3 ms·

> I still fail to see why people are so vehemently opposed to masks. In my case it's driven because of a) evidence for their being effective at all is lacking[

> I still fail to see why people are so vehemently opposed to masks. In my case it's driven because of a) evidence for their being effective at all is lacking[1], and b) as you rightly put it “they are annoying”. I'm not sure why I wouldn't be against that. Additionally, I live in Japan where the kind of mask-adherence those back in the west can only have wet dreams about is the norm here, and there's no evidence it's helped here either. You may have noticed the lack of crowds at the Olympics as Tokyo is under a state of emergency due to a wave of cases. Masks just don't seem to have any effect against the delta variant. I'm not surprised. [1] https://www.cebm.net/covid-19/masking-lack-of-evidence-with-politics/ https://www.cebm.net/covid-19/masking-lack-of-evidence-with-...

tablespoon 5y ago
> I'm not sure why I wouldn't be against that. Additionally, I live in Japan where the kind of mask-adherence those back in the west can only have wet dreams about is the norm here, and there's no evidence it's helped here either. Per https://www.nytimes.com/interactive/2021/world/covid-cases.html https://www.nytimes.com/interactive/2021/world/covid-cases.h...: Japan: 818 all time cases per 100k capita. US: 10,793 all time cases per 100k capita. I don't think that's "no evidence it's helped here either." It's is evidence that masks didn't completely solve the problem. But mitigations aren't bad. You have to keep in mind that different places have different ideas of what "failure looks like." Many Americans seem to think failure is only when they, as an individual, are personally dying of COVID right now.
- criticaltinker 5y ago
  > But mitigations aren't bad I support wearing a mask for individuals who are symptomatic or have a positive test result. Beyond that, it's likely that mandatory nonpharmaceutical interventions such as masks and lockdowns will be bad for public health in the long run. Consider the possibility that all the masking and isolation we've done is setting us up for an extremely bad flu season in the coming year or two [1]. We see the same pattern in forest management, where by constantly preventing the small natural forest fires, we unintentionally set the stage for massive record breaking wildfires. [1] The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections https://www.pnas.org/content/117/48/30547 https://www.pnas.org/content/117/48/30547
  - tablespoon 5y ago
    > Beyond that, it's likely that mandatory nonpharmaceutical interventions such as masks and lockdowns will be bad for public health in the long run. > Consider the possibility that all the masking and isolation we've done is setting us up for an extremely bad flu season in the coming year or two [1]. That logic is frankly messed up. That's like saying better die now, because if don't you're just setting yourself up to die later. In most situations, that extra span of life is worth it. Even if that's true about the next flu season, it's not an argument against masks. It's a warning not to declare premature victory.
  - mmastrac 5y ago
    This is not a great analogy, because you don't accumulate susceptibility to disease by avoiding it. Your immune system will work either way. And as long as we continue social distancing and masking, these other viruses will have their R0 reduced at the same time. If anything, this is a better argument for continuing the mitigations and slowly removing them over time rather than going all in on removing all restrictions like some jurisdictions are doing.
    - criticaltinker 5y ago
      > you don't accumulate susceptibility to disease by avoiding it But you do accumulate protection against pathogens by being exposed to them. > as long as we continue social distancing and masking The source I cited mentions that one of the primary risks is overwhelming medical facilities with huge waves of people who are all sick at the same time with endemic illnesses like the flu, RSV, etc. > this is a better argument for continuing the mitigations and slowly removing them over time An idea worth exploring for sure, but I think it will be difficult to achieve practically. At some point in that process there is going to be a majority of people out living their lives and not adhering to the mitigations, which is when the aforementioned consequences of these NPI's will become relevant.
- brigandish 5y ago
  If it doesn't mention testing[1] then that figure is misleading by lack of context. That's only where I'd begin. To really show any impact it would need comparison with a similar population, e.g. one part of Japan with another, not a country the size of a continent with an island whose populace doesn't have an obesity problem. [1] https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&facet=none&pickerSort=asc&pickerMetric=location&Metric=Tests&Interval=7-day+rolling+average&Relative+to+Population=true&Align+outbreaks=false&country=JPN~USA https://ourworldindata.org/explorers/coronavirus-data-explor...
  - kthejoker2 5y ago
    Please plant some actual goalposts so we can kick the ball through, the constant zigzagging in these threads is tiring and unhelpful.
    - brigandish 5y ago
      If you think that highlighting how a statistic is misleading* is moving the goalposts then I'm happy to continually move goalposts, but you might learn or use the definition of "moving the goalposts" correctly in the meanwhile. If you don't like the fact that the studies show no evidence that masks are of benefit, that's your problem, but don't try and attribute any fallacy to me without providing a damn sight more reasoning and evidence as it gives the appearance of you wishing to smear me to cover up what you lack, a valid, considered, and persuasive argument. * or worse, being used to mislead, which I don't think was happening from @tablespoon but I wouldn't put it past those who'd jump in with ad hominem and think it was a worthy contribution to the debate.
- seanp2k2 5y ago
  Also, given how much mass transit the average person in Japan is likely to use and the higher population density on average, it seems like a pretty big mistake to conclude that masks are useless.
  - brigandish 5y ago
    I fail to see the causal link you're proposing. Where is the evidence that masks have had an effect on preventing cases? On the other hand, we have good evidence[1] that obesity levels have a huge impact on cases: > Professor Rachel Batterham, Royal College of Physicians' lead adviser on obesity, said: > “The link between high levels of obesity and deaths from COVID-19 in the UK is indisputable, as is the urgent need to address the factors that lead so many people to be living with obesity. > “With 30% of COVID-19 hospitalisations in the UK directly attributed to overweight and obesity, and three quarters of all critically ill patients having overweight or obesity, the human and financial costs are high. From just the opening page of the report[2] itself: > We show that in those countries where overweight affects only a minority of the adult population, the rates of death from COVID-19 are typically less than one tenth the levels found in countries where overweight affects the majority of adults. > We also show that the drivers of overweight – especially high levels of consumption of processed foods – are associated with mortality from COVID-19. From the report's country profiles: Adult overweight BMI >25kg/m2 (2016) US : 67.9 UK : 63.7 Japan : 27.2 Adult obesity BMI >30kg/m2 (2016) US : 36.2 UK : 27.8 Japan : 4.3 Insufficient physical activity % adults (2016) US : 40.0 UK : 35.9 Japan : 35.5 Pulses per capita kg/pa (2014-2017) US : 3.6 UK : 3.7 Japan : 1.5 Root vegetables per capita kg/pa (2014-2017) US : 55.5 UK : 88.5 Japan : 24.9 Vegetable oil per capita kg/pa (2014-2017) US : 19.5 UK : 13.1 Japan : 15.5 Animal fat per capita kg/pa (2014-2017) US : 3.3 UK : 5.6 Japan : 1.0 Sugar per capita kg/pa (2014-2017) US : 66.2 UK : 37.8 Japan : 26.9 Sugar energy per capita kcal/pd (2014-2017) US : 607 UK : 342 Japan : 252 Sugar-sweetened beverage per capita l/pa (2015) US : 236.6 UK : 124.0 Japan : 144.3 There is much more in that report, it's well worth a read. This CDC report[3] states: > Among 4,899,447 hospitalized adults in PHD-SR, 540,667 (11.0%) were patients with COVID-19, of whom 94.9% had at least 1 underlying medical condition > Certain underlying conditions and the number of conditions were associated with severe COVID-19 illness. Hypertension and disorders of lipid metabolism were the most frequent, whereas obesity, diabetes with complication, and anxiety disorders were the strongest risk factors for severe COVID-19 illness. Cases are most frequently discovered due to severity of symptoms as being symptomatic will lead to testing. Thus the link between confirmed cases and underlying health conditions is easy to see. It goes on to state: > The analysis also shows that the total number of underlying conditions is strongly associated with severe COVID-19 illness. > The percentage of the US adult population known to have 2 or more underlying medical conditions ranges from approximately 38% to 64% by state (12). Previous studies demonstrated that patients with medically attended COVID-19 often had multiple underlying medical conditions (6). However, studies have rarely focused on the effect of the number of conditions on severe COVID-19 illness. We found that the risk of death, IMV, and ICU admission was often incrementally higher with a higher number of underlying medical conditions. Our finding that the number of underlying medical conditions is itself a risk factor for severe disease from COVID-19 identifies a population that has not been clearly described in previous literature. As I pointed out in another comment, the lack of testing in Japan keeps its number of confirmed cases low (which has seemed convenient given the government's clear desire for the Olympics to proceed), but the country is experiencing a huge uptick in cases right now - is this because of people suddenly dispensing with masks? I haven't noticed it, it's close to 100% compliance among adults even outdoors. Is there anything on this graph[4] to suggest that masks have efficacy at all? Why do randomised controlled trials repeatedly fail to show a positive effect? As to population density, Japan is only 41st on this list[5]. If being packed into a train is the problem then why the uptick now and not before? There's no lockdowns here and working from home is still not the norm. Did masks slow down the spread just until this point yet could not be held back any longer? So I say again, where is the evidence like this for masks? There is none. [1] https://www.rcplondon.ac.uk/news/rcp-responds-world-obesity-federation-report-showing-link-between-covid-19-deaths-and-obesity https://www.rcplondon.ac.uk/news/rcp-responds-world-obesity-... [2] https://www.worldobesityday.org/assets/downloads/COVID-19-and-Obesity-The-2021-Atlas.pdf https://www.worldobesityday.org/assets/downloads/COVID-19-an... [3] https://www.cdc.gov/pcd/issues/2021/21_0123.htm https://www.cdc.gov/pcd/issues/2021/21_0123.htm [4] https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&facet=none&pickerSort=asc&pickerMetric=location&Metric=Confirmed+cases&Interval=7-day+rolling+average&Relative+to+Population=true&Align+outbreaks=false&country=JPN~USA~GBR https://ourworldindata.org/explorers/coronavirus-data-explor... [5] https://en.wikipedia.org/wiki/List_of_countries_and_territories_by_population_density https://en.wikipedia.org/wiki/List_of_countries_and_territor...

tablespoon 5y ago

> I'm not sure why I wouldn't be against that. Additionally, I live in Japan where the kind of mask-adherence those back in the west can only have wet dreams about is the norm here, and there's no evidence it's helped here either. Per https://www.nytimes.com/interactive/2021/world/covid-cases.html https://www.nytimes.com/interactive/2021/world/covid-cases.h...: Japan: 818 all time cases per 100k capita. US: 10,793 all time cases per 100k capita. I don't think that's "no evidence it's helped here either." It's is evidence that masks didn't completely solve the problem. But mitigations aren't bad. You have to keep in mind that different places have different ideas of what "failure looks like." Many Americans seem to think failure is only when they, as an individual, are personally dying of COVID right now.

criticaltinker 5y ago
> But mitigations aren't bad I support wearing a mask for individuals who are symptomatic or have a positive test result. Beyond that, it's likely that mandatory nonpharmaceutical interventions such as masks and lockdowns will be bad for public health in the long run. Consider the possibility that all the masking and isolation we've done is setting us up for an extremely bad flu season in the coming year or two [1]. We see the same pattern in forest management, where by constantly preventing the small natural forest fires, we unintentionally set the stage for massive record breaking wildfires. [1] The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections https://www.pnas.org/content/117/48/30547 https://www.pnas.org/content/117/48/30547
- tablespoon 5y ago
  > Beyond that, it's likely that mandatory nonpharmaceutical interventions such as masks and lockdowns will be bad for public health in the long run. > Consider the possibility that all the masking and isolation we've done is setting us up for an extremely bad flu season in the coming year or two [1]. That logic is frankly messed up. That's like saying better die now, because if don't you're just setting yourself up to die later. In most situations, that extra span of life is worth it. Even if that's true about the next flu season, it's not an argument against masks. It's a warning not to declare premature victory.
- mmastrac 5y ago
  This is not a great analogy, because you don't accumulate susceptibility to disease by avoiding it. Your immune system will work either way. And as long as we continue social distancing and masking, these other viruses will have their R0 reduced at the same time. If anything, this is a better argument for continuing the mitigations and slowly removing them over time rather than going all in on removing all restrictions like some jurisdictions are doing.
  - criticaltinker 5y ago
    > you don't accumulate susceptibility to disease by avoiding it But you do accumulate protection against pathogens by being exposed to them. > as long as we continue social distancing and masking The source I cited mentions that one of the primary risks is overwhelming medical facilities with huge waves of people who are all sick at the same time with endemic illnesses like the flu, RSV, etc. > this is a better argument for continuing the mitigations and slowly removing them over time An idea worth exploring for sure, but I think it will be difficult to achieve practically. At some point in that process there is going to be a majority of people out living their lives and not adhering to the mitigations, which is when the aforementioned consequences of these NPI's will become relevant.
brigandish 5y ago
If it doesn't mention testing[1] then that figure is misleading by lack of context. That's only where I'd begin. To really show any impact it would need comparison with a similar population, e.g. one part of Japan with another, not a country the size of a continent with an island whose populace doesn't have an obesity problem. [1] https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&facet=none&pickerSort=asc&pickerMetric=location&Metric=Tests&Interval=7-day+rolling+average&Relative+to+Population=true&Align+outbreaks=false&country=JPN~USA https://ourworldindata.org/explorers/coronavirus-data-explor...
- kthejoker2 5y ago
  Please plant some actual goalposts so we can kick the ball through, the constant zigzagging in these threads is tiring and unhelpful.
  - brigandish 5y ago
    If you think that highlighting how a statistic is misleading* is moving the goalposts then I'm happy to continually move goalposts, but you might learn or use the definition of "moving the goalposts" correctly in the meanwhile. If you don't like the fact that the studies show no evidence that masks are of benefit, that's your problem, but don't try and attribute any fallacy to me without providing a damn sight more reasoning and evidence as it gives the appearance of you wishing to smear me to cover up what you lack, a valid, considered, and persuasive argument. * or worse, being used to mislead, which I don't think was happening from @tablespoon but I wouldn't put it past those who'd jump in with ad hominem and think it was a worthy contribution to the debate.
seanp2k2 5y ago
Also, given how much mass transit the average person in Japan is likely to use and the higher population density on average, it seems like a pretty big mistake to conclude that masks are useless.
- brigandish 5y ago
  I fail to see the causal link you're proposing. Where is the evidence that masks have had an effect on preventing cases? On the other hand, we have good evidence[1] that obesity levels have a huge impact on cases: > Professor Rachel Batterham, Royal College of Physicians' lead adviser on obesity, said: > “The link between high levels of obesity and deaths from COVID-19 in the UK is indisputable, as is the urgent need to address the factors that lead so many people to be living with obesity. > “With 30% of COVID-19 hospitalisations in the UK directly attributed to overweight and obesity, and three quarters of all critically ill patients having overweight or obesity, the human and financial costs are high. From just the opening page of the report[2] itself: > We show that in those countries where overweight affects only a minority of the adult population, the rates of death from COVID-19 are typically less than one tenth the levels found in countries where overweight affects the majority of adults. > We also show that the drivers of overweight – especially high levels of consumption of processed foods – are associated with mortality from COVID-19. From the report's country profiles: Adult overweight BMI >25kg/m2 (2016) US : 67.9 UK : 63.7 Japan : 27.2 Adult obesity BMI >30kg/m2 (2016) US : 36.2 UK : 27.8 Japan : 4.3 Insufficient physical activity % adults (2016) US : 40.0 UK : 35.9 Japan : 35.5 Pulses per capita kg/pa (2014-2017) US : 3.6 UK : 3.7 Japan : 1.5 Root vegetables per capita kg/pa (2014-2017) US : 55.5 UK : 88.5 Japan : 24.9 Vegetable oil per capita kg/pa (2014-2017) US : 19.5 UK : 13.1 Japan : 15.5 Animal fat per capita kg/pa (2014-2017) US : 3.3 UK : 5.6 Japan : 1.0 Sugar per capita kg/pa (2014-2017) US : 66.2 UK : 37.8 Japan : 26.9 Sugar energy per capita kcal/pd (2014-2017) US : 607 UK : 342 Japan : 252 Sugar-sweetened beverage per capita l/pa (2015) US : 236.6 UK : 124.0 Japan : 144.3 There is much more in that report, it's well worth a read. This CDC report[3] states: > Among 4,899,447 hospitalized adults in PHD-SR, 540,667 (11.0%) were patients with COVID-19, of whom 94.9% had at least 1 underlying medical condition > Certain underlying conditions and the number of conditions were associated with severe COVID-19 illness. Hypertension and disorders of lipid metabolism were the most frequent, whereas obesity, diabetes with complication, and anxiety disorders were the strongest risk factors for severe COVID-19 illness. Cases are most frequently discovered due to severity of symptoms as being symptomatic will lead to testing. Thus the link between confirmed cases and underlying health conditions is easy to see. It goes on to state: > The analysis also shows that the total number of underlying conditions is strongly associated with severe COVID-19 illness. > The percentage of the US adult population known to have 2 or more underlying medical conditions ranges from approximately 38% to 64% by state (12). Previous studies demonstrated that patients with medically attended COVID-19 often had multiple underlying medical conditions (6). However, studies have rarely focused on the effect of the number of conditions on severe COVID-19 illness. We found that the risk of death, IMV, and ICU admission was often incrementally higher with a higher number of underlying medical conditions. Our finding that the number of underlying medical conditions is itself a risk factor for severe disease from COVID-19 identifies a population that has not been clearly described in previous literature. As I pointed out in another comment, the lack of testing in Japan keeps its number of confirmed cases low (which has seemed convenient given the government's clear desire for the Olympics to proceed), but the country is experiencing a huge uptick in cases right now - is this because of people suddenly dispensing with masks? I haven't noticed it, it's close to 100% compliance among adults even outdoors. Is there anything on this graph[4] to suggest that masks have efficacy at all? Why do randomised controlled trials repeatedly fail to show a positive effect? As to population density, Japan is only 41st on this list[5]. If being packed into a train is the problem then why the uptick now and not before? There's no lockdowns here and working from home is still not the norm. Did masks slow down the spread just until this point yet could not be held back any longer? So I say again, where is the evidence like this for masks? There is none. [1] https://www.rcplondon.ac.uk/news/rcp-responds-world-obesity-federation-report-showing-link-between-covid-19-deaths-and-obesity https://www.rcplondon.ac.uk/news/rcp-responds-world-obesity-... [2] https://www.worldobesityday.org/assets/downloads/COVID-19-and-Obesity-The-2021-Atlas.pdf https://www.worldobesityday.org/assets/downloads/COVID-19-an... [3] https://www.cdc.gov/pcd/issues/2021/21_0123.htm https://www.cdc.gov/pcd/issues/2021/21_0123.htm [4] https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&facet=none&pickerSort=asc&pickerMetric=location&Metric=Confirmed+cases&Interval=7-day+rolling+average&Relative+to+Population=true&Align+outbreaks=false&country=JPN~USA~GBR https://ourworldindata.org/explorers/coronavirus-data-explor... [5] https://en.wikipedia.org/wiki/List_of_countries_and_territories_by_population_density https://en.wikipedia.org/wiki/List_of_countries_and_territor...