6 ms·

> there was never data that said "masks don't work for the public" Actually there was plenty of data saying that masks don't work for the public. For example,

> there was never data that said "masks don't work for the public" Actually there was plenty of data saying that masks don't work for the public. For example, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0013998 https://journals.plos.org/plosone/article?id=10.1371/journal... And there are many others - that was just an easy one I found today. Some similar studies even showed an increase in flu transmission among the subject population wearing masks. There were plenty of articles (such as the Tufekci one you cite) at the time explaining that normal folks don't know proper mask discipline, such as how to fit masks and avoid fomite transmission. In this situation with limited supply it makes sense to preserve masks for skilled people who are facing numerous likely transmission sources, especially on the front line of providing health care. The new data was that fomite transmission is not a strong vector for COVID19, that even modest mask technology is a good source transmission interrupter, and that the contagion window is well in advance of active symptoms. This new data meant that the flu based studies were not representative.

hn_throwaway_99 5y ago
Well, for what it's worth, there are lots of other studies that said the opposite: https://www.ijidonline.com/article/S1201-9712(08)01008-4/fulltext https://www.ijidonline.com/article/S1201-9712(08)01008-4/ful... https://www.cambridge.org/core/journals/epidemiology-and-infection/article/face-masks-to-prevent-transmission-of-influenza-virus-a-systematic-review/64D368496EBDE0AFCC6639CCC9D8BC05 https://www.cambridge.org/core/journals/epidemiology-and-inf...
titzer 5y ago
IMHO it was just a stupid call, because in the face of conflicting data, it would have been a better default option to recommend masks. That's easier to walk back than "oops, we were lying because we don't trust you rubes enough not to hoard, even when explicitly instructed not to hoard." In the beginning of the pandemic I, with effectively zero sewing skills, made a cloth mask out of spare clothing. They could have had an infomercial showing people the most effective cloth mask designs they could sew at home. That's easier to walk back to "oh, cloth doesn't work that great, we recommend N95 now" when the supply of those was adequate. In short, they could have pretended that the public is not stupid and just told the damn truth.
- autoexec 5y ago
  I agree. Wanting to keep supplies to healthcare workers wouldn't have even been all that hard. Thanks to the horrific amount of consolidation in retail they could have gone to only a handful of major players like amazon and walmart and said "Please pull these masks off of shelves and help us save them for healthcare workers" and that would have kept them out of the hands of the vast majority of the population. A few might have tried ordering them from overseas or spent hours trying to get them from random places online hoping that they were getting the real thing and not overpriced knockoffs, but most people were not going to do that, especially if the reasons they shouldn't were communicated to them. Claiming the masks are useless to the public but critical for healthcare workers made no sense. I mean, I think most people would accept that putting just about anything in front of your gaping virus-spewing face holes would have some benefit. Health agencies have pushed for things like the vampire cough/sneeze for ages to reduce the spread of all kinds of things, although the crook of your elbow is hardly a panacea. I think either way we'd have ended up with a bunch of dumb or selfish people who refused to put a mask on, and there were already plenty of people distrustful of the CDC and WHO but they sure didn't do themselves any favors.
  - eftychis 5y ago
    I am not sure if going to e.g. Amazon or Walmart would have worked. If this is timed incorrectly it is easy to cause needless mob hoarding -- see toilet paper de-buckle... That said yes blatant misinformation backfired royally. I recall at the point already people were calling bullshit and ignoring the "do not need masks" guideline. This did not happen only in the U.S. or just due to the masks. E.g. the handling of Astrazeneca and other vaccination complications have instilled fear and also a sense of mistrust. I think there would be a few people not wearing masks or not vaccinated but the percentage would be much lower -- low enough that we can progress forward. The moment masks and vaccinations became a political tool in the U.S. and there was no political solidarity it was game over. Couple that with lying and can you really blame people not trusting the government?
  - ravel-bar-foo 5y ago
    At the beginning of the pandemic, there were a lot of problems that required "thinking outside the box," and the US wasn't up to the task. China banned mask exports for a time. Large N95 exports might still require a license in Korea. The Korean government politely asked Samsung in January 2020 to import a few tons of meltblown plastic, and in March instituted export limits and mask rations to secure the domestic mask supply. (The plastic was then allocated from Samsung to mask manufacturers, and when the manufacturers tried to flex their newfound market power the government threatened to take them over.) Meanwhile the US continued to allow foreign entities to hoard and export masks and meltblown plastic, and didn't make any effort to secure or guarantee domestic production. It would have been so easy for the national stockpile to place an order for 5~10 billion masks, and then set themselves up as an additional link in the supply chain to hospitals which buffers against fluctuations. I imagine they were limited by their legal framework and budget.
autoexec 5y ago
> This new data meant that the flu based studies were not representative. I don't think it's a huge stretch to say that having some conflicting data on the effectiveness of masks to reduce the spread of flu is not the same as having data on the effectiveness of those same masks to reduce the spread of a novel virus. Throw in distinctions between types of masks, estimates for how well people will use/handle/fit them, and things get very complicated very quickly. Distinctions like that can seem like splitting hairs, but they matter and it makes messaging difficult. I totally get why they wanted to keep supplies for healthcare workers and how hard it would be educate everyone on all the factors, but they really could have handled it better and been more honest.
SkyMarshal 5y ago
> Actually there was plenty of data saying that masks don't work for the public. ... (a year of arguing and studies ensues while a pandemic of a new and not-well-understood virus spreads out of control) ... > The new data was that ... even modest mask technology is a good source transmission interrupter, and that the contagion window is well in advance of active symptoms. A wasted year and all that rigamarole just to figure out what Asian societies have known for decades, and common sense untainted by politics should easily conclude. Masks are a cheap and easy way of reducing airborne transmission. The US and other Western countries that botched this really need to learn a few things: - how to learn from other societies that have more recent experience with certain things like airbone pandemics than we do. - how to do better cost-risk-benefit analysis. Masks are an extremely cheap, easy and minimally invasive means of mitigating potentially serious and vastly more costly systemic bio-risks. This NIH attitude, and notion that we have to spend a year doing studies to figure out what a little back-of-the-napkin risk analysis shows and other societies already know from first-hand experience, is absurd.
- oblio 5y ago
  You're fighting against such an ingrained level of belief in one's superiority that's it's almost impossible. The US, especially.
- native_samples 5y ago
  No, actually, there's still no data that mask mandates work. You can simply look at case graphs for different countries, and try to figure out when mandates were added or removed. It can't be done, although introducing changes to the case curves big enough to notice was the only justification for the policy. Given the short serial interval any mandates should have made a clear and obvious impact on case numbers within days, but that never happened. "we have to spend a year doing studies to figure out what a little back-of-the-napkin risk analysis shows" Both risk analysis and the studies proved wrong. The real world data is the ground truth here, because that's what the policies were designed to affect.
- cjsplat 5y ago
  The article "hn_throwaway" cited was March 17th, 2020, and indicates the emerging understanding well. San Francisco issued a mask mandate on April 17, 2020. So that delay was mid February to mid April. So help me out here since you say it three times. Where is that "wasted year"?
paul_f 5y ago
If masks worked effectively, it would be quite simple to find a strong correlation between cases and areas with lax mask usage. Instead it is all over the map (pun intended).

hn_throwaway_99 5y ago

Well, for what it's worth, there are lots of other studies that said the opposite: https://www.ijidonline.com/article/S1201-9712(08)01008-4/fulltext https://www.ijidonline.com/article/S1201-9712(08)01008-4/ful... https://www.cambridge.org/core/journals/epidemiology-and-infection/article/face-masks-to-prevent-transmission-of-influenza-virus-a-systematic-review/64D368496EBDE0AFCC6639CCC9D8BC05 https://www.cambridge.org/core/journals/epidemiology-and-inf...

titzer 5y ago

IMHO it was just a stupid call, because in the face of conflicting data, it would have been a better default option to recommend masks. That's easier to walk back than "oops, we were lying because we don't trust you rubes enough not to hoard, even when explicitly instructed not to hoard." In the beginning of the pandemic I, with effectively zero sewing skills, made a cloth mask out of spare clothing. They could have had an infomercial showing people the most effective cloth mask designs they could sew at home. That's easier to walk back to "oh, cloth doesn't work that great, we recommend N95 now" when the supply of those was adequate. In short, they could have pretended that the public is not stupid and just told the damn truth.

autoexec 5y ago
I agree. Wanting to keep supplies to healthcare workers wouldn't have even been all that hard. Thanks to the horrific amount of consolidation in retail they could have gone to only a handful of major players like amazon and walmart and said "Please pull these masks off of shelves and help us save them for healthcare workers" and that would have kept them out of the hands of the vast majority of the population. A few might have tried ordering them from overseas or spent hours trying to get them from random places online hoping that they were getting the real thing and not overpriced knockoffs, but most people were not going to do that, especially if the reasons they shouldn't were communicated to them. Claiming the masks are useless to the public but critical for healthcare workers made no sense. I mean, I think most people would accept that putting just about anything in front of your gaping virus-spewing face holes would have some benefit. Health agencies have pushed for things like the vampire cough/sneeze for ages to reduce the spread of all kinds of things, although the crook of your elbow is hardly a panacea. I think either way we'd have ended up with a bunch of dumb or selfish people who refused to put a mask on, and there were already plenty of people distrustful of the CDC and WHO but they sure didn't do themselves any favors.
- eftychis 5y ago
  I am not sure if going to e.g. Amazon or Walmart would have worked. If this is timed incorrectly it is easy to cause needless mob hoarding -- see toilet paper de-buckle... That said yes blatant misinformation backfired royally. I recall at the point already people were calling bullshit and ignoring the "do not need masks" guideline. This did not happen only in the U.S. or just due to the masks. E.g. the handling of Astrazeneca and other vaccination complications have instilled fear and also a sense of mistrust. I think there would be a few people not wearing masks or not vaccinated but the percentage would be much lower -- low enough that we can progress forward. The moment masks and vaccinations became a political tool in the U.S. and there was no political solidarity it was game over. Couple that with lying and can you really blame people not trusting the government?
- ravel-bar-foo 5y ago
  At the beginning of the pandemic, there were a lot of problems that required "thinking outside the box," and the US wasn't up to the task. China banned mask exports for a time. Large N95 exports might still require a license in Korea. The Korean government politely asked Samsung in January 2020 to import a few tons of meltblown plastic, and in March instituted export limits and mask rations to secure the domestic mask supply. (The plastic was then allocated from Samsung to mask manufacturers, and when the manufacturers tried to flex their newfound market power the government threatened to take them over.) Meanwhile the US continued to allow foreign entities to hoard and export masks and meltblown plastic, and didn't make any effort to secure or guarantee domestic production. It would have been so easy for the national stockpile to place an order for 5~10 billion masks, and then set themselves up as an additional link in the supply chain to hospitals which buffers against fluctuations. I imagine they were limited by their legal framework and budget.

autoexec 5y ago

> This new data meant that the flu based studies were not representative. I don't think it's a huge stretch to say that having some conflicting data on the effectiveness of masks to reduce the spread of flu is not the same as having data on the effectiveness of those same masks to reduce the spread of a novel virus. Throw in distinctions between types of masks, estimates for how well people will use/handle/fit them, and things get very complicated very quickly. Distinctions like that can seem like splitting hairs, but they matter and it makes messaging difficult. I totally get why they wanted to keep supplies for healthcare workers and how hard it would be educate everyone on all the factors, but they really could have handled it better and been more honest.

SkyMarshal 5y ago

> Actually there was plenty of data saying that masks don't work for the public. ... (a year of arguing and studies ensues while a pandemic of a new and not-well-understood virus spreads out of control) ... > The new data was that ... even modest mask technology is a good source transmission interrupter, and that the contagion window is well in advance of active symptoms. A wasted year and all that rigamarole just to figure out what Asian societies have known for decades, and common sense untainted by politics should easily conclude. Masks are a cheap and easy way of reducing airborne transmission. The US and other Western countries that botched this really need to learn a few things: - how to learn from other societies that have more recent experience with certain things like airbone pandemics than we do. - how to do better cost-risk-benefit analysis. Masks are an extremely cheap, easy and minimally invasive means of mitigating potentially serious and vastly more costly systemic bio-risks. This NIH attitude, and notion that we have to spend a year doing studies to figure out what a little back-of-the-napkin risk analysis shows and other societies already know from first-hand experience, is absurd.

oblio 5y ago
You're fighting against such an ingrained level of belief in one's superiority that's it's almost impossible. The US, especially.
native_samples 5y ago
No, actually, there's still no data that mask mandates work. You can simply look at case graphs for different countries, and try to figure out when mandates were added or removed. It can't be done, although introducing changes to the case curves big enough to notice was the only justification for the policy. Given the short serial interval any mandates should have made a clear and obvious impact on case numbers within days, but that never happened. "we have to spend a year doing studies to figure out what a little back-of-the-napkin risk analysis shows" Both risk analysis and the studies proved wrong. The real world data is the ground truth here, because that's what the policies were designed to affect.
cjsplat 5y ago
The article "hn_throwaway" cited was March 17th, 2020, and indicates the emerging understanding well. San Francisco issued a mask mandate on April 17, 2020. So that delay was mid February to mid April. So help me out here since you say it three times. Where is that "wasted year"?

paul_f 5y ago

If masks worked effectively, it would be quite simple to find a strong correlation between cases and areas with lax mask usage. Instead it is all over the map (pun intended).