"Are masks effective" is the completely wrong question, anyway. The question should be "how effective are masks?"
Preferably, "How effective are masks against X under Y circumstance?"
In relation to Covid, I think it's likely masks reduced transmission. But, under normal social environments, did they reduce it by 5% or by 50%? It makes a big policy difference. It seems that studies are coalescing around masks having a 'real but small' effect, but I get it's a hard thing to study.
https://journals.aps.org/rmp/abstract/10.1103/RevModPhys.95.... is one article that provides some insight. It describes the nature of viral particles exhaled in different activities, and explains how effective different masks are at preventing these particles from being inhaled.
Separately, I was surprised to see that OP's article looked at studies starting in 1978, since modern electrostatic filtering masks were only patented in 1995--so I'm not sure how meaningful it is to lump studies on older mask technologies in with modern masks.
Masking during a pandemic is never just about individual risk. Collective action has an exponential effect on prevalence, so the real risk goes down by far more than 5%.
Not taking action to reduce risk of illness or death is irrational.
There's a trade-off between doing things you enjoy (or don't enjoy) and the risk of death, and it's a personal trade-off, not something that can be assessed rationally.
You misunderstand the utility of masks, where it is significantly more an infected wearer of the mask who protects others by their wearing. So, being infections before you have symptoms is the problem, which is why people should - as is standard in Japan, for example - wear masks in public whenever they feel unwell or feel a 'cold' coming on.
A quality mask costs around $1. Per-capita GDP is about $33 per day worldwide. Or put another way, with 8 billion people in the world, a mask a day runs around $3 trillion annually.
The world is interconnected.
I like masks since, aside from viruses, they filter pollution and allergens. I feel a lot better post-2020. However, universal HEPA filters and covid masks are very much for the rich.
More than once per day? It's complicated. There are two designs:
- Electrostatic masks work well so long as the mask remains charged (those are the 3M N95 ones). Efficiency drops as they become moist, especially. However, for good ones, even after extended use, it's still surprisingly high.
- Nano masks basically work forever. The initial efficiency is lower than electrostatic, but remains pretty good for longer than I'd want to use one.
For real-world use, I really prefer nano. Unless you're much more careful than I am, enough air leaks around the mask that I'm not sure there's a big difference between 99%, 95%, or even 80% filtration.
And the numbers are extremely conservative too -- they look at filtration around a few hundred nanometers, which is the worst-case. Most diseases come in on much larger droplets.
One thing which tends to be under-emphasized is that it's not binary. Viral load is important. A single virus particle probably won't cause an infection (it probably won't infect a cell, and if it does, your innate immune system will probably flush it). If it does cause an infection, your adaptive immune system has a lot of time to react, so it probably won't be a bad one.
This is even more true for pollution and allergens.
For my purposes, I find nano masks to be the right bang-for-the-buck. They're much more breathable too. And they handle environmentals like rain or sweat better.
The Asians are right; living in a big city, I've felt better since 2020, with masks, air quality monitors, and HEPA filters everywhere. I get sick less often, have milder seasonal allergies, and just generally do better.
On a related note, other aspects of air quality matter too: CO2 levels, humidity, etc.
No. I've been using N95s since the start of the pandemic and have spent a fair amount of time learning about them, e.g., reading the written material that comes with the box of masks, and I've never seen that kind of recommendation. The written materials say things like, "throw the mask away as soon as it becomes stained or discolored."
I use each of my masks for probably at least 10 hours before throwing it away, and I've never gotten covid except once (in Jan or Feb 2020) before I started wearing masks (in fact, before anyone in my country -- the US -- knew about covid).
(I have to write "probably" because I don't actually keep written records of how long I have each mask on. I rarely have one on for more than an hour at a time.)
I've used mainly 3M 8511 masks.
The most important distinction between mask models is that some models have valves / vents and some do not.
Hospitals use ones without valves. The lack of a valve means that the part of the mask that filters the air gets a lot more damp than it would if a value were present (because exhaled air is damp) which might drastically reduce how long the mask will last, so that might be why some hospitals instruct their employees to use a new mask for each new patient contact.
> The written materials say things like, "throw the mask away as soon as it becomes stained or discolored."
For some N95 masks, that's because they assume you are using it to block out particles that will accumulate on the mask, like paint droplets or sawdust or whatever.
In contrast, breath is mostly water vapor, and COVID-19 particles have a short-enough half-life that you can probably rotate between masks and be pretty safe.
> dramatic reduction on the (exponential) virus spread.
Check your assumptions, please!
If you are comparing e^(kt) to e^(0.5 kt), sure, they’re very different. But Covid didn’t spread like that at all. It grew exponentially-ish until the fraction infected was no longer negligible, and then the dynamics changed dramatically, as they must have. After all, you can’t have 1 million times the entire population infected after a couple years.
Another question most of these studies fail to ask is what is the effectiveness of each type of mask? An N95 mask is going to have a big difference in efficacy vs a surgical mask without a seal.
Another issue is that most of these studies are just surveys. Did participants actually use their masks for x hours? Did they use their masks correctly?
Common sense? Restricting exhalation to reduce transmission of airborne disease? Have you never been taught to cover your mouth when you sneeze or cough?
Like it would be remarkable if it did nothing. THAT would be a blockbuster result.
The thing worth studying is if the effect is worth the trouble or not. It could be worth doing or it could effectively be a waste of time due to whatever other factor.
Common sense says if you put your hand over your mouth and breath out you will be able to. That says the pressure is overcoming the blockage.
The other way round is far more difficult.
If you leak then you are wasting your time because in a static air environment you’ll delay the critical level build up by a few minutes at most.
Medicine doesn’t like aerosolisation because it sounds too much like miasmia theory.
So we have too much focus on droplets and fomites.
Fundamentally this should have been sorted with a properly designed trial with the correct protocol of sufficient size to answer the question. Given what was on the line why has it not been done?
> Fundamentally this should have been sorted with a properly designed trial with the correct protocol of sufficient size to answer the question. Given what was on the line why has it not been done?
That's an interesting question but if you're suggesting it implies something either direction: why?
Obviously there are a LOT of politicians and people strongly interested in a "masks are useless" position.
But it's not just that the "masks are useful" people have failed to satisfy you.
It's also that the "masks are not useful" crowd has not published a conclusive study of their own.
So it's not convincing to me that the truth is anything other than "masks have varying effectiveness, though the supply-chain-crunch plain-cloth-mask world of 2020 wasn't the ideal type of mask."
Do you have reason to believe an N95 isn't effective? What about a P99? (In the world of media I consume, these types of masks vs cloth masks are things that were widely discussed, along with PM2.5 etc. So the "it was presented as black and white" crowd seems just uniformed of their own volition, maybe watching too much partisan media who had an interest in presenting the issue in a one-sided manner.)
Aye, that brings up another issue. What exactly does “airborne” mean? The assumption early on was that Covid was not airborne, and required droplets of a certain size, though I think that changed over time.
We might never know this about COVID as further studying it can only uncover more malfeasance at this point, but traditional airborne stuff like smallpox or measles won't be affected by a dirty bandana on one's mouth or, even, over the nose.
> Meanwhile, all those deplorable schmucks in the trades, who've been lectured to death about choosing the right respiratory protection for the job, were able to comprehend that big mask hole and tiny virus is a Bad Choice. You want the mask holes to be smaller than the Bad Thing. Therefore, "Masks Don't Work".
It's interesting that you stop here, and not go further to the next level of relevant knowledgeableness, which is that the virologists and materials engineers who work on masks know something the tradespeople don't, which is a) that viruses rarely travel around as single viral particles and b) that this is why we make surgical and N95 masks electrostatically charged. (https://www.wired.com/story/the-physics-of-the-n95-face-mask...)
(For a clear example of why a) matters, try peeing through your pants. The water molecules are, after all, far too small to be blocked!)
> A clear explanation of the different modes of operation, and framing it as a polite thing to do (akin to covering your mouth/nose when you cough or sneeze), probably would have been sufficient.
> which is that the virologists and materials engineers who work on masks know something the tradespeople don't, which is a) that viruses rarely travel around as single viral particles and b) that this is why we make surgical and N95 masks electrostatically charged.
Right. Which is why we saw a great many "virologists" (who are not "maskologists", btw, so I'm not sure where we get this idea that they "work on masks" [1]) blindly assert that it didn't matter what kind of mask you wear, then for a long time defended the silly notion of a 6-foot rule (remember "ballistic droplets"? I do!), then said, "OK, cloth masks probably don't do much, but 'swiss-cheese model!'", and so on and so forth. Literally anything than just be intellectually honest about what the data says.
This entire debate has been insipid, and OP is correct: a great many people who should have known better shifted their brains into neutral and allowed slogans to drive the conversation. The entire point of the linked article is that the CDC has historically used crap studies to make causative arguments that wouldn't work in any other scientific debate.
[1] ...and let's not forget people like Jeremy Howard (philosophy major; Kaggle guy) and Zeynep Tufecki (librarian) somehow get cited as 'mask experts' and publish total gibberish in PNAS and other high-profile journals, despite having zero relevant experience. Expertise is a slippery concept when the speaker makes an argument you like!
But what's the cost? You're walking around with a bit of cloth on your face. Other cultures have done this habitually for decades and are still able to function.
IMO this was never about masking. This was about a minority of cluster-B types having a public meltdown at the ideologically intolerable fact that collective responsibility is a real thing.
There is no ambiguity about "Masks work." It simply means masking is better than nothing.
There's nuance in the type of mask, and masking practices, and other fine details. But the principle is straightforward.
And unless you're seriously going to try to argue that dentists and surgeons have been wasting their time and money on PPE for all this time, the effects are clear.
> IMO this was never about masking. This was about a minority of cluster-B types having a public meltdown at the ideologically intolerable fact that collective responsibility is a real thing.
Whoa there...you skipped a big step. "Collective responsibility" requires that the thing you're all doing is shown to be responsible. If the thing doesn't have any effect, then you're just engaged in theater. Or worse, maybe the thing has negative consequences. Because that's certainly possible, and not something you can just hand-wave away.
You don't get to skip the test of effectiveness, blindly assume that whatever you're mandating is automatically good, and dismiss anyone who dares to question your assumptions as "irresponsible".
Instead of just running the damned experiments, it's tribal warfare and insults, and clinging desperately to crappy data.
> And unless you're seriously going to try to argue that dentists and surgeons have been wasting their time and money on PPE for all this time, the effects are clear.
Huge conceptual leap from "dentists and surgeons wearing fitted, fresh PPE in a sterile environment" to "people on the street wearing unwashed cloth rags" (aka "a bit of cloth on your face"), so I'd probably start there.
I think you've nailed it exactly, and I've saved this comment to my "COVID Stupidity" Zotero collection for later.
The parent is also certainly on to something with the Cluster B's and those pesky "ideologically intolerable fact[s]", I'm just not sure it's so one-sided.
The entire thing was ideology first, science second, to the point of science worship. Many people with a reasonable grasp on science were labeled as heretics simply for asking questions or talking about anything that suggested masks/vaccines weren't 100.00% effective with 0.00% downside. Remember Faucisexuals? Yikes.
As someone said, we need to stop "believing" in science (or not) and start "understanding" it.
I saw some police walk up to a small elderly and otherwise inoffensive woman and kick her off a tram because she wasn't masked up. It is better than a Jew Badge, but I think people can have a legitimate concern that the same authoritarian mindset was behind both mandates. Drawing the line at police telling people they have to start dressing differently as a show of public support for a cause is an extremely reasonable position.
Especially since as far as I've seen there is still no evidence it achieved anything beyond just offering up a "hey, wear a mask" as advice and encouraging voluntary behaviour. This study makes it look like even the evidence for voluntary masking is up for question.
I don’t think you can blame mask policies for police power trips. For one, police unions widely opposed mask/vaccine mandates. For two, ACAB; if it’s not masks, it will be something else.
Looking at the data on other respiratory illnesses showed that something certainly worked. Really hope we get good at figuring out the relative effectiveness of different measures before the next pandemic.
Yeah, yeah, but N95s didn't come into play until much later.
The earliest piece of advice was "please don't go out and buy all the masks because the hospitals need them (and the common ones won't protect you anyway because the virus is too small - you'll need an N95, which are expensive and also needed in hospitals)"
A little later, the advice was "on second thought, if we all cover our mouths and noses, we'll probably slow the spread by virtue of not coughing and sneezing all over everything. Save the N95s for the doctors, and cover your face with I-dont-care-what".
The opprobrium cited the earlier advice, with a "wait, you said these were useless, now we have to wear them?"
Instead of addressing this most simple point of confusion, it jumped to "MASKS WORK! SHUT UP AND PUT YOUR MASK ON, IDIOT!"
By the time production ramped up and we had N95s to go around, the conversation was already stupid beyond repair.
Again, it was never The Science™, but the piss-poor communication of it - and by people who should have known better.
== Instead of getting everyone on the same page, ==
Your post seems to be continuing this trend. Nobody called anyone “deplorable schmucks” or “puppy kicking grandma killer” but you. Your victimhood really comes out in the language you choose to describe others.
The parent seeks to convey the zeitgeist irrational emotional response of the populace to alternate perspectives during the COVID era and to my mind does so successfully.
As someone who not only mapped the rise of COVID for Wikipedia before it was mainstream media acknowledged in January 2020 - https://github.com/globalcitizen/2019-wuhan-coronavirus-data - but also had the unique fortune of experiencing (catching) COVID in all of China, Australia and the US, while all countries had irrational response I would classify Australian social paranoia as some of the worst. Absolutely, people were being shamed and attacked and removed from society, employment, etc. if they did not have vaccinations or refused to wear masks. While all countries had irrational response, Australia's was certainly "up there". Furthermore, they turned the whole country in to a prison (you needed 'special permission' to leave, even as an Australian citizen), and virtually nobody complained.
There are no such people so hopelessly enslaved as those who believe they are free. - Goethe
I personally found the recent withdrawl of some of the vaccines - which people were hounded and shamed in to taking in to their bodies - with proven mortality risk, as something of a vindication. None of my family had any vaccines, not because we are against them per se, but because we didn't encounter a legal requirement to do so as we visited the US right after the requirement for travelers was dropped, and had already developed natural resistance through repeated exposure. If we were dealing with a more vicious pathogen, we would have been first in line.
My problem is the person engaging the exact things they accuse the other side of doing, all while lamenting the inability to “get people on the same page.”
The general trend on this forum was that anything queationing the official narrative on issues related to COVID was heavily downvoted, even if you just quoted conflicting research. Thus it was not only “specific individuals”.
Funnily enough, I am first upvoted, then downvoted to -1 for a comment that people were downvoted for saying certain things. Nobody has any counter-argument but they just downvote because they disagree. Kind of proves the point.
Revisiting The Science™ today is obviously useful for tomorrow. Suddenly dropping the issue is a bewildering position, especially from such a "pro-Science™" crowd.
Why wouldn't we want to know how effective (or not) a given intervention is? It feels like a way to avoid embarrassment.
But I'd argue that most of the lessons to be learned are not about virology or the minutiae of masks. They're about the consequences of politicizing something that's not political, of implementing drastic measures with poorly-communicated rationale.
They're of non-physicians spreading their own opinions and misexplainations (however well-intentioned) while condescending to other non-physicians that they're not entitled to their own opinions because they're not a physician. Like, what?
It would be a bewildering position, which is why nobody suggested to suddenly drop the issue or stop studying it. I’m not sure where you got that idea.
I was talking about revisiting people’s comments on a message board from 4 years ago in an attempt to re-stoke the flamewar conversations everyone claims to be against.
I have no opinion on this thread but I find it weird when people dig through others’ comment history and try to use it as an argument.
If you read the rest of that thread GP states that he was thinking of a specific different police brutality case and mistakenly referred to the George Floyd case instead. I also have no idea what he means by black supremacists there but the ridiculous part of your quote was essentially a typo by GP (allegedly anyway).
Thank you for taking the time to go through my thousands of comments. Did you read all comments or were you looking for specific keywords that match your worldview?
My views were based off of cnn and cam footage shown.
I was reading through your history. Why all the Apple hate. Did you ever recover from the botched Apple interview?
No need for perusal, just a good memory for usernames.
Apple hate? Me? I’ve got an iPhone, Watch, and a house full of Macs. Apple is by far my preferred tech company out of the big ones. I hate Apple about as much as George Floyd was killed by black supremacists.
I’m not sure how three years of CNN coverage of the Floyd murder left you thinking he was offed by black supremacists instead of a visibly white cop.
== Shame on you for trying to hide your collective cowardly actions.==
I needed a reminder on why I stopped posting here. This type of arrogant indignation is the perfect example. It completely cuts off actual discourse and makes a host of negative assumptions about others while demanding that others treat your ideas with care and nuance.
Shame on me for trying to have a discussion. Back to your flamewars!
N95 style and other similar masks don't work by making holes that are smaller than the particles they are meant to filter, they filter smaller particles primarily with electrostatic effects.
I think one needs to have different standards for an academic discussion versus a public health campaign.
For example, taking drinking and driving. If we're talking academically, it's an incredibly nuanced topic, and I'm sure the actual risk depends a ton on the individual, their skills, their reaction times, their built-up alcohol tolerance, and many other factors.
But if we're talking about actual individuals getting hammered and then grabbing the keys, then "Don't Drink And Drive. Ever." is about the right level for the discussion.
And I think part of the reason that it's so important to hammer home messages like that is that the people who want to do the thing that's dangerous for others will seize upon the nuances of the academic discussion, use anything that gives them permission, and absolutely ignore the rest of it. That's true of drunk drivers for sure. It was also true of smokers before they lost that battle. And of course the Andrew Wakefields of the world are great at building a whole grift around that.
But this falls apart immediately, in much the same way as the rest of it.
If someone tells me I'm incapable of driving because I had a glass of wine with dinner, I'm likely to laugh at them and disregard everything they say after that, because I now perceive them as someone who understands neither drinking nor driving.
It doesn't take a PhD to understand that people react differently to alcohol (etc, etc). Most people I know figured that out before they were 18 and had a pretty robust understanding by their early 20's.
The right level of discussion, IMHO, is not paternalistic, absolutist condescension, but one that promotes self-awareness and enables people to appraise individual risk in specific situations. (Be careful: if you assess wrong, you die or go to jail!)
I'd also disagree that the people who excuse their behavior like this are seizing upon nuances of academic discourse, but rather rejecting an insultingly-simplistic slogan held up as some kind of absolute truth.
It reminds me of a line from this thing my dad had framed, to the effect of "Be wary of giving advice: the fool won't heed it and the wise don't need it." Somewhere in the middle are reasonably-intelligent, non-sociopathic adults who need to understand the limits/risks/benefits so they can make informed decisions.
To the original point, I think we'd have seen much better results and much less collateral/residual damage if we were in the habit of "ELI18" and not "ELI5".
I look forward to seeing your evidence for that theory. But you write a lot about what you want and what you find personally offensive, but not at all about your experiences getting people to do things, so I don't see much reason to think your personal tastes tell us much about how people actually change behavior.
Preferably, "How effective are masks against X under Y circumstance?"
In relation to Covid, I think it's likely masks reduced transmission. But, under normal social environments, did they reduce it by 5% or by 50%? It makes a big policy difference. It seems that studies are coalescing around masks having a 'real but small' effect, but I get it's a hard thing to study.