See my post. In the context of the study it seems to me that the case against masking in the community and in the general hospital environment is cut and dried. Masks simply don't work and this is something that has been known ever since the Spanish Flu in 1918 and reconfirmed N times. What you really want to know is whether masks are at…
See my post. In the context of the study it seems to me that the case against masking in the community and in the general hospital environment is cut and dried. Masks simply don't work and this is something that has been known ever since the Spanish Flu in 1918 and reconfirmed N times. What you really want to know is whether masks are at all helpful and for how long are masks helpful if one is examining a patient with COVID or another respiratory virus illness.
Saw your post. I appreciate the additional questions you bring to the issue, which I think highlights the many uncertainties here. I'd add that the situation with masks now is different than March 2020 facing a novel virus for which any population-wide immunity was lacking and in which setting masks may prove more (or potentially less) effective at preventing viral transmission.
Currently, I find it hard to agree with such unequivocal statements like "masks simply don't work." We know RCTs can only answer yes/no questions, to reject or accept null hypotheses. But, as you're alluding to in your questions, it seems nuance is important here, and the question we should be asking is "under what conditions and and in what contexts do masks work (and what kind of masks)?" But we can't answer that question directly with the tools we have. We have to answer it over time with serial experiments. Until we determine those conditions, policymakers or hospital/clinic administrators do while the important question remains unsettled?
Not so sure. Thomas Jefferson made an interesting point recently in regard to this whole business. For example, he was talking about the impact of sending people home from the workplace who had an ILI (which includes COVID of course). Well of course this reduces spread in the workplace, but as a consequence increases spread in the home. So there's no way to escape.
In the context of masks in the hospital environment, it is clear to me (and I believe to VP as well) that, in general, masks have no effect. Indeed, the recent RCT at the Cleveland Clinic comparing surgical masks with fitted N95s in healthcare workers in their network (of some 30,000 or more people) showed no difference whatsoever. Since the fit of an N95 is clearly superior to that of a surgical mask and the filtration properties of an N95 are vastly superior to those of a regular surgical mask, this result goes to prove that mask wearing in the hospital environment is in general useless because nobody is wearing them 100% of the time, few are even wearing the N95s properly, people are taking them off to eat and drink, and of course nobody in their right mind is wearing a mask at home.
So the only circumstance where a mask may be useful is when a physician is examining a covid patient for a short period of time. Whether this is even useful under these circumstances needs to be properly tested, but I think most can agree that wearing a mask for 5 min (including a fitted N(5 which is really uncomfortable) is not a big deal. But wearing a mask for 8 hrs a day in the hospital is a very big ask and a big deal, and really shouldn't be done if it has no benefit. And the Cochrane report shows this general use of masking simply doesn't work.
I still struggle with the idea the issue is that clear when the issue seems pretty complicated. I agree that we need to be following the evidence, but for interventions like masking, I'm not convinced an RCT (and a meta analysis aggregating apples and oranges) really provides more clarity or just elicits confirmation bias. What are your thoughts on this piece that Dennis Perry posted on this thread:
The article in the conversation you linked to says absolutely nothing. They present absolutely no evidence for any of their assertions. Basically they say “ we believe masks work and therefore they work” . Except in the real world they don’t work.
Here’s the deal. If masks were truly effective in the real world they would have impacted the course of the pandemic and prevented new waves. But they didn’t.
Nothing is 100%, right? Seems like masks may have an efficacy but it's not like an on-off switch where if people wore masks it would have stopped the pandemic in its tracks. I thought the question we're trying to answer was whether masks can flatten the curve. Maybe I'm missing something but that seems like a matter of percentages and doesn't seem so black and white to me.
Same with that article - I'm surprised by the statement that the article presents no evidence at all. It's true the studies it presented were observational or real-world trials which make it difficult to generalize, but I wouldn't go so far as to call it 'absolutely no evidence'. If I'm hearing you right, it sounds like you would define evidence as RCTs only, is that right?
See my post. In the context of the study it seems to me that the case against masking in the community and in the general hospital environment is cut and dried. Masks simply don't work and this is something that has been known ever since the Spanish Flu in 1918 and reconfirmed N times. What you really want to know is whether masks are at all helpful and for how long are masks helpful if one is examining a patient with COVID or another respiratory virus illness.
Saw your post. I appreciate the additional questions you bring to the issue, which I think highlights the many uncertainties here. I'd add that the situation with masks now is different than March 2020 facing a novel virus for which any population-wide immunity was lacking and in which setting masks may prove more (or potentially less) effective at preventing viral transmission.
Currently, I find it hard to agree with such unequivocal statements like "masks simply don't work." We know RCTs can only answer yes/no questions, to reject or accept null hypotheses. But, as you're alluding to in your questions, it seems nuance is important here, and the question we should be asking is "under what conditions and and in what contexts do masks work (and what kind of masks)?" But we can't answer that question directly with the tools we have. We have to answer it over time with serial experiments. Until we determine those conditions, policymakers or hospital/clinic administrators do while the important question remains unsettled?
Not so sure. Thomas Jefferson made an interesting point recently in regard to this whole business. For example, he was talking about the impact of sending people home from the workplace who had an ILI (which includes COVID of course). Well of course this reduces spread in the workplace, but as a consequence increases spread in the home. So there's no way to escape.
In the context of masks in the hospital environment, it is clear to me (and I believe to VP as well) that, in general, masks have no effect. Indeed, the recent RCT at the Cleveland Clinic comparing surgical masks with fitted N95s in healthcare workers in their network (of some 30,000 or more people) showed no difference whatsoever. Since the fit of an N95 is clearly superior to that of a surgical mask and the filtration properties of an N95 are vastly superior to those of a regular surgical mask, this result goes to prove that mask wearing in the hospital environment is in general useless because nobody is wearing them 100% of the time, few are even wearing the N95s properly, people are taking them off to eat and drink, and of course nobody in their right mind is wearing a mask at home.
So the only circumstance where a mask may be useful is when a physician is examining a covid patient for a short period of time. Whether this is even useful under these circumstances needs to be properly tested, but I think most can agree that wearing a mask for 5 min (including a fitted N(5 which is really uncomfortable) is not a big deal. But wearing a mask for 8 hrs a day in the hospital is a very big ask and a big deal, and really shouldn't be done if it has no benefit. And the Cochrane report shows this general use of masking simply doesn't work.
I still struggle with the idea the issue is that clear when the issue seems pretty complicated. I agree that we need to be following the evidence, but for interventions like masking, I'm not convinced an RCT (and a meta analysis aggregating apples and oranges) really provides more clarity or just elicits confirmation bias. What are your thoughts on this piece that Dennis Perry posted on this thread:
https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992
The article in the conversation you linked to says absolutely nothing. They present absolutely no evidence for any of their assertions. Basically they say “ we believe masks work and therefore they work” . Except in the real world they don’t work.
Here’s the deal. If masks were truly effective in the real world they would have impacted the course of the pandemic and prevented new waves. But they didn’t.
Nothing is 100%, right? Seems like masks may have an efficacy but it's not like an on-off switch where if people wore masks it would have stopped the pandemic in its tracks. I thought the question we're trying to answer was whether masks can flatten the curve. Maybe I'm missing something but that seems like a matter of percentages and doesn't seem so black and white to me.
Same with that article - I'm surprised by the statement that the article presents no evidence at all. It's true the studies it presented were observational or real-world trials which make it difficult to generalize, but I wouldn't go so far as to call it 'absolutely no evidence'. If I'm hearing you right, it sounds like you would define evidence as RCTs only, is that right?