5 ms·

> I am amused that folks seem to think we could eradicate so many widespread diseases with just masks. Sorry, who "seems to think this?". I haven't seen this

by ajross 4y ago

> I am amused that folks seem to think we could eradicate so many widespread diseases with just masks. Sorry, who "seems to think this?". I haven't seen this claim, or anything like it, anywhere. The point many were making was that the overwhelmingly successful suppression of all these other diseases was clear proof that "masks work" to suppress disease, and by extension that we should wear them to effect the suppression of a much more dangerous pandemic. So when there's a largely uncontrolled pandemic happening, you should wear a mask. Now, general immunity seems to have reached a point where the pandemic is at least reasonably controlled without mitigation strategies. Covid of mid-2022 is now a worrisome endemic disease, comparable to (but yet rather more dangerous than) the worst flu seasons we've seen in the past century (since 1918). So... we can take our masks off now (most of us, admitting that some people have different levels of risk tolerance, etc...). The calculus changes because the facts on the ground have changed. None of that is an argument that you shouldn't have worn a mask in late 2020. You absolutely should have, and it remains horrifying to me that so many of us didn't.

taeric 4y ago
Oddly, you are making the claim I question here. This "proof that masks work" is likely more just proof that not having kids in schools cuts a lot of spread. I really cannot underscore enough how much more sick you will get when you have kids in school than when you don't. And homeschool isn't really an answer here, sadly. It is fairly well documented that kids that come out of homeschool and finally enter a workforce or other social environment are at a heightened risk of sicknesses that the general populace just doesn't notice. Edit: I hasten to add that I agree this is not an argument that masks don't work. And I don't understand why some folks still insist on fighting not to wear them.
- superkuh 4y ago
  Before we can have a debate about "masks" we have to define what masks are. It's undeniably clear that wearing actual respirator N95 or ffp2 masks that are fit to the face work in preventing infection and spread. That's just physics. But when most are only wearing a partial covering "mask" that just blocks spittle of course it's not going to prevent infecting or infection by an aerosol spread disease. The real problem with "masks" was that our governments' intentionally lied about the need for them at the start of the pandemic. The messaging never recovered from this and I imagine even if government health institutions stated the truth today, that face fit respirators are required, it'd just be ignored. The problem wasn't ever actual masks, it was people lying about them and people not wearing them. Sure, unfit "masks" might have some mitigation potential and it's better than wearing nothing. But masks, in the context of an aerosol spread infection, have to mean fit respirator masks.
  - taeric 4y ago
    I think you also need to consider direction of spread. It is easy to see how spread from an individual is cut with masks. Spread to the individual is almost certainly affected, but to really cut it down, you almost certainly need gloves and a ton of hand washing going on. But, again, I am /not/ arguing against masks. I fully agree that if you are sick, stay home and wear a mask when you do go out. My point is that much of the reduction is more easily explained with "stay home" than it was "a lot of folks were wearing masks." I further agree that both had an likely had an impact. But, just as having a more streamlined car will give you better gas mileage, if you are trying to make a bigger impact, you are almost certainly better focusing on buses than you are personal vehicles.
- ajross 4y ago
  > This "proof that masks work" is likely more just proof that not having kids in schools cuts a lot of spread. It is? I mean, something worked. You think the fact that flu deaths dropped to essentially zero for two years was exclusively due to school closures? Is there any evidence for that? I'll admit to some individual dithering on the evidence for any given mitigation strategy. But clearly, on the whole, societal mitigations for covid worked very well to control disease. You admit that much, right? People freaked out about school closures too. They freaked out about distancing. They freaked out about travel restrictions. (also covid-specific rules like testing requirements, and vaccination programs). And it was, overall, the same people arguing against all this stuff that was, again, clearly working as evidenced by its effect on influenza and et. al. So why did people argue so hard against exactly those (working!) mitigation strategies?
  - jdminhbg 4y ago
    > You think the fact that flu deaths dropped to essentially zero for two years was exclusively due to school closures? More likely due to nursing home closures I would think.
    - ajross 4y ago
      Is there any evidence for that? This again seems like the kind of whataboutism designed to deflect and not engage. Clearly what we did worked vs. the flu. So arguments that "what we did" was not effective vs. covid seem prima facie wrong. Right? It's OK to argue at the margins about what the most effective strategies were, and I'm happy to engage on that. But almost everywhere I see this argument, it seems more like an attempt to paper over a historical refusal to accommodate any mitigation at all.
      - jdminhbg 4y ago
        There's exactly as much evidence for that as there is for any other mitigation, which is to say none because the CDC has spent approximately 0 dollars trying to study any of them seriously. We're all just guessing.
glofish 4y ago
Alas even today there is no RCT on masks. Why? Countries and states with strict mask policies did not do better than those without these policies (see US States for an example). So do mask work? It is like a religious belief system, you would get the same reaction when questioning if God existed and asked parishioners and atheists. Everything is evidence for those that want to believe. Studies that claim to "prove" that masks work turn out to be shambolic messes - yet are published in the most selective of journals, see for example: Effect size is significantly more important than statistical significance. http://www.argmin.net/2021/09/13/effect-size/ http://www.argmin.net/2021/09/13/effect-size/
- frenchy 4y ago
  How would you ethically design an RCT on masks (as a method of reducing COVID-19 transmission obviously)?
  - glofish 4y ago
    How would you "ethically" design a vaccine study? There is your answer.
- maxerickson 4y ago
  You say: Studies that claim to "prove" that masks work turn out to be shambolic messes Do you have a list of the 10 or 20 studies on high filtration masks that you found to be better than the others that you evaluated?
  - glofish 4y ago
    "Revisiting Pediatric COVID-19 Cases in Counties With and Without School Mask Requirements" https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4118566 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4118566 > We failed to establish a relationship between school masking and pediatric cases using the same methods but a larger, more nationally diverse population over a longer interval. Our study demonstrates that observational studies of interventions with small to moderate effect sizes are prone to bias caused by selection and omitted variables. If you look at the plot - there were more cases when masks were required!

by ajross 4y ago

taeric 4y ago

Oddly, you are making the claim I question here. This "proof that masks work" is likely more just proof that not having kids in schools cuts a lot of spread. I really cannot underscore enough how much more sick you will get when you have kids in school than when you don't. And homeschool isn't really an answer here, sadly. It is fairly well documented that kids that come out of homeschool and finally enter a workforce or other social environment are at a heightened risk of sicknesses that the general populace just doesn't notice. Edit: I hasten to add that I agree this is not an argument that masks don't work. And I don't understand why some folks still insist on fighting not to wear them.

superkuh 4y ago
Before we can have a debate about "masks" we have to define what masks are. It's undeniably clear that wearing actual respirator N95 or ffp2 masks that are fit to the face work in preventing infection and spread. That's just physics. But when most are only wearing a partial covering "mask" that just blocks spittle of course it's not going to prevent infecting or infection by an aerosol spread disease. The real problem with "masks" was that our governments' intentionally lied about the need for them at the start of the pandemic. The messaging never recovered from this and I imagine even if government health institutions stated the truth today, that face fit respirators are required, it'd just be ignored. The problem wasn't ever actual masks, it was people lying about them and people not wearing them. Sure, unfit "masks" might have some mitigation potential and it's better than wearing nothing. But masks, in the context of an aerosol spread infection, have to mean fit respirator masks.
- taeric 4y ago
  I think you also need to consider direction of spread. It is easy to see how spread from an individual is cut with masks. Spread to the individual is almost certainly affected, but to really cut it down, you almost certainly need gloves and a ton of hand washing going on. But, again, I am /not/ arguing against masks. I fully agree that if you are sick, stay home and wear a mask when you do go out. My point is that much of the reduction is more easily explained with "stay home" than it was "a lot of folks were wearing masks." I further agree that both had an likely had an impact. But, just as having a more streamlined car will give you better gas mileage, if you are trying to make a bigger impact, you are almost certainly better focusing on buses than you are personal vehicles.
ajross 4y ago
> This "proof that masks work" is likely more just proof that not having kids in schools cuts a lot of spread. It is? I mean, something worked. You think the fact that flu deaths dropped to essentially zero for two years was exclusively due to school closures? Is there any evidence for that? I'll admit to some individual dithering on the evidence for any given mitigation strategy. But clearly, on the whole, societal mitigations for covid worked very well to control disease. You admit that much, right? People freaked out about school closures too. They freaked out about distancing. They freaked out about travel restrictions. (also covid-specific rules like testing requirements, and vaccination programs). And it was, overall, the same people arguing against all this stuff that was, again, clearly working as evidenced by its effect on influenza and et. al. So why did people argue so hard against exactly those (working!) mitigation strategies?
- jdminhbg 4y ago
  > You think the fact that flu deaths dropped to essentially zero for two years was exclusively due to school closures? More likely due to nursing home closures I would think.
  - ajross 4y ago
    Is there any evidence for that? This again seems like the kind of whataboutism designed to deflect and not engage. Clearly what we did worked vs. the flu. So arguments that "what we did" was not effective vs. covid seem prima facie wrong. Right? It's OK to argue at the margins about what the most effective strategies were, and I'm happy to engage on that. But almost everywhere I see this argument, it seems more like an attempt to paper over a historical refusal to accommodate any mitigation at all.
    - jdminhbg 4y ago
      There's exactly as much evidence for that as there is for any other mitigation, which is to say none because the CDC has spent approximately 0 dollars trying to study any of them seriously. We're all just guessing.

glofish 4y ago

Alas even today there is no RCT on masks. Why? Countries and states with strict mask policies did not do better than those without these policies (see US States for an example). So do mask work? It is like a religious belief system, you would get the same reaction when questioning if God existed and asked parishioners and atheists. Everything is evidence for those that want to believe. Studies that claim to "prove" that masks work turn out to be shambolic messes - yet are published in the most selective of journals, see for example: Effect size is significantly more important than statistical significance. http://www.argmin.net/2021/09/13/effect-size/ http://www.argmin.net/2021/09/13/effect-size/

frenchy 4y ago
How would you ethically design an RCT on masks (as a method of reducing COVID-19 transmission obviously)?
- glofish 4y ago
  How would you "ethically" design a vaccine study? There is your answer.
maxerickson 4y ago
You say: Studies that claim to "prove" that masks work turn out to be shambolic messes Do you have a list of the 10 or 20 studies on high filtration masks that you found to be better than the others that you evaluated?
- glofish 4y ago
  "Revisiting Pediatric COVID-19 Cases in Counties With and Without School Mask Requirements" https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4118566 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4118566 > We failed to establish a relationship between school masking and pediatric cases using the same methods but a larger, more nationally diverse population over a longer interval. Our study demonstrates that observational studies of interventions with small to moderate effect sizes are prone to bias caused by selection and omitted variables. If you look at the plot - there were more cases when masks were required!