[tn890]

> I would suspect that most people who are were already vulnerable have already passed or built immunity if the virus is equally dangerous, resulting in a lower than equal death rate despite equivalent risk.

You are forgetting about the most vulnerable group of all: immunosuppressed people.

They cannot mount a sufficient immune response, in severe immunosuppression like after a transplant event months or years after. In some cases the covid mortality for these people can approach 40% for young adults.

We have to be mindful of people like this when thinking about dropping mask mandates and such. Or "whoever's not vaccinated dies of their own fault". Not 100% true.

We as a society must protect those most vulnerable.

[wonderwonder]

I live in a state where mask mandates are essentially gone. Very few people wear masks here and they are not required in schools so only ~5% of kids are wearing them at my children's elementary school. Everything seems pretty good so far, no marked rise in cases and almost no cases in my kids school over the last year, maybe 25 total, all mild. I am in no way saying masks don't work, in fact I think that they do. With that said, I have not worn a mask in a long time, I am fully vaccinated including a booster and essentially figure that is enough. I work from home so if I get covid its going to be from my kids.

"We have to be mindful of people like this when thinking about dropping mask mandates and such."

Not arguing with you, just genuinely interested on how long you would advocate for mask mandates? Would you be willing to accept mask mandates in perpetuity?

[nicoburns]

> Would you be willing to accept mask mandates in perpetuity?

I think it depends on location. In key environments like public transport and supermarkets and other spaces that everyone needs to be able to access it seems reasonable to me that we might keep them for at least a 5-10 year horizon if that proves necessary. It just doesn't seem like a big deal to wear a mask, and it would cut down on the need for more restrictive measures like lockdowns.

[lieut_data]

> It just doesn't seem like a big deal to wear a mask, and it would cut down on the need for more restrictive measures like lockdowns.

My wife has a medical exemption from wearing a mask. She cannot live a normal life when the standard response to her being out in public is disgust, constant questioning, or outright rejecting her due to "in-store policies."

My father has been wearing a mask, but constantly deals with hyperventilation issues. He's working with his family doctor to determine next steps.

Some things are a big deal for some people. I support anyone wearing a mask if they so choose. I oppose mask mandates as a one-size fits all solution.

[kenjackson]

Actually legit medical exemptions are rare. Why can't we do mandates with exemptions (maybe an exemption card from a doctor)?

[lieut_data]

> Why can't we do mandates with exemptions (maybe an exemption card from a doctor)?

I expect my wife would have to strap her card over her mouth to satisfy the social pressure to conform. It's not in most people's imaginations that anyone else could suffer from something that doesn't bother them.

[spookthesunset]

> It just doesn't seem like a big deal to wear a mask

What about the fully vaccinated, boostered employees who work at these places? Should they also continue wearing masks despite being at virtually zero risk of major covid issues?

But yeah, no thanks. We didn't do masks in 2019 and we sure as heck shouldn't keep doing them going forward. Masks were a hack to get us to vaccines. They aren't something we should be keeping around anymore.

[rajup]

No thanks.

[iso1631]

It's interesting how Scotland, which kept a mask mandate, and England, which dropped it, affected cases.

From start to end of October, cases per 100k, 7 day average

Glasgow -- 300->220

Edinburgh -- 210->250

Manchester -- 290->220

Birmingham -- 250->280

4 similar cities, two with mask mandates, two without.

And smaller ones

Aberdeen -- 267->330

Southampton -- 300->410

Perth -- 320->260

Hereford -- 290->580

So there may be something there, would need more data to really see, but it certainly isn't a glowing mandate for masks

[roywiggins]

There's already data that shows masks work.

https://med.stanford.edu/news/all-news/2021/09/surgical-mask...

[iso1631]

Perhaps, but given there's doesn't seem to be a clear difference between Scotland and England, that leads to questions like

1) Were people in Scotland (with higher masking) being less cautious in other areas (washing hands, staying further away, etc)

2) Was the weather worse in Scotland, leading to more closed windows

3) Are people in Scotland more likely to be tested and thus more cases caught

The problem I have is that

The Scientific method comes out with great studies (wearing masks, all things being equal, reduces transmission)

That leads to a prediction (enforcing masks reduces cases figures)

That prediction doesn't hold out (Scottish cases figures)

So we need to revisit the prediction,

1) Does a mask mandate increase mask usage (anecdotally it appears so, but I only went to Glasgow and Manchester in October)

2) Does increased mask usage lead to other behaviours which would increase risk

3) Does increased mask usage lead to more awareness in testing

4) Do anti mask people go round licking door handles to try to spread covid to prove their points

These are perfectly valid questions, yet you can't ask them, because half the responses will be some idiotic cultish anti-mask covid denier, and the others will be some cultish mask worshiper

[defaultprimate]

https://boriquagato.substack.com/p/bangladesh-mask-study-do-...

https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article

"At present there is only limited and inconsistent scientific evidence to support the effectiveness of masking of healthy people in the community to prevent infection with respiratory viruses, including SARS-CoV-2 (75). A large randomized community-based trial in which 4862 healthy participants were divided into a group wearing medical/surgical masks and a control group found no difference in infection with SARS-CoV-2 (76). A recent systematic review found nine trials (of which eight were cluster-randomized controlled trials in which clusters of people, versus individuals, were randomized) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness. Two trials were with healthcare workers and seven in the community. The review concluded that wearing a mask may make little or no difference to the prevention of influenza-like illness (ILI) (RR 0.99, 95%CI 0.82 to 1.18) or laboratory confirmed illness (LCI) (RR 0.91, 95%CI 0.66-1.26) (44); the certainty of the evidence was low for ILI, moderate for LCI."

https://apps.who.int/iris/bitstream/handle/10665/337199/WHO-...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546829/

[roywiggins]

Look, I'm not qualified to evaluate a study like this, but between Science and "el gato malo" published on Substack, I think I'm going to have to go with Science on this one, pending some recognized expert in the field with a human name saying otherwise.

[mikeyouse]

The author of the study that the bad cat is trying to discredit wrote a long, persuasive rebuttal to the simplistic critiques he's been reading on Tyler Cowen's blog;

https://marginalrevolution.com/marginalrevolution/2021/11/ja...

They saw a significant reduction in covid presence in communities with more masking -- even though total masking was still only 40% in those communities -- which is very much in line with all the other literature.

I literally can't believe people still pretend like masks (especially surgical/KN95s) don't protect people when it's completely self-evident since we've used them forever to protect people in medical settings.

[defaultprimate]

Skepticism and methodological criticism are definitionally "science". Not cult like faith. Ad hominems and appeals to authority are not valid arguments.

[sjg007]

There are plenty of scientific studies showing that masks work.

[kansface]

Obviously, the material a mask is made from stops medium sized particles from flowing through some highish percentage of the time. No good faith actor is disputing that. Studies don't control for real world usage, actual public adoption, actual masks, etc. They also do not control for changes in behavior that we'd expect to occur contemporaneously to the time periods mask mandates are adopted (ie, during spikes in infection). When infections go up, I personally stop going places where lots of people congregate - a huge percentage of people change their behavior in ways that are both germane and impossible to track in response to perceived risk. They also do not or can not control for the differences in behavior in the societies that can actually adopt and enforce mask mandates in the first place; ie, a city that refuses a mandate in the face of a spike has citizens that are more risk tolerate (or something) as compared to eg SF.

[adolph]

I think the number analyzing actual mask usage is fewer than you’d think.

[spookthesunset]

All conducted in the heat of the moment where saying anything that gives the slightest wiff of "masks don't work" gets you shunned, your career destroyed, and all social media platforms labeling your content as "misinformation".

Yeah... I'm sure all these studies done post-2019 are totally legit though.

[iso1631]

But do they show how much mask mandates work in the real world, do they explain why Edinburgh and Glasgow are indistingishable from Mancehster and Birmingham in numbers of cases detected?

[Aloha]

I think in reality, COVID fatigue has set in, and thats the issue.

[iso1631]

Via what mechanism? Were people not wearing masks in Scotland despite the mandate? Were they wearing masks in England despite no mandate? Is there enough difference in behaviour between Glasgow and Manchester to explain the difference?

[roywiggins]

We are maybe a couple months from Pfizer's new antiviral becoming widely available, and it will probably work for immune compromised people. There's also a recent EUA for a long-acting antibody PrEP injection that should help immune compromised people avoid infection in the first place.

Both of these may be widely available in the US quite soon.

[wonderwonder]

This is a good response and I think would be something that should be taken into account. I am still not going to start masking again unless a much more severe variant rises but I can understand setting a firm deadline based on an emerging technologies. Issue is that there will never be a 100% solution and some states more willing than others to let mandates run forever. What happens if those emerging technologies are not as effective as hoped? It becomes a slippery slope with the deadline kicked down the road. Personally I think we are all going to get covid eventually in much the same way we all get the flu. Everyone that wanted to get vaccinated (in the US) and boosted has had a chance to do so now. Most Americans that want to avoid human contact can for the most part via amazon and food delivery services, work is obviously a different matter for most people. Perhaps I am selfish which I am open to, but at this point after having taken 3 shots and been very mask conscious for the first ~14 months I am tapped out and willing to roll the dice as the risk ratio seems relatively low to my age group and I have no pre-existing morbidities.

[roywiggins]

The Pfizer data on their new pill Paxlovid is very good. It's not emerging, it's here and will be available to people very soon. We will probably all get covid, wouldn't it be better if we all got it after treatments that cut deaths by 90% are widely available?

https://www.washingtonpost.com/health/2021/12/14/does-pfizer...

[landemva]

The unmentionable and ridiculously safe antiviral is available today. But Ivermectin is cheap so it must not be considered.

[mikeyouse]

If only it worked at all, that'd be a great option.

[landemva]

NIH report says it does.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539925/ 'Ivermectin is an FDA-approved broad-spectrum antiparasitic agent with demonstrated antiviral activity against a number of DNA and RNA viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).'

[mikeyouse]

That's not an NIH report -- that's a random paper posted on the NIH domain. IVM may have some benefit in countries with parasite problems, unfortunately it doesn't do much in the rest of the world. Has already been discussed to death, there's no conspiracy, everyone would have loved for it to help but it really just doesn't;

https://astralcodexten.substack.com/p/ivermectin-much-more-t...

[Karsteski]

> Not arguing with you, just genuinely interested on how long you would advocate for mask mandates? Would you be willing to accept mask mandates in perpetuity?

This is the problem, isn't it? For how long will these mandates be in place for? Right now, it's clear that they won't end until populations start revolting.

[jkubicek]

> Right now, it's clear that they won't end until populations start revolting.

That's not at all clear. My very cautious Northern California county dropped the mask mandates when cases started dropping this summer and only re-implimented them when cases and hospitalizations started to rise again.

I don't see any reason for them not to drop the mandates again when infection/hospitalization rates drop down to acceptable levels.

[spookthesunset]

> acceptable levels

Define acceptable levels? And does this suggest we continue masking every winter when "cases surge"? There will always be a variant of covid. Always. It's never going away. Basing mask mandates of any metric, be it cases, hospitalizations or deaths means every winter you'll be wearing a state mandated mask.

[jkubicek]

Are you trolling or do you really think that "every winter you'll be wearing a state mandated mask"?

We've been in this pandemic now for close to 2 years. At every single point, government rules and guidance have lagged recommendations from the experts. I'm confident that there is exactly 0 chance that any governmental body in the US is going to continue to mandate masking after it's no longer necessary.

[spookthesunset]

> Are you trolling or do you really think that "every winter you'll be wearing a state mandated mask"?

At this point, in the states that have mandates? I'm honestly not sure. There sure seems to be no rush to remove them despite having low "cases" and hospitalizations not being an issue. And given none of these states have given a single hint as to when they will go away... who knows?

States that continue this are absolutely normalizing mandated masks. Vaccines were sold as the end of masks (and they morally should have been regardless of what politicians say). Vaccines are the best we can do. Mandated masks in a post-vaccine world makes absolutely no sense at all. What other target could a government reasonably set after a vaccine? "Cases"? "Hospitalizations"? Well... those will always be there. So do we just keep doing this forever?

And if you say "hospital capacity" shouldn't these governments have fixed that already? We gave them two years and it was an emergency so where is the hospital capacity we put our lives on hold for? I mean, its still an emergency right? Shouldn't people be super pissed that government hasn't dealt with the actual problem they keep saying we have?

[ineedasername]

"Everything seems pretty good so far"

There shortages of hospital beds across many states [0] If you want a full perspective on things, look further than your own state.

Unless you live in Wyoming, Colorado, Alaska, North Dakota, or Montana then everything is not going very well. Most people don't live in these states, and many of the states with loose mask mandates are not in that short list. A small are just about holding their ground, but about 40 states have seen a >= 15% increase in infections just in the last two weeks, and one of the least restrictive states for mask mandates (Texas) has increased by 80%. [1]

[0] https://protect-public.hhs.gov/pages/hospital-utilization

[1] https://www.nytimes.com/interactive/2021/us/covid-cases.html

[landemva]

Increase in infections does not equal death. It does bring the population closer to herd immunity. Infections and recovery bring sterilizing immunity, which is not provided by the shots.

[ineedasername]

Infections have been a lagging indicator for deaths this entire time and immunity from infections does not appear to last as long as immunity from vaccinations. The people most resistant to right now are those who had covid already and get vaccinated.

I also don't understand your assessment that we are reaching (or can reach) herd immunity: We're not there on the common cold or influenza, and it seems COVID mutates at rates that will keep it around as well. Early evidence on Omicron indicates that it in particular is better at reinfection than other strains, so I hope the data in the next few weeks confirms its milder nature, but reinfection provides even more opportunity for variants to emerge.

We're much better off than we were a year ago: The holiday spike is (so far) not as bad, deaths are lower than last year at this time, and vaccines are widely available. But we're not back to normal yet (probably never will be) and I don't think we're doing as well right now as we could be, and I think we can make a lot more progress before we declare this thing over and adjust to a new status-quo.

[TurkishPoptart]

"cases" is not really a relevant variable anymore. It's been two years of a "pandemic" and I don't know a single person who's died from this ting yet. Of course, none of my Seattle neighbors will go out to walk their dog without wearing 3 masks.

[ineedasername]

Cases are absolutely relevant: they have been a lagging indicator for deaths the entire time. It will take another 2-3 weeks to see how the current spike in cases plays out in deaths. Hopefully Omicron actually is less lethal, but we'll see soon enough.

As for your experience, it is not predictive or representative given the ~800,000 US deaths. Especially because you live in an admittedly very cautious area.

[mikeyouse]

It's funny too - there's apparently no consideration given to "maybe I don't know anyone who's died because everyone in my community is so cautious".

[ineedasername]

Yes-- and yet just about anyone in this community would roll over laughing before pointing out the obvious if someone said "Why are we devoting so much energy to computer security? We've never even been hacked"

[TurkishPoptart]

That's a good point.

[sjwalter]

> I am in no way saying masks don't work, in fact I think that they do.

This is still so hilarious to me. It's pretty obvious that some masks work, that is, n95 or whatever actual respirator masks. It's pretty obvious that other masks don't work at all, that is, 99.99% of masks worn by the public at large.

[roywiggins]

Surgical masks probably help on a population level.

https://med.stanford.edu/news/all-news/2021/09/surgical-mask...

[jjgreen]

This is still in peer-review

[roywiggins]

It's since been published in Science.

https://www.science.org/doi/10.1126/science.abi9069

[iso1631]

Given that surgical masks stop droplets from spreading as much (especially when you sneeze), and given that bugs spread via droplets, clearly they do something. You may argue on the level of that reduction, or that your right to go out in public without wearing a mask outweighs that reduction, but to just say "masks don't work" is disingenuous.

[mitigating]

" It's pretty obvious that other masks don't work at all"

So a N95 mask works and covering your mouth with a bandana has no effect at all? Not even 10%?

[adolph]

I was putting on two N95s until someone said three was three times as effective so I started wearing three, then one day I did the math myself and don’tcha know, 95% of 95% of 95% is 86%! So I’m back to one mask now, underneath my motorcycle helmet.

[sjg007]

Just wear a mask in indoor public places until the pandemic is over.

[spookthesunset]

> Just wear a mask in indoor public places until the pandemic is over.

I'm fully vaccinated, so why should I? And when will the pandemic "be over"? Covid is here forever and ever. As long as we keep testing at the level we do, we will always find new variants and always see "spikes" of cases every single winter.

When, specifically, do the states with mask mandates remove them? Why not today? What makes a month better? Or a year? Or never?

Pushing for masks at this stage is arguing we wear masks forever. That isn't a world I care to live in.

[wonderwonder]

Your solution is a good one and makes logical sense but do you think that this pandemic is going to end? It shows no signs of abating currently and the new variant is even more communicable. How does one determine when the pandemic has ended, what is the benchmark? Covid will always be with us going forward. your solution also involves kids wearing masks in school for potentially years and years. I noticed a massive difference in behavior with my youngest kid during his year of wearing a mask in school and after the mandate went away. He went from a reserved almost sad little kid when I picked him up each day back to his prior outgoing happy self after a few weeks. Obviously my experience is anecdotal but I have spoken with other parents that observed the same.

[jaywalk]

No.

[AustinDev]

This may come off wrong but... COVID is not the first virus. Immunosuppressed people for all of human history have been falling victim to the common cold, the flu and other infections most humans can deal with safely. You can't stop the world economy and the benefit that brings to the majority of society to save a fraction of a percentage point of the population that is Immunocompromised.

[tn890]

Wearing a mask in a supermarket does not "stop the world economy". Americans are borderline insane with the mask mandate

[jkubicek]

Americans are full-on insane with their opposition to mask mandates.

[mitigating]

How does wearing a mask hurt the economy?

[spookthesunset]

I personally go out a heck of a lot less with these insane mask mandates. I hate wearing a mask.

Plus many of these people arguing to keep them around forever forget that actual living humans work at these businesses. It takes a lot of privilege to suggest employees should continue wearing masks forever to make a small set of extremely fearful customers feel "safe". I bet 99% of the "pro mask" people on are not in a place requiring them to wear a mask 40 hours a week.

[alex-korr]

Try having a 3 year old child with a speech impediment that has to wear a mask in childcare for 6 hours a day. Does wonders for their ability to communicate.

[vkou]

This may be a simple answer to a simple question - but it doesn't.

[unmole]

What were these people doing every flu season?