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 -
Masking is one area where a lot of people seem to have lost their minds, or at least dropped their scientific reasoning over some sort of gut feeling.
As I said in a reply, the default position is that masks do nothing until proven otherwise. We have research dating back to 1919 that suggest they do in fact do nothing. They mandated them in Spanish Flu and found no difference in mortality anywhere. There have been many pandemics since 1919 - for example the nasty Asian flu of 1958 and Hong Kong flu of 1968. Masks were never recommended to the public for any of them, because the consensus was that they did nothing. When SARS hit in the early 2000s, not only were they not recommended but you could be fined in some countries up to $100,000 for trying to claim they did in order to sell them.
This all changed in 2020 - not because of any new evidence, but because people threw away all of the research in a fit of politicisation. I mean that literally too - websites which had articles dismissing masks based on the available evidence were pulled down because they "disagreed with the current climate". Even in 2020 it was fairly trivial to look at heavily masked countries vs unmasked countries and not see any real difference. Journalists liked to pick a specific country like Czechia and claim they beat COVID with masks, and then fell silent as Czechia became one of the worst countries in Europe for COVID mortality. This pattern happened a lot - barely any articles from 2020 stood the test of time.
Up until 2021 people liked to use Asia as "proof" that masks worked. Of course that has now fallen apart since then, as South Korea has shot up the rankings (along with Singapore, Taiwan and Hong Kong). All of those countries are 99%+ masked, and South Korea is actually fascinating as they had more cases per capita in the span of 2 months than the US has had during the entire pandemic - while fully masked, and with the majority of people wearing KN94s (i.e. much better than surgical or cloth masks).
Some like to claim N95s work (not based on any actual evidence as far as I can tell). Even assuming they did, they only work if they're professionally fit-tested to ensure there are no gaps, because even a tiny gap renders it totally useless. You can't filter air if it's not going through the filter. It's not feasible for an entire population to be fit-tested (especially not once per year as is required for professionals), and it's not at all realistic for people to be able to gauge it for themselves. Not to mention that everyone would have to shave off all of their facial hair and possibly remove piercings. And again, there's no real evidence that they work against COVID anyway. The huge numbers of medical staff that were off sick with COVID despite wearing N95s suggests they do not work against it. We don't even fully understand how COVID spreads - we believe it to be airborne, but for all we know it's infecting people via their eyes.
At this point I genuinely don't know how people still believe in them. There are no longer any cherrypicked countries people can point to to say "see masks worked here! but not the other places that wore them at the same level, because reasons!". We've had lot of opportunities for comparison - England after they dropped the mask mandates vs Scotland which kept enforcing them (Scotland performed worse), US counties which re-adopted masking while their neighbours didn't such as Alameda county vs Contra Costa (no difference), German provinces with mandated N95s vs the other provinces with surgical or cloth (no difference).
The claims have decayed from the lofty "if 50-80% of people wore masks, the pandemic would be over!" in summer 2020, to the current "they might make a slight difference, but don't trust the studies - trust my gut". The public-facing experts who pushed masks so strongly have turned out to be mostly quacks - people who suggested you wear panty liners on your face as a filter. People who thought scarves and t-shirts would be a suitable substitute. How many videos are there of politicians donning the mask for the cameras, and then removing it when the cameras were off? Even someone like Fauci didn't wear one at the airport. These people didn't actually believe in masks. It was a political policy, not a medical policy.
I mean back in that era essentially the best they could do was hessian sackcloth.
I agree that masks are likely of essentially zero value, and if they were going to be of value it'd be of the 'If you follow all 58 laws of medical compliance, never breathe too hard or adjust your mask whatsoever you might receive a 1% resistance to a disease of your choice' which is beyond implausible. The whole adoption during COVID was far more about team membership than anything.
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