Hacker News Reader

Comment by marcell | Hacker News Reader

Those two studies you cite aren't strong scientific evidence. There is no control group, so we don't know what would have happened if they had not been wearing masks. Also the sample size is quite small (n=2 across the two studies).

I've seen some studies that have good controls on influenza, in particular there is a college dorm study that compared no intervention vs. masks vs. hand washing: https://www.cidrap.umn.edu/news-perspective/2010/01/masks-pl... . This specific study doesn't give strong evidence that masks stop influenza spread.

Also, the individual rights argument is pretty strong. If mask wearing is already at 70% without any government mandate, I'd want really strong evidence and strong reasons to justify government intervention just to push that number a little higher.

View on HN

The individual rights argument is not pretty strong. Here’s a partial list of things I did today for the sake of my neighbors/community that are also government mandated:

- Wore a shirt

- Turned on my headlights and used my turn signals

- Held on to my empty coffee cup until I got to a trash can when I could have just dropped it on the ground

- Kept my dog on a leash and picked up his poop

- Parked in a parking spot instead of conveniently stopping my car in the middle of traffic directly in front of the grocery store door

I’m sure there are plenty others. Being a member of society comes with a lot of privileges and a handful of obligations but it only works if we all do our part. No freeloaders, right?

Edit: An extra word

> - Wore on a shirt

Where do you live where this is government mandated?

I’m a woman so my nipples are criminalized in most of the United States.

That's terrible. I'm glad that this is not the case here in Canada. It does make no sense whatsoever for it to be like this in the US. I agree with your other examples, but this one is clearly unjust and should change.

In many parts of the U.S., it's not actually illegal for women to be topless, they just don't. It is often a requirement for a liquor license, however. For example, where I live in Austin, Texas, state law does not prohibit a woman being topless, and Texas is not generally among the most liberal of states.

Proactively mitigating the abuses that would emerge from a state that doesn't need to encourage more low paying jobs that have a very high rate of sex trafficking? At least the Bud Light at the strip club isn't $12 like that place I went in Las Vegas.

Just wanted to add that it's legal for women to be topless in NYC. There's even a celebration day for it at the end of August.

It's legal statewide and specifically because it would be unfair for men to have the exclusive privilege.

If you’re a woman this might be considered indecent exposure in many parts of the US unless you’re at a beach or in a resort town.

In stores pretty much anywhere.

That's not government mandated.

But the anti-maskers insist on having the right to not wear a mask in stores as well when the business has clearly marked masks are required and staff ask them to leave.

If the anti-maskers respected the rights of others around them as much as they insist on others respecting their rights, this would be nearly a non-issue.

I had assumed it was state laws for ostensible health reasons. But it turns out to have sort of an interesting history and, as you say, apparently isn't legally mandated in any state according to this article: https://people.howstuffworks.com/where-did-shirt-shoes-requi...

>- Wore a shirt

I still insist you wear chaps on top of pants or your short trousers. Pants are fashion, chaps protect.

These are objective concessions. Most of these concessions took tens (or thousands) of years to become objective.

In the case of masks, you have a big change in human tradition. There are very few societies that have ever required all people to wear masks all the time. I can't think of any examples. A small handful of modern societies require it for specific subgroups, but that's it.

Generally, extraordinary claims require extraordinary evidence. In the case of masks, I want to see very strong evidence that masks are very necessary, and other approaches wouldn't have similar or better results with lower change to human tradition. So far, I haven't seen that at all. The scientific evidence that masks are effective or necessary is weak. Alternate approaches (eg. wearing a mask if you're symptomatic, staying at home if you're symptomatic) may be just as effective.

The examples you cite have roots in human tradition, and have been established for many years, mostly with strong evidence.

In the case of seatbelts, you have a big change in human tradition. There are very few societies that have ever required all people to wear seatbelts all the time. I can't think of any examples. A small handful of modern societies require it for specific subgroups, but that's it. Generally, extraordinary claims require extraordinary evidence. In the case of seatbelts, I want to see very strong evidence that seatbelts are very necessary, and other approaches wouldn't have similar or better results with lower change to human tradition. So far, I haven't seen that at all. The scientific evidence that seatbelts are effective or necessary is weak. Alternate approaches (eg. improved driver training) may be just as effective. The examples you cite have roots in human tradition, and have been established for many years, mostly with strong evidence.

You still have freedom loving individuals in places like New Hampshire who embrace beltless freedom, or even more stupidly riding motorcycles without helmets.

At least in those cases, that “freedom” usually kills only them when things go wrong.

Well, seatbelts aren't the be-all, end-all, either... And people have indeed complained about them when they were mandated. So, it's not like "one could say the same thing about seatbelts, so look how absurd it is". Someone else might easily reply "my life, my choice" about wearing one (same as for drinking, smoking, over-eating, etc).

But even so, we can consider seatbelts as a necessary wearable/accessory for car use, which is also a recent development (cars and driving). Masks are different in that they affect people going on about doing things people did for millenia without requiring a mask.

https://youtu.be/9_Af8w2SAT4

What harm will befall people who see my breasts and what strong scientific evidence can you provide to substantiate that theoretical harm?

Usually the root of the argument boils down to your exposed breasts will titillate men and cause them to act out of the lust in their heart. If you dig, you’ll often find statement to that effect made by the legislators or lobbyists responsible for laws against exposure of breasts.

It contrasts with professed love of freedom, but humans are always creatures of paradox.

Then we should also ban advertising, because it causes people to act out of envy in their heart.

Doesn't have to be "scientificaly substantiated" harm.

Killing someone is not a scientifically substantiated harm either. Of course we harm the other person's health (that's objective), but that in itself is only bad in the sense that "life is good" and "we should respect life / not kill". And that is not a scientific argument but a moral one. The universe doesn't care either way.

What does "scientifically substantiated" mean to you?

The same thing anybody would understand by the term. Did something gave you a different impression?

That there's a scientific proof that harm is being done by an action.

But harm is a moral term, and science is not about moral judgements. It can help inform them, but the guidelines for what is "harm" or "good" come from morality ultimately.

E.g. what is "good for society" is based on a value judgement / decision by said society based on its goals, what it wants to conserve or change, etc.

Science can tell you that X technique is more productive for example. But whether "more productivity" is desired is a matter of social values/priorities, not a scientific matter.

To be honest that topic people can debate. Men are allowed to walk around without a shirt. Women breastfeed in public pretty frequently.

There is however a long history and tradition of humans wearing clothing to cover their genitals. Even very primitive societies have this norm, and it has pretty obvious reasons behind it.

United States, 1918.

Instead of projecting arrogant puffery, why don’t you think about the potential consequences of prioritizing your comfort and self aggrandizement to people whose lives are put in danger.

I have a neighbor who unknowingly was infected early on and likely infected several of her elderly clients, most of whom are now dead. She is devastated... think about how you will feel if you did the same thing, without the innocence of being ignorant.

> There is no control group, so we don't kno

It is unethical to have a study with a control group which involves a live virus.

There is enough evidence that masks are effective that they should be required until it's proven they are ineffective or the virus risk is reduced.

There are doctors, experts and even whole nations that disagree with you that there is evidence masks are effective.

This is the problem with arguments like this. It inevitably turns into a fight over who gets to pick the evidence and experts, as there is always reasoned disagreement.

Heck, China is an existence proof that mask wearing doesn't stop the virus in any meaningful way. Sample size, a billion. Checkmate. Are we done?

China, Hong Kong, and Taiwan all have lower infection rates than we do, and one of their biggest ways of controlling it has been masks. Taiwan in particular has never had more than a few cases and they are near neighbors to the epicenter of this whole thing. They controlled it by cutting off travel and using masks and they've never had to do a shut down.

You don't actually know that using masks cut it down, you're just assuming it.

You're also assuming the Chinese numbers are reliable, etc etc. I mean there are just so many ways to slice it. Suffice it to say, COVID happened in China despite widespread mask wearing. If you want to prove masks work it'd take a much more rigorous analysis than cherry-picking countries and attributing their numbers to masks, that's my point.

Where is this evidence? Is this evidence for n95 masks, or the cotton nonsense most people wear?

>I'd want really strong evidence and strong reasons to justify government intervention just to push that number a little higher.

Why?

Look I know we've all heard the Friedman quip about temporary government programs, but that refers to normal situations. It's one thing when a program might drop off the political radar and outlast its mandate by decades, but in the case of COVID-19, there is absolutely no way on Earth, at all, that people could just forget that it happened. If the COVID-19 pandemic were a war, it would already rank among the 50 deadliest ever.

Our rights are not devalued in the long term by rapid action in a pandemic which, by the best available estimates, could kill over a million Americans if left to run unchecked. They are not devalued in the long term because it is always going to be easy for people to know whether we are experiencing this kind of emergency. The loudest deniers on Facebook are not representative of the population: most Americans do recognize the threat, despite one of the largest disinformation campaigns in human history.

So what if there's a small chance we might be too strict about masks? It's not a large injustice, and it's not a slippery slope.

> So what if there's a small chance we might be too strict about masks? It's not a large injustice, and it's not a slippery slope.

It very strongly depends on exactly how the mask requirement legislation works. If it's "all persons in a public in the state of California must wear a face covering until December 31, 2020. Failure to do so will result in a fine of no more than $150", that's probably fine. People will still complain, somewhat justifiably, that this legislation is safety theater rather than an actually useful law, but in the grand scheme of things it just wouldn't be that big of a deal. However, if it's "any person who knowingly performs an action which endangers the health or well-being of others is subject to a fine of up to $10,000 or 5 years in prison", we now have yet another law that most people are arguably in violation of at least some of the time, which allows bad actors in government to impose enormous pressure to comply with unreasonable or illegal demands under threat of large fines or jail time.

I personally worry quite a bit that something more like the second will be passed, and will be very selectively enforced.

The state of New Mexico currently mandates the use of masks while in public with the penalty of a small fine (I forget the exact amount, but it’s only a couple hundred dollars). So in practice, the former is what is already being done. And yes, people do still complain, but as far as I can tell almost everyone complies.

> There is no control group

There's no ethical way to do a control in a study of infectious diseases. You'd have to mandate that some study participants not wear masks, when your hypothesis is clearly they the masks will keep some of them from getting sick or dying.

You're asking for far too much here. Masks are known to stop disease spread from (literally) centuries of use. We don't have to throw all that intuition out with covid, even though the numbers may change.

And again: why should we have to prove this technique via completely impractical research constraints when it is very likely that it helps, in a situation of dire urgency.

This is such an asinine comment. What’s the need for any law, since ~70% will comply anyways? And this of all cases? Where a few rogue “super spreaders” can give it to thousands of people?

>What’s the need for any law, since ~70% will comply anyways?

Codifying morals is done for the purpose of having cheaper and fairer enforcement.

Wearing pants would be higher than 70% without government mandate -- does that mean that a law that you must have your junk covered an impingement on individual rights?

Of course. So is having to wear a mask.

A mask is justified in the short term, the fact that you don't want to see my junk rates no higher than me not wanting to see your sportsball t-shirt. Unfortunately one of them is illegal and it isn't the sportsball t-shirt.

Sorry, but this doesn't sound like "no strong evidence":

Without adjustments for other variables, the two intervention groups had about a 10% reduction in overall ILI incidence over the 6 weeks compared with the control group, but this was not statistically significant.

However, when the researchers analyzed the ILI rates for each week of the study and adjusted for other variables (age, sex, ethnicity, baseline hand washing practices, sleep quality, alcohol use, flu vaccination), they found that the FMHH group had significantly lower rates than the controls in weeks 4, 5, and 6 (35%, 44%, and 51%, respectively).

The adjusted rates for the mask-only group also were lower than those of the control group in weeks 4, 5, and 6, with reductions ranging from 28% to 42%, but this did not meet the authors' significance criterion of P<.025.

The authors say several factors may explain why a significant reduction in ILI was found only during the second half of the intervention period. One is that recruitment of students continued through the first 2 weeks of the intervention, increasing the sample size by 11%. Also, the proportion of FMHH participants who wore their masks more than the average 3.5 hours a day increased in the later weeks of the study, and confirmed flu cases on campus peaked in weeks 4 and 5.

Well, it depends on what you think is "strong" evidence. A 10% reduction doesn't seem very compelling, and when you introduce the more advanced statistical analysis, that hurts the case in my eyes. There are probably less disruptive ways to get a 10% reduction.

I found that study from this meta study here: https://pubmed.ncbi.nlm.nih.gov/20092668/ which reviews a lot of these studies for influenza. Note, however, that most of the studies only look at if the masks protect the individual, not whether masks stop the spread of influenza, but the evidence seems pretty inconclusive.

I agree that 10% reduction is not much in normal situation but not when ICU are at capacity or economy is shut down.

Results from weeks 4, 5 and 6 are interesting. Another study could see if this can be reproduced.

If we’re having this much trouble sorting out individual egos and absolutist ideologies with masks, where the choice is so simple and risk-free, we are REALLY going to be in the soup when vaccines start to come out.

The individual rights argument is based on community norms so if it's 70% already it becomes weaker, not stronger.

Reply on news.ycombinator.com