Hacker News Reader

Comment by wwweston | Hacker News Reader

This is an instance of what I described in my above comment.

"STOP BUYING MASKS" is not "Masks don't work," especially given the rest of the context of the statement where he's saying they're important to protect high-exposure roles healthcare providers. Which means he's also saying they work.

"They are not effective in preventing the general public" might be reasonably interpreted as "masks don't work", but given that he's clearly saying they work in the same breath, it's a better bet that he means something else.

View on HN

When one says that "masks are not effective", it's literally the definition of "masks don't work." Please don't try to weasel out of it by trying to argue basic definitions of words. That's like Bill Clinton arguing over the definition of what "is" means to try to save himself. Just admit that you're wrong and move on.

It's clear that the message in the early stages of the pandemic was that "all masks didn't work, but you should save it for the health care workers". The absurd contradiction of that statement was what made reasonable people such as myself no longer trust what they said, because it was obvious they were hiding things from us. It's obvious that if you have a respiratory disease, then wearing a mask will be effective.

Since then, it has come out that masks are actually extremely effective in preventing spread.

> Since then, it has come out that masks are actually extremely effective in preventing spread.

No it hasn't. Show me the research.

> "all masks didn't work, but you should save it for the health care workers". The absurd contradiction

It's not an absurd contradiction. A member of the public walks around and is only going to meet a few people with covid-19, and hopefully they are pre-symptomatic (because if they have symptoms they need to stay at home)

A healthcare professional is stuck in a room with symptomatic people, often in close contact. And they're not wearing a cloth mask or fluid resistant surgical mask, they're wearing a mask that has to be fitted to them. They have training on how to put it on and take it off. They also wear gloves, a gown, and a face shield or eye protection. They have running water and soap, and they have alcohol handgel. For fluid resistant surgical masks they take them off and use a new one for each patient.

One patient in one ICU bay will have 30 pairs of gloves used by staff per day.

> No it hasn't. Show me the research.

Here: https://www.livescience.com/face-masks-eye-protection-covid-...

> With face masks, the chance of infection or transmission was 3% with a mask compared with 17% without a mask, a reduction of more than 80%. And for eye protection, the chance of infection or transmission was 6% with protection and 16% without.

The problem is not all people in the public at large will apply that same logic and just take the statement at face value at first glance. Masks don't work. Don't buy masks. When you ask them the question of "what did they initially tell you" later, their response would be "masks don't work."

With someone in such an official position, misinformation can do great harm for people that know no better. Anyone who doesn't do their own research might think they're supposed to trust these people when worst comes to worst. And when they find out the advice is contradictory, that trust is lost, and might not be rebuilt for a very long time. It breeds doubt.

Personally however, I couldn't for the life of me believe that having no mask is better than having one.

Totally on board with criticism of how effectively (or not) the tweet communicates key ideas. There's some hazards, and we could reasonably expect that people who are appointed to provide clear public leadership would be better at that job.

But that reinforces the importance of well-curated communication, which is the context for this discussion, where apparently some are criticizing Amazon for refusing to release communication that is not only not-well expressed, as the tweet arguably is, but is actively disinformative to delusional.

Here's an extended quote of his, found on Snopes fact check.

https://www.snopes.com/fact-check/surgeon-general-against-ma... > One of the things [the general public] shouldn’t be doing is going out and buying masks … It has not been proven to be effective in preventing the spread of coronavirus amongst the general public … Folks who don’t know how to wear them properly tend to touch their faces a lot, and actually can increase the spread of coronavirus. You can increase your risk of getting it by wearing a mask if you are not a healthcare provider.

I'm pretty sure all of that is still true. In some cases, for some people, wearing a mask can be neutral or even net-negative. Maybe we learned enough to find that for the population at large wearing masks is better than not, but it's still a trade off.

It's completely untrue. Multiple studies have come out afterwards saying that masks are very effective at reducing spread. It is an overwhelming net positive to wear masks.

Please elaborate on these cases in which masks have supposedly a net negative effect on the wearer.

It's in the above tweet. Your mask is by definition contaminated (that's why you wear it, to catch the contamination), and many people fiddle with their masks. They then rub their eyes, or they touch their mouth.

Then let's solve that problem!

We need better evidence that masks provide any benefit and don't cause harm before we try to fix problems.

We really don't at this point:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

> The use of face masks was protective for both health-care workers and people in the community exposed to infection, with both the frequentist and Bayesian analyses lending support to face mask use irrespective of setting. Our unadjusted analyses might, at first impression, suggest use of face masks in the community setting to be less effective than in the health-care setting, but after accounting for differential N95 respirator use between health-care and non-health-care settings, we did not detect any striking differences in effectiveness of face mask use between settings. The credibility of effect-modification across settings was, therefore, low. Wearing face masks was also acceptable and feasible. Policy makers at all levels should, therefore, strive to address equity implications for groups with currently limited access to face masks and eye protection.

The onus is on the "they're dangerous!" folks now.

You know you've linked me to a pop-sci piece about a study that I've already linked several times in this thread?

> However, the authors note that the findings on face masks and eye protection are based on limited evidence.

So limited that this finding was "low confidence". And that's for optimal use of N95 masks, not for fluid resistant surgical masks or cloth masks.

Here's what the actual study said:

> From a policy and public health perspective, current policies of at least 1 m physical distancing seem to be strongly associated with a large protective effect, and distances of 2 m could be more effective. These data could also facilitate harmonisation of the definition of exposed (eg, within 2 m), which has implications for contact tracing. The quantitative estimates provided here should inform disease-modelling studies, which are important for planning pandemic response efforts. Policy makers around the world should strive to promptly and adequately address equity implications for groups with currently limited access to face masks and eye protection. For health-care workers and administrators, our findings suggest that N95 respirators might be more strongly associated with protection from viral transmission than surgical masks. Both N95 and surgical masks have a stronger association with protection compared with single-layer masks. Eye protection might also add substantial protection. For the general public, evidence shows that physical distancing of more than 1 m is highly effective and that face masks are associated with protection, even in non-health-care settings, with either disposable surgical masks or reusable 12–16-layer cotton ones, although much of this evidence was on mask use within households and among contacts of cases. Eye protection is typically under considered and can be effective in community settings. However, no intervention, even when properly used, was associated with complete protection from infection. Other basic measures (eg, hand hygiene) are still needed in addition to physical distancing and use of face masks and eye protection.

The article links to The Lancet. I've edited and cite directly from the paper, and no, it's not "for optimal use of N95 masks". See my quoted segment.

Even the bit you're quoting says "face masks are associated with protection, even in non-health-care settings".

> Even the bit you're quoting says "face masks are associated with protection, even in non-health-care settings".

What's the control group?

Here's what the paper says about the evidence:

> Further high-quality research, including randomised trials of the optimum physical distance and the effectiveness of different types of masks in the general population and for health-care workers' protection, is urgently needed.

> What's the control group?

People who don't wear masks?

"We need more studies" is not the same as "our own study is bullshit". It's a simple statement of "there's something here that needs further confirmation".

In the meantime, I'm wearing a mask based on preliminary results, and the abject lack of "masks are actively dangerous" studies of any quality the anti-mask folks can refer to as a counterpoint.

People touch their faces all the time, whether they're wearing masks or not. This theoretical harm exists equally in both cases; in fact, touching the mask may remind you you're not supposed to be touching your face, and trigger a hand washing or hand sanitizer use.

> In some cases, for some people, wearing a mask can be neutral or even net-negative.

If you don't wear it on your face.

Even with this very charitable interpretation, he was still completely incorrect about their effectiveness for stopping public spread, was he not?

No.

There's no evidence that masks do anything at all to prevent public spread.

People point to countries that had successful anti-covid work and use of masks, but they're missing all the other work those countries did around social distancing and track and trace.

Lack of evidence is not evidence of absence.

But we have evidence about respiratory viruses and masks, and it all says they don't work.

We even have the beginnings of evidence coming through for SARS-CoV-2. They got people who have covid to wear a mask and cough on a petri dish. Covid escaped the masks.

> But we have evidence about respiratory viruses and masks, and it all says they don't work.

What? Medical personnel regularly utilize surgical masks against respiratory viruses spread by droplets successfully.

They're less useful against aerosolized stuff like measles, but SARS-CoV-2 is primarily spread via droplet.

Your first paragraph is a blatant strawman on the argument presented here in the comments.

Reply on news.ycombinator.com