"A study then in 1919 concluded that mandatory mask mandates did not make any difference on epidemic, while observing that a likely reason for their ineffectiveness was that masks were worn outdoors and not inside in gatherings when conditions for transmission would be greatest."
Why is it so hard for public officials to learn from past experiences, and always repeat the same mistakes?
The paragraph in the article immediately after the one you quote says:
"However, according to medical historians, the decline in deaths from influenza in San Francisco can be partly attributed to the mandatory mask-wearing policies."
> "However, according to medical historians, the decline in deaths from influenza in San Francisco can be partly attributed to the mandatory mask-wearing policies."
The full quote is "Yet in cities like San Francisco, the decline in deaths from influenza was partly attributed to the mandatory mask-wearing policies." It contains no further attribution or references.
> "A study then in 1919 concluded that mandatory mask mandates did not make any difference on epidemic, while observing that a likely reason for their ineffectiveness was that masks were worn outdoors and not inside in gatherings when conditions for transmission would be greatest. It also noted that most masks were improperly constructed of inadequate materials."
One is a recent quote from the Lancet, a respected medical journal. The other is from 1919, before the discovery of viruses. But I am not going to argue which holds the most credence. What is concerning though is that the original comment selectly quoted the paragraph that supported their no doubt political opinion while ignoring the other.
“47% of the group we asked to consider wearing masks wore them sometimes, and the whole group got a little bit less sick” is a crap study. which is what you’d expect with patient reported data.
How is it a crap study? They had a bunch of people wear masks, which they did with varying levels of compliance ("46% of participants wore the mask as recommended, 47% predominantly as recommended, and 7% not as recommended"), and found no statistically significant reduction in infection rates.
To me that seems like a pretty convincing reason to believe that wearing a mask is not going to decrease my chances of getting COVID.
Do you have a compelling reason to believe otherwise?
- if you run a study about the effectiveness of mitigation methods when there's a low incidence rate during your study duration, don't be surprised when you're sampling noise and get inconclusive answers.
- a sub-50% self reporting compliance rate is pretty shit.
- that masks are better at keeping your gross breath in than it is in keeping everyone else's out is not a very contentious claim, and it's upheld here. Asymptomatic transmission being what it is (ie, real), you would expect to see high compliance with masks and social distancing correlate well with reduction in overall caseload. That hypothesis was not investigated here, so this study contributes no information to it.
- the authors of the paper themselves conclude “We think you should wear a face mask at least to protect yourself, but you should also use it to protect others ... We consider that the conclusion is we should wear face masks.”
The study claims its sample sizes were large enough to see an effect if there were one; I'm not expert enough to evaluate the math, but I assume they are telling the truth.
None of your other points give me any reason to believe masks provide protection to the wearer. I agree the study does not speak to whether wearing masks provides protection to others. (And I have so far not seen analysis that convinces me one way or the other on that point.)
That alone is almost enough to discount it right there.
Even studies done only 50 years ago are often discounted by scientists today because of their poor quality and lack of rigor compared to today's studies. A study done 100 years ago is likely to be even worse.
But even were it not, we have to ask:
- What study?
- Was it published in a reputable peer-reviewed journal?
- How large was the study?
- Was it double-blind?
- Were the results statistically significant?
When even very recent studies are mentioned on HN, they're often torn apart for not having met one or more of these and other criteria.
Yet at other times mere mention of "a study", some anonymous study done 100 years ago, published who knows where, of completely unknown quality is supposed to be given credence just because it's "a study"?
You are looking at it too shallowly, you need to observe multiple dimensions.
As someone mentioned, quality of the study in 1919 is quite questionable.
But in 1919, population density was way different.
Average home was about 5 people, now its about 2.5.
US has about 8 times more households than back then.
Back then, there were 9 areas that had population between 500k-1 million. Now, theres about 40 in that category and about 40 in above 1 million category.
Why take a look at this data?
Because it shows you what happened - less people inside, more people outside. There are more external centres of congregation than we had before - more malls with more people, more bars, more shops. The chances are you will encounter 5-10 times more people than back then on your way to the store, and thats a low guesstimate.
Edit: My point is, masks outside are now way more necessary than in 1919 when in mid-high populated areas.
Some of the complaints I hear are difficulty breathing, and fogging up glasses. Seems to me that in such cases a different mask design might suffice. Some also believe that the masks aren't useful, so don't bother.
I suffer from both problems (fogging up glasses and difficult to breath) but I still prefer to wear a mask. It just means I go less to places where its mandatory to wear one. Which means I go out less, which is statistically good to combat the pandemic. My mother does the very same, except she's a risk group while I'm not. As does my partner. n=3 but I doubt we're alone. Even in a seemingly unlikely way such as this indirect example, masks work.
Because you're so easy to manipulate, we will have another massive wave of death from bacteria pneumonia caused by keeping wet rags over your blow holes.
Turn the light around.
I'd be curious what percentage of people were advised to wear masks and chose not to, if there was any way to tease out even a rough guess of that. How it compares with our current situation might be relevant. If it's higher now, I would be saddened but not surprised. If it's the same, that might actually be a bit of a relief.
I don't really get it...assume there is a 1% chance that masks work, just wear the mask, what is the cost to you?
I am not sure that masks work, I live somewhere where it is mandatory in almost every situation, and our number of cases is now significantly higher than it was when no-one was wearing them...but just wear one. Is the number of vain adults really this large?
Anti-maskers in America fall into the group that believes in small government, so they see mandatory masks as a huge overreach of power and an attack on their freedom/metaphorical muzzle/etc.
But the reason you wear a mask is to protect other people. The point of liberty is the freedom to do what you want to do without imposing costs on other people.
If you believe that you are free to use your neighbour's bathroom, you are free to have that belief but not to impose that belief on your neighbour.
Liberty does not mean my beliefs to the exclusion of others (indeed, it is the opposite, tyranny is attempting to impose beliefs on others).
And public health is one of those areas in which, I believe, the role of govt is questioned by very few libertarians (the converse of this view is ludicrous, the point of a public health crisis is that it imposes costs to individuals that are less than the cost to the group).
So...it is hard to understand. Maybe the "Live Free or Die" crowd have a secret vanity?
One could also assume that there's a 1% chance that a mask is harmful (let's say due to oxygen deprivation). If that person believes that they are harmful, then why would take the 1% risk?
(For the record, this is not my opinion. Just pointing out that this reasoning isn't very convincing.)
Oxygen issues was a “let’s say” and the op said they don’t follow that. The point is not oxygen, the point is that some people feel the risk of wearing a mask always may be close to or greater than the risk of covid. Here’s a different take I’ve heard from those worried about masks: keeping a warm, moist cloth around your face holes while constantly having to adjust it by hand might lead to increased chance for other infections.
Wondering if I’m feeding a troll at this point. I assume you are aware that we exhale and that contains moisture. Same reason why lots of people are complaining about fogged glasses.
Not at all. I’m claiming that some people weigh their perceived risk of mask vs no mask and their reasoning does not fall into the category of wearing a mask.
I wear a mask everywhere I go but I don’t label anti-mask people as immediately illogical. Your position seems to assume that mask wearing has 0% risk so therefore if it is 1% helpful, just do it. Is that assumption based in logic? There is some evidence that cloth masks specifically don’t help much and can actually hurt:
Dr. Fauci himself at the beginning of the conflict said not to wear masks. Then he admitted he was lying to prevent a run on masks. Is it any wonder people are skeptical or at least confused?
> Dr. Fauci himself at the beginning of the conflict said not to wear masks. Then he admitted he was lying to prevent a run on masks. Is it any wonder people are skeptical or at least confused?
The same shit happened in Germany, with the added confusion between the various types of masks and people believing that painters' masks (the one with a passthrough for exhaling) are effective too while they are not.
It was a madness all around, and one that may cost us a lot of public trust in science and politics.
I don't think the people who distrust science or politics are coming to that conclusion in a necessarily rational way. Their lack of faith is more of a general malaise. When most of your people think the elected body that makes laws is mostly corrupt, you've already conceded that the society's core guidance is corrupt.
All you have to do then is wait for things to upset the public, like a mandatory inconvenience, for them to start to protest and later revolt. It's similar for both Black Lives Matter as for no-maskers/no-lockdowners. They're pissed that the system is corrupt and imposing itself on them. At that point they may throw out any institution of authority if they feel oppressed by it.
The lack of faith comes from incorrect or manipulated information being delivered with the same confidence as information that had sounder foundations. One of the weaknesses of a mainstream media that only deals in propaganda is that it delivers all official declarations with an equal, demanding intensity.
It might have been an advantage to have such a hated executive branch during the period, which at least forced something that seemed like a debate at the margins since there was at least an effort to show why Trump was wrong about stuff. Even that ended up backfiring with the shit Hydroxychloroquine Lancet study fraud. I guarantee that being published and witdrawn resulted in at least twice the people drinking "Miracle Solution" i.e. chlorine dioxide than would have if they hadn't published. The Lancet made Wakefield famous, and now they turned Trump into a health care martyr.
> Their lack of faith is more of a general malaise. When most of your people think the elected body that makes laws is mostly corrupt
If I understood correctly, you're saying people don't distrust politics due to rational reasons, they're just generally pissed at the system? That doesn't answer the question. Why are they pissed in the first place? It could perfectly be due to rational reasons.
I wouldn't say it's a distrust of science itself, either. It's a distrust of whatever is presented to you as science.
They're pissed because they think something is wrong and they want it fixed. But they don't know what is wrong, and they don't know how to fix it. So I think they are pissed because it just seems like they should be.
> It could perfectly be due to rational reasons.
If you ask a very loud shouty person why they are so angry, they usually launch into a tirade of "everything that's wrong with the country." But you don't hear one single specific issue or well-thought-out rationale. The only common thread is cultural or political. Us-versus them; it's all those people's fault that everything is wrong. There are common themes, but no one specific root cause, issue, or analysis.
So they don't really know what's wrong or what the cause of it is. The only thing they're sure of is that something is wrong, and they grasp at whatever has been pissing them off lately. As social primates, when we are generally pissed off and think something is wrong, the most common group that we blame is "the authority" (the next-most-common group to blame being "the foreigner")
The general evidence I give is here (https://news.gallup.com/poll/1600/congress-public.aspx). In the 1970s, around 50% of Americans disapproved of how Congress did it's job. For the past 10 years, around 80% of Americans have disapproved of how Congress did its job.
Congress is an elected body. If the people really thought Congress was the cause of their anger, they could just vote them all out; doesn't take a genius to figure that out. Yet most people stay in Congress. So I think the anger at Congress is really just a symptom of the malaise, regardless of whether Congress does either a good or bad job.
> If the people really thought Congress was the cause of their anger, they could just vote them all out; doesn't take a genius to figure that out. Yet most people stay in Congress.
A large part of the cause is single-issue voters, especially abortion and gun control. Many people vote R simply because they are so hellbent on turning back abortion rights or keeping the right to buy guns in supermarkets and vice versa. And the parties know and exploit that - Bush, Obama and Trump had times with supermajorities in which they could have ended the respective issues permanently, but they didn't.
The result is a dysfunctional Congress whose members are not held accountable by their voters no matter what they do, and a subsequently disappointed public.
And the same mechanic also applies to the Presidency elections. A lot of people only voted Biden because they wanted to get rid of Trump, and one might say that many people voted Trump in '16 to prevent Clinton who's as Establishment as it can be.
The linked article makes a convincing case against cloth masks in a healthcare setting but doesn't suggest they're not helpful or harmful outside that.
It’s not to “prevent a run on masks”, that’s an oversimplification. Not recommending masks was because we KNEW the n95 type masks worked, but there were not nearly enough of them for health care workers, let alone the rest of us. As science progressed in the topic, we learned that even cloth masks which are easier to produce reduce the amount of virus people spread out into the environment.
If people are skeptical or confused, it’s because they refuse to understand the concept that our knowledge about the world changes and evolves over time.
> Not recommending masks was because we KNEW the n95 type masks worked, but there were not nearly enough of them for health care workers, let alone the rest of us.
So it's not an oversimplification, you just agree with the tactic. It's alright to agree with the tactic without accusing the people who describe what happened accurately of arguing in bad faith.
People were being told that masks can be effective to stop spread, government agent says don't wear masks, then later says you must wear masks, then admits they said this to prevent you from getting a mask when they were available to you before the government and private industry squashed access to the supply.
That level of deceit is enough to make anyone skeptical of anything else going forward.
Then move 6 months into the future after we get more data, we know specifically who the virus harms, how it harms them, we've all interacted with someone who had it and realized it wasn't the end of the world, which adds further to the confusion on the overreaching response.
We can also finely target the response now to mitigate spread if needed, yet governments are still using total lock down as the only model, despite having the data to do it better.
A further issue, total "cases", which we now know most are mild, are the only metric used by government and media to engineer a propaganda campaign against a population as justification to destroy everyone's livelihoods and freedoms.
Being a little salty at this point is justified, we don't lack understanding at this stage.
Back in the 90's, artist Jenny Holzer famously wrote, "Lack of charisma can be fatal." The problem in the current pandemic isn't the science, it's that the quality of people in leadership roles is not sufficient for people to align behind them and move together. The explanation with the most predictive power in all of this is that the (mostly conservative) anti-mask people today are the visible face of what is really an anti-lockdown movement. They are revolting against what they perceive to be unworthy leaders, who demand they sacrifice their livelihoods and accept the direct consequence of generational poverty, to protect a group of people (upper middle boomers) who express open contempt for them.
Johnathan Haidt's old "Righteous Mind" was one book that talked about some of these values and mindsets. The mindset also means that they are willing to take a %0.003 risk of death to continue to provide prosperity for their families and communities, but accepting poverty for their families and communities at the behest of people they perceive as not taking the same risk is anathema.
They co-operated in initial stages of the pandemic when the viable action reinforced their cultural heroic understanding of action, but leadership everywhere has forfeited that by using the pandemic as leverage for a pre-existing social management agenda, and now we've got anti-mask protests.
A few years ago, I had a conversation with someone from the Sierra Club about whether they thought better technology could resolve the climate crisis and whether they'd be interested in a VC model for investing in moonshot green tech. Their response was it wouldn't matter because the technology would not provide mobilization for the true goal of global justice. That deceit ended my support. This same conversation is happening everywhere about the pandemic today.
The various conspiracy theories around masks are expressions of this underlying dynamic. If we want to contain the pandemic, there are absolutely ways to do it, but if people find their leadership is using deception against them, the pandemic will be the least of the risks our societies will face, in my opinion. It will have truly been a lack of charisma that was fatal.
Only half of us have been wearing masks. For places in which rules were stricter and compliance was wider-spread, see countries that currently don't have lockdowns.
As a counterpoint, in Spain where I live, mask wearing in public is very high (Statista says 95% always wear a mask) and we still have a lot of lockdown measures, as infection numbers are still fairly high. You could argue that we have lockdown in spite of high mask use, due to cultural habits/private meetings/bad laws/low compliance of other measures, but it shows that high mask use alone isn't sufficient to avoid lockdown.
This simple messaging from a credible leader would suffice. What didn't work is the idea that masks prevent something we can't control. The hard problem is solving for credibility.
During the initial lock downs with government support, many people did not face a choice of death or poverty. They only have that issue now because of lack of support from the Senate (specifically Sen. McConnell, who by rules controls what is voted on).
Yet many of the people that attend anti-mask rallies also are ardent Republicans (same as Sen. McConnell). So I have trouble squaring your argument that it is about government over-reach. Likewise, if it about government spending causing issue, where were the rallies about the tax cuts for the highest earning segment last year? That law caused a lot more debt than the stimulus to support lockdown.
" it's that the quality of people in leadership roles is not sufficient"
This is rubbish, they are high quality leaders, not only that, they are perceptibly so.
This statement is easily disproven by the examples in almost every other country besides the US where masks are generally not contentious (they are in some small circles, but not broadly), the difference in the US being 1/2 of the countries populist leaders are either against masks or don't openly support them.
'The problem' is that Trump, Fox News, certain famous individuals, and Conservative politicians will not openly support masks, and attack the credibility of the medical system.
If Trump and Brett Favre were to make a 10 second video vignette promoting mask wearing, and Trump+Fox+GOP+Everyone else were behind this ... then there wouldn't be much of an issue.
" but leadership everywhere has forfeited that by using the pandemic as leverage for a pre-existing social management agenda"
Again, this is conspiratorial falsehoods.
"but if people find their leadership is using deception against them"
More conspiratorial falsehoods.
This is a disturbing misunderstanding of the situation: Americans would, by and large, be 'mostly ok' with masks, if 1/2 of the populist leaders told them to be. That's the only issue here.
Turning the pandemic into a political weapon is the problem.
I'm appreciating how ironically we are in agreement. There are people who can influence people, and those who can't. The former are real and credible leaders, the latter are not, and this is the danger. That the U.S. has almost a popular majority who do not believe their mandarin class has the national interest in mind (hence their preoccupation with so-called "globalists") is the evidence of this danger.
It's not enough to be merely correct, you need to be able to prevail on the population to wear masks or make greater personal sacrifices to stop the pandemic. I live in Canada, where our prime minister is amusing to the sort of people he flatters, but the level of tolerance people have for sacrifice based on his word is very low. He'd be called a "lame duck president," in the U.S. My point is that leadership weakness is what puts the whole country in danger if it in fact ever had to unite to do anything. I agree that the U.S. president could get the entire country onside if he chose to, but clearly he is not convinced it's worth destroying the small businesses that would cost the country a generation of growth.
If this were a partisan argument, I'd just bait you into reinforcing more of your prejudices and aspirations, but there is a serious conversation to be had about the the credibility of leadership in bringing people through a crisis like a pandemic. It's not enough for us to blame the outgroup, the virus doesn't care, so we need to look at what adapting to beat it might look like.
Whether masks are effective is controversial. There's a lot of "experts" saying different things. Also getting actual science on this is really hard as you need to do an ethical study on this in a controlled environment.
What we do know is that China is owning this pandemic in every possible way. Life is already back to normal in that country. They also all wear masks. Whether the masks were effective is unknown.
So basically we know that something or multiple things that China did are effective at suppressing the spread of Covid. If one of the things they did included using masks... then it may be that masks are very effective or partially effective in conjunction with everything else china did to stop the disease.
Keep in mind there's no hard science on any of this. Nobody knows for sure. We just know China did many things to suppress the disease but we don't know which thing or which subset of things China did was actually effective at curtailing the disease.
But we do know by copying everything China is doing we will for sure his that subset of effective countermeasures.
If they wear masks in China... we should be wearing masks too.
I think there would be more compliance if we could have an adult conversation about the conditions under which masks will no longer be required. Given endemic seasonal viruses that already kill people in waves all year every year, one could argue masks should be required forever. However, I think there’s a real value to smiles in public, and the community and goodwill they engender. The moralism that has defined the conversation to date gives me no hope we’ll ever find our way out. And it quickly begins to appear less about helping people in an extraordinary time of crisis and more about virtue signaling. That, I think, is what breeds the hostility to mask mandates. People want to help one another, but there is a wide range of individual risk profiles that are completely rational, that politicians routinely ignore. “Science” can’t tell you how much death is an OK amount of death. Life requires we impose non-zero risk of death on others.
For this particular disease, my personal threshold is something like, "A vaccine exists, and most of the vulnerable population at least has access to it." This kind of lockdown seems wildly inappropriate for most other yearly diseases.
That threshold has become more realistic as vaccines have taken much less time than usual, but it’s a decent suggestion, and in my view is precisely the kind of conversation decision makers should be having publicly. There are tradeoffs to weigh, and some humility is warranted. Instead, the Oregon governor (at least) specializes in shaming and finger wagging, which I think exacerbates hostility to her proposals.
> For this particular disease, my personal threshold is something like, "A vaccine exists, and most of the vulnerable population at least has access to it."
As far as masks and distancing go in the US, we might need to keep it up longer than that.
Consider the annual flu vaccinations in the US. Typically less than 50% of adults get it even though they are widely available and are fully covered under most health plans (and are not hard to get for free if you do not have health insurance).
There are a lot of people who believe the propaganda about COVID being no worse than a mild flu, so I expect that a lot of the people who do not get flu vaccinations will also not get COVID vaccinations.
There are also a fair number of people who believe COVID is hoax. I expect that a lot of them won't get a COVID vaccination even if they do get flu vaccinations.
Sure, once you get vaccinated and wait the couple of weeks or whatever for it to provide protection for you, there is no medical reason that you need to wear a mask or distance any more.
But I don't think it is going to be practical to have a mask/distancing mandate that only applies to people who are not vaccinated (or immune through already having had it), at least in places that are open to the general public.
Unless we are just going to write them off, those people who fell for the propaganda still need to be wearing masks and distancing when they are around other such people, and so to have a practical mask/distancing mandate that will work with them we will probably need it to apply to everyone, at least in places open to the general public.
The reason that conversation isn’t being had is because the intention from a lot of these public health folks is to never end the mask mandates, since as you said they are such an effective tribal signaling mechanism.
This might honestly be one of the dumbest takes on mask use I think I've seen so far. Let's just ignore the fact that masks limit the propagation of an airborne virus and conclude that the only interest in advocating for their use is virtue signaling during a FUCKING PANDEMIC!!!! Your argument here is either being completely made in bad faith, you forgot your "/s" sarcasm marker or you're a complete moron.
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On the one hand, this is a fair question. On the other hand, isn't it blindingly obvious, what the condition will be?
Essentials, most countries are trying to flatten the curve [1]. Mandating masks is one layer of a swiss cheese [2] security model to try to keep the curve as flat as needed to prevent overloading of the health care systems.
Isn't it obvious we will need to follow the mask mandate as long as there is a risk that the curve crosses the capacity of our health care systems?
Leaving us with essentially four possible reasons why we can stop wearing masks:
a) We reach sufficient immunity through vaccination
b) We have successfully eradicated the virus
c) We have a cure for the infection
d) Everyone (epidemiologically speaking, so a relevant proportion of the population) has had the virus and we have developed sufficient immunity through exposure
masks were never necessary for the masses, as opposed to care workers and others who deal with the public in the course of their work. they're very marginal for common interaction scenarios we see day-to-day, but a huge political distraction keeping us from honing in on the main sensible measure we need to "flatten the curve", which is reasonable distancing at private social gatherings, not any of the additional political noise of mask-wearing outside for signaling or social pressure, and limiting certain businesses from operating but not others. mask mandates were only essential for politicians to show that they were tackling the problem, not to actually reduce infection rates.
Obviously distancing is the best possible option we have right now. If we could perfectly distance from each other for 2 weeks, we would eradicate the virus altogether. Unfortunately, this is not feasible, if we also want to maintain society as is.
Don't you think that masks can be a useful tools in cases where keeping distance is not possible?
yes, the policy all along should have been to only wear masks at social gatherings where distancing isn't guaranteeable (along with previously-noted public-facing workers). the fatigue of wearing a mask all the time (for complicity or social pressure) encourages us to take them off in private, exactly where they might have actual marginal benefit.
that’s a paper on a fluid dynamical model of how masks might work, and the theoretical filtration rates of the model. they didn’t test mask efficiency against covid. it’s a neat application of navier-stokes and computational fluid dynamics, but not too relevant to mask effectiveness and public health policy in real-world applications.
I agree there hasn't been enough discussion of this sort of thing -- what sorts of conditions call for what kinds of control measures -- in part because we've (in the US) never gotten it together to have a coordinated rational calm response, it's seemed like "got to struggle just to get people to do ANYTHING" the whole time.
If we were to have that discussion, I'd think the way "conditions in which this control measure is needed" is dicussed is in terms of current observed covid case numbers -- what else could it be? Say, when positive cases per population or per test given are below X, for instance. It's likely that the 'right' number that makes sense for not having masks is pretty low, and possibly lower than will be realistically gotten to without widespread effective vaccine or other significant change in the landscape. (Some countries like Australia or New Zealand got there without a vaccine; we've missed that boat, if it was ever possible here).
The "right" number for masks should be pretty low because the social/economic/etc "cost" of masks -- while I agree it is non-zero -- is lower than about any other effective measures. Closing schools or businesses, for instance. You'd want to resort to universal mask use before closing schools, because the social/economic cost of closing schools is so much higher. Masks are pretty effective at comparatively much lower cost, so make sense to be a much earlier resort. (although I agree non-zero; I find masks very uncomfortable and hard to breathe in myself). At this point in the US, numbers are bad enough that masks are a no-brainer and we need a lot more than that.
Those against wearing masks might also be contributing to a rational conversation about costs and benefits more if they talked about under what conditions they thin masks would be appropriate -- say, what number of covid cases diagnosed per 100K population would make masks well-advised?
I wonder how many people against wearing masks basically think there are no conditions under which masks are advisable though.
79 comments
[ 11.2 ms ] story [ 2620 ms ] threadWhy is it so hard for public officials to learn from past experiences, and always repeat the same mistakes?
The paragraph in the article immediately after the one you quote says:
"However, according to medical historians, the decline in deaths from influenza in San Francisco can be partly attributed to the mandatory mask-wearing policies."
Take your pick:
> "However, according to medical historians, the decline in deaths from influenza in San Francisco can be partly attributed to the mandatory mask-wearing policies."
From a social science piece published in May 2020, https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820....
The full quote is "Yet in cities like San Francisco, the decline in deaths from influenza was partly attributed to the mandatory mask-wearing policies." It contains no further attribution or references.
> "A study then in 1919 concluded that mandatory mask mandates did not make any difference on epidemic, while observing that a likely reason for their ineffectiveness was that masks were worn outdoors and not inside in gatherings when conditions for transmission would be greatest. It also noted that most masks were improperly constructed of inadequate materials."
Comes from an actual medical study by the California Board of Health, published in 1919. https://babel.hathitrust.org/cgi/pt?id=uc1.31378008030317&vi...
https://www.acpjournals.org/doi/10.7326/M20-6817
Perhaps useful to other people, but that's just speculation.
“47% of the group we asked to consider wearing masks wore them sometimes, and the whole group got a little bit less sick” is a crap study. which is what you’d expect with patient reported data.
To me that seems like a pretty convincing reason to believe that wearing a mask is not going to decrease my chances of getting COVID.
Do you have a compelling reason to believe otherwise?
- if you run a study about the effectiveness of mitigation methods when there's a low incidence rate during your study duration, don't be surprised when you're sampling noise and get inconclusive answers.
- a sub-50% self reporting compliance rate is pretty shit.
- https://www.vumc.org/health-policy/sites/default/files/publi... Figure 1.
- that masks are better at keeping your gross breath in than it is in keeping everyone else's out is not a very contentious claim, and it's upheld here. Asymptomatic transmission being what it is (ie, real), you would expect to see high compliance with masks and social distancing correlate well with reduction in overall caseload. That hypothesis was not investigated here, so this study contributes no information to it.
- the authors of the paper themselves conclude “We think you should wear a face mask at least to protect yourself, but you should also use it to protect others ... We consider that the conclusion is we should wear face masks.”
- if you want to see population statistics where community transmission is frankly rampant: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947e2-H.pdf , https://pubmed.ncbi.nlm.nih.gov/32543923/
None of your other points give me any reason to believe masks provide protection to the wearer. I agree the study does not speak to whether wearing masks provides protection to others. (And I have so far not seen analysis that convinces me one way or the other on that point.)
That alone is almost enough to discount it right there.
Even studies done only 50 years ago are often discounted by scientists today because of their poor quality and lack of rigor compared to today's studies. A study done 100 years ago is likely to be even worse.
But even were it not, we have to ask:
- What study?
- Was it published in a reputable peer-reviewed journal?
- How large was the study?
- Was it double-blind?
- Were the results statistically significant?
When even very recent studies are mentioned on HN, they're often torn apart for not having met one or more of these and other criteria.
Yet at other times mere mention of "a study", some anonymous study done 100 years ago, published who knows where, of completely unknown quality is supposed to be given credence just because it's "a study"?
Average home was about 5 people, now its about 2.5. US has about 8 times more households than back then. Back then, there were 9 areas that had population between 500k-1 million. Now, theres about 40 in that category and about 40 in above 1 million category.
Why take a look at this data? Because it shows you what happened - less people inside, more people outside. There are more external centres of congregation than we had before - more malls with more people, more bars, more shops. The chances are you will encounter 5-10 times more people than back then on your way to the store, and thats a low guesstimate.
Edit: My point is, masks outside are now way more necessary than in 1919 when in mid-high populated areas.
Our mandates are focused on indoor gatherings, and we have access to high quality masks.
I am not sure that masks work, I live somewhere where it is mandatory in almost every situation, and our number of cases is now significantly higher than it was when no-one was wearing them...but just wear one. Is the number of vain adults really this large?
If you believe that you are free to use your neighbour's bathroom, you are free to have that belief but not to impose that belief on your neighbour.
Liberty does not mean my beliefs to the exclusion of others (indeed, it is the opposite, tyranny is attempting to impose beliefs on others).
And public health is one of those areas in which, I believe, the role of govt is questioned by very few libertarians (the converse of this view is ludicrous, the point of a public health crisis is that it imposes costs to individuals that are less than the cost to the group).
So...it is hard to understand. Maybe the "Live Free or Die" crowd have a secret vanity?
(For the record, this is not my opinion. Just pointing out that this reasoning isn't very convincing.)
https://news.ycombinator.com/newsguidelines.html
https://www.sciencedaily.com/releases/2015/04/150422121724.h...
Dr. Fauci himself at the beginning of the conflict said not to wear masks. Then he admitted he was lying to prevent a run on masks. Is it any wonder people are skeptical or at least confused?
The same shit happened in Germany, with the added confusion between the various types of masks and people believing that painters' masks (the one with a passthrough for exhaling) are effective too while they are not.
It was a madness all around, and one that may cost us a lot of public trust in science and politics.
All you have to do then is wait for things to upset the public, like a mandatory inconvenience, for them to start to protest and later revolt. It's similar for both Black Lives Matter as for no-maskers/no-lockdowners. They're pissed that the system is corrupt and imposing itself on them. At that point they may throw out any institution of authority if they feel oppressed by it.
It might have been an advantage to have such a hated executive branch during the period, which at least forced something that seemed like a debate at the margins since there was at least an effort to show why Trump was wrong about stuff. Even that ended up backfiring with the shit Hydroxychloroquine Lancet study fraud. I guarantee that being published and witdrawn resulted in at least twice the people drinking "Miracle Solution" i.e. chlorine dioxide than would have if they hadn't published. The Lancet made Wakefield famous, and now they turned Trump into a health care martyr.
If I understood correctly, you're saying people don't distrust politics due to rational reasons, they're just generally pissed at the system? That doesn't answer the question. Why are they pissed in the first place? It could perfectly be due to rational reasons.
I wouldn't say it's a distrust of science itself, either. It's a distrust of whatever is presented to you as science.
They're pissed because they think something is wrong and they want it fixed. But they don't know what is wrong, and they don't know how to fix it. So I think they are pissed because it just seems like they should be.
> It could perfectly be due to rational reasons.
If you ask a very loud shouty person why they are so angry, they usually launch into a tirade of "everything that's wrong with the country." But you don't hear one single specific issue or well-thought-out rationale. The only common thread is cultural or political. Us-versus them; it's all those people's fault that everything is wrong. There are common themes, but no one specific root cause, issue, or analysis.
So they don't really know what's wrong or what the cause of it is. The only thing they're sure of is that something is wrong, and they grasp at whatever has been pissing them off lately. As social primates, when we are generally pissed off and think something is wrong, the most common group that we blame is "the authority" (the next-most-common group to blame being "the foreigner")
The general evidence I give is here (https://news.gallup.com/poll/1600/congress-public.aspx). In the 1970s, around 50% of Americans disapproved of how Congress did it's job. For the past 10 years, around 80% of Americans have disapproved of how Congress did its job.
Congress is an elected body. If the people really thought Congress was the cause of their anger, they could just vote them all out; doesn't take a genius to figure that out. Yet most people stay in Congress. So I think the anger at Congress is really just a symptom of the malaise, regardless of whether Congress does either a good or bad job.
A large part of the cause is single-issue voters, especially abortion and gun control. Many people vote R simply because they are so hellbent on turning back abortion rights or keeping the right to buy guns in supermarkets and vice versa. And the parties know and exploit that - Bush, Obama and Trump had times with supermajorities in which they could have ended the respective issues permanently, but they didn't.
The result is a dysfunctional Congress whose members are not held accountable by their voters no matter what they do, and a subsequently disappointed public.
And the same mechanic also applies to the Presidency elections. A lot of people only voted Biden because they wanted to get rid of Trump, and one might say that many people voted Trump in '16 to prevent Clinton who's as Establishment as it can be.
If people are skeptical or confused, it’s because they refuse to understand the concept that our knowledge about the world changes and evolves over time.
So it's not an oversimplification, you just agree with the tactic. It's alright to agree with the tactic without accusing the people who describe what happened accurately of arguing in bad faith.
People were being told that masks can be effective to stop spread, government agent says don't wear masks, then later says you must wear masks, then admits they said this to prevent you from getting a mask when they were available to you before the government and private industry squashed access to the supply.
That level of deceit is enough to make anyone skeptical of anything else going forward.
Then move 6 months into the future after we get more data, we know specifically who the virus harms, how it harms them, we've all interacted with someone who had it and realized it wasn't the end of the world, which adds further to the confusion on the overreaching response.
We can also finely target the response now to mitigate spread if needed, yet governments are still using total lock down as the only model, despite having the data to do it better.
A further issue, total "cases", which we now know most are mild, are the only metric used by government and media to engineer a propaganda campaign against a population as justification to destroy everyone's livelihoods and freedoms.
Being a little salty at this point is justified, we don't lack understanding at this stage.
Johnathan Haidt's old "Righteous Mind" was one book that talked about some of these values and mindsets. The mindset also means that they are willing to take a %0.003 risk of death to continue to provide prosperity for their families and communities, but accepting poverty for their families and communities at the behest of people they perceive as not taking the same risk is anathema.
They co-operated in initial stages of the pandemic when the viable action reinforced their cultural heroic understanding of action, but leadership everywhere has forfeited that by using the pandemic as leverage for a pre-existing social management agenda, and now we've got anti-mask protests.
A few years ago, I had a conversation with someone from the Sierra Club about whether they thought better technology could resolve the climate crisis and whether they'd be interested in a VC model for investing in moonshot green tech. Their response was it wouldn't matter because the technology would not provide mobilization for the true goal of global justice. That deceit ended my support. This same conversation is happening everywhere about the pandemic today.
The various conspiracy theories around masks are expressions of this underlying dynamic. If we want to contain the pandemic, there are absolutely ways to do it, but if people find their leadership is using deception against them, the pandemic will be the least of the risks our societies will face, in my opinion. It will have truly been a lack of charisma that was fatal.
This is rubbish, they are high quality leaders, not only that, they are perceptibly so.
This statement is easily disproven by the examples in almost every other country besides the US where masks are generally not contentious (they are in some small circles, but not broadly), the difference in the US being 1/2 of the countries populist leaders are either against masks or don't openly support them.
'The problem' is that Trump, Fox News, certain famous individuals, and Conservative politicians will not openly support masks, and attack the credibility of the medical system.
If Trump and Brett Favre were to make a 10 second video vignette promoting mask wearing, and Trump+Fox+GOP+Everyone else were behind this ... then there wouldn't be much of an issue.
" but leadership everywhere has forfeited that by using the pandemic as leverage for a pre-existing social management agenda"
Again, this is conspiratorial falsehoods.
"but if people find their leadership is using deception against them"
More conspiratorial falsehoods.
This is a disturbing misunderstanding of the situation: Americans would, by and large, be 'mostly ok' with masks, if 1/2 of the populist leaders told them to be. That's the only issue here.
Turning the pandemic into a political weapon is the problem.
It's not enough to be merely correct, you need to be able to prevail on the population to wear masks or make greater personal sacrifices to stop the pandemic. I live in Canada, where our prime minister is amusing to the sort of people he flatters, but the level of tolerance people have for sacrifice based on his word is very low. He'd be called a "lame duck president," in the U.S. My point is that leadership weakness is what puts the whole country in danger if it in fact ever had to unite to do anything. I agree that the U.S. president could get the entire country onside if he chose to, but clearly he is not convinced it's worth destroying the small businesses that would cost the country a generation of growth.
If this were a partisan argument, I'd just bait you into reinforcing more of your prejudices and aspirations, but there is a serious conversation to be had about the the credibility of leadership in bringing people through a crisis like a pandemic. It's not enough for us to blame the outgroup, the virus doesn't care, so we need to look at what adapting to beat it might look like.
What we do know is that China is owning this pandemic in every possible way. Life is already back to normal in that country. They also all wear masks. Whether the masks were effective is unknown.
So basically we know that something or multiple things that China did are effective at suppressing the spread of Covid. If one of the things they did included using masks... then it may be that masks are very effective or partially effective in conjunction with everything else china did to stop the disease.
Keep in mind there's no hard science on any of this. Nobody knows for sure. We just know China did many things to suppress the disease but we don't know which thing or which subset of things China did was actually effective at curtailing the disease.
But we do know by copying everything China is doing we will for sure his that subset of effective countermeasures.
If they wear masks in China... we should be wearing masks too.
As far as masks and distancing go in the US, we might need to keep it up longer than that.
Consider the annual flu vaccinations in the US. Typically less than 50% of adults get it even though they are widely available and are fully covered under most health plans (and are not hard to get for free if you do not have health insurance).
There are a lot of people who believe the propaganda about COVID being no worse than a mild flu, so I expect that a lot of the people who do not get flu vaccinations will also not get COVID vaccinations.
There are also a fair number of people who believe COVID is hoax. I expect that a lot of them won't get a COVID vaccination even if they do get flu vaccinations.
Sure, once you get vaccinated and wait the couple of weeks or whatever for it to provide protection for you, there is no medical reason that you need to wear a mask or distance any more.
But I don't think it is going to be practical to have a mask/distancing mandate that only applies to people who are not vaccinated (or immune through already having had it), at least in places that are open to the general public.
Unless we are just going to write them off, those people who fell for the propaganda still need to be wearing masks and distancing when they are around other such people, and so to have a practical mask/distancing mandate that will work with them we will probably need it to apply to everyone, at least in places open to the general public.
It's tempting to get angry at bad faith arguments, but that's pretty much what "feeding the trolls" means.
This hurts the discussion as well.
Essentials, most countries are trying to flatten the curve [1]. Mandating masks is one layer of a swiss cheese [2] security model to try to keep the curve as flat as needed to prevent overloading of the health care systems.
Isn't it obvious we will need to follow the mask mandate as long as there is a risk that the curve crosses the capacity of our health care systems?
Leaving us with essentially four possible reasons why we can stop wearing masks:
a) We reach sufficient immunity through vaccination
b) We have successfully eradicated the virus
c) We have a cure for the infection
d) Everyone (epidemiologically speaking, so a relevant proportion of the population) has had the virus and we have developed sufficient immunity through exposure
[1] https://en.wikipedia.org/wiki/Flattening_the_curve
[2] https://en.wikipedia.org/wiki/Swiss_cheese_model
Don't you think that masks can be a useful tools in cases where keeping distance is not possible?
If we were to have that discussion, I'd think the way "conditions in which this control measure is needed" is dicussed is in terms of current observed covid case numbers -- what else could it be? Say, when positive cases per population or per test given are below X, for instance. It's likely that the 'right' number that makes sense for not having masks is pretty low, and possibly lower than will be realistically gotten to without widespread effective vaccine or other significant change in the landscape. (Some countries like Australia or New Zealand got there without a vaccine; we've missed that boat, if it was ever possible here).
The "right" number for masks should be pretty low because the social/economic/etc "cost" of masks -- while I agree it is non-zero -- is lower than about any other effective measures. Closing schools or businesses, for instance. You'd want to resort to universal mask use before closing schools, because the social/economic cost of closing schools is so much higher. Masks are pretty effective at comparatively much lower cost, so make sense to be a much earlier resort. (although I agree non-zero; I find masks very uncomfortable and hard to breathe in myself). At this point in the US, numbers are bad enough that masks are a no-brainer and we need a lot more than that.
Those against wearing masks might also be contributing to a rational conversation about costs and benefits more if they talked about under what conditions they thin masks would be appropriate -- say, what number of covid cases diagnosed per 100K population would make masks well-advised?
I wonder how many people against wearing masks basically think there are no conditions under which masks are advisable though.