Great post! I too hate masks and especially hate their effect on communication and socialization. Every year we get 36 new 19-y.o. students in our design studio-based degree program, and it's a very interactive program. A very strong and enduring sense of community always develops among the class, but the class of Fall 2020 is an exception. They just never really have "clicked" as a group. Another weird thing: when I see those guys around the building (now maskless of course), I often don't recognize them, because I spent the first two semesters (Fall 2020 and Spring 2021) never seeing their faces.
Something I keep noticing: a great many colleagues here at the university seem to have been very, very attached to the idea of mask mandates and also the idea of remote teaching/meeting as a reasonable alternative to in-person interaction at the university. Not sure what's going on here. It seems like some amalgam of excessive "safetyism" (all precautions are unquestionably a good thing; not gonna even talk about downsides) and rationalization (from the comfort of my home office, as opposed to my office in that big building several miles away, I insist that remote teaching is working just fine).
It always seemed to me that masks were probably helpful for protection from coughing or sneezing people. I'm guessing this is why transmission of other communicable diseases like seasonal flu dropped off in the masky era. But even at the outset, I thought mask mandates outdoors on campus were silly. These were of course, not opinions based on science, but rather on intuition.
But I'm just sayin': my intuition works pretty well sometimes. Remote teaching was a massive fail. This seemed blastingly obvious to me from the start, for so many reasons, not the least of which being the total breakdown of peer-learning (design studios heavily rely on this as pedagogy). But for the entirety of 2021—both semesters—in-person teaching was optional, and the majority of instructors stayed home. I pretty much had the Design building to myself (and the parking lot, which was nice, haha!).
Maybe I'm a cynic, but I suspect there were very powerful motivational undercurrents around here during the COVID epoch. People are complicated, I always say, so it is a mistake to write them off for some presumed devious motivation. People make choices and take stances for a whole array of reasons. In any case I see circumstantial evidence that remote teaching was very much grounded in convenience (at great unacknowledged cost for teaching and learning), and that mask-wearing eventually became at least partly a sort of uniform or "signifier" of allegiance, a political act and a desire to assert control.
We are a "University of Science and Technology", but "science" had kind of gone into hiding.
I agree with all of this. Masks are a powerful tribal signal, and it can be hard to let go of that. And your point about remote teaching is interesting. Of course people might have preferred to work from home for all kinds of reasons, and used safety as a justification. (I think many jobs could be done from home, but teaching isn’t one of them.)
Ugh yes. I’m also at a scientific institution and the students STILL have a mask mandate for attending classes. Sigh. And we still get a daily report of new cases on campus, and contact notifications. Way to lock that barn door.
The mandates on college campuses are the craziest of all. These kids are the least likely to be hurt by Covid, and among the most likely to be hurt by the social stunting masks cause.
We haven’t had a mask mandate on our campus for 3 semesters and rates are at their lowest. We do still have a vaccine mandate which is also ridiculous because the students catching COVID are all fully vaxed and double boosted! Only one non vaccinated student has had COVID in the past 2 semesters!!!!
You have my sympathies! Still kind of amazing to me that universities, where science presumably abides, haven't been places where science was applied in the COVID era. I didn't mean to have hijacked this thread from maskery to remote teaching, but for me that's the part of this that's peculiar to teaching. People who teach know from experience about teaching effectiveness, because they understand students as learners. Why anyone would think that remote learning would be OK, I can't imagine. And if you did think that, wouldn't you, as the scholarly sort, look for evidence that it was OK?
I think your best point is so simple that everyone overlooks it- if people see/feel the benefit of wearing masks, they wear them. Just like Londoners following Blitz precautions. I don't wear my seat belt in my car because I'm afraid of getting a citation for not wearing it- I wear my seat belt because I've seen what can happen to people in accidents when they aren't wearing one.
Exactly! Masks could have been a win-win, because they do protect individual wearers. If you want or need to wear one, do so, and God bless! The issue is forcing unwilling people to wear them.
One way to get people to think more like scientists would be to encourage them to be very skeptical of medical and science reporting, even about something that seems so science-y, so cut and dried, and so respectable on the surface as a Cochrane review.
I’ve been reading faulty health and medical reporting for too many decades to think health decisions should be made by each of us based on what we read in the media.
I’ll just hit a couple little points because no one wants to hear my whole spiel:
I object to the media’s takeaway message from the Cochrane review that “masks don’t work.”
Maybe it’s true that “masks don’t work” if you wear them incorrectly or wear them in situations where you don’t need them (eg, the beach; or a meeting room with an open window; or you expect kindergartners to wear them all day long).
You make a good point about “the army you have” Mari, and also: The army would not be hard to train to be more effective with good public health messaging. I cannot emphasize this enough: This is such a solvable problem. It would not be hard to teach people:
1. What kind of masks work?
N95 or KN95
2. How are they properly worn?
a. Choose a size that is fits close to your face.
b. Press the metal adjustable band so it fits closely around your nose.
c. If the mask moves in and out a bit with your breathing, that’s a good enough fit (and will probably avoid glasses fog).
3. When should I wear one, in a way that makes a difference to myself and the community?
This is a judgment call, but in general for a healthy person, the answer is “crowded indoor poorly ventilated spaces where you’ll be for a long time.“ Examples:
subway at rush hour
crowded lecture call
standing-room-only jury selection room
That’s about ALL people need to know or understand. It would be so easy to teach people what’s effective.
Maybe in fact “masks are very effective” if you choose the right time, place, mask, and method of wearing them, which is as simple as I just laid out. And not just great for the wearer; great for the wider community (as epidemiologist Katelyn Jetelina pointed out last week in her substack post about the Cochrane review):
“even if masks only reduce the risk of transmission for each individual by a small fraction, when a community masks, those small effects compound exponentially across a population, making a big dent in cases. Just like compounding interest—a small change in the percentage makes a big difference down the road.”
To me it’s a shame (more than a shame) when the information is presented through the lens of a media who say things like “Look! Masks don’t work!”
Is anything that simple?
Why did health care workers stop dying when they figured out the right PPE to wear in covid units (before the vaccines)?
And as I pointed out on a different substack last night, asking whether masks work makes as much sense as asking whether vitamins work: which vitamins? in what form? taken when? how much? for how long? for what purpose?
This Cochrane review jumbled too many things together with predictable results. If you jumbled together all the research on “whether vitamins work,” you’d come up with a big, correct “no,” but you’d also miss — in that same jumble— the fact that even if most vitamins truly don’t live up to their claims, vitamin K shots do prevent bleeding conditions in newborns.
The answer to sweeping questions (do masks work? do vitamins work?) will almost always be no. The answer to specific questions (do well-fitted N95s in close quarters prevent covid infection? do vitamin K shots prevent bleeding in newborns?) is often more interesting.
And while we’re waiting for better treatments and preventatives for covid, which I believe are coming, wearing “well-fitted N95s in close quarters” in targeted commonsense situations is something we can do not just for ourselves but others.
I agree with a lot of what you said. The takeaway from Cochrane should not be "masks don't work," because the evidence shows that N95 and KN95 masks, when properly worn, do work for individuals. That's why I emphasized that the problem is with the mandates. It is impossible in a free society to enforce near-perfect compliance, which is what we would need in order for the mandates to work on a virus that is this contagious. But this isn't bad news! People who are at heightened risk from Covid or are just worried can wear a mask to protect themselves.
I think it clearly goes beyond the individual. I think, lacking good public health information from trusted sources that gives us a general consensus, there should in fact be mandates in targeted situations where people don’t make good decisions for themselves.
I was raised in a happy Catholic family, we attended church regularly, and I was a true believer. I always had a tendency for science and logic, so as I got older my faith got updated with (at the time to me) more mature ways of understanding religion and god. I enjoyed discussions and debates with my religious and nonreligious friends, always looking for deeper understanding. I attended a seminary (just for one year) and would probably be there still had I known about Jesuits at the time.
One day on a very long bus ride, I was thinking about some philsophical problem, trying to incorporate some solution into my current beliefs. I thought to try the logical tactic where you assume the opposite of your thesis to be true, then prove it false, hopefully in support of your origianal thesis. So I started with the most basic principle, assume a universe in which there is no god. What does that look like? What truth which I know will be shown to be inconsistent with that? After hours of thinking through everything I could come up with, I realized that I had a perfectly consistent universe that made sense with no weird exceptions or logical pretzels to untangle. The universe that I had been living with up to that point was very much more complex. So I had no choice to apply Occam's razor and at that moment I became an atheist.
Now that I've typed all that I'm not sure how it's really about believing the science. Obviously there is no experiment or control group-- therefore not science. But it did set me on a new way where I learned to scrutinize all the data in everything, and not take anything for granted just based on intuition and personal preferences. It's hard work, but often quite rewarding.
It's so frustrating to see the world willingly succumb to pseudoscience, I thought through the advances of EMB and meta-science we had devised ways of knowing to inoculate ourselves from falling back into superstition. Sure, mistakes can be made, like administering hormone-replacement therapy to post-menopausal women, but we sought evidence anyway and overturned consensus through slow and careful analysis. This mask hysteria? It's like Bloodletting all over again - no matter how many times William Harvey asked to "divide patients into two lots, you bloodletters do as ye do", you get anecdotes of efficacy to overrule observable data and RCT. Crazy.
But here we are.
A few additional points (Love the RC example, I used similar one but with tying an Onion to you Belt - old Simpsons reference).
1) "if only everyone wore their masks properly all the time, then the masks would work. This is probably true." Even this may be false, and it would be extremely useful in understanding viral transmission dynamics to know whether is true or not. You could place 3000 virions within the space of a single n95 micropore. *Any* gap in the mask - where the bridge meets your nose, by the chin, by the sides, etc would render it useless. The same people who hashtag "Covid is Airborne" seem to fail to recognize the obvious rule of fluid dynamics - airflow follows path of least resistance.
2) Suppose you tape the mask around the perimeter of your face to get a strict seal. Can a virion which pass through the micropoes anyway? Consider when scaled to the size of a beach ball the micropore of an n95 mask would be scaled to the size of the Epcot Center Buckyball. We literally only discovered viruses because contemporaries of Pasteur were finding something invisible still contaminating water passed through ceramic chamberland filters (designed to trap the much larger bacteria) which they named "Filter Passing Viruses". It would be 50 years until we developed electron microscopes to actually see them. You could fit 300 *billion* virions in the space of a speck of dust.
3) Even if a mask captures "95%" of particles, what about the 5%? If you exhale 1000 infectious particles per breath and it only takes 100 virions for an infectious dose, how many minutes of time does a sealed n95 provide? Don't the videos of people finding out n95 masks don't work against pepper spray (which particles are several magnitudes larger than viruses) tell us something?
When confronted with the Cochrane analysis Wallensky argued "they only counted RCTs though". Embarrassing.
Carl Sagan called it.
"I have a foreboding of an America in my children’s or grandchildren’s time – when the United States is service and information economy; when nearly all the key manufacturing industries have slipped away to other countries; when awesome technological powers are in the hand of a very few, and no one representing the public interest can even grasp the issues; when the people have lost the ability to set their own agendas or knowledgeably question those in authority; when, clutching our crystals and nervously consulting our horoscope’s, our critical faculties in decline, unable to distinguish between what feels good and what’s true, we slide, almost without noticing, back into superstition and darkness."
Great comment. I love “counting your hits and forgetting your misses.” (And the Bangladesh study was actually a miss--in a study population of 300,000 people, the treatment group had only 20 more symptomatic cases than the control group. But somehow that information never made into the articles about the study.)
And ugh, the tape suggestions. Masks fit me terribly, because I have a small face and a ski jump nose, and so there are always gaps. A friend suggested, in all sincerity, that I duct tape the mask to my face. No! Having the skin peeled off my face is worse than Covid!
I live in a county in Georgia (USA) that had intense mask mandates and closed schools. The contiguous county did not. For a long time we got monthly reports. The non-masking county had better COVID outcomes. No one has studied this for a paper just my observations over the lockdown. Schools did far better in statewide reports in the unmasked county.
It really is a shame that masks became so politicized, because there was a lot of evidence out there that mask mandates weren’t helping, but it was completely unacceptable in health and media circles to say so.
Same in Alameda county; our mask mandates didn’t see us fare any better with our case counts. Whether that’s because masks don’t work or compliance is unknown, and in my opinion, kind of irrelevant. We actually had a two-week mask mandate mid-2022 that got unceremoniously dropped because there was no way to enforce it and everyone was Over It. And in our cousin county Los Angeles, multiple attempts to bring mask mandates back failed because law enforcement refused to provide support to put it into place. Just over it. Even in deep blue California, everyone’s over it.
Except I work at a legal non-profit and we still have a mask mandate, even for outdoor work like pop-up clinics, and are barred from gathering with other employees for company sanctioned events like farewell parties. It’s depressing, and the people who most insist on these measures are safetyists who work remotely or barely come into the office. They’re just imposing their highly-neurotic preference on the whole firm and there’s no socially-acceptable way to push back without being accused of being a eugenicist or a Covid hoaxer.
We will have to agree to disagree on this issue, Mari. There are problems with the Cochrane Review and how it was reported. The authors themselves say that their conclusions on the ineffectiveness of masks are not firm: "The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect." Also, if you read the Review (which I did cursorily), they looked at studies done over the last fifty years. Fifty years in health care is a very long time. I'd have to spend more time with the study than I want to to explore those older trials, but comparing them to RCTs done over the last five years is probably like apples to oranges. Finally, the authors themselves acknowledge a high degree of bias in the trials they studied. Bret Stephens was irresponsible to report on the Cochrane Review the way he did. Science, and public health in particular, is complicated, in part because humans are complicated. He could say the evidence is mixed or uncertain--that is true. But to say that masks absolutely make no difference is not validated by the Cochrane Review.
I would be open to a solid study that showed the ineffectiveness of masks to prevent the spread of respiratory infections, but this Cochrane Review is not that. I obviously feel strongly about this--the authors of the review highlighted their conclusions without giving time to the doubts they express in the same paper. That is also irresponsible.
Public health by press release is bad public health, but we seem to be stuck with it.
Well, as I said to Salonnière above, I think we partly agree. Some outlets have misreported the Cochrane review’s conclusions inaccurately as being against masks. The review’s conclusion was that mandates haven’t been shown to be effective, which is a different issue. In particular, the Bangladesh study--from only a couple of years ago and using high-quality surgical masks rather than cloth masks--really looks dubious to me. The media reported on the study without releasing the raw numbers. But it would have been useful to know that the treatment group had only twenty fewer symptomatic cases than the control--out of a total population of 300,000! That can’t possibly rise to a level of statistical significance.
As I said in my post, we should be encouraging individuals to wear high-quality masks if they need to protect themselves, and we should be educating people on how to wear masks properly. But evidence shows that the costs of forcing masks on unwilling people outweighs the benefits.
I understand your point of view better now--thanks. I would say that there are political and social costs to mask mandates, as we painfully saw here in the U.S. But I don't agree that there are public health costs. I haven't looked at the Bangladesh study, but 20 fewer symptomatic cases is still 20 fewer, and there could have been other unsymptomatic cases because people got smaller doses of Covid due to being masked. The bottom line, though, is that the authors themselves of the Cochrane study do not claim high reliability for their conclusions. More study is needed and that's hard to do with a question of people masking during a pandemic. Mandates are hard and in some places unpopular. Covid is terrible and deadly for some people. Balancing those two different sets of concerns is very difficult.
True, and as Salonnière points out, with exponential growth, even small initial differences can become important. The twenty-case difference was after only one month and might have become significant later.
I think we just don’t have enough information to know either way, and in the absence of clear evidence of significant benefit, mandates don’t make sense, especially if they have negative effects we didn’t consider before mandating them. I worry about the damage masks may have caused to a cohort of kids, for example (but, as I said in the footnote, we would need to study that too).
You’re up late! (And I’m up early 😊.) I hope you have a great weekend!
I'm focused on harm reduction, and since I used to work with severely immune-suppressed patients I see mask mandates as reducing harm. My experience is unique, but potent for me, obviously.
In other news, I'm off to Georgia tomorrow to speak at a conference of nurse educators. Should be fun. I've never been to the Blue Ridge Mountains before. I'm sure they don't compare to the Swiss Alps, but will probably be beautiful in their own way. Wishing you a great weekend, too!
So I flew to Florida for spring break around March 8, 2020. Some people were wearing masks, some were wiping down every surface in sight. I did neither. The plane was blissfully nearly empty. That evening on the news they said a known positive case had flown from New York to West Palm Beach on Jet Blue but thankfully not my plane. People at the “resort” I was visiting were horrified to hear I had come from that cesspool of infection (NYC) and avoided me!!! Returning home 5 days later after hearing all the rising numbers and the NCAA March Madness cancellation (now you know it is real if they cancel sports!!!!) the plane was full and people were visibly nervous. Once home I made myself a mask and was one of the first to wear it at ShopRite. Fast forward I was one of the first people back at work and wore a mask around other people but ripped it off as soon as I could alone!!!! I did not contract Covid until May 2022 even though I was increasingly lax about wearing it! Fast forward again to last night we are STILL wearing masks at choir rehearsal which I consider to be ridiculous!!!! I do not wear a mask anymore anywhere else and am significantly at higher risk of being exposed due to my job in a healthcare center at a university. And have only caught COVID once (fingers crossed!). I followed the science at the beginning which was playing catch up from day one, I now believe that with vaccinations we have done what we can to protect ourselves so we need for life to go on.
I agree. The vaccinations, in combination with population immunity, in combination with the new variants' being far less virulent, all remove the necessity for masks for everyone except people at high risk. As for Ember, I'm sorry to hear that they are still wearing masks. It seems as thought the arts and academia are the last holdouts on masking. It's too bad, because singing together is one of the great joys of life, and unmuffled sound and seeing each other's faces is a part of that joy.
Great post! I too hate masks and especially hate their effect on communication and socialization. Every year we get 36 new 19-y.o. students in our design studio-based degree program, and it's a very interactive program. A very strong and enduring sense of community always develops among the class, but the class of Fall 2020 is an exception. They just never really have "clicked" as a group. Another weird thing: when I see those guys around the building (now maskless of course), I often don't recognize them, because I spent the first two semesters (Fall 2020 and Spring 2021) never seeing their faces.
Something I keep noticing: a great many colleagues here at the university seem to have been very, very attached to the idea of mask mandates and also the idea of remote teaching/meeting as a reasonable alternative to in-person interaction at the university. Not sure what's going on here. It seems like some amalgam of excessive "safetyism" (all precautions are unquestionably a good thing; not gonna even talk about downsides) and rationalization (from the comfort of my home office, as opposed to my office in that big building several miles away, I insist that remote teaching is working just fine).
It always seemed to me that masks were probably helpful for protection from coughing or sneezing people. I'm guessing this is why transmission of other communicable diseases like seasonal flu dropped off in the masky era. But even at the outset, I thought mask mandates outdoors on campus were silly. These were of course, not opinions based on science, but rather on intuition.
But I'm just sayin': my intuition works pretty well sometimes. Remote teaching was a massive fail. This seemed blastingly obvious to me from the start, for so many reasons, not the least of which being the total breakdown of peer-learning (design studios heavily rely on this as pedagogy). But for the entirety of 2021—both semesters—in-person teaching was optional, and the majority of instructors stayed home. I pretty much had the Design building to myself (and the parking lot, which was nice, haha!).
Maybe I'm a cynic, but I suspect there were very powerful motivational undercurrents around here during the COVID epoch. People are complicated, I always say, so it is a mistake to write them off for some presumed devious motivation. People make choices and take stances for a whole array of reasons. In any case I see circumstantial evidence that remote teaching was very much grounded in convenience (at great unacknowledged cost for teaching and learning), and that mask-wearing eventually became at least partly a sort of uniform or "signifier" of allegiance, a political act and a desire to assert control.
We are a "University of Science and Technology", but "science" had kind of gone into hiding.
I agree with all of this. Masks are a powerful tribal signal, and it can be hard to let go of that. And your point about remote teaching is interesting. Of course people might have preferred to work from home for all kinds of reasons, and used safety as a justification. (I think many jobs could be done from home, but teaching isn’t one of them.)
Ugh yes. I’m also at a scientific institution and the students STILL have a mask mandate for attending classes. Sigh. And we still get a daily report of new cases on campus, and contact notifications. Way to lock that barn door.
The mandates on college campuses are the craziest of all. These kids are the least likely to be hurt by Covid, and among the most likely to be hurt by the social stunting masks cause.
We haven’t had a mask mandate on our campus for 3 semesters and rates are at their lowest. We do still have a vaccine mandate which is also ridiculous because the students catching COVID are all fully vaxed and double boosted! Only one non vaccinated student has had COVID in the past 2 semesters!!!!
You have my sympathies! Still kind of amazing to me that universities, where science presumably abides, haven't been places where science was applied in the COVID era. I didn't mean to have hijacked this thread from maskery to remote teaching, but for me that's the part of this that's peculiar to teaching. People who teach know from experience about teaching effectiveness, because they understand students as learners. Why anyone would think that remote learning would be OK, I can't imagine. And if you did think that, wouldn't you, as the scholarly sort, look for evidence that it was OK?
I think your best point is so simple that everyone overlooks it- if people see/feel the benefit of wearing masks, they wear them. Just like Londoners following Blitz precautions. I don't wear my seat belt in my car because I'm afraid of getting a citation for not wearing it- I wear my seat belt because I've seen what can happen to people in accidents when they aren't wearing one.
Exactly! Masks could have been a win-win, because they do protect individual wearers. If you want or need to wear one, do so, and God bless! The issue is forcing unwilling people to wear them.
One way to get people to think more like scientists would be to encourage them to be very skeptical of medical and science reporting, even about something that seems so science-y, so cut and dried, and so respectable on the surface as a Cochrane review.
I’ve been reading faulty health and medical reporting for too many decades to think health decisions should be made by each of us based on what we read in the media.
I’ll just hit a couple little points because no one wants to hear my whole spiel:
I object to the media’s takeaway message from the Cochrane review that “masks don’t work.”
Maybe it’s true that “masks don’t work” if you wear them incorrectly or wear them in situations where you don’t need them (eg, the beach; or a meeting room with an open window; or you expect kindergartners to wear them all day long).
You make a good point about “the army you have” Mari, and also: The army would not be hard to train to be more effective with good public health messaging. I cannot emphasize this enough: This is such a solvable problem. It would not be hard to teach people:
1. What kind of masks work?
N95 or KN95
2. How are they properly worn?
a. Choose a size that is fits close to your face.
b. Press the metal adjustable band so it fits closely around your nose.
c. If the mask moves in and out a bit with your breathing, that’s a good enough fit (and will probably avoid glasses fog).
3. When should I wear one, in a way that makes a difference to myself and the community?
This is a judgment call, but in general for a healthy person, the answer is “crowded indoor poorly ventilated spaces where you’ll be for a long time.“ Examples:
subway at rush hour
crowded lecture call
standing-room-only jury selection room
That’s about ALL people need to know or understand. It would be so easy to teach people what’s effective.
Maybe in fact “masks are very effective” if you choose the right time, place, mask, and method of wearing them, which is as simple as I just laid out. And not just great for the wearer; great for the wider community (as epidemiologist Katelyn Jetelina pointed out last week in her substack post about the Cochrane review):
“even if masks only reduce the risk of transmission for each individual by a small fraction, when a community masks, those small effects compound exponentially across a population, making a big dent in cases. Just like compounding interest—a small change in the percentage makes a big difference down the road.”
https://open.substack.com/pub/yourlocalepidemiologist/p/do-masks-work?r=r6z4&utm_medium=ios&utm_campaign=post
To me it’s a shame (more than a shame) when the information is presented through the lens of a media who say things like “Look! Masks don’t work!”
Is anything that simple?
Why did health care workers stop dying when they figured out the right PPE to wear in covid units (before the vaccines)?
And as I pointed out on a different substack last night, asking whether masks work makes as much sense as asking whether vitamins work: which vitamins? in what form? taken when? how much? for how long? for what purpose?
This Cochrane review jumbled too many things together with predictable results. If you jumbled together all the research on “whether vitamins work,” you’d come up with a big, correct “no,” but you’d also miss — in that same jumble— the fact that even if most vitamins truly don’t live up to their claims, vitamin K shots do prevent bleeding conditions in newborns.
The answer to sweeping questions (do masks work? do vitamins work?) will almost always be no. The answer to specific questions (do well-fitted N95s in close quarters prevent covid infection? do vitamin K shots prevent bleeding in newborns?) is often more interesting.
And while we’re waiting for better treatments and preventatives for covid, which I believe are coming, wearing “well-fitted N95s in close quarters” in targeted commonsense situations is something we can do not just for ourselves but others.
I agree with a lot of what you said. The takeaway from Cochrane should not be "masks don't work," because the evidence shows that N95 and KN95 masks, when properly worn, do work for individuals. That's why I emphasized that the problem is with the mandates. It is impossible in a free society to enforce near-perfect compliance, which is what we would need in order for the mandates to work on a virus that is this contagious. But this isn't bad news! People who are at heightened risk from Covid or are just worried can wear a mask to protect themselves.
I think it clearly goes beyond the individual. I think, lacking good public health information from trusted sources that gives us a general consensus, there should in fact be mandates in targeted situations where people don’t make good decisions for themselves.
I was raised in a happy Catholic family, we attended church regularly, and I was a true believer. I always had a tendency for science and logic, so as I got older my faith got updated with (at the time to me) more mature ways of understanding religion and god. I enjoyed discussions and debates with my religious and nonreligious friends, always looking for deeper understanding. I attended a seminary (just for one year) and would probably be there still had I known about Jesuits at the time.
One day on a very long bus ride, I was thinking about some philsophical problem, trying to incorporate some solution into my current beliefs. I thought to try the logical tactic where you assume the opposite of your thesis to be true, then prove it false, hopefully in support of your origianal thesis. So I started with the most basic principle, assume a universe in which there is no god. What does that look like? What truth which I know will be shown to be inconsistent with that? After hours of thinking through everything I could come up with, I realized that I had a perfectly consistent universe that made sense with no weird exceptions or logical pretzels to untangle. The universe that I had been living with up to that point was very much more complex. So I had no choice to apply Occam's razor and at that moment I became an atheist.
Now that I've typed all that I'm not sure how it's really about believing the science. Obviously there is no experiment or control group-- therefore not science. But it did set me on a new way where I learned to scrutinize all the data in everything, and not take anything for granted just based on intuition and personal preferences. It's hard work, but often quite rewarding.
Thanks for sharing these thoughts. I think it is so important to scrutinize our beliefs, on all topics, no matter how sacred.
<insert gif-meme of DiCaprio clapping>
It's so frustrating to see the world willingly succumb to pseudoscience, I thought through the advances of EMB and meta-science we had devised ways of knowing to inoculate ourselves from falling back into superstition. Sure, mistakes can be made, like administering hormone-replacement therapy to post-menopausal women, but we sought evidence anyway and overturned consensus through slow and careful analysis. This mask hysteria? It's like Bloodletting all over again - no matter how many times William Harvey asked to "divide patients into two lots, you bloodletters do as ye do", you get anecdotes of efficacy to overrule observable data and RCT. Crazy.
But here we are.
A few additional points (Love the RC example, I used similar one but with tying an Onion to you Belt - old Simpsons reference).
1) "if only everyone wore their masks properly all the time, then the masks would work. This is probably true." Even this may be false, and it would be extremely useful in understanding viral transmission dynamics to know whether is true or not. You could place 3000 virions within the space of a single n95 micropore. *Any* gap in the mask - where the bridge meets your nose, by the chin, by the sides, etc would render it useless. The same people who hashtag "Covid is Airborne" seem to fail to recognize the obvious rule of fluid dynamics - airflow follows path of least resistance.
2) Suppose you tape the mask around the perimeter of your face to get a strict seal. Can a virion which pass through the micropoes anyway? Consider when scaled to the size of a beach ball the micropore of an n95 mask would be scaled to the size of the Epcot Center Buckyball. We literally only discovered viruses because contemporaries of Pasteur were finding something invisible still contaminating water passed through ceramic chamberland filters (designed to trap the much larger bacteria) which they named "Filter Passing Viruses". It would be 50 years until we developed electron microscopes to actually see them. You could fit 300 *billion* virions in the space of a speck of dust.
3) Even if a mask captures "95%" of particles, what about the 5%? If you exhale 1000 infectious particles per breath and it only takes 100 virions for an infectious dose, how many minutes of time does a sealed n95 provide? Don't the videos of people finding out n95 masks don't work against pepper spray (which particles are several magnitudes larger than viruses) tell us something?
4) Why does the US CDC rely on anecdotes and ignore evidence against the hypothesis. This is pseudoscience 101 - as Francis Bacon called it "counting your hits and forgetting your misses" . Here, the CDC includes Bangladesh, but not Danmask. https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/masking-science-sars-cov2.html
When confronted with the Cochrane analysis Wallensky argued "they only counted RCTs though". Embarrassing.
Carl Sagan called it.
"I have a foreboding of an America in my children’s or grandchildren’s time – when the United States is service and information economy; when nearly all the key manufacturing industries have slipped away to other countries; when awesome technological powers are in the hand of a very few, and no one representing the public interest can even grasp the issues; when the people have lost the ability to set their own agendas or knowledgeably question those in authority; when, clutching our crystals and nervously consulting our horoscope’s, our critical faculties in decline, unable to distinguish between what feels good and what’s true, we slide, almost without noticing, back into superstition and darkness."
Great comment. I love “counting your hits and forgetting your misses.” (And the Bangladesh study was actually a miss--in a study population of 300,000 people, the treatment group had only 20 more symptomatic cases than the control group. But somehow that information never made into the articles about the study.)
And ugh, the tape suggestions. Masks fit me terribly, because I have a small face and a ski jump nose, and so there are always gaps. A friend suggested, in all sincerity, that I duct tape the mask to my face. No! Having the skin peeled off my face is worse than Covid!
I live in a county in Georgia (USA) that had intense mask mandates and closed schools. The contiguous county did not. For a long time we got monthly reports. The non-masking county had better COVID outcomes. No one has studied this for a paper just my observations over the lockdown. Schools did far better in statewide reports in the unmasked county.
It really is a shame that masks became so politicized, because there was a lot of evidence out there that mask mandates weren’t helping, but it was completely unacceptable in health and media circles to say so.
Same in Alameda county; our mask mandates didn’t see us fare any better with our case counts. Whether that’s because masks don’t work or compliance is unknown, and in my opinion, kind of irrelevant. We actually had a two-week mask mandate mid-2022 that got unceremoniously dropped because there was no way to enforce it and everyone was Over It. And in our cousin county Los Angeles, multiple attempts to bring mask mandates back failed because law enforcement refused to provide support to put it into place. Just over it. Even in deep blue California, everyone’s over it.
Except I work at a legal non-profit and we still have a mask mandate, even for outdoor work like pop-up clinics, and are barred from gathering with other employees for company sanctioned events like farewell parties. It’s depressing, and the people who most insist on these measures are safetyists who work remotely or barely come into the office. They’re just imposing their highly-neurotic preference on the whole firm and there’s no socially-acceptable way to push back without being accused of being a eugenicist or a Covid hoaxer.
Wow, they are some serious hold-outs if they insist on masks outdoors!
We will have to agree to disagree on this issue, Mari. There are problems with the Cochrane Review and how it was reported. The authors themselves say that their conclusions on the ineffectiveness of masks are not firm: "The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect." Also, if you read the Review (which I did cursorily), they looked at studies done over the last fifty years. Fifty years in health care is a very long time. I'd have to spend more time with the study than I want to to explore those older trials, but comparing them to RCTs done over the last five years is probably like apples to oranges. Finally, the authors themselves acknowledge a high degree of bias in the trials they studied. Bret Stephens was irresponsible to report on the Cochrane Review the way he did. Science, and public health in particular, is complicated, in part because humans are complicated. He could say the evidence is mixed or uncertain--that is true. But to say that masks absolutely make no difference is not validated by the Cochrane Review.
I would be open to a solid study that showed the ineffectiveness of masks to prevent the spread of respiratory infections, but this Cochrane Review is not that. I obviously feel strongly about this--the authors of the review highlighted their conclusions without giving time to the doubts they express in the same paper. That is also irresponsible.
Public health by press release is bad public health, but we seem to be stuck with it.
Well, as I said to Salonnière above, I think we partly agree. Some outlets have misreported the Cochrane review’s conclusions inaccurately as being against masks. The review’s conclusion was that mandates haven’t been shown to be effective, which is a different issue. In particular, the Bangladesh study--from only a couple of years ago and using high-quality surgical masks rather than cloth masks--really looks dubious to me. The media reported on the study without releasing the raw numbers. But it would have been useful to know that the treatment group had only twenty fewer symptomatic cases than the control--out of a total population of 300,000! That can’t possibly rise to a level of statistical significance.
As I said in my post, we should be encouraging individuals to wear high-quality masks if they need to protect themselves, and we should be educating people on how to wear masks properly. But evidence shows that the costs of forcing masks on unwilling people outweighs the benefits.
I understand your point of view better now--thanks. I would say that there are political and social costs to mask mandates, as we painfully saw here in the U.S. But I don't agree that there are public health costs. I haven't looked at the Bangladesh study, but 20 fewer symptomatic cases is still 20 fewer, and there could have been other unsymptomatic cases because people got smaller doses of Covid due to being masked. The bottom line, though, is that the authors themselves of the Cochrane study do not claim high reliability for their conclusions. More study is needed and that's hard to do with a question of people masking during a pandemic. Mandates are hard and in some places unpopular. Covid is terrible and deadly for some people. Balancing those two different sets of concerns is very difficult.
True, and as Salonnière points out, with exponential growth, even small initial differences can become important. The twenty-case difference was after only one month and might have become significant later.
I think we just don’t have enough information to know either way, and in the absence of clear evidence of significant benefit, mandates don’t make sense, especially if they have negative effects we didn’t consider before mandating them. I worry about the damage masks may have caused to a cohort of kids, for example (but, as I said in the footnote, we would need to study that too).
You’re up late! (And I’m up early 😊.) I hope you have a great weekend!
I'm focused on harm reduction, and since I used to work with severely immune-suppressed patients I see mask mandates as reducing harm. My experience is unique, but potent for me, obviously.
In other news, I'm off to Georgia tomorrow to speak at a conference of nurse educators. Should be fun. I've never been to the Blue Ridge Mountains before. I'm sure they don't compare to the Swiss Alps, but will probably be beautiful in their own way. Wishing you a great weekend, too!
So I flew to Florida for spring break around March 8, 2020. Some people were wearing masks, some were wiping down every surface in sight. I did neither. The plane was blissfully nearly empty. That evening on the news they said a known positive case had flown from New York to West Palm Beach on Jet Blue but thankfully not my plane. People at the “resort” I was visiting were horrified to hear I had come from that cesspool of infection (NYC) and avoided me!!! Returning home 5 days later after hearing all the rising numbers and the NCAA March Madness cancellation (now you know it is real if they cancel sports!!!!) the plane was full and people were visibly nervous. Once home I made myself a mask and was one of the first to wear it at ShopRite. Fast forward I was one of the first people back at work and wore a mask around other people but ripped it off as soon as I could alone!!!! I did not contract Covid until May 2022 even though I was increasingly lax about wearing it! Fast forward again to last night we are STILL wearing masks at choir rehearsal which I consider to be ridiculous!!!! I do not wear a mask anymore anywhere else and am significantly at higher risk of being exposed due to my job in a healthcare center at a university. And have only caught COVID once (fingers crossed!). I followed the science at the beginning which was playing catch up from day one, I now believe that with vaccinations we have done what we can to protect ourselves so we need for life to go on.
I agree. The vaccinations, in combination with population immunity, in combination with the new variants' being far less virulent, all remove the necessity for masks for everyone except people at high risk. As for Ember, I'm sorry to hear that they are still wearing masks. It seems as thought the arts and academia are the last holdouts on masking. It's too bad, because singing together is one of the great joys of life, and unmuffled sound and seeing each other's faces is a part of that joy.