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I basically stopped wearing masks around COVID patients in Feb 2021. I am a primary-care internist who side-hustles as a hospitalist. The only time I even think of wearing one is an N95 in an enclosed space with a COVID patient "blowing and going" with high respirations and coughing paroxysms. I became fed up very early on with how many physicians bought into the whole mask-savior propaganda. I called BS early on along with y'all. Turns out common sense is a superpower.

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Dec 5, 2022·edited Dec 5, 2022

The amazing thing is that they have done this well-constructed study, but NO ONE will just do a study (for practical purposes a repeat of the Denmark study) as to whether masks have any value at all. There is plenty of evidence that they do not (except in non-real-world settings) from both not-quite-RCTs and endless observational studies both pre-covid and using covid data.

Vinay has whined about this endlessly, but I do not see him (or anyone else) doing such a study. I would get it funding if someone would just do it and we could all be done with it. I assume it is because people fear that the results (which I would be happy to take 100:1 odds on) would be against The Narrative. I cannot think of any other reason. The study would be simpler than this one and the conversation would be ended.

Seems too simple so I suppose it will just never get done so we can all argue about angels dancing on the head of a pin until we die of old age.

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1) I can't believe I had never heard of the Peto Astrological study. Love it!

2) Why can't we strongly consider that masks don't work? We have had 2 years of them failing to produce any benefit at a population or sub population level. Every prediction of what the masks could do has failed over [1], and over [2], and over [3]. Every time another bastion of mask utopia succumbs to Covid we have to pretend the hypothesis hasn't been falsified and take shelter under the "Swiss Cheese Model" to create post hoc excuses of how masks are only "part" of the layered defense.

Am I the dense one on this?

I can understand intuitively how the average person can believe they work, but on First Principles - it makes no sense.

Not to repeat previous comments, but we only discovered viruses because some invisible pathogen smaller than bacteria kept getting past our *ceramic* Chamberland Filters back in the 1890's, which we named "filter passing viruses".

Now, nearly a century and a half later, with the tools to finally see these invisible filter passing viruses, and the understanding of just how tiny they truly are, we collectively decided that masks with millions of gigantic holes could somehow stop what ceramic couldn't? (Out of curiosity I even dropped a few hundred bucks to buy my own chamberland filters, wondering if perhaps they were more porous than I imagined - like volcanic rock. They are not) [4]

Refresher on just how tiny these are, this is an incredible video on scale of small things

https://www.youtube.com/watch?v=k0l1kLt917A

Consider at 1:31 you see the size of Coronavirus, then compare to 2:29 for chloroplast (size of n95 micropore) to 3:23 for Neron (still smaller than micropore in Surgical Mask) to 3:54 for taligrade (micropore size in cloth mask)

If you scaled these to "human size" where a coronavirus is scaled to 1 foot, then the n95 micropore would be 90 feet, surgical mask micropores 700 feet, and cloth mask micropores scaled to 16,400 - and that is best case scenario - fresh masks, single use, perfectly fit (which is utterly impossible, but I digress).

Right there I would think the premise of mask efficacy should be default to "no they won't work" and you would have to rigorously prove they would make a difference, as we know you could place between 7,000 - 32,000 virions side by side within the space of a n95 micropore. It is an absolutely extraordinary claim so the burden should be on the pro-mask faction to provide extraordinary evidence.

Yet all we get are mannequin studies, 2 hairstylists in a salon, and Bangladesh.

And each day, I keep finding the loudest voices encouraging us to mask children based their religion on fantasies all along [5]

_____________________

[1] "If 80% of Americans Wore Masks, COVID-19 Infections Would Plummet, New Study Says"

https://www.vanityfair.com/news/2020/05/masks-covid-19-infections-would-plummet-new-study-says

[2] "Texas and Mississippi lifting their Covid mask mandates is like pouring gas on a fire"

https://www.nbcnews.com/think/opinion/texas-mississippi-lifting-their-covid-mask-mandates-pouring-gas-fire-ncna1259733

[3] "Emerging COVID-19 success story: South Korea learned the lessons of MERS"

https://ourworldindata.org/covid-exemplar-south-korea

[4] Still missing the pump apparatus though... someday

https://imgur.com/a/g0CPgJC

[5] Katelyn Jetelina: "I keep thinking of 'why does my surgeon wear a mask when I am in surgery' you know, it must do something, it has to work! There's that biological plausibility for example"

https://www.youtube.com/watch?v=vu4rK8dAgnU&t=1980s

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Thanks for explaining this study!

You are right, Alasdair Munroe's Substack is interesting.

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Well and let’s not forget the bias of using healthcare workers as subjects! They are already trained to wash hands often, have access to alcohol rubs, and utilize the protocol that - let’s be honest - kids and most adults probably rarely did prior to Covid and likely are already back to old habits! 😉

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Dec 5, 2022·edited Dec 5, 2022

With the significant (?) incidents of RSV I would appreciate if you could comment on effectiveness of masks (any kind) to protect infants, especially preemies, from RSV? E.g. should adults wear masks around the infants, or is there any benefit if adult caretakers wear masks when out in public?

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Lucid post! Thanks for doing this -- I get moist with excitement every time somebody cites the riveting example from cardiology of that "subgroup thought experiment" that compared outcomes after aspirin use/non-use and outcomes sorted according to a particular astrologic sign. It's a safe bet that George Babbitt (see Lewis, Sinclair) would have loved reading your post because the writing was terse yet combined plenty of Sizzle and lots of Punch.

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