promoting measures that will actually make a difference. Two, folks just want a reason to avoid the minor inconvenience or, worse, have been led to believe that mask mandates seriously impinge upon their rights. My concern is that the most common answer is the second and articles like this only serve to confuse people at a time when we need to accept that we must make small sacrifices to solve this problem.

kencausey 6y ago
Just in response to your comment "It just hardly seems like much of an inconvenience.": I suspect that means you are not out of shape or live in a hot humid place. I wear a mask on those very few occasions when I leave my home but it takes a while to acclimate to it each time and often when I take it off my face is wet. And don't even get me started on the pain of wearing both a mask and glasses in a humid environment. Is it a valid excuse for not wearing one? No it isn't. Edit: logic correction, I think... Edit 2: I proofread poorly.
- lkxijlewlf 6y ago
  I'm in Fl. When I walk out of a grocery store my glasses fog up. Is that a big enough inconvenience to ask them to turn off the AC? Nah... My glasses don't fog up nearly so much as that by simply wearing a mask; little bit on some exhales. So, given the benefits to others, I'm okay with it.
krapp 6y ago
>So then why so much effort into deciding if it works or not? FUD around masks and their effectiveness is being deliberately spread by people and groups with a political agenda, primarily through disinformation campaigns on social media. This isn't an entirely organic phenomenon.

prox 6y ago

So what is needed to get to that certainty? What research is being done or must be done?

cmiles74 6y ago
Should we even bother, now that masks are becoming easier to purchase?
- lolc 6y ago
  Given that we're heavily inconvenienced by the masks and other measures, we should find out how well they work so we can focus on the stuff that helps the most.
jjgreen 6y ago
No need, mask wearing is not a matter of science, it is theology; would you ask for a proof of God's existence?
cma 6y ago
Crowded Brooklyn bridge and other areas during during Floyd protests: lots of mask usage, no uptick in cases. It could just be that outdoors in sunlight is relatively safe though and that had a bigger effect than the masks. Or just even though it looked like huge packed crowds it was still tiny relative to NYC population.

deleted 6y ago

[deleted]

stri8ed 6y ago

I would like to see more discussion around, if the initial viral load is related to the severity of the infection[1]. If yes, then in theory, a mask could provide large benefits, even in absence of a perfect seal around the face. [1] https://www.lesswrong.com/posts/3ArEA7tHDXQxE6PED/taking-initial-viral-load-seriously https://www.lesswrong.com/posts/3ArEA7tHDXQxE6PED/taking-ini...

credit_guy 6y ago
Absolutely. The initial disinformation campaign by the western governments (and the CDC and the WHO) that masks are useless for their wearer (due to the shortage of masks, and the fear they won't be enough for the health care personnel) has long lasting effects. That was an abject lie, and people have paid with their life for that. The governments now don't know exactly how to turn around and communicate that yes, masks are useful, we've been lying to you all this time, sorry for that, now you can go ahead and wear some. You can't do an 180 like that, can you? So for now it's "masks are good for the others, but they won't help you. but don't you want to be a good team player?".
- nefitty 6y ago
  What is stopping individuals from holding a nuanced understanding of politics similar to this comment?
  - JMTQp8lwXL 6y ago
    Indoctrination to their social circle (family, friends, etc). You'll become an outsider by expressing opposing opinions.

lurquer 6y ago

Fluids flow through the path of least resistance. A loose-fitting mask is uttterly worthless, as the air you are breathing does NOT go through the cloth. (Of course, even if it did, it wouldn't 'filter' out a virus.) Sneezing and coughing? That's not what the masks are for. If you are sneezing through your mask -- and continuing to wear it -- you're a sick pig. And, if you claim you carry around enough masks to change it whenever you sneeze, you're a liar. Looose-fitting masks are nothing more than a virtue-signaling placebo

augustt 6y ago
Just wear the fucking mask. Ever been hit by spittle in the face? When you’re talking you’re spraying your mouth juices all over the place. Masks undoubtedly help reduce that.
- jjgreen 6y ago
  This unpleasant bullying is increasingly common in these discussions.
  - mindslight 6y ago
    When 130k Americans have died due to gross ignorance and selfishness, it should be no surprise that those who are following sensible precautions have dwindling patience. Sooner or later, the US is going to have to actually buckle down and work to confront COVID-19.
- drvdevd 6y ago
  This is actually a very important point in lieu of the linked article. In the absence of evidence, we have sometimes have to resort to common sense. The old phrase "say it don't spray it" comes to mind. We've all been there. Also, as for sneezing or coughing, I suggest actually trying it with a mask on if you doubt the efficacy of whatever mask you're wearing. I have and can tell you my shitty cloth mask blocks a significant percentage of particles from entering the air around me. I don't need science to inform me about that, I can literally just feel it with my own face.

arminiusreturns 6y ago

I just want to point out all the people who say "It's about protecting others, not yourself" or some variation are part of the problem! That can be said about the random diy cloth masks, but for everything else: The science of masks hasn't changed... N95 – Filters at least 95% of airborne particles. Not resistant to oil. Surgical N95 – A NIOSH-approved N95 respirator that has also been cleared by the Food and Drug Administration (FDA) as a surgical mask. N99 – Filters at least 99% of airborne particles. Not resistant to oil. N100 – Filters at least 99.97% of airborne particles. Not resistant to oil. R95 – Filters at least 95% of airborne particles. Somewhat resistant to oil. P95 – Filters at least 95% of airborne particles. Strongly resistant to oil. P99 – Filters at least 99% of airborne particles. Strongly resistant to oil. P100 – Filters at least 99.97% of airborne particles. Strongly resistant to oil. I've been wearing a p100 respirator that makes a good seal to protect myself, and been changing out a small piece of cloth on the out-valve to protect others. Please, stop perpetuating the myth that masks don't protect you. Of note is that while many of the higher rated masks tend to be tested at .3 microns, this is often a buffer and real world they tend to filter about .1... and the virus is said to be .12+ micron. So if you can, I would suggest getting your hands on n100 or p100, preferable use an oximeter to make sure you have the physical fitness needed to force the air through, but if you are doing very small timeframe adventures this becomes less of an issue. Something that makes a good seal is ideal. Guys, you should heavily consider shaving. There is a reason in the military NBC training they started requiring with only a few exceptions, shaves... and no, the military gas masks will not work for this application unless you get the specific filters for this application (if you do, they would be great since they integrate the eyepro), which have a much wider ranger to select from than the above I reference... note: it is also very important to verify you haven't been sold a fake product https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/default.html https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part...

nickthemagicman 6y ago
Airflow follows the path of least resistance. Air and the particles in it will go around the edges of the mask where there is zero resistance.
- 6y ago

woodandsteel 6y ago

This article has some interesting points, but overall it is click-bait. The recommendation at the end is, “We don’t know how well cloth masks work, so distancing should come first, but masks are likely to work to some extent and not everyone can distance themselves.” But for most of the article it talks as if the whole matter is so uncertain no recommendation can be made. Anyway, the whole idea that we should wait until the science is all settled before we make policy decisions is quite impractical. We are learning as we are fighting the epidemic, and so we have to make decisions before we have full evidence. Indeed, the only way we can learn if masks work to help stop the epidemic is to have some countries mandate them and compare the results with countries that don't. Epidemics are very different than individual diseases. You have to make decisions at the group level, and when it is a new disease you have to do so without really good understanding. And we know that the countries that have pursued a whole set of rigorous policies that includes face masks have been successful, while countries that are lax, include face masks, have failed. So the smart thing to do is pursue the set of policies that includes face masks, and later on find analyse the data and find out exactly how important they are.

whoopdedo 6y ago

When is a mask not a mask? The CDC does and does not recommend: -- A filtered breathing apparatus. -- or A sterile medical mask. -- or A disposable paper mask. -- or A reusable cloth face covering. Each of those serves a different purpose. Some are meant to protect a healthy wearer from sick people around them. One of the others is for a sick person to avoid spreading their disease to others. Or a combination of protecting both wearer and nearby people, but with different risk factors. Add to it that they have different costs and conditions of use. But we cover all these use cases under one broad description of "mask". Is there any wonder people are confused?

drummer 6y ago

Not only do masks not protect you but they are also a potential health hazard. Oxygen levels behind the mask are lower which results in shortness of breath and headaches for many people. A quick duckduckgo search shows what the impact of low oxygen is on the brain. Apart from that people keep touching their masks and handling them in the wrong way which might even increase their risks of getting sick. If you've ever seen a surgeon putting on his masks and gloves, you'll note that assistants put those on for him; touching it himself would risk contamination. So the whole masks thing is just a false sense of security in the worst possible way.

lkxijlewlf 6y ago
I was at the grocery store earlier and, man, within 10 minutes I started seeing people dropping to the floor struggling to breath! It was cra-cra! I ran around tearing their masks off, yelling, "Breath! Breath!" Some, sadly, I was too late.
ceejayoz 6y ago
> Oxygen levels behind the mask are lower which results in shortness of breath and headaches for many people. This is false; anyone with a $30 pulse oximeter can disprove it. I've checked my oxygen levels; there are a bunch of videos of healthcare workers demonstrating it has no impact. > If you've ever seen a surgeon putting on his masks and gloves, you'll note that assistants put those on for him; touching it himself would risk contamination. If you're not slicing into the interior of a human, this is significantly less of a concern.
drummer 6y ago
Might want to check this https://m.youtube.com/watch?v=hyENddY1NbM https://m.youtube.com/watch?v=hyENddY1NbM

nateberkopec 6y ago

It's been really interesting to watch this pandemic from Japan, where I've been for the last ~3 months. I am an American citizen. Walking around Tokyo this week I'm still seeing mask rates of >95%. Lockdown ended about 2 weeks ago. In America, mask-wearing carries a different set of social signals. It seems that not wearing a mask is perceived, by some, as a signal of one's virility and freedom. The article makes this all pretty clear, but the comments here are getting bogged down in "but the data says masks are/aren't effective". The point is that the data doesn't matter. Mask-wearing is determined by social/political expectations and signaling, not by data. If a study came out tomorrow that said mask-wearing reduces transmission by 95%, Trump still wouldn't wear one. Looking for a silver bullet study to prove a point either way is a waste of time at this juncture. Apparently, asking Americans to show that they care about the health of another American via a very low-impact signal (the $10 it costs to get/make a mask, the minor inconvenience of wearing one) is too much. How can a society solve any size of a problem when it cannot be bothered to put a piece of paper or cloth on their face for the possible benefit of another? If your political climate makes such a minor gesture controversial, how will you solve any meaningful issue where your factions disagree? How do you get Americans to care about the health and welfare of other Americans?

trynewideas 6y ago
since "looking for a silver bullet study to prove a point" is the only thing fivethirtyeight has left, it should probably just stop now
aliante 6y ago
> How can a society solve any size of a problem when it cannot be bothered to put a piece of paper or cloth on their face for the possible benefit of another? A friend's mother will tell anyone she encounters who is wearing one that they are a ninny and a coward. So for some people it is also an indicator of courage/weakness.
HeyZuess 6y ago
> Walking around Tokyo this week I'm still seeing mask rates of >95%. Lockdown ended about 2 weeks ago. I currently live in Asia and have been for many years, I am from a western country. I think in Asia, face masks are just a fact of life, including pre-covid. There is/was an expectation that if you are sick, then you should probably wear a mask. Given that a lot of cities are crowded, many wear masks also not to get sick. As a westerner, I understand the negative connotations of wearing a mask, it is not a part of "normal life" in many countries. But life has changed, people should get used to it. Americans should just look at the stats to know that there is a problem. This isn't an attack on their freedoms, it is an attempt not to save their life, but the life of a fellow American, by preventing the spread. While China may have been the epicenter of the virus, the spread is the responsibility of the citizens of the secondary country.

corny 6y ago

From an outsider perspective (I'm Canadian), the politicalization of wearing a mask seems like a huge distraction from action that can make a much bigger difference: * staying home when even a little bit sick * physical distancing (esp. indoors) * hand washing * don't touch your eyes, nose, mouth with unclean hands * getting tested if having symptoms * if physical distancing is not possible, then wearing a mask (esp. indoors) I kind of worry that in a desperate attempt to improve the economy, US governments will continue to ignore the advice of experts and embrace mask-wearing as a panacea.

SpicyLemonZest 6y ago
US governments have to deal with the fundamental problem that the US public doesn't want to physically distance anymore. They want to gather with friends and family, eat in restaurants, drink in bars, even hold large public gatherings for their political causes. If the government doesn't offer advice on how to do these things safely, that'll just mean they get done unsafely.
- closeparen 6y ago
  Was it ever the plan to maintain physical distancing for the next several years? As lockdowns started, the most alarming projections had us cycling it on and off periodically. Not going cold turkey on all human interaction for the long haul.
  - SpicyLemonZest 6y ago
    Those projections called for a long initial period, long enough to drive transmission to near-zero, which hasn’t yet happened in the US.
  - dragonwriter 6y ago
    > As lockdowns started, the most alarming projections had us cycling it on and off periodically. Not going cold turkey on all human interaction for the long haul. The projected initial period of lockdown before going into cycling was longer than even the places that locked down early and reopened late had it, and that was assuming coordinated national response not many places not initially participating in the lockdown.

deleted 6y ago

[deleted]

trhway 6y ago

The CDC best estimate is that US has 20M+ covid cases right now ( https://www.nbcbayarea.com/news/coronavirus/cdc-says-covid-19-cases-in-us-may-be-10-times-higher-than-reported/2315636/ https://www.nbcbayarea.com/news/coronavirus/cdc-says-covid-1...) . That number has beem reached with all the masks wearing and lockdowns. So, what is the difference between the expectations in case of mask wearing vs. not wearing by the end of the year? Even with masks wearing and lockdowns we're probably talking about high tens of millions or even 100M for US. Can it be higher without masks and lockdowns? Spanish flu infected just under one third of total population. For covid, New York had probably reached about 2M cases (~20% of population) and the infection rate went down after that. Using that model of 20% (and NY has much higher population density) it means 70M infections for the whole US. Given how we've already reached 20M+, i think that number will be reached no matter what in a few months (give or take a bit depending on masks, lockdowns, etc.), well before wide availability of vaccine. So, it is really not about whether masks work, it is about whether it makes any noticeable difference in the current situation. I personally was for total population mask wearing, temp checking, etc. back then in Dec/Jan/Feb because back then we had a chance to stop the spread. These days i just don't see any arithmetically consistent way to avoid the described above scenario and stop the current flooding/tsunami.

mennis16 6y ago
The places surging right now in the US are all places where mask wearing was a controversy and many people did not wear masks. So I don't think it is fair to say that the case numbers are "with mask policy".
adjkant 6y ago
You assume here that NYC's numbers went down via some property of the disease, not a lockdown being observed by the whole city along with high mask usage. Letting this "run its course" would spike NYC and the whole US far above 70M cases. We would easily be looking at 500,000 dead at least even with how we've learned to decrease the death rate. That death rate would also go up as we stop flattening the curve, as we saw happen quickly with Texas. NYC has had decreasing numbers despite large outdoor protests, which had high mask usage. In a week or two there will be some numbers on how Phase II reopening is going in an area with high mask usage as well which should be another good data point. Here are some actual interesting scenario tools for controlling the virus even as it runs its course: https://ncase.me/covid-19/ https://ncase.me/covid-19/ As a note, a big factor here is that it appears that antibodies may only last for 2-3 months which breaks some of those recovery models. If that is true, without any mitigation and even with most at-risk people dying off earlier, we could still end up losing .1% - 1% of the population every 3 months until we have a treatment or vaccine. I don't like how those numbers look even if we manage to get a vaccine in 12 months.

ljlolel 6y ago

https://medium.com/p/4ef05aa357c5?source=linkShare-72308c464041-1586107578 https://medium.com/p/4ef05aa357c5?source=linkShare-72308c464...

SonnyTark 6y ago

Here in NZ, masks were never required. The rationale is that when people wear masks no matter how you explain it they believe they themselves are safe, which makes them get closer to other people (I can't give them the disease) and be less cautious in general (I'm protected). Take the mask away and the only things they have is social distancing and being obsessive about touching surfaces. Which in my experience works very well and it's what the community here focused on. In the meantime my folks in Maine wear masks and gloves and think now everything is fine we can do anything and go anywhere.

hassancf 6y ago

This is a good read “The Masks Masquerade” by Nassim Taleb of Black Swan fame: “First error: missing the compounding effect” ... “Third Error: Mistaking Absence of Evidence for Evidence of Absence” ... https://medium.com/incerto/the-masks-masquerade-7de897b517b7 https://medium.com/incerto/the-masks-masquerade-7de897b517b7

justnotworthit 6y ago
I liked his point that if you believe in "cause no harm" (non-agression), you should wear the mask. It raises issues in what counts as real harm/aggression (wearing clothes someone in society dislikes is technically "harm", but not a harm considered real or aggressive or... I forget the terms). Then he insults everyone who disagrees with him multiple names and accusations of bad faith (which makes serious discussion undesirable and difficult). I think that's a thing Taleb does (online).

giardini 6y ago

As timer notes in another post below, the episode "Special Episode: Masks and Science" talks about the history of masks vis-a-vis Covid-19: https://www.cidrap.umn.edu/covid-19/podcasts-webinars/special-ep-masks https://www.cidrap.umn.edu/covid-19/podcasts-webinars/specia... In this episode, Dr. Osterholm and host Chris Dall discuss the current science on COVID-19 and cloth masks. Transcript available at https://www.cidrap.umn.edu/revised-mask-transcript-6220 https://www.cidrap.umn.edu/revised-mask-transcript-6220

johndoe42377 6y ago

The "science" of mask wearing is plagued by redundant and irrelevant abstract mathematical concepts. A mask is a membrane (not perfect, of course) and this is how it must be properly modelled. It is that simple - just use proper (right) abstractions. All the sophisticated statistical extrapolations is just flawed bullshit.

deleted 6y ago

[deleted]

jakeogh 6y ago

The virus is in the same class as some common colds. It's not "going away". If people are concerned about it they should use a real mask designed to filter viruses[1]. Instead, the population is being conditioned to force medical procedures on other people. Forever. The "flatten the curve" thing was predictably re-goalposted. There are strong financial incentives to keep people irrationally in a state of fear. After this, there will be the next. This keeps getting ignored: What is the non-COVID-19 pneumonia # for 2019-2020? CDC Influenza and pneumonia deaths by influenza season and age: United States, 2008–2015: https://www.cdc.gov/nchs/data/health_policy/influenza-and-pneumonia-deaths-2008-2015.pdf https://www.cdc.gov/nchs/data/health_policy/influenza-and-pn... (these are not estimates, see the footnote) CDC #'s 2015-2016 Flu: 7,961 Pneumonia: 131,858 All: 1,769,940 [1] https://news.ycombinator.com/item?id=22232633 https://news.ycombinator.com/item?id=22232633

corny 6y ago
> If people are concerned about it Until more is learned about covid-19 people should be concerned. Where the disease is out of control, hospitals are filling up and many people in need of health care are suffering as a result. BTW, at least in Canada, the number of deaths due to covid-19 has been concentrated most in long-term care homes. These are also places where deaths due to pneumonia and flu are common. We're learning now that the quality of care in these homes has been insufficient to deal with covid-19. All of the measures that are now in the works to improve the quality of care in those homes should have the side-effect of reducing deaths from other infectious diseases in the future.
- jakeogh 6y ago
  The excess death stats are accessible to us all. What's the non-COVID-19 pneumonia # for 2019-2020 so far? It's nonsensical to expect everyone to agree, those that want a mask, should use one for viruses. This is like pretending the cold is going away, and we must all obey until that happens. Wont happen. As you mention, fixing the situation of the vulnerable is the way. Quite possibly would have been better response in the first place. Viruses are only getting easier to engineer. Shutting down the country only makes them _more_ valuable.

pabe 6y ago

"Martin worried that wearing masks might lead people to feel more safe than they actually were — and make choices that increased their risk of contracting or transmitting COVID-19." - I don't see people wearing masks jumping into my face. It's people who're feeling safe for other reasons, that do. People who don't see there's a pandemic. People who think it's all made up. People who feel invincible or who're thinking they can show-off as invincible to impress others. Those people don't wear masks and throw one Corona Party after another. I'd assume that most people wearing a mask care more deeply about others than those who don't. So, wearing a mask is also a statement. And it's got almost nothing to do with politics.

xtiansimon 6y ago

> “... a public health and disease expert who is worried that mask effectiveness is being over-hyped...” Medical professionals have their own sources of information (just talk to a doctor about hand washing vs. hand sanitizer). Then I assume the concern is some members of the public are taking risks while wearing masks, thinking they are more safe than they really are? I don’t understand the concern, because if you’re really concerned about the virus you’re staying home. If you’re cavalier about the whole thing, then you’re likely standing <6feet and doing other “risky things”. And finally, for everyone else there are the simple rules. This seems totally different than, say, the controversy about the anti-malarial drug, which had severe potential side effects. What am I missing?

wdr1 6y ago

I wear a mask. I encourage all my friends to wear a mask. It's a very low cost, with large potential upside. There's no good reason not to wear a mask. But I am also interested in the pure science & am asking strictly from that point of view. Again, I am not suggesting we don't need to wear masks. I found this report on the CDC website that states: "Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza" (emphasis mine) https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article I'm aware it's for influenza & not COVID-19, but most research, including evidence suggesting we should wear masks, is based on research done on influenza. I think it's reasonable, given the paucity of COVID-19 data and we have to do something, and given they're both RNA viruses, experts feel it's reasonable as well. My conclusion from above is that while we should still definitely wears masks, it's unlikely wearing them will see a noticeable change in R0, which is what we need to really open up. I.e., opening with mask compliance probably isn't going to work, and we need people to stay home. I'm not an expert, so would to love to learn if I've got anything wrong. Thanks in advance.