This one is against rationalists because when Scott wrote his review that masks could be effective many of us trusted it.
I don't blame Scott for failing this one because doing review of hundreds of studies is hard and one person can hardly do it. But this clearly shows that rationalist way of thinking has no special formula, they can be easily mistaken and fall by accepting general consensus just like any other person.
I was impressed when Scott did his review about masks. I trusted it because there was no other clear evidence available. Cochrane hadn't done its review yet and NICE guidelines were silent on the issue. We vaguely knew from previous studies that masks are not effective, The WHO had said so. Suddenly everyone flipped and it was not because the evidence had changed. We simply wanted to believe that masks work and we mocked those who said “no evidence that masks help”.
Even with the belief that masks work, I never wanted mask mandates. I preferred recommendations only, so that no one was penalized or prohibited entry, travel etc if one doesn't want to wear mask. Scott unwillingly had been a catalyst for governments to introduce mask mandates and all this heavy handed approach has been for nothing.
Now we are back to square one, the evidence about masks is weak and it does not support their use even in hospital settings. We can all reflect now what happened in between during these 2 or 3 years. When I realized that Scott's review is clearly insufficient as evidence, I asked some doctors if they have any better evidence that masks work. Instead of getting answer I was told not to be silly, parachutes don't need RCTs and accused me of being covid denier for nor reason. Many so-called experts were making the same mistake as Scott by looking at the issue too emotionally. It is time to get back to reality and admit that it was a mistake and we should have judged the issue with more rational mind.
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Notes -
I just saw something on this and started writing a top level post myself. Might as well consolidate to your thread, seeing as you got in first.
Here is the review of many studies: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full
Here's a substack interview where the lead author talks about the report probably being suppressed back when they first finished it in late 2020. They were made to water down the conclusions as well:
https://maryannedemasi.substack.com/p/exclusive-lead-author-of-new-cochrane
I'm quite surprised because it seemed logical that masks would work. Why do doctors wear them if they don't work? In the past I've argued against the competence of the health authorities on the basis that they backflipped from dismissing masks to endorsing them. I thought at the time they made an error in starting off being anti-mask, since that goes against the logic of airborne diseases. But if they made an error in the other direction, that masks don't actually work and then suppressed it for years... That's much worse!
Fundamentally, if we don't have the skills and capability to quickly test and determine correctness or incorrectness of these things, we will not survive this century. We cannot expect just to have easy challenges forever. AI, more advanced bioweapons, nano... things are going to get harder not easier. We must get things done correctly, regardless of whether it makes people uncomfortable. Could we not have gotten some prisoners and deliberately infected them with COVID, just to see how effective masks are in various scenarios? Nobody had any qualms about doing roughly the same thing to the elderly in New York!
https://www.propublica.org/article/andrew-cuomos-report-on-controversial-nursing-home-policy-for-covid-patients-prompts-more-controversy
I maintain that there should be extremely high stakes for such failures. Our species cannot afford to get these things wrong and not learn from the mistake. Imprisonment is the absolute bare minimum, there should be executions. We should be absolutely, totally certain of whether masks work on an airborne disease that's THREE YEARS OLD! Top officials should be happily staking their lives on this, since they know they've taken every possible step to be totally certain that their advice is correct.
Fauci delenda est.
I'd say one problem is: even if masks are mildly effective as such, are they as effective as people think they are? If masks are mildly effective but people think they are super effective, they're going to engage more in behavior that will enable them to get or spread the disease (ie. moving out and about while mildly sick), which then might compensate or overcompensate for the mitigatory effect, particularly if the masks are worn incorrectly but the user thinks it's on correctly.
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It isn’t logical that masks work. It is akin to believing that a chain link fence will keep out mosquitoes.
If covid was spread via droplets, then yeah masks “make sense.” But aerosols transmissions makes masks act like a chain link fence v mosquitoes
This is nonsense resulting from trying to apply macroscopic intuitions at a microscopic scale. Completely unintuitively, N95 masks filter particles smaller than 0.3 microns better, even though the macroscopic intuition is that smaller particles would more easily fit through the holes. Here's a pop-science explanation from Wired.
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Thanks for that second link with the interview.
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The history of medicine is littered with harmful non-evidence based practices. And it's not just pre-modern medicine either. For example, in the 1930s, among 1000 schoolchildren in New York, 61% had had their tonsils removed. When the remaining children were presented to doctors, all but 65 of them were told they needed tonsillectomies. Even in the 1970s, tonsillectomies were the 3rd most common surgical procedure in U.S. hospitals.
The idea that the medical consensus is 100% correct in 2023 requires us to adopt the magical belief that previous errors have all been corrected, despite the fact that new errors are constantly being discovered.
How many unnecessary colon and breast cancer screenings are being performed even today? What is the cost, both in money and human suffering that these screenings impose?
Doctors wear masks for the same reason regular people wear masks: social conformity and medical theater.
I actually think there is a good reason for doctors to wear masks: spit. Quite often, saliva just gets ejected from the mouth, whether it's from coughing or merely speaking. It doesn't really matter if masks prevents spread of disease via spit, it's just gross to get spat on, and this is a situation where I'm comfortable saying that it "just makes sense" that masks will block ejecta from the mouth. It goes both directions, people don't want to be spat on by doctors, and doctors don't want to get their patients' spit in their mouths.
Anecdote: my mother noticed a cashier at her local grocery store had briefly stopped masking when the mandates lifted, but went back to wearing one. When asked, the cashier said she wasn't worried about COVID, but she had realized that the mask prevented her from getting customers' spit in her mouth. And cashiers don't have to get right up in their customers' faces.
In medicines all such good reasons should be verified, with RCTs if possible. So many things that “just makes sense” were proven wrong.
As for spitting, it is how people have interacted with each other for thousands of years and it never bothered anyone except in some gross cases. To become concerned about it now would indicate that the person has too much anxiety.
Just for a note, I never masked as a pharmacist, except when administering vaccines. For vaccines it is a protocol that we have to strictly observe but for other interactions it is optional. I also noticed that in other countries covid vaccines are administered differently. For example, we do not clean the skin with alcohol wipe (unless visibly dirty) because the studies showed that it makes no difference.
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