5 ms·

Substitute "crystal healing", or "hydroxychloroquin" for "population-wide mask usage to contain a viral disease". To the medical sciences, these three are (were

Substitute "crystal healing", or "hydroxychloroquin" for "population-wide mask usage to contain a viral disease". To the medical sciences, these three are (were) more alike than they are different: they all are interventions that may or may not achieve a desired outcome, and may or may not have some unwanted side effects. In January/February 2020, there was about as much evidence for either of those propositions. The evidence on masks was thin, and limited to use by professionals in a medical setting. Existing studies of their use as practiced in parts of Asia were inconclusive. Yes, I know: Masks seem like a really good idea. The whole concept makes sense. There's a theory as to how they work. But medicine stopped believing any theory as to what may or may not be useful around a hundred years ago, after killing countless people with bloodletting, mercury, vapour-vaping, whatever... All those interventions may seem ridiculous to you, but they all followed some entirely believable logic that accounted for all the known facts as long as one did not actually run a double-blind trial. It's instructive to look at the fate of two of those interventions: masks and that quinine. We now know the former works and the latter does not. And I'll be immodest and mention that I considered masks to be effective from day one, while spending only about a week drinking Gin Tonics for health reasons, until the full extend of the seediness of that French doctor pushing it became public (and I had to go back to a different set of reasons for the drinks). But at about the same time along each treatment's timeline, there really was more actual, or at least claimed to be factual, evidence for the Malaria-malarky than there was for masks. And while I'm supremely excellent at predictioneering, I utterly fail when trying to distill some set of specific rules to follow. Maybe there's wisdom in numbers? Do a survey in the US right now, and you'll probably get 55 % to advocate for masks, 42 % believing in the insect-repellant. And that's about four months after the science on those questions has been settled.

drtillberg 6y ago
Actually, there's no reasonable pathway for crystal healing to help here. On the other hand, it's entirely plausible and there's real-world experience to support (1) masks filtering harmful particles and (2) hydroxychloroquin being useful against an immune system run amuck, which is the way 'flu' often injures patients. So, no, only two of the three were similar. Zero credit to those who would equate all three or who would dismiss either of the latter two without diligent, unbiased investigation and solid empirical evidence.
- IfOnlyYouKnew 6y ago
  Yes, I don't disagree. I chose crystal healing because it's silly. I supported masks because it seems to make sense. But none of that is evidence in the double-blind trials sense of the word. And you're actually making my case: there was a plausible mechanism for hydroxychloroquine, as well as for masks. But only one of them works, while the other probably killed a few people, and wasted a whole lot of time.
  - tertius 6y ago
    HCQ is a very safe medicine.
    - IfOnlyYouKnew 6y ago
      That's neither particularly true not in connected to the argument. Quote from above: Medicine also isn't in the "we recommend it because there aren't many reasons against it" business.
      - tertius 6y ago
        It is particularly true. And too many armchair academics are painting HCQ in a bad light when it is an immensely important and safe drug. > Medicine also isn't in the "we recommend it because there aren't many reasons against it" business. I'm not arguing with this. Who cares. Doctors still recommend it, it still works and doctors still use it themselves.
  - tertius 6y ago
    Nope, but for masks, overwhelming evidence exists prior to 2020. Just because you don't understand how this virus spreads does not mean that we need a new trial before we can make a recommendation.
    - IfOnlyYouKnew 6y ago
      Link to a study?
wutbrodo 6y ago
This reasoning is implicit in the apologists for our early pandemic public health incompetence, but it's incredible to see it concretely articulated. How do you add absence of high-quality, narrow evidence for effectiveness + strong prior for effectiveness + ~zero-cost intervention and land at "don't recommend cloth face covering"? All the other examples you gave fail one of these criteria: there's no prior suggesting that Crystal healing is valuable, HCQ has side effects and presents costs/supply chain challenges that _cloth_ doesn't, etc. An example from the other side is vitamin D: there's been enough weak evidence that anyone scientifically literate has been keeping an eye on their vitamin D since the early pandemic, given that: there's moderate evidence it's protective + there's a high chance you're deficient anyway + D toxicity is pretty hard to achieve.
- IfOnlyYouKnew 6y ago
  One side effect that was mentioned at the time was people engaging in risky behaviour thinking they'll be protected by the mask. Medicine also isn't in the "we recommend it because there aren't many reasons against it" business. They neither recommended masks nor warned against them, but laid out the facts: "we don't (didn't) know. We're scrambling to get data. We'll let you know" I'm honestly baffled that the concept of a trial is so alien to people, and that nobody seems to be capable of the tiny transference of recognising that masks are no different than a pill. I could come up with a possible reason Aspirin might work: maybe it's the fever that kills, Aspirin lowers it. The risk is known and rather small. Should medical science recommend everyone to take Aspirin? Does it seem entirely implausible that a significant number of people would say/think "It's not the best time for a wedding, but everyone has taken triple doses of Aspirin so it should be fine"
  - tertius 6y ago
    Masks and the way this virus spreads isn't new. New medicines, requiring trials are novel. Golden eggs and apples shouldn't be compared. What new data has finally come in that has shown that masks do not slow the spread or that they do? And new we have guidance? The problem here is that the medical community, when they have skin in the game wear and recommended masks, from day 1. Again, the virus is novel, how it spreads is not.

drtillberg 6y ago

Actually, there's no reasonable pathway for crystal healing to help here. On the other hand, it's entirely plausible and there's real-world experience to support (1) masks filtering harmful particles and (2) hydroxychloroquin being useful against an immune system run amuck, which is the way 'flu' often injures patients. So, no, only two of the three were similar. Zero credit to those who would equate all three or who would dismiss either of the latter two without diligent, unbiased investigation and solid empirical evidence.

IfOnlyYouKnew 6y ago
Yes, I don't disagree. I chose crystal healing because it's silly. I supported masks because it seems to make sense. But none of that is evidence in the double-blind trials sense of the word. And you're actually making my case: there was a plausible mechanism for hydroxychloroquine, as well as for masks. But only one of them works, while the other probably killed a few people, and wasted a whole lot of time.
- tertius 6y ago
  HCQ is a very safe medicine.
  - IfOnlyYouKnew 6y ago
    That's neither particularly true not in connected to the argument. Quote from above: Medicine also isn't in the "we recommend it because there aren't many reasons against it" business.
    - tertius 6y ago
      It is particularly true. And too many armchair academics are painting HCQ in a bad light when it is an immensely important and safe drug. > Medicine also isn't in the "we recommend it because there aren't many reasons against it" business. I'm not arguing with this. Who cares. Doctors still recommend it, it still works and doctors still use it themselves.
- tertius 6y ago
  Nope, but for masks, overwhelming evidence exists prior to 2020. Just because you don't understand how this virus spreads does not mean that we need a new trial before we can make a recommendation.
  - IfOnlyYouKnew 6y ago
    Link to a study?

wutbrodo 6y ago

This reasoning is implicit in the apologists for our early pandemic public health incompetence, but it's incredible to see it concretely articulated. How do you add absence of high-quality, narrow evidence for effectiveness + strong prior for effectiveness + ~zero-cost intervention and land at "don't recommend cloth face covering"? All the other examples you gave fail one of these criteria: there's no prior suggesting that Crystal healing is valuable, HCQ has side effects and presents costs/supply chain challenges that _cloth_ doesn't, etc. An example from the other side is vitamin D: there's been enough weak evidence that anyone scientifically literate has been keeping an eye on their vitamin D since the early pandemic, given that: there's moderate evidence it's protective + there's a high chance you're deficient anyway + D toxicity is pretty hard to achieve.

IfOnlyYouKnew 6y ago
One side effect that was mentioned at the time was people engaging in risky behaviour thinking they'll be protected by the mask. Medicine also isn't in the "we recommend it because there aren't many reasons against it" business. They neither recommended masks nor warned against them, but laid out the facts: "we don't (didn't) know. We're scrambling to get data. We'll let you know" I'm honestly baffled that the concept of a trial is so alien to people, and that nobody seems to be capable of the tiny transference of recognising that masks are no different than a pill. I could come up with a possible reason Aspirin might work: maybe it's the fever that kills, Aspirin lowers it. The risk is known and rather small. Should medical science recommend everyone to take Aspirin? Does it seem entirely implausible that a significant number of people would say/think "It's not the best time for a wedding, but everyone has taken triple doses of Aspirin so it should be fine"
- tertius 6y ago
  Masks and the way this virus spreads isn't new. New medicines, requiring trials are novel. Golden eggs and apples shouldn't be compared. What new data has finally come in that has shown that masks do not slow the spread or that they do? And new we have guidance? The problem here is that the medical community, when they have skin in the game wear and recommended masks, from day 1. Again, the virus is novel, how it spreads is not.