Missouri found mask mandates work, but didn’t make findings public | Hacker News Reader

Missouri found mask mandates work, but didn’t make findings public

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234 pointsnojito339 comments

I live in Japan and everyone here wears a mask, but more importantly, wears them properly. Many Japanese people are already attuned to wearing them during flu season, and everyone wears them if they think they are getting a cold so it's no big deal for everyone to wear them the whole time, kids included. I'm not Japanese, but I get with the program and after a while, you don't notice it.

Masks are, of course, effective. Again, if you wear them properly and constantly, and everyone wears them.

The people who DON'T want to wear them and who wish to make it a political act will dredge up all sorts of B.S studies and data showing that "mandates" don't work and therefore extrapolate from that that masks themselves don't work, when any examination of the scene will show 60% of people wearing them 60% of the time, noses hanging out, lifting them up to talk, only putting them on when they've taken a few steps into the shop etc etc.

Masks work. If you wish to be honest about it, you'd say "They work, but we can't get our citizens to wear them."

How much of a mask's effectiveness is due to the physical barrier? and how much is due to it's role as a uniform, promoting conformity with other anti-covid behaviors in the group?

Mask effectiveness is to help prevent you spreading things. When you exhale, water droplets are still quite large and some will get caught on the fibers in even a t-shirt mask. After that has dissipated in the air, it will be smaller and will be breathed in through all but the best masks. There were lots of videos online when this became an issue where people showed how when it is really cold, you can "see" your breath (this is solely caused my warm moist air condensing into a "cloud" in the cold air). Put on even a crappy mask and you can't "see" it anymore. Sure it isn't 100% blocking but clearly is blocking moisture. Also, if you wear a heavy mask for a while, you will notice that it feels damp inside.

I keep repeating this to mask-skeptics (which in my country is nearly everyone): Asia had their Sars-scare early, and they've basically been wearing masks ever since. They're doing pretty OK, not just because some countries (e.g. China) can and will _really_ lock a city down. Masks, hygiene, sickness discipline... they work. But even now nearly nobody objects when a colleague is obviously ill and still bring their snotty nose to work, COVID-free or not. I wish people would regard this like we regard washing our hands. But no, somehow people seem to think we've always washed our hands, and we have never changed our ways, and we shan't right now either because of freedumb. Uggghhh.

Nonsense. Have you ever actually been to Asia? The vast majority of people haven't been wearing masks since the last SARS scare.

East Asia seems to be pretty good at wearing them, but youre right: Asia is a big place.

We have no idea of knowing how China is actually doing, since they haven't reported a single death since April *2020*. And even the numbers they have reported are highly unlikely to be accurate.

I was specifically not talking about China, it seems I wasn't clear enough. Taiwan, Japan, masks are common in either.

Sorry, you specifically called them out ("e.g. China") so I thought you were focusing on them.

> We have no idea of knowing how China is actually doing, since they haven't reported [...]

That assumes that the only way we could get information is by whatever China reports.

In reality there are a large number of people from Western countries who spend a large amount of time in China and regularly interact with the population. There are business people there to deal with Chinese factories that make their good. Many Western companies have offices in China. There are diplomatic offices [1].

That puts a limit on how much China can successfully downplay mass events like a pandemic that affect the population at large because there are too many independent observers interacting with the population with means of communication to outside of China that China cannot block or censure.

[1] The US has an embassy in Beijing as do 172 other countries, and consulates in Guangzhou, Shanghai, Shenyang, and Wuhan. Most of the biggest EU countries and Japan and South Korea also have several consulates there.

You say that like people doing business in China never self-censor.

Can we please give this China hard lockdown success story up?

There are no hard lock-downs in a face-dictatorship. There is a hard lockd-down show. Some doors are welded shut for tv-cameras. Covid Quotas are handed out to doctors and the rest becomes pneumonia.

Similar: Before the iron-curtain fell, sovjet propaganda claimed they were economically the more successful side. This did not hold up - at all.

State propaganda produces the illusion of working measures, while the normal citizen just bribes or work otherwise around the restrictions. What you see publicized by the state media to youtube or face-book is not real or reality.

Its a "strong" government fantasia, produced by the people who run it. There are no "free" opinions by mainland citizens on the web.

I wasn't clear. I meant to exclude China from the discussion for precisely the reason you mention.

When March 2020 hit, I was really hoping that Asian mask culture would finally hit North America and people would choose to wear a mask when they have a cold or other illness, even post-COVID.

Unfortunately it seems to have completely gone the other way in many parts of the USA and Canada thanks to politicization.

The Bay Area has been under a mask mandate for 17 months now. I’m not sure what the criteria of “working” is, but I would define it as returning to pre-pandemic norms. Yet, we are still far from that.

If however your definition of “working” is “prevent hospitals from being overwhelmed” or some other less ambitious criteria, then sure, it can be claimed that mask mandates work.

>I would define it as returning to pre-pandemic norms.

Magically fixing everything is a completely unreasonable threshold to define whether a health measure "works".

Also the pre-pandemic norm was not to wear a mask, so according to you mask mandates definitionally cannot "work".

> Also the pre-pandemic norm was not to wear a mask, so according to you mask mandates definitionally cannot "work".

The idea is we wear a mask for a temporary amount of time, eliminate community spread, and eliminate masks. Countries outside of North America have done this. For example, the UK is just now requiring theater goers to wear a mask again.

> ... and eliminate masks. Countries outside of North America have done this. For example, the UK is just now requiring theater goers to wear a mask again.

If the act of eliminating masks needs to be followed by imposing another mask mandate, this is not a solid argument that mask mandates can be successfully rolled back when some threshold has been crossed. (I'm reporting from Indiana, where there is no mask mandate, unless you're unvaccinated, and there is no system in place to tell vaccinated from non folks except for what amounts to basically, say so on your honor! :upside_down_smile:)

Well, again, it's just unreasonable to expect masks - alone - to completely eliminate community spread. You've got to think in terms of the reproduction rate R. If it's above 1 you're losing, if it's below 1 you're winning. Each measure, like mask wearing, knocks a little fraction off R. The goal is to knock as many little fractions off as possible. It's totally possible for masks to "work" in the sense of knocking a worthwhile chunk off R, and yet have the public health strategy as a whole fail to bring it below 1.

The trouble is, managing R is an ongoing challenge. If you manage to get it below 1 and the rate of new infections decays to nearly nothing, great! But unless you completely shut the borders to prevent new seed infections, you have to keep doing whatever you were doing. If you relax, then R goes above 1, and exponential growth does its thing again and you're back where you started. There's a natural ceiling to the exponential growth - nobody quite knows why, though it's presumably something to do with acquired immunity - but it's a grim place to be.

I wouldn't look to the UK as an example of how to manage a pandemic. It has been bouncing along its infection ceiling ever since all measures were relaxed in July. I predict that the new mask mandates will have no detectable effect on infection rates; their modest effect on R will fail to bring it below 1, and rates will continue to "bounce along the top".

The reasonable definition of "working" is "reduces rate of transmission relative to comparable areas with no mask mandate, by an amount that is statistically significant", and it certainly meets that definition. When people argue that mask mandates "don't work", what they really should be saying is that the effect size is too small to justify the inconvenience. At least that's an actual argument, though I think the people who make it are whiny babies.

Masks may "work" to a limited extent to reduce the risk of transmission in any single interaction, but in the long run that won't save anyone. The virus is now endemic and almost everyone will eventually be exposed regardless of public health measures. You can't seriously expect asymptomatic people to wear masks in public forever.

https://www.medpagetoday.com/opinion/vinay-prasad/94646

So what are the exit criteria?

I kind of like them so I just might. I haven’t had a single cold for 2 years.

> You can't seriously expect asymptomatic people to wear masks in public forever.

why not? I enjoy foiling facial recognition efforts, and those efforts are everywhere. I probably won't ever stop wearing a mask in public.

because there are a lot of people that feel the exact opposite of you - i dont ever want to wear one again!

> i dont ever want to wear one again!

Why do you feel so strongly about this? Masks of a few kinds are standard PPE in many fields, it's not like they're particularly restrictive or anything.

Those fields people choose to join, they made the decision to accept that requirement. Plus as others have said in the grand scheme it's not the most effective Solution. Remote work, contactless services and other similar initiatives would yield a higher success and would reduce other things like crime and environmental impacts, why not pursue that or a contactless society instead if the goal is to prevent transmission

Why not both?

Nobody should have to justify why they don't want to wear a mask, the same way nobody should have to justify why they do. Justification is needed when you want to force your opinion on others.

>Nobody should have to justify why they don't want to wear a mask, the same way nobody should have to justify why they do.

Consider you are doing UX design. You wrote some software that helps your customer, but they won't use it. Why won't they use it? How can you improve it? What alternatives can you implement to keep the benefits that you are trying to give to your customers while also making the product "acceptable"?

Short questions like "why won't you use masks?" Can come off as antagonistic (e.g. shame on you! Just use the Fing mask), but they may also be inquisitive (e.g. what concerns do YOU have with masks). This being HN, I prefer to assume the intent is the latter.

You are correct, of course. And if the parent I replied to was simply being inquisitive, I apologize for my tone. But in the current climate, it's hard for me to read it that way without it being specifically pointed out.

when their refusal to do so in the public sphere endangers others. indeed they do need to justify it.

I have a family member who is a surgeon who is obviously accustomed to wearing a mask frequently in her job, but now that she has to wear it 100% of the time at work she finds it particularly exhausting and rips it off as soon as she is done.

>Why do you feel so strongly about this?

From a practical point of view I think that the plastic ones are probably going to be horrible from an environmental perspective - especially to the marine environment which is where a lot of plastic litter ultimately ends up. I'll admit there's also an element of iconoclasm involved in why I'll be keen to see the back of them when their times comes. From a purely symbolic point of view (ie regardless of their effectiveness) they're quite a dystopian thing in my opinion, it's a signal of "be afraid of disease" or worse still "my fellow human beings are disgusting plague vectors". I can't help that feel that making hiding our faces a permanent social norm would lead to society becoming even more atomised than it already is which is also fairly dystopian.

On a purely personal note, I also don't like that they give every moral authoritarian and insufferable busybody yet another thing to harass strangers about, especially when legal penalties for non-compliance exist.

I live in a warm/hot climate and they are very uncomfortable when it's 90F+ outside. Vaccines are available to everyone in the US, and I'm double vaxxed, everyone I know is double vaxxed, and I'm not afraid of getting COVID -- why should I wear one?

If people want to wear one for the rest of their lives (I doubt they will), have at it. If it is to avoid facial recognition, I guess I get that but have to understand that in that situation you are in a tiny minority of people willing to cover your face in defense of your digital privacy. (Look around you, 90% of the people are uploading themselves to TikToc without a care in the world)

At this point, the masking mandates in the US makes absolutely no sense either. If you fly on a plane, you are allowed to take your mask off to eat or drink but then have to put it back on when your not doing either, as if COVID disappears when you're eating. You can cross state boarders without being tested, etc.

We need to start learning how to live with COVID, because zero COVID is no longer an option. That ship has sailed.

> as if COVID disappears when you're eating

No, but you can't really eat with a mask on so keeping it on for the entire rest of the time minimizes the risk of spreading and transmitting it. Even if it's not 100% perfect, it still has a significant positive benefit.

I disagree.

you disagree with how statistics work?

taking off your mask to eat does not negate the rest of the time you wore the mask.

how the hell do people not understand why masks work? I do not understand this.

an analogy:

let's say I am at work, and I fart, but oops, it's poo instead, and now it's all over this side of the conference room floor, even in places you can't see with the naked eye. should I have worn clothes? clothes are so intrusive and restrict my ability to move and express myself, and it's immoral that you create a rule that keeps me caged when I only crap in the conference room three times a year.

the poo in that analogy represents the aerosol saliva and mucus of someone that is contagious with anything, which is stuff that is regularly produced when people talk or breathe. the clothes are a facemask.

how do people not understand why facemasks are effective? I don't want to step in anyone's crap that they left behind wherever they coughed or sneezed or touched the break room chair. wash your damned hands and wear a facemask if you're sick, dammit.

Show me the statistics or studies that show that the mask policy on airplanes in the US as of today (aka hundreds of people in a small, closed environment with no fresh air, where mask are taken off for long periods of time and then put back on again) reduce spread of COVID compared to if there was 100% masking (presumably would reduce the spread) or no masking at all (basically the currently policy)

I understand statistics, you have no statistics to back up your claim. Just so we are clear, I think masks do work if they are used properly - they are not used properly on airplanes in the US, so they are pointless.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543400/

It's not a study from the US but it includes enough flights where there were confirmed index cases and there were 4 levels of masking rigidity. The case we're describing, where people only unmask to eat, there were no transmissions.

> On flights N–R with the rigid masking policies (meals served) of Emirates Airlines, no secondary cases were identified on Day 14 screening despite 58 passengers who were PCR+ on a total of 5 flights of 8 hours each with ~1500–2000 passengers.

thanks!

That's fine. Disagreement, in and of itself, isn't a refutation of my point, though.

> it still has a significant positive benefit.

can you provide some links to the evidence of this?

This visage, no mere veneer of vanity, is a vestige of the “vox populi” now vacant, vanished.

Voilà! In view, a humble vaudevillian veteran, cast vicariously as both victim and villain by the vicissitudes of fate.

For social reasons. There's so much information you get from one person face that keep using the mask forever would have very negative social effects that are probably almost impossible to measure.

Gait recognition doesn't care about masks. I don't know how far the technology got, but as a human I find recognising humans by their gait trivial enough.

Thanks for reminding us that there are A LOT of different ways to recognize people! I had never considered looking at their gait, that sounds like cool research

I once recognized a former football teammate from the stands years later when he was in full pads and helmet just from how he ran onto the field. No doubt an AI could be even more accurate, which is why I recommend wearing a mask and riding a hoverboard everywhere.

that is a non-statement somehow; you aren't responding to anything I actually said, but what you imagined that I said, and then you came up with a counter argument to the imaginary statement...

the things people do really confuse me, sometimes. I .. I am just not capable of understanding why people do most of what they do.

I didn't say I wanted to defeat gait recognition, did I? No, I did not.

my turn to imagine something you'll say: "oh well you can also be recognized by your voice"

I didn't say I wanted to defeat voice recognition, either.

etc

Actually there's a simple reason. If I have to wear a mask and social distance, I see no value in a vaccine. The point behind the "political" position isn't that masking is bad, the main position is that a mandate requiring it is bad. In a country where "My body, my choice" this is clearly a contradiction.

Significantly reducing my risk of dying intubated and in agony is a fairly compelling vaccine use case for me.

My body my choice is about to be ruled illegal by the conservative court.

LMAO, you're not foiling anything. They've moved to gait analysis years ago... which you probably can't fake.

>why not?

I don't think even the most vocal opponents of masks saying we should ban them, if you want to wear a mask forever that's your business. I'd be monumentally miffed if mandates were in force forever though, especially in the half-arsed way we have them in the UK which is so arbitrary it makes a mockery of the whole concept.

> You can't seriously expect asymptomatic people to wear masks in public forever.

Before we catastrophise, how about we start with the pragmatic - ask people to wear masks while infection rates are high. Which is unlikely to be forever

There's a big difference between 'Covid is going to be with us forever' and 'Covid infection rates will threaten to overwhelm health services forever'.

I agree with this, but in many places in the US health authorities have kept mask mandates indefinitely, regardless of current hospital capacity.

FWIW, case rates in Japan are near nil (~15 people daily in Tokyo), the vaccination rate is closing in on 80%, and everyone still wears a mask.

I don't know about "forever", but people in Japan have no problem wearing masks in public while asymptomatic with low case rates because we know it's a public health issue, and it's working. That's why we keep wearing them.

I wasn't used to masking up pre-pandemic. I got used to it within the first month. Now I can't leave the house without a mask on. It feels wrong. (This doesn't mean I'm deathly afraid to remove/lower it, e.g. while eating at restaurants or when I'm outside with nobody around and I feel like a bit of a break).

You clearly then do not suffer from poor eye-sight that requires you to where a mechanical device on your face (i.e glasses) to correct for this

How every abelist of you.

My experience with masks, and glasses is very poor, specifically the more common cloth masks that go over the ears. Something like a Gaiter mask is slightly better but many say these are less effective

I'm the exaxt opposite. Before wearing a mask I would routinely have trouble keeping my glasses on. When I wear a mask it's actually easier to wear glasses because I can hook the sides into the ear loops and they won't fall off when I look down.

I too wear glasses. It depends on the kind of mask.

Disposable surgical masks with the "metal-bendy-bit" for the bridge of your nose has worked great for me.

I also use cloth masks all the time due to the ease of keeping one on me, and washing it with the whites and bleach at the end of the date. Cloth masks definitely fog up my glasses more, but I find that adjusting them and not breathing through my mask help me.

Japan has plenty of people with poor eyesight who wear glasses, including several friends of mine, and nobody has a problem with masks.

> You can't seriously expect asymptomatic people to wear masks in public forever.

Why not? Many societies expect that you wear clothes in public, and most people willingly comply every day. In many places it's actually mandated by law! Where are the anti-clothers protesting in state capitals? Oh yeah, they're nudists and most people don't take them seriously.

Why is being required to wear a mask in public any different than being required to wear pants?

> Where are the anti-clothers protesting in state capitals?

> Why is being required to wear a mask in public any different than being required to wear pants?

I was one of the people defending the mitigations early on, speaking out against the "conspiracy theorists" - those who said the new controls by those in power would never be given up and that this would be the new normal.

I slowly came to see that they were right. Sentiments like this prove it.

Perspectives like this baffle me. Why would those in power never give up the power to… make people wear masks? It’s a pretty shitty power. It also makes ubiquitous surveillance more difficult because you can’t scan people’s faces reliably.

I also don’t understand why sentiments like this prove anything. Is the OP a person in power? Nothing suggests that. They’re just a person that’s being (overly) cautious. FWIW I don’t agree with them but I also don’t think they’re a lizard person.

Because it's an incremental step along the path to reducing or eliminating the right to self-ownership.

If you can normalize something like mask wearing, there's a strong psychological effect. There's a sort of built-in obedience that's a clear signal to those around you. Arm bands also come mind.

Is it then such a leap to grant the power of forced vaccination? I mean, it's all for the public good right?

Flu is a deadly killer. We should probably go ahead and mandate that vaccine too, while we're at it.

Traffic accidents are a leading cause of death in the U.S. - why are we allowing private car ownership? We could save tens of thousands of lives per year if we centralized control of transportation.

Guns? They're right out.

While we're at it, there's no good reason to allow fast food restaurants to continue to exist. Obesity is an epidemic and costs the U.S. billions, if not trillions and is a leading cause of heart disease. Let's get rid of all fast food restaurants.

Since we're doing that, we should also probably mandate that every restaurant remove the deep fried. They can make something more healthy.

And on. And on.

This never ends.

You say that the perspective baffles you. I'm trying to illustrate the perspective that those of us who believe in maximizing personal liberty hold.

Incrementalism is a real thing. An affront to liberty must be stopped at the beginning, if it is to be stopped at all.

Many people reading through what I just wrote actually believe doing all of those things would be a good idea, and they may be right.

I think a better idea is to allow people to live their lives the way they chose.

> Incrementalism is a real thing

And so is the slippery slope fallacy.

If you can normalize something like seatbelt wearing, there's a strong psychological effect. There's a sort of built-in obedience that's a clear signal to those around you. Life jackets also come to mind.

Measles, mumps and rubella are deadly killers. We should probably go ahead and mandate that vaccine too, while we're at it. Oh wait, we already do with school kids. Have done for decades.

And on. And on.

Human beings love to see patterns. In reality A does not necessarily lead to B, and to C. You can evaluate individual decisions according to how beneficial they are and say yes or no.

Take a look at the number of comments on HN and elsewhere that use the Jacobson [1] decision in 1918 to justify the current vaccine mandates, even though it was completely different.

Take a look at all of the federal powers that have been seized based on Wickard [2] interpretation of the ICC.

These are just a couple obvious cases of incrementalism.

The entropic state of humanity is to allow power to accumulate and centralize.

It takes active energy to resist this.

[1] https://en.m.wikipedia.org/wiki/Jacobson_v._Massachusetts

[2] https://en.wikipedia.org/wiki/Wickard_v._Filburn

And yet that very liberty that you take for granted today is the result of a continuous slippery slope from hereditary monarchies to a world where you're even allowed to choose who leads you or have a right to be free at all. Incrementalism is what gave us the liberty we have. It wasn't that long ago that women were incrementally given the right to vote. What's next? Allowing dogs and cats to vote too?

> I think a better idea is to allow people to live their lives the way they chose.

I'm not allowed to recklessly speed down any road I please. I'm not allowed to fire guns wherever I please. I'm not allowed to build my house in any way I please. I'm not allowed live in any house I please. I'm not allowed to build bombs in my garage. I'm not allowed to dump waste in the local water system. If I walk around downtown without any clothes I'll almost certainly be arrested. There are countless things we're all forbidden from doing by society. We are not free to live as we please with no regard for anyone else. That is the price of participating in a society.

Liberty is an artificial construct that we, as a society, have agreed upon and set the boundaries for. There is no natural state of liberty that exists, it must be explicitly defined and agreed upon. It's OK to disagree on the boundaries of liberty. We can arbitrarily choose where to draw the line as we please. So we can choose to mandate masks and yet allow fast food to exist.

These "I'm not allowed" assertions are all over the map.

You can't "recklessly speed" down a road, but are you not generally allowed to drive along any public road for any reason - or no reason - so long as you're not "reckless"? Should you be made to justify your need to be on the road, or your choice to drive rather than ride a bus? After all, these things impact public safety and the climate.

You're not allowed to fire guns wherever you please, but you're also not allowed to even HAVE a lawfully obtained gun in many settings simply because those in power have deemed it so. Try getting a concealed carry permit in NYC. Should it be that way everywhere?

You can't live in "any house you please" perhaps, but you're certainly allowed to live in any house that you can afford. Are you trying to justify bringing back things like redlining or neighborhood exclusionary rules?

I won't go over every single "I'm not allowed" item. But I'll finish by saying that "recklessly speed" and "drive where I please when I please" are different things. Almost every rule in existence finds SOME degree of justification in necessity, which is why "necessity" has always been the go-to justification for any authoritarian regime or ruler throughout history. And it never stops until people push back.

> These "I'm not allowed" assertions are all over the map.

So what? Is that a bad thing or something? Opinions on what is an acceptable amount of laws and regulations is all over the map. Some think we should have no laws. Some think everything should be regulated. Many are somewhere in between. Mask mandates are not a slippery slope towards authoritarianism, it's a step on the spectrum toward some equilibrium on the spectrum of anarchy and total authoritarianism that society, on average, finds acceptable.

Some reductions in liberty are beneficial: speed limits, private property rights, bans on exclusionary lending practices. The question is always, "is it worth it?" Many people believe that mandating the wearing of a mask in public is part of an acceptable definition of "liberty." There is no natural state of liberty (other than complete anarchy) that is violated by a mask mandate, there is only the degree of liberty we choose to grant ourselves. Even the right to life is a man-made right, granted only by mutual assent.

In England it was optional to wear masks during the summer, I would estimate about 75% of people I saw in places like supermarkets chose not to wear them.

So society, in England at least has already decided that if it's their choice, they'd rather not wear them.

Being able to see each others’ faces is pretty central to communication.

Nobody claims masks need to be worn forever. That is your statement.

We still need to slow down the spread though, as several operations otherwise can't handle the load.

In NL, our undertakers have employed external cooling cells again, just like last winter, to be able to 'service' the dead.

The top comment uses Japan as the example. They do wear masks forever. So maybe the top comment shouldn't used Japan as the example.

Japan doesn't, and hasn't, had an indefinite mask mandate, like SF has had.

If wearing "forever" means individuals wear masks when they're feeling ill, or when they're in a place with current high transmission of respiratory illness, then I'm all for wearing masks "forever".

Exactly this. We have to live with the virus same as with the flu.

And I agree that having healthy people wear masks just to be safe is unacceptable.

Is having drunk driving laws just to be safe unacceptable?

I don't think that's entirely the same thing, but let's say it is just for arguments sake.

Without the vaccines you might have a point, except that Corona and the large flu seasons are not that different for most countries if you measure hospitalizations and deaths.

With the vaccine it's two wholly different things as the vaccine is your way to protect yourself.

A SUV driven by a drunk driver can kill a dozen people, that have no way of avoiding that.

Driving a car is not a right. It is privilege.

Since when breathing open air become a privilege?

Why isn’t it a right?

> in the long run that won't save anyone

> eventually

I don't know exactly about the US but in NL that is precisely the sticking point. It doesn't matter that everyone will get it, it matters when everybody gets it because we don't have the ICU capacity to treat everyone at the same time (+ regular ICU patients and overhead for scheduled surgeries)

In Germany, a country with among the highest rate of ICU beds per capita, we reached a point where scheduled surgeries for cancer patient are delayed because of this. Yet alone to speak about emergencies, in some regions it really is a bad time to have a heart attack or a stroke. Or a serious accident.

Which is why I am so frustrated with people refusing to be vaccinated and with our politicians that ignored all warning over a calm summer, again after they did the same ting in 2020. Because reasonable, innocent people are suffering now. Sometimes I wished voluntarily unvaccinated people would be consequent enough to refuse treatment.

Very good point. Slow the spread. If you slow it to near zero we are well off.

This reminds me of someone telling me "If even vaccinated people can get Covid what's the point of me getting vaccinated?"

The answer is simple but perhaps subtle and may be hard for some people to understand and accept: To lower the risk.

You can't fully eliminate the risk but you can and should lower the risk as much as is easily possible.

There are 777k Covid deaths in the US now and I wonder why media doesn't tell us that number every day. I guess many people don't want to hear it.

https://www.google.com/search?q=how+many+people+have+died+fr...

Don't forget that the vaccine also lower the risk of severe form of Covid.

> Masks may "work" to a limited extent to reduce the risk of transmission in any single interaction, but in the long run that won't save anyone.

Could you elaborate on the statement at the end - "but in the long run that won't save anyone.". Anyone, as in nobody? How come?

He's saying (approximately correctly) that everyone will get COVID eventually.

Though I'd like to add that you could get a vaccine instead.

> So what are the exit criteria?

Vaccination. Which is one of the reasons it’s especially infuriating when anti-maskers are also anti-vaccine. By far and away the easiest way to do away with masks is for everyone to just get the vaccine.

For myself, I have two small children that are currently not eligible to be vaccinated. So I will be continuing to wear a mask indoors until they can be.

> You can't seriously expect asymptomatic people to wear masks in public forever.

Another shame this has become such a culture war topic because there’s nothing wrong with the idea of wearing masks when appropriate, indefinitely. As the OP said, in Japan people wear them during flu season and when they feel themselves coming down with a cold. There’s nothing wrong with that, nor is it a particular burden on the vast majority of the population.

I live in NYC and might continue to wear a mask when I’m on the subway during flu season, it feels like common sense. But I know if I try to do that in other cities in the country I’ll be looked upon as if I’m a leper.

Do you not pay attention? Have you not seen case numbers in Gibraltar? Fully vaxed Lebron James caught it. In what world do you live in such that you can ignore the vaccines are obviously not preventing transmission?

Vaccines dramatically reduce the danger of the virus. I have friends who caught COVID pre-vaccine and it was horrendous. Some are still dealing with the effects today. I have other friends that caught it while vaccinated. They felt rough for a few days.

The public health argument is very clear: vaccines reduce transmission. No, they don’t stop it. But they also reduce the strain on ICUs and other healthcare facilities needed to treat people with extreme cases.

In what world do you live in such that you can ignore that?

> Vaccines dramatically reduce the danger of the virus

Obviously, if you take the same COVID-naive person and subject this person to a virus both in vaccinated and unvaccinated state (repeatedly), you can derive a conclusion. This is a simple and easy to understand impossible experiment.

How your conclusion was derived? (I'm not arguing with it, I just don't understand the method.)

Have you not seen the case-numbers in USA: 777,000 people dead from Covid. https://www.google.com/search?q=how+many+people+have+died+fr...

I wonder, how many of those people didn't have easy regular access to medical services.

Reminds me of the vaccine for the flu - where time and time again, I'm told by anti-vaxers that the flu vaccine doesn't work, they got the flu, and were fine.

Lest we forget that the flu killed millions of people a century ago, the vaccine likely reduced the chance you caught it, but still managed to catch the disease, and the reduction in severe symptoms when you get it.

I remember reading every year about someone who refused to vaccinate their kids, and one of the kids died from the flu.

Vaccines don't 100% prevent catching any virus. Especially fast mutating viruses.

The CDC disagree with you as they now say everyone should wear a mask regardless of vaccination status because we now know that even vaccinated people spread the virus you just do not get as sick

>infuriating when anti-maskers are also anti-vaccine

I am anti-mandates, so would you count me as an anti-masker and anti-vaxer?

>>and when they feel themselves coming down with a cold

This is the key point that betrays your statement, They wear them to prevent spreading sickness to others, your statement imply you will wear them prevent getting sick. Non-n95 masks are not effective at preventing you from becoming sick, and infact in some ways should concentrate a flu virus and make you sick where you would not have otherwise gotten ill.

Masks are good for already sick people to use to prevent further spread that is the correct use for normal non-n95 masks

> This is the key point that betrays your statement

Why do these conversations always devolve into people trying to make “gotcha” points?

I was pointing out reasons why wearing a mask could be sensible. Those reasons aren’t necessarily anything to do with COVID. But there’s now such a cultural issue around it that the reasons won’t even matter. You’re a “masker” or an “anti-masker”.

It seems to me that it’s become a culture war topic because people are advocating for something stronger than that. I also plan to wear a mask on public transit for the long term (I kinda wanted to before), but I don’t want to have to wear a mask grocery shopping, or do the thing where you wear it for five seconds while walking from a restaurant door to your table.

It's a bit counter-intuitive that it is precisely in the presence of people who don't wear a mask that YOU should be wearing one.

Our intuitive understanding, inclination is "do as others do". "Oh, nobody's wearing a mask, must mean there is no virus around here". No. Not. If people are not wearing masks it is more likely that there's a lot of virus going on.

People who don't wear a mask in your presence are likely to be careless about protecting them against the virus in other ways, and therefore are more likely to have it already.

Vaccinations has to a degree the same issue as masks. The question isn't if they work, but rather how effective they are in different contexts. It seems we are now at three vaccinations for just 2021, and multiple different mutations of the virus. I hope strongly this third dose will be it and this latest mutation will be the final one, however listening to researchers that discuss the subject makes me less hopeful.

The exit criteria is that the general population get enough protection that covid outcomes behave similar to other seasonal flu viruses. The hope is that this will be achieved through a combination of vaccinations and time, but we won't know until the data is in. What is known in many countries is that transmission of covid by vaccinated people has surpassed greatly those of unvaccinated (by simple quantity of people who are vaccinated), which is why masks in high risk areas is still recommended for tipple vaccinated people. I would recommend a mask in NYC subway to combat Covid regardless of how much vaccine you have taken.

I live in NYC and can't imagine not wearing a mask in the subway ever again... it smells rank enough to begin with.

There is nothing wrong with wearing a mask however long you want. There is however something very wrong with being forced to wear a mask against your will however long someone else wants.

There might be effective drug treatment in the near future. It would be nice to not get COVID to then.

We already have effective drug treatments. How much more effective do you want?

https://www.covid19treatmentguidelines.nih.gov/about-the-gui...

And remember that while the vaccines don't reliably prevent infection, they're pretty good at preventing severe symptoms.

Worst case: what if there isn't exit criteria?

Are you that weak of a human to not wear a mask when you're sick, or during a pandemic? Or is this just a "Lets Go Brandon" (aka: fuck joe biden) dogwhistle?

Cause your "question" isnt certainly about anything scientific.

Your comment perfectly illustrates the concerns that those of us who resisted mask mandates from the beginning hold.

From your comment I can infer that when you observe a person not wearing a mask, you make an immediate assumption about their political ideology.

I believe that this was the main purpose of mask mandates, not public health.

Remember when this started, and we wanted to reduce 'R0' to slow the spread so hospitals could manage? Masks help with that, whatever absolutist arguments folks come up with. Sure they're not 100%, won't guarantee anything. But they DO slow transmission. So lets quit with the indignation and blamethrowing, and wear the damn mask, do your part.

When this started it was "2 Week to flatten the curve", and that 2 Weeks was not masking, it was stay at home, do not travel, do not interact, and DO NOT wear a mask. We were told to NOT wear masks, so much so the government was confiscating masks from businesses.

That's apocryphal. For instance it didn't happen around here. Sure some folks over-reacted in some places. But in the interest of not spreading more indignation and outrage, it's pointless to go on about that.

Not commenting on the nature of your comment but just wanted to point out that the author of that article was one of the authors of the Great Barrington Declaration that attempted to convince the Trump administration that "herd immunity" was the best solution in dealing with COVID-19 because the people that signed it were losing money.

I wear masks when my country mandates that I should. But I think the issue is this...

Covid is here to stay, many countries have very high vaccination rates at this point, so effectively if we continue to wear masks even in very high vaccination countries we're essentially saying we have to wear them forever, because what's going to change? Unless some new vaccine comes out that actually prevents transmission covid is a permanent thing.

And to put it simply, while I understood the need to wear one when we had no vaccines because anything that helped was a good idea, I'm not sure I'm prepared to wear one indefinitely.

I think the point you and the sibling comment makes are good ones: health authorities, at least in the US, have never been clear on the exit criteria for ending interventions, and the goal posts have continually been moved. Remember when "flatten the curve" was the original goal early in the pandemic? That almost seems like a quaint notion now.

But that said, with an endemic disease I think the idea behind flatten the curve is the only one that makes sense - that is, masks should only be required if health care facilities are at risk of being overloaded. I'm fully vaccinated, so the only time I'll wear a mask are if transmission rates in my area are currently high (or if I'm entering a place that has a specific mask mandate - I don't enjoy wearing a mask but I also don't think it's a very big deal so I don't understand why so many choose it as their hill to die on).

> health authorities, at least in the US, have never been clear on the exit criteria for ending interventions

"When we are confident we are not hours away from a nationwide medical emergency" is not easy to communicate. I'm sure if they literally said that, all the people complaining they have no clear exit criteria would loudly complain it is not clear; what, of course it isn't. If people knew all the details about how the pandemic will behave, they would have told you.

> When we are confident we are not hours away from a nationwide medical emergency

Huh? We've basically never been "hours away" from any sort of national emergency at any time during this pandemic, and that sort of unwarranted catastrophizing is what frustrates so many people.

Heck, my city, like many, does have easily understood, rational criteria for additional recommended interventions based on hospital intake rates. My only objection is that our local authorities have ignored their own criteria frequently by raising a stage level prematurely or by keeping at a high stage weeks and months after hospitalization rates have gone down.

Masks work. I don't dispute that. I just don't want to wear one for the rest of my life. I don't want my government telling me what to wear.

I got vaccinated months ago because I thought that would be the end of masks. That was the entire point of vaccinating: not needing a mask because the virus could do nothing to you. The vaccination rate in my country is almost 80% and we still have a mask mandate. I will not even consider taking a booster until they do away with the mask.

While I agree with your general sentiment, saying "I will not even consider taking a booster until they do away with the mask" seems like cutting off your nose to spite your face. Wouldn't you want to get a booster just to lower your risk of getting a potentially severe illness?

That is not necessary because I'm forced to wear a mask. If we are forced to wear masks, it's because masks work. Right?

On the other hand, I fell ill for an entire day after taking the second dose, and I refuse to go through that again.

I don't think it's binary like that(I'm willing to be proven wrong).

Vaccines are effective at preventing infection and particularly severe infections.

Masks are only effective at preventing you spreading your own infection. If you wear an n95 it will prevent you from getting infected but there is user error involved in tightness/compliance/etc....

My understanding has been that vaccines are more effective at preventing infection than masks so if you're picking between the two for your own safety, it would seem that the vaccine is the better choice for yourself.

I will agree with you that the side effects from the vaccine are certainly a counter-argument for getting a booster every 6 months(or whenever a variant comes out that needs a different vaccine). I got mine last month and was asking myself, "I am pretty fit, in my 30's, I work from home, and my leisure activities are all outdoors(running/hiking/climbing)... Am I just going to get knocked out for 1-2 days every 6 months when my perceived risk level of catching covid is so low?"

My hope is that we're spending time working on better vaccines with fewer side-effects. If the side-effects are like the flu shot i'll gladly get a booster whenever needed without thinking twice.

Aww look, a coward.

It is a shame that someone turned a health crisis into a political issue.

When people don't have the crayons and pencils they need to express themselves, they will reach for what is available.

Is this a jab at a particular political group? It sounds really deep

> I live in Japan and everyone here wears a mask, but more importantly, wears them properly

I lived in Japan, and have many friends in Japan. This is true only if you redefine "properly" to exclude all indoor environments. People in Japan routinely gather inside without masks, then put them on when they go outside. You can watch the TV news and see people gathered in bars and restaurants with masks off, but then they wear them religiously while walking around the city. Absolutely pointless behavior. I see this behavior amongst my own friends regularly on Instagram and Facebook.

Moreover, it's fairly common to see things like "chin masks", like this:

https://zqxkk1h5ljq1vh5rd1kit5ok-wpengine.netdna-ssl.com/wp-...

I'm not sure what these are supposed to be doing, exactly, but sure, I guess people are "wearing masks".

> Many Japanese people are already attuned to wearing them during flu season, and everyone wears them if they think they are getting a cold

This wasn't even close to true, pre-pandemic. I was regularly sandwiched between people on trains with obvious head colds, sniffing their snot every 5 seconds. Sure, some people wore masks, but it wasn't "everyone". Not by a long shot.

> Masks are, of course, effective.

This is an assertion. The best available data from randomized controlled trials shows a minimal effect:

https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...

> Masks work.

Repeating this phrase, without evidence, does not make it true. Even ignoring the top-line RCT evidence, you have to define what you mean by "masks" to get close to a meaningful statement -- a chin shield is obviously nothing like a cloth mask, is nothing like a full-face respirator.

> The best available data from randomized controlled trials shows a minimal effect.

Be careful what you are arguing that these trials show: whether masks, when worn properly, work, or whether mask mandates work.

Because a randomized study that shows that mask mandates work, which has been shown (the best example I am aware of is the study from India), would necessarily mean that properly worn masks would need to be much more effective than the effect size from a mask mandate study, because of course tons of people under a mask mandate still don't wear masks, or wear them as chin warmers, or never wash them, etc.

So I'm always curious that when a mask mandate study shows minimal, but significant, effectiveness, that the response isn't "See, masks work, even when a ton of people still don't wear them or wear them haphazardly" as opposed to "masks hardly work".

> Be careful what you are arguing that these trials show: whether masks, when worn properly, work, or whether mask mandates work.

The RCTs have been for masks themselves, not for mandates (this gets a little complicated because of compliance and intention-to-treat analysis, but it's basically true; the researchers were testing masks themselves, not rules surrounding masks). If the masks don't have strong evidence, I don't expect mandates to make the situation better.

Where are you getting this idea that they don't have strong evidence? We have several studies now, in schools, cities, states, and other places, that have shown that, while not perfect, masks have a very noticeable positive effect on reducing transmission and spread.

I don't think you're operating in good faith, but since you asked, other people might find this useful. You'll also note that none of the links I am providing here are from Vinay Prasad, since you are convinced he is some kind of astroturfing organization...

There have been exactly two RCTs for masks and Covid during the pandemic, neither of which has shown a large effect [1][2]. The DANMASK study showed no significant PPE effect, and the Bangladesh RCT showed a total effect size of around 0.09% (or a difference of 20 infections on base of thousands). Prior to the pandemic, RCTs for masks and respiratory disease showed weak effects, at best. Cochrane did a review of the literature [3], and found:

> Seven studies took place in the community, and two studies in healthcare workers. Compared with wearing no [surgical] mask, wearing a [surgical] mask may make little to no difference in how many people caught a flu-like illness (9 studies; 3507 people); and probably makes no difference in how many people have flu confirmed by a laboratory test (6 studies; 3005 people).

> We are uncertain whether wearing masks or N95/P2 respirators helps to slow the spread of respiratory viruses.

There have been many uncontrolled studies published. These are useless. Uncontrolled studies are not science (the Missouri study discussed in the OP is not a controlled study, btw).

There have been many laboratory studies published. These are suggestive, but just like a lab study for a drug, not meaningful in the real world without real-world evidence.

[1] https://www.acpjournals.org/doi/10.7326/m20-6817

[2] https://www.poverty-action.org/sites/default/files/publicati...

[3] https://www.cochrane.org/CD006207/ARI_do-physical-measures-s...

The Danish study is self reported with no policing of wearing a mask correctly at appropriate times and always using clean masks (not reusing masks from day to day).

> Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others.

The Bangladesh study found masks were effective.

The third is a literature review with no indication of quality control, so basically as reliable as the Danish study (no policing of actual mask wearing, no policing of proper mask wearing, no policing of mask hygiene).

> The Danish study is self reported with no policing of wearing a mask correctly at appropriate times and always using clean masks (not reusing masks from day to day).

So was the Bangladesh study. They did some surveys to estimate the rate of compliance, but it's not like there was a mask policeman following the participants around.

If only you folks would spend half as much effort reading the studies you prefer as you do the ones you dislike, you might be more credible.

> The Bangladesh study found masks were effective.

The Bangledesh study found a grand total of 20 infections separating the two arms of the surgical mask study. Out of thousands. A total effect size of 0.09%. It found that cloth masks had no significant effect.

Also, my favorite: It found that one color of cloth mask was significantly different than the other one. We all know that viruses have a strong red/blue preference, right?

Maybe we should be a little circumspect about what "significance" means here.

I am not sure why you are attributing motive to me when I am simply pointing out the flaws in an anti-masker’s supposed supporting evidence.

I mean, there has to be a literal _wealth_ of data on mask efficiency by now, considering the _wildly_ different mask mandates between countries? If they are effective it should be somehow visible in transmission rates or whatever after and before masks became mandated.

Sweden where I live has never had any kind of wide mask mandate in public. There has been rules for public transport where I live, and in the office where I work but we worked at home so. Also recommendations for wearing a mask in shops if you are unable to keep a 2m distance. But I have never seen a majority of people anywhere here wear masks.

There is. The OP even talks about a study done during one of the worst outbreaks of delta and the significant effect it had in Missouri. The same type of change in multiple cities where the treatment (mandate) was in effect occurring while also not happening in the other places where it wasn't in effect? That's not a coincidence anymore.

For Missouri's study to be valid, statistically and empirically, you'd have to measure the actual wearing of masks in areas with mandates, and control for other factors. Did the Missouri study measure actual mask use, and control for other factors?

There are no legal mandates to wear mask in Japan, but many shops order to wear mask.

Particulates are bad, so while a mask outdoors may not matter for pandemic, it may be more than absolutely pointless.

After almost two years of pandemic, there have been essentially no examples of documented spread of the virus outside (there have been a handful of examples in weird situations involving outdoor structures, crowds, etc., but these are the exception, not the norm).

You don't need to wear a mask outside. Not for a virus, anyway.

This thread looks like it's being astro-turfed by supporters of Vinay Prasad and the nonsense he keeps peddling. There are plenty of studies showing that masks work and that they reduce transmission and spread and there are even studies that show that mask mandates have a drastic positive effect in limiting community transmission and spread.

"Astroturfed"...that's hilarious. I'm a real person. I've been on the site for years. I think for myself and read and interpret data. Big Vinay Prasad is not paying me to come here and spread the gospel of randomized controlled trials and rigorous science.

If you disagree with the data, you're more than welcome to bring rigorous arguments to the debate, and not merely propaganda.

> There are plenty of studies showing that masks work and that they reduce transmission and spread and there are even studies that show that mask mandates have a drastic positive effect in limiting community transmission and spread.

And, as noted, the vast majority of those "studies" are terrible, and the good studies show the opposite.

This is not a game of collecting "papers", and the side with the most papers wins. They're not monopoly money or science points. You have to read them and understand the details. A paper that uses biased or flawed methodology (i.e. most mask studies) is useless for drawing conclusions.

I don't know who that is, the reason I'm skeptical is the sheer amount of cofounders in most observational studies. My pre-pandemic prior was slightly positive towards masking, strongly negative towards government mask mandates.

My personal totally subjective risk estimates after reading a ton of studies and metanalyses is that n95 masks probably reduce transmission at least somewhat (90% confidence), surgical masks probably have a weak or negligible effect (50% confidence), and cloth masks probably don't work at all (50% confidence).

I personally still wear a surgical mask while at work, at the hospital/doctor's office, and in crowded spaces I expect to be in for a long time such as the DMV, airplanes, trains. I don't wear a mask outdoors, in grocery stores and convenience stores, or when visiting family members. I am moderately against government-imposed mask mandates (both for science-based reasons and ideological reasons) though I do comply with them when they are imposed.

Breaking the site guidelines like this will get you banned here, regardless of how wrong someone else is or you feel they are.

Between this comment, https://news.ycombinator.com/item?id=29419551, https://news.ycombinator.com/item?id=29423080, and https://news.ycombinator.com/item?id=29419708, you went way over the line and well into bannable offense. You've also been posting flamewar comments elsewhere too. That's not gooo.

If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it.

> This is an assertion. The best available data from randomized controlled trials shows a minimal effect:

> https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...

From your link

> Scientists have lost any consistent standards for evidence appraisal.

Just... wow.

The underlying paper was published, not on a peer reviewed scientific site, but Cato, which is a libertarian institute.

> > Scientists have lost any consistent standards for evidence appraisal.

> Just... wow.

Solid rebuttal.

> The underlying paper was published, not on a peer reviewed scientific site, but Cato, which is a libertarian institute.

So what? Have you read it, or are you just disparaging it because you don't like the server where it is hosted? The authors are doctors from UCSF, and experts in medical evidence.

Reading the paper was the first thing I did, unfortunately.

I read it, until I realized it had no data, and that it was completely biased towards a single narrative.

Only then did I look to see who published it.

Yeah, this is an example of what I'm talking about. I'll get on the train this morning and ride to work and probably see 100,000 people, none of whom are unmasked or wearing "chin masks". I'll work all day and not see a single one of my co-workers faces. Same thing on the way home. Then, because it's Friday, I'll go out for drinks with my wife or maybe the same friends I usually see because we aren't in lockdown, and spend a couple of hours in a bar unmasked. Maybe I'll post a photo of myself having a beer?

Yet you have some friends on Instagram who post when they're out, and have seen some news reports (probably of the variety of "Japan's COVID mystery, why are their numbers so low?") where they hunt out some drongos in some dodgy tachinomya who aren't wearing masks for their story about how Japanese people aren't wearing masks either, and because it fits into your worldview, you'll glom onto that and post some non-peer reviewed rubbish that confirms your fervent wish that you shouldn't be in any way inconvenienced.

Oh look at that, I just saw the morning news. 115 new cases of COVID today in a country of 120 million during the Delta wave. It's a mystery I tell you. A complete mystery.

Don't listen to this guy, wear a mask, get vaccinated.

> Don't listen to this guy, wear a mask, get vaccinated.

What are you talking about? Did I say anything about vaccines? Check your biases.

> I'll get on the train this morning and ride to work and probably see 100,000 people

Oh stop. You don't see 100,000 people a day. You could stand in the middle of Shinagawa station all day long, and I doubt you'd see that many people pass by you. And you certainly aren't confirming if they're wearing masks.

> I'll work all day and not see a single one of my co-workers faces. Same thing on the way home. Then, because it's Friday, I'll go out for drinks with my wife or maybe the same friends I usually see because we aren't in lockdown, and spend a couple of hours in a bar unmasked. Maybe I'll post a photo of myself having a beer?

Well, yes. This is exactly the behavior I am describing. You're doing it, too. You think the virus somehow knows that you're out for a drink and stops being infectious?

Your contention is that masks don't work, and Japanese people don't wear them? I travel the loop line to and from work during rush hour each day, and yeah, while I don't canvas every single person, to my mind, I don't see anyone not masked up and wearing it correctly.

On my way today actually, remembering your goofy statements, I kept a special eye out, just for you. Carriages stuffed full of people, lines and lines on the platforms, train doors opening and waves of people pouring out to change trains, little groups of elementary schoolkids walking together to school....I didn't see a single person today (bar a couple of dudes with their masks down while they smoked outside Lawsons) not masked. You just don't see people not fully masked up. Day in, day out. Sorry if I don't keep a little tally counter on me.

"You're doing it too." What does this even mean? I drink within a closed circle of friends or family in a bar with separated tables and screens up. The staff all wear masks. Life goes on, but because of the masks and distancing measures, the transmission rates remain low.

You have an incoherent world-view and grasp of logic. Are you incapable of understanding that there is a sliding scale of masking behaviour? With Japan at one end, and the dolts screaming about mandates in street protests at the other?

Again, I say, don't listen to this guy. Wear a mask (properly). Get vaccinated. (Is that punctuation more to your liking?)

> Your contention is that masks don't work, and Japanese people don't wear them?

No. My evidence-backed argument is that masks don't have much of an effect, and secondarily, my personal observation is that Japanese people don't wear them as much as you claim, particularly inside, while eating and drinking and socializing. They definitely wear them outside, where it doesn't matter much at all.

Arguing that you rode a train today and saw lots of people wearing masks on your commute is unsurprising. Completely consistent with what I'm saying.

> I drink within a closed circle of friends or family in a bar with separated tables and screens up. The staff all wear masks. Life goes on, but because of the masks and distancing measures, the transmission rates remain low.

Right. So you've now twice admitted that you do exactly what I am describing: you go out to eat and drink and socialize and take off your mask, inside, with groups of other people who are also not wearing masks. But it doesn't count when you do it, because reasons. Shields. Treating the staff as Others who have to wear masks around you, in a room full of unmasked people. It's all the same performative logic: you're OK because you're a person who wears a mask (except when you don't).

Invent all the rationalizations you like; I don't particularly care. I am not a member of the church. I'm just stating what I see, and you're...well, you're agreeing with me.

I live in Tokyo, Japan. Nearly Everybody wears masks here (correctly). Several people even wear 2. Don't listen to him, he claimed there were spikes in Japan this winter when somebody pointed out the mask wearing ... Fundamental anti-masker :) https://news.ycombinator.com/item?id=29294849

Yeah, he's on some kind of messed up head trip, that's for sure. Osaka here.

> 115 new cases of COVID today in a country of 120 million during the Delta wave. It's a mystery I tell you. A complete mystery.

In case anyone is curious, Japan has done far fewer Covid tests per capita than somewhere like Namibia, a country with one-tenth the GDP per capita.

(Of note: some sources like https://items.ssrc.org/covid-19-and-the-social-sciences/covi... claim Japan's intentional testing restrictions causally decreases the number of cases, by avoiding nosocomial infections.)

This article was from almost two years ago when the pandemic wasn't even going properly.

The data I mentioned about testing per capita is through today. In concrete numbers, Japan has performed ~25 million tests and has a population of ~125 million.

There are THREE articles, and I chose them so that they spanned the past two years. The second article is from June 28, 2021 and the headline is "Testing at elderly care facilities expands, but at a snail’s pace".

In Japan, how long can you keep a minimum distance of 1,5 meter or greater to any other human being while outside your home? Japan is not exactly known for its low population density, nor having a young population.

I think most would agree that if they weren't effective in any situation then hospitals wouldn't had used them before the pandemic. The question has thus never been about if mask works, as obvious they do, but rather at what level of risk that they start being more effective than background noise.

If I traveled to Japan I would distinctly wear a n95 mask both on the plane (a small tube of recycled air with minimal distance to each other for a long period of time), and inside Japan when near people. I wouldn't however go out to work/school if I felt like I was getting a cold, even if culturally people would look down on me for missing work. I can imagine that the social pressure would increase the general risk and thus masks would be a useful mitigation tactic.

Obviously they work. Washing your hands works. Not having face to face contact with other humans works. The issue I think most people have is whether the data supports various health mandates and whether in the long run they'll actually have any impact.

Even if the data is supports the claim that masks reduce spread, the data is less clear on if it's an effective means to combat a pandemic. Specifically, will masks limit the total number COVID cases given enough time, or just slow the time it takes for everyone in the population to be infected? An argument could be made that slowing spread gives time for vaccines and antivirals to be developed, in turn limiting cases and deaths, but this argument would then also depend on data and safety in regards to current / future vaccines and antivirals.

> The people who DON'T want to wear them and who wish to make it a political act will dredge up all sorts of B.S studies

I do get your annoyance here. I know a couple of people who don't just disagree with the concept of mask mandates, but also seem to be basing their opinion on some of the "B.S studies" you're referring to. I don't think this is the majority though. Most people just don't like being told what to do, especially when the benefits of mask mandates is probably quite negligible given they don't offer full protection, won't stop the pandemic, and the fact a lot (the majority?) of people will wear masks simply because they're recommended.

I guess I sort of see it as similar to drinking alcohol or eating doughnuts. The data is pretty clear these things are bad and causing people to die in huge numbers, but the bar at which the government should step in and say you must or can't do something should probably be quite high. And in the case of mask mandates their effectiveness depends massively on the mask itself and how the wearer is wearing and using it. I've been at the store and had people cough right next to me in thin fabric masks while mandates were in place. I'm not even sure an effective mask mandate is possible, they certainly haven't given me much more comfort. Were I more concerned about COVID I'd personally be avoiding social contact as much as possible regardless of mask mandates.

So yeah, masks work. People should wear them. I usually wear one in public. But the risk of COVID and their effectiveness doesn't justify mandating them imo.

> Most people just don't like being told what to do

Bingo. I live in a "blue part" of red Indiana and this is the conclusion I've come to as well. It's extremely frustrating knowing that masks work when everyone wears them, but you are basically powerless to make a change when 90% of the people around you don't wear a mask at all, and 9 of 10 remaining folks that do wear one aren't wearing it correctly. I imagine that most of my neighbors are good folks that want to do something to help, but you can't control the people around you.

If we could simply grant that "we don't like being told what to do" at the outset of the argument, I think we'd get a lot further in the national conversation. But "you can't tell me what to do" isn't a winning legal argument, so we get religious objections, and bogus "harm of the vaccine" studies with even more outrageous arguments, simply because those people who didn't like the idea of a mandate are smart enough to know they actually stand a chance in court with those arguments.

>Specifically, will masks limit the total number COVID cases given enough time, or just slow the time it takes for everyone in the population to be infected?

Slowing the spread in order to not overburden hospitals (which causes death & mayhem and affects not just COVID patients) was always _the_ reason why we wear masks and have lockdowns. It's about slowing the pandemic, not ending the pandemic (that's maybe what the vaccines can do).

So yes, masks have an impact, they saved countless lives already. And yes, people will continue to break the law, but that's not a good reason to abolish the law and accept many many deaths.

Of course the most scared conformist is at the top. You have no idea what you're talking about. I'm sus that you've even lived in Japan for any amount of time. Also masks don't work, living in another country isn't proof, it just means that Japanese are super conformist. Duh.

I don't wear them because they fog up my glasses, and I can't talk for more than a few seconds without gasping for air. Fitting them properly makes both annoyances much worse. I'm not saying they're not effective, but the trade-off for such a small amount of efficacy is just not worth it for me.

One thing I've noticed is that, when I try to explain this to pro-mask people, they're the ones that try to make it political. Most just cannot accept that there are non-political reasons for someone to not want to wear a mask.

This title is a bit sensationalist. According to the article itself, the difference between masked and unmasked confirmed contagion is 5.9 cases per 100,000 population.

The death rate for confirmed contagion by COVID is 1.6 % in the USA. So, imposing mask mandates in Missouri would result in 0.096 fewer deaths per 100,000 people, or, in all Missouri with a population of 6,137,428, enforcing mask mandates, would have saved 6 (six, single-digit) people.

Is it reasonable, to impose a mandate such as this that negatively alters people daily life to this extent, in order prevent 6 people in the all-state from dying?

EDIT: Grammar

The implication of your "logic" is that there is a specific threshold number of people who would need to die for you to decide it's worthwhile asking people to wear masks. That number has to be more than 6, or you'd be saying the mandate was worthwhile and should have been imposed. I wonder how many it is.

Yes, there is always a threshold proportional to the inconvenience caused. If you are fine with any inconvenience, then the number one life saving thing is banning travelling.

Travel bans are only effective if each area has different rates of infection. Without that bans are simply another form of social distancing, shutting down airports being roughly equivalent to shutting down movie theaters.

That isn't quite right. Even with same infection rates travel bans limit the ability of virus mutations to escape.

However for a travel ban to work it needs to be applied strongly and for a long time. If you wait until a new variant is found worth watching closely it is too late as it is already across the ban and will spread on both sides.

The US needs a travel ban that covers cities (MSA?) to really be good. I have no idea how you would pull that off. (both constitutionally and logistically seem impossible)

Logistics is also an issue at the national level. In practice travel bans aren’t completely effective so novel variants like Omicron will slip through national level travel bans outside of tiny island nations.

That isn’t to say slowing things down is useless, nor that quarantines are completely ineffective. It’s just that travel bans tend to have gaps and with a disease it only takes one.

The logic is sound.

You can save essentially every single person who will die in a traffic accident by banning cars. That’s likely a hundred or two people a year just in Missouri.

There’s a cost and a benefit, and most people would say that - no, the benefit of 100-200 people per year is not worth the cost of banning cars. But if it was 200,000/year, they would likely say yes.

The costs of masks are small but not zero - there’s pollution, there’s bacterial infections (masks that aren’t replaced every few hours are Petri dishes), there’s cognitive delay for babies, there’s horrible experience for the hearing impaired lip readers.

You may believe the cost/benefit is worth it, someone else will disagree.

But it always comes down to just that - a cost benefit analysis.

I've wanted to ban cars for that reason for years, I know it isn't realistic, but I still want to. I favor more drivers training. I favor limiting the drivers ability to adjust the radio. I favor more/better transit. If self driving cars ever become real I'll favor them (right now they have enough limits as to not count).

> You can save essentially every single person who will die in a traffic accident by banning cars.

This, but unironically.

(This post brought to you by Train Gang.)

If your reasoning for refusing to wear a mask when you go to Walmart is "What if a lip-reader can't tell what I'm saying?!" then I think you might be a ... well, I won't put the word here because some people don't like it, but it begins with C.

If that’s what you read into my post, all I can say is, we’ll, not sure what I can say cause you’ll likely read it wrong too.

We tolerate driving, construction sites, motorcycles, alcohol consumption, cops with guns and don't go into lockdowns during flu season. There's a number of people who need to die every day due to those factors, and you're okay with that. What is your number?

We tolerate those things because they're useful. They enable our way of life. Wearing a mask has essentially no impact on our lives, so it's not really worth accepting deaths in order to not wear one. You just wear one, and fewer people die, and nothing else changes. It's not like giving up cars or construction sites at all.

The problem here is that you're trying to claim that the utility that cars provide to society is equivalent to the utility of going shopping without a mask on. That argument is obviously stupid.

Breathing air that's not filtered through wet dirty piece of cloth is useful too.

If you're ready to wear mask all the time for the rest of your life, would you agree that we need to start wearing hard hats all the time? That will definitely save some lives. Same for motorcycle helmets for bicycles - why not? Hazmat suits for shopping - why not? They must be much more efficient than just masks. Why wouldn't we ban motorcycles and mountain bikes? They are not "useful" and take lives every year. Safety is number one priority out of one, right?

BTW words like "stupid" and "obviously" don't add credibility to whatever you say.

The implication of your logic is that any mandate that saves even one life is worth it, no matter how onerous. This is what the authoritarians that want to ban smoking, sugar and alcohol are hoping you agree with.

The implication of your logic is that any mandate that saves even one life is worth it, no matter how onerous.

That's not the logical implication of my post at all. I'm not saying "lives are more important than everything else"; I'm saying "wearing masks isn't onerous, so how many people need to die before you'll wear one?" To suggest that we should totally change our way of life to save people, by giving up alcohol for example, is too much. To make a tiny change that has almost no impact on you to save lives isn't too much.

The crux of the issue is that there is a cutoff point somewhere, where lives saved outstrips the burden to the individual, but we cannot agree on a cutoff point because it involves a variety of subjective value judgements. We probably agree that there are cases where the value of individual freedom is more important than the lives saved (e.g. most people would be against banning sugar in soda pop), and that there are cases where lives saved is more important than individual freedoms (e.g. most people would be in favor of banning cyanide in soda pop).

Then there are cases where there is a pretty healthy debate, e.g. "should sarsaparilla be banned in soda pop?" Sarsaparilla, the traditional flavor of root beer, contains safrole, which has been shown to be highly carcinogenic in mice, which is why the FDA recently banned it. But if you ask the people who are against the ban, they might give you a variety of reasons you don't expect, which is a good exercise because there are some decent analogues to the anti-mask argument, even if it's not a perfect analogy obviously:

* the evidence that it's harmful is humans is somewhat debatable (anti-mask-mandate people might argue about the quality of the evidence that wearing masks reduces deaths)

* other foods like nutmeg contain safrole but aren't banned (anti-mask-mandate people might argue that restrictions are arbitrary and thus may have an ulterior motive)

* sarsaparilla has a quality that some people prefer to the non-toxic alternatives for subjective reasons such as the taste (anti-mask-mandate people might say that they subjectively prefer not wearing masks, e.g. because they find them uncomfortable or inconvenient)

* sarsaparilla farmers may be impacted particularly heavily even if most people are not (anti-mask-mandate people might suggest that while most people, even themselves, are not heavily burdened by wearing masks, it might more seriously burden a smaller minority of people [1])

* people with certain moral/ethical/religious/political beliefs might be fundamentally against the idea of a government forcing such a ban on the population, or even the government having the authority in the first place to impose such a ban, even if they agreed with the rationale and personally stopped drinking sarsaparilla soda (the anti-mask-mandate argument is roughly identical of course)

Hopefully the analogy isn't too out-there. I'm still ambivalent personally on mask mandates myself to be clear, for a combination of some of the arguments above.

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417296/

That’s the difference over 2 months for a specific implementation, longer term you need to multiply that by the number of months during the pandemic and the feedback loop from having fewer infected people walking around.

Are mask mandates worth saving at minimum 3 lives per month (~150 nationwide) and significantly more suffering? Well that depends on why you think a mandate is a bad idea. Some people might say killing 3,000 people per month is perfectly acceptable to avoid a mask mandate, others might say even avoiding 1 hospitalization is worth a mask mandate.

The CDC's best estimate of fatality rate was 0.6% (not 1.6%) back when we had a largely unvaccinated population. Now with vaccines and other improved treatments the fatality rate is significantly lower.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

That’s measuring something else. Asymptomatic carriers and people with mild symptoms only get tested when promoted by something other than the disease.

So 0.6% of infections, is roughly equivalent to 1.6% of positive test results because very sick people are vastly more likely to get tested. Aka 15.9 infections per 100,000 people is roughly equivalent to 5.9 confirmed cases and they result in the same number of deaths.

On the other hand, that depends on ICUs being able to manage capacity. As the infection rate goes up, the death rate can go up as less of those improved treatments are available. Also, as infection rate goes up, you get side-effect problems where non-urgent but necessary treatments (like cancer surgeries) are deferred.

Death isn't the only negative outcome of a COVID-19 infection.

That's also why using excess deaths is a better metric than direct deaths, since if COVID overwhelms hospitals and e.g. heart attack or cancer deaths skyrocket that is a related death.

But if you've created a bunch of new disabled people, that isn't exactly a fantastic outcome either and one more poorly tracked (e.g. I personally know someone who couldn't work for a few months following hospitalization and recovery).

You forgot the so important "per day" part.

> The statewide data shows that, from the end of April to the end of October, jurisdictions with mask mandates experienced an average of 15.8 cases per day for every 100,000 residents compared to 21.7 cases per day for every 100,000 residents in unmasked communities.

So, we have a decrease from 21.7 cases PER DAY, to 15.8 cases PER DAY, that is a 27% decrease. A "layman's analysis" would tell us that mask mandates would have saved 6 people per day, ~180 per month in the state. That is already a considerable number, but that is not even the whole story, epidemics are all about the exponential transmission, every small decrease compounds to a much greater decrease in the future.

Great and subtle point we must reduce the spread before it gets too big, Not after that.

It is like the story of a boy who saw a hole in the damn and put his finger in it to stop it. There was not much water passing through such a small hole. But the boy was smart and realized if he let the water run through the hole, the hole would fast grow bigger and bigger so the whole damn would soon break. When the levee breaks mama you got to go.

All due respect but this comment demonstrates a naive understanding of COVID and mask mandates. It's possible this comment is just trolling as it's the only comment your account has made but I'll attempt to address the issues with it regardless.

First, calculating a theoretical number of deaths through end result statistics does not result in a number that can be used to support a logical argument. When approximating deaths for something like COVID, the things that matter are:

1. The fatality rate of COVID, assuming the hospital you're treated at has sufficient means to treat you.

2. The fatality rate of COVID, assuming the hospital you're treated at does NOT have sufficient means to treat you.

3. The contagiousness/ability of the virus and likelihood that you'll spread the virus to someone else once you've contracted it (R naught). Basically, think of this as the number of people you'll infect if you get the virus.

4. The number of people in a population who can be infected by an individual at any specific time (effective reproduction number)

You can't just take a slice of time and say "6" people will die, and remove mask mandates, as COVID spreads through exponential growth. The benefits of wearing a mask compound, just like not wearing mask compounds in a worse way. Think of it this way. If the R naught of a virus is above 1, (say 1.1) then the virus will continue to spread. If it continues to infect more and more people, unchecked, it will eventually infect almost everyone. If it infects everyone, with a fatality rate of 1.6% in Missouri, it will kill thousands, not 6.

The ways available to us to stop COVID are to attack all facets mentioned above. I won't go into all of them, as mask mandates solely aim to curb 3. The goal of mask mandates is to make it so if you have the virus, you infect less than 1 person, so that the virus stops spreading.[1] But the benefits affect all the above, such as, if the virus continues to spread (R naught above 1), then eventually we run out of hospital capacity. If we run out of hospital capacity, the death rate skyrockets, as many preventable deaths are no longer preventable. So, mask mandates now also potentially benefit healthcare capacity (flatten the curve, remember?).

So, to specifically isolate the issue with your argument, the number of cases per 100k with and without masks doesn't matter if the virus is still spreading. If it's still spreading, it will still infect everyone eventually, and take its 1.6% of the population at the end of the day. Mask mandates are one component (on top of vaccines, social distancing, hygiene, etc) to lowering the R naught below 1.

So, is it reasonable, to impose a mandate such as this that negatively alters people daily life to this extent, in order to prevent tens of thousands of deaths in the all-state from dying?

The answer is yes.

[0] Good introduction to R naught and R_e https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751056/ [1] Thorough review of mask wearing statistics and benefits https://www.pnas.org/content/pnas/118/4/e2014564118.full.pdf [2] A better introduction to modeling COVID 19 https://www.nature.com/articles/s41591-020-1132-9

6 cases can be the difference between an R value > 1 or < 1, resulting in positive or negative growth. Remember geometric growth is in play.

Hey another brain user, so nice to see others with braincells that function. One day you might even get voted down to the cool kids table, but you have to tell a bunch of helpless nerds with no life experience how the world works as they cower under their desks and click the down button until the bad man can't be seen.

That is a weird graph. Am I missing something, or does it say that the counties with a mask mandate began to have substantially lower cases than those without starting two months before the first mask mandates were reimposed?

Same thought -- makes you think it has less do you with masks/mandates and more with city-folk being cautious as delta surges. Maybe the mandates encourage this behavior shift?

Top points if politicians noticed this difference off the bat and create the mask mandate to engineer the illusion that it was their policy that worked, even though it would've happened anyways -- aka action bias.

In any case, I think we can all agree people need to stop (1) using different random X-day moving averages and (2) give us the data.

edit: there's an entire literature on methodologies (1) Regression Discontinuity Design (RDD) and (2) Difference-in-Difference (DiD) that's designed to address this problem in analysis.

The reason for a 7 day running average is because there is a great deal of noise in the source data, that is how you clarify the picture to remove short term trends in numbers.

Confounding trends might exist for various reasons like: labs want people to have a day or two off, so process less on the weekends or some days of the week in spreading that weekend out.

People might interact in different risk settings over the course of a week. (E.G. For some higher risk on the job and shut in on the weekends. For others time to go out clubbing on the weekends and shut in jobs during the week).

So the 7 day running average just says: we can't disentangle to get at the true raw numbers, this is the best we can do to get useful data out of the data-feed.

PS: The only way to get truly useful data would be sufficient testing capacity to issue fully randomized tests on everyone, in a mandatory way, on a regular basis. A 'well designed survey' would probably still have biases but might approach that. To the best of my knowledge (public news media), currently most tests are probably focused on populations perceived to be at higher risk, who show visible possible symptoms, or who are obviously ill.

I get why it's used, but I strongly believe people are better off seeing the raw data. Exactly as you said, we can probably infer if there is variation in testing (weekends).

Or at the very least show the 7-period SD so we can see if the confidence intervals overlap.

You can absolutely use averages to hide data points and data quality.

PS: I disagree with your PS -- if we're being wildly theoretical and impractical about this we should just create a second Earth where everyone wears mask and a third Earth where no-one wears masks and compare all the Earths....

And none of what you're saying addresses the core problem I mentioned, which is that the divergence in the series starts before the policy date.

Yes, this headline is really misleading. You could argue the gap widened a bit after the mandate, but that is probably more a factor of behavior/vaccination rate compounding than masking. This is anything but conclusive about mask.

If I wanted to create a graph that disproved the effectiveness of mask I would use cities near the coast during the summer, one with mask mandates and one without. I would look at all those people that are outdoor in the warm and humid climate.

If I wanted to do the opposite I would pick cities that are inland with temperate climate during that fall, with the air dry and most people inside poorly ventilated buildings.

How is that relevant given these are all in MO, during the same time period?

Sorry, I should have developed the comment a bit more.

Transmitting and date rates are determined by multiple factors, many that are known. Risk groups, ability and convenience to do social distancing, population density, ventilation, weather, population movement patterns and more. In this case we got Kansas city vs St. Louis, through the article is trying to making an argument about the world in general.

Graphs like this are basically pointless except for one thing. They imply that there might be a benefit of masks, and thus while its not evidence of effectiveness its is not evidence of the opposite. It is what researcher use as support for doing further studies that later accounts for known factors. If however one uses it to jump ahead, someone else can create a similar graph in a different locations and time to create the opposite conclusion.

(Small note about the time period). It is worth looking at the period between April and August. The two lines swap places which each other. St. Louis started out with a higher rate than Kansas city, and end up with a lower rate afterward. This is a pretty common pattern and follow the old "even out the curve" concept.

Note that this graph was created by the reporters and was not generated by the health department.

The labeling is weird. The reinstatement arrow should point SSW not NW. That says that during the surge, those counties* had a lower death rate.

Presumably the counties that ever had a mask mandate had higher compliance even during periods when the mandate was lifted, but the article doesn’t discuss any of that, and it’s only a presumption.

* I think the blue line should be labeled “death rate in the four counties”.

How does changing the arrow change the fact that they had significantly lower case rates at the end of June while the mask mandate came into effect on July 26?

> The reinstatement arrow should point SSW not NW.

It points to the the point on the blue line at July 26. Why should it point SSW? Does SSW even intersect with the blue line at any point?

Even if the change started the day after the mask mandates we would know that the drop wasn’t caused by the mask mandates. Why? Because of incubation times.

You are assuming people would wait until the mandate was in effect to change behavior rather than for example buying masks in preparation for a mandate.

So your contention would be that people will wear masks even when they are not mandated? I would agree that could happen.

But then, that’s not a result of masks being mandated, is it?

No. I am saying if you create a mandate on date X, people will prepare for it before it comes into effect.

Yes, lots of things happen before and after lots of other things. But figuring out causes is a lot harder than saying something happened after something else.

Regardless, if people are willing to voluntarily wear masks before they are required, like you claim, then one thing is clear: Masks do not need to be mandatory for people to wear them. Imagine if they dropped the speed limit from 70 to 50. How many people would start driving 50 a week early to "prepare"? Not many. If people are so resistant to an idea that it has to be mandated for them to do it, then they aren't going to suddenly do it before it is mandatory. And if they aren't resistant to it, then it won't take a mandate.

In theory you might be right, but we don’t have to guess people have collected actually evidence.

Also, you can’t fake the response from an impending mandate without a mandate. Most people fill out their taxes early, but if taxes were optional then nobody would be filling them out. The test would simply be to look up when a mandate was announced and then when it took effect.

The supposed "actual evidence" is what we are arguing about right now.

At the end of May, the places that would institute a mask mandate two months later fell below the other places. Then they stayed below the other places. Attributing that to the mandates is bordering on absurdity. We aren't talking about a week. We're talking about two months. That's long before people are preparing for a mandate that nobody is even considering yet.

You might as well say, "Places that will eventually have mask mandates have higher infection rates two months prior to the mandates."

I don’t think anyone was suggesting that, the masked line was above the masked line in the article but that’s summing data across multiple sources and mask mandates that took place at different times.

Look at the underlying data for each mandate in the state and things become much more obvious.

In fact, the way I read the chart, it rather proves that mask mandate were ineffective as there was no inflection point following the introduction of the mandate. Instead the two curves remained pretty much parallel, suggesting the evolution wasn't related to masks.

it rather proves that mask mandate were ineffective as there was no inflection point following the introduction of the mandate

That might indicate that the mask mandate was ineffective and the evolution was due to something else, or it might indicate people didn't abide by the mandate as soon as it came in.

When you look at the world through mask tinted glasses, all the mask flags just look like flags.

It depends on interpretation and I think conclusions are unclear from that graph.

Try this: shift the blue curve about 15 days to the left. We may then interpret masks acted in lowering the infection peak, since masks were introduced at an earlier infection stage. In other words, if St Louis reinstated masks at the same infection count as Missouri it might have seen a higher infection peak.

This is what makes me laugh about everyone trying to figure out which country did it “right”.

One country is on the down slope of a wave and get kudos for an effective strategy. Some country on an upslope get trashed. And it changes every few months.

We won’t know which countries handled it well for another 5-7 years once analyses can be done that take into account the full impact of strategies.

Then add on top their stats aren’t even comparable due to different levels of testing, different categorization, etc.

Just looking at raw stats says Africa did really well with Covid even without the vaccine. But if you don’t test, you can’t find cases. No cases, no covid deaths.

> Just looking at raw stats says Africa did really well with Covid even without the vaccine.

Africa is doing surprising well with COVID-19, considering expectations. Reasons may include:

* Not kidding themselves like UK and US did that they were "world leaders", and had this in the bag. (1)

* Recent and ongoing experience of combatting other diseases, e.g. HIV, TB, Ebola.

1) "In October 2019, an extensive report two years in the making placed the US and the UK first and second respectively in a global ranking of countries’ pandemic preparedness." https://www.huffingtonpost.co.uk/entry/uk-coronavirus-pandem...

Another reason may be better ventilation.

The population is perhaps much younger in Africa as well? The healthcare system is also less advanced / widespread so there are fewer people living with underlying illnesses that increase the severity of Covid once infected.

The last time I was in an African city there wasn't air-conditioning as standard in houses. Sure, windows were open in summer, but closed up in winter. Office buildings had the usual levels of ventilation. I can't really describe this as "better" - how about you?

Obesity is one of several critical factors. The obesity rate in most African countries is relatively low.

https://www.wfae.org/health/2021-09-30/novant-says-9-of-10-c...

Vietnam has low obesity and has one of the higher fatality rates.

I’d argue it’s all about how Covid deaths are counted and how widespread testing is.

Having worked in healthcare attributing a cause of death is not easy in many cases. There are underlying factors and comorbidities.

In Singapore pneumonia deaths were typically 4,000 per year. That went down dramatically with covid. Why? Because they died of covid not pneumonia.

Yeah, anyone who's been following the way the virus spreads will have seen how countries will be declared success stories that beat the virus, and then a couple of months later get an enormous surge. Or we'll be told that a country is on the brink of collapse, but then the wave breaks and the cases suddenly start dropping. Just to give one example, here's how Czechia was presented in the summer of 2020[1]:

> Anyone interested in a real world case study on the extraordinary effectiveness of face masks in suppressing the spread of the coronavirus need look no farther than Prague. In this capital city of 1.3 million, among the first in Europe to decree mandatory universal mask-wearing almost four months ago, life has now returned to normal.

Most of Europe in general was presented as having beat COVID before the late summer surge.

No matter what happens, people say it proves their preconceived beliefs correct. "This country is doing better? Well, that's simply because they did [THING I LIKE]. Now it's doing worse? It must be because they're not doing [OTHER THING I LIKE]."

[1] https://www.usatoday.com/story/opinion/2020/07/14/how-czech-...

I think your observation points to the fact that Covid must be stopped globally. No country is safe until all countries (who allow international travel) are safe.

COVID can never be stopped globally. SARS-CoV-2 is now the fifth endemic human coronavirus and will never be eradicated regardless of how many people wear masks or get vaccinated or whatever. There is no such thing as "safe", we just have to accept the risk and move on. Fortunately the vaccines and other treatments are very effective at preventing deaths.

https://www.businessinsider.com/delta-variant-made-herd-immu...

As someone who lives in one of the areas in this study that instituted a mask mandate, I think the clearest explanation of the lower case rates preceding the mandates is the general willingness of the population to mask prior to the dates noted on the graph. Yes, the most recent mask mandates weren't instituted until July 26th, but, for whatever my anecdata is worth, masking use in the more urban areas was already substantially higher than it was in the areas without the mandates. There's also the small matter of the more populous areas having higher vaccination rates than the state's more rural areas.

To me, the story here is not the data itself; it's another example of elected officials hiding data that doesn't agree with their position. Is the headline the best interpretation of the data? Not at all. But it's one more data set showing that the areas that are most closely following relevant recommendations are seeing better outcomes than areas that aren't.

I think it may ultimately be more useful to think of mask mandates as an effect rather than a cause of reduced disease spread. Communities that are culturally predisposed toward prosociality don't actually need mandates to produce collective behaviors that reduce spread. It's politically viable to impose a mask mandate in those places, even though it's unnecessary for producing a public health impact. The converse, in areas where it's politically infeasible for public officials to impose a mandate, appears in a population where individuals are not predisposed to adopting public health measures on their own.

Yep. There's a very strong correlation simply by political affiliation. This Washington Post columnist has some very telling graphs:

https://twitter.com/pbump/status/1466261627074920452

Basically, the more urban and politically blue the county is, the more success they had against COVID, despite the fact that urban locations with higher density and more shared spaces have an intrinsic disadvantage in stopping the spread of disease.

By politicizing public health measures, they got outcomes split by political culture.

Exactly. If you remove the labels from the two lines and then ask which set of counties imposed mask mandates in July, there would be no way to tell. If anything, you might think it was the higher line; "see, their cases were spiraling out of control, then they required masks and their cases peaked and declined at the same time as the less hard hit counties".

Unless that chart is a horribly misleading presentation of the data (quite possible!), it's evidence against mask mandates having any discernible impact.

This study is not a randomized controlled study and it lacks even modest efforts at statistically controlling for confounding factors. It is therefore not possible to draw any meaningful conclusions from it. It appears science education is not what it used to be. For a comparison between outcomes for two groups to be informative, those groups must be selected in a way that structurally eliminates the possibility of confounding factors. If that is categorically impossible to achieve, then a well-constructed study will seek to control for all conceivable confounding factors by sampling other variables and statistically controlling for the possible influence of those variables. This is not hard.

I'd say that of the endless studies and pieces of data, 90% indicate masks do nothing. All pre-covid mask studies concluded they do nothing...there was even a paper about why people in Japan wore masks despite them doing nothing. The two most robust studies (Bangladesh and Denmark) concluded masks do nothing. COVID rates in nearby mask vs non-mask places (endless sources of this) show masks do nothing. The few things suggesting masks work are usually the product of data mining, aren't statistically significant, or have other fatal flaws such as not being able to distinguish between causation/correlation or behavioral factors. The CDC's own study was comically flawed, cut off before COVID spikes last November...it doesn't even qualify as amateur hour.

The idea that masks work is just wishful thinking from people who are anxiety-ridden. They're placebos, amulets. If people want to wear them, fine, but the notion that there's enough evidence to justify universal mask mandates is truly one of the sorriest aspects of COVID because it's so symbolic of how we've done away with reason and scientific process completely.

Without analyzing more closely which jurisdictions were “masked” we can’t make a thorough conclusion on mask mandates. Masks have been shown to have some effectiveness, but not necessarily its mandates, as the latter does not imply appropriate usage.

Wouldn't the data they gather include artifacts of improper usage and ultimately feed into their conclusion on whether mandates work?

If your point is that looking at counties and assigning mask_mandate = 1 vs mask_mandate = 0 isn't rigorous, agreed.

If you look at the series the different in case rates started before the mandate, making me think it's more about behavior differences in cities vs rural areas than the mandate (makes sense).

No, nothing I said at all is in regards to what you mention.

I'm replying to the point that mask mandates do not imply proper mask usage, which is almost certainly correct. However the usage errors the general population will make with masks should show up in the overall case rates and be accounted for in the data and conclusions here.

We don't need "a thorough conclusion" in order to decide if mask mandates should be enforced, just a good-enough conclusion. Demanding "thorough" is a great way to induce analysis paralysis rather than make an operationally effective decision.

It's awfully hard to make any sort of decision if the data isn't made available, yes?

The article lists the four jurisdictions which had mandates: St. Louis, St. Louis County, Kansas City and Jackson County.

What more do you want?

It's fun to cherry-pick the literature:

"Our findings show that the Public Mask Mandate significantly lowers the incidence of developing all COVID-19 symptoms by 0.29 percentage points." - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379388/

"The mask mandate is consistently associated with lower infection and mortality rates in the short term. Early adoption of mask-wearing mandates is also consistently associated with lower COVID-19 infection rates in the long term, indicating the link between a government’s intervention speed and policy instrument efficacy." - https://onlinelibrary.wiley.com/doi/full/10.1111/puar.13426

I have no issue with masks, but that graph clearly shows divergence long before masks were mandated, and no obvious change in relative infections once they're introduced.

What is the bottom line on masks and COVID-19? I am really out of the loop, since the toxicity of the debate was exhausting. The last I heard was that transmission is mostly via aerosolized viral particles, so most masks are essentially useless except N95 or higher grade.

Anyone have resources I can check out? thanks

Yes respirators are better than cloth. Both make sense when getting close to strangers, like in a bus, train or airplane. They don't make sense outside where people density is low. Effectiveness most probably tanks immensely once you get into a room with bad air exchange were infectors spend longer time. These contraptions can't stop viral particles from saturated air going through the microscopic and macroscopic holes.

The reality no one wants to admit is that there is ample evidence for both "sides" of the argument.

"I've convinced myself that this {is, is not} a good idea, now everybody has to agree with because I'm RIGHT!"

I cannot wear a mask, it fucks up my breathing badly. Neither side of the debate has room or time for me or those like me. I stayed out of the neighboring county for most of last year because of their mask mandate.

Another thing about masks is that they're specially effective if the infected person is wearing one. Even if it's not perfect, it reduces the number of droplets and the distance the virus can travel.

I started to believe these analyses were conducted by people who intentionally wanted to mislead. It’s impossible to find the effect of mask mandates this way. Anybody with a little common sense should know that. Why? Mask mandates were never implemented alone. Places implemented mask mandates usually also have other regulations like social distancing, closing restaurants or indoor dining, or temperatures measuring, etc. Claiming the effects are just masking is intentional misleading.

Right, all this graph shows is that jurisdictions that imposed mask mandates had much lower case rates. Presumably that's because they had a lot of policies in place that put together were effective. Clearly they were doing something that worked, and it might even be sensible to use mask mandates as a proxy for that, but the article is a bit misleading. It would be nice to see how mask wearing rates had an effect but I suppose that's not as easy to track over time.

It may also be that people in these places took more precautions of their own initiative.

It seems a bit unlikely that mass co-ordinated behaviour that's this effective would spontaneously arise like that.

Also, at least based on the area where I live, the locations with a higher proportion of believers in science, less in "freedom", and so on, are the places that impose mask mandates. So there may be some tail wagging dog going on.

Exactly. Regions implemented mandates have different population than regions didn’t.

This kind of one variable comparison is totally junk science.

If masks were effective against a virus just show proof. It should be super easy to do. But they won't because They can't. Because if you have two braincells to click together it doesn't make sense. It makes sense to Reduce transmission, but there's No proof that happens, and if there were we'd all know by now. So if you're sneezing or coughing, dont leave the house, you should stay home and our government would support that if they cared, but you have to go to work with a mask, even if you're not sick, it's retarded and just makes people more conformist or picks out the non conformists. If you like other countries that have no choice but to do stupid things like everyone else (ahem, Japan) well you can't move there permanently because they're super super racist, but nobody cares, but go live there for a bit, it sucks, it's extremely conformist and lacks all freedom of individuality, that's why GI's almost always come back after a few years. Think for yourself, question authority.

My dad lived through the seatbelt mandates. People came up will all sorts of justifications why seatbelts were bad, more dangerous, choked them, gave them aches, etc. simply because they didn't want to wear them.

Best policy/strategy isn't necessarily the same for every possible place in a country. It is not easy to compare numbers for different places and judge strategies absolutely, when observed differences between counties or larger areas are this low.

Also, it's not just the question of whether masks are effective, it's also the question whether enforcing them is warranted. Arresting infectious people and sending them to isolation would also be "effective", but that's not something that civil society principles are compatible with. It's perfectly possible that masks are effective, yet the negatives of enforcing them are so big that people in charge decide to not do that.

Is it just me, or does it seem like only one end of the political spectrum has perfected information virality?

What is it about these messages that is making them so sticky? Is it volume, medium, semantic construction, social proof?

I'm hoping this link's threads manage to remain intellectually directed because I'm really curious what people here think.

>I'm really curious what people here think

HN has its fringes just like anywhere else. And just like anywhere else they tend to be noisy. Anything with a hint of politics attached to it is best ignored (which I'm obviously failing at).

I guess the clunky efforts people go to here to give the appearance of being neutral and objective console me. Maybe people with different beliefs really can communicate in a dignified way...

There is a huge PR asymmetry.

There are actually parties involved with huge financial interest who want to sell masks, vaccines, PCR tests, etc.. If they are successful in convincing the people that their offered products are a solution for the pandemic, they can make a huge profit, so it pays for them to financially support their narrative. For the sceptics there is not much money to be made if they succeed.

So for masks, vaccines, tests, etc you have the opinion of people who sincerely think this is the right solution PLUS the marketing budget of companies with financial interest. On the opposite side you only have the opinion of people who are sincerely sceptical.

In Germany we had some politicians suddenly became very active in the mask business. In Bavaria there was even an FFP2 mandate (which didn't achieve shit) to support their mask industry.

> For the sceptics there is not much money to be made if they succeed.

Some of the skeptics have been selling supplements and miracle cures for autism, cancer, and anything else you can think of for years.

Others are leveraging anti-masking for political gain.

There’s plenty of budget on the anti-mask/anti-vax side of things.

That's not a good answer. Political gain is the same for the mask wearing side. Political characters can have side gigs on both sides.

For the sceptics, the money to be made is coming from tourism / small businesses. Small businesses are probably incapable to organise themselves, so that leaves big companies in tourism.

If I were Booking.com or a flight company, for example, I would support the anti-vax side of things.

On the mask / vaccine side, you have big pharma / big tech / the government.

> Political gain is the same for the mask wearing side.

Not really, no. It's pretty clear Republican politicians have been able to seize on the issue in a way Democrats have not. That may be a bit on the Democrats' tendency towards disarray in general, but if you want to be a prominent Republican right now, you're probably not gonna talk about being pro-vaccination too much.

> If I were Booking.com or a flight company, for example, I would support the anti-vax side of things.

That seems unlikely, given the damage to their businesses low vaccination rates cause. I recently traveled to French Polynesia; vaccination was all but required. Ten day quarantine if you aren't. They know what "people are dying there" headlines do to tourism.

> On the mask / vaccine side, you have big pharma / big tech / the government.

Big tech has been significantly responsible for the spread of anti-vax and anti-mask beliefs.

Nonsense. According to Senate minority leader Mitch McConnell: "Kentuckians and All Americans Should Accept the COVID-19 Vaccine".

https://www.republicanleader.senate.gov/newsroom/press-relea...

He's the most prominent Republican politician in the country.

> He's the most prominent Republican politician in the country.

He really isn't. There's at least one you're missing.

McConnell's currently trying to avoid having his party shut down the government over vaccine mandates.

Which one am I missing? House minority leader Kevin McCarthy and former President Trump have also encouraged vaccination.

https://www.kget.com/news/local-news/house-minority-leader-k...

https://www.politico.com/news/2021/03/16/trump-americans-cov...

> former President Trump have also encouraged vaccination

Yes, Trump is the one.

If you're counting Trump, you're reading "you're probably not gonna talk about being pro-vaccination too much" very differently than I intended. Trump similarily gave the occasional half-hearted "you should wear a mask" statement, but pretending he's a masking advocate would be silly.

His latest half-hearted attempt at promoting vaccination resulted in booing from the crowd, and he hasn't really touched that live wire since. https://www.nbcnews.com/politics/donald-trump/trump-booed-al...

McConnell is set to retire at the end of his current term.

> If I were Booking.com or a flight company, for example, I would support the anti-vax side of things.

How does that make sense? How does a more vulnerable population help booking.com? You'd think they'd want to overcome the pandemic too?

Sure, they might be anti-lockdown, and might get lumped with anti-vax, but there is less than zero benefit for travel-related companies in advocating against vaccinations.

There are other incentives than financial. A lot is based on group identity - many people have no idea about vaccines, pros or cons, and just follow what someone they respect says. If you don't have the same recommendation as their 'guru', you're either an industry shill or a conspiracy theorist depending on which way it goes.

Which end of the political spectrum has perfected information virality?

The far right. I'm on the opposite end and I still find it easier to conjure their talking points better than the ones I subscribe to.

The right has more uniformity in terms of messaging. They seem to be able to more succinctly distill their messages. They leverage emotional affect. They target a wider swath of values, as opposed to the monotone drone of "fairness".

Besides the technical aspects of propaganda, what really fascinates me is how well they've transmitted the meta techniques of effective messaging. I can name dozens of right wing intellectuals, but I falter with the left. Does Zizek count? Lex Fridman? Sam Harris? Does AOC write books or have a podcast?

I've definitely noticed that my amateurish attempts to learn what biohackers do has given me unexpected insights into memetic warfare. As in biology, memes often have both a vector and a payload - the vector convinces a cell to allow in a foreign body, and the payload tells the cell what to use its resources for once it's being treated as friendly. These two are fairly independent, in biology for example one can remove all genetic information from a viral body (the vector) and replace it with one's own instructions (the payload). I think Dawkins' analogy of memes to genes has turned out to be much richer and predictive than it would have seemed at first, replicating information seems to follow similar dynamics no matter the medium.

To your question, I'm not sure I know the full story but I have a theory. If you're at all familiar with the public intellectual Jordan Peterson, you probably know of his polemics against 'Postmodern Neomarxism'[1]. Given that Peterson is a self-described american pragmatist, which defines truth more similarly to postmodernism than most schools of though, I wondered why he would hold such animosity to a philosophy so similar to his own. Someone did in fact ask him about this a while back. His answer was unfortunately rushed, but if I understood it correctly he believes pragmatism describes truth as 'what is most beneficial to believe' while postmodernism describes truth as 'the winner of a Darwinian conflict against other versions of truth'.

If that is an accurate description, then I think it's quite obvious: messages informed by a postmodern tradition are more 'sticky' because they have been selected for maximum sticky-ness, which is related to the wellbeing of the host but not identical. Competing messages have been selected for maximum benefit to the host, which is related to the ease with which they stick but is not identical.

[1]As an aside: a lot of readers would have had the mental equivalent of an immune response the moment the saw 'Jordan Peterson'. The use of the unflattering descriptor 'polemics' to describe him immediately thereafter is a deliberate attempt to modify the vector so as to convince those readers in particular to allow the message through regardless. Fans of Peterson would of course read on despite this, as they tend to engage in discussions involving him with friendly or unfriendly parties. Note that this use of language only affects the vector with which I delivered my idea, the payload relates to variance in memetic selection and is independent of how it is packaged. This is a very simple example of how I understand memetic warfare working - I hope our memetic immune systems are strengthened by this demonstration.

You deployed that meme effectively. I generally cringe at the mention of Peterson, but "polemics" disarmed my knee jerk. That was a cool example of the vector-payload model!

It's Followers following bro. It's like that Peter pan song. We're following the leader, the leader, the leader, we're following the leader wherever he may go. Do dum, do dee. Anyways. It's a hierarchy of following, I like to imagine a tree list moving together towards the memory collection function and your leader, just an item further up the hierarchy, and your leader is like: Don't worry. Just follow. I won't collect your memory, unless you disagree. Nobody knows though, this mofo can't collect your memory, that's a process, but dude thinks he can tell you the process isn't real, and he's actually the one who controls the garbage process. Everyone gets collected, nobody knows its them until it is. The thing your group is running from is still coming, it's catching the slow ones first, but it will catch you all, and you're being sold the idea that it can be staved off, but really, You just never see it coming.

Here is another study, which was published:

https://www.imf.org/en/Publications/WP/Issues/2021/08/05/Mas...

"Crucially, we find that the effect of mask mandates depends on the attitudes toward mask wearing at the county level, with larger effects in counties more positively inclined towards mask wearing."

and

"Importantly, this paper does not estimate the effect of wearing masks, but rather the effect of mandating mask wearing."

This indicates that the mask wearing itself may not be the cause, but the behaviors of people who are more "positively inclined" to the mandate. The study does nothing to separate correlation.

I’m confused by the conclusions of Missouri’s ‘study’. Did I misread, or are they claiming that a mask policy—whose adherence is nearly impossible to validate—correlates with improved health outcomes? For that to be credible, wouldn’t it require actually verifying mask wearing?

Meanwhile my home state continues to quibble about mask mandates in federal court.

https://www.dallasnews.com/news/education/2021/12/01/gov-abb...

I see legal arguments but no evidence from any party on this matter.

Why look at Missouri which is a really small sample? Look at the rest of the world where mask mandates are in effect. Europe for example, isn't a COVID free haven, quite the opposite.

A colleague of mine got sick of COVID last January while he did everything by the book (masks, gel, distancing etc).

So the effectiveness of masks is probably marginal IMHO.

Masks (the N95 kind not the loose dentist kind), gel, distancing, double Pfizer shots. Still got COVID with severe symptoms not even 4th month in after the second shot.

Why is there no good statistics over breakthrough infections, not merely how many double vaccinated are in hospital? Why not blast the non-immunity provided by supposed vaccine the same way as "infections per day" is shown everywhere?

Show "failure of vaccine to provide immunity cases per day"

>Masks (the N95 kind not the loose dentist kind), gel, distancing, double Pfizer shots. Still got COVID with severe symptoms not even 4th month in after the second shot.

Ouch. Anecdotes like this really scare me. I also have friends with double Pfizer shots who got the COVID and had strong symptoms.

Maybe Pfizer should go back to the drawing board though.

Though I assume, without the vaccine they would have probably ended up in the hospital. Glad I got my 3rd dose now.

An anecdote in the other direction: I know people that were working in the hospital, treating COVID-19 infected people, before vaccines. Protection was a N95 mask (well-fitted and tight), a gown and gloves. They worked for months without an outbreak, until a bunch of them got infected. The source of that infection was probably in a meeting with a patient (for things unrelated to COVID) in a closed room when they were wearing non-N95 masks. None of them had strong symptoms other than a few days feeling awful.

> Maybe Pfizer should go back to the drawing board.

Maybe we should look at the data and see that the vaccines are still pretty effective. Think about the difference in restrictions and people behavior between now and before the vaccines: they have pretty much enabled normal life again and made COVID a much less worrying disease, even with high case numbers again.

Maybe Pfizer should go back to the drawing board though.

The vaccines (on the U.S. market, at least) were never promoted as providing complete protection from Covid. It was about preventing serious illness and keeping people out of the hospital. As others have pointed out, they have been largely successful in those goals.

I'm not claiming the vaccines are perfect, but I think a large part of the population was under the impression that these vaccines were some sort of silver bullet that would end the virus in a few short months.

edit: spelling

"The vaccines (on the U.S. market, at least) were never promoted as providing complete protection from Covid."

Then do not call it a vaccine, because it is not.

I did not take my TBE vaccine, to be greeted a year later by TBE.

What definition of "vaccine" are you using? From Wikipedia[0]:

Vaccines can be prophylactic (to prevent or ameliorate the effects of a future infection by a natural or "wild" pathogen), or therapeutic (to fight a disease that has already occurred, such as cancer). Some vaccines offer full sterilizing immunity, in which infection is prevented completely.

The key word up there is "ameliorate," which is exactly what the Covid vaccines available in United States promise to do.

[0] https://en.wikipedia.org/wiki/Vaccine

Look at the CDC definition of Vaccine from 2020 Summer and from today. Compare the Wikipedia entry of Vaccine from today and from a few months ago.

Notice anything in particular? While yes, the definition has changed.

It is an anecdote, not data. Simple math: if Pfizer says their vaccine is 90% effective at preventing severe disease then 10% of people are at risk of getting severe disease. Not everybody catches COVID (masks, distancing, etc. do reduce the risk significantly, it seems), so say that’s another 90% reduction for each. That means that 1 in 1000 people you talk to will get severe COVID even when fully vaccinated.

Keep in mind that the person you are replying to is here to tell the tale. It is unclear what the vaccine did or did not do but if I was in their shoes I would certainly be glad that I wasn’t facing that infection unvaccinated. That could very well have been the difference between severe and deadly COVID. The effectiveness numbers have been always quoted as against severe illness but I would much prefer to focus on effectiveness against hospitalization and death. It seems that all three vaccines authorized/approved in the US are effective against these two outcomes, more so than merely protecting against a severe case.

Also keep in mind that what a random stranger describes on the internet as “severe” could mean a variety of things. I have had some severe colds. I haven’t had one since the pandemic started due to social distancing and masks. Don’t panic. Get your shots (booster included) and keep an eye on the data.

> Simple math: if Pfizer says their vaccine is 90% effective at preventing severe disease then 10% of people are at risk of getting severe disease.

That’s not quite how vaccine efficacy works. Suppose the risk of getting sick is 0.5% per thousand person hours when unvaccinated. A 90% vaccine efficacy means that the risk of getting sick is reduced to 0.05% per thousand person hours, not that 10% of people who get vaccinated are still vulnerable.

I think you’re mixing effectiveness and efficacy. You’re both correct but talking about different terms minus that the parent comment needs some prior adjustment in the numbers to get the posterior.

According to the WHO, efficacy refers to vaccine performance in controlled studies whereas effectiveness refers to performance in the broader population [0]. Data aggregated by JHU appears more or less consistent with estimates of vaccine efficacy [1].

[0] https://www.who.int/news-room/feature-stories/detail/vaccine...

[1] https://coronavirus.jhu.edu/pandemic-data-initiative/data-ou...

Maybe the Pfizer dose just needs to be higher like Moderna's

I don't know about your country, but in Spain we have those stats each day from the ministry of health. Turns out that the efficacy is still pretty high, around ~80% for infection. There was also a report with rates of hospitalization between vaccinated and non-vaccinated (I can't find it right now, I'll try again later) and it's a pretty clear difference, 6-14 times (depending on the age) more hospitalizations for unvaccinated persons per capita.

England for one has open source statistics, and most cases are breakthrough. Alex Berenson has some good analysis of these statistics on his Substack.

> England for one has open source statistics, and most cases are breakthrough

I was thinking why one would say this without mentioning that the vaccination rate is pretty high, so one would expect more breakthrough cases than cases in unvaccinated people. For an extreme example, with 100% vaccination rate, all cases would be breakthrough. I can't find the UK data, so can't answer exactly, but not unexpected at all.

> Alex Berenson

And this explains why you didn't include it. I didn't know this person, but apparently he's a writer, no education in stats/biology/medicine, from the US, and apparently has made multitude of wrong claims [1]. I wonder if it's that you don't know better or you're making a bad faith argument.

1: https://www.theatlantic.com/ideas/archive/2021/04/pandemics-...

>I was thinking why one would say this without mentioning that the vaccination rate is pretty high

Does that really need to be stated? I don't think even the most suspicious among us think the vaccines make a person more likely to catch Covid all else being equal. It seems more a commentary on the narrative (not promulgated by you, but it is out there) that vaccines+distancing will somehow be able to eliminate the novel coronavirus entirely.

> It seems more a commentary on the narrative (not promulgated by you, but it is out there) that vaccines+distancing will somehow be able to eliminate the novel coronavirus entirely.

To be honest, the only times I've seen this narrative is when people say it's out there and argue against it. I've never seen it seriously supported.

That may be an effect of my own filter bubble at play, they do tend to bring the most insane examples of the outside belief structure to the fore. While I haven't seen anyone try to defend it, I have seen people imply they believe it's true. Would you not see this as an example of implicit belief that coronavirus can be eliminated through such measures? https://xkcd.com/2287/

And even more than mentioning vaccination rate you also have to consider age distribution.

Age is still a significant factor of infection chance and disease severity/outcome.

If older people are more likely to be vaccinated than younger people then it skews to more breakthroughs. You can even get a simpson's paradox where people were seeing higher fatalities in overall vaccinated vs unvaccinated but is not true when you controlled for age.

And these days one would probably also have to consider time since last vaccination since antibody titer wanes with time which is likely important.

The data for the UK shows a reduction of both hospitalization and deaths in the vaccinated population [0].

[0] https://www.bmj.com/content/374/bmj.n2306

Luckily we have data and not just anecdotes and humble opinions. For example, see https://www.nature.com/articles/s41562-020-01009-0: ‘Wearing a mask’ exhibits a significant impact on Rt in three methods (ΔRt between −0.018 and –0.12)'

It's not a silver bullet, of course, and there are some situations were masks will be useless: for example, when you get in a closed room with no ventilation with other people for a long time, masks won't do too much. Or if you get together to have dinner with others and take your mask off, well, they won't do much obviously. But masks are effective, and a pretty low cost intervention to reduce the incidence. That's a fact.

There's at least one RCT on masking w.r.t. covid that finds no statistical benefit. I don't think it's appropriate to reference modeling as evidence after we have thorough studies published.

https://www.acpjournals.org/doi/10.7326/m20-6817

Inconclusive results != no statistical benefit. A 95% of CI that ranges between 46% decrease and 23% increase is pretty much inconclusive, you can't say masks are better with that study but you wouldn't be justified either in saying they don't do anything.

Quoting the results section.

> Although the difference observed was not statistically significant

I'm not sure I understand your objection, but you most definitely can say there was no statistically significant benefit.

> but you most definitely can say there was no statistically significant benefit.

Yes, but this study also doesn't point too conclusively that they don't have any effect. If the CI was something like 1% increase in infections - 1% decrease, you could say with a lot of confidence that it doesn't seem that masks did anything at all. But -23% to 46% is a gigantic range to say anything at all about effectiveness. So while this study is, as you say, not supporting the hypothesis that masks are effective, it doesn't support either the hypothesis that masks are not effective.

No, it very specifically supports the hypothesis that masks are not effective. Maybe not to the rigor you would hope for, but to my knowledge this is the most rigorous covid/mask study to date, so it's the best we've got.

That isn't to say we should ignore all other studies, but the body of literature on mask effectiveness is very split. Maybe masks do work, I wouldn't be surprised if that were true, but given the body of evidence I'm of the opinion if they do work their effect is marginal.

> No, it very specifically supports the hypothesis that masks are not effective.

It very clearly doesn't. No support for "masks are effective" is not the same that "support for masks are ineffective". To put an extreme example, suppose I make an study with just two participants, one with mask and another one without, and neither of them get infected. The results wouldn't support the hypothesis that masks are effective, but neither could support the hypothesis that masks are ineffective. Which is the point: the study you linked to does not have enough power to actually check effectiveness of the measure. The 95% confidence interval is way too large to draw any conclusion.

Another issue for the study is that it's evaluating surgical masks, which are less effective than N95 masks, and only for infection of the wearer, when we know they're much more effective at avoiding others from getting infected.

That's why population-level studies are important, and you'll find that those support the effectiveness of masks.

That study is about the benefit of wearing surgical masks "in a setting where masks were uncommon and not among recommended public health measures"--thus answering the question "do surgical masks protect the wearer."

Surgical masks are thought to have a relatively limited benefit for the wearer, so this isn't surprising. However, https://www.nature.com/articles/d41586-021-02457-y demonstrates clearly that in a randomized controlled trial where surgical masks are distributed to a whole community, there was a statistically significant reduction in cases:

"The decrease was a modest 9%, but the researchers suggest that the true risk reduction is probably much greater, in part because they did no SARS-CoV-2 testing of people without symptoms or whose symptoms did not meet the World Health Organization’s definition of the disease."

There's certainly more to learn here, of course.

This comment begins with a call for larger sample sizes, segues to a single anecdote about a colleague, and ends with a sweeping conclusion that's contrary to most empirical research.

I'm not trying to be a dick, but maybe this demonstrates the flaws in a lot of our casual reasoning about public health measures.

Masks by themselves aren't enough to eliminate the virus, though they can be part of a larger set of measures.

The entire package of measures that bring viral prevalence to zero are well established, and have been implemented in several countries. They include:

* Initial lockdowns to drive incidence down to near-zero.

* After reopening, strict quarantine for people arriving from regions where the virus is circulating.

* Thorough contact tracing, and the ability to quarantine people who come into close contact with infected people.

* Temporary restrictive measures (like stopping mass gatherings) during new outbreaks.

* The ability to rapidly test large populations during an outbreak, in order to quickly identify and isolate infected people and quarantine their contacts.

This is an entire system aimed at keeping viral prevalence at zero over the long term. It actually allows most of society to function normally most of the time, because as long as there is zero prevalence, everyone can go about their lives normally.

> Europe for example, isn't a COVID free haven, quite the opposite.

> So the effectiveness of masks is probably marginal IMHO.

Non-sequitur.

Europe for example, isn't a COVID free haven, quite the opposite.

Do we know if Europe actually has stricter mask mandates (that are observed) and more mask wearing, like you seem to be suggesting? Because based on my casual observation I'd say no.

It'll depend a huge amount on the country in Europe you're referring to. Germany is a lot stricter than the Netherlands, for example.

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