Liked On Randomized Trials and Medicine by zeynep (Insight)

In reality, while opposing masks has now become an ideological component of pandemic-denialism, some the problems I outline above permeate not just supporters of this president, but much of Western medical establishment as well. This is also why the instruction to “just follow the science” isn’t enough to address this pandemic. Yes, we should absolutely follow the science, but here’s the awful truth: we do not have a “science” that is fully up to the challenge, especially when it comes to understanding the intersection between human behavior and the pandemic, and the many complications and twists of the failings of our expert communities and how they relate to society. That task remains ahead of us.

Zeynep Tufekci explains why just ‘following the science’ is not enough. A part of the problem are the limitations to what can be measured when it comes to randomized trials.

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.

With Melbourne slowly opening up, I had to go to an appointment. The specialist is located on the first floor of a business centre. Unable to locate the stairs, I pressed the button for the lift. As I entered the lift, two other people turned up. I entered wondering what the protocol is. When I was last in the office, our policy was one person at a time. The other two people entered. It was at that point that I noticed that neither person was wearing a mask.

For me, this epitomises the real challenge. We can talk about Dan Andrews and a failed hotel quarantine. However, neither of these things are necessarily within our control. Wearing a mask is. I think that Kin Lane captures this best:

It is fascinating to be able to see who cares about other people and who doesn’t, simply by looking around to see who is where a mask and who isn’t.

As David Truss asserts:

The economy can stay open if people wear masks, socially distance themselves and sanitize appropriately. Some people might disagree with me, and on a topic like this we can agree to disagree.

However, with 40,000,000+ cases worldwide 1,118,443 deaths, and over 9,000,000 known active cases worldwide this is not just a bad flu, it’s a pandemic. And if you want to disagree with that well then sorry… you are wrong.

Put a mask on, and thank those around you for being respectful and doing the same.

The problem I have is what do I say or do in this situation? Sometimes I feel like asking where they got their cure from? However, sarcasm never really succeeds much. So I stay silent and sad.

Replied to Wear a Mask by David Truss (Daily Ink)

Masks and social distancing should be mandatory in public spaces. These two things actively create a barrier between people to reduce the spread of Covid-19. It’s no harder to do than remembering to put your seatbelt on… once you get used to it, it’s just what you do.

It is fascinating to see the debate around masks. I keep coming back to Jason Kottke’s point:

There’s no credible evidence that wearing a mask is harmful, so at worse it’s harmless. If there’s like a 1-in-10 chance that masks are somewhat helpful — and the growing amount of research suggests that both 1-in-10 and “somewhat helpful” are both understatements — isn’t it worth the tiny bit of effort to wear one and help keep our neighbors safe from potential fucking death (source)

Liked What’s the deal with Masks? (erinbromage.com)

Face mask use is a social contract. My mask protects you; your mask protects me. But face masks are not perfect and they need to be used in conjunction with other measures to lower risk of infection such as physical distancing and hand washing. There is ample evidence to suggest that widespread use of masks results in significant reductions in the transmission of respiratory viruses. Mask use is grounded in biology and can have a real world and meaningful effect on slowing the spread of infection, protecting your coworkers, and those vulnerable members in your community.

Replied to COVID Diaries: The Mask (markomearaau.wordpress.com)

I first wore my mask to the shop less than a week ago and I felt really self conscious, so much so that I had to overtly will myself to put it on and keep it on. My glasses fogged up, of course, but worse things happen at sea.

I have been wearing a cloth mask at the shops for over a month. Kind of disappointed that the government did not push the change earlier. Although I have read ways and means to stop my glasses from fogging up, I just wear my contacts when out and about.
Bookmarked How Masks Went From Don’t-Wear to Must-Have During the Coronavirus Pandemic (Wired)

Floridians were screaming at their city councils that their rules on wearing masks were part of a 5G/pedophilia conspiracy that involved “the devil’s laws.” A discredited documentary, widely spread on social media, wrongly claimed that masks actually made people sick, or cut off their air supply. Some anti-mask conservatives co-opted the rallying cry of the abortion rights movement—“my body, my choice”—to defend their anti-mask-ness. People who believe that the whole pandemic is some kind of left-wing hoax (it is not) declined to wear masks. Mask use somehow got tied up in the heady, conspiratorial brew of rugged individualism, 5G paranoia, and anti-vax sentiment. They became symbols of an insidious, freedom-sapping plot.

Megan Molteni and Adam Rogers dive into the world of masks and how there place in confronting the current pandemic has changed. The current hope is that mask wearing maybe enough to get RO under 1.

Based on the available evidence, his team estimates that near-universal mask wearing could cut transmission by as much as a third. Would that be enough to turn back the record-smashing tide of new cases breaking across large parts of the US? Probably, says Murray. It will depend on exactly how fast local outbreaks are growing. The reproduction number, or R0 (pronounced R-naught), is a measure of how many people one contagious person infects. If R0 is higher than 1, cases will grow exponentially. If it’s below 1, an outbreak will shrink. In places like Brazil, where a chaotic response and lack of social distancing measures has led to an R0 trending above 1.3, a mask mandate likely won’t be enough to bring cases under control. But Murray says the US still has a chance.

It is interesting to read this investigation alongside Maciej Ceglowski’s post. I think what stands out is that other than slight inconvenience, what is lost?

Replied to Time to rethink the face mask! (Erin Bromage PhD:)

If you are wearing a mask, and an infected person breaths, coughs, or sneezes on you. Can you take the mask off without contaminating yourself or your environment? Here’s the fun part. Make your mask. Wear your mask. Then get one of your kids to cover the entire mask in shaving cream. Can you get the mask off and into a safe space without getting shaving cream on anything? Practice this!

Erin, I so often struggle to make sense of infection. I really like your use of shaving cream to explain how you might be infected while removing a mask.
Bookmarked Let’s All Wear A Mask by Maciej Ceglowski (Idle Words)
Maciej Ceglowski argues that we should all be wearing procedure masks or the cloth equivalent.

The point of wearing a mask in public is not to protect yourself, but to protect other people from you. We know that many people who fall ill won’t show symptoms during the time when they are most infectious. Some people may even remain asymptomatic through the whole course of the disease, never knowing they had it.

The safest thing to do is assume you’re sick all the time, and wear the mask.

This he suggests needs to become a cultural norm.

The goal is not only to keep people safe, but to make it rare and weird to see anyone outside with a bare face.

Ceglowski lists some of the benefits of wearing a mask:

  • Keeps you from touching your nose and mouth
  • Is a useful mental reminder
  • Somewhat uncomfortable, therefore a useful constraint to spending too long in public
  • Gives cover to sick people around you
  • Protects those who are being persecuted for doing so

He also notes that anyone wearing an N95 mask should reconsider:

If you have any N95 masks, you need to donate them to a hospital. These masks are lifesaving protective equipment for doctors and medical staff. They are in incredibly short supply. Wearing them in daily life is like wearing a fireman’s coat instead of suntan lotion—it doesn’t do much for you, and wastes an invaluable resource that could save the life of a first responder.

Ceglowski ends with a range of further resources and readings. Ian O’Byrne has also bookmarked a number of posts on the topic too.

In his own piece, Jason Kottke looks at the research and wonders why we are still debating the topic.

There’s no credible evidence that wearing a mask is harmful, so at worse it’s harmless. If there’s like a 1-in-10 chance that masks are somewhat helpful — and the growing amount of research suggests that both 1-in-10 and “somewhat helpful” are both understatements — isn’t it worth the tiny bit of effort to wear one and help keep our neighbors safe from potential fucking death?

Coming from an Australian perspective, Norman Swan has raised concern about the wearing of masks on the Coronacast podcast.

Although it must be said that he has since changed has stance to advocate for mask wearing.

As a note, although masks may stop some particles from getting through, there is a danger of thinking that because you are wear a mask that you are somehow safe. The New York Times has put together visual unpacking how masks actually work.

The ABC elaborates on this further explaining why masks are not mandated by the government in Australia.

Not much different from the advice we’ve been given from the start: wash your hands, don’t touch your face and stay home if you’re sick.

In the end, the most important thing we can focus on is social distancing.

Liked Perspective | Simple DIY masks could help flatten the curve. We should all wear them in public. (Washington Post)

Yes, there is a shortage of manufactured masks, and these should go to hospital workers. But anyone can make a mask at home by cutting up a cotton T-shirt, tying it back together and then washing it at the end of the day. Another approach, recommended by the Hong Kong Consumer Council, involves rigging a simple mask with a paper towel and rubber bands that can be thrown in the trash at the end of each day.