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PaperclipPerfector  1yr ago (text post)   38805 thread views

Culture War Roundup for the week of June 5, 2023

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Some more claims I did a double-take on, having never heard them before: [...] that masks are entirely ineffective in preventing the transmission of COVID-19?

By the best standards of evidence available, masks do nothing for covid-19. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6

Some people caveat this by saying the evidence against is weak. My response to this is that if you're going to force billions of people to do so, you should have strong evidence in favour, not weak evidence against it. The default position for medical interventions should be that they don't work until proven otherwise. Others argue against the findings on the basis that masks necessarily must work because physics, on the grounds you don't need to do a scientific study to determine if a parachute works. This is called unfalsifiability, and is the classic sign of pseudoscience. Regardless if we did do a study on parachutes and got a null result that would actually be very good evidence against parachutes.

Stuff like this means we need to caveat any claim that Kennedy has wacky beliefs / conspiracy theories with the fact that his political opponents hold the similarly wacky (but in practice far more destructive) belief / conspiracy theory that masks work for covid.

The Cochrane meta-review contains 12 studies, only 2 of which are covid-specific. Those 2 studies are https://www.science.org/doi/10.1126/science.abi9069 which says

mask wearing averaged 13.3% in villages where no interventions took place but increased to 42.3% in villages where in-person interventions were introduced. Villages where in-person reinforcement of mask wearing occurred also showed a reduction in reporting COVID-like illness, particularly in high-risk individuals

and https://www.acpjournals.org/doi/10.7326/M20-6817, reporting that

Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%)... Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.

That's 1 positive and 1 neutral study, with the positive study having a much, much larger sample size; based on https://www.stat.ubc.ca/~rollin/stats/ssize/b2.html the neutral study is only about 30% powered to detect a decrease from 2% to 1.5% infection rate.

In addition, all of these studies are really testing the combined effectiveness of masks against COVID, and whether various measures to get people to wear masks actually do so, and the baseline level of mask wearing. For example, the latter study I quoted above says

Based on the lowest adherence reported in the mask group during follow-up, 46% of participants wore the mask as recommended, 47% predominantly as recommended, and 7% not as recommended.

and the former has the adherence levels in the passage I quoted.

Obviously you can't do a meta-analysis with 2 studies, which is why Cochrane grouped these 2 in with the other 10, but "By the best standards of evidence available, masks do nothing for covid-19." is simply not true. In some cases an individual study is more reliable evidence than a meta-analysis, and this is probably one of those cases.

The physics argument is also wrong. It would be akin to saying that a chain link fence can stop a mosquito. Once we understood that aerosol transmission was how covid spread and not droplets the logic for masking was over.

Also, masking was not low cost but high cost. It retarded development in kids, caused psychological issues for all who wore them (ie reinforced the idea one should panic), and seemed to create build up of CO2.

It is also funny because masks have been studied in a lot of other situations and they routinely don’t demonstrate efficacy. Thus the prior should’ve heavily been “masks don’t work.”

The physics argument is also wrong. It would be akin to saying that a chain link fence can stop a mosquito. Once we understood that aerosol transmission was how covid spread and not droplets the logic for masking was over.

This is not how N95 masks work. Their filtering efficiency is better for very small and very large particles than for medium ones. This is why people wear N95s (or better) when dealing with much more serious diseases than covid.

Cloth and surgical masks were always dubious though.

I am making this stat up, but I’d wager that at least 90% of masks used were cloth on surgical. Focusing on N95 (which have increased costs) isn’t talking about the primary or even secondary form of mask. It was always a

Motte and Bailey where people would talk about masking has used and people would respond with N95s. Yet when they spoke about costs, the costs were the masks actually used.

The motte and bailey goes both ways, because people on the other side of the issue claim that masks don't work, period, and then inevitably walk it back (not all masks!)

In practice, N95s don't work either. It's just not as obvious a priori that they wouldn't.

Again, N95s do work, and have kept people from contracting diseases much worse than covid many times.

The linked meta analysis has a null result for N95 masks. If you're going to argue that there's a mask out there known to work you'd probably need to point to some kind of respirator.

N95s in practice failed to work against COVID. Whether they worked against diseases "worse than COVID" is immaterial.

N95s do work against covid. Thank you for demonstrating the motte and bailey I am talking about.

More comments

This is not how N95 masks work. Their filtering efficiency is better for very small and very large particles than for medium ones. This is why people wear N95s (or better) when dealing with much more serious diseases than covid.

Yeah but they're wearing them with utmost attention to hygiene, regular replacements and full mask discipline for short periods of time

It's important to not spread made up facts to counter made up facts. It's true both that some masks work and that most mask wearing is theater.

It's important to not spread made up facts to counter made up facts. It's true both that some masks work and that most mask wearing is theater.

Some masks work*

  • if applied by a medical hygienist with utmost attention to following our simple 50-point guideline on how to best utilize your N95

Yep, you need a phd to wear an n95, it's not like blue collar workers manage it on a day to day basis.

You don't need a PhD to wear it, but it looks like - according to the current research - you need something like a PhD to wear it in a way that protects you from covid by a measurable degree. Either we say "experimental evidence is king, we are rationalists rooted in reality" and then recognize the fact that whatever the reasons are, mass masking is not doing what it promised to do, or we go "we should do it anyway because that sends a message and makes people feel blah blah blah" and then stop pretending we are following The Science (TM) and The Experts (TM) and recognize we just had one more weird social ritual among many weird social rituals we used to have over the history and stop trying to rationalize it.

It was quite strange seeing industries that should have very strong familiarity with how masks work or don't work (painting with aerosols, asbestos removal etc) suddenly jettison that when covid came along. Thankfully I'm yet to witness anyone decide a surgical mask is good enough for those.

Also, masking was not low cost but high cost. It retarded development in kids, caused psychological issues for all who wore them (ie reinforced the idea one should panic), and seemed to create build up of CO2.

I don't know if it has been studied but I suspect they also greatly increased crime.

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