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Masks, Masks, Masks, Is Your Whole Life Masks, Part 2

By November 20, 2020Commentary

Some Minnesotans who listen to a certain sports talk show host will get the reference in the title, but I have to tell you, I really am tired of talking about masks.  Every time I write about them, including the recent post on the Danish mask study, I get a lot of comments, most of which I don’t bother to publish because they basically are pointing out what I already know, I am an idiot.  It just shows how fetishized, how totemic, masks have become, what a symbol of I either do or don’t care about other people, what a reflection of the authoritarian, do what government says instincts of a large segment of our population.  Has nothing to do with data or science, obviously.  And seriously, the only reason I keep responding is because people really should be aware that they are not likely to substantially prevent transmission, either from you or to you, so be smart and take other measures if you are concerned.  I am living as a normal a life as I can, and I think I avoid infection mostly because my one rule is to avoid crowds of people I don’t know.  Restaurants and bars and stores are fine by me if they aren’t crowded.  If I see a group of people I don’t know I avoid being in their presence for any length of time.  And I depend on the people I know to be responsible and tell me if they think they might be infected, and I would certainly do the same for them.

Here is the big picture on this topic.  Don’t read this blog if you think it supports the idea that CV-19 is a hoax or not a serious public health issue.  This is a serious problem, but it deserves a serious response, driven by actual science and data and consideration of all the effects of both the epidemic itself and our potential responses to that epidemic.  I don’t care if people wear a mask or not.  If it were up to me I definitely wouldn’t mandate use, because I don’t believe they make a difference, and we do live in a free country, supposedly.  I wear a mask whenever required to, largely because I never want  to put some poor retail clerk or waitress in the position of having to deal with a non-compliant person.  But I don’t delude myself that it will keep me from getting or passing an infection, especially as used by the general public.  One of goals here is to give people access to science and data, not just my summaries or analyses, but the source, so you can go look for yourself and make your own interpretations.  But try to do so with an open, although skeptical mind, try to synthesize all that you read.  If you don’t like my summary of the Danish mask study, don’t tell me I’m an idiot or I miss the point because it was only dealing with the effect on the wearer of the mask, when I very specifically addressed the issues people had already brought up about the study.   If you don’t want to believe that the study says what it says, then just admit that you are determined to believe, and it is a belief, that masks make a big difference, despite the lack of any rigorous evidence to that effect and despite that fact that in locations with mask mandates and high mask-wearing we see the same case surges.  Be intellectually consistent and just say, I am going to believe this no matter what.

And to add a little more fuel to the fire, here is the Cochrane update on evidence relating to physical interventions, i.e. masks, to prevent spread of respiratory viruses, including CV-19.  The Cochrane Institute is regarded as one of, if not the, leading groups for compiling evidence on health and medical interventions and treatments.  Uhhh, just like everyone else, no conclusive evidence of benefit of masks.  Could exist, but not shown yet.  (Cochrane Review)

Join the discussion 15 Comments

  • Steve Gerads says:

    I’ve encountered a new wrinkle in the mask debate: they don’t prevent transmission but instead reduce the viral load to both others & the wearer. The number of asymptotic & mild cases is thus proof of mask efficacy. I’m not sure what to make of this more subtle argument except that it seems unprovable and that’s it’s attraction. The argument seems like a textbook example of Richard Feynman’s Cargo cult science.

  • M. McRae says:

    You’ve nailed it, Kevin.
    Their faith is unshakable: They don’t Know if they work. They kinda Think (deductively) that they work. But, man, they faithfully BELIEVE that they work!
    Not much more you can do or say.

    “It’s easier to fool people than to convince them that they have been fooled.”
    Mark Twain

  • Joel Erickson says:

    Keep fighting the good fight Kevin. It seems to me that over the last 20, or maybe even 30 years, feelings are driving the behavior of people much more than facts, science or data. I read John Phelan’s article from the American Experiment, who points out that only 1.7% of the new COVID-19 infections in Minnesota since June 10th are traced or attributed to restaurants, bars, gyms, etc. So we get another lockdown of restaurants, bars, gyms, etc. to “stem the spread” as an attempt to “follow the data”. Many years ago, my grandparents used to use the phrase “having taken leave of their senses”. I guess that might be one explanation fo what we are seeing happen.

  • Rob says:

    Steve, thank you for reminding me of that Feynman chapter. I hadn’t read that in 30 years but I still have the book in my library and just re-read that. There’s a reason Feynman made it the final chapter in “Surely You’re Joking.” I’d encourage everyone to read it, although I know that it won’t hit home to anyone more concerned with their position than with their integrity.

  • Matt R says:

    “It *could* help” becomes the wailing cry of the True Believers… but interestingly enough, isn’t the evidence just as (not) clear, that it *could* harm? I believe the old RCT on masks and influenza actually saw a higher infection rate in the mask cohort. Not to mention other possible ‘harms’ – even if subjective/emotional to those who enjoy seeing smiling faces, they are real harms. And then there what appears to be a very likely harm of masses of people assuming masks work and thus over-crowding / not distancing, etc. That was the concern at CIDRAP, and the countries that didn’t encourage mask wearing, and the charts of masking populations at the very least does nothing to disprove that is happening.

    Whatever happened to “First, do no harm” anyway?

  • Debbie says:

    I am so discouraged by all of it. Kevin, honestly, I don’t know how you manage to keep moving forward and provide the research that truly is data driven. But, it seems to make no difference….to our leaders and politicians, my friends and neighbors, reputable colleagues, anyone. They all are drinking the Kool-aid. Did anyone see the full page ad to mask up in the WSJ yesterday?? ugh. How weird just after the Danish mask study was published. Gee, how did that happen?

    I feel like I’m alone on this desert island waving a white flag and no one is seeing me. But wave it I shall until help arrives.

    Keep the faith for us all, Kevin, it matters!

  • Burt b. says:

    There were theories , in March and April and repeated as gospel since, that CV-19 has a longer period with no symptoms, but highly transmissible.
    2 weeks was the hypothesis, where “experts” were spouting the idea that normal flu transmission only occurs immediately or with in hours of noticeable flu symptoms.

    What is your understanding of the current literature regarding how long a person with CV-19 can spread the disease, without experiencing symptoms?:

    • Kevin Roche says:

      I think the study I posted on earlier this week would suggest that aysmptomatic transmission could occur for as long as a week after the infection developed. i think it is very hard for them to know, because with asymptomatic people it is harder to figure out when they became infected. In general infected people are most infectious within a few days before and after symptoms develop, which typically is within a very few days after infection. So I would assume the same window for asymptomatic persons, a couple of days after exposure they could begin to be infectious.

  • dirtyjobsguy says:

    I was trying with my limited german to read an article in Die Welt about masks etc. They did have a nice term where mask were part of the COVID talisman collection. They are paper rabbits feet to wear hoping to propitiate the virus. (perhaps like Garlic worn against werewolves?) Early in COVID I was flying several times a month and then masks were not obligatory. You saw a few people with masks or faceshields and more than one with a complete Tyvek suit, goggles and shields. I found I was sympathetic to them as they were frightened and still got up the nerve to travel. Only when masks became obligatory did my resentment kick in. Part of this was knowing a bit about fluid dynamics and math as well as keeping up with the scientific literature on COVID, but part was that this was pure fear mongering at its worst.

  • Colonel Travis says:

    Kevin, you’re one of the (very) few rational people discussing this subject. Sorry that many people don’t see it, even if they disagree. The irrationality in America now is off the charts. So many people in authority have been screaming MASK! for so long, it’s become so pervasive that it seems heretical and dangerous to even question what people are told. Also, doctors wear masks, it makes sense I need to wear one! I can’t see a virus but a mask is protection I can see, I’m doing my part to save lives, I’m a good person!

    Most people don’t question what they’re told by people they think should be trustworthy. They’ll sure scoff at Joe Citizen, mask-skeptic. Pffft. What does he know? Everyone knows mask skeptics are idiots! Very few ask people in authority, “Why are you saying this?” or, “Based on what?” And if they do ask that, they’re given a superficial answer and that’s satisfactory because a Trusting Person has said so. Once you have been conditioned to think a certain way, questioning your beliefs becomes uncomfortable. How many people ask themselves: why do I have this belief? Not just with masks, but anything. The idea of being wrong, to some, is so scary, they’d rather sink their claws into their beliefs deeper. Those beliefs turn into a moral crusade.

    This year has shown tyrants how easy it is to control people, it will not stop when this virus panic levels off.

  • Chris Foley MD says:

    All…Plz read my own latest effort. I have reached out to Walz and Osterholm and await their response. Kevin, Greg Plotnikoff and I are submitting a scholarly and collegial editorial to the NYTs, WashPo, Strib, PP, and WSJ. are will see who bites.

  • SteveD says:

    ‘ they don’t prevent transmission but instead reduce the viral load to both others & the wearer.’

    A new wrinkle? I’ve been harping on viral load since last February. I’ve wondered about masks and severity since almost the beginning of the pandemic. It’s possible and it seems more likely that masks would reduce the severity than the number of infections (although you can also argue that an effect on one would necessitate an effect on the other). However, there are very few studies which specifically measure viral load and there is no evidence either way. At the moment it’s just a paper argument. We would need another Dutch study in which viral loads were measured to investigate it.

  • SteveD says:

    There is also an argument than masks could increase the severity of infection. Again, a paper argument.

  • Nick says:

    Quoting your post: “I think I avoid infection mostly because my one rule is to avoid crowds of people I don’t know.”

    I find this puzzling. You’re assumption is that people you know are less likely to be carriers of the disease? For someone very driven by facts and data (I like that about your posts), this seems very non fact or data driven. Maybe theres something unsaid about the people you know that leads you to believe this?

    I personally doubt masks are the magical answer some would like to believe. But given most (including you, I think you’ve said) believe this virus is primarily airborn spread, it seems logical that a mask would have some benefit, if used correctly. It’s that last caveat that is the rub, correct mask use is probably very low. That would make what mask proponents say technically correct, but explain studies showing the actual benefit is much lower.

    So then we’re left to decide, is the imperfect use of masks, and related measures, better than taking no preventive measues at all? If we found that these measures ruduced infection, and therefor hospitalization and death rates by say, just 25% (made up number), would that be worth it? I wonder where you would think the tipping point is, between fooling ourselves and worth the impact to society/economy.

    • Kevin Roche says:

      I suspect we all make our own decisions about what is going on in the circle of people we regularly see. I know I can trust them to warn me if they have any reason to believe they might be infected and I would definitely do the same for them. It has worked so far and I don’t have any reason to think it will stop working. You have to remember too, the reality is that true asymptomatic spread accounts for a small fraction of transmission.

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