Suppose there was a virus that you're terrified of and there was no way to protect yourself. You would be reducing human contact to the absolute bare minimum.
Now suppose people were told they could go about their business if they just put on masks. Simple cloth masks. Not proper KN95 masks, because those are rationed. People would go about their business as usual, with their cloth masks somewhat covering their faces.
The stronger the message that "masks work", the more human contact there is, there more infections there are. Humans have trouble processing mixed messages, they want to think in binaries, they want to believe things are going to be fine if they follow the rules.
I think the WHO had it right all along. They considered the all implications of mask usage, not just the physics of viral particles.
Your entire analysis is a guesstimate based on sociology/behavioural economics/anthropology/ and not medicine. WHO has no competence whatsoever to judge on that basis, and as far as I know they haven't consulted with anyone who does.
If they had bothered to consult with actual experts, they'd tell them that humans can be communicated with if one picks the right words. Even now, in no place with a mask mandate has there been an increase in human contact. It turns out that the public can process some mixed messaging (and that diseases are really scary and that lockdowns reduce contact). Experts would probably file your analysis under 'elite panic'.
The analysis that simple cloth masks "work" is a guesstimate based on physics and not medicine - or at least it was at the time.
Absent scientific data, the best we can do is to use reason to effectively make a guess.
> WHO has no competence whatsoever to judge on that basis, and as far as I know they haven't consulted with anyone who does.
That sounds questionable, epidemiology certainly does have human behavior as a component of study.
> If they had bothered to consult with actual experts, they'd tell them that humans can be communicated with if one picks the right words.
I find the "appeal to anonymous experts" argument unconvincing. What kind of experts are we talking about? Communications experts? PR people? Isn't it their job to make you believe that communication is possible? To sell you a workshop on how to talk to people?
Speaking from personal experience with at-risk individuals, it took a lot of effort to presumably convince people that simple cloth masks do not protect them. People are desperate to hear that a low-effort intervention will save them from peril. It's a strong confirmation bias effect.
> Even now, in no place with a mask mandate has there been an increase in human contact.
How would you be able to tell? What's your baseline? Even in areas without a mandate, people are free to wear masks or hold the belief that "my mask protects me".
Actually, there were medical studies on this issue predating the pandemic showing a small benefit for respiratory diseases. Yes, a guesstimate (nobody could have tested for effect on Coronavirus in advance), but at least it's a guesstimate based on some things WHO, Fauci, etc. had knowledge of. Fauci says he was aware of this but worried about a run on mask supplies.
My point was that assessing social behaviour was far beyond the remit of the typical WHO member or apparently even epidemiologists. They should have 'followed the science' themselves and talked to people who actually have some expertise and experience in that, rather than make policy on a whim.
>That sounds questionable, epidemiology certainly does have human behavior as a component of study.
Fauci worried that if there was a mask mandate early on, would people have made a run on masks, leaving nothing to doctors. What's the epidemiological answer? What's the epidemiological model for even getting an answer?
There isn't any, because their toolbox for humans is much more limited than their toolbox for viruses. One really needs to ask other professions - you know, sociologists, economists, etc. for that one.
There were alternatives even if the answer was 'yes'. One could have mobilized production via DPA, or banned the sale of N95 masks. Instead, Fauci made a personal call based on no data.
>> Even now, in no place with a mask mandate has there been an increase in human contact.
>How would you be able to tell? What's your baseline?
Google (and I believe Apple too) release aggregate positional tracking data on activities. Most of the world shows decreases, including places with a mask mandate. I haven't seen any reporting of an increase tied to mandates in places that have them.
https://www.reddit.com/r/askscience/comments/9qw3y0/do_count...
And here is a meta analysis that suggests hand washing has a significantly protective effect, while wearing masks has a protective effect just not significant,
https://www.sciencedirect.com/science/article/pii/S175543651...
Given that information it would make sense to broadly encourage hand washing over wearing masks. And that's exactly what the CDC did.
Looking at the state of things now, I see far more messaging about wearing masks than washing hands, and I'm not convinced that this has been beneficial. OTOH, maybe we were screwed either way. Some people have been determined to ignore guidelines.
I still find it interesting, though, that in practice most experts (doctors, governments) do wear masks and/or encourage their use (some very recent "newcomers" as well - e.g. Switzerland and Sweden, who are only starting mask-wearing recommendations new). Are they denying settled science, or just being pragmatic (masks probably help, so even if it's not proven, doesn't hurt to wear them)?
I think the emphasis on wearing masks is simply because that isn't the norm in the West. Washing hands is the norm (or rather, should be, we've all been hearing it since childhood...).
Medical professionals wore them prior to this pandemic because they receive training on how to use them properly and they are well stocked where needed. Single use, only touch the strings, etc. They also know they are constantly in the presence of disease and risk transmitting it to those they are trying to help. In non-pandemic times there is a higher chance for an asymptomatic doctor or nurse to infect an at-risk patient than there is for an asymptomatic member of the general public to infect an at-risk person.
> I think the emphasis on wearing masks is simply because that isn't the norm in the West. Washing hands is the norm (or rather, should be, we've all been hearing it since childhood...).
I agree. The part that should be normal worldwide is that sick people should wear a mask to prevent transmission of any virus, pandemic or no pandemic. Hong Kong and Taiwan learned this during SARS and maintained the habit as part of their culture. They also wear them to filter air pollution. So, those two factors made it easy for them to accept masks for all in 2020. I don't think mask wearing for sick people was regular practice anywhere outside of medical professionals before 2002. And AFAIK it has not yet caught on everywhere even amidst this pandemic.
The only variable that has changed is a respiratory virus.
Hint: there aren't any studies credible enough for professionals (doctors themselves) to believe them, hence they all wear masks these days (not just surgeons ostensibly "to protect the patients").
Edit: also, even if scientifically they might have been "correct" (no proven efficacy) the start of a pandemic is not the right time to start pretending medicine is a science and demanding a RCT for each procedure. Medicine was always closer to engineering ("we need results now") than science ("just let these people die until we have 5-sigma scientific proof the treatment works"). WHO made the wrong executive decision.