[LostJourneyman]

I'll assume your line of reasoning is in good faith and answer it as such.

To OP's point, leading research actually has answers to the questions you're asking and backs up your friend's behavior. The fundamental difference is that this isn't in the same families of viruses as your typical one and done vaccines of childhood. This is a coronavirus, which are known to have a high mutation and variation rate and tend to be vaccine resistant. This is why you have a flu vaccine every year, but chicken pox once. It's somewhat rare, but it would have been possible for your friend to have gotten a different variant, or act as a carrier for a different variant. He chose to follow expert advise to keep himself and others safe.

I would like to point out also that wearing a face covering is a small price to pay for public safety even if it wasn't needed for every individual. As an example, even fully vaccinated and having had the virus, I wear my own mask constantly. It would be unkind of me to force people to choose if they trust my judgement and my word just to feel safe around me. If we discuss it and they feel safe, often I'll remove the mask for ease of conversation. But the point here is: we should care about other people, we should strive to make the world we all live in as safe and comfortable as possible for everyone around us, and we need to weigh the risk of slight personal discomfort against the benefits of interpersonal relationships, public safety, and the well-being of those around you.

To conflate

  “You know what? Let’s slow down for a second, and find out what’s what, because for the past year everyone’s been lying” 

With

  “Oh because I’m waiting for the vaccine.”

As equally reasonable positions is disingenuous at best, but it's worth checking your motivations.

Edits:grammar

[ianai]

There’s a lot to be said for asking everyone to wear a mask so it’s the default behavior. Otherwise a stigma could be attached to mask wearing that would keep people from wearing them when it matters most.

[whb07]

It is in good faith. But the burden of proof lies on the argument that the vaccine won’t work for this. Not the other way around.

In the US, in theory, it’s supposed to be “innocent until proven guilty”.

For the past century, it’s been assumed “survive infection, you should be good until proven otherwise.”

It’s never been quarantine the healthy.

In the past century+, cloth masks haven’t been shown to help do anything and in Asia, they are typically used by the people who are feeling off or actually have a cold, etc.

For proof on masks, see Fauci’s emails or the plethora of studies and CDC materials prior to 2020.

There is a difference between doing smart and reasonable things, and imposing draconian measures globally with unproven actions.

Lastly, only the rich countries are able to lock down and print funny paper while this lasts. The rest of the world has to face starvation and go to work to provide the rich countries with goods.

[LostJourneyman]

I'm afraid you have a fundamental misunderstanding of what the "burden of proof" means in this context. Let's clarify a few things:

1) there is adequate and persuasive evidence that adding a barrier across the nose and mouth will impede particulate spray during speech and normal bodily functions like coughing or sneezing. It will not act as a micron level filter. To say that cloth masks "haven't been shown to help do anything" is demonstrably false, but trying to treat masks as a full respirator is equally misleading.

2) Using a mask when you have or suspect you have a cold shouldn't be stigmatized, as you are literally helping to make sure that you are minimizing other people's exposure to whatever is making you ill

3) Social distancing is not the same as quarantine. Asking you to stay home as much as possible during a pandemic is a measure to help slow transmission rates. Stopping all travel into our out of a designated area is quarantine. If you're staying home after travel and unable to leave your home, that's quarantine. If you're avoiding restaurants, that's social distancing.

4) the burden of proof test is a legal test in determining who is responsible for providing evidence to back their claim, and the innocent until proven guilty standard is limited to criminal trials. To conflate that with assuming someone is healthy during a pandemic until they show symptoms shows a gross misunderstanding of how communicable disease transmission works. In many viruses, this included, the incubation period comes without symptoms and is fully communicable. You can be actively infecting other people without symptoms. Surely you can understand the reasonable difference between the two.

5) your claim that the standard in the last century has been "survive infection, you should be good until proven otherwise" is also false. This is true for some diseases but not others. Again, flu comes to mind as an example.

I want to address your last point separately. It is well acknowledged and understood that resource, income, healthcare, and access disparity have played a large role in how this pandemic was handled and mis-handled. We have much to learn from our experience here. That said, you cannot simply hand-wave "funny paper" and say that public health doesn't matter. Sure, the society that we live in is heavily reliant on exploitation. Yes, that's a problem, and not a simple one. Yes, because of that people have to work, and people have to take those risks when it shouldn't be necessary. That's all the more reason to place caution over pride and comfort. They are forced to bear undue risk, why should anyone have the privilege to add to that burden of risk when much of it is easily mitigated by limiting how much time we spend in public spaces and by wearing a face covering?

[sudosysgen]

To note, extremely sucessful lockdowns were executed by Vietnam, which has a GDP per capita of 2700$, a seventh of the global average. That is to say, if they have a competent government, even poor countries did lockdown successfully.

[whb07]

By true sense of the word "quarantine", means locked up in some room while you recover/pass infection. Someone has to come to you, feed you, observe you etc. So this isn't happening.

What is really happening is:

* Keep megastores and large companies open. With the lower classes going to work, and entire cities cramming into specific stores that are open.

* upper-middle and upper classes staying inside, working remote, and ordering take out.

But let's not talk about specifics, of which these I am sure happened in Vietnam as well.

If you really wanted to reduce mortality for this one chosen disease, then you'd address the biggest risk factors which are obesity and age. So if you really wanted to significantly reduce the risk of death from this you would:

* force everyone who is obese to work out 1 hour daily. * ban high carb and junk foods for the next "2 weeks".

voila! coincidentally those measures would reduce all-cause mortality.

[sudosysgen]

Yes, I did say lockdown and not quarantine though.

Real lockdowns are much more effective than your suggested state mandated diet and workouts though. They, in countries that did it for real, which means not keeping megastores and large companies open but actually locking down everything and using the army and police to deliver food that you then cook to everyone, you can get the mortality rate to basically zero. Which Vietnam did.

[brigandish]

> To say that cloth masks "haven't been shown to help do anything" is demonstrably false

From the only RCT I'm aware of having been published during the pandemic[1]:

> the difference observed was not statistically significant

The full quote is:

> Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.

But the important part is the difference observed was not statistically significant, not just because statistically significance is counted as significant for good reason, but because there's a possible 23% greater chance of infection. That's quite the swing, and something that's been seen before[2]:

> Conclusions This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.

That's without going into the many statements by leading doctors of the public health response during the pandemic (like Fauci or Jenny Harries).

This helpful Spectator article[3] goes over the damning lack of evidence there's been since long before this pandemic and also lists a few to watch out for. Still not heard any demonstrable falsification coming from an rct yet though. I wonder how long we'll have to wait?

Of course, we could always rely on reviews instead of randomised controlled trials, they give much better results… <cough> <cough> Excuse me while I put on my mask.

Note: this response was made in good faith ;-)

[1] https://www.acpjournals.org/doi/10.7326/M20-6817

[2] https://bmjopen.bmj.com/content/5/4/e006577

[3] https://www.spectator.co.uk/article/how-much-do-face-masks-a...

[disgruntledphd2]

I think you raise important points, that are useful more generally in understanding the process of science and scientific review of papers.

However, the correct answer to a non-significant study is not to assume that there is no difference, rather that we have not been able to detect a difference.

The results section:

A total of 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%). The between-group difference was −0.3 percentage point (95% CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio, 0.82 [CI, 0.54 to 1.23]; P = 0.33). Multiple imputation accounting for loss to follow-up yielded similar results. Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.

So, overall there were 95 participants who got a Covid diagnosis, of the 6k enrolled, and the 4.8k who completed the study.

This is basically noise. My personal prior is that had this study taken place in the US or Brazil, we would have been able to detect an effect. However, clearly I don't have any evidence for this.

tl;dr that study gives us very little information, because the baseline prevalance of Covid was so low that we don't have enough power to detect a difference between the two groups. This is consistent with a finding of masks don't work, and masks work (but we can't detect the difference in this study).

[brigandish]

> the correct answer to a non-significant study is not to assume that there is no difference, rather that we have not been able to detect a difference.

I completely agree (which might be why I didn't write that there is no difference:) In fact, we don't know if there's a difference, or if there is, what the difference is, and right now the evidence (as a whole) points to a negative difference for the outcome we're hoping for. It's essentially a (fairly) open question at this point (which again leads back to the religiosity on show from some "sides" in this debate).

The statement was:

> To say that cloth masks "haven't been shown to help do anything" is demonstrably false

I just want to cut down statements like that, statements that really are demonstrably false* in their certitude.

[sudosysgen]

Hmm, I disagree. Vietnam was able to lock down. They're below average in GDP per capita. Their lockdowns were more effective than in any rich country and as a result they had a smaller economic impact.

Ultimately wether lockdowns can or can't be done is a question of governmental efficiency. In general, either the population is mostly rural in which case very little social contact is necessary for economic activity to continue, or the have a very urban population which means that they only need a smaller part of the population to work to make the country tick for a month or so.

[iudqnolq]

You're treating your friend as guilty until proven innocent. Shouldn't you need to clear the burden of proof to tell him he's stupid to do something that doesn't harm you?

[whb07]

Fear and stress harms the individual. It raises your cortisol, lowers the immune system etc.

My mother in law was so freaked out and in constant stress that she developed an infection combined with shingles (first time).

[brigandish]

> This is why you have a flu vaccine every year, but chicken pox once. It's somewhat rare, but it would have been possible for your friend to have gotten a different variant, or act as a carrier for a different variant. He chose to follow expert advise to keep himself and others safe.

There's a couple of things wrong in this statement that circle back to the religious belief statement earlier.

Firstly, the use of keep himself and others safe. That's a specious as talking about computer security in terms of safety instead of risk, which is a far more insightful, nuanced - and most importantly - useful way of looking at this. He could never again drive nor allow his family into or near any kind of motor vehicle and that would make them more "safe" but would it be rational? That would require a discussion of risk and its trade offs.

Next, you'd have to show antigenic escape against natural immunity. There is some, and it's very small[1]:

> Because the data in the system were person-identifiable, the authors were able to determine that 3·27% of those who were uninfected during the first surge had a positive test during the second surge, compared with 0·65% among those who had previously recorded a positive test. Thus, they determined from that, in general, past infection confers 80·5% protection against reinfection, which decreases to 47·1% in those aged 65 years and older.

So, again, we're back to looking at risk instead of safety (and that Lancet article is straining to argue that natural immunity isn't enough, a very poor effort in my view, just look at citation 11).

There's also not much evidence of the high level of mutation seen in other coronaviruses because of the method of replication[2]:

> In contrast to the rapid evolution of other RNA viruses, SARS-CoV-2 has low genomic variability because of its proofreading function

A good thing because it means the vaccines are showing good efficacy against variants too.

Lastly, because I don't know if you're arguing in good faith (seriously, just respond to comments, starting off with such a slight makes me question you more than anyone else) you'd then need to show what that reinfection could mean in terms of consequence - will you experience symptoms? Will you end up in hospital? Will you end up in ICU? Will you need a respirator? Could you die? Is there a change in transmissability?

Again, a risk assessment. Feel free to provide this and show that the person sat there in a mask, who I assume is of working age and therefore in the cohort with greater protection from reinfection, is not behaving irrationally.

Perhaps they really do never get into a car, never go out in a thunderstorm, and wear a hard hat whenever they leave the house. Still, in the absence of other, competing and compelling data, to sit there believing you're keeping yourself and those around you safe by continuing to wear a mask is irrational and not based on "leading research" at all.

And you're going to tell me he knows any of this? Please.

Btw, both of these are worth a read, and citation 11 of each, too ;-)

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

[2] https://www.nature.com/articles/s41591-021-01347-0