3 ms·

Correct, we don’t know if masks work … in the same sense that we “don’t know” if parachutes work[1]. That is, we don’t (and can’t) do the level of randomized co

by SilasX 4y ago

Correct, we don’t know if masks work … in the same sense that we “don’t know” if parachutes work[1]. That is, we don’t (and can’t) do the level of randomized controlled trials that would precisely mimic real-world application. Nevertheless, we’re capable of appropriate risk based inference. We can verify that masks slow down the spread of airborne particles and we know SARS-type viruses spread that way. Combined with the low cost of mask wearing and the huge impacts of a pandemic, a good risk analysis weighs heavily in favor of using them. Even accepting the over-skeptical view you’ve given, official statements were still overconfident. Fauci was saying in February 2020 that “there’s no reason for anyone to be wearing a mask”, which you can’t justify by these claims of ignorance. “A small chance of slowing a SARS-type virus” is a great reason to wear a mask! [1] https://slatestarcodex.com/2020/04/14/a-failure-but-not-of-prediction/ https://slatestarcodex.com/2020/04/14/a-failure-but-not-of-p...

ethanbond 4y ago
Yep, agreed with all of this which is why I think when it became the case that the general population wearing masks would not have negative impacts on supply for medical workers, it made sense to default to “wear masks.” When the gen pop wearing masks would have a negative impact on supply, it seems defensible at least to advocate against the population buying masks. Note that what confuses people here is not that the consensus on whether masks work or not changed, but that it didn’t change. “We don’t know if masks work, don’t get them” turned to “we don’t know if masks work, start wearing them.” I agree it would’ve helped the credibility issue a lot if they were more open about the supply calculus behind the scenes, but I’m personally pretty confident this would’ve yielded worse outcomes. No chance that the population wouldn’t have scrambled for masks and therefore no chance that the people who did actually in reality need them most would’ve gotten them. Of course there’s a lot, a lot of room for criticism of the mask/PPE shortage existing at all, but obviously the solution to that looks different than the solution to “CDC said masks don’t work.”
- SilasX 4y ago
  But they weren’t advising the public not to wear masks based on genuine skepticism, but on a confused belief that it would have the narrow effect of relieving the supply crunch, with no long term effect on mask compliance in the future, even given the loss of trust from having told the public BS reasons not to wear them. (Like the Fauci quotes and assertions of ineffectiveness.) That was stupid, and foreseeably so.
  - ethanbond 4y ago
    I think even now it's very hard to establish whether it was stupid, never mind foreseeably so. Do you have evidence to suggest either 1) there was no supply crunch, 2) the supply crunch wasn't alleviated by this guidance, or 3) the supply crunch wouldn't have affected the medical system's capacity? It's completely believable to me that future mask compliance among the general population is way less valuable than ensuring that medical professionals had N95s in the first half or first quarter of 2020. Also seems believable that that guidance reduced N95 consumption among the general public.
    - SilasX 4y ago
      Do you have evidence that the earlier advice wasn’t responsible for mask reluctance later? Because when you tell people masks are ineffective, that’s a very very hard bell to unring, and indeed, many mask rejecters were citing those very same health officials. And why wouldn’t they? Those are the trusted authorities! Of course there was a mask shortage. But like the others said, the correct way to fight a toilet paper shortage is not to tell people that it’s ineffective at removing feces from your anus. It’s to a) throttle sales at retail, b) give guidance on alternatives (here, how to turn a shirt into a mask), c) coordinate on increased production. If masking up had been a high status thing to do early on, that would have saved a lot of effort in policing later. Yes, lying to the public and expecting them to both trust and keep up with the latest lie is foreseeably stupid. I hope you don’t need insurmountable evidence to agree with that part.
      - ethanbond 4y ago
        Well no I don't have evidence of that. On the contrary I know for a fact it did, but that's not a necessary premise for my position. Again, CDC did not say masks aren't effective. They said we don't know if they are. This was and largely remains true. For your other solutions, you think instituting a nationwide rationing system was a more accessible solution than saying "we don't know if they work [true] and medical professionals need them more [true], please don't buy them?" And yes, we very obviously should've invoked the Defense Production Act pretty much immediately on testing and PPE. Quite indefensible that we didn't. "Has foreseeable negative consequences" != "is stupid," especially in emergency scenarios where you're picking between bad options and worse ones.

by SilasX 4y ago

ethanbond 4y ago

Yep, agreed with all of this which is why I think when it became the case that the general population wearing masks would not have negative impacts on supply for medical workers, it made sense to default to “wear masks.” When the gen pop wearing masks would have a negative impact on supply, it seems defensible at least to advocate against the population buying masks. Note that what confuses people here is not that the consensus on whether masks work or not changed, but that it didn’t change. “We don’t know if masks work, don’t get them” turned to “we don’t know if masks work, start wearing them.” I agree it would’ve helped the credibility issue a lot if they were more open about the supply calculus behind the scenes, but I’m personally pretty confident this would’ve yielded worse outcomes. No chance that the population wouldn’t have scrambled for masks and therefore no chance that the people who did actually in reality need them most would’ve gotten them. Of course there’s a lot, a lot of room for criticism of the mask/PPE shortage existing at all, but obviously the solution to that looks different than the solution to “CDC said masks don’t work.”

SilasX 4y ago
But they weren’t advising the public not to wear masks based on genuine skepticism, but on a confused belief that it would have the narrow effect of relieving the supply crunch, with no long term effect on mask compliance in the future, even given the loss of trust from having told the public BS reasons not to wear them. (Like the Fauci quotes and assertions of ineffectiveness.) That was stupid, and foreseeably so.
- ethanbond 4y ago
  I think even now it's very hard to establish whether it was stupid, never mind foreseeably so. Do you have evidence to suggest either 1) there was no supply crunch, 2) the supply crunch wasn't alleviated by this guidance, or 3) the supply crunch wouldn't have affected the medical system's capacity? It's completely believable to me that future mask compliance among the general population is way less valuable than ensuring that medical professionals had N95s in the first half or first quarter of 2020. Also seems believable that that guidance reduced N95 consumption among the general public.
  - SilasX 4y ago
    Do you have evidence that the earlier advice wasn’t responsible for mask reluctance later? Because when you tell people masks are ineffective, that’s a very very hard bell to unring, and indeed, many mask rejecters were citing those very same health officials. And why wouldn’t they? Those are the trusted authorities! Of course there was a mask shortage. But like the others said, the correct way to fight a toilet paper shortage is not to tell people that it’s ineffective at removing feces from your anus. It’s to a) throttle sales at retail, b) give guidance on alternatives (here, how to turn a shirt into a mask), c) coordinate on increased production. If masking up had been a high status thing to do early on, that would have saved a lot of effort in policing later. Yes, lying to the public and expecting them to both trust and keep up with the latest lie is foreseeably stupid. I hope you don’t need insurmountable evidence to agree with that part.
    - ethanbond 4y ago
      Well no I don't have evidence of that. On the contrary I know for a fact it did, but that's not a necessary premise for my position. Again, CDC did not say masks aren't effective. They said we don't know if they are. This was and largely remains true. For your other solutions, you think instituting a nationwide rationing system was a more accessible solution than saying "we don't know if they work [true] and medical professionals need them more [true], please don't buy them?" And yes, we very obviously should've invoked the Defense Production Act pretty much immediately on testing and PPE. Quite indefensible that we didn't. "Has foreseeable negative consequences" != "is stupid," especially in emergency scenarios where you're picking between bad options and worse ones.