4 ms·

Yes, masks work. The evidence has always been consistent on that. https://www.pnas.org/content/118/4/e2014564118 https://www.pnas.org/content/118/4/e201456411

Yes, masks work. The evidence has always been consistent on that. https://www.pnas.org/content/118/4/e2014564118 https://www.pnas.org/content/118/4/e2014564118 That we are still having this question raised after a year of the pandemic is embarrassing for humanity as a species.

timr 6y ago
The only randomized controlled trial for masks and Covid-19 found no statistically significant protective effect. Jeremy Howard didn't even bother citing it in the review you're linking: https://www.acpjournals.org/doi/10.7326/m20-6817 https://www.acpjournals.org/doi/10.7326/m20-6817 The Howard review is, in general, of extremely low quality. The top-line conclusions of some of the cited articles are completely mis-interpreted, and the citations within are sloppy and misleading -- bold assertions are made without evidence, and the reader is led to assume that a leading/trailing citation provides support for the claim, when it does not. There are far better reviews of the available literature. Here is one: https://www.cebm.net/covid-19/masking-lack-of-evidence-with-politics/ https://www.cebm.net/covid-19/masking-lack-of-evidence-with-... The meta-study commissioned by the WHO is another: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... You'll note that they found a small positive effect for masks in the community, only when including and aggregating a large number of low-quality studies. They admit that the evidence base is weak. In general, there's a great deal of uncertainty around the effectiveness of masks in the hands of the general public. There may be a small positive effect, but we simply don't know. One of the biggest mistakes of this pandemic has been the political weaponization of this issue, and the exaggeration of certainty -- on both sides of the debate.
- jasonvorhe 6y ago
  I'm pretty happy with how it was handled in Germany. Masks clearly aren't marketed as a perfect solution, but as a key element in a mix of other measures that are social distancing, work from home, leave home for necessities, keep your distance during visits to the supermarket, etc. I'm really surprised that masks turned out to be such a cause for drama. At the worst they caused discomfort, especially for people with big beards/prescription glasses, but if it turns out wearing masks helped just by a margin, isn't that already worth it, in the grand scheme of things? Isn't 1 live saved out of a 1000 already with the negatives? It just baffles me.
  - timr 6y ago
    Yes, I agree about the German approach. Japan (which I follow closely) is similar -- the issue of masks is drama-free, and much more pragmatic than in the US. But when I say "pragmatic", I mean it on both sides: you also don't see the insanity of people scolding other people over something with uncertain marginal effect. That's the part I can't stand here in the US. I do think that of all of the things we have done in this pandemic, the act of forcing someone to wear something -- and on the face, no less -- is fairly obviously a politically fraught act. I'm not terribly surprised that the symbolism of the act became the story.
    - sep_field 6y ago
      it's like a condom for your face. What's not to love? I plan to keep wearing it even after this is all over. In smarter countries, people wear masks whenever they are sick as a thoughtful courtesy to protect those around them. I'd like to see that attitude worldwide.
      - timr 6y ago
        > it's like a condom for your face. What's not to love? I know you're being cheeky here, but just to be serious for a moment: there's a HUGE literature on the subject of condom use and public-health messaging from the 80s and the HIV crisis. Condoms are...not exactly popular, of course (the TL;DR is that shaming doesn't work very well. Honesty and education >> scolding and shaming when it comes to behavioral change that is intimate and unpleasant). It's continually astounding to me how many lessons from that pandemic seem to have been forgotten.
    - TheOtherHobbes 6y ago
      There is no "uncertain marginal effect." The science is in, and it's clear. https://www.nature.com/articles/d41586-020-02801-8 https://www.nature.com/articles/d41586-020-02801-8 As for "politically fraught" - people are forced to wear things called clothes literally every day. Some are forced to wear business suits and other eccentric, uncomfortable, and context-specific attire. People are also forced to wear seatbelts and act in other ways which show responsibility for public health - for example by not smoking in public areas. The political point here is that masks - which have now been proven to be helpful - are only considered a 'politically fraught act' by people who want to politicise the Covid response. For people who are rational about this, there is no issue. For people who are hostile to public rationality, there is.
- hluska 6y ago
  I find this need for certainty to be the most embarrassing part of this whole pandemic. What kind of person really cares how effective they are? They cost next to nothing, they’re comfortable and convenient. If they save one life, that’s worth wearing a mask. Again to echo the person you’re replying to, the fact we still have to have this conversation is embarrassing.
  - timr 6y ago
    > I find this need for certainty to be the most embarrassing part of this whole pandemic. What kind of person really cares how effective they are? A scientist. There are a great many things that we did during this pandemic that had no evidence whatsoever, and turned out to be wrong. Some turned out to be harmful (over-ventilation, for example). Are mask mandates one of these things? I have no idea. Neither do you. It isn't wrong to admit that we don't know, because that's the first step to finding the answer.
    - TheOtherHobbes 6y ago
      The one thing that defines fervent anti-maskers, anti-vaxxers, the "let's open for business while people are still dying" crowd, and others with bizarre beliefs is that they make their statements with absolute certainty, and with no admission that they might ever be wrong. Medical understanding of Covid has made huge strides over the last year, precisely because doctors and researchers never claimed to be omniscient about the virus. Meanwhile the deniers are still claiming the virus is "just a bad case of flu" and "masks don't do anything" and "lockdowns don't work" in spite of the accumulated mountain of evidence that those statements are nonsense.
      - timr 6y ago
        > The one thing that defines fervent anti-maskers, anti-vaxxers, the "let's open for business while people are still dying" crowd, and others with bizarre beliefs is that they make their statements with absolute certainty, and with no admission that they might ever be wrong. You have now commented twice in response to me, and in one post you cited an editorial in Nature as definitive proof of "the science" on masks, and now you are making black and white claims that would seem to group together people who question masks with "anti-vaxers" and other negative charicatures. To the extent that I am making a claim here, it is that we need to be more circumspect in our discussions of science. I am advocating for less certainty, and more humility. You seem to be making claims with a great deal of certainty.
DaniloDias 6y ago
Everyone I’ve seen for the last year has been wearing masks. Masks either don’t work in a meaningful way, or this pandemic is not meaningfully stopped by masks. Our inability to stop exponential growth is not embarrassing. It is frightening how little the average human truly understands about exponential growth.
- Arainach 6y ago
  Your reasoning is incorrect. This virus is incredibly contagious. Just because we haven't been able to reduce R0 below one doesn't mean that precautions haven't been having a significant effect. In a downpour, a car's windshield wipers may not be able to move fast enough to provide clear vision. This doesn't mean that they don't work or aren't making a significant improvement.
- pbourke 6y ago
  And have you been following people into their homes to see if they meet indoors, maskless, with those not in their household?

timr 6y ago

The only randomized controlled trial for masks and Covid-19 found no statistically significant protective effect. Jeremy Howard didn't even bother citing it in the review you're linking: https://www.acpjournals.org/doi/10.7326/m20-6817 https://www.acpjournals.org/doi/10.7326/m20-6817 The Howard review is, in general, of extremely low quality. The top-line conclusions of some of the cited articles are completely mis-interpreted, and the citations within are sloppy and misleading -- bold assertions are made without evidence, and the reader is led to assume that a leading/trailing citation provides support for the claim, when it does not. There are far better reviews of the available literature. Here is one: https://www.cebm.net/covid-19/masking-lack-of-evidence-with-politics/ https://www.cebm.net/covid-19/masking-lack-of-evidence-with-... The meta-study commissioned by the WHO is another: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... You'll note that they found a small positive effect for masks in the community, only when including and aggregating a large number of low-quality studies. They admit that the evidence base is weak. In general, there's a great deal of uncertainty around the effectiveness of masks in the hands of the general public. There may be a small positive effect, but we simply don't know. One of the biggest mistakes of this pandemic has been the political weaponization of this issue, and the exaggeration of certainty -- on both sides of the debate.

jasonvorhe 6y ago
I'm pretty happy with how it was handled in Germany. Masks clearly aren't marketed as a perfect solution, but as a key element in a mix of other measures that are social distancing, work from home, leave home for necessities, keep your distance during visits to the supermarket, etc. I'm really surprised that masks turned out to be such a cause for drama. At the worst they caused discomfort, especially for people with big beards/prescription glasses, but if it turns out wearing masks helped just by a margin, isn't that already worth it, in the grand scheme of things? Isn't 1 live saved out of a 1000 already with the negatives? It just baffles me.
- timr 6y ago
  Yes, I agree about the German approach. Japan (which I follow closely) is similar -- the issue of masks is drama-free, and much more pragmatic than in the US. But when I say "pragmatic", I mean it on both sides: you also don't see the insanity of people scolding other people over something with uncertain marginal effect. That's the part I can't stand here in the US. I do think that of all of the things we have done in this pandemic, the act of forcing someone to wear something -- and on the face, no less -- is fairly obviously a politically fraught act. I'm not terribly surprised that the symbolism of the act became the story.
  - sep_field 6y ago
    it's like a condom for your face. What's not to love? I plan to keep wearing it even after this is all over. In smarter countries, people wear masks whenever they are sick as a thoughtful courtesy to protect those around them. I'd like to see that attitude worldwide.
    - timr 6y ago
      > it's like a condom for your face. What's not to love? I know you're being cheeky here, but just to be serious for a moment: there's a HUGE literature on the subject of condom use and public-health messaging from the 80s and the HIV crisis. Condoms are...not exactly popular, of course (the TL;DR is that shaming doesn't work very well. Honesty and education >> scolding and shaming when it comes to behavioral change that is intimate and unpleasant). It's continually astounding to me how many lessons from that pandemic seem to have been forgotten.
  - TheOtherHobbes 6y ago
    There is no "uncertain marginal effect." The science is in, and it's clear. https://www.nature.com/articles/d41586-020-02801-8 https://www.nature.com/articles/d41586-020-02801-8 As for "politically fraught" - people are forced to wear things called clothes literally every day. Some are forced to wear business suits and other eccentric, uncomfortable, and context-specific attire. People are also forced to wear seatbelts and act in other ways which show responsibility for public health - for example by not smoking in public areas. The political point here is that masks - which have now been proven to be helpful - are only considered a 'politically fraught act' by people who want to politicise the Covid response. For people who are rational about this, there is no issue. For people who are hostile to public rationality, there is.
hluska 6y ago
I find this need for certainty to be the most embarrassing part of this whole pandemic. What kind of person really cares how effective they are? They cost next to nothing, they’re comfortable and convenient. If they save one life, that’s worth wearing a mask. Again to echo the person you’re replying to, the fact we still have to have this conversation is embarrassing.
- timr 6y ago
  > I find this need for certainty to be the most embarrassing part of this whole pandemic. What kind of person really cares how effective they are? A scientist. There are a great many things that we did during this pandemic that had no evidence whatsoever, and turned out to be wrong. Some turned out to be harmful (over-ventilation, for example). Are mask mandates one of these things? I have no idea. Neither do you. It isn't wrong to admit that we don't know, because that's the first step to finding the answer.
  - TheOtherHobbes 6y ago
    The one thing that defines fervent anti-maskers, anti-vaxxers, the "let's open for business while people are still dying" crowd, and others with bizarre beliefs is that they make their statements with absolute certainty, and with no admission that they might ever be wrong. Medical understanding of Covid has made huge strides over the last year, precisely because doctors and researchers never claimed to be omniscient about the virus. Meanwhile the deniers are still claiming the virus is "just a bad case of flu" and "masks don't do anything" and "lockdowns don't work" in spite of the accumulated mountain of evidence that those statements are nonsense.
    - timr 6y ago
      > The one thing that defines fervent anti-maskers, anti-vaxxers, the "let's open for business while people are still dying" crowd, and others with bizarre beliefs is that they make their statements with absolute certainty, and with no admission that they might ever be wrong. You have now commented twice in response to me, and in one post you cited an editorial in Nature as definitive proof of "the science" on masks, and now you are making black and white claims that would seem to group together people who question masks with "anti-vaxers" and other negative charicatures. To the extent that I am making a claim here, it is that we need to be more circumspect in our discussions of science. I am advocating for less certainty, and more humility. You seem to be making claims with a great deal of certainty.

DaniloDias 6y ago

Everyone I’ve seen for the last year has been wearing masks. Masks either don’t work in a meaningful way, or this pandemic is not meaningfully stopped by masks. Our inability to stop exponential growth is not embarrassing. It is frightening how little the average human truly understands about exponential growth.

Arainach 6y ago
Your reasoning is incorrect. This virus is incredibly contagious. Just because we haven't been able to reduce R0 below one doesn't mean that precautions haven't been having a significant effect. In a downpour, a car's windshield wipers may not be able to move fast enough to provide clear vision. This doesn't mean that they don't work or aren't making a significant improvement.
pbourke 6y ago
And have you been following people into their homes to see if they meet indoors, maskless, with those not in their household?