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 -
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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