I think this is probably the most interesting part, and worth watching in future studies.
I think this is probably the most interesting part, and worth watching in future studies.
Would be great to see numbers for N95 masks. Intuitively I'd assume they'd be much more effective as they have better fit + higher filtration, but of course, confirmation would be great.
Fits with what we're seeing in Europe such as airlines banning cloth masks, though.
The great incoherent idiocy of anti-* Americans on the issue of masks has always been that they say "cloth masks are ineffective" and propose a solution of "do nothing" instead of "get effective masks."
Just want to add clarification here. The 11% number is the community impact of the programs designed to increase mask usage. It is not the effectiveness of a mask on an individual level. That number will be much higher since as you said a number of people didn't/don't comply at a societal level.
...or it will be lower. The study confounds the effects of distancing and mask-wearing. Distancing was higher in the surgical mask cohort. Also, as others note, the confidence interval for the surgical mask group overlaps zero. You can't rule out that the observed effect is due to chance.
this is why mask mandates, as currently constructed, are misguided and ignorant at best. the mandate should be to wear a mask when you're intimately sharing air (within ~3ft/1m) with another person indoors. the reason we don't have that sort of mandate is because it would mean we'd have to wear them around friends and family rather than those gross strangers who are out to kill us with their ignorance and malice (they're not).
this is also why the current mandates for restaurants (and most retail) makes no sense, as we're only going to be intimately sharing air with our friends and family in those places anyway.
I thought that was the whole aerosols debate that's basically settled by now, i.e. virus can stay suspending in the air for extended periods. With the Delta variant's characteristics this is also a much bigger problem (i.e. the same indoor space that might have been ok is no longer ok).
There were early studies with the less infectious variants that showed how people situated far from each other in indoors spaces infect each other.
So the mandate for masking in any common indoor space seems to make a lot of sense.
that's why a mask can work (better than distancing) in that one particular situation, but distancing is a better general mitigation.
by the way, those early "studies" on long indoor spread were conjecture-based (e.g., using models), not rigorous science, and have failed to replicate.
Also: https://www.the-scientist.com/news-opinion/ferret-study-rein...
Even early on with the Diamond Princess you've seen wide spread of the virus despite passengers being largely confined to their cabins. There were multiple other examples.
We also know the Delta variant is more infectious.
I'm not saying distancing doesn't work. Even if you assume the virus is spread in the indoors air it's not a terrible bad assumptions to think that a person emitting virus continuously will have a higher concentration of virus in their immediate vicinity. So sure, it's layers of defense. The mask is also about limiting the emissions in the first place and distancing indoors is not always practical in public busy spaces.
But sure. It is not settled science. Science takes time. If your point is that we don't understand exactly what happens then sure, but we rarely do for anything in this field anyways.
but yes, viral concentration is higher near an infected person, but it falls off rapidly (to something like the 3rd power iirc) with distance and time, especially the latter of which being why incidental exposure in public places is unlikely to be material. it's also something a small minority of people have at a given time (on average less than 1% of those around you). it's mainly socializing for extended periods of time where masks can potentially help reduce infection (that's when we're also most likely to let our guard down).
i'd go so far as to posit that sociability (via variables like social graph size/breadth) is likely more correlated to infection than (the lack of) mask usage.
>The intervention increased proper mask-wearing from 13.3% in control villages (N=806,547 observations) to 42.3% in treatment villages (N=797,715 observations)... Physical distancing increased from 24.1% in control villages to 29.2% in treatment villages
Mask wearing increased 218% while distancing increased by 21%. I agree this is not proof specifically about masks, the study is about specific public policy programs and not mask wearing in general, but it certainly seems like masks wearing is the biggest contributor to the reduction seen.
You can't just compare "percentage change" of two wildly different things, and leap to the conclusion that the magnitude of change is causal. It begs the entire question: if physical distancing works well, and mask wearing does not work, you could increase mask wearing by whatever percentage you like, and a smaller change in physical distancing would still overwhelm it. We don't know.
But aside from that, you skipped over an important part of what I said: distancing was higher in the surgical mask group. See Table 2.
There's nothing in the study remotely suggesting that masks have no effect. Instead the study shows that mask wearing combined with other factors have a clear and unquestionable correlation with reduce Covid spread.
Even if you wish to nitpick the contribution of mask wearing in the reduction in Covid spread, it makes absolutely no sense at all to jump to the conclusion that surgical masks have no impact in spreading airborne pathogens as that's precisely what surgical masks do and the whole reason why they are extensively used by the medical community for decades.
The study shows that cloth masks (combined with other factors) have no effect on seroprevalence. It shows that surgical masks (combined with other factors) has a small-but-significant effect on seroprevalence. The confidence interval on the surgical mask group overlaps zero, so you can't rule out "no effect". At these small effect sizes, you also can't rule out the role of confounders -- it's possible that behavior change could explain all of it.
In short, neither result is "clear and unquestionable". An accurate description of the results are that they are "weak and debatable".
No, not really. If you happen to take a few minutes to read the paper, you'll notice that the study was conducted with a type of cloth mask produced locally which had a filtration efficiency rate of around 37% with a standard deviation of 6%, compared with the surgical mask's filtration efficiency of 95%.
The study also points out that the filtration efficiency of surgical masks washed 10 times with soap was 76%, and that they evaluated a type of cloth mask which can achieve a filtration efficiency of 60%.
Thus, what the study actually states is that they observed that wearing poor quality cloth masks showed high-variance results whose confidence interval includes the point estimate for surgical masks.
In other words, the study actually pointed out that using a specific type of cloth mask produced locally and which was known to have poor filtering efficiency had an effect that lies somewhere between being as good as surgical masks and not wearing anything at all.
> The confidence interval on the surgical mask group overlaps zero, so you can't rule out "no effect".
No, not really. That's not how confidence intervals work. At most, the only conclusion you can objectively draw from the data is that even though the positive effect of wearing surgical masks in the past study is clear and beyond doubt, further studies would be required to increase the resolution of that estimate.
In fact, if you happen to read the study you'll notice that the conclution states quite clearly that "We found clear evidence that surgical masks are effective in reducing symptomatic seropreva- lence of SARS-CoV-2; while cloth masks clearly reduce symptoms, we cannot reject that they have zero or only a small impact on symptomatic SARS-CoV-2 infections (perhaps reducing symptoms of other respiratory diseases)."
Also, your comments feel like a mix of moving the goalpost combined with a considerable amount of cherry-picking. It's a widely known fact that the whole point of wearing masks is primarily to reduce the viral load emitted by the wearer, and a minor benefit is to reduce our own exposure to the virus. Thus I feel that you're trying to misrepresent the whole point of wearing masks by trying to frame it as a "seroprevalence" issue. That was never, at any point in time, the reason why we have the social obligation to wear face masks and respect social distancing.
I read it, thanks. The mask they used was much better than what most people are wearing:
> The cloth mask had an exterior layer of 100% non-woven polypropylene (70 grams/square meter [gsm]), two interior layers of 60% cotton / 40% polyester interlocking knit (190 gsm), an elastic loop that goes around the head above and below the ears, and a nose bridge
If a cloth mask with three layers of different materials and a nose bridge is dramatically less efficient than a simple surgical mask, then that's pretty damning for the whole idea of a cloth mask, in general.
Can you give a citation for that? I think you might be in a strange place. Here nearly everybody wears surgical masks, most people were 2 : a surgical and cloth mask.
Also I'm interested in an experimental design or study design you would find acceptable. I saw your comments now on 3 papers showing evidence for mask wearing. It seems you are moving goal posts ever time.
Normally you would expect effective contagion control measures to have an exponentially larger effect at a societal level than it does at an individual level, even if you don't reach the critical threshold to stop the epidemic: if you can drop R from 2.0 to 1.9, that reduces your individual risk by 5%, but it also reduces the number of cases in the next generation by 5%, the number of cases in the generation after that by 10%, the number of cases in the generation after that by 14%, etc. After 20 generations of transmission you've reduced the number of cases by 64%, which reduces everyone's infection risk by 64%. Of course, with such a high exponential growth rate, that only means that people get infected 1.6 generations later at that point, but if you're comparing different communities at the same time, the difference is about 3:1.
So it seems like probably the effectiveness of the mask on an individual level was truly tiny.
4636 deaths as reported by the CCP to foreign journalists. Same party whose official line is that nothing happened in Tiananmen Square.
That number is completely laughable. It's literally communist propaganda.
Isn't this dependent on the assumption that the risks are reduced uniformly across society? Lockdowns/quarantines are the obvious counterexample. Someone going into complete lockdown reduces their risk to practically zero. However a small group of people doing that won't have much effect on the societal numbers. Therefore the societal reduction is much less than the individual reduction until that R value drops low enough.
I'm not sure if people remember: but there was a shortage of masks of all kinds in March 2020. Cloth masks were the only thing we could get, and we all knew they were kind of crap (a lot of us were using coffee filters stapled onto the masks to increase its effectiveness).
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Now that the N95 shortage is over (at least, I'm buying N95 duckbills at $1 each these days), I think its time to seriously consider using N95 in the public. At least in America, where we seem to have suddenly a huge influx of N95 availability this year.
Going for full N95 means that the strap goes all the way around my head and is way more comfortable for extended use (ex: airplane rides or whatnot)
I'll admit I've tried the plastic & velcro ones and didn't like them - but I also don't wear them for hours at a time but just for quick trips so found them annoying to put on and off.
Where I live, N95 masks are mandatory in public transport since February, and it's really uncomfortable to be in an non-airconditioned metro car which is full to the brim, with water running down the windows from condensation. That's totally acceptable with surgical masks, but there's a face melting heat under any N95 mask in this condition :-D
Of course I wear them as mandated, but I really hope we can switch back to the more practical surgical masks soon, with enough vaccinations :-)
(Or that there is an early onset of winter :-D)
It was definitely hard to find the good stuff at first - and I was much more reclusive as a result too - but yeah, things have changed.
I wish people wouldn't respond to changes in policy/advice as evidence of "lying" before, as much of it has just been learning more. (Though the "we're gonna tell people they're ineffective because we want to reserve them for professionals" thing was a huge unforced error, IMO.)
https://accumed.com/30-pack-fda-cleared-niosh-n95-surgical-r...
These straps kinda suck though. I recommend carrying a few extras somewhere since the straps may snap throughout the day. I'm still looking for a better mask. For all of its faults, this one is available today and at the promised $1 price too.
The BNX duckbill masks used to be $1 per. But they seem sold out. Keep an eye on them just in case they come back into stock. https://bnx.com/products/bnx-50-pack-n95-mask-respirator-nio...
The Kimtech 53358 Duckbill WAS $1 each just a month ago. But their prices suddenly skyrocketed to $1.50ish from most sources. EDIT: If you buy 300 of them, you should get close to the $1/each price, but I want to "test" them before dropping $300 buckaroos on it...
EDIT: WB Mason is selling the Kimtech Duckbills at $50 per 50-pack, so that's $1 each: https://www.wbmason.com/ProductDetail.aspx?ItemDesc=Kimtech-...
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I'm not sure how much I trust Amazon's supply chain for proper N95 / NIOSH approved products. A lot of Amazon's stuff are 3rd party shippers and/or 3rd party suppliers instead of official sources, and comingling is an issue.
If its $1.50 from a proper medical store, then the $0.80 price at Amazon is probably too good to be true. If we're paying extra for the N95 rating, I'm willing to pay extra for proper supply chain.
Home Depot sells this 20 pack for $24 from 3M. That’s $1.20 each.
The told me I can gladly travel 30 min back to the store and wait in line for a refund. No thanks.
I think the "no nothing" solution has more to do with a desire to return to normal than it is a refusal to "get effective masks" and just wear them forever or until some agency says not to anymore. There is a valid point to be made that once you're vaccinated and most people around you are vaccinated it's time to start learning to live with the reality of covid being a mild disease you get once in a while. I suppose a masked up future is one of better public health for some, but for many it is psychologically exhausting to see your friends and coworkers as potentially dangerous vectors of contamination. This is especially dystopian when the government forces you to do this whether it's sensible or not.
The people pushing N95 mask requirements are not the same people required to wear them 40 hours a week. The people pushing non-N95 mask requirements are confused about the effectiveness of non-N95 "masks".
So the governments are optimizing for this (forcing us to do X) ... not for the individual but for public health and public (general) concerns. Just like they're forcing us (and fining us, darn!) not to drive through red lights, or exceed the speed limit. Are they always doing a great job? nope, but hey we voted for those guys (at least in functioning democracies)...
So here we are.
I think that is really hard to say.
IF they are properly fitted (that won't normally be the case).
As I see it (as well intuitively) if the virus is transmitted "directly" by droplets then cloth, surgical or N95 won't make much difference from a clear plastic shield (as we have seen many in hospitals wear, besides the masks), while if it is transmitted by aerosol the filtration capacity changes matters greatly.
Point is whether a (poorly) fitted N95 does actually protect more than a surgical mask.
Since a N95 is "harder" to breath in (as it filters much more), it is possible that a lot more non-filtered air comes from the (poor) fitting gaps.
In my personal case I have (now) a beard and #1 lesson when years ago I was taught how to wear a N95 (actually a FPP2, almost the same as N95) was that you had to be cleanly shaven, and - besides that - I had to try some 5 or 6 different mask models before finding a suitable one (the mask shape need to be suited to your face shape for a proper fit).
This is a pet-peeve of mine, but noone actually wears N95 masks properly: https://news.ycombinator.com/item?id=22728367 https://news.ycombinator.com/item?id=23957506
I wish early in the pandemic someone would have made some piece of equipment to asses whether a given cloth mask is good or not. Most people have a few now and I'm sure they would like to use the best one.
I guess the point is "not certified".
On the other hand I would like to opt out of this exercise, since I'm totally not concerned with COVID.
And then there's long Covid. . .
So yeah, sheesh. It's hardly any worse than taking out several nations worth of people with VX.
According to the original article, masks do change this fact.
The paper does not say this. It shows an 11% reduction in spread in the group that was encouraged to wear surgical masks. Masks were not mandated, only encouraged. It also shows that 5 months after the researchers stopped encouraging mask-wearing, compliance dropped by 14%. So masks reduce the spread, and encouraging people to wear them leads to higher compliance.
No idea if they're all ~10% effective, nor if you can just add percentages up like that... but it's not hard to list measures we can take, both individually and as a society.
We know that R of covid in a naive environment is probably more than 4. So any group of measure that dont reduce it 1 is not going to be enough. There is no 1.05 in reality for covid. When you are at 1.05 it is already because of group of measures are in place
Ah and here I was thinking you thought those weren't effective. Ok, sorry.
https://www.npr.org/sections/goatsandsoda/2021/08/11/1026190...
There is no plausible way to bring it below 1 for an extended period of time. The most we can do is slow it down a little.
The 6-7 range would be in a theoretical environment where nobody is vaccinated, there are absolutely no countermeasures and the number of opportunities to spread is equivalent to the pre-COVID days. Obviously, we do not live in that world.
In short, R0 is not a property of a particular virus strain but of the sum total of virus + all factors relating to population, behavior etc.
It is also best determined afterwards the way it is being treated right now as though it is some kind of input variable which can be controlled for is fundamentally wrong.
The relation between transmission and cases is not exponential as :
1. Cases can't go to infinity
2. R is variable, and actually changes a lot for plenty of reasons
More compliance, much increased results than that 11%.