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Was the study bogus? Reading the article (https://www.theatlantic.com/science/archive/2021/12/mask-gui...) from the Atlantic that this article is truncating as well as the original study (https://www.cdc.gov/mmwr/volumes/70/wr/mm7039e1.htm?s_cid=mm...) you might find that the Atlantic article presents the following arguments towards the point that the study has serious flaws, they are as follows: 1. The author (David Zweig) points to https://www.theatlantic.com/ideas/archive/2021/09/school-mas... as proof of skepticism about the costs and benefits of mandating that children 2-12 wear masks in school. That article begins with the statement "The potential educational harms of mandatory-masking policies are much more firmly established, at least at this point, than their possible benefits in stopping the spread of COVID-19 in schools." but ends with the statement "Do the benefits of masking kids in school outweigh the downsides? The honest answer in 2021 remains that we don’t know for sure." The author has failed to present a coherent thesis for their skepticism, and as it reads it appears that their view actually softens by the end of the piece. 2. David Zweig begins their second critique of the Arizona study with, "This estimated effect of mask requirements—far bigger than others in the research literature—would become a crucial talking point in the weeks to come." yet this is a fundamental misread of the study that happens often in science reporting. They study actually says, "In the crude analysis, the odds of a school-associated COVID-19 outbreak in schools with no mask requirement were 3.7 times higher than those in schools with an early mask requirement (odds ratio [OR] = 3.7; 95% CI = 2.2–6.5). After adjusting for potential described confounders, the odds of a school-associated COVID-19 outbreak in schools without a mask requirement were 3.5 times higher than those in schools with an early mask requirement (OR = 3.5; 95% CI = 1.8–6.9)." This is not a causal statement, it is a correlative one. This is to say that the study does not make the point that the mask mandates cause reduction in covid outbreaks, but that those schools with mask mandates clearly experience fewer outbreaks. This conflation is made many times throughout the rest of the article. It matters because, like most science, the study adds to our understanding of reality, and if we misunderstand the science it's likely we are misunderstanding reality. 3. Jonathan Ketcham is quoted, at first without an actual point, as saying: "You can’t learn anything about the effects of school mask mandates from this study". This isn't really an argument so it's interesting that it's made it into the an article on the science section of the Atlantic. It also shows that Jonathan Ketcham may have conflated causation and correlation as well. Without naming them or providing any other attribution, the article then makes an implicit argument from Ketcham's quote: "His view echoed the assessment of eight other experts who reviewed the research, and with whom I spoke for this article. Masks may well help prevent the spread of COVID, some of these experts told me, and there may well be contexts in which they should be required in schools. But the data being touted by the CDC—which showed a dramatic more-than-tripling of risk for unmasked students—ought to be excluded from this debate." So the experts interviewed all agreed that masks "may well help prevent the spread of covid" and that there "may well be contexts in which they should be required in schools", but the data in the study we are citing should be excluded from the public discourse. To me, this section requires a lot of brain twisting work. The experts (even those critiquing this study) say masks help (this is not a may well statement). The experts say we might want to mandate masks in schools. But for some reason, this study that finds some valid correlations shouldn't be talked about in the public debate. I find this nonsensical considering the article that wants the public to not use this research in debate must use the research to achieve its goal. If the author really wanted that data to go away it should be doing what any good scientist would do, which is more science. Get some more data, show that the models presented by the study are in fact wrong. 4. Noah Haber is quoted as saying that the research is, "so unreliable that it probably should not have been entered into the public discourse." Great quote for a science article. It's got a lot of information to sink your teeth into. At this point in the article I find that I'm very annoyed by the lack of actual science reporting. It mostly reads as shit stirring to me. ...continued |
6. Louise-Anne McNutt and Ketcham point to a possible detection error in the study. Namely, "...according to Maricopa County guidelines, students are considered 'close contacts' of an infected student—and thus subject to potential testing and quarantine—only if they (or that infected student) were unmasked. As a result, students in Maricopa schools with mask mandates may have been less likely than students in schools without mandates to get tested following an initial exposure." To this the study authors responded that it is, "highly speculative to make the assumption that identified close contacts are more likely to be tested than other students." This is a little harder to muddle through as we are getting a core argument on designing a reliable study. So, we are looking at the definition of an outbreak. The study states its definition thusly, "A school-associated outbreak was defined as the occurrence of two or more laboratory-confirmed COVID-19 cases§ among students or staff members at the school within a 14-day period and at least 7 calendar days after school started, and that was otherwise consistent with the Council for State and Territorial Epidemiologists 2020 outbreak definition¶ and Arizona’s school-associated outbreak definition." The CSTE defines an outbreak thusly, "Two or more laboratory-confirmed COVID-19 cases among students or staff with onsets within a 14-day period, who are epidemiologically linked, do not share a household, and were not identified as close contacts of each other in another setting during standard case investigation or contact tracing." The confounding factor that McNutt and Ketcham are referring to, which is that if two people are considered an outbreak they could have caught covid from outside of the school instead of each other, is sort of moot here as the paper states they conducted adjusted logical regression analysis against many factors including the, "7-day COVID-19 case rate in the school’s zip code during the week school commenced". That means that detection bias should not be present and we can be fairly certain that the definition of outbreak in this study is both consistent and likely means that the two or more cases are in fact school related.
7. Jason Abaluck makes the point that vaccination status could be a confounding variable. It can be! This is a flaw in the study that the study itself acknowledges. I'm not sure how this is an argument for the study being junk science. It's a little like one of the first probability and statistics examples I was taught. In this example a study was done on Coney Island where the scientists looked at ice cream sales and the number of drownings in the area. They found that there is a clear correlation between them as when ice cream sales went up so did drownings. In the study they unfortunately could not get access to temperature data or visitor counts. They concluded that ice cream sales are a good indicator of drownings. Of course, the reason ice cream sales and drownings are correlated is because people go to Coney Island when it is hot out. They also eat ice cream when it is hot out. With more people going to Coney Island there are more people that are likely to drown. The study did not make the claim that ice cream sales cause drownings, just like this study does not claim that mask mandates reduce covid outbreaks. However, in both cases the indicator is useful. In the case of mask mandates we also have data that shows masks reduce covid transmission in many other scenarios. So, yes, vaccination status is a known confounding variable that I'm sure the authors of the study would like to control for. Since they can't they did the next best thing and established that mask mandates are a good indicator for reduced covid outbreaks.
8. David Zweig attempts to reproduce some of the data himself. He attempts to build part of the data set used in the study for Maricopa county. In the end he gets the list of schools from the study authors. He writes, "Yet it still included at least three schools in Pima County, along with at least one virtual academy, one preschool, and more than 80 entries for vocational programs that are not actual schools. In response to a follow-up inquiry, they acknowledged having included the online school by mistake, while attributing any other potential misclassifications to the Arizona Department of Education." This is interesting, but ultimately the misclassification of some schools does not ultimately change the statistical methods used.
This is it. Eight arguments meant to show, "...the study’s methodology and data set appear to have significant flaws." I don't see the points made as exposing significant flaws. However, I am a simple programmer who studied mathematics and reads technical specifications in my spare time.
At the end of the day please remember these truths. Covid kills a lot of people, mainly the older ones. Covid transmits via aerosolized bodily fluids (coughs, sneezes, breathing), and things like wiping your nose then touching doorknobs where someone does the same in reverse order. Masks, preferably well fitting n95 and kn95 ones, irrefutably reduce the spread of covid. Washing your hands well and often irrefutably reduces the spread of covid. The science here is icing on the cake and it just tells us, sometimes roughly, how much these things help. Beyond those two things the vaccines are an entirely different story (because thanks Trump), but the science is more clear there, they also help.