Why Masks? Because Powerless Citizens Rarely Emerge.

 

Why masks? I think the answer to that is fairly simple, and fairly obvious as well.

I have just finished — much to my dismay — reading the 20th and final (not including the unfinished 21st) book in Patrick O’Brian’s amazing Aubrey/Maturin “Master and Commander” series. In a recent book, Steven Maturin discusses an old sailor who he is treating. He knows exactly what the problem is, and he treats it as best he can. But he notes that the sailor is absolutely convinced that the problem stems from the consumption of meat and alcohol. Therefore, the sailor self-prescribes total abstinence from these two things. Maturin comments that sailors are stubborn, especially with respect to their own health, and that the abstinence does no great harm, so he goes on treating the sailor as he would, and he doesn’t argue with him about the diagnosis. Later in the book, the sailor dies, as Steven knew he would.

This is partly why everyone is wearing masks. People are stubborn when it comes to things that are unknown and over which we have no power. Irreligious people are especially stubborn in this respect, and we live in a particularly irreligious time and place.

At the beginning of this pandemic, our politicians acted. Of course, they acted. They couldn’t just stand there. They acted on the best information they had, which was terrible, and they acted in the only way they could, which was clumsy, overbroad, and devastating. The more we know, the more we are learning that it is quite possible that these actions, for all their costs, were certainly ill-advised (on balance), and even without their costs, may have been almost entirely ineffective for their stated purpose.

But a terrified public went along. They were told that death waits around every corner and that the only way to beat it is to hide in their homes. They hid in their homes, obsessively refreshing their Twitter and Facebook feeds, eyes glued to the television. And deaths piled up in spite of the fact that they were all obediently cowering in their homes.

There is no way out of that.

The truth would be to say that, well, we were wrong. That is a phrase that appears in no government handbook ever printed, and in no media guide ever consulted. We were wrong. As far as we can tell, the outcomes resulting from this virus were inevitable and unavoidable — we may have mitigated them somewhat (especially by keeping people out of hospitals), and, then again, we may also have simply traded one harm for another. We’ll never know the outcome of that impossible balance between “lives saved” as a result of our actions, and “lives lost” as a result of our actions.

But there is still no way out. My local hospital lied to the public when it said that we would be overrun with COVID-19 deaths by April 8, and would be turning people away to die in their homes or in the streets. This was a noble lie because a terrified citizenry is most likely to be complacent. It wasn’t just my hospital, it was nationwide. Instant death lurks around every corner. Anyone could have it and is likely contagious. Even you. You probably have it and you don’t even know that you have it. Not only is instant death lurking around every corner, but instant death emanates from your very being.

Turns out we were wrong. This is a virus, and it is worse than some other viruses that we are used to, and it is not as bad as some other pandemics that we have experienced. It is dangerous for some, and we really do now have a pretty decent grasp on who those people are. It is either widespread and not very deadly, or it is not very widespread and pretty deadly … or, it is becoming more and more widespread, and less and less deadly. But it cannot be all of these things. Death is not lurking around every corner, and it is extremely unlikely that you have it, and even less likely that you will give it to someone else. It is even less likely that you will get it when you pass by your neighbor on the street or in a store, or when you eat at a restaurant or play in a park or go to the beach or earn money at your job or barbeque with your friends or watch your kids play baseball. It is less dangerous for children than most dangers they face on a daily basis (even at home!) and there is virtually no evidence that it spreads from children to adults, or even from children to one another.

There is still much that we don’t know. But what we do know is that we were wrong. Our CDC guidelines were wrong and continue to be wrong. Our models were unbelievably wrong, and they are only getting worse. Our politicians were wrong. Our Twitter and Facebook feeds were wrong.

And that’s why we need masks. We are not willing to admit that we were wrong. We are not prepared to accept that we were powerless and that we continue to be powerless. We are not about to crawl out from under the house simply because somebody tells us that we were mistaken to crawl down there to begin with. We cannot just stand there, knowing how little we know – we must do something! We must exercise control, and if we don’t have control, we must exercise what little control we can muster, even if it is only control over our own behavior.

The rationale for that behavior is itself filled with contradictions. If the virus is so contagious that masks will help prevent its spread, then we are too late to start wearing masks, and if it truly is that contagious, then “running its course” is the best and only thing we should be doing. If it is not so contagious that masks will help prevent its spread, then we are wearing the masks just for fun. Same thing is true if asymptomatic aerosolized spread is not a meaningfully important mode of transmission, even if such a thing is scientifically possible in some circumstances.

Even the best case for masks seems to be a pretty silly one. There is a small percentage of people infected; there is a smaller percentage asymptomatic; there is a smaller percentage asymptomatic and contagious; and there is a possibility that the subgroup within that subgroup may possibly sneeze, which is about the only thing cloth masks are designed to mitigate, and even then, they mitigate only slightly, so that at the end of the day, what masks accomplish is the slight reduction of contagion that could possibly come from the small percentage of asymptomatic contagious within the small percentage of asymptomatic within the small percentage of infected. But to be absolutely safe, we need to make laws that cover everyone. No, it’s not just like using a chain-link fence to catch mosquitoes, it’s like using TNT to catch a minnow when the minnow really wasn’t your problem to begin with. But, we’re not really concerned with the minnow. We are concerned with human nature.

Masks are the placebo that allows us to feel like we are still in control of a situation where all of the evidence tells us that we have never been in control. If you are the CDC or a politician and saying “sorry, I was wrong” is simply out of the question, it is essential that you have a plan (for, as we know, all smart people have plans, so if you want to be smart, you must first have a plan). If there is one thing a patient most dreads — and which most patients simply will not accept — it is to walk away from the doctor empty-handed, without a plan. Virtually all doctors know and understand this. Doctors in the 18th century understood this very well, especially where sailors were concerned.

I have heard and read interviews with doctors … fear is debilitating. It is not all of these doctors who have stoked and built and endlessly perpetuated that fear. But they do understand that fear is debilitating, and they have not lost the wisdom of Steven Maturin.

Should I wear a mask?

Sure, why not. If it will make you feel better.

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  1. A-Squared Inactive
    A-Squared
    @ASquared

    Mendel (View Comment):
    I agree that troubling second-order effects exist. But a) they are still miniscule compared to the second-order effects of so many of the other measures currently in place (that masks et al. would hopefully replace), and b) the first-order damage caused by the lockdowns is so great that we may not be alive to deal with the second-order effects of masks if we don’t rescind the lockdowns soon.

    FWIW, I agree on b, but I think masks are additive and permanent.

    If the legislature proposed a bill that said mask wearing is mandatory for one year and all other economic restrictions are lifted and the mask requirement automatically expires in one year and requires new legislation to extend, I would happily support it.  But the reality is, it is going to be masks plus economic lockdowns until the people revolt. The only way to lift the economic lockdowns is to convince the politicians that the political cost of not lifting the economic lockdowns is greater than the political costs of continuing them.  Masks are a distraction to avert your focus from the continued economic destruction. 

    But I accept that we disagree on that.

    • #151
  2. Randy Webster Inactive
    Randy Webster
    @RandyWebster

    Mendel (View Comment):
    It puzzles me that “big government” countries have been simultaneously more pragmatic and more respectful of human autonomy than most states in the “freedom-loving” US.

    It may be something as simple as that we’re wimpier than they are.

    • #152
  3. Mendel Inactive
    Mendel
    @Mendel

    A-Squared (View Comment):
    FWIW, I agree on b, but I think masks are additive and permanent.

    It depends a great deal on the society.

    Here in Germany, almost everyone wears their mask (in stores and public transportation) willingly but very grudgingly. That has put pressure on decision makers to continually justify the mask mandate, both based on current science demonstrating their effectiveness but also based on the current transmission load within the country.

    As a result of that pressure, states with almost no registered cases (and fairly strong background testing programs) are discussing dropping mask requirements, in some cases as early as next week.

    If a big government-loving society like Germany’s can put that type of pressure on its government without resorting to open disobedience, surely the people of the US can as well.

    A-Squared (View Comment):
    The only way to lift the economic lockdowns is to convince the politicians that the political cost of not lifting the economic lockdowns is greater than the political costs of continuing them.

    Yes and. If the people are too afraid to go out and participate in normal society, the economic destruction will continue. The unjustified fear among so many Americans is indeed a huge problem.

    • #153
  4. Hammer, The Inactive
    Hammer, The
    @RyanM

    MiMac (View Comment):

    How can you claim we are not concerned with other deaths when the America LEADS the world in healthcare expenditures EVERY year? The main difference is that CV disease isn’t contagious so we don’t apply techniques to reduce contagion to prevent it- but we do spend billions every year on cath labs, statins, echo labs etc. Furthermore, unlike CV diseases, we had a chance to essentially stamp this out (like SARS & MERS were contained) by taking action.

    We lead in healthcare expenditures because we are a rich country and we spend a lot of money on our own healthcare.  We are very concerned with our own lives.  But we are not actually all that concerned with other people’s lives.

    One of the first thing democrats did during this pandemic was try to make sure that abortions would not be curtailed.  We don’t give 2 figs about lives that aren’t our own.

    • #154
  5. Mendel Inactive
    Mendel
    @Mendel

    Hammer, The (View Comment):
    Roderic summed it up perfectly. “You’re scaring me. Stop being a dick.”

    I found Roderic’s comment in very poor taste, even though it likely reflects the sentiments of many Americans.

    But it certainly doesn’t reflect mine, so please don’t use it as a counterargument toward me.

    • #155
  6. MiMac Thatcher
    MiMac
    @MiMac

    Hammer, The (View Comment):

    MiMac (View Comment):

    Except the evidence is that masks WORK to decrease transmission-so opposing them is much more likely to be idiotic than wearing them. It is a respiratory virus-how do suppose it spreads? Decreasing the opportunity to come into contact with respiratory secretions (droplets, aerosolised -ie fine droplets) will decrease transmission. Ample evidence exists that masks DO reduce the spread of respiratory viruses. Since so many infected are asymptomatic we cannot rely on symptoms to avoid people with it- therefore the urging of widespread use of masks when in close/confined contact.

    This is a great example of not understanding how to interpret and actually use evidence. It is kind of like observing that compound X kills the virus in a petri dish and then thinking that you’ve found the cure. You are vastly overstating your case. And in that one comment, you’ve made no less than 5 claims of fact – confidently – that you simply cannot take for granted.

    I suppose you’ve had the flu, no? I have. I had it twice last year (or maybe I had covid, who knows?). I got it because my kids got it, and when they are sick, they lay on my chest and I rub their hair until they’re asleep. When they get sick, I usually get sick. But of course, I don’t always get sick when they get sick. My wife and don’t always get each other sick, and we sleep face to face. As far as I know, I have never gotten sick – with any respiratory illness – by walking through the fog of some person in a grocery store. Just because something makes theoretical sense when you list out a bunch of assertions and then try to fit them into a theory, does not make it actually true. As A-squared pointed out, if people were getting sick from maskless infected shoppers in grocery stores, we would have seen millions upon millions of cases. Your R number wouldn’t be 2 or 2.5, it would be up in the hundreds. But it’s not, because we have absolutely no evidence of that ever happening. Even totally unchecked, this virus has spread in dense living and working situations, and it shows its face when it hits at-risk populations, mostly in nursing homes.

    Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.

    No re-read the article you cited earlier- the authors cite REAL world evidence that masks reduce the spread of respiratory viruses (2003 case controlled study of mask use in SARS as an example). We have seen millions of cases of the virus (~2million CONFIRMED cases in the US-& by most estimates ~10x as many cases which were not confirmed by lab analysis-that’s millions & millions). We certainly expect that number to grow. And that was with lockdowns & social distancing.

    As to not be able to interpret evidence- excuse me but one of us has actually been a paid developer in immunological assays & I am pretty sure it wasn’t you.

    • #156
  7. Hammer, The Inactive
    Hammer, The
    @RyanM

    Mendel (View Comment):

    Hammer, The (View Comment):
    The dark truth behind all of this is that we really don’t care about lives. Nobody cares that 100,000 people have died, except the families of those who have died. As I said, 650,000 people die every year just from heart disease. That is the leading cause of death, but it is not alone – how many people die of all causes every year? I don’t know the exact number, but it is a hell of a lot higher than 100,000, and nobody bats an eye.

    You’re moving to an extreme position that isn’t defensible.

    We have a very complicated relationship to saving other peoples’ lives.

    Lots of chatroom philosophers love to bring up the analogy that we could save lots of lives by reducing the speed limit to 5 MPH, but we accept those deaths for the sake of convenience. Of course we do.

    But then why do we have a speed limit at all? Because there’s some cost-benefit balance between ultimate safety and ultimate convenience.

    Or to take your example here: if we don’t care about trying to prevent old people with comorbidities from dying, why is Medicare so popular and why do conservatives pop a fuse when Obama suggested trying to save money on heroic end-of-life care?

    So on the one hand nobody bats an eye when the number of seasonal flu deaths doubles from 35,000 to 65,000, but on the other hand we’re willing to fork over a lot of our hard-earned money to keep the same type of people alive for another few days.

    We don’t have a national all-or-nothing policy when it comes to when the community sacrifices to save a particular life. We have a hodge-podge that roughly approximates some balance between preventing death (even among the old and infirm) with making life liveable. My proposed response to the Covid crisis attempts to take exactly that path: find the happy medium between saving others’ lives and saving ourselves.

    You correctly observe that I have employed hyperbole…

    The panic over covid is not driven by concern for other people’s lives – and the tendency to turn to government to mandate compliance with behavioral changes is not driven by concern for other people’s lives.  If this crisis was happening only in Montana and Wyoming, people in New York would tweet that they hope we all die.  People only act in this way because they feel personally threatened.  As I said, Roderic put it perfectly:  You’re frightening me, so “stop being a dick.”

    I have called this a “twitter pandemic,” also hyperbole.  But there is some truth in that.  The media/politicians/etc… have done a fantastic job of terrifying the public.  And people are scared primarily because they feel that they are at risk.

    • #157
  8. Hammer, The Inactive
    Hammer, The
    @RyanM

    Mendel (View Comment):

    Hammer, The (View Comment):

    Mendel (View Comment):
    I’m also not making a judgment call about when a life is worth saving. It’s clear that if this present epidemic had naturally dwindled out around 100,000 total deaths many people wouldn’t have even noticed it.

    Interestingly, there is much reason to believe that it will naturally dwindle with not a heck of a lot more than 100,000 deaths. Maybe 150,000. That is literally a drop in the bucket. Nobody would notice it. It would get some headlines, where reporters have pictures of tired doctors and filled hospitals for that week in New York – and other than that, it would go completely unnoticed.

    That is the problem with all of those “mitigation in order to open society” actions that you listed above – and it was the whole damned point of this post, if you had bothered to read for content instead of criticism. How many times have I heard “if it helps us reopen?!”

    Contact tracing, testing and testing and testing, masks – these things, if they change those numbers, will change them only on the margins. Roughly the same number of people will die regardless of what we do. But when you say “in order to reopen,” all you are doing is saying exactly what I said in my post. It is to make people feel better so that they are willing to crawl out of their holes.

    You are making many statements here based on scientific certainty that doesn’t exist.

    There are many, many plausible scenarios that a) the virus won’t die out naturally after 150,000 deaths, and b) that testing/tracing/masks/whatever actually can make a meaningful difference in both the spread of the virus and the number of people who die before we find an effective drug or vaccine. Your postulations above are also plausible, albeit in my opinion less likely.

    But I have neither the time nor the energy to expand this into a grueling scientific debate over this.

    I am not speaking with scientific certainty.

    Interestingly, you just said exactly what I said.  Until we find an effective drug or vaccine.  That is something we need to be honest about.  If it is true that an effective vaccine or drug is right around the corner, then obviously we could save plenty of lives, and people wouldn’t have much of a problem with that.  But that’s a big presumption.  The implication, of course, is that if there is never a vaccine or drug, these measures would need to continue indefinitely.

    • #158
  9. MiMac Thatcher
    MiMac
    @MiMac

    Hammer- as to the R of SARS-CoV-2 it is high- the number is NEVER in the hundreds as you used- measles or Rotavirus -which are the most highly transmissible viruses have a R0 of 12-18-and they spread like wildfire. Measles is also airborne & requires >90% immunity for herd immunity.

    • #159
  10. Hammer, The Inactive
    Hammer, The
    @RyanM

    MiMac (View Comment):

    Hammer- as to the R of SARS-CoV-2 it is high- the number is NEVER in the hundreds as you used- measles or Rotavirus -which are the most highly transmissible viruses have a R0 of 12-18-and they spread like wildfire. Measles is also airborne & requires >90% immunity for herd immunity.

    I am well aware of that.  My point was that if it spread in the manner you proposed, we would see much different numbers.  And, of course, you were well aware of that.  Speaking of psychology, it is a very interesting phenomenon when people attempt to sound smart in order to shut down debate…  I don’t particularly care; this is commonplace and heck, it’s something I’ve even done from time to time.  But it generally doesn’t convey useful information so much as express condescension.  Much like:  “I don’t have either the time or energy to enter into a rigorous scientific debate.”  That condescension is virtually always unwarranted, but it sure feels good, doesn’t it?

    • #160
  11. Hoyacon Member
    Hoyacon
    @Hoyacon

    Hammer, The (View Comment):

    Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.

    Well, I decided to take a break, but have tried to catch up.  Did I miss the evidence for the fact that masks don’t prevent transmission under any circumstances?

    • #161
  12. MiMac Thatcher
    MiMac
    @MiMac

    Condescending- you mean like “this is a great example of how not understanding how to interpret…”

    • #162
  13. Hammer, The Inactive
    Hammer, The
    @RyanM

    MiMac (View Comment):
    As to not be able to interpret evidence- excuse me but one of us has actually been a paid developer in immunological assays & I am pretty sure it wasn’t you.

    These appeals are as amusing as they are illogical.  I’m terribly sorry if you once held a job – maybe (you’ve been all over the board about your qualifications and experiences.  Did I ever mention that I once caught a 7-foot salmon?  I lost the picture, but I made a drawing of it…  Once you said you were a doctor, now you’re a computer programmer?) – and you are foolish enough to believe that this makes you immune to errors in judgment.

    Funny thing about professionals (and I know this all too well, as a professional, myself).  You and Mendel have both been rather condescending just now…  but you don’t even agree with one another.  You have made some extremely bold statements about the effectiveness of masks, where Mendel (who seems to have actually had a paid job working with viruses) says the evidence is slim…

    He says “give it a try, because why not?”

    And you are my example of “why not.”

    But thank you for coming onto this thread and proving my point.

    • #163
  14. Hammer, The Inactive
    Hammer, The
    @RyanM

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.

    Well, I decided to take a break, but have tried to catch up. Did I miss the evidence for the fact that masks don’t prevent transmission under any circumstances?

    Did I miss the comment where anyone at all made that claim?

    You are free to do whatever you want.  You do not even need to provide evidence that what you’re doing is the correct thing.  But if you want to legally mandate that I also do something, the burden of proof is on you.

    • #164
  15. Hoyacon Member
    Hoyacon
    @Hoyacon

    Hammer, The (View Comment):

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.

    Well, I decided to take a break, but have tried to catch up. Did I miss the evidence for the fact that masks don’t prevent transmission under any circumstances?

    Did I miss the comment where anyone at all made that claim?

    To me, saying masks do not meet “any existing, present need” is that claim.

    You are free to do whatever you want. You do not even need to provide evidence that what you’re doing is the correct thing. But if you want to legally mandate that I also do something, the burden of proof is on you.

    I’ve had plenty to say about how this is a personal choice above, and was challenged on that despite conceding that I don’t like mandates.  Yet one continues to read, if by implication if nothing else, that those who favor the elective wearing of masks are complicit in “tyranny” and contributing to the decline and fall of civil liberties.  

     

    • #165
  16. MiMac Thatcher
    MiMac
    @MiMac

    Hammer, The (View Comment):

    MiMac (View Comment):
    As to not be able to interpret evidence- excuse me but one of us has actually been a paid developer in immunological assays & I am pretty sure it wasn’t you.

    These appeals are as amusing as they are illogical. I’m terribly sorry if you once held a job – maybe (you’ve been all over the board about your qualifications and experiences. Did I ever mention that I once caught a 7-foot salmon? I lost the picture, but I made a drawing of it… Once you said you were a doctor, now you’re a computer programmer?) – and you are foolish enough to believe that this makes you immune to errors in judgment.

    Funny thing about professionals (and I know this all too well, as a professional, myself). You and Mendel have both been rather condescending just now… but you don’t even agree with one another. You have made some extremely bold statements about the effectiveness of masks, where Mendel (who seems to have actually had a paid job working with viruses) says the evidence is slim…

    He says “give it a try, because why not?”

    And you are my example of “why not.”

    But thank you for coming onto this thread and proving my point.

    Credentials do matter on technical questions- if your statement was you weren’t going to wear masks b/c you didn’t want to (or a civil libertarian claim) then that wouldn’t be a debate. But your claim is that you won’t wear a mask b/c there is no evidence they work-so now you are venturing out to where you have little demonstrated ability to judge the data. In fact, the weight of evidence favors that masks reduce the spread of respiratory viruses- the data isn’t great but it is all we have to go by. Until better data arrives that shows this to be wrong the proper position for medical personnel is to advocate their use. And health professionals should try to counter claims that masks, social distancing etc doesn’t work UNTIL data arrives demonstrating they don’t work (b/c CURRENT data supports their use). As a matter of fact, in the past I thought mask wearers in public were wasting their time-but reading the literature changed my mind . It is a professional responsibility of healthcare providers to inform the public what the weight of data supports- ie masks-but if you maintain that you don’t like masks (rather then claim they don’t work or are worse than nothing) then that is a different kettle of fish.

    BTW Hammer- wearing a mask at Kroger for 15 minutes bothers me more than wearing it for 50 hours/week at work. So I don’t like them either.

    • #166
  17. Hammer, The Inactive
    Hammer, The
    @RyanM

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.

    Well, I decided to take a break, but have tried to catch up. Did I miss the evidence for the fact that masks don’t prevent transmission under any circumstances?

    Did I miss the comment where anyone at all made that claim?

    To me, saying masks do not meet “any existing, present need” is that claim.

     

    There is a very big difference.

    • #167
  18. Hoyacon Member
    Hoyacon
    @Hoyacon

    Hammer, The (View Comment):

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.

    Well, I decided to take a break, but have tried to catch up. Did I miss the evidence for the fact that masks don’t prevent transmission under any circumstances?

    Did I miss the comment where anyone at all made that claim?

    To me, saying masks do not meet “any existing, present need” is that claim.

     

    There is a very big difference.

    Well, it’s not evident to me. I won’t speculate on how evident it would be to others. Sorry for being obtuse.

    • #168
  19. Hammer, The Inactive
    Hammer, The
    @RyanM

    MiMac (View Comment):

    Credentials do matter on technical questions- if your statement was you weren’t going to wear masks b/c you didn’t want to (or a civil libertarian claim) then that wouldn’t be a debate. But your claim is that you won’t wear a mask b/c there is no evidence they work-so now you are venturing out to where you have little demonstrated ability to judge the data. In fact, the weight of evidence favors that masks reduce the spread of respiratory viruses- the data isn’t great but it is all we have to go by. Until better data arrives that shows this to be wrong the proper position for medical personnel is to advocate their use. And health professionals should try to counter claims that masks, social distancing etc doesn’t work UNTIL data arrives demonstrating they don’t work (b/c CURRENT data supports their use). As a matter of fact, in the past I thought mask wearers in public were wasting their time-but reading the literature changed my mind . It is a professional responsibility of healthcare providers to inform the public what the weight of data supports- ie masks-but if you maintain that you don’t like masks (rather then claim they don’t work or are worse than nothing) then that is a different kettle of fish.

    BTW Hammer- wearing a mask at Kroger for 15 minutes bothers me more than wearing it for 50 hours/week at work. So I don’t like them either.

    I wouldn’t wear a mask either way.  I have said that in order to legally mandate something, the burden of proof is exceptionally high, and that “some evidence” is insufficient.  Even evidence that they work is far different from evidence that they are necessary.  If you told me that I could reduce my risk by wearing a mask, I’d take a look at my current risk (very low) and the reduction that masks provide (statistically insignificant reduction of an already very small number), and I’d toss the mask in the garbage.  Of course, you take it one step further when you say that I should be legally required to go along with it.

    Fact is, this:  “Until better data arrives that shows this to be wrong the proper position for medical personnel is to advocate their use.”

    Is not much different from the point of my essay.  The truth is, we really don’t know much at all.  There is probably very little that we can do about this virus.  As I said to Mendel, if we knew a vaccine/drug was just around the corner, we could lock down in order to save some thousand or so lives (if we think it would be worth the cost, which I don’t).  Masks are what we get when we essentially acknowledge that there isn’t anything we can do, but we want to do something anyway.

     

     

    • #169
  20. MiMac Thatcher
    MiMac
    @MiMac

    Hammer, The (View Comment):

    MiMac (View Comment):

    Credentials do matter on technical questions- if your statement was you weren’t going to wear masks b/c you didn’t want to (or a civil libertarian claim) then that wouldn’t be a debate. But your claim is that you won’t wear a mask b/c there is no evidence they work-so now you are venturing out to where you have little demonstrated ability to judge the data. In fact, the weight of evidence favors that masks reduce the spread of respiratory viruses- the data isn’t great but it is all we have to go by. Until better data arrives that shows this to be wrong the proper position for medical personnel is to advocate their use. And health professionals should try to counter claims that masks, social distancing etc doesn’t work UNTIL data arrives demonstrating they don’t work (b/c CURRENT data supports their use). As a matter of fact, in the past I thought mask wearers in public were wasting their time-but reading the literature changed my mind . It is a professional responsibility of healthcare providers to inform the public what the weight of data supports- ie masks-but if you maintain that you don’t like masks (rather then claim they don’t work or are worse than nothing) then that is a different kettle of fish.

    BTW Hammer- wearing a mask at Kroger for 15 minutes bothers me more than wearing it for 50 hours/week at work. So I don’t like them either.

    I wouldn’t wear a mask either way. I have said that in order to legally mandate something, the burden of proof is exceptionally high, and that “some evidence” is insufficient. Even evidence that they work is far different from evidence that they are necessary. If you told me that I could reduce my risk by wearing a mask, I’d take a look at my current risk (very low) and the reduction that masks provide (statistically insignificant reduction of an already very small number), and I’d toss the mask in the garbage. Of course, you take it one step further when you say that I should be legally required to go along with it.

    Fact is, this: “Until better data arrives that shows this to be wrong the proper position for medical personnel is to advocate their use.”

    Is not much different from the point of my essay. The truth is, we really don’t know much at all. There is probably very little that we can do about this virus. As I said to Mendel, if we knew a vaccine/drug was just around the corner, we could lock down in order to save some thousand or so lives (if we think it would be worth the cost, which I don’t). Masks are what we get when we essentially acknowledge that there isn’t anything we can do, but we want to do something anyway.

    Unfortunately, I think you are overly optimistic that the burden of proof is exceptionally high to mandate [insert your program] in a legal sense- our regulatory state mandates many things with much less evidence than that for the effectiveness of masks. You might have a chance in a free speech case, but I think a wide, temporary, public health exception would be made. If such a case made it to the Supreme Court you might have a chance, but by then it might be moot. I’d have more confidence if we didn’t have a living constitution- so alive in fact it often resembles a body contortionist. Especially after the Obamacare ruling- is it a tax or a fine or government imposed purchase of a good….

    • #170
  21. Hammer, The Inactive
    Hammer, The
    @RyanM

    MiMac (View Comment):

    Unfortunately, I think you are overly optimistic that the burden of proof is exceptionally high to mandate [insert your program] in a legal sense- our regulatory state mandates many things with much less evidence than that for the effectiveness of masks. You might have a chance in a free speech case, but I think a wide, temporary, public health exception would be made. If such a case made it to the Supreme Court you might have a chance, but by then it might be moot. I’d have more confidence if we didn’t have a living constitution- so alive in fact it often resembles a body contortionist. Especially after the Obamacare ruling- is it a tax or a fine or government imposed purchase of a good….

    I suspect we disagree much less than we’ve made it seem.  I imagine we’d enjoy conversation over a few beers…  but I’m not going to wear a mask or sit 6 feet away.  So it’ll have to wait.

    • #171
  22. MiMac Thatcher
    MiMac
    @MiMac

    Hammer, The (View Comment):

    MiMac (View Comment):

    .

    I suspect we disagree much less than we’ve made it seem. I imagine we’d enjoy conversation over a few beers… but I’m not going to wear a mask or sit 6 feet away. So it’ll have to wait.

    Isn’t that the problem with social media forums? Maybe I’ll bring a looong straw.

    • #172
  23. Flizzo Stizzo Member
    Flizzo Stizzo
    @FlizzoStizzo

    I am late to this disco, so I apologize if this is ground that I missed in a previous comment.

    Has anyone seen or heard discussion about the possibly negative effects of limiting exposure to all pathogens? I had always heard that the immune system needs a healthy level of exposure to stay robust and develop antibodies, especially in developing children. 

    If everyone wore masks all the time and we rarely left our houses from now on,  we could probably limit cases of the flu each year, but what is the trade off on our body’s ability to fend off garden variety diseases? Will we see an increase in non-Covid diseases in the fall from a population full of weakened immune systems?

    I don’t have a particular agenda in raising this question other than curiosity and a little surprise that I haven’t heard anyone address it during the pandemic response. 

    • #173
  24. Hammer, The Inactive
    Hammer, The
    @RyanM

    Flizzo Stizzo (View Comment):

    I am late to this disco, so I apologize if this is ground that I missed in a previous comment.

    Has anyone seen or heard discussion about the possibly negative effects of limiting exposure to all pathogens? I had always heard that the immune system needs a healthy level of exposure to stay robust and develop antibodies, especially in developing children.

    If everyone wore masks all the time and we rarely left our houses from now on, we could probably limit cases of the flu each year, but what is the trade off on our body’s ability to fend off garden variety diseases? Will we see an increase in non-Covid diseases in the fall from a population full of weakened immune systems?

    I don’t have a particular agenda in raising this question other than curiosity and a little surprise that I haven’t heard anyone address it during the pandemic response.

    I believe those Bakersfield doctors brought up this very thing before being censored.  I think it is especially important with respect to kids… I am very worried about what sort of garbage will be imposed on them this fall.

    • #174
  25. CarolJoy, Above Top Secret Coolidge
    CarolJoy, Above Top Secret
    @CarolJoy

    A-Squared (View Comment):

    Hoyacon (View Comment):
    As I said in another post, at my age and in my geographical location, I have made a personal cost benefit analysis in favor of wearing a mask SNIP

    SNIP

    What masks really do is tell everyone else in the store that you are taking COVID seriously. In other words, whatever you think of the cost/benefit, it has a huge virtue signalling component.

    SNIP

    Points taken. Allow me to clarify (if necessary). To the degree I wear a mask, it’s a matter of encouraging others to wear one in certain environs. I understand they don’t work for self-protection. My reason may be fruitless as well, but, well, cost-benefit.

    SNIP That off-chance that the one person who happens to be a high-viral-shedding asymptomatic carrier might happen to be convinced by your wearing the mask? If that’s the degree of risk that you’re willing to change your behavior for, why would you ever leave the house?

    The benefit to you is we can more safely reopen the economy w/o precipitating a 2nd wave- a huge economic & public health gain (recessions cause depression etc). SNIP Mask wearing is particularly helpful b/c many infected people are asymptomatic and there is data that a small %age of people are responsible for a great majority of the spread (https://www.medrxiv.org/content/10.1101/2020.05.21.20104521v1).

    Bob W (View Comment)

    .

    the Hammer’s main complaint is … not really about the science of whether masks work. SNIP But it’s been proved that masks are effective in this context SNIP

    @JudgeMental

     

    @mendel

     

     

    Many of us are stating that it has not been proven that masks are decent tools in the COVID battle. At least, not in the ubiquitous ways we are being forced to wear them. Should I have a relative in a nursing home, I’d think my wearing a mask when I visit them would be important. But to go to the same hardware store I have visited once a week for 6 weeks  prior to the mask decree, now as summer temps are close to a 100 – “Nay!” say I and so many others. (Summer temps are the traditional bane of corona illnesses.)

    Although info at the URL from above did state that there are asymptomatic people known to spread the disease to quite a level, so what? Most people who then get the disease are themselves asymptomatic.

    I suggest if we really want  to know how to handle any similar outbreaks like this – look to the nursing homes. Twenty percent of NY state deaths were in nursing homes. For a while, 50% of Washington state’s death toll was there. Overall, thirty percent of all COVID deaths in USA were in nursing homes.  American nursing homes are understaffed, hire most of their poorly paid personnel from foreign countries, and ignore the basic needs of most of their inmates.

    End of Part One –

    • #175
  26. CarolJoy, Above Top Secret Coolidge
    CarolJoy, Above Top Secret
    @CarolJoy

    Part Two

    @judgemental

    @mendel

     

    So when you look at the nation of Japan, with its population of 126.5 million, the entire culture there fawns on the elderly. The nation lost 850  people total to COVID.

    The Japanese  demand that the institutions that take care of their elderly are properly staffed. Their staff members are well trained, and also disciplined to do things correctly. In Japan it is possible to do things correctly as staffing numbers are so much higher. They do not cut corners by hiring far too few staff members as we do here. In many American care facilities, one person as a nursing aide takes care of 18 people. Imagine being that person – brushing their dentures, combing their hair, oral hygiene, hearing aids, dressing and feeding them once or twice each shift. Changing their adult diapers or escorting them to the toilet. Seeing the patients are each  are showered several times a week. Imagine one person to do that for 18 people.

    The Japanese also do not put some ideal of “tolerance and diversity” above needs of the patients. Their staff speak the national language. When I worked in the SF Bay area, only one nursing home I knew of had the policy of hiring people fluent in the language of the majority of  its patients.

    That was a Japanese nursing home in Japan Town inside San Francisco. Its admins were allowed to have only Japanese-fluent staff be hired, as it was considered racist to deprive the Japanese elderly of that necessary factor. But in most Caucasian or AA nursing homes, on the West coast, Latinas are the main employees and they lack fluency in English. Many nursing home admins did not care as this way they got much cheaper workers. But those administrators who did care were told it was racist to prevent the hiring of Latinas just because they did not speak English.

    Most US nursing homes do not have a doctor as part of the staff. I bet that is the opposite of how things are done in Japan. Also in America, with our medical system falling prey to corporate policies & profits, few people now have a doctor who will visit them in a nursing home. Most of us are lucky if we get our doctor to spend more than  the average of 8 to 12 mins for the appointment we have made. I find it impossible to believe that our nursing home patients ever see their usual doctor, once put away in these expensive warehouses.

    This is a major reason why the whole “to mask or not to mask” issue gets my blood boiling. I cannot tell you how many times, as someone privately hired to do nursing for an individual in a nursing home, once  they fell asleep, I saw to it that other patients had their meals served, or got a large glass of water on a hot day.  This is the situation that needs discussing – not masks on healthy people!

    • #176
  27. CarolJoy, Above Top Secret Coolidge
    CarolJoy, Above Top Secret
    @CarolJoy

    Flizzo Stizzo (View Comment):

    I am late to this disco, so I apologize if this is ground that I missed in a previous comment.

    Has anyone seen or heard discussion about the possibly negative effects of limiting exposure to all pathogens? I had always heard that the immune system needs a healthy level of exposure to stay robust and develop antibodies, especially in developing children.

    If everyone wore masks all the time and we rarely left our houses from now on, we could probably limit cases of the flu each year, but what is the trade off on our body’s ability to fend off garden variety diseases? Will we see an increase in non-Covid diseases in the fall from a population full of weakened immune systems?

    I don’t have a particular agenda in raising this question other than curiosity and a little surprise that I haven’t heard anyone address it during the pandemic response.

    The Bakersfield doctors spent quite some time discussing exactly your point. Our bodies need the stimulation of a certain amount of virus  germs, bacteria, fungal matter etc in order to stay revved up and to work properly. If you haven’t caught their video, I will see if I can find the new URL – as it has been taken down from youtube for its suggestion that HCQ with AZ and zinc works wonders. Also they dared to mention the 50% of the patients at their clinics are now wary of vaccines, due to all the many vax injuries surfacing after our children in Calif were mandated to have 71 of them before their 18th birthday.

    • #177
  28. Hammer, The Inactive
    Hammer, The
    @RyanM

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Hoyacon (View Comment):

    Hammer, The (View Comment):

    Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.

    Well, I decided to take a break, but have tried to catch up. Did I miss the evidence for the fact that masks don’t prevent transmission under any circumstances?

    Did I miss the comment where anyone at all made that claim?

    To me, saying masks do not meet “any existing, present need” is that claim.

    There is a very big difference.

    Well, it’s not evident to me. I won’t speculate on how evident it would be to others. Sorry for being obtuse.

    @hoyacon;

    Because if the logic is “they keep you from sneezing on people,” that may well be true, but if the disease is not primarily spread in that manner, measures taken to address it may not be necessary. Hence, “works,” doesn’t always mean “is necessary.”

    Per your earlier question, here is a study from 2009, so not done under any pressure wrt covid:

    https://www.reliasmedia.com/articles/114492-surgical-masks-not-effective-study-shows

    That article also discusses some of what I was saying about “works” not equating to necessary or “effective for the intended purpose.”

    As I said, I suspect that most Doctors would tell you that the primary effect of masks is psychological, which was the subject of this post.

    • #178
  29. MDHahn Coolidge
    MDHahn
    @MDHahn

    I’m sorry, but I find this entire argument very condescending and cynical. Judging by the comments, I may not be a coward for wearing a mask, but I am likely stubborn and/or dumb. There seems to be an underlying premise here that people are irrational and fearful, and therefore, they react irrationally and stupidly. I think this is unfair and far too broad.

    It is true that we have learned a great deal about this virus and how it spreads. But it is a new virus that we know very little about compared to other viruses. We know that it is spread through close contact, and we also know that masks will reduce that risk. Do we know how much of an effect it has? No, not really. But it seems like a very minor inconvenience if we are now reopening and getting back to normal. I find all of this debate over masks to be extremely ridiculous. I am tired of this being a culture war issue. It should not be and it certainly is not tyranny.

    Yes, people made mistakes responding to this. Yes, people overestimated the extent of the danger to much of the US. However, I am inclined to give people the benefit of the doubt. The CDC and many, not all to be sure, but probably the vast majority of the public health officers, government officials, and elected officials acted in good faith based on the information at hand. That does not mean they lied, or that they had ill motives. That means they are human and made mistakes. Should they admit them and be held accountable? Absolutely. But normal people trying to get back to normal making a prudent decision about masks based on the available evidence is not dumb or irrational.

    • #179
  30. Hoyacon Member
    Hoyacon
    @Hoyacon

    MDHahn (View Comment):

    I’m sorry, but I find this entire argument very condescending and cynical. Judging by the comments, I may not be a coward for wearing a mask, but I am likely stubborn and/or dumb. There seems to be an underlying premise here that people are irrational and fearful, and therefore, they react irrationally and stupidly. I think this is unfair and far too broad.

    Well, I think you’ve captured what much of the back and forth here seems to be about, and you’ll find the word “condescending” in my first post at #1.  But I’m wondering if this viewpoint is a bridge too far, and what’s really going on is that we’re talking past one another.   I’ve taken some of the comments here, and in other threads, personally.  Whether that’s on me or the writer, I don’t know, but it may not be what’s intended.  I respect a generalized opposition to masks, particularly to mandatory wearing of them in most situations.  But I think the problem starts when there is a failure to recognize that my circumstance may not be another’s circumstance (and vice versa), so that one’s view on this is distinctly affected by one’s personal and geographical situation.

    • #180
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