[timr]

> I live in Japan and everyone here wears a mask, but more importantly, wears them properly

I lived in Japan, and have many friends in Japan. This is true only if you redefine "properly" to exclude all indoor environments. People in Japan routinely gather inside without masks, then put them on when they go outside. You can watch the TV news and see people gathered in bars and restaurants with masks off, but then they wear them religiously while walking around the city. Absolutely pointless behavior. I see this behavior amongst my own friends regularly on Instagram and Facebook.

Moreover, it's fairly common to see things like "chin masks", like this:

https://zqxkk1h5ljq1vh5rd1kit5ok-wpengine.netdna-ssl.com/wp-...

I'm not sure what these are supposed to be doing, exactly, but sure, I guess people are "wearing masks".

> Many Japanese people are already attuned to wearing them during flu season, and everyone wears them if they think they are getting a cold

This wasn't even close to true, pre-pandemic. I was regularly sandwiched between people on trains with obvious head colds, sniffing their snot every 5 seconds. Sure, some people wore masks, but it wasn't "everyone". Not by a long shot.

> Masks are, of course, effective.

This is an assertion. The best available data from randomized controlled trials shows a minimal effect:

https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...

> Masks work.

Repeating this phrase, without evidence, does not make it true. Even ignoring the top-line RCT evidence, you have to define what you mean by "masks" to get close to a meaningful statement -- a chin shield is obviously nothing like a cloth mask, is nothing like a full-face respirator.

[TheProbes]

Yeah, this is an example of what I'm talking about. I'll get on the train this morning and ride to work and probably see 100,000 people, none of whom are unmasked or wearing "chin masks". I'll work all day and not see a single one of my co-workers faces. Same thing on the way home. Then, because it's Friday, I'll go out for drinks with my wife or maybe the same friends I usually see because we aren't in lockdown, and spend a couple of hours in a bar unmasked. Maybe I'll post a photo of myself having a beer?

Yet you have some friends on Instagram who post when they're out, and have seen some news reports (probably of the variety of "Japan's COVID mystery, why are their numbers so low?") where they hunt out some drongos in some dodgy tachinomya who aren't wearing masks for their story about how Japanese people aren't wearing masks either, and because it fits into your worldview, you'll glom onto that and post some non-peer reviewed rubbish that confirms your fervent wish that you shouldn't be in any way inconvenienced.

Oh look at that, I just saw the morning news. 115 new cases of COVID today in a country of 120 million during the Delta wave. It's a mystery I tell you. A complete mystery.

Don't listen to this guy, wear a mask, get vaccinated.

[timr]

> Don't listen to this guy, wear a mask, get vaccinated.

What are you talking about? Did I say anything about vaccines? Check your biases.

> I'll get on the train this morning and ride to work and probably see 100,000 people

Oh stop. You don't see 100,000 people a day. You could stand in the middle of Shinagawa station all day long, and I doubt you'd see that many people pass by you. And you certainly aren't confirming if they're wearing masks.

> I'll work all day and not see a single one of my co-workers faces. Same thing on the way home. Then, because it's Friday, I'll go out for drinks with my wife or maybe the same friends I usually see because we aren't in lockdown, and spend a couple of hours in a bar unmasked. Maybe I'll post a photo of myself having a beer?

Well, yes. This is exactly the behavior I am describing. You're doing it, too. You think the virus somehow knows that you're out for a drink and stops being infectious?

[TheProbes]

Your contention is that masks don't work, and Japanese people don't wear them? I travel the loop line to and from work during rush hour each day, and yeah, while I don't canvas every single person, to my mind, I don't see anyone not masked up and wearing it correctly.

On my way today actually, remembering your goofy statements, I kept a special eye out, just for you. Carriages stuffed full of people, lines and lines on the platforms, train doors opening and waves of people pouring out to change trains, little groups of elementary schoolkids walking together to school....I didn't see a single person today (bar a couple of dudes with their masks down while they smoked outside Lawsons) not masked. You just don't see people not fully masked up. Day in, day out. Sorry if I don't keep a little tally counter on me.

"You're doing it too." What does this even mean? I drink within a closed circle of friends or family in a bar with separated tables and screens up. The staff all wear masks. Life goes on, but because of the masks and distancing measures, the transmission rates remain low.

You have an incoherent world-view and grasp of logic. Are you incapable of understanding that there is a sliding scale of masking behaviour? With Japan at one end, and the dolts screaming about mandates in street protests at the other?

Again, I say, don't listen to this guy. Wear a mask (properly). Get vaccinated. (Is that punctuation more to your liking?)

[timr]

> Your contention is that masks don't work, and Japanese people don't wear them?

No. My evidence-backed argument is that masks don't have much of an effect, and secondarily, my personal observation is that Japanese people don't wear them as much as you claim, particularly inside, while eating and drinking and socializing. They definitely wear them outside, where it doesn't matter much at all.

Arguing that you rode a train today and saw lots of people wearing masks on your commute is unsurprising. Completely consistent with what I'm saying.

> I drink within a closed circle of friends or family in a bar with separated tables and screens up. The staff all wear masks. Life goes on, but because of the masks and distancing measures, the transmission rates remain low.

Right. So you've now twice admitted that you do exactly what I am describing: you go out to eat and drink and socialize and take off your mask, inside, with groups of other people who are also not wearing masks. But it doesn't count when you do it, because reasons. Shields. Treating the staff as Others who have to wear masks around you, in a room full of unmasked people. It's all the same performative logic: you're OK because you're a person who wears a mask (except when you don't).

Invent all the rationalizations you like; I don't particularly care. I am not a member of the church. I'm just stating what I see, and you're...well, you're agreeing with me.

[kgarten]

I live in Tokyo, Japan. Nearly Everybody wears masks here (correctly). Several people even wear 2. Don't listen to him, he claimed there were spikes in Japan this winter when somebody pointed out the mask wearing ... Fundamental anti-masker :) https://news.ycombinator.com/item?id=29294849

[TheProbes]

Yeah, he's on some kind of messed up head trip, that's for sure. Osaka here.

[areyousure]

> 115 new cases of COVID today in a country of 120 million during the Delta wave. It's a mystery I tell you. A complete mystery.

In case anyone is curious, Japan has done far fewer Covid tests per capita than somewhere like Namibia, a country with one-tenth the GDP per capita.

See also https://www.nytimes.com/2020/02/29/world/asia/japan-elderly-... https://www.asahi.com/ajw/articles/14382671

(Of note: some sources like https://items.ssrc.org/covid-19-and-the-social-sciences/covi... claim Japan's intentional testing restrictions causally decreases the number of cases, by avoiding nosocomial infections.)

[TheProbes]

This article was from almost two years ago when the pandemic wasn't even going properly.

[areyousure]

The data I mentioned about testing per capita is through today. In concrete numbers, Japan has performed ~25 million tests and has a population of ~125 million.

There are THREE articles, and I chose them so that they spanned the past two years. The second article is from June 28, 2021 and the headline is "Testing at elderly care facilities expands, but at a snail’s pace".

[sandos]

I mean, there has to be a literal _wealth_ of data on mask efficiency by now, considering the _wildly_ different mask mandates between countries? If they are effective it should be somehow visible in transmission rates or whatever after and before masks became mandated.

Sweden where I live has never had any kind of wide mask mandate in public. There has been rules for public transport where I live, and in the office where I work but we worked at home so. Also recommendations for wearing a mask in shops if you are unable to keep a 2m distance. But I have never seen a majority of people anywhere here wear masks.

[dkonofalski]

There is. The OP even talks about a study done during one of the worst outbreaks of delta and the significant effect it had in Missouri. The same type of change in multiple cities where the treatment (mandate) was in effect occurring while also not happening in the other places where it wasn't in effect? That's not a coincidence anymore.

[stakkur]

For Missouri's study to be valid, statistically and empirically, you'd have to measure the actual wearing of masks in areas with mandates, and control for other factors. Did the Missouri study measure actual mask use, and control for other factors?

[fomine3]

There are no legal mandates to wear mask in Japan, but many shops order to wear mask.

[nzealand]

> This is an assertion. The best available data from randomized controlled trials shows a minimal effect:

> https://vinayprasadmdmph.substack.com/p/do-masks-reduce-risk...

From your link

> Scientists have lost any consistent standards for evidence appraisal.

Just... wow.

The underlying paper was published, not on a peer reviewed scientific site, but Cato, which is a libertarian institute.

[timr]

> > Scientists have lost any consistent standards for evidence appraisal.

> Just... wow.

Solid rebuttal.

> The underlying paper was published, not on a peer reviewed scientific site, but Cato, which is a libertarian institute.

So what? Have you read it, or are you just disparaging it because you don't like the server where it is hosted? The authors are doctors from UCSF, and experts in medical evidence.

[nzealand]

Reading the paper was the first thing I did, unfortunately.

I read it, until I realized it had no data, and that it was completely biased towards a single narrative.

Only then did I look to see who published it.

[hn_throwaway_99]

> The best available data from randomized controlled trials shows a minimal effect.

Be careful what you are arguing that these trials show: whether masks, when worn properly, work, or whether mask mandates work.

Because a randomized study that shows that mask mandates work, which has been shown (the best example I am aware of is the study from India), would necessarily mean that properly worn masks would need to be much more effective than the effect size from a mask mandate study, because of course tons of people under a mask mandate still don't wear masks, or wear them as chin warmers, or never wash them, etc.

So I'm always curious that when a mask mandate study shows minimal, but significant, effectiveness, that the response isn't "See, masks work, even when a ton of people still don't wear them or wear them haphazardly" as opposed to "masks hardly work".

[timr]

> Be careful what you are arguing that these trials show: whether masks, when worn properly, work, or whether mask mandates work.

The RCTs have been for masks themselves, not for mandates (this gets a little complicated because of compliance and intention-to-treat analysis, but it's basically true; the researchers were testing masks themselves, not rules surrounding masks). If the masks don't have strong evidence, I don't expect mandates to make the situation better.

[dkonofalski]

Where are you getting this idea that they don't have strong evidence? We have several studies now, in schools, cities, states, and other places, that have shown that, while not perfect, masks have a very noticeable positive effect on reducing transmission and spread.

[timr]

I don't think you're operating in good faith, but since you asked, other people might find this useful. You'll also note that none of the links I am providing here are from Vinay Prasad, since you are convinced he is some kind of astroturfing organization...

There have been exactly two RCTs for masks and Covid during the pandemic, neither of which has shown a large effect [1][2]. The DANMASK study showed no significant PPE effect, and the Bangladesh RCT showed a total effect size of around 0.09% (or a difference of 20 infections on base of thousands). Prior to the pandemic, RCTs for masks and respiratory disease showed weak effects, at best. Cochrane did a review of the literature [3], and found:

> Seven studies took place in the community, and two studies in healthcare workers. Compared with wearing no [surgical] mask, wearing a [surgical] mask may make little to no difference in how many people caught a flu-like illness (9 studies; 3507 people); and probably makes no difference in how many people have flu confirmed by a laboratory test (6 studies; 3005 people).

> We are uncertain whether wearing masks or N95/P2 respirators helps to slow the spread of respiratory viruses.

There have been many uncontrolled studies published. These are useless. Uncontrolled studies are not science (the Missouri study discussed in the OP is not a controlled study, btw).

There have been many laboratory studies published. These are suggestive, but just like a lab study for a drug, not meaningful in the real world without real-world evidence.

[1] https://www.acpjournals.org/doi/10.7326/m20-6817

[2] https://www.poverty-action.org/sites/default/files/publicati...

[3] https://www.cochrane.org/CD006207/ARI_do-physical-measures-s...

[manicdee]

The Danish study is self reported with no policing of wearing a mask correctly at appropriate times and always using clean masks (not reusing masks from day to day).

> Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others.

The Bangladesh study found masks were effective.

The third is a literature review with no indication of quality control, so basically as reliable as the Danish study (no policing of actual mask wearing, no policing of proper mask wearing, no policing of mask hygiene).

[timr]

> The Danish study is self reported with no policing of wearing a mask correctly at appropriate times and always using clean masks (not reusing masks from day to day).

So was the Bangladesh study. They did some surveys to estimate the rate of compliance, but it's not like there was a mask policeman following the participants around.

If only you folks would spend half as much effort reading the studies you prefer as you do the ones you dislike, you might be more credible.

> The Bangladesh study found masks were effective.

The Bangledesh study found a grand total of 20 infections separating the two arms of the surgical mask study. Out of thousands. A total effect size of 0.09%. It found that cloth masks had no significant effect.

Also, my favorite: It found that one color of cloth mask was significantly different than the other one. We all know that viruses have a strong red/blue preference, right?

Maybe we should be a little circumspect about what "significance" means here.

[maxerickson]

Particulates are bad, so while a mask outdoors may not matter for pandemic, it may be more than absolutely pointless.

[timr]

After almost two years of pandemic, there have been essentially no examples of documented spread of the virus outside (there have been a handful of examples in weird situations involving outdoor structures, crowds, etc., but these are the exception, not the norm).

You don't need to wear a mask outside. Not for a virus, anyway.

[dkonofalski]

This thread looks like it's being astro-turfed by supporters of Vinay Prasad and the nonsense he keeps peddling. There are plenty of studies showing that masks work and that they reduce transmission and spread and there are even studies that show that mask mandates have a drastic positive effect in limiting community transmission and spread.

[dang]

Breaking the site guidelines like this will get you banned here, regardless of how wrong someone else is or you feel they are.

Between this comment, https://news.ycombinator.com/item?id=29419551, https://news.ycombinator.com/item?id=29423080, and https://news.ycombinator.com/item?id=29419708, you went way over the line and well into bannable offense. You've also been posting flamewar comments elsewhere too. That's not gooo.

If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it.

[timr]

"Astroturfed"...that's hilarious. I'm a real person. I've been on the site for years. I think for myself and read and interpret data. Big Vinay Prasad is not paying me to come here and spread the gospel of randomized controlled trials and rigorous science.

If you disagree with the data, you're more than welcome to bring rigorous arguments to the debate, and not merely propaganda.

> There are plenty of studies showing that masks work and that they reduce transmission and spread and there are even studies that show that mask mandates have a drastic positive effect in limiting community transmission and spread.

And, as noted, the vast majority of those "studies" are terrible, and the good studies show the opposite.

This is not a game of collecting "papers", and the side with the most papers wins. They're not monopoly money or science points. You have to read them and understand the details. A paper that uses biased or flawed methodology (i.e. most mask studies) is useless for drawing conclusions.

[harpersealtako]

I don't know who that is, the reason I'm skeptical is the sheer amount of cofounders in most observational studies. My pre-pandemic prior was slightly positive towards masking, strongly negative towards government mask mandates.

My personal totally subjective risk estimates after reading a ton of studies and metanalyses is that n95 masks probably reduce transmission at least somewhat (90% confidence), surgical masks probably have a weak or negligible effect (50% confidence), and cloth masks probably don't work at all (50% confidence).

I personally still wear a surgical mask while at work, at the hospital/doctor's office, and in crowded spaces I expect to be in for a long time such as the DMV, airplanes, trains. I don't wear a mask outdoors, in grocery stores and convenience stores, or when visiting family members. I am moderately against government-imposed mask mandates (both for science-based reasons and ideological reasons) though I do comply with them when they are imposed.