[u32480932048]

One of my pet peeves is the continued use of ambiguous phrases like "masks work" or "masks help" when there are effectively two different mechanisms (inhalation/exhalation).

I suspect the prolonged mass confusion over such an elementary topic will be one for the Science Communicator books.

[titzer]

IMHO the issue is that masks work but masking as a social phenomenon can suffer a number of problems, like non-compliance, partial compliance, poor fit, children, misuse, reuse, damaged masks, cloth masks, needing to eat, and all kinds of factors. So scientific experiments in a controlled setting with one or two people show that masks work as a mechanism, but getting everyone to go along with and practice good masking etiquette might not work so well. So population studies show masks working much worse than their mechanism would suggest they can. Especially when there is intentional non-compliance and protests motivated by culture war battles.

Arguing with people who just spout "masks don't work" and then intentionally are non-compliant (and encourage others to) is like arguing with motivated idiots.

No, masks work, period. Masking only works if people freaking do it.

edit: spelling

[agos]

on the flip side, so much of the Covid discourse was about these fabled policies which would do great things (but required 100% compliance), followed by indignation/panic and hysteria/angry mobs when it turned out that 100% compliance is hard.

[Sporktacular]

We won't need 100% effectiveness and 100% compliance. If they only work at 10% effectiveness, then over a network of thousands, they will measurably save lives.

Studies have shown they work (such as https://pubmed.ncbi.nlm.nih.gov/33483277/), despite the 'ah, yes but only [insert unsupported caveat here]' of some.

[timr]

> No, mask work, period.

...on a mannequin, in a lab, or when used as a filter between two hamster cages. Perhaps. But there have now been plenty of negative studies in hospitals, which really starts to beg the question: if you can't get effective compliance in a hospital, where are you going to get it?

Just to be clear, I was with you right up until the part I quoted. It's fine to say that mechanistic studies show something to be true, but it's totally wrong to leap to the conclusion that these mean anything. If I tell you that you're 100% certain to lose weight if you stop eating, that's True ("Starving works. Period."), but it's not meaningful.

Every failed drug ever tested worked in a laboratory before it went to clinical trials.

[Sporktacular]

Except masks do work. Here:

https://pubmed.ncbi.nlm.nih.gov/33431650/ - "We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation." https://pubmed.ncbi.nlm.nih.gov/33370173/ - "Evidence suggests that the potential benefits of wearing masks likely outweigh the potential harms when SARS-CoV-2 is spreading in a community". Mentions the network effect. https://pubmed.ncbi.nlm.nih.gov/32497510/ - "Face mask use could result in a large reduction in risk of infection" https://www.mayoclinic.org/diseases-conditions/coronavirus/i...

"...on a mannequin, in a lab, or when used as a filter between two hamster cages. Perhaps." No, you are coping hard. The studies above are not done by idiots.

"if you can't get effective compliance in a hospital, where are you going to get it?" Nice pivot, but the subject is whether they work, which they do. Compliance is a different question. That's like arguing that condom effectiveness is low when people don't use them properly. And because the figure is low, let's just conclude condoms are ineffective so people should stop using them altogether.

"Every failed drug ever tested worked in a laboratory before it went to clinical trials." And some actually worked in trials. Your job is to explain which is the better analogy. That unanticipated practical considerations exist does not invalidate every conclusion you dislike.

However, even if masks work slightly, or not at all, even if there are dozens of studies saying so, there is enough conjecture to warrant wearing them anyway just in case. If two equally qualified mechanics disagree on whether to change your brakes, you change your damn brakes. If you don't that's stupid. If you don't and then drive a busload of people, that's criminal.

But masks do work, and they're cheap and barely an inconvenience. The problem is everyone thinks they're smarter than an epidemiologist. Thanks Internet.

[timr]

I'm not getting in an argument about this. You don't understand what you're reading, and you're cherry picking papers based on a poor understanding of data quality. I will say that your first link is the Masks4all (Jeremy Howard) paper, and it is not a reputable scientific publication. It doesn't follow a valid methodology for a literature review, and leaves out/minimizes major RCTs that don't support their pre-determined conclusions.

The second link is not a study, or a meta-review, and contributes nothing. The fourth link is not a scientific paper at all.

The third link is the WHO summary of masking data in mid-2020. It covers the same ground as the Cochrane review (below), but re-weights the data somewhat arbitrarily to achieve the stated conclusions.

The Cochrane review is the gold standard summary of the evidence for public masking, considers all published data, and includes/excludes/weights data based on a rigorous standard for statistical and experimental quality. Please read it.

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

[Sporktacular]

You've not refuted anything about your own methodological error or conspiratorial bent, but just cast doubt on the sources I gave. We can do that all day. The Cochrane review is controversial and has pretty clearly been misinterpreted by some. Check out some of the commentary by doctors on FactCheck (https://www.factcheck.org/2023/03/scicheck-what-the-cochrane... - sources included):

- Aggregating the three studies together, he said, “they show a consistent and fairly convincing effect.”

- “Taken together, these two RCTs are consistent with a small reduction in risk,”

- "“To me, this shows that there is a reasonably clear modest benefit to community masking interventions during the COVID-19 pandemic, decreasing the rate of infections in groups of people who are given masks and told to wear them by ~13%," he said. “That’s quite an important benefit in the context of a pandemic.”

I'm not sure why you think your opinion on what constitutes a high quality source is somehow superior to that of the thousands of experts who have concluded otherwise. Unless you are also an epidemiologist and a scholar I'm not convinced your cherry picking is worth more than anyone else's. I'm okay with leaving things up to them. But even if you are, you're in the minority.

Point is: 1) a modest increase protection is amplified by a network effect. There is evidence pointing to that increase.

2) people's lives depend on this, so if there's any uncertainty, do the reasonable, socially responsible thing and put up with the minor inconvenience of a mask, just out of caution

3) I don't need to understand every source as I don't pretend to be an expert. We already have those (that presumably aren't all part of big-mask) and they can and should be trusted to fairly weigh up the available evidence and advise us.

Your motivation to conclude one way just seems irrational, suggesting you aren't an expert either.

[Sporktacular]

If masks only work one way and one infected person is in a train car with 10 uninfected people, then they all get protection if they all wear masks.