To mask or not to mask?

[Cap'n Jack]

Politicians hate wearing masks because they can't tell bald-face lies.

I hate politicians wearing masks because I can't tell if they are lying. If I see their lips moving, I know they are lying.

 

[RJM62]

I keep seeing that and reading that...& I think most folks understand why and what it means
but I can't help but thinking there probably is some benefit for me for me to wear a mask.
depending on the fabric, it may not offer much filtration, but even an open-ish weave fabric will catch something. Yeah, I get it that viruses are small....but I'm hoping that I'm not sticking my head into a virus-saturated environment either. If there are two little viruses floating in the air hopefully it'll at least catch 1 and my body can fight off the other 1...where I might not be able to fight off two
and even if filtration is essentially zero, the mask will help me to reduce touching my face while I'm wearing it.....which is at least something

The problem is that it's also a fomite. Spend a day in a crowd breathing through it, and you can be sure beyond any doubt that it's chock full of pathogens. So at best, you're trading one risk for another.

Personally, my approach is to never touch the damn thing unless I'm washing it. I hook one loop behind one ear, drag it across my mug, and hook the other loop behind my other ear. Once I've made my last stop of the trip, I unhook it the same way, never touching anything other than the loops until I'm home. Then the whole thing gets washed while I wash my hands, and then hung to dry or tossed in the dryer.

I find that dish detergent is a good thing to use to wash both hands and mask. It seems to rinse out better than anything else I've tried. But soap works, too.

Rich

 

[NoHeat]

I find that dish detergent is a good thing to use to wash both hands and mask.

A week ago you declared “never” to liquid soap, for handwashing. I suppose we’re all adapting day to day.

 

[RJM62]

A week ago you declared “never” to liquid soap, for handwashing. I suppose we’re all adapting day to day.

Indeed. Although I never really used nor even thought of dish detergent as hand soap before. But it does rinse out of the mask a lot more easily.

Rich

 

[PeterNSteinmetz]

“The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations."

Results of a quick google scholar search produced a number of articles in the actual medical scientific literature regarding the effectiveness of cloth masks in slowing the spread of respiratory infections like Covid-19.

Here is one in the British Medical Journal, April 7, 2020. "Covid-19: What is the evidence for cloth masks?" https://www.bmj.com/content/369/bmj.m1422.short

In discussing a systematic review of this question, which is a preprint available at https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v1 the authors of that review state in full (excerpt above)

"Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations. Further high quality trials are needed to assess when wearing a facemask in the community is most likely to be protective."

My view is pretty much in exact agreement with the authors of that preprint. Also please note that the authors did not in any way consider the possible negative consequences of making a broad scale community recommendation to wear cloth masks.

 

[RJM62]

“The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations."

Results of a quick google scholar search produced a number of articles in the actual medical scientific literature regarding the effectiveness of cloth masks in slowing the spread of respiratory infections like Covid-19.

Here is one in the British Medical Journal, April 7, 2020. "Covid-19: What is the evidence for cloth masks?" https://www.bmj.com/content/369/bmj.m1422.short

In discussing a systematic review of this question, which is a preprint available at https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v1 the authors of that review state in full (excerpt above)

"Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations. Further high quality trials are needed to assess when wearing a facemask in the community is most likely to be protective."

My view is pretty much in exact agreement with the authors of that preprint. Also please note that the authors did not in any way consider the possible negative consequences of making a broad scale community recommendation to wear cloth masks.

They do protect against this, however:

https://www.ny1.com/nyc/all-borough...handcuffs-in-clash-over-face-mask-regulations

Rich

 

[Cap'n Jack]

“The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations."

Results of a quick google scholar search produced a number of articles in the actual medical scientific literature regarding the effectiveness of cloth masks in slowing the spread of respiratory infections like Covid-19.

Here is one in the British Medical Journal, April 7, 2020. "Covid-19: What is the evidence for cloth masks?" https://www.bmj.com/content/369/bmj.m1422.short

In discussing a systematic review of this question, which is a preprint available at https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v1 the authors of that review state in full (excerpt above)

"Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations. Further high quality trials are needed to assess when wearing a facemask in the community is most likely to be protective."

My view is pretty much in exact agreement with the authors of that preprint. Also please note that the authors did not in any way consider the possible negative consequences of making a broad scale community recommendation to wear cloth masks.

Both of those citations seem to refer to the same study.

 

[cowman]

I ventured into Quincy, IL today for a grocery run. Quincy is a large town/small city with a population a little under 40,000. What I’m seeing is that all the stores have signs up saying you need to wear a mask and probably 1/4 - 1/3 of the people going in aren’t wearing them. Nobody seems to care either, probably just a sign someone required them to put up. I do get a ton of complements on my plague doctor mask though.

 

[PeterNSteinmetz]

Both of those citations seem to refer to the same study.

No, did you look at the articles?

Both quotations are from the second one, which was the quick review of the literature (as noted the first quote is an excerpt from the second)

The first reference is the BMJ article which cited the quick review and other articles, as well as quoting a number of experts on why cloth masks may not work so well.

The quick review of course cites a fair amount of other literature.

 

[Cap'n Jack]

No, did you look at the articles?

Both quotations are from the second one, which was the quick review of the literature (as noted the first quote is an excerpt from the second)

The first reference is the BMJ article which cited the quick review and other articles, as well as quoting a number of experts on why cloth masks may not work so well.

The quick review of course cites a fair amount of other literature.

Of course I did. One even quoted the other. Both citations appear to be from from BMJ, the second one has the BMJ logo on it. It's the same group. The overview was sufficient, since it covered the other reference. It's essentially citing the same thing twice. I hope you don't do that on your publications.
There isn't consensus on this subject- https://www.nature.com/articles/s41591-020-0843-2
"Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals."

In any case, it doesn't matter to me. I have a few masks. If a store wants people to wear masks while inside, I don't see it as a big deal. If you have an issue with it, don't go to those places.

 

[denverpilot]

Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals."

The words “surgical” and “cloth” or the word omitted altogether, are important in these studies.

I have a surgical mask sitting here. It’s nothing like the junk you see people wearing outside.

Has a metal nose bridge that can be bent to force a better top seal, and is typically made from material that will filter at what most engineers would term “80%” against say, the actual N95 standard.

Masks without a top seal simply create a constant source of mixed air over the one place you don’t want air blowing. Your eyeballs.

Especially if you’re a glasses wearer. The glasses are easily better protection form something flying toward your eyes than blowing mixed air up from under them with every exhale.

The bjggest medical effect most masks will have on most people of the silly variety people are wearing, is to make them constantly breathe their own CO2 back in. It won’t be Covid.

But we’re all wearing them, because ... people are stupid panicky creatures and they believe the thing is saving someone in *every* scenario instead of thinking about it.

 

[tspear]

Yeah, in the western world, we largely have focused on the wrong thing. Only now are you starting to see medical studies actually catch up to what Asia has already figured out.
Cloth masks do not protect you against infection. They protect your neighbor from you.

Tim

 

[Cap'n Jack]

The words “surgical” and “cloth” or the word omitted altogether, are important in these studies.

I have a surgical mask sitting here. It’s nothing like the junk you see people wearing outside.

Has a metal nose bridge that can be bent to force a better top seal, and is typically made from material that will filter at what most engineers would term “80%” against say, the actual N95 standard.

Masks without a top seal simply create a constant source of mixed air over the one place you don’t want air blowing. Your eyeballs.

Especially if you’re a glasses wearer. The glasses are easily better protection form something flying toward your eyes than blowing mixed air up from under them with every exhale.

The bjggest medical effect most masks will have on most people of the silly variety people are wearing, is to make them constantly breathe their own CO2 back in. It won’t be Covid.

But we’re all wearing them, because ... people are stupid panicky creatures and they believe the thing is saving someone in *every* scenario instead of thinking about it.

Like I said, it doesn't matter to me. Don't wear them if you don't wish to.

 

[denverpilot]

Cloth masks do not protect you against infection. They protect your neighbor from you.

If you’re within 6’ of your neighbor. Mostly indoors.

Even then something like a 4% chance of transmission in 24 hours or whatever number came out of family housing in Italy before everybody stopped trying to get one.

In other words, your neighbor will get it from touching where it fell behind you and sticking their finger in their eyeball.

If they learn to wash up, they’ll avoid it a lot longer and a lot more effectively, than your mask will do anything for them.

The only way you’d be able to beat their own risk to themselves is if you licked your finger and poked them in the eye.

 

[PeterNSteinmetz]

Of course I did. One even quoted the other. Both citations appear to be from from BMJ, the second one has the BMJ logo on it. It's the same group.

The first article is essentially a commentary in the BMJ by Mahase. That article references and quotes the second article, a preprint, which is a rapid review of the literature by a a different set of authors. The BMJ commentary also quotes a different set of experts.

Contrast https://www.bmj.com/content/369/bmj.m1422 versus https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v1

These are two very different types of articles, a commentary versus a rapid review. The preprint has not been published yet so far as I know.

So no, both citations were not to the same article. The quotations were both from the rapid review, with the leading quotation being an excerpt from the larger quotation, as noted.

Perhaps some of the apparent confusion here may be due to a difference between formal academic citation practice and lay interpretation.

In any case, I found both articles informative in somewhat different ways which is why I shared them both.

I think the rapid review did a fairly good job of summarizing the available evidence at that time, early April. The comments by the experts in the BMJ article are informative as to why theoretical advantages of cloth masks, such as those studied in the Nature article which you cited, may not translate to slowing the spread of Covid-19.

 

[PeterNSteinmetz]

In any case, it doesn't matter to me. I have a few masks. If a store wants people to wear masks while inside, I don't see it as a big deal. If you have an issue with it, don't go to those places.

Agreed that if a private store wants to require masks, that is their business. If you don’t like it, either shop somewhere else, complain to management, or do both.

I just think it is ridiculous all the people one sees one social media being outraged that others are not wearing cloth masks in public.

 

[Cap'n Jack]

“The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations."

Results of a quick google scholar search produced a number of articles in the actual medical scientific literature regarding the effectiveness of cloth masks in slowing the spread of respiratory infections like Covid-19.

Here is one in the British Medical Journal, April 7, 2020. "Covid-19: What is the evidence for cloth masks?" https://www.bmj.com/content/369/bmj.m1422.short

In discussing a systematic review of this question, which is a preprint available at https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v1 the authors of that review state in full (excerpt above)

"Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations. Further high quality trials are needed to assess when wearing a facemask in the community is most likely to be protective."

My view is pretty much in exact agreement with the authors of that preprint. Also please note that the authors did not in any way consider the possible negative consequences of making a broad scale community recommendation to wear cloth masks.

No confusion here between formal academic citation practice and lay interpretation.

However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations. Further high quality trials are needed to assess when wearing a facemask in the community is most likely to be protective."

My view is pretty much in exact agreement with the authors of that preprint. Also please note that the authors did not in any way consider the possible negative consequences of making a broad scale community recommendation to wear cloth masks.

However, as mentioned below... it appears the study is backwards. The masks are intended to protect others, who aren't yet infected, from those who might be.

Yeah, in the western world, we largely have focused on the wrong thing. Only now are you starting to see medical studies actually catch up to what Asia has already figured out.
Cloth masks do not protect you against infection. They protect your neighbor from you.

Tim

This supports that hypothesis:
https://www.nature.com/articles/s41591-020-0843-2

 

[Tom-D]

Agreed that if a private store wants to require masks, that is their business. If you don’t like it, either shop somewhere else, complain to management, or do both.

I just think it is ridiculous all the people one sees one social media being outraged that others are not wearing cloth masks in public.

Wearing a mask trying to catch a virus, is like trying to catch a humming bird with a football goal.

 

[Cap'n Jack]

Wearing a mask trying to catch a virus, is like trying to catch a humming bird with a football goal.

I suppose, Tom, that you won't mind if your surgeon chooses not to wear a mask if you should require major surgery (and I hope you don't need anything of the sort).

 

[PeterNSteinmetz]

However, as mentioned below... it appears the study is backwards. The masks are intended to protect others, who aren't yet infected, from those who might be.

The rapid review covered articles looking at both sides of the equation. In other words, at whether the wearer was protected and whether others were protected from the wearer.

It concluded that there was not enough good information to make a recommendation for general public use at that time. (Sentence just before the one you bolded.) Also again in the discussion at the end of the review they state “We do not consider that the balance of evidence across all available studies supports routine and widespread use of facemasks in the community.”

Agreed that the study you cited provides theoretical reasons to think mask wearing might protect others. And there is a long standing recommendation to provide surgical masks for those who are known to have an active respiratory infection, particularly those who are coughing or sneezing. But that does not directly show that wearing cloth masks will reduce the spread of Covid-19 when worn by the general public. I am not aware of any empirical studies which suggests that the general public wearing cloth masks will achieve that goal.

 

[denverpilot]

I suppose, Tom, that you won't mind if your surgeon chooses not to wear a mask if you should require major surgery (and I hope you don't need anything of the sort).

As the nurse here told someone this morning, that mask is to keep you from a bacterial infection, not a viral one.

Your surgery team isn’t operating on you if they’re sick. If they’re asymptomatic you got lucky.

If it’s not emergency surgery they already ran a batch of tests on you and they’re relying on the mask to keep your bodily fluids away from them.

Protecting you from a virus is not the intended purpose of the surgical mask. But it’s a nice try.

 

[Cap'n Jack]

As the nurse here told someone this morning, that mask is to keep you from a bacterial infection, not a viral one.

Your surgery team isn’t operating on you if they’re sick. If they’re asymptomatic you got lucky.

If it’s not emergency surgery they already ran a batch of tests on you and they’re relying on the mask to keep your bodily fluids away from them.

Protecting you from a virus is not the intended purpose of the surgical mask. But it’s a nice try.

So you are fine with your surgical team not wearing masks when they operate on you?
To be honest, it seems there is no consensus on this, either.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/

Although applicability to the current situation is shown here, where some measurements seem to have been done:
https://www.nature.com/articles/s41591-020-0843-2

 

[Cap'n Jack]

The rapid review covered articles looking at both sides of the equation. In other words, at whether the wearer was protected and whether others were protected from the wearer.

It concluded that there was not enough good information to make a recommendation for general public use at that time. (Sentence just before the one you bolded.) Also again in the discussion at the end of the review they state “We do not consider that the balance of evidence across all available studies supports routine and widespread use of facemasks in the community.”

Agreed that the study you cited provides theoretical reasons to think mask wearing might protect others. And there is a long standing recommendation to provide surgical masks for those who are known to have an active respiratory infection, particularly those who are coughing or sneezing. But that does not directly show that wearing cloth masks will reduce the spread of Covid-19 when worn by the general public. I am not aware of any empirical studies which suggests that the general public wearing cloth masks will achieve that goal.

https://www.ncbi.nlm.nih.gov/pubmed/24229526
https://www.ncbi.nlm.nih.gov/pubmed/32355904
https://www.ncbi.nlm.nih.gov/pubmed/20497389
https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v3
TL;DR
Not as good as surgical masks, but better than nothing.

 

[PeterNSteinmetz]

Although applicability to the current situation is shown here, where some measurements seem to have been done:
https://www.nature.com/articles/s41591-020-0843-2

One of the important limitations in this study in terms of a recommendation for the general public is that all participants were actively ill. So the implications for the general public are weaker given that most of them will not be actively ill.

 

[PeterNSteinmetz]

TL;DR
Not as good as surgical masks, but better than nothing.

I think one really has to read the articles and understand them to determine whether they imply that a recommendation for the general public to wear cloth masks will actually slow the spread of Covid-19 and thus be “better than nothing”.

If one is not willing or able to do that, then likely best to rely on the impressions expressed by experts in published commentaries or reviews.

Of those so far, none have concluded there is good evidence to recommend the use of cloth masks for the general public.

 

[denverpilot]

So you are fine with your surgical team not wearing masks when they operate on you?
To be honest, it seems there is no consensus on this, either.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480558/

Although applicability to the current situation is shown here, where some measurements seem to have been done:
https://www.nature.com/articles/s41591-020-0843-2

No. Mostly because I suspect I don’t like MRSA.

But it’s not my call anyway. It’s their call.

My last surgery they intubated me to protect themselves from me breathing on them for a procedure normally done wide awake.

They didn’t need masks at all after that.

Probably wore them, but I was out and couldn’t tell ya.

 

[Cap'n Jack]

I think one really has to read the articles and understand them to determine whether they imply that a recommendation for the general public to wear cloth masks will actually slow the spread of Covid-19 and thus be “better than nothing”.

If one is not willing or able to do that, then likely best to rely on the impressions expressed by experts in published commentaries or reviews.

Of those so far, none have concluded there is good evidence to recommend the use of cloth masks for the general public.

Like I said, no consensus as yet:
https://www.theguardian.com/world/2020/may/04/scientists-disagree-over-face-masks-effect-on-covid-19

Some of the confusion is because some cloth masks are better than others, depending on the materials used:
https://pubs.acs.org/doi/10.1021/acsnano.0c03252

One of the important limitations in this study in terms of a recommendation for the general public is that all participants were actively ill. So the implications for the general public are weaker given that most of them will not be actively ill.

Yes, only the "ill" ones really need a mask. But given that some people are asymptomatic, yet "actively ill", there is still a degree of protection from those people.

 

[PeterNSteinmetz]

Like I said, no consensus as yet:
https://www.theguardian.com/world/2020/may/04/scientists-disagree-over-face-masks-effect-on-covid-19

Firstly, the Guardian is not a scientific journal like the British Medical Journal. It does refer to a preprint however. Many of the experts quoted by the Guardian were highly skeptical of the conclusions the authors of the preprint drew, saying they over-stated the evidence and ignored the possibility that wearing cloth facemasks generally could do harm.

Thus I would not consider the pre-print indirectly cited to be even good evidence for a public health recommendation for the general public to use cloth masks. OTOH, it would be fair to say there is some segment of the scientific community which thinks they might work.

Now to get to the bottom of an evolving issue like this one has to actually read and understand and critically think about the reviews and the primary research articles available.

Short of doing that, I think the conclusions of the brief review I cited are a pretty balanced summary.

 

[PeterNSteinmetz]

URL]

Some of the confusion is because some cloth masks are better than others, depending on the materials used:
https://pubs.acs.org/doi/10.1021/acsnano.0c03252

True, there is likely a great deal of variability, particularly amongst the make commonly being made and used by the general public in the US, both in terms of the materials and the level of seal achieved.

Yes, only the "ill" ones really need a mask. But given that some people are asymptomatic, yet "actively ill", there is still a degree of protection from those people.

This deals with a very important issue that likely limits the utility of masks worn by the general public and must be considered when making a public health recommendation.

People who have recently been infected are likely only shedding the virus in significant amounts and by routes likely to impact others for perhaps 1-2 weeks.

This is why it is important to rely on actual measurements of the effects in the real world rather than just theory.

 

[Groundpounder]

It's amazing how fast it went from "flattening the curve" to some sort of over politicised social experiment.

 

[Palmpilot]

In another thread I posted a link to a new study that claims universal masking (or at least 80%) is urgently needed:

https://www.pilotsofamerica.com/community/threads/did-you-catch-it.125186/page-18#post-2919349

Abstract

We present two models for the COVID-19 pandemic
predicting the impact of universal face mask wearing
upon the spread of the SARS-CoV-2 virus one employing
a stochastic dynamic network based compartmental
SEIR (susceptible-exposed-infectious-recovered) approach,
and the other employing individual ABM (agent based
modelling) Monte Carlo simulation indicating (1)
significant impact under (near) universal masking when at
least 80% of a population is wearing masks, versus minimal
impact when only 50% or less of the population is
wearing masks, and (2) significant impact when universal
masking is adopted early, by Day 50 of a regional outbreak,
versus minimal impact when universal masking is
adopted late. These effects hold even at the lower filtering
rates of homemade masks. To validate these theoretical
models, we compare their predictions against a new empirical
data set we have collected that includes whether
regions have universal masking cultures or policies, their
daily case growth rates, and their percentage reduction
from peak daily case growth rates. Results show a near
perfect correlation between early universal masking and
successful suppression of daily case growth rates and/or
reduction from peak daily case growth rates, as predicted
by our theoretical simulations.

Taken in tandem, our theoretical models and empirical
results argue for urgent implementation of universal
masking in regions that have not yet adopted it as policy or
as a broad cultural norm. As governments plan how to exit
societal lockdowns, universal masking is emerging as one
of the key NPIs (non-pharmaceutical interventions) for
containing or slowing the spread of the pandemic. Combined
with other NPIs including social distancing and
mass contact tracing, a “mouth-and-nose lockdown” is far
more sustainable than a “full body lockdown”, from economic,
social, and mental health standpoints. To provide
both policy makers and the public with a more concrete
feel for how masks impact the dynamics of virus spread,
we are making an interactive visualization of the ABM
simulation available online at http://dek.ai/masks4all. We
recommend immediate mask wearing recommendations,
official guidelines for correct use, and awareness campaigns
to shift masking mindsets away from pure selfprotection,
towards aspirational goals of responsibly protecting
one’s community.

 

[Cap'n Jack]

Firstly, the Guardian is not a scientific journal like the British Medical Journal. It does refer to a preprint however. Many of the experts quoted by the Guardian were highly skeptical of the conclusions the authors of the preprint drew, saying they over-stated the evidence and ignored the possibility that wearing cloth facemasks generally could do harm.

I'll remind you of this comment:

If one is not willing or able to do that, then likely best to rely on the impressions expressed by experts in published commentaries or reviews

Most people will get their data from The Guardian, WHO, or the CDC web sites.

Thus I would not consider the pre-print indirectly cited to be even good evidence for a public health recommendation for the general public to use cloth masks. OTOH, it would be fair to say there is some segment of the scientific community which thinks they might work.

Now to get to the bottom of an evolving issue like this one has to actually read and understand and critically think about the reviews and the primary research articles available.

Short of doing that, I think the conclusions of the brief review I cited are a pretty balanced summary.

I disagree about the conclusions of the brief review, it was rather one-sided.

True, there is likely a great deal of variability, particularly amongst the make commonly being made and used by the general public in the US, both in terms of the materials and the level of seal achieved.

Still, it seems they are better than nothing at all.

This deals with a very important issue that likely limits the utility of masks worn by the general public and must be considered when making a public health recommendation.

People who have recently been infected are likely only shedding the virus in significant amounts and by routes likely to impact others for perhaps 1-2 weeks.

This is why it is important to rely on actual measurements of the effects in the real world rather than just theory.

As I said earlier, by the time you get the data that you, in particular, would like, it is too late. China may have over-reacted, but with a novel, potentially highly infectious disease, one needs to act quickly. Unfortunately, the USA wasted a bunch of time doing little more than stopping people from coming from China. We knew something was happening in January:
https://www.vox.com/policy-and-poli...irus-presidential-daily-intelligence-briefing

I myself knew something was going on from friends and colleagues over there via WeChat. I got out of Hong Kong literally days before the virus was generally known in China. They canceled spring festival, that pretty much the same as canceling New Years and Christmas over here (one image below, I heard the same information from other people prior to the break. The Chinese government stopped travel prior to the break). My point is that the USA had time to evaluate this thing that we wasted. The theory is good enough, given this is an airborne virus. The earlier citations looked at influenza and earlier corona viruses, and except for the number of people affected this time, the information from those outbreaks can certainly be applied. My experience supports the reports cited that the USA actually also knew of the virus. I agree that the studies you suggest would be best, but we ****ed that time away.

 

[Bell206]

In another thread I posted a link to a new study that claims universal masking is urgently needed:

Perhaps you can answer the question then: of the 100,000s of preventable deaths out there, why is death by covid so special that we must wear masks, lockdown life, destroy an economy, and no telling what else, to save 0.030581039755352% of the US population considering no one gave a rats azz to save 0.30581039755352% of the population prior to covid??? FYI: key part is the decimal point.

 

[Palmpilot]

Perhaps you can answer the question then: of the 100,000s of preventable deaths out there, why is death by covid so special that we must wear masks, lockdown life, destroy an economy, and no telling what else, to save 0.030581039755352% of the US population considering no one gave a rats azz to save 0.30581039755352% of the population prior to covid??? FYI: key part is the decimal point.

I'm pretty sure that mask wearing is not what's destroying the economy.

 

[PeterNSteinmetz]

Most people will get their data from The Guardian, WHO, or the CDC web sites.

OK, let me clarify further. I think it is best to be able to actually evaluate the data and analyses, but short of that to rely on published reviews and commentaries in the scientific literature. I do not think it is wise for individuals to rely upon commentaries in popular publications like The Guardian. Sorry if it was not clear that as a scientist I would be referring to the scientific literature, but I hope that clarifies.

In terms of recommendations by public health authorities, the recommendations regarding public mask wearing is mixed. CDC presently recommends that and the WHO does not (https://www.who.int/emergencies/dis...9/advice-for-public/when-and-how-to-use-masks).

I disagree about the conclusions of the brief review, it was rather one-sided.

Well, to parse further which pre-print reviews are better one really would have to go and examine the articles they reference, read, and understand them. But apparently that is TL;DNR. So I really don't know how we could have a meaningful conversation about what the different reviews have concluded. We will likely just have to agree that you disagree with those experts then.

My point is that the USA had time to evaluate this thing that we wasted. The theory is good enough, given this is an airborne virus. The earlier citations looked at influenza and earlier corona viruses, and except for the number of people affected this time, the information from those outbreaks can certainly be applied. My experience supports the reports cited that the USA actually also knew of the virus. I agree that the studies you suggest would be best, but we ****ed that time away.
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Sort of trending off the issue of current recommendations of public mask usage. I would agree that perhaps at that time, given the scary stories were were hearing, that some type of emergent intervention might have been reasonable. But by the time the coercive lockdowns were being put in place, there was already a ton of social distancing occurring, we knew those really scary numbers probably weren't true, and we should have waited for more data. I also note that there is no good empirical evidence that the coercive lockdowns have reduced the number of cases or deaths due to Covid-19, as I have discussed extensively in the "Did you get it?" thread. Let's move further discussion of that over there if you want to go over those issues.

 

[Bell206]

I'm pretty sure that mask wearing is not what's destroying the economy.

The public fear of mandating a mask is. Just as your link stated. So back to the question, why is wearing a mask so much more important than say banning all tobacco products that kill over 400,000 a year?

 

[PeterNSteinmetz]

I disagree about the conclusions of the brief review, it was rather one-sided.

This actually brings me to a question I have wanted to ask. It is related but deals with personal opinion, so feel free to ignore if you want.

Why do you want to think that cloth mask wearing by the public will help stop the spread of Covid-19? Is it because it is something that might help that people can do? Or have you been forced to wear them by an employer?

 

[PeterNSteinmetz]

Just looking again at the WHO recommendation. Striking actually in its contraction of the CDC

"If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.

• Wear a mask if you are coughing or sneezing.
• Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
• If you wear a mask, then you must know how to use it and dispose of it properly."

 

[Palmpilot]

The public fear of mandating a mask is. Just as your link stated. So back to the question, why is wearing a mask so much more important than say banning all tobacco products that kill over 400,000 a year?

I didn't write the paper. Maybe you should contact the authors and ask them.

 

[Bell206]

I didn't write the paper. Maybe you should contact the authors and ask them.

I didn't ask about the article. So you're 0-2 on answering the question. Care to try again with a different version... why is wearing a mask more important than say requiring obese people to lose weight which kills over 300,000 per year?