3 ms·

> The "flip-flop" occurred very shortly after it was demonstrated that they were transmitted by aerosol particles. This is both false and doesn't make any sens

> The "flip-flop" occurred very shortly after it was demonstrated that they were transmitted by aerosol particles. This is both false and doesn't make any sense. 1) There was ample evidence of the distinct _possibility_ of airborne transmission, certainly by March. Medical culture has a severe problem with confusing "absence of evidence" and "evidence of absence", and the cost-benefit tradeoff of mask recommendations given what we knew back then was crystal-clear (and there were people loudly and consistently saying so throughout). 2) The CDC and Surgeon General (of "Seriously people, STOP BUYING MASKS" fame) have claimed[1] that the "flip-flop" was due to a change in concern about asymptomatic spread. It's not a coincidence that this is the _third_ distinct (and often mutually-contradictory!) excuse I've heard on this thread: because the real reason is basically down to systemic cultural rot in the field (especially at a scale that large and politically-influenced) and no one wants to admit that. > 3. This event primarily demonstrates the difficulty of communicating science---a "this is the best advice we can give now based on our limited understanding" is treated as permanent, universal truth by the general public; any later changes in that advice is "insane" and "deeply poisons the well" of trust. Scientific consensus changes all the time, and no stigma is (or should be) associated the work on the earlier, less accurate model. That's just what science _is_. I'm not sure if you're being intentionally obtuse or accidentally so, but my point is obviously that the initial no-masks assessment was insane, and based on a shoddy interpretation of both the science of the virus and the fundamentals of how public policy works. [1] https://www.axios.com/surgeon-general-reversal-face-mask85e2d5-42b7-433e-89a6-3584f3e61bf3.html https://www.axios.com/surgeon-general-reversal-face-mask85e2... .

mcguire 6y ago
The concern for asymptomatic spread is coincident with the concern about aerosol particles. This is because coughing or sneezing are symptoms. The medical culture also has a bit of a problem with crying wolf---the community has to take care not to do so because randomly changing things can easily cause more damage than it prevents. In particular, the community tends to want to avoid prescribing major behavioral changes without good reason. Do you remember, say, roughly this time last year here on HN? Hydroxychloroquine was the biggest topic in any COVID discussion. And "why aren't the stupid, rotted, insane medical community providing a cheap, known-safe medication as a prophylactic to everyone?" was the question everyone here was asking. After all, there was the distinct possibility that it could help. Turns out that the supply was constrained, that it has side-effects, and that it doesn't work. Yay for the medical community, right? Everyone celebrating the success of science? Apparently not: "Medical culture has a severe problem with confusing 'absence of evidence' and 'evidence of absence', and the cost-benefit tradeoff...." But as soon as the ongoing, large-scale trials started dropping hydroxychloroquine from their protocols, the issue disappeared, with no admission that anyone had been wrong. You are absolutely right that "scientific consensus changes all the time, and no stigma is (or should be) associated the work on the earlier, less accurate model." And yet it does: their earlier assessment is "insane"; it represents "systemic cultural rot". Your Axios link gives me a 404; do you mean "Surgeon general defends reversal on face mask policy (12 Jul 2020)" (https://www.axios.com/surgeon-general-reversal-face-mask-d385e2d5-42b7-433e-89a6-3584f3e61bf3.html https://www.axios.com/surgeon-general-reversal-face-mask-d38...) or possibly "Where the science stands on using face masks against coronavirus (25 Jun 2020)" (https://www.axios.com/coronavirus-face-mask-science-e9df446b-e7fb-447b-a980-67a9cf73556a.html https://www.axios.com/coronavirus-face-mask-science-e9df446b...). The latter article points to: "Assessment of Fabric Masks as Alternatives to Standard Surgical Masks in Terms of Particle Filtration Efficiency (17 April 2020)" (https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v2.full.pdf https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v...) "Association of country-wide coronavirus mortality with demographics, testing, lockdowns, and public wearing of masks (Update June 15, 2020)" (https://www.researchgate.net/publication/342198360_Association_of_country-wide_coronavirus_mortality_with_demographics_testing_lockdowns_and_public_wearing_of_masks_Update_June_15_2020 https://www.researchgate.net/publication/342198360_Associati...) "CDC to make updated recommendation on masks (22 Jun 2020)" (https://www.wwlp.com/news/health/coronavirus/cdc-to-make-updated-recommendation-on-masks/ https://www.wwlp.com/news/health/coronavirus/cdc-to-make-upd...) "Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis (27 Jun 2020)" (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext#seccestitle150 https://www.thelancet.com/journals/lancet/article/PIIS0140-6...) "Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US (August 2020)" (https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2020.00818 https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2020.0...) That is (a) exactly what I am saying, and (b) actually a little later than I can date the change---I've previously seen (and posted, IIRC) scientific discussion in mid-April to May about the changing consensus on transmission and mask effectiveness. When you write "it's not a coincidence that this is the _third_ distinct (and often mutually-contradictory!) excuse I've heard on this thread", you do realize that there are multiple people involved in this thread and that some of them are simply wrong. But of course I would be saying that because I'm just making excuses and covering up rot, trying to cover up that everyone except the genii software engineers here on YN are complete idiots.

mcguire 6y ago

The concern for asymptomatic spread is coincident with the concern about aerosol particles. This is because coughing or sneezing are symptoms. The medical culture also has a bit of a problem with crying wolf---the community has to take care not to do so because randomly changing things can easily cause more damage than it prevents. In particular, the community tends to want to avoid prescribing major behavioral changes without good reason. Do you remember, say, roughly this time last year here on HN? Hydroxychloroquine was the biggest topic in any COVID discussion. And "why aren't the stupid, rotted, insane medical community providing a cheap, known-safe medication as a prophylactic to everyone?" was the question everyone here was asking. After all, there was the distinct possibility that it could help. Turns out that the supply was constrained, that it has side-effects, and that it doesn't work. Yay for the medical community, right? Everyone celebrating the success of science? Apparently not: "Medical culture has a severe problem with confusing 'absence of evidence' and 'evidence of absence', and the cost-benefit tradeoff...." But as soon as the ongoing, large-scale trials started dropping hydroxychloroquine from their protocols, the issue disappeared, with no admission that anyone had been wrong. You are absolutely right that "scientific consensus changes all the time, and no stigma is (or should be) associated the work on the earlier, less accurate model." And yet it does: their earlier assessment is "insane"; it represents "systemic cultural rot". Your Axios link gives me a 404; do you mean "Surgeon general defends reversal on face mask policy (12 Jul 2020)" (https://www.axios.com/surgeon-general-reversal-face-mask-d385e2d5-42b7-433e-89a6-3584f3e61bf3.html https://www.axios.com/surgeon-general-reversal-face-mask-d38...) or possibly "Where the science stands on using face masks against coronavirus (25 Jun 2020)" (https://www.axios.com/coronavirus-face-mask-science-e9df446b-e7fb-447b-a980-67a9cf73556a.html https://www.axios.com/coronavirus-face-mask-science-e9df446b...). The latter article points to: "Assessment of Fabric Masks as Alternatives to Standard Surgical Masks in Terms of Particle Filtration Efficiency (17 April 2020)" (https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v2.full.pdf https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v...) "Association of country-wide coronavirus mortality with demographics, testing, lockdowns, and public wearing of masks (Update June 15, 2020)" (https://www.researchgate.net/publication/342198360_Association_of_country-wide_coronavirus_mortality_with_demographics_testing_lockdowns_and_public_wearing_of_masks_Update_June_15_2020 https://www.researchgate.net/publication/342198360_Associati...) "CDC to make updated recommendation on masks (22 Jun 2020)" (https://www.wwlp.com/news/health/coronavirus/cdc-to-make-updated-recommendation-on-masks/ https://www.wwlp.com/news/health/coronavirus/cdc-to-make-upd...) "Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis (27 Jun 2020)" (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext#seccestitle150 https://www.thelancet.com/journals/lancet/article/PIIS0140-6...) "Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US (August 2020)" (https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2020.00818 https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2020.0...) That is (a) exactly what I am saying, and (b) actually a little later than I can date the change---I've previously seen (and posted, IIRC) scientific discussion in mid-April to May about the changing consensus on transmission and mask effectiveness. When you write "it's not a coincidence that this is the _third_ distinct (and often mutually-contradictory!) excuse I've heard on this thread", you do realize that there are multiple people involved in this thread and that some of them are simply wrong. But of course I would be saying that because I'm just making excuses and covering up rot, trying to cover up that everyone except the genii software engineers here on YN are complete idiots.