[quesera]

> ... even Fauci, told people that masks don't work.

So, this troubles me.

One thing about science, of course, is that you need to be certain of your measuring equipment, and of your observations.

I cannot find any evidence that Fauci ever said that "masks don't work".

I have found:

* Late Feb: "at this moment, there is no need to change anything that you’re doing on a day-by-day basis"

* March 8th: "There's no reason to be walking around with a mask"

* March 8th: "When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face"

* March: "Right now in the United States people should not be walking around with masks … You should think of healthcare providers who are needing them and the people who are ill."

I see:

* ~"No need to panic at this time" (Feb)

* ~"Masks do not confer perfect protection, make sure to use them correctly, social distancing is still required" (Mar)

* ~"Reserve PPE (e.g. N95 masks) for the people who need it most" (Mar)

And shortly after this time, his recommendation changed to strongly recommending masks, when three critical things changed: asymptomatic spread was established, PPE supplies were beginning to stabilize, and testing determined that cloth masks are roughly as effective as surgical masks (not N95 masks).

All of those statements and decisions strike me as reasonable, from a spokesperson for public health in that time frame.

My memory of last spring is that masks were not recommended for the general public, but the clear message was that they do work, otherwise they would not be recommended for health workers.

I do not ever remember any non-political health professionals saying that masks do not work. So it troubles me to see it repeated ad nauseam that Fauci said such a thing.

If I have missed something, please help me out.

[WillPostForFood]

"When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face"

What do you think is being communicated here? It makes you feel better, but there are unintended consequences is worse than they don't work, it is saying they are worse than nothing. Around the same time the Surgeon General more explicitly said they don't work.

“They are NOT effective in preventing general public from catching #Coronavirus, but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!”

Which was an absurd statement at the time - if they are not effective for the public, why would health care providers need them.

https://www.nytimes.com/2020/02/29/health/coronavirus-n95-fa...

[quesera]

This a classic communication error. Media can't handle subtlety of message. It's a mistake Fauci should not make, being a decades-long expert.

But I hear, and I heard at the time, "Masks help, but they are not perfect, and if you use them in the obviously-wrong way, they are useless or harmful".

Which aligns with my understanding of every tool used for any purpose.

The Surgeon General, OTOH, was never a person to be taken seriously. But I don't blame Fauci for that.

[ergocoder]

It wasn't communication error. Fauci admitted he lied for the greater good.

It was really short-sighted. He could have suggested cloth masks.

And Fauci was considered the best COVID thought leader. US is so dead.

[quesera]

> Fauci admitted he lied for the greater good.

Again, this is repeated a lot -- but it does not match my memory, nor can I find evidence of it in my searches.

If you know differently, please share a link.

> He could have suggested cloth masks.

IIRC, the consensus pre-COVID and post-SARS, was that cloth masks are inferior to N95 masks. When the supply of N95 masks was not considered unreliable, there was no need for public health to think about bandanas.

In Feb/Mar, before asymptomatic transmission was proven, it was reasonable to not bother suggesting cloth masks, and simultaneously to preserve the "useful" (N95) masks for the most at-risk.

> US is so dead.

There were so many failures. The system that Fauci was relying upon turned out to not have been funded. Maybe he should have known that, but I'm not sure he had visibility into the problem.

I see Fauci as the firefighter who arrives at the scene, hooks up the hoses, and discovers that the hydrants are dry and the city hadn't bothered to tell anyone.

I'm sure it's more complicated than that. He has definitely made some mistakes, but the system which is supposed to back him up has completely failed him and all the rest of us.

[ergocoder]

"I don't regret anything I said then because in the context of the time in which I said it, it was correct. We were told in our task force meetings that we have a serious problem with the lack of PPEs," he said.

https://www.businessinsider.com/fauci-doesnt-regret-advising...

It makes no sense since cloth masks don't cause PPE shortage.

> IIRC, the consensus pre-COVID and post-SARS, was that cloth masks are inferior to N95 masks. When the supply of N95 masks was not considered unreliable, there was no need for public health to think about bandanas.

It's inferior but still better than nothing.

So, you agree that cloth masks are better than nothing.

> In Feb/Mar, before asymptomatic transmission was proven, it was reasonable to not bother suggesting cloth masks,

The precautionary principle 101.

https://en.m.wikipedia.org/wiki/Precautionary_principle

They should have be cautious first. Like come on, it's beginner's level of crisis management.

They even implied against it (because you would touch your face and etc.)

A tweet from US surgeon general: https://www.jacksonville.com/story/news/healthcare/2020/03/0...

"They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!"

Why would you say masks are NOT effective? With emphasis on NOT.

Fauci never refuted this tweet at the time, so what were we supposed to think?

> I see Fauci as the firefighter who arrives at the scene, hooks up the hoses, and discovers that the hydrants are dry and the city hadn't bothered to tell anyone.

It's more like he showed up and said water didn't help put out fire. Let's not use water.

He also didn't regret it because, well, we were in the water shortage period.

> He has definitely made some mistakes

A mistake that caused many lives.

He made a bad judgement call. Bad at communication with public. No idea how to manage crisis.

Just say "hey, it looks like a flu. We should be cautious and cover our face with something. Please don't buy n95 because doctors need it".

At the time, I covered my face in public and kept saying masks worked, and I felt like an anti-vaxx for going against "science". What a shit show.

[quesera]

"Masks" meant something different in March than it does now.

Cloth masks were a thing in Asia, but the US had never thought about them much. They were not available for sale.

When Fauci discouraged use of masks among the general public, but implored that they be conserved for medical professionals, he was speaking in the context of PPE. N95 masks, etc.

Sometime in March, people started asking "well do cloth masks work at all"? And there was no consensus answer until (IIRC) early May.

Maybe someone should have said "Hey, we don't know for sure, we've never studied it -- but they use cloth masks in Asia and they have more experience than we do. They certainly can't hurt as long as you recognize clean side/dirty side, and wash them regularly. You can't buy them, but you can make them. Don't make them poorly."

Remember that Fauci was sidelined for a while in there though. And that his job is not public health communications management.

I really don't think you can blame Fauci for the failures here. His messaging, when able to speak, was not that confusing or contradictory. And yet he still got in trouble with the people who wanted him to be less honest. He was simply not able to counter the extreme bloviation and misinformed dishonesty coming from the administration. And he received death threats for trying!

Blame Deborah Birx, a bit, for conflicting signals and bending to pressure. Blame Jerome Adams, for not having the background to separate truth from fiction, and lacking the strength to demand accuracy and clarity. But even those two didn't have much power, their biggest error was lending the appearance of credibility to the broken process which employed them. Blame their boss for having an agenda at odds with direct and honest communication.

Anthony Fauci did not save us, nor did Robert Redfield. We all wish they had. They both spoke honestly when given the chance though, and in a functional government, they (along with the rest of NIAID, CDC, HHS, and OSG) might have given the country a fighting chance.

Or maybe not. Most of the rest of the world is in pretty rough shape too.

[jussij]

Considering this part of his statement I think his message might have even more subtle than that:

but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!

I suspect at the time of the statement, health care works where struggle to get PPE, which would not have been helped by the run on masks by the general public.

In that context I see this a plea for the public to understand a mask in the hand of a medical worker is much more valuable than one in the hand of a member of the public. So lets try and help the medical staff before we try and help ourselves.

[nmfisher]

> The Surgeon General, OTOH, was never a person to be taken seriously. But I don't blame Fauci for that.

Why? I'm not from the USA, so obviously I don't understand the specifics of that position.

[quesera]

The US Surgeon General is a political appointee, with a largely ceremonial role and little policy influence.

Some have been better than others, but they mostly serve as a mouthpiece for the administration's agenda as it relates to health-adjacent matters.

As such, when the President does not take a health matter seriously (historically: AIDS, opioids, obesity, guns, tobacco, mental health, drunk driving; newly: COVID-19), the Surgeon General is not to be taken seriously.

[mcguire]

As I've not been commuting for a couple of years, I am way behind in my podcasts. Just this weekend, I listened to the March 10, 2020 episode of "Naked Scientists" (https://www.thenakedscientists.com/), a British radio science show from Cambridge. Chris Smith, a virologist, (https://www.thenakedscientists.com/users/chris-smith), at that time, said to buy beer rather than masks; you'll enjoy the beer and it'll protect you as well as a mask.

His concerns were that (1) cloth masks wouldn't help, and (2) that wearing masks incorrectly wouldn't help either. He was wrong about (1), but (2) is still a problem.

I'm sure I'll have opportunity to provide updates as I get further along. :-)

The Nature podcast didn't get on the mask bandwagon until early June, when they had an interview on the effectiveness of masks in this specific case.

No one I've seen has said that medical masks don't work.

[blub]

Maybe the population wouldn't have to reserve N95 masks for medical personnel if:

* the production hadn't been outsourced to China which then decided to ban exports while also accepting the PPE donations of other countries

* the government would have noticed that there's a pandemic brewing, and instead of saying "nothing to see here" would have ramped up PPE production or at least procured PPE from the market.

* failing all of the above, at least instituted an export stop so that the remaining PPE wouldn't have been bought from under their noses.

But yes, when one fails so utterly, one has to end up begging the people to work against their own interests with predictable results.

And yes, Fauci and the surgeon general lied. Nothing ambiguous about it, even if they were trying to save PPE for medical personnel.

[DanBC]

Can you show me the peer reviewed studies that you think Fauci etc showed have used to recommend mask wearing in the general population?

We had lots of studies around mask wearing, and most of them really struggled to show any kind of benefit.

[blub]

Whether they work for the general population is maybe a concern for Fauci, the government and the odd HN commenter. The message was that they don't work to protect individuals from the virus, hence they should not be bought by normal people.

That's obviously false. And an individual will be first and foremost concerned about their own safety, not if they can single-handedly stop the pandemic.

[DanBC]

> That's obviously false.

It's not obviously false, because there were studies available at the time that showed masks did not work to protect individuals, especially members of the public.

But, again, I'd be interested to read any studies you have that were 1) available at the time and 2) showed benefit of wearing masks.

[blub]

I've linked this somewhere else: https://news.ycombinator.com/item?id=25479729. This references studies from the SARS times and for flu. N95/FFP2 masks are pretty well established, they were used by front line workers in all the pandemics in the last decades.

That's why most Western countries were stockpiling them - as protection in case of a flu pandemic.

[fitzie]

saying that masks work, is a tad simplistic. there are many types of masks, and while they have their benefits there is plenty of evidence that mask wearing has not inhibited the virus from spreading in the population. there is little evidence that the casual masks that are being worn have significantly reduce the risk of exposure.

fauci was well justified when he said before that mask wearing isn't the solution to this pandemic, but now any nuanced discussion is not tolerated, which, perhaps, is the reason people aren't trusting the science. another reason is that politicians are making arbitrary decisions claiming it is what science (facts and data) told them to do.