The fear was two fold. That people would be sloppier with social distancing when wearing masks. That handling masks wrongly would increase the mask wearers risk of getting infected.
So it was not perceived as a zero-cost intervention here at least.
Also this seems like worrying about second-order negative effects to the extent that one neglects the first-order positive effect.
Also, a huge amount of our day to day behavior is driven by habits and norms which we later rationalize when questioned. Even with good arguments you need early adopters out there being visible to shift norms. Visible success or high status adopters can be important too.
> mocking a woman for wearing a medical mask on a plane.
I feel like these hosts have some combination of poor credentials, ginormous egos, or that toxic desire to play up a take to their audience. attention. I hope they acknowledged how foolish they were.
Regardless of the effect of masks on COVID, there are some individuals who should wear them for a variety of indications. If they wear the right kind of mask and wear it properly, it can help them. They did it before the pandemic and will continue to do so after the pandemic is over.
So simply observing that somebody was wearing a mask and making assumptions that there was no legitimate reason is simply bad public health. That's not just being wrong about COVID-19 and it's not just a lack of empathy for person who was herself unsure of the details and just doing her best. That's just wrong on the epidemiology.
Within 24 hours that question could have been answered.
It would have gone something like this:
* Hour 1:. Health minister directs ministry to urgently answer this question, since it will impact policy.
* Hour 2: health ministry contacts 5 university professors to conduct study.
* Hour 3: university professor decides to invite 50 students in (paying them $50 each) to do a study. Email 1000 people, first 50 to reply get invited in.
* Hour 4, professor and assistants go to shop to buy cameras and sticky blue ink.
* Hour 5, study begins. Participants have ink spread over faces and cameras sit recording around the room. Participants are allowed to do whatever they like (study, call friends, watch TV, etc). Half are instructed to wear masks except when eating and drinking.
* Hour 7, study ends. Turns out the ink dried out and didn't work, but footage from cameras is reviewed.
* Hour 9. Exact counts of face touches for each group are produced.
* Hour 10. Preliminary results forwarded to the health ministry and other universities.
* Hour 11. Other university professors review data and method and say "our best guess is the initial theory of 12 hours ago is likely wrong".
* Hour 12: Health ministry gives advice to wear masks.
Afterwards each person in this chain is paid generously for dropping all work to handle this urgent matter.
Not trying to defend the authorities, I still think they were waaay too far from the optimum course. A few weeks in we already had a fair guess that it's more air than touch. But still, it wasn't as trivial to be solved in one afternoon.
My government would be issuing a request for proposals 6 months later, and the actual study results would cost tens of millions of dollars and only be delivered 3 years later.
* week 3-10 wait for research program to open for submission
* week 11 submit
* week 12-20 wait for outcome
* week 21: actually a surprise, it is fundes
* week 22: since this is involving human test subjects: submit to ethic commitee of university
* week 23- 30 wait for reply, approved
* week 30-38: term break (so no students around to ask)
* week 39-80 conduct the study (you need to have billable hours!)
* week 81: result is inconclusive further investigations in a new study needed
They could have bombared us through TV, billboards, online. But nope.
When the RIVM heard of these actions in February, they downplayed the effectivity of masks. Only in March and April, when the crisis hit us (unprepared), reasons had to be given why our supplies of masks were depleted. This is when the media started spinning the story that mask wearing causes increased touching of the face. There is no scientific basis for that claim.
You should never believe anyone outright (including oneself). So yes, you get to choose when to believe them.
The RIVM has traditionally had a very good reputation to its level of scientific research. Nevertheless, this does not entail a good consulting role on policy making, especially under duress.
In conversations I have had with governance experts, the relatively weak political position of the RIVM has come up many times. During normal times, this political position is irrelevant, since the RIVM is merely a reflection of scientific insights. During times of crisis and power struggles, the leadership position crumbles.
That, in and of itself, is the sole reason the RIVM has struggled the last year. Power was not balanced. You can see this numerous times:
- RIVM was forced to make a position on the role of COVID-19 on children. Absence of evidence became evidence of absence.
- RIVM was forced to make a position on face masks. Same thing happened. There simply was not enough strong evidence (according to their own strict rules of peer-reviewed, double-blind research).
Similar miscommunications have happened on the topic of aerosols and schools as an important contributing vector.
Please realise how important this is. This is a large scale and continuing failure of governance.
It is completely untrustworthy and has shown time and again it is willing to lie for political purposes.
RIVM by law is independent. It cannot be forced to take positions. It is by its own choice that it bends over backwards and makes false statements for political purposes.
It is a scientific institution that has failed science. It is rotten to the core, it is less than worthless, it must be dismantled and replaced.
It was a real concern, you could find American scientists quoted in news articles years before Covid criticizing the East Asian public for wearing masks in the face of a MERS resurgence in South Korea, for instance.
The fear of people getting infected by handling the mask was also perfectly fitting in with all the other fears about surface and fomite transmission and the obsession about washing hands and sanitizing, which as we have learned more about the disease seems to be almost entirely wasted effort.
Pretty sure what actually turned American and European opinion around on masks was noticing that South Korea, China, and Japan were all doing a lot better against Covid and were using masks widely not just in the hospital.
Also, at least in the USA a lot of government communications are subject to FOIA and no one came up with any sort of smoking gun email indicating the government knew widespread masking would help in late February/early-to-mid-March and was suppressing the truth. Whereas we got plenty of other emails about the disorganized response (search for “Red Dawn” and “coronavirus” on google).
> zero-cost intervention
When people hear the word "free," their bullshit detector gets activated. But if you call it a "zero-cost intervention" you can let your claim go unquestioned. Not to say this was done pervasively, or intentionally.
(But “here” in this case would be Sweden)
FWIW Sweden is famous, I presume worldwide, but certainly here in Australia, for its novel response to COVID-19.
I'm sure there's a wealth of confounding social and political factors everywhere - though some nation states more than others - when looking at correlations with Vit-D and health outcomes.
I understand we are quite extreme in our ways https://www.worldvaluessurvey.org/photos/EV000190.JPG
You don't want to give people a sense of false hope because it discourages compliance with interventions with known effectiveness, like social distancing.
It's been very disheartening watching so many of our essential institutions toss aside their credibility this last year. I wish I had to words to express how dangerous this is moving forward.
I don't know who else was involved but it certainly wasn't just von der Leyen, this was complete institutional failure.
Probably as well the most effective Brexit propaganda you can imagine.
Of those suppliers, only AstraZeneca acted with bad faith to excuse non-delivery. The other suppliers - having the sense to understand Covid is a global problem, not a national one - didn't.
The UK then used its gamble on an untested schedule - the gap was originally supposed to be weeks, not months - to turn vaccination into a propaganda exercise.
Meanwhile the British variant, which appeared because the UK failed to lock down properly in the first place, is still causing tens of thousands of deaths across the EU.
Institutional failure you say? Indeed it is - on the British side. If the UK had acted rationally and responsibly a year ago, there would have been no need for vaccine nationalism.
Changing the vaccination schedule in the UK, on the other hand, was an informed gamble that - based on what was known about the vaccine at the time - would likely result in much fewer people dying and being hospitalized than sticking to the original, basically arbitrary, vaccination schedule.
Also, blaming AstraZeneca for the EU falling behind the UK in vaccination is 100% pure propaganda. As far as I can tell, at this point their vaccine deliveries to the UK are about as far behind schedule as the ones to the EU, and the UK is a lot more reliant on AZ vaccinations than the EU. The EU just didn't order enough - their initial AZ order was about the same size as the UK one, for a much larger population, meaning they ended up with less production capacity relative to their population than the UK. The reason it seems like the UK vaccination scheme is going to plan is because the UK contract had contractual clauses with teeth requiring AZ to promptly notify them of how much they were actually going to deliver once they had their plants up and running, and the UK's plan was based on the actual delivery schedule. The EU... didn't. At all. I don't think they understand this even now, judging from all the conspiracy theories about how the yield problems are an excuse and AZ are really just sneaking off doses to the UK.
1) What do we want people to do?
2) How do we get them to do it?
The answer to 2 should always be simply explaining the reasoning for 1, even if it would be a little less effective than making up some lie. In the long run this builds trust in the government, instead of reducing it leading to a total breakdown of compliance because they lie all the time.
The most dangerous and insidious thing about this dynamic, IMHO, is that a certain type of smart or self-identified elite person will go along with it, because they, too, believe that you can't just tell the truth to the general public (of which they don't consider themselves a part of course).
Even at the time the CDC gave its guidance, the published evidence to support the general public wearing masks was quite weak. Here is an extract from a systematic review of the published research from shortly after the CDC gave its guidance.
> There is uncertainty about the effects of face masks. The low‐moderate certainty of the evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of randomised trials did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks during seasonal influenza.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
So the CDC was faced with a situation where there was minimal evidence for the efficacy of the general public wearing masks and a severe shortage of PPE among medical personnel. In that context, they held back recommending that the general public wear masks.
It wasn't really till May/June that evidence started mounting in support of the general use of masks amongst the public.
So there was no conspiracy, just hard working people trying to do their best in a difficult situation. The world is much more dull than people like to believe.
I don't have any evidence that the CDC was deliberately withholding information (not to say it doesn't exist), but I do have evidence that medical leaders have felt it okay to lie to the public with regards to covid.
> In the pandemic’s early days, Dr. Fauci tended to cite the same 60 to 70 percent... And last week, in an interview with CNBC News, he said “75, 80, 85 percent” and “75 to 80-plus percent.”
> In a telephone interview the next day, Dr. Fauci acknowledged that he had slowly but deliberately been moving the goal posts. He is doing so, he said, partly based on new science, and partly on his gut feeling that the country is finally ready to hear what he really thinks.
> “When polls said only about half of all Americans would take a vaccine, I was saying herd immunity would take 70 to 75 percent,” Dr. Fauci said. “Then, when newer surveys said 60 percent or more would take it, I thought, ‘I can nudge this up a bit,’ so I went to 80, 85.”
https://www.nytimes.com/2020/12/24/health/herd-immunity-covi...
> “We need to have some humility here,” he added. “We really don’t know what the real number is. I think the real range is somewhere between 70 to 90 percent. But, I’m not going to say 90 percent.”
He's not lying, like the rest of us, he doesn't know. Especially, with the advent of the new variants.
Also, it's odd you're pointing out him giving information during an on-the-record interview as evidence that he's lying.
> Dr. Fauci acknowledged that he had slowly but deliberately been moving the goal posts... partly on his gut feeling that the country is finally ready to hear what he really thinks.
From wikipedia (https://en.wikipedia.org/wiki/Lie):
> Lying by omission, also known as a continuing misrepresentation or quote mining, occurs when an important fact is left out in order to foster a misconception. Lying by omission includes the failure to correct pre-existing misconceptions.
Dr. Fauci believed that the real range was somewhere between 70 to 90 percent as you pointed out; however, he gave lower estimates to the public because he didn't believe the public was "ready to hear what he really thinks". So not only was he failing to correct pre-existing misconceptions, but he was actively spreading misconceptions about how much of the population he believed needed to be vaccinated. As such, he was lying by omission.
When Dr. Fauci was claiming lower figures: no vaccine had completed clinical trials; variants had not yet emerged; and governments were more willing to implement lockdowns, mask orders, and social distancing restrictions.
If he's guilty of anything, it is misleading the public into thinking he knows what the number is. Nobody knows what the real number is, there are so many confounding factors that it'll take years of research to come up with a decent estimate as to the real herd immunity level of Covid-19 immunisation.
This is a general problem in public scientific messaging. Science deals with uncertainty and nuance, but the fearful public seek certainty and simplicity. People in these positions don't always get the balance right (especially in a crisis), but I wouldn't impune somebody's reputation on that basis.
The physical basis of a face mask is well understood, and engineers have measured filtering efficiencies in labs. What was weak, was randomised controlled trials where you give masks to people and ask them to use them, with a control group to which you don't give masks. This kind of studies also give at best weak evidence that condoms would help preventing sexually transmitted diseases or unwanted pregnancies.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3009845/
"Despite the public health importance of increasing condom use there is little reliable evidence on the effectiveness of condom promotion interventions."
According to your criteria, we should maybe stop recommending condoms?
* Humans would have to require at least some fluids to pass through during sex to survive, so condoms would have to be porous enough to allow these fluids through while trapping sperm
* Condoms capable of this feat would have to be relatively scarce, so the general population would instead use improvised genital coverings
* Women would have to be able to become pregnant by merely touching some dried out sperm on a door handle and then rubbing their genitals some time later
* Men would have to be of the habit of ejaculating on various public surfaces throughout the day
* Women would have to be of the habit of rubbing their genitals throughout the day
* A large segment of the population would have to refuse to wear their genital coverings while ejaculating on public surfaces or rubbing their genitals
* Even those that complied with state genital covering regulations were prone to adjusting them throughout the day and accidentally rubbing their genitalia.
So yes, with those minor tweaks, I'll concede your point.
The US Surgeon General, CDC, WHO, etc. got on national television and said masks don't work when what they appear to have really believed is that masks DO work, but they wanted to reserve them for healthcare workers. The cost of this dishonesty is that when they flipped the script people were less likely to comply/believe them. And any recommendations they give going forward has to go through the "Are they sacrificing me for the greater good" filter.
When the question of whether COVID is lab generated is brought up, the relevant institutions consistently respond in a dishonest manner. They pretend that "lab generated" means gene editing and they vociferously deny the gene editing hypothesis. But that's not what is being asked. What's being asked about is gain of function research.
These things are categorically different than something like "I think if they closed the borders sooner we would've had less impact." That might fall under "not performed perfectly" and I'm willing to grant a lot of leeway for that category of error under emergency circumstances.
I think this was just a problem of messaging. The science really wasn't there to support the hypothesis that masks could help limit transmission in the community. Even the evidence for their effectiveness in a clinical setting was extremely limited.
There was reason to believe, however, that if they were effective, they'd be more effective in a clinical setting because they'd be used in combination with other PPE, hand washing would be more frequent, and staff were trained on how to wear masks correctly. Clinicians also happened to be putting their necks on the line by knowingly coming into close contact with infected individuals, while the rest of us were hunkered down at home.
Here is an extract from a review of the published literature shortly after the CDC gave its guidance for the community to wear masks:
> There is uncertainty about the effects of face masks. The low‐moderate certainty of the evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of randomised trials did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks during seasonal influenza. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness. Harms associated with physical interventions were under‐investigated.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
> What's being asked about is gain of function research.
I'm glad that we can (seemly) agree that Covid-19 created using genetic engineering. Are you aware of any evidence to suggest that its evolution was guided by deliberate human action?
In addition, crises of different nature have similar structures. The readiness to deal with the structure of crises of different nature can be tested.
This is wrong. You probably can employ bayesian causal inference if you know that two observed variables have a causal relationship and want to know about the direction. But if you already know that, most of the riddle has been solved a priori. Double-blind RCTs are the gold standard.
They are also extremely slow. Appropriate for efficacy testing of new treatments, not as much for public health messaging at the onset of a crisis.
It’s important to have a methodological basis for decision making in those early hours where information is sparse and of dubious quality. Without that, people panic and make short-sighted decisions that may undermine the legitimacy of their organization for years to come.
At the beginning of the pandemic (and even now), many countries were PPE-constrained, particularly on masks.
The messaging was "no need to wear a mask", but the reasoning was that the supply we did have should go to front-line healthcare workers.
In other words, the Opportunity Cost was high.
I remember to begin with the messaging was not to use cloth masks as they were essentially useless, so it really was N95 or nothing, and the N95 supply was needed in hospitals. Now we know that a cloth mask is actually better than nothing, and we also have a lot of supply of not-great-not-bad disposable or tightly woven cloth masks.
N95s are also somewhat available.
People who told me banning plastic straws was helpful are now calling billions of disposable masks per week a "zero-cost intervention"?
So many words and FUD in continued denial that there is more to science than “gold standard” double-blind randomised controlled trials. Bayesian statistics can inform hypotheses at any level of evidence, and zero-cost interventions like “wear a mask” and “take Vitamin D” require just a tiny bit of evidence. And even without any evidence they’re still better than the reverse (“don’t wear a mask”, “don’t take Vitamin D”) which are also without evidence.
In a novel crisis, you have to act without firm evidence (I cal this “executive ability”). Most Western governments and medical organisations failed to do that, so now they’re continuing to gaslight the public to conceal their failure.