8 ms·

"We had no evidence that masks help and then we found no evidence." Actually we did from the decades surgeons wore masks to prevent the spread of airborne dise

"We had no evidence that masks help and then we found no evidence." Actually we did from the decades surgeons wore masks to prevent the spread of airborne diseases. Once we knew Covid was one of them, then even if the protection was one way, it would have reduced infections if everyone wore one.

u32480932048 3y ago
One of my pet peeves is the continued use of ambiguous phrases like "masks work" or "masks help" when there are effectively two different mechanisms (inhalation/exhalation). I suspect the prolonged mass confusion over such an elementary topic will be one for the Science Communicator books.
- titzer 3y ago
  IMHO the issue is that masks work but masking as a social phenomenon can suffer a number of problems, like non-compliance, partial compliance, poor fit, children, misuse, reuse, damaged masks, cloth masks, needing to eat, and all kinds of factors. So scientific experiments in a controlled setting with one or two people show that masks work as a mechanism, but getting everyone to go along with and practice good masking etiquette might not work so well. So population studies show masks working much worse than their mechanism would suggest they can. Especially when there is intentional non-compliance and protests motivated by culture war battles. Arguing with people who just spout "masks don't work" and then intentionally are non-compliant (and encourage others to) is like arguing with motivated idiots. No, masks work, period. Masking only works if people freaking do it. edit: spelling
  - agos 3y ago
    on the flip side, so much of the Covid discourse was about these fabled policies which would do great things (but required 100% compliance), followed by indignation/panic and hysteria/angry mobs when it turned out that 100% compliance is hard.
    - Sporktacular 3y ago
      We won't need 100% effectiveness and 100% compliance. If they only work at 10% effectiveness, then over a network of thousands, they will measurably save lives. Studies have shown they work (such as https://pubmed.ncbi.nlm.nih.gov/33483277/ https://pubmed.ncbi.nlm.nih.gov/33483277/), despite the 'ah, yes but only [insert unsupported caveat here]' of some.
  - deleted 3y ago
    [deleted]
  - timr 3y ago
    > No, mask work, period. ...on a mannequin, in a lab, or when used as a filter between two hamster cages. Perhaps. But there have now been plenty of negative studies in hospitals, which really starts to beg the question: if you can't get effective compliance in a hospital, where are you going to get it? Just to be clear, I was with you right up until the part I quoted. It's fine to say that mechanistic studies show something to be true, but it's totally wrong to leap to the conclusion that these mean anything. If I tell you that you're 100% certain to lose weight if you stop eating, that's True ("Starving works. Period."), but it's not meaningful. Every failed drug ever tested worked in a laboratory before it went to clinical trials.
    - Sporktacular 3y ago
      Except masks do work. Here: https://pubmed.ncbi.nlm.nih.gov/33431650/ https://pubmed.ncbi.nlm.nih.gov/33431650/ - "We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation." https://pubmed.ncbi.nlm.nih.gov/33370173/ https://pubmed.ncbi.nlm.nih.gov/33370173/ - "Evidence suggests that the potential benefits of wearing masks likely outweigh the potential harms when SARS-CoV-2 is spreading in a community". Mentions the network effect. https://pubmed.ncbi.nlm.nih.gov/32497510/ https://pubmed.ncbi.nlm.nih.gov/32497510/ - "Face mask use could result in a large reduction in risk of infection" https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-mask/art-20485449 https://www.mayoclinic.org/diseases-conditions/coronavirus/i... "...on a mannequin, in a lab, or when used as a filter between two hamster cages. Perhaps." No, you are coping hard. The studies above are not done by idiots. "if you can't get effective compliance in a hospital, where are you going to get it?" Nice pivot, but the subject is whether they work, which they do. Compliance is a different question. That's like arguing that condom effectiveness is low when people don't use them properly. And because the figure is low, let's just conclude condoms are ineffective so people should stop using them altogether. "Every failed drug ever tested worked in a laboratory before it went to clinical trials." And some actually worked in trials. Your job is to explain which is the better analogy. That unanticipated practical considerations exist does not invalidate every conclusion you dislike. However, even if masks work slightly, or not at all, even if there are dozens of studies saying so, there is enough conjecture to warrant wearing them anyway just in case. If two equally qualified mechanics disagree on whether to change your brakes, you change your damn brakes. If you don't that's stupid. If you don't and then drive a busload of people, that's criminal. But masks do work, and they're cheap and barely an inconvenience. The problem is everyone thinks they're smarter than an epidemiologist. Thanks Internet.
- Sporktacular 3y ago
  If masks only work one way and one infected person is in a train car with 10 uninfected people, then they all get protection if they all wear masks.
isolli 3y ago
Surgeons don't wear masks to prevent the spread of airborne diseases. They wear them to prevent spittle going into an open wound and to protect themselves from blood splatter. If they wore masks to prevent airborne diseases, they would wear them when meeting patients, not just during the operation.
- sobani 3y ago
  The difference is during a regular meeting, the skin is uncut. The skin is a major protection against diseases and the body has a bunch of mechanisms at its regular openings (nose, ears, etc) to protect you. When you cut through someones skin, you bypass one of the major first lines of defense. Therefor surgeons reduce the risks, for a similar reason why clean their tools before use.
timr 3y ago
> Actually we did from the decades surgeons wore masks to prevent the spread of airborne diseases. Funny you should say that. There were randomized controlled trials on exactly this question prior to 2020. Guess what the outcomes were? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/ (Notably, this review is from 2015...it is not subject to the ridiculous politics of Covid.) > However, overall there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination. More rigorous contemporary research is needed to make a definitive comment on the effectiveness of surgical facemasks. Also, rather (in)famously, a review saying the same thing was censored from the web in spring 2020, because...reasons. While I'd personally love to see extensive, rigorous investigation of this question, simply repeating "masks work", or "people didn't do it correctly" (your current argument) when all of the current high-quality evidence suggests otherwise doesn't inspire confidence in those of us who actually use the scientific method.
- classichasclass 3y ago
  Are you actually suggesting we should have surgeons unmask in an operating theatre and see if the rate of post-op infections go up? I'd like to see that get through an IRB. This is the same mentality that says every current vaccination should be compared against saline placebo.
  - Sporktacular 3y ago
    No, I think they're more saying that until studies prove with certainty that surgical masks work with 100% effectiveness, doctors should not feel the inconvenience of having to wear them.
    - classichasclass 3y ago
      The specific claim quoted was for surgeons, though. I don't see how this can be tested without having them mask off in the OR.
indymike 3y ago
> Actually we did from the decades surgeons wore masks to prevent the spread of airborne diseases. I remember asking my dad (who was a doctor who performed surgeries - mostly c-sections and appendectomies - often) about masks, and his answer in the early 80s was interesting: “It’s mostly to prevent me from getting spit into open wounds and incisions when I'm talking or I have to sneeze or cough. Bacteria is a real problem, and the mask stops that.” I never really thought much of that until recently.
- classichasclass 3y ago
  But you can see this go both ways. Ortho surgeons in total procedures have full air filtering due to the large amount of bone dust that's liberated, some of which are very fine particles. No one wants to breathe that in. Meanwhile, I'll be in TB clinic shortly with an N95 mask on. I've yet to convert my TB test in 17 years. We absolutely rely on surgical masks not to contaminate the field. But they don't have one way valves, so if we trust the airflow one way, it's logical to trust them for airflow going the other.
  - generalizations 3y ago
    >> “It’s mostly to prevent me from getting spit into open wounds and incisions when I'm talking or I have to sneeze or cough. Bacteria is a real problem, and the mask stops that.” > so if we trust the airflow one way Pedantic, but it matters: that's not airflow, that's droplets and spit.
    - EasyMark 3y ago
      [dead]

u32480932048 3y ago

One of my pet peeves is the continued use of ambiguous phrases like "masks work" or "masks help" when there are effectively two different mechanisms (inhalation/exhalation). I suspect the prolonged mass confusion over such an elementary topic will be one for the Science Communicator books.

titzer 3y ago
IMHO the issue is that masks work but masking as a social phenomenon can suffer a number of problems, like non-compliance, partial compliance, poor fit, children, misuse, reuse, damaged masks, cloth masks, needing to eat, and all kinds of factors. So scientific experiments in a controlled setting with one or two people show that masks work as a mechanism, but getting everyone to go along with and practice good masking etiquette might not work so well. So population studies show masks working much worse than their mechanism would suggest they can. Especially when there is intentional non-compliance and protests motivated by culture war battles. Arguing with people who just spout "masks don't work" and then intentionally are non-compliant (and encourage others to) is like arguing with motivated idiots. No, masks work, period. Masking only works if people freaking do it. edit: spelling
- agos 3y ago
  on the flip side, so much of the Covid discourse was about these fabled policies which would do great things (but required 100% compliance), followed by indignation/panic and hysteria/angry mobs when it turned out that 100% compliance is hard.
  - Sporktacular 3y ago
    We won't need 100% effectiveness and 100% compliance. If they only work at 10% effectiveness, then over a network of thousands, they will measurably save lives. Studies have shown they work (such as https://pubmed.ncbi.nlm.nih.gov/33483277/ https://pubmed.ncbi.nlm.nih.gov/33483277/), despite the 'ah, yes but only [insert unsupported caveat here]' of some.
- deleted 3y ago
  [deleted]
- timr 3y ago
  > No, mask work, period. ...on a mannequin, in a lab, or when used as a filter between two hamster cages. Perhaps. But there have now been plenty of negative studies in hospitals, which really starts to beg the question: if you can't get effective compliance in a hospital, where are you going to get it? Just to be clear, I was with you right up until the part I quoted. It's fine to say that mechanistic studies show something to be true, but it's totally wrong to leap to the conclusion that these mean anything. If I tell you that you're 100% certain to lose weight if you stop eating, that's True ("Starving works. Period."), but it's not meaningful. Every failed drug ever tested worked in a laboratory before it went to clinical trials.
  - Sporktacular 3y ago
    Except masks do work. Here: https://pubmed.ncbi.nlm.nih.gov/33431650/ https://pubmed.ncbi.nlm.nih.gov/33431650/ - "We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation." https://pubmed.ncbi.nlm.nih.gov/33370173/ https://pubmed.ncbi.nlm.nih.gov/33370173/ - "Evidence suggests that the potential benefits of wearing masks likely outweigh the potential harms when SARS-CoV-2 is spreading in a community". Mentions the network effect. https://pubmed.ncbi.nlm.nih.gov/32497510/ https://pubmed.ncbi.nlm.nih.gov/32497510/ - "Face mask use could result in a large reduction in risk of infection" https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-mask/art-20485449 https://www.mayoclinic.org/diseases-conditions/coronavirus/i... "...on a mannequin, in a lab, or when used as a filter between two hamster cages. Perhaps." No, you are coping hard. The studies above are not done by idiots. "if you can't get effective compliance in a hospital, where are you going to get it?" Nice pivot, but the subject is whether they work, which they do. Compliance is a different question. That's like arguing that condom effectiveness is low when people don't use them properly. And because the figure is low, let's just conclude condoms are ineffective so people should stop using them altogether. "Every failed drug ever tested worked in a laboratory before it went to clinical trials." And some actually worked in trials. Your job is to explain which is the better analogy. That unanticipated practical considerations exist does not invalidate every conclusion you dislike. However, even if masks work slightly, or not at all, even if there are dozens of studies saying so, there is enough conjecture to warrant wearing them anyway just in case. If two equally qualified mechanics disagree on whether to change your brakes, you change your damn brakes. If you don't that's stupid. If you don't and then drive a busload of people, that's criminal. But masks do work, and they're cheap and barely an inconvenience. The problem is everyone thinks they're smarter than an epidemiologist. Thanks Internet.
Sporktacular 3y ago
If masks only work one way and one infected person is in a train car with 10 uninfected people, then they all get protection if they all wear masks.

isolli 3y ago

Surgeons don't wear masks to prevent the spread of airborne diseases. They wear them to prevent spittle going into an open wound and to protect themselves from blood splatter. If they wore masks to prevent airborne diseases, they would wear them when meeting patients, not just during the operation.

sobani 3y ago
The difference is during a regular meeting, the skin is uncut. The skin is a major protection against diseases and the body has a bunch of mechanisms at its regular openings (nose, ears, etc) to protect you. When you cut through someones skin, you bypass one of the major first lines of defense. Therefor surgeons reduce the risks, for a similar reason why clean their tools before use.

timr 3y ago

> Actually we did from the decades surgeons wore masks to prevent the spread of airborne diseases. Funny you should say that. There were randomized controlled trials on exactly this question prior to 2020. Guess what the outcomes were? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/ (Notably, this review is from 2015...it is not subject to the ridiculous politics of Covid.) > However, overall there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination. More rigorous contemporary research is needed to make a definitive comment on the effectiveness of surgical facemasks. Also, rather (in)famously, a review saying the same thing was censored from the web in spring 2020, because...reasons. While I'd personally love to see extensive, rigorous investigation of this question, simply repeating "masks work", or "people didn't do it correctly" (your current argument) when all of the current high-quality evidence suggests otherwise doesn't inspire confidence in those of us who actually use the scientific method.

classichasclass 3y ago
Are you actually suggesting we should have surgeons unmask in an operating theatre and see if the rate of post-op infections go up? I'd like to see that get through an IRB. This is the same mentality that says every current vaccination should be compared against saline placebo.
- Sporktacular 3y ago
  No, I think they're more saying that until studies prove with certainty that surgical masks work with 100% effectiveness, doctors should not feel the inconvenience of having to wear them.
  - classichasclass 3y ago
    The specific claim quoted was for surgeons, though. I don't see how this can be tested without having them mask off in the OR.

indymike 3y ago

> Actually we did from the decades surgeons wore masks to prevent the spread of airborne diseases. I remember asking my dad (who was a doctor who performed surgeries - mostly c-sections and appendectomies - often) about masks, and his answer in the early 80s was interesting: “It’s mostly to prevent me from getting spit into open wounds and incisions when I'm talking or I have to sneeze or cough. Bacteria is a real problem, and the mask stops that.” I never really thought much of that until recently.

classichasclass 3y ago
But you can see this go both ways. Ortho surgeons in total procedures have full air filtering due to the large amount of bone dust that's liberated, some of which are very fine particles. No one wants to breathe that in. Meanwhile, I'll be in TB clinic shortly with an N95 mask on. I've yet to convert my TB test in 17 years. We absolutely rely on surgical masks not to contaminate the field. But they don't have one way valves, so if we trust the airflow one way, it's logical to trust them for airflow going the other.
- generalizations 3y ago
  >> “It’s mostly to prevent me from getting spit into open wounds and incisions when I'm talking or I have to sneeze or cough. Bacteria is a real problem, and the mask stops that.” > so if we trust the airflow one way Pedantic, but it matters: that's not airflow, that's droplets and spit.
  - EasyMark 3y ago
    [dead]