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Despite the obviously charged assertion the authors make, I believe this is a good topic to discuss now that the weight of the pandemic is complete. You don't c

by tomrod 4y ago

Despite the obviously charged assertion the authors make, I believe this is a good topic to discuss now that the weight of the pandemic is complete. You don't change emergency management plans in the middle of an emergency. We can and should question our approaches, extracting global principles that can be used next time this happens. Similar topics we should rigorously evaluate include FDA and CDC policies, but those are outside scope of the article. I respect the authors' asking the question, but think their narrative is a bit weak / not tied down sufficiently to make a strong claim based solely on literature review. For example: they raise the question of increases in stillborn births and then cite a 3X increase in stillbirths among studied women versus the population rate. Without additional facts, that looks potentially damning to mask wearing during a pandemic driven by a respiratory virus. What is less clear is how the accounting for observed versus actual is performed. Similar to crime statistics, the count of incidence is biased by several positive and negative factors, and stillbirths are not always captured. What _was_ observed was a significant increase in stillbirths due to COVID-19 (especially the Delta variant, which to be fair the authors mention).

frankreyes 4y ago
[flagged]
- autoexec 4y ago
  Good thing that since then we've gathered extensive evidence supporting their effectiveness. Not that it should really surprise anyone. Putting literally anything in front of our virus spewing face holes helps people avoid getting sick which is why children are taught to vampire cough/sneeze. The crook of our arms aren't filtering viruses like an N95 mask would but somehow it still helps.
  - frankreyes 4y ago
    > N95 Did you read the article? No you didn't. >>> But, wait, hold on. What about N-95 masks, as opposed to lower-quality surgical or cloth masks? “Makes no difference — none of it,” said Jefferson. >>> Do you think that COVID is the first virus ever to come to humanity? Do you think that nobody ever thought about the effectiveness of face masks? Do you think that somehow face masks lost effectiveness after 2020 but before they were effective? No. No. No. Scientists knew all along that face masks didn't work. Edit: >>> Compared to masks, N95 respirators conferred superior protection against CRI (...) and laboratory-confirmed bacterial (...), but not viral infections or ILI ...[influenza-like illness] <<< COVID-19 is a virus, and an ILI. https://academic.oup.com/cid/article/65/11/1934/4068747 https://academic.oup.com/cid/article/65/11/1934/4068747
    - emj 4y ago
      > Scientists knew all along that face masks didn't work. No. Masks were not mandatory here [1], they were not even recommended in the beginning. Later masks were recommended [2] in public transport during rush hours during a 6 month period in 2021. The reasoning for not recommending masks in the beginning was that there were too little data supporting the effectiveness of masks. So scientist did not "know" for certain. I am not sure we can discuss this issue yet, there are still too many with non scientific agenda engaged in the debate. [1] Sweden https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic#Europe https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19... [2] EDIT: I said mandatory, it was not.
      - frankreyes 4y ago
        I gave scientific evidence of both and after studies that agreed each other, but you insist of spinning this in terms of politics... When actions contradict scientific evidence it's all about politics, no disagreement there. In your example of Sweden, I'd say it's a prisoner's dilemma politicians are forced to follow suit on what other countries are doing. It happened in my country that the National Health Minister had to resign under pressure of ineptitude, not following international practices, and corruption during pandemic. But your statement about evidence, it's simply not true. Go back and read one more time my two scientific pieces of evidence. Here there are again: Before: https://academic.oup.com/cid/article/65/11/1934/4068747 https://academic.oup.com/cid/article/65/11/1934/4068747 After: https://archive.is/sWXis https://archive.is/sWXis
        rhaway84773 4y ago
        Your first link is a meta analysis which does not say masks don’t work. It says that they do work, but complains about the lack of data and it’s inconsistency (presumably this meta analysis hopes to help resolve that issue). > This systematic review and meta-analysis supports the use of respiratory protection. Your second link is to an opinion writer with no scientific background who infamously wrote his first opinion piece in the NYTimes denying the scientific evidence for climate change, but worse, with so many errors it needed a whole bunch of corrections appended to it. Your “scientific pieces of evidence” are (a) not evidence for what you claim they’re evidence for, and (b) not scientific.
  - TexanFeller 4y ago
    > Good thing that since then we've gathered extensive evidence supporting their effectiveness. The US conducted zero RCTs, so we don't actually have high quality evidence supporting masking. RCTs conducted in other countries showed a small but not statistically significant difference with masking. When I say masking I mean those silly cloth and "surgical" masks, not N95s and similar which definitely make a big difference. > The crook of our arms aren't filtering viruses like an N95 mask would but somehow it still helps. Maybe it helps with other common viruses that spread through large droplets on surfaces, but for an airborne virus like covid that spreads almost like measles it might not at all.
    - autoexec 4y ago
      > The US conducted zero RCTs I'm sure many researchers would have loved to do more controlled research, but for some reason people weren't lining up to participate in trails where the participants get infected by Covid and then try to infect others in a lab setting. This is one of those things where it should be easy to devise high quality experiments, but ethics make it impossible. In the end we got a bunch of people doing the best research they could. That meant studies with serious flaws and limitations. Some variants spread more easily than others, the amount of community spread varied with time/location, some people didn't make it all the way through studies, mask usage couldn't be constantly monitored to ensure compliance, etc. Most research looked only at how many people got sick when masked or unmasked instead of how the virus spread when already infected people were masked vs unmasked. We still managed to come up with a ton of research (including RCTs done elsewhere) which, taken in totality, showed that any kind of masking helped to some degree. > Maybe it helps with other common viruses that spread through large droplets on surfaces, but for an airborne virus like covid that spreads almost like measles it might not at all. Covid also spreads through droplets, but generally airborne ones. Getting any of those same droplets stuck to surfaces like the inside of your arm or the inside of mask keeps them out of the air other people breathe, but obviously you can't get all of them. Since how much virus gets breathed in matters, reducing the amount of droplets that go out into the air can mean the difference between getting someone sick or not, as well as how sick they get if their immune system can't respond fast enough to prevent the virus from establishing a foothold in the body. I think the effectiveness of cloth masks declined as the virus evolved, and N95 masks were always going to be the better option, but anything is certainly going to be better than nothing.
westcort 4y ago
An essentially no-risk intervention plausibly reduces infection risk and all of a sudden the bar of evidence to practice basic hygiene ratchets up to randomized phase 3 studies. Meanwhile, the same people will cite this preclinical, speculative, provocation of a paper and say masking is murder. Look at Japan’s experience with COVID. Look at the United States. That’s epidemiological data. Look at how elastomeric masks reduced TB infection rates to nil at the Texas Center for Infectious Disease. Masks (of any type) don’t work? That’s a political slogan, not evidence.

by tomrod 4y ago

frankreyes 4y ago

[flagged]

autoexec 4y ago
Good thing that since then we've gathered extensive evidence supporting their effectiveness. Not that it should really surprise anyone. Putting literally anything in front of our virus spewing face holes helps people avoid getting sick which is why children are taught to vampire cough/sneeze. The crook of our arms aren't filtering viruses like an N95 mask would but somehow it still helps.
- frankreyes 4y ago
  > N95 Did you read the article? No you didn't. >>> But, wait, hold on. What about N-95 masks, as opposed to lower-quality surgical or cloth masks? “Makes no difference — none of it,” said Jefferson. >>> Do you think that COVID is the first virus ever to come to humanity? Do you think that nobody ever thought about the effectiveness of face masks? Do you think that somehow face masks lost effectiveness after 2020 but before they were effective? No. No. No. Scientists knew all along that face masks didn't work. Edit: >>> Compared to masks, N95 respirators conferred superior protection against CRI (...) and laboratory-confirmed bacterial (...), but not viral infections or ILI ...[influenza-like illness] <<< COVID-19 is a virus, and an ILI. https://academic.oup.com/cid/article/65/11/1934/4068747 https://academic.oup.com/cid/article/65/11/1934/4068747
  - emj 4y ago
    > Scientists knew all along that face masks didn't work. No. Masks were not mandatory here [1], they were not even recommended in the beginning. Later masks were recommended [2] in public transport during rush hours during a 6 month period in 2021. The reasoning for not recommending masks in the beginning was that there were too little data supporting the effectiveness of masks. So scientist did not "know" for certain. I am not sure we can discuss this issue yet, there are still too many with non scientific agenda engaged in the debate. [1] Sweden https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic#Europe https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19... [2] EDIT: I said mandatory, it was not.
    - frankreyes 4y ago
      I gave scientific evidence of both and after studies that agreed each other, but you insist of spinning this in terms of politics... When actions contradict scientific evidence it's all about politics, no disagreement there. In your example of Sweden, I'd say it's a prisoner's dilemma politicians are forced to follow suit on what other countries are doing. It happened in my country that the National Health Minister had to resign under pressure of ineptitude, not following international practices, and corruption during pandemic. But your statement about evidence, it's simply not true. Go back and read one more time my two scientific pieces of evidence. Here there are again: Before: https://academic.oup.com/cid/article/65/11/1934/4068747 https://academic.oup.com/cid/article/65/11/1934/4068747 After: https://archive.is/sWXis https://archive.is/sWXis
      - rhaway84773 4y ago
        Your first link is a meta analysis which does not say masks don’t work. It says that they do work, but complains about the lack of data and it’s inconsistency (presumably this meta analysis hopes to help resolve that issue). > This systematic review and meta-analysis supports the use of respiratory protection. Your second link is to an opinion writer with no scientific background who infamously wrote his first opinion piece in the NYTimes denying the scientific evidence for climate change, but worse, with so many errors it needed a whole bunch of corrections appended to it. Your “scientific pieces of evidence” are (a) not evidence for what you claim they’re evidence for, and (b) not scientific.
- TexanFeller 4y ago
  > Good thing that since then we've gathered extensive evidence supporting their effectiveness. The US conducted zero RCTs, so we don't actually have high quality evidence supporting masking. RCTs conducted in other countries showed a small but not statistically significant difference with masking. When I say masking I mean those silly cloth and "surgical" masks, not N95s and similar which definitely make a big difference. > The crook of our arms aren't filtering viruses like an N95 mask would but somehow it still helps. Maybe it helps with other common viruses that spread through large droplets on surfaces, but for an airborne virus like covid that spreads almost like measles it might not at all.
  - autoexec 4y ago
    > The US conducted zero RCTs I'm sure many researchers would have loved to do more controlled research, but for some reason people weren't lining up to participate in trails where the participants get infected by Covid and then try to infect others in a lab setting. This is one of those things where it should be easy to devise high quality experiments, but ethics make it impossible. In the end we got a bunch of people doing the best research they could. That meant studies with serious flaws and limitations. Some variants spread more easily than others, the amount of community spread varied with time/location, some people didn't make it all the way through studies, mask usage couldn't be constantly monitored to ensure compliance, etc. Most research looked only at how many people got sick when masked or unmasked instead of how the virus spread when already infected people were masked vs unmasked. We still managed to come up with a ton of research (including RCTs done elsewhere) which, taken in totality, showed that any kind of masking helped to some degree. > Maybe it helps with other common viruses that spread through large droplets on surfaces, but for an airborne virus like covid that spreads almost like measles it might not at all. Covid also spreads through droplets, but generally airborne ones. Getting any of those same droplets stuck to surfaces like the inside of your arm or the inside of mask keeps them out of the air other people breathe, but obviously you can't get all of them. Since how much virus gets breathed in matters, reducing the amount of droplets that go out into the air can mean the difference between getting someone sick or not, as well as how sick they get if their immune system can't respond fast enough to prevent the virus from establishing a foothold in the body. I think the effectiveness of cloth masks declined as the virus evolved, and N95 masks were always going to be the better option, but anything is certainly going to be better than nothing.

westcort 4y ago

An essentially no-risk intervention plausibly reduces infection risk and all of a sudden the bar of evidence to practice basic hygiene ratchets up to randomized phase 3 studies. Meanwhile, the same people will cite this preclinical, speculative, provocation of a paper and say masking is murder. Look at Japan’s experience with COVID. Look at the United States. That’s epidemiological data. Look at how elastomeric masks reduced TB infection rates to nil at the Texas Center for Infectious Disease. Masks (of any type) don’t work? That’s a political slogan, not evidence.