[keenmaster]

I'm not 100% agreeing with the OP, but I am horrified by the massive number of scientists, medical leaders, and medical professionals who:

1. Downplayed the role of masks as a public measure to mitigate the spread of COVID-19 early on (often out of a duplicitous desire to preserve PPE for the medical community, without considering that homemade cotton masks would not reduce PPE supply for medical workers)

2. Didn't advocate for the use of masks, beginning with cotton masks (this is actually a different point than #1. Spreading confusion and not providing clarity are two different bad things.)

3. Downplayed COVID in general, and publicly wondered whether a ton more people had immunity than we thought. That was with specious evidence and, damningly, it increased confusion and probably reduced compliance with mitigation measures.

[ummonk]

Also claiming that China's totalitarian lockdown measures would achieve nothing.

[baddox]

I agree with all those criticisms to some extent, but without some alternative I don't find the argument very useful, and I certainly don't find the original commenter's approach useful.

It's like listing the many many examples of plane crashes due to pilot error. That's not controversial. I don't think many people claim that individual pilots act without flaw, or that the entire system of pilot training and qualification is without flaw. But surely the proposal should not be to take comfort as more and more people "doubt the entire notion of an airplane piloting establishment that the population should 'trust' to make decisions without oversight."

[keenmaster]

Criticism moderates duplicity and complacency. The mere presence of widespread criticism would help. It would also serve as a foundation for a system to mitigate these problems going forward. You can't solve the problem until you:

1. First identify it as a problem (which I don't think we've done enough but you think the problem is apparent to everyone)

2. Direct the criticism to the right people (not just politicians, but medical leaders and the medical establishment as a whole - believe it or not, they have a halo effect and are not sufficiently criticized. The industry systematically weaponizes our high regard for the medical profession in order to prevent what it sees as adverse reforms)

3. and acknowledge that there is a way to mitigate the problem ex ante, instead of saying "sure it's a problem but it's unsolvable because of all the emergent complexity." Say what you want about Elon Musk, but the man thought "I'm going to shoot multiple giant rockets through the atmosphere and land them back on a moving boat simultaneously" then proceeded to actually do it. He didn't throw his hands up to emergent complexity. SpaceX took complexity by the horns. Synthesizing and amplifying non-duplicitous, high quality advice from medical leaders/orgs is not that complicated! Only they can lead you to believe that it's complicated, and then somehow deny that they did that. If they contradict themselves, it's because "we used the best available facts at the time." Laughable, and completely non-falsifiable.

As an aside, perhaps Americans would be less anti-scientific if a majority of them weren't scammed by the medical industry and charged $150-$200 for a tiny consultation with someone who is bribed by pharmaceutical representatives to shill for harmful drugs. Maybe Americans would be less anti-scientific if their government wasn't captured by medical lobbyists for over a century so that there isn't a faint hope for reforms like universal healthcare. The industry doesn't care, because they know that if America wakes up, and politicians aren't captured, total compensation for doctors and surgeons would eventually drop 40% with negligible or no impact on innovation and medical outcomes. To them, something is wrong if a huge chunk of your disposable income isn't siphoned to their wallets every year (part of which you never even see - that is, insurance premiums paid by your employer that you would otherwise receive as income).

[baddox]

The trouble with your example of healthcare is that Americans for whatever reason overwhelmingly approve of the American system of private health insurance plans, and even if they didn’t, I don’t think many would make an association between expensive health care and fundamental problems with the scientific community.

[keenmaster]

I'm highly skeptical of the "overwhelmingly approve" part.

Do Americans overwhelmingly approve of the deprivation of their disposable income and health due to the broken status quo? Of course not. It's just that many don't connect the dots because the debate isn't even happening. Democrats and Republicans are captured. The media doesn't seem interested. The system is too complex for people to even understand and know what to criticize. Most Americans don't even grok the fact that they would receive employer-paid premiums as salary under universal healthcare. They don't have a clue how well universal healthcare works in other countries and how widely approved it is (relative to a privatized system). Saying that Americans overwhelmingly approve of their private insurance plan is like saying Russians overwhelmingly approve of Putin...ya, ok, but I don't think the people who repeat that statement know how meaningless it is.

Do you know what American political scientists call foreign democracies with captured politicians, distorted media, and widespread corporate cronyism but...ostensible elections? Pseudo-democracies. There's a spectrum from democracy to pseudo-democracy, and we all know where we're headed.

As for the connection to trust in science, I already spoke about that from one angle (the exploitative interface between the average American and their medical care). Another angle is the following: the very same medical paternalism that broke our healthcare system also broke the institutional guidance regarding COVID-19.

[baddox]

I don’t really want to get into arguments of the form “they think they want X but they actually want Y,” because if you’re willing to use that mode of argument then it’s completely irrelevant to you what people think or say they want, and you might as well just argue for what they “actually” want without any regard for their input.

But the fact of the matter is that common proposals to overhaul the American health insurance system are extremely unpopular, and people overwhelmingly report being very happy with their private insurance plans.

[keenmaster]

How about this: 58% of Americans favored Medicare for All according to a Kaiser Family Foundation poll. This was back in 2015, when people were in a less medically and economically precarious position, and despite all the aforementioned misunderstandings regarding universal healthcare. I'm sure the medical industry will play up the "but mah haylth insurance" trope as the prospect of universal healthcare becomes more real. https://www.kff.org/uninsured/poll-finding/kaiser-health-tra...

[timr]

"Downplayed the role of masks as a public measure to mitigate the spread of COVID-19 early on (often out of a duplicitous desire to preserve PPE for the medical community, without considering that homemade cotton masks would not reduce PPE supply for medical workers)"

Or maybe you're being deceived now?

Honestly, the evidence for universal masking hasn't changed (recent papers on this have largely been terrible and/or meta-analyses of the same group of papers that were written before the pandemic). There are still a lot of informed, intelligent scientists who have been saying the idea isn't supported by data. The "consensus" on this issue appears to be driven by politicians and media, not by science:

https://www.cebm.net/covid-19/masking-lack-of-evidence-with-...

https://www.cidrap.umn.edu/covid-19/podcasts-webinars/specia...

[keenmaster]

Thank you for inadvertently proving my point. The evidence for the efficacy of universal, compliant mask-wearing is extremely strong, but there will always be specious studies with contra-claims. It's a self-fulfilling prophecy: the more those studies are amplified, the more confused people are, the less they wear masks, the less their politicians mandate that they wear masks, the more it becomes a political issue, etc...and the less masks do their job, leading to more death and injury. I can't understate the marginal economic injury either. All for what? Seriously, for what? So that people don't put a $5 chunk of cloth on their face to save lives? Good lord. We're talking about a nearly certain enormous gain with very little "cost." There isn't even a real trade-off.

[timr]

"Thank you for inadvertently proving my point. The evidence for the efficacy of universal, compliant mask-wearing is extremely strong,"

Indeed, thank you for providing a wonderful example of "scientism": a blind belief in the conclusions of "science", even when you're presented with ample scientific evidence that disproves your belief.

If your secret evidence is so strong, you should cite it, instead of merely asserting that it exists. I just gave you two incredibly well-sourced articles showing that the opposite is true, and your response is to insult me and claim I'm wrong (without proof).

Michael Osterholm (CIDRAP) and the Oxford Center for Evidence-Based medicine are not crackpot organizations, and the cited articles are reviews of all literature, not "specious studies". In all likelihood, these articles have already discussed the evidence that you believe is compelling.

[keenmaster]

Here is an excellent study with both theoretical and empirical results showing the efficacy and importance of universal mask wearing, even when cotton masks are used (PDF download is in the upper right corner): https://arxiv.org/abs/2004.13553

Institutions involved: University of Cambridge, University College London, Ecole de Guerre Economique, and Hong Kong University of Science and Technology

As for Michael Osterholm, I don't have much patience for people like him so I won't cite this but you can easily look it up: he clarified his comments and said that people should universally wear masks. Of course, he followed up with strawman arguments, implying that many people have the illusion that COVID would be suddenly be "driven to the ground" if everyone wore masks. He also said that other measures are important. Of course they are.

As for Oxford Center for Evidence-Based Medicine: simply put, they are like a hammer in search of a massive double blind nail. When it becomes more and more clear how tragically incorrect and misguided such organizations are during a pandemic, the "evidence" in their title will suddenly have a sardonic ring to it. Their example will demonstrate that sometimes expertise of a certain kind, if not properly adapted to a new situation, can become an impairment in the new context. Read the discussion at the following link: https://journals.plos.org/plosmedicine/article?id=10.1371/jo...

That being said, the University of Oxford in general is a top rate institution. The Oxford Vaccine Group might be first to deliver a COVID-19 vaccine. They're also home to professor and NIH senior investigator Dr. Trisha Greenhalgh, who sharply discussed the limitations of evidence-based medicine during this pandemic at the above link :) Of course, that's evidence-based medicine as a specific category, not the general idea of medicine backed by proof.

[timr]

"Here is an excellent study with both theoretical and empirical results showing the efficacy and importance of universal mask wearing, even when cotton masks are used (PDF download is in the upper right corner)"

This is not a study of masks. First, and most importantly, it assumes that masks work, and makes a model of a world in which they work. From the methods:

"A gradual increase in mask wearing was modelled using a linear increase in the proportion of individuals randomly allocated with a reduced rate of transmission. The factor by which β was reduced was conservatively set to 2."

And for their second model:

"Varying degrees of mask effectiveness are modelled by the mask transmission rate T and mask absorption rate A, which denote the proportion of viruses that are stopped by the mask during exhaling (transmission) versus inhaling (absorption), respectively. We set T = 0.7 and A = 0.7"

So when you make a model that assumes masks reduce infection by half or more, the model shows that infections are reduced. Shocking.

Then, when they say that their models have a "nearly perfect correlation" with reality...they don't actually compare their models to reality, nor do they calculate any correlations. They simply quote a bunch of numbers they cherry-picked from news sites (with no controls or normalizations) classifying countries into "mask-wearing cultures"...which is so obviously silly that any halfway rational person should see right through it. This is a "paper" only in the sense that it might someday be printed on paper by someone who was gullible enough to believe it.

Regarding your comments on the researchers I mentioned: perhaps you should spend more time reading the articles you cite, and less time judging well-established scientists who disagree with your opinions.