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. Hammer, The Inactive
    Hammer, The
    @RyanM

    Hoyacon (View Comment):

    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.

    I believe it is a product of the medium.  That is why comments sections are virtually always cesspools.  I have also found myself taking comments personally, and then reacting in kind.  It happens.  Usually, for me, that spell is very quickly broken, and I default back to being friendly.  I find that this sort of thing virtually never happens in person, when you can read body language, smile, etc…

    That being said, here’s another paper that I saw discussing masks (as not working).  :)

    https://www.researchgate.net/publication/340570735_Masks_Don't_Work_A_review_of_science_relevant_to_COVID-19_social_policy

     

     

    • #181
  2. Hammer, The Inactive
    Hammer, The
    @RyanM

    MDHahn (View Comment):
    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.

    Unfortunately, I think much of this is the subject of dispute.

    I wrote a different post that delves a little bit more into the issue of government overreach and the dangers to liberty that our virus response has accelerated.  The post is here:  http://ricochet.com/759923/on-covid-and-the-rule-of-law/

    I apologize for the length, and I imagine that you will disagree with much of what I say.  But it does offer some perspective with respect to my view that the “liberty vs. tyranny” discussion is very much an appropriate one to be having.

    • #182
  3. MiMac Thatcher
    MiMac
    @MiMac

    The researchgate review cited above DOES NOT show what it claims-read the articles-they are being misrepresented. The Jacobs article doesn’t include enough of a description of methods to evaluate it (might behind the paywall)-but it appears it may only test the effectiveness of wearing masks at WORK to prevent a common cold. Additionally, the article states “a larger study is required to establish non inferiority”-ie it is a weak study. The Cowling article summary states “there is some evidence to support the wearing of masks..to protect others”-ie the whole rationale for wearing masks. The bin-Reza article’s summary reads like an endorsement of masks GO AHEAD and read it. Specifically “8 of 9 retrospective observational studies found that mask &/or respirator use was INDEPENDENTLY associated with a reduced risk of SARS.”[emphasis mine]. The conclusion reads “In conclusion, there is a limited evidence base to support the use of masks and/or respirators in the community setting.” The Smith article is a review comparing N95 to standard masks and concludes N95s are not better- BUT IT DOES NOT SAY MASKS DO NOT WORK- in fact everyone wore a mask-either surgical or N95! It NEVER says masks don’t work, in fact the point it seems to be trying to establish is that N95s are overkill. The Offeddu article states “Our analysis confirms the effectiveness of medical masks and respirators against SARS.” They did not recommend cloth masks but on review I did not see that they actually had any data on cloth masks in their meta-analysis . I am glad the author Rancourt isn’t a MD b/c he is misrepresenting the studies.

    Many that oppose mask use think fine aerosols are the means of transmission (& that is the presupposition specifically made by Rancourt)-but currently it is thought that is not the mechanism of spread of the novel coronavirus- it is thought to spread by droplets-& they are larger and easier to stop. Fine aerosols (think measles) are much more difficult to combat with masks (in fact N95s allow much larger particles thru than many viruses). . The Infectious Disease Society of America continues to recommend the use of masks & face shields while easing restrictions. https://jamanetwork.com/journals/jama/fullarticle/2765525

    • #183
  4. MiMac Thatcher
    MiMac
    @MiMac

    addendum- didn’t see the next two articles in the Rancourt review b/c they were on another page-but to summarize those:

    Long- concludes N95s aren’t better than standard surgical masks-but again doesn’t conclude masks don’t work- just that the general public and low risk medical personnel don’t need N95s. It did NOT study the effectiveness of masks vs no masks. (Actually sort of presupposes masks work-otherwise why use them at all…)

    Radonovich-again compares N95 vs standard surgical masks & concludes masks are as good as N95s! It doesn’t state masks don’t work-and didn’t try to show that.  (Actually sort of presupposes masks work-otherwise why use them at all…)

    Rancourt misrepresents the conclusions of these studies to claim there is no data that masks work. Medicine isn’t like physics-we can’t do experiments that are as well controlled-otherwise we end up with studies like Tuskegee Study of untreated syphilis. Furthermore, this is a novel virus so we can only go on studies with similar viruses-respiratory viruses(flu & SARS) so there will be no “conclusive” study possible- due to its novelty & the ethics of experimenting on humans.

    • #184
  5. A-Squared Inactive
    A-Squared
    @ASquared

    MDHahn (View Comment):
    Judging by the comments, I may not be a coward for wearing a mask, but I am likely stubborn and/or dumb.

    I don’t think anyone is saying that you are a coward for wearing a mask.

    The gist of Hammer’s argument is that you shouldn’t be allowed to force him to wear a mask. 

    There is a difference.

    • #185
  6. Hoyacon Member
    Hoyacon
    @Hoyacon

    A-Squared (View Comment):

    MDHahn (View Comment):
    Judging by the comments, I may not be a coward for wearing a mask, but I am likely stubborn and/or dumb.

    I don’t think anyone is saying that you are a coward for wearing a mask.

    The gist of Hammer’s argument is that you shouldn’t be allowed to force him to wear a mask.

    There is a difference.

    I agree that it’s important to keep the players and posts straight on this issue since I may have been guilty of not doing that myself.  But the sentiment across several posts here is a contributing factor.  There have been pejorative implications, if not direct comments, that those endorsing masks are sheep, uninformed, and contributing to the onset of tyranny.  But , as you say, it’s important to try to keep in mind who said what.

     

    • #186
  7. CarolJoy, Above Top Secret Coolidge
    CarolJoy, Above Top Secret
    @CarolJoy

    Hoyacon (View Comment):

    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.

    Hoyacon, I agree that there needs to be gradients on the important issue of masks. And there needs to be gradients regarding most issues.

    However, the ability to have dialectical considerations has sadly  been drummed out of people. (For the most part.)

    The One Big Money Party has demanded that “you are either with us, or you are against us.” Doesn’t matter what the issue is: there is only one right approach. Whereas in reality, nothing is ever black and white. So then you get some “real geniuses” who want the solutions to be a sad mixture of black and white, when gray rarely if ever is the solution.

    Your presentation of your viewpoint struck me as sensible. I’ll have to look back on my comments to see if I acted sensibly in replying to you, or not. If not, I apologize.

    • #187
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