>A travel ban is not an evidence-based solution unless you stop all travel from every country.
Okay, why not do that? China's done it. Vietnam, Australia and New Zealand require a week+ quarantine for international travelers. It obviously works: it stopped two Omicron carriers at the border in Hong Kong. Why not do that?
If COVID-19 is such a serious threat that it requires shutting down all schools for more than a year, why not take the comparatively minor step of halting or drastically limiting international travel?
2) When would you ever open then (since you need a proactive approach)?
3) How would trade look? I can't think of a single way of halting a contagious virus between countries that wouldn't completely shut us down as a race. The cost to humanity would be beyond imagination. Perhaps on the order of 100x-1000x that of corona.
I wonder why you feel that it is fine to say "too late" for this measure that obviously works. Do you also say too late to lockdowns, vaccine mandates, restaurant and schools closures, and mask requirements. If you don't, then maybe spend a moment thinking if your epidemic response is guided by your political allegiances
Is New Zealand an authoritarian state?
According to their government...
> for this measure that obviously works
it obviously isn't since the various variations of the virus are spreading
We already know we're acting on imcomplete, time-delayed information, i.e. we will only learn a few days later when the variant arrives in another country. So we have to compensate for that either by shutting everything down or by introducing artificial delays. And that's assuming all countries are testing and reporting the spread early. Some countries might lack coverage and thus act as dark hubs.
We do not have and shouldn't have a zero covid goal and negative tests + vaccine checks are a reasonable enough. AU/NZ are outliers, but there are countries with strict border policies like them but that failed to contain their spread, such as Australia's neighbor Indonesia. That suggests there's more to the story that requires further study. Australia + NZ are not good case studies for Europe + NA to follow because they are rich islands with limited ports of entry that get less international air traffic in a year than busy European or NA airports get in a month. Furthermore I don't see what the major quality of life improvements for Aussies/Kiwis has been as a result of their overly strict policies. They have a statistic they can be proud of but at what cost?
There's been too much binary thinking by the media and politicians - for example masks aren't 100% effective, but they do reduce the viral load by 30-50% which could be the difference between getting mildly sick and getting a fatal exposure. We shouldn't let perfect be the enemy of better.
I think the effect is much larger than that, but yes, absolutely. This is an important point that is constantly lost in the public discourse. We realize there's a big difference in dosage with poisons and radiation, but it's the same with viral infections; viruses do take time to replicate, so having a low initial exposure can give the immune system to ramp up sooner, before the infection has become severe (and then the immune response will also be severe).
https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...
To date, I'm aware of no study that has quantified a difference in infection, hospitalization or death that is attributable to travel bans.
Also, last time I checked, most people aren't wearing N95 masks. Probably because they're annoying and difficult to wear.
> Which isn't minor. It's been over a year. If you're not using an N95, you're doing yourself and those around you a disservice.
I am vaccinated. Which brings up an important point: there is absolutely no evidence that a mask of any sort provides any benefit to those around me, a vaccinated person.
At some point, you have to put up evidence for your increasingly implausible claims -- you can't just keep leaning on lab studies of filtration efficiency. It's been two years now. Where is the real-world data backing your claims?
Among other things, vaccinated persons can and do contract, carry, and spread, during which a decent* mask does do its thing.
And who doesn’t wear an N95 class mask? I see about 2/3rds N95, KN95, or KF94s, 1/3 useless masks, appearing to be mostly correlated along economic lines ($2/masks vs. $0.50/masks).
PS. This is bigger than “fractions of a percent”:
https://jdrampage.org/real-world-covid-mask-trial-proves-mas...
* This shows lame mask are lame:
https://pubmed.ncbi.nlm.nih.gov/32512240/
Put those two concepts together, you get humdinger models suggesting:
“… if only around half of the population opted to wear respirator-type masks from the beginning of the pandemic, COVID-19 would have failed to establish in the United States.”
https://royalsocietypublishing.org/doi/10.1098/rsos.210699
(Would have needed closer to 2/3 with those sneeze guard ’surgical’ masks.)
I can't comment on the rest of the science, but fwiw, I live in NYC and I'd estimate that maybe 1 / 20 people I see on the street are wearing N95/KN95/KF94 masks. Everyone else just wears cloth masks, or paper surgical masks.
TBC, I’d agree that your point, that of the article you shared, is valid. But it doesn’t pertain to the claims of inefficacy of masks outside a lab.
No, it isn't. If you'd bothered to read the content of the link I posted in the comment to which you're replying, you'd see that it's about the same paper.
That paper is mentioned numerous times in the thread you're commenting on, I've linked to it, as have others, and I've cited the absolute effect size: 0.09%.
The paper showed that there was an 11% drop on a baseline infection rate of 0.79%, in a fully unvaccinated population with very little natural immunity. It is the absolute best possible argument for masks, and it showed that cloth masks had no detectible effect, and that surgical masks had an effect size measured in tiny fractions of a percent.
2) You're right that Americans are idiots who mostly can't tell the difference between a piece of cloth, which reduces viral loads marginally, and a proper mask.
3) Vaccinations have minimal impact on spread for extended in-door socialization (~30% reduction in odds of spread at this point). They do pretty well for reducing risk to you (e.g. death or hospitalization), and they seem to do pretty well for avoiding casual spread (e.g. passing someone on the street).
- fwiw, I personally plan to wear n95 mask outside of home in enclosed public spaces for the foreseeable future, and for things like shopping etc (where I'm exposed to strangers) basically indefinitely / as long as social norms and laws will allow.
- I would like for strangers around me to wear masks. There's too much uncertainty and I don't know how to quantify and otherwise address risk from stranger e.g. In waiting / cashier line, or worse yet elevator (enforced enclosed proximity). I really see no good reason to be in an elevator with unmasked stranger.
- how long and where do we legally mandate masks? Whooeee, I'm glad I don't have to make that awful formal call! :-)
But yeah. If risk is forever, than at least some of us will use ways to mitigate the risk forever in turn. It's not binary, it's a sliding scale that's very individual. so... Yeah. Welcome to the new world! Cyberpunk dystopia future is here! :-)
You know what would help with this? A randomized controlled trial. This isn't tricky at all, except that we can't do the science because it has become political, because people insist that they know the answer already! And if the study shows what they don't want to see, then they censor it, bury it, downvote it into oblivion, or...write missives about how they're going to ignore it.
Also, are you vaccinated? Yes? Then the answer is almost certainly no risk at all. This much we know from ~all of the data regarding vaccines and serious illness, worldwide.
That is not my lay person interpretation of the currently best available data.
A vaccinated person can get infected, can get seriously ill, and can spread out to others more vulnerable. It helps, drastically, and I sure as heck got mine, but my understanding is that it does not confer individual invulnerability.
I can get hit by a car when I walk down the street, but I've been doing it my entire life and I'm still here. I can die in a horrible plane crash when I fly, but I still do it. I can have a heart attack when I go to the gym, but it's still a net positive for my life.
Do you have a grasp on the actual risks involved here? You do realize that, even unvaccinated, unless you're elderly or obese or severely immunocompromised, the risk from this virus is measured in fractions of a percent, right? And if you've had even a single dose of an approved vaccine, you can take that number and divide it by 10?
At some point, you have to let the terror go.
> my understanding is that it does not confer individual invulnerability.
Who promised you invulnerability?
The Thing that makes covid tricky is which actions am I making for myself vs others. Safety belt and helmet are largely for myself (but still enforced in many places due to agreed societal cost that goes beyond Individual). Mask, we don't have common universal agreement to yet. (this is not to say I don't have am opinion on it, but I understand looking around that while mainstream it's not universal).
So while I think we have agreement in framework, we may disagree on personal implementation. Mostly, I don't know that I agree with "at some point you have to let terror go". This ain't over yet, may never be over, so some mitigation steps may never be over, is the sobering world to raise offspring Into. Alberta took foot off the brake for just a little while and next thing they were begging other provinces for ICU spots. And there's a whole conplicated interlocked system of individual causes and effects rather than some simple binary rule that have rise to that reality.
But you make an excellent point: the average NYC citizen probably takes bigger risks crossing the street on a daily basis than she would by going un-masked.
>>"I'm doing great without one. No need to worry about longterm risks from a rushed vaccine. 1 year does not equal 10. Ever."
There are categories of knowledge where I'm profoundly uninterested in any individual's experience (best friend or stranger on the internet alike:). Simply put - a person surviving Russian Roulette does not make playing Russian Roulette a good idea, no matter how convinced they are and loudly proclaimed that it worked out great for them :).
I do not know your situation - maybe you've gone hermit; maybe you're in an area of low risk; maybe you're being careful; maybe you're the one asshole around and everybody else is vaccinated/wearing mask/implementing lockdown while you're taking credit for not getting your sorry ass sick; or (most likely but I have no way of judging), you're just lucky - see the Russian roulette above.
But in risk evaluation of this sort, again, I'm far far more interested in verifiable statistics than individual's lived experience.Don't get me wrong - we can have a nice round of drinks and talk about how last year's been to us and approaches we've taken and it'll be interesting and we can share; but it's not a policy-guiding thing.
As of the week before last, 28% of all hospitalizations in my state (NM) related to COVID19 involved fully vaccinated people.
Also, the eldest people (largely those most at risk of hospitalisation) are substantially more likely to have been vaccinated already, no?
None of this is an argument against vaccination, of course.
Next to politization there is also public health, which is more of a management science than an emperical science. And economic concerns.
From all the data worldwide, you only reduce risk of hospitalization and death, not for spreading to your grandmother or catching it from a bypasser sneezing in your face. To act like there is no risk for the leaky vaccinated, is to actually increase your risk. Data shows that asymptomatic breakthrough infections are able to cause long-COVID. Now you did not even feel sick and gave your body and immune system rest to clear the virus. Very risky!
Thank you for perfectly illustrating the problem. I was actually sort of worried that people wouldn't take me seriously when I said that science has become so political that we actually can't do any. It sounds conspiratorial, doesn't it? But, alas:
1) I post results of RCTs showing that masks do little, if anything.
2) Someone replies that the evidence is insufficient for reasons X, Y, Z.
3) I say "great, let's gather more evidence to resolve those uncertainties".
4) Someone replies "we can't, it's unethical".
Quite a fine castle you've built on that cloud, good sir. Very safe indeed.
In a First, Randomized Study Shows That Masks Reduce COVID-19 Infections
A large study co-authored by Yale SOM’s Jason Abaluck and Mushfiq Mobarak tested the effectiveness of a mask-promotion program in Bangladesh in increasing mask use and preventing symptomatic infections. The study found that masks significantly lower symptomatic infections, especially among older people and when surgical masks [instead of cloth] are used.
https://insights.som.yale.edu/insights/in-first-randomized-s...
The fact that we don't is an indication of how hard it's been to pursue any sort of science in this area. Almost nobody funds it, you can't get it published if it doesn't fit the public health narrative, and even if you do, the the news media won't report on it, and it might just get censored on social media.
* The pandemic is affecting 8,000,000,000 people all around the world. A large size RCT enrolls X0,000 participants. For example, the Pfizer covid mRNA vaccine clinical trial had 21,728 placebo participants. For every RCT participant, the RCT results are going to inform the course of action for hundreds of thousands of people. This is to say that such RCTs are extremely valuable given the high infectiousness of the virus.
* The risk to the participants is at worst a moderate increase in the chance of being infected with covid. The covid fatality risk to a healthy adult is small. In the US there have been about 50,000 deaths with covid in <50yo age group. An RCT with 20,000 <50yo people on the placebo arm may see about 3 covid deaths assuming all the placebo participants are going to be infected. Realistically, only a fraction of participants are going to actually be infected with covid, thus there is a good chance every single one of the RCT participants will continue their lives just fine, especially if the study designers are careful to not include people with serious comorbidities.
* Vaccines are available to reduce the death risk by another order of magnitude if deemed necessary. Alas, while the vaccines have strong effects in preventing serious covid, they only have a middling effect on preventing infections [edit: after a few months]. The mask/no mask infection effect remains measurable.
* Covid is endemic. Everyone is at risk to to be infected with covid sooner or later. Wearing a mask may decrease the daily risk by a moderate margin, unfortunately integrated over many days the infection probability approaches 1. The RCT is merely speeding the risk by a moderate margin for the placebo arm participants.
* There is a large pool of potential volunteers that don't (want to) wear masks anyways. Adults have the right to volunteer for risky activities, including activities that may result in death.
>* There is a large pool of potential volunteers that don't (want to) wear masks anyways. Adults have the right to volunteer for risky activities, including activities that may result in death.
This is certainly true. But the difference is that once we begin performing medical studies that ask this of people, the medical industry is now complicit in adults performing risky activities that may result in death and is asking people to do so, or if doing so, to do so for the benefit of medical research. This is a line that has not been crossed by the modern medical research industry as it has been long decided that this extra pressure, however small, is a lever they do not want to pull because it is fundamentally incompatible with 'Do no harm.'
It isn't 'do no harm, except a little when we think it might outweigh the downsides'
It's a line I don't think we should cross. I understand why someone would disagree with that.
Not the least because it would be completely infeasible. You may pretend that we can "simply" do a "controlled experiment" but you ignore how impossible it is to tell any sizeable group of people to behave in a certain way and report honestly about it.
"Randomised control trials" are the platonic ideal but in the real world, you can't endanger people for your curiosity, and you will have greatest problems to actually enforce your test protocol. It's more than "tricky". Unless you have access to some spherical people in a vacuum.
Now, I look forward to it being more socially acceptable to wear masks when you have an infection.
Ah, so this is the real reason. That's fine, but it's also not really applicable to the wider population and hence isn't about what I originally asked -- which is why we would universally continuing wearing masks forever.
The answer is we wouldn't, because that makes no sense.
I live in Virginia, FWIW.
The two-cities trial early in 2020 in Germany saw a ~20% reduction. Those are in the number of infections - the number looks low but can make a massive difference in the actual transmission rate. In the German case, after a month infections dropped close to zero.
The study was not blind, so the intervention group (those that wore surgical masks and showed the large efficacy increase) we're paid money to be part of the group. The non-intervention groups (cloth and control) did not receive any monetary compensation.
Recording of masking was done via people observing mask wearing, which also could potentially mess with the data ( as this was not blind).
Reporting of covid symptoms was entirely based on the population manually reporting it, there was no random testing to see variances in covid.
Only around 30 to 40% of cases were actually verified via a test.
The education that came with the intervention group may have caused the older population to stop going out as much, which impacted the result.
My take is that the study proved you could pay people to mask, but it's efficacy result is dubious.
CATO has a meta analysis about mask studies that is interesting (pre print still): https://www.cato.org/working-paper/evidence-community-cloth-...
> were paid money to be part of the group
That's simply not true. This is the document describing the intervention to raise mask usage: https://docs.google.com/document/d/1mgY6k5SooeMt6PIqwx-7z5LZ...
It says they tested monetary & non-monetary incentives, but if you look at the execution table, it's all "Public Reinforcement". The conclusion was that Nudges and incentives outside of the core NORM [1] intervention had no effect on mask-wearing..
> Recording of masking was done via people observing mask wearing
This is good. It means they observed the overall effect on the entire population. Some previous studies relied on self-reporting which is not as reliable.
> Only around 30 to 40% of cases were actually verified via a test.
You can't force people to take a test. But the rate of positives within the ones that agreed to collection was similar to the overall self-reported one. The study goes into this at length. There is a whole section trying out a different approach where they assign the average soropositivity to non-consenters, instead of excluding them, and that makes the results even stronger.
> The education that came with the intervention group may have caused the older population to stop going out as much, which impacted the result.
That sounds like a very random hypothesis. I can come up with another dozen of these. Maybe it rained more? Too cold? Maybe there was a soap opera on, that 60 year olds love to watch? You'd think a dozen scientists from Yale, Stanford, Berkeley, John Hopkins & others would find a way to control studies for external factors... if it was this easy to challenge results you could do it for basically every paper ever published.
The paper is available for free here: https://www.poverty-action.org/sites/default/files/publicati...
[1] no cost, offering, reinforcing, modelling
> Cloth masks should be made with two or more layers of a breathable fabric that is tightly woven (i.e., fabrics that do not let light pass through when held up to a light source).
So cloth masks are allowed. Also, this is an issue that I agree has been settled for a while, but the media/political effort to push it has been minimal, it's always "mask up", without going into the details, which can be very important.
Intervention & Money: The doc you link just says they tried different approaches, but don't seem to details the differences with the different motivational types. It's not clear to me from what I saw that they really dived into this. And when there are any kind of rewards (ie: not blind), you will get different results in the intervention group that you were not expecting (people change behavior).
Observations of Mask Usage: I agree, this is probably the better than survey based (as from what I've seen, people self-report very differently than what they really do). This was a weak critique on my part and I would have to understand what alternatives there are that could be better.
Positivity Testing: I think my original point was moot here as well. I think the better argument here is that we do not know the change that covid had already spread in any given area prior to this test. I understand that they tried to group control and intervention groups that were near one another to try to cut down on this, but it is still a big blind spot for this study.
My other issue here is that there was no random testing done to find asymptomatic cases. This is a huge issue with this virus in general, and it makes our numbers not as good (The UK being one of the few countries that has this kind of data, but it's not truly randomized still).
Older Population Education: See this post on the topic[1]. The point she makes is that the reduction in covid by age group should have been equal if masks worked equally, but the results from the study show that the reduction in cases was mainly in the older age groups.
[0] https://www.cdc.gov/quarantine/masks/mask-travel-guidance.ht...
[1] https://twitter.com/Emily_Burns_V/status/1433122687765856259
Be interesting if anyone has done a proper comparison between say Glasgow and Manchester.
Basically the dude has his own biases and agenda here, and the study he cites isn't a definitive nail against mask wearing.
1. https://vinayprasadmdmph.substack.com/p/how-democracy-ends
This is a blog post summarizing his review of every study on masks ever conducted. So yes, he's citing that. You should read it.
I linked to it because most people won't have time to read 30,000 words on masks, and want the TL;DR.
Everything else you've said is an ad hominem.
Regardless, the paper covers pretty much ~all of the prior literature for masks and respiratory illness.
You have got to be joking, because NZ, Taiwan, and Australia all achieved COVID zero by effectively quarantining their countries, i.e. travel bans. It's basic logic that viruses cross borders and oceans via infected people, not by wafting magically through the air.
That said, travel bans are only effective in the very early phase, when infections are near zero. The US, Europe, and most of Asia are highly connected and by the time COVID infections were spreading, it was pretty much too late. Also, the US's travel bans were not particularly ineffective. Like the US's entire response, haphazard, half-hearted, and actively opposed by lots of weaponized ignorance.
Why would you need a study to tell you that if nobody with covid travels to a country, that country remains covid-free? Perhaps you are unaware, but there are countries on this planet that covid hasn't gotten to, and those countries have travel bans.
Like, because of an experiment done on Wednesday, a piece of meat kept carefully covered with metal is not going to sprout maggots and flies. Because maggots and flies are caused by flies laying eggs. That same piece of knowledge can then be used to predict with decent certainty that you’re still not going to sprout maggots and flies if you cover it with glass instead of metal and do it on a Tuesday.
Germ theory of diseases says if you quarantine travel, you can prevent (or reduce probability of) novel COVID diseases sprouting up in your country. Because the disease is caused by germs carried by infected people during the few weeks they’re contagious. You don’t need an exact study to prove that, although it’d certainly be nice.
Seriously. Empiricism is great. Using a kind of mindless empiricism (“models don’t tell you anything, so unless every situation is measured, you have no idea”) to throw doubt on science is not.
It's like saying boats don't work after trying to build one out of grocery bags or untreated plywood. Yeah, crappy boats are going to have leaks. Lockdowns are hard; it's not something we really practice (and worse, there are malicious defectors who want lockdowns to fail). A lot of people, we have learned, are selfish and unwilling or unable to make any sacrifice, even in the face of severe collective consequences, and worse, will sabotage efforts either for political gain or just the sheer pleasure of watching everyone else fail (and die!). I really don't know how we can expect global society to continue given how craven some people are.
At least some of those are lying.
So it's perpetually locking you into travel bans to be effective, which is in itself very harmful to a country in today's world.
It only works if everyone did it and you succeed in killing the virus. Right now that is no longer possible because the animal kingdom will keep it alive.
For example if we assume it gets to the US eventually, what is, say, an extra few weeks buying the US?
On day 1 or in year 1, I see the value in those weeks. You can build ventilators, field hospitals, and learn treatments. At this point, are there new useful ways to use a few weeks of lead time?
well said, in my opinion
So far, our track record isn't that great. The two RCTs for masks and Covid showed minimal (if not zero) effect [1], and you can barely say the results out loud lest you get silenced by the angry mob (as you can see from the color of this comment). I'm not hopeful.
But please let me know when someone actually does an unbiased study of travel restrictions. I have yet to see one. The biggest tragedy of this pandemic is the number of people who are willing to substitute their (popular) opinions for evidence and call it "science".
I guarantee that every response to this comment will be from someone asserting that "masks work", and linking to a paper that they haven't actually read, or worse: an editorial about papers they haven't read. Most people have literally no idea what the data is on any of this.
[1] https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...
There's one from Stanford & Yale that says they do.
https://www.poverty-action.org/sites/default/files/publicati...
It said that it can’t support an impact of cloth masks usage on infection rates, but associates them with reduced severity/symptoms.
That’s a notably distinct proposition from “no effect.”
What this should tell you is that "symptoms" are a bad endpoint for a randomized-controlled trial, not that if the good endpoint doesn't show you what you want, you should rely on the bad one.
They found a tiny effect in symptomatic seroprevalence at a single point in time.
First, the study conflates distancing and mask-wearing. They admit this in the paper (there is a significant increase in distancing amongst the mask wearers). There is also a large change in the size of the populations that could easily swamp the effect size (i.e. the size of the mask population was something like 9% bigger than the control).
Second, just because you observe effect size X at time T does not mean that you will see an equivalent effect at T+1. It also doesn't mean that you will see a compounding effect. In human terms: maybe you get a surge of behavior at the start of the intervention that doesn't continue, due to burnout or non-compliance. Or maybe you got lucky at time T, and randomly saw a population that yielded a result. You can't make the assumption.
No, you want to measure if an intervention works if you do everything reasonable to enact it. You don't get to invent an alternate reality where people are 100% compliant and there are chocolate rivers and gumdrop trees.
Otherwise, I have the perfect diet plan that will end all obesity, worldwide: don't eat if you're fat. Simple! If it fails, it's because you didn't follow my brilliant advice.
The point of these studies is to show people that the intervention works if people do it. And, yes, there are public policy studies showing that mask mandates don't work, but that doesn't mean they don't work for the people actually wearing them. It just means people who refuse are cutting their noses off to spite their faces. As noted in another comment, this isn't the beginning of the Third Reich, and should not be controversial at all.
If you show that a drug works in a petri dish, that's completely irrelevant if it's so toxic that people don't take it because of side-effects.
If you show that full-face respirators work on a mannequin in a box, that's completely irrelevant if real-world people don't wear full-face respirators because they suck.
> If you show that full-face respirators work on a mannequin in a box, that's completely irrelevant if real-world people don't wear full-face respirators because they suck.
And these examples are straw men. That's completely irrelevant to the point.
All of the good evidence (RCTs) on masks is extremely marginal, at best, and there hasn't been a single RCT I'm aware of that showed any effect of the other interventions.
https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...
We've had two years to increase the output of N95s and expand the hospital facilities to handle severe COVID. Almost nothing has been accomplished.
Compliance in public transport and supermarkets is extremely high, pretty much never see any adult with just a mask, everybody wearing actual respirators.
Would you chill out? People are disagreeing with you & presenting evidence, not burning you at stake. When did everyone get so damn fragile??
Here we see the GP disappointed that every time he and others bring up salient points, they are silenced by an angry mob. It's a real stretch to call him the snowflake in this situation. Nobody calls people a snowflake for disagreeing, it's the way that traditional snowflakes disagree that people have a problem with.
> The researchers enrolled nearly 350,000 people from 600 villages in rural Bangladesh. Those living in villages randomly assigned to a series of interventions promoting the use of surgical masks were about 11% less likely than those living in control villages to develop COVID-19, which is caused by infection with the SARS-CoV-2 virus, during the eight-week study period. The protective effect increased to nearly 35% for people over 60 years old.
https://med.stanford.edu/news/all-news/2021/09/surgical-mask...
Earlier studies said there wasn’t sufficient evidence, not that masks aren’t effective:
> Results: Fourteen studies were included in this study. One preclinical and 1 observational cohort clinical study found significant benefit of masks in limiting SARS-CoV-2 transmission. Eleven RCTs in a meta-analysis studying other respiratory illnesses found no significant benefit of masks (±hand hygiene) for influenza-like-illness symptoms nor laboratory confirmed viruses. One RCT found a significant benefit of surgical masks compared with cloth masks.
> Conclusion: There is limited available preclinical and clinical evidence for face mask benefit in SARS-CoV-2. RCT evidence for other respiratory viral illnesses shows no significant benefit of masks in limiting transmission but is of poor quality and not SARS-CoV-2 specific. There is an urgent need for evidence from randomized controlled trials to investigate the efficacy of surgical and cloth masks on transmission of SARS-CoV-2 and user reported outcomes such as comfort and compliance.
https://pubmed.ncbi.nlm.nih.gov/33565274/
The cost of wearing a mask is basically zero when there is sufficient supply. While waiting to gather evidence, it seems like an easy low cost precaution while gathering evidence.
Slate Star Code (March 2020):
> Please don’t buy up masks while there is a shortage and healthcare workers don’t have enough.
> If the shortage ends, and wearing a mask is cost-free, I agree with the guidelines from China, Hong Kong, and Japan – consider wearing a mask in high-risk situations like subways or crowded buildings. Wearing masks will not make you invincible, and if you risk compensate even a little it might do more harm than good. Realistically you should be avoiding high-risk situations like subways and crowded buildings as much as you possibly can. But if you have to go in them, yes, most likely a mask will help.
https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...
Once we agree that the evidence for masks is weak and mixed, then sure, we can debate costs and benefits of the intervention. Or...we can do more studies.
It's been almost two years now. I think it's rather shameful that we haven't done the science, and we're still guessing, don't you?
A mask is not a respirator, yet the two of these are regularly confused not just in the public discourse, but were even confused in official messaging during the beginning of the pandemic.
The WHO and health agencies the world over were suddenly asking people to "prioritize masks for at risk groups", which in some places was parsed as "no need to wear masks", as everybody was struggling to get medical masks, and particularly respirators, for the HCW treating infected patients.
Here's a review of every mask study ever performed:
https://www.cato.org/working-paper/evidence-community-cloth-...
Here's a summary written by the same author, in case you're too busy to read 30,000 words:
https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...
https://en.wikipedia.org/wiki/Intention-to-treat_analysis#Ad...
Otherwise, I have a brilliant plan to end all obesity, worldwide: don't eat when you're fat. Guaranteed to work. If it fails, it's your fault for not following the plan.
> When democratically elected systems transform into totalitarian regimes, the transition is subtle, stepwise, and involves a combination of pre-planned as well as serendipitous events. Indeed, this was the case with Germany in the years 1929-1939, where Hitler was given a chance at governing, the president subsequently died, a key general resigned after a scandal and the pathway to the Fuhrer was inevitable.
It's a mask & a vaccine, not the beginning of the Third Reich. The fact that your sources can't see the two as different things (and not as part of some slippery slope), tells me they've already arrived at a conclusion and will ignore all contrary evidence.
I know masks & vaccines feel oppressive -- but facts simply do not concern themselves with your feelings. There is a world of difference between the Third Reich and public health measures to slow the tide of preventable deaths. To be honest, I can't believe I'm having this debate here.
I am calling for scientific studies. More data to justify our actions and guide our decisions. You are...calling me hysterical.
Please -- you're not being silenced, you are not some martyr, people are just disagreeing with you.
I'm sure the downvoting here has nothing to do with the fact that comments get sorted to the bottom and grayed out.
Would you stop with the hysteria? You're getting downvoted not only because people disagree with you, but also because you've managed to turn that disagreement into some kind of cause for martyrdom.
To quote you:
"projection, plain & simple"
I'm just feeding into the problem by replying to you, but none of us can expect any discourse with you to be productive when you are working from a position that relies on believing someone acting in obvious bad faith.
Facts simply do not concern themselves with your feelings. I know it feels like oppression (a new Third Reich!!111!) & like there is no metric to get rid of masks, but your feelings alone do not make these true statements. The fact -- and we should concern ourselves with facts, not vague feelings or bouts of hysteria -- is that all of these measures will go away once the pandemic has abated to such an extent that it no longer poses a substantial threat to human lives. It's as simple as that: given that masks do an excellent job of slowing the spread, ceteris paribus, wearing a mask is better than not wearing one.
This kind of "feelings logic" is why Trump lost, more or less -- most people are willing to undergo mild inconvenience to save lives & slow the spread of a deadly virus. Despite the feelings of frustration, which we all have.
COVID is never going away. There is so much more to live for than being treated as a vector for exactly one disease.
And what I said is a value statement. Facts or science have nothing to do with it besides they guided and informed my opinions.
They absolutely should, and I think this is an intractable disagreement we have. Sorry.
But I agree that COVID is never going away -- I'm saying that all of these measures should go away once the pandemic has abated to such an extent that it no longer poses a substantial threat to human lives. I.e. there is a version of COVID where we have tamed its lethality to the point where it's a shadow of its former self.
We have that today.
And you don't see that as a problem?
Masks help prevent you from spreading the virus to other. As a vaccinated individual, you are highly unlikely to have serious illness from CV19, but you can still get it and spread it to others, even if you are only mildly symptomatic.
And this is based on data from the prior variants. Who knows how things are with Omicron - we need more data.
>Humans are meant to see faces.
Humans are/aren't meant to do X is a bad argument. We have made all sorts of behavioral changes over our time as a species. We adapt. I like having cars, and planes, and an industrialized society. But humans weren't "meant" to do any of that, until we did. All of these things have real, serious, drawbacks. But the overwhelming majority of people would agree that having these things is better than not having them.
If the new normal is to have a deadly and highly transmissible disease with us from now until forever, then yes, masks should also be the new normal. I don't think that's the case - the stakes and motivation for figuring out alternatives is quite high - but if it is, then, well, it's better than the alternative.
For those who wish to wear them, sure. But for those who don’t? That is fine too. Masks should be a personal choice at this point. Not something forced by the state.
We have vaccines. Getting one ends your obligation to participate in this Covid stuff. Forcing these NPI’s on vaccinated individuals is completely immoral in my opinion.
But vaccines do not prevent you from catching and transmitting covid to others. And some people are precluded from getting vaccinated for legitimate medical reasons, same as they are precluded from other vaccines. A vaccinated person wearing a proper mask is less likely to transmit the virus to an unvaccinated person than they would be without the mask.
I’m sorry, your argument just doesn’t make sense. You are arguing we should always be masked forever.
Yes, I did say this is a possibility. I don't think it's likely, but it is a possibility.
>We never took this kind of moral grandstanding before. Why are we doing this for this one specific virus?
This is the first virus with this sort of reach in the era of modern science. It's pretty simple - we have never before had a virus that has infected and killed this many people while also having an understanding that masking cuts down on transmission rates.
>I’m sorry, your argument just doesn’t make sense.
You disagreeing with it doesn't mean it doesn't make sense, it just means that you, for whatever reason, value people not having to wear a mask over cutting down on the loss of human life during a global pandemic.
>You are arguing we should always be masked forever.
If we live in a state of perpetual covid-esque pandemic from now until forever, yes, that would be a perfectly prudent thing to do.
> For example, we had a travel ban with China in March 2020, only to be infiltrated with a European strain.
Isn't this a good sign that the travel ban actually worked -- i.e. created enough of a delay in the spread of covid to result in a meaningfully different pandemic than we would have otherwise experienced?
* we have always named diseases from where they are found, and China/Wuhan virus would have been more catchy. However that hurt the pride of Xi and suddenly we all changed our minds.
If every politician did it, it must be easy to find a clip.
[0] https://en.wikipedia.org/wiki/Hijackers_in_the_September_11_...
So yes, it had no other purpose than being racist. Just like Trump didn't really care to use the time bought by the Chinese travel ban to actually develop tests or ramp up PPE. It always was a show rooted in xenophobia.
The official record is better, though. This bill calls out travel discrimination based on national origin: https://www.congress.gov/bill/116th-congress/house-bill/2214...
By the time a European travel ban was created, it was basically pointless because spread within the US was at wildfire levels compared to any possible contribution from international travel (the question of the morality of forcing flight crews to expose themselves to a deadly novel virus is of course quite a different one).
The story of the Trump pandemic response is taking weak action months too late.
> to buy time for the “weeks” of analysis needed that could help with further reducing risk,
We’re not going to learn anything useful in the few weeks bought by stopping these flights.
And remember, even though the general public insists on these bans, international law proscribes no country can prevent its own citizens from returning home, so no ban can be absolute.
The unstated alternative to writing it off as not working is just enforcing bans on the basis of “better safe than sorry”. To me it’s clear that experience with the other variants shows that it just isn’t safe, so there is no “better safe than sorry”.
Let’s talk about not just writing off the alternative as well.
"Slowing the spread" is not a good enough argument in my opinion. Everyone wants to slow the spread, the only question worth asking is: at what cost?
At what point do you deem something effective and worthy of sacrificing your freedoms for? 1% efficacy "slows the spread". Is that worth it? Where do you draw the line? 20%? 50%?
Life is risky, everything is a gamble, yet somehow with COVID, all nuance has disappeared, life is not worth living until we can be 100% sure that there is no risk at all.
Asking society to myopically focus on nothing but “slowing the spread” of one very specific illness for years on end is, quite frankly, madness. There is vastly more to life than just living it to slow the spread of exactly one disease.
At some point in the near future, perhaps right today, people need to acknowledge that Covid and all its variants past present and future will be around forever. They can either learn to return to full normal 2019 life or piss an entire generation of people away on a battle that cannot ever be won.
I'm not recommending dropping them altogether but we'll need to find a balance. To go from crisis mode into discussing long-term strategy.
- "Walls don't work": closes and locks door when entering own home, probably has walls in house too
- "Ivermectin is horse paste": is actually not good for COVID, but is on the WHO list of essential medicines and has saved countless lives and has a side effect profile that's tamer than most of the antibiotics that most US doctors will prescribe as a precautionary measure for a multitude of things
The more they BS-us, the less we listen. Is that what they really want?
The reason travel bans don't work is because we apply them too late and too selectively, because otherwise trade shuts down and we have other issues. A travel ban targeting African countries is not effective when the variant is already spreading on two other continents.
You also cannot ban people from returning to their home country, so there is no way to truly prevent variants landing on the soil of a country with a travel ban.
Establishments requiring vaccines acknowledge that you cannot stop the spread of the virus but require you take some minimal steps to reduce the risk profile.
They are not the same thing.
>- "Walls don't work": closes and locks door when entering own home, probably has walls in house too
Doors and windows will not stop a motivated person from entering your home. Neither does a wall.
People crossing the border illegally are motivated people, and a wall would not stop them either.
Doors and locks are there to increase the effort required to break in, which is often a crime of opportunity. Border crossings are not a thing of opportunity.
They are not the same thing.
> "Ivermectin is horse paste"
While I'm sure some people do not understand that Ivermectin is more than just horse paste, this largely has come out of people literally buying it in horse paste form from Tractor Supply and taking it because they think it will help with CV19. If someone is dealing with a parasitic infection then we should not mock them for taking ivermectin, but that has not been the context for 99.999% of all ivermectin related discussion over the past year.
So then don't do either of those things.
> You also cannot ban people from returning to their home country
You can quarantine them for two weeks.
> Establishments requiring vaccines acknowledge that you cannot stop the spread of the virus but require you take some minimal steps to reduce the risk profile. They are not the same thing.
But that's exactly what the US acknowledges with travel bans. They are minimal steps to reduce the risk profile and slow the spread.
> Doors and windows will not stop a motivated person from entering your home. Neither does a wall.
And yet you lock your doors, because they still provide a net-positive benefit and protection.
> People crossing the border illegally are motivated people, and a wall would not stop them either.
And yet mere talk of a wall gave us the lowest illegal border crossings in decades, while welcoming them with open arms, unsurprisingly, has now given us the highest number of illegal border crossings in decades.
You can't let the perfect be the enemy of the good here. Do you also not use hand sanitizer because it "only" kills 99.9% of germs and bacteria?
> this largely has come out of people literally buying it in horse paste form from Tractor Supply and taking it because they think it will help with CV19
No, it comes from the establishment demonizing ivermectin (or any vaccine alternative) from the beginning, causing a few loonies to become paranoid and try to secure some ivermectin for themselves. Then, the establishment took those few loonies, and shut down any legitimate discussion about ivermectin for use against COVID by repeating "horse paste" over and over and over ad nauseum. That doesn't sound very scientific to me. It sounds like treating the vaccine like a religion, and anyone who doesn't follow the establishment-party line is a heretic.
Do you know how many times the average American gets an antibiotic prescription in the US over their lifetime? It's given out like candy. Ivermectin is just as harmless if not more so. And yet the media is real big on these new Merck pills which we're now finding out are probably barely effective and have plenty of side effects, much more so than ivermectin.
Have we really arrived at the point where we've become the parody of a society in a Harry Potter book?
This one point compromised the article for me. The standard for “working”, like all measures, is to slow down the spread. We all know travel bans got a bad name because you-know-who proposed them. But all countries imposed travel bans and we ought to be concrete about the level of delay they create or not. Let’s not hold any measure to a different standard due to political signaling. If travel restrictions are good on a risk adjusted basis to buy time for the “weeks” of analysis needed that could help with further reducing risk, let’s talk about it not write it off as “not working” which is non-sensical. Masks “don’t work”, vaccines “don’t work”, nothing “works” if that is taken to mean a silver bullet.