The demand for a randomized trial proving the benefits to mask-wearers rests on one of the most important but least understood facts about why we started recommending masks in the first place: to prevent disease transmission to others. Mask-wearing is not an individual benefit, it’s a community benefit. Further, this discussion reveals some of the underlying reasons for our feeble response to this pandemic: reasons that go beyond the obvious and many failures of the OUTGOING (!) administration.
To have a proper study for masks for source-control, we’d need to enroll communities and do a cluster randomized study—comparing communities, not just individuals. That is both difficult and also with much less explanatory power than one would hope since pathogen is also overdispersed: some people get hit badly by the disease just by chance. That makes causal inference harder.
Five years in, it’s clear that Discord has done something remarkable. It’s built a space that feels unlike any other on the internet. It’s not quite group chat, it’s not quite forums, it’s not quite conference calling. It’s all of those things and none of them. It turns out, in that messy middle, is a place that mirrors what it’s like to be human, and interact with other humans, more closely than just about anything else on the internet. (For better, and sometimes for worse.) That’s not what Citron, Vishnevskiy and their team were going for, but it’s what they have now. And they’re not pivoting anymore.