The defective masks not noticeably different from regular N95s.(of course) By now I assume it's generally agreed that it's aerosols. So any mask less than N95 is nearly useless. AND it's required to tape the edges (especially at the top) of the mask. Visitors to Stanford med. got their masks taped at the entrances.
Actually Mr. Cifu, You are all wrong because of the underlying assumption you have, that its "the masks" producing the data. You're thinking process is dead in the water before it even gets started. There does actually exist, a science that has determined the strengths of all the different mitigation controls. Guess what. Pretty much everything is stronger and overshadows masks, and Certainly everything we were doing during Covid. But if your belief in "masks doing something" derives from the lab experiments that proved they work. I'd encourage you to go look again. closer. The lab experiments were gamed. all of them. https://open.substack.com/pub/doranpeck/p/masks-the-indisputable-end-to-the?r=ygaqy&utm_campaign=post&utm_medium=web
The goal of my post was to try to help people make informed decisions about masking. I think mandates might make sense as an emergency measure in desperate situations, but we are not there.
As to viral infections being inevitable, so is death, but that does not mean efforts to postpone it are not worthwhile.
Finally, I'm sure you'll admit that you are unlikely to hear from the great-grandmothers who DIDN'T survive Hitler, COVID, etc.!
Let’s be serious: Randomizing a plainly visible ‘treatment’ is a joke.
And even if one is generous and polite and accepts the 3% number, it is also laughable. It’s much too small to even consider as a rationale for a population-wide measure. So quibblers can continue to go back and forth on whether or not masks are ‘useless’ or have some very small marginal effect (perhaps, and that is being incredibly accommodating and generous), but the evidence in favor of community masking is *still* paltry.
Masks are developed for hundred of years, and tested in the most dangerous jobs and situations, from labs to diving, nuclear reactors, all kinds industry, astronautics. The idea that masks generally do not work for respiratory viruses are insane.
If mask does not work, it means only one of two things (1) Mask you use is not good enough for that purpose. For god sake, don't use surgical face mask to prevent respiratory viruses. They are not made for that purpose. They can stop DROPLETS, not AEROSOL. For aerosol, use FFP1, FFP2, FFP3, P3 or better. (2) Masks are not used correctly or consistently.
So the pro-mask (pro-government-overreach, pro-fascist and anti-human, in my opinion) horde is now parroting a paper from Norway, which shows, in a beautiful randomized-controlled trial, that approximately 12% of people who mask for 14 days report symptoms of respiratory viruses, compared to approximately 9% of people who don't mask.
1. Let's ignore the fact that these are not PCR-confirmed infections (or any other objective measure) but rather, simply, reports of "I have a runny nose." Let's ignore the incredible bias built into that 3% absolute risk reduction over a two-week period, which could, alternatively, be described as a 25% relative risk reduction. Leave all the "confounding" out of it. Let's just take this study in plain English as, "Over a 2-week period, approximately 10% of people reported cold-like symptoms and people who wore surgical masks reported slightly less incidents of cold-like symptoms."
2. Some of what I am thinking is a direct paraphrase of my spirit-animal, Vinay Prasad. However, even if we leave the bias and the placebo effect out of our analysis, we are still left with the following:
The math of this study seems to suggest that: masks or not, about 10% of people in this population will get a cold in a 2-week period. Slightly fewer will report that cold if they are masked. This seems to suggest, vaguely, that 100% of people will get a cold in a 20-week period.
3. You could extrapolate out, just by one trial-length (i.e. 2 more weeks) and speculate that starting with a population of 1000 people, 100 got sick in the first 2 weeks and then approximately 90 more would get sick in the next two weeks, including about 3 of the 30 people who would have, in the first 2-weeks, otherwise reported a cold but didn't, ostensibly because they wore a mask. Again, I am obviously simplifying the numbers, but extend it one more period. By the end of 6 weeks, 30% of the population has contracted the virus and, already, at least 6 of the people spared in the first 2-week period have contracted the virus. You don't need to play this thought experiment out very far until everyone, masked or not, has contracted the virus.
4. How much inconvenience, how much cost, how much pollution, how much potentially-inhaled microplastic, how much language-development loss are you willing to incur for the chance that you might postpone your inevitable infection by a few weeks or maybe months?
Subpoint 4a. Why is nobody talking about the particles being shed by the masks: microplastic, other fibers, which are almost certainly going to lead to restrictive airway disease that outweighs any benefit they could possibly offer?
5. And none of this discussion even includes the hypothetical but well-studied costs of avoiding infection. We have a well-described "hygiene hypothesis" to explain the allergic phenotype. We have at least a handful of diseases (EBV, VZV to name a couple) which are well described as better-tolerated the earlier we encounter them. We have seen the very clear age-gradient of negative outcomes for the Wuhan virus and its COVID derivatives. Furthermore, we simply don't know whether avoiding viruses is better or worse for the individual in the long-run. Could individuals raised in sterile environments ultimately be more prone to auto-immune disease or cancer? I am not suggesting the affirmative is necessarily true but we don't have proof or even evidence of the negative. Finally, we are totally ignoring the obvious, but well-obfuscated truth that masks are undeniably and obviously detrimental to children's development. I assert that emotional development and language development depend on seeing the faces of those around us and being aware that our faces are also visible. More than that, however, masks teach children that they should fear their neighbors, as they are a source of infection, rather than mutual benefit, and that they should fear the literal air that they breathe.
If we are trying to create the most iatrogenically-poisoned, neurotic, fearful and developmentally-stunted generation of Western children in recorded history, I think we are all doing a great job. If this is not what we want, it is time to put aside our tribal allegiances and consider interventions based on their merit and their actual evidence. And we should leave our kids alone.
I’ve sold 100’s of thousands of KN95 masks during the plandemic, but never wore them myself. After stopping selling the masks, I got very suspicious of China made PPE products so I took one of the KN95 masks and turning inside out, gently shook the mask over a microscope slide! To my horror the slide was covered in microscopic glass shards and nanoparticles!!! The CCP is Not our friend!!! See here. http://photos.adezignmerch.com/3-22-24/KN95/
I haven't read Vinay's article yet, but the biggest issue I have with using symptoms as the primary end point is it does not differentiate viral particulate matter from larger matter such as allergens or bacteria. Granted winter is not prime allergy season, but maybe that is why it's only 3% instead of 10% benefit. Further, if a few people develop a bacterial sinusitis or URI and this is confused as viral, while it may still be a benefit to the user and reduce contagion, it does not help us make good public health decisions during flu season.
In short, I do think the primary measures need to be S/S that can at least effectively r/o allergen etiologies such as fever, lymphadenopathy, serological markers.
I should also add that even if you write some substack post on the phone, before you send it, please add the reference when you later have your computer or whatever the necessary device may be.
Thank you, Adam. Your criticism and analysis are well taken, but I think Vinay's arguments, in the aggregate (not necessarily every one), are slightly better. I still very much appreciated your valuable comments. Thank you for including the reference! It is something. Vinay doesn't do it at times and he needs to do it every time. If necessary, even if written on the phone, he should add the reference later and then send the substack out.
I appreciate the public disagreement between two astute consumers of the medical literature. Physicians are human. Most people won’t read the study and at the end of the day we are all biased by our ‘priors’, values, beliefs, and preferences.
Masking isn’t worthless. I’ve worked in front door medicine for 12 years and used to spend most of every winter with a cold or flu; now I’m good about masking, that’s MUCH less likely. Also, ive started wearing FFP3s on airplanes and I haven’t caught an airplane cold in years.
It works, and if you’re in a high risk environment it’s certainly worth it.
My first pathophysiology teacher emphasized that the number one way we get colds or flus is by infecting ourselves through touch ("picking your nose" was his exact phrase) because we introduce the pathogen/s directly.
I know wearing a mask makes me way more conscious of -- and reduces -- my face-touching. It has bothered me that this possible aspect of masking has been discussed nowhere that I have seen. Let that be yet another variable to confound mask studies.
Funny thing... the only illness I had while wearing a mask was Covid -- instead of the usual 1 - 3 mild colds per years. (I masked for 3.5 years due for dental reasons, using cloth & disposable masks both.). N=1 and totally useless on a broad scale. But I currently take away 2 points:
1. Hard for me to believe any study that suggests masking will protect me from Covid since 1 of my 3 bouts happened after exposure while masking.
2. If I was, say, traveling on a plane and wanted to reduce my exposure generally, I wouldn't hesitate to wear a mask, hand-wash frequently, etc.
High quality masks work on trained healthcare workers in close contact settings? Highly possible.
Masks work in the community at large as a public health care policy? Maybe on paper, but I highly doubt it in reality.
My choice anecdote for the latter was that during the omicron wave, at one point South Korea were getting 600,000 infections a day. And if it doesn't work for them, it won't work for us.
Most covid infections come about due to prolonged face to face contact indoors, so if you're high risk, the best option is to cut your exposure to these situations. And I would expect the viral load needed to overcome innate immunity is lower in these groups, so a leaky mask isn't a lot of good.
This is indicated as “intention to treat” meaning, I assume, that people who were told to where a mask but didn’t are counted as if they did. Right? This is not science, no matter how many doctors can talk themselves into believing it is.
But why would someone volunteer for a mask study, and then lie about wearing a mask? There was a self-reported adherence and about 20% said they wore the mask less than 50% of the time. It seems more likely to me that if someone got completely bored of wearing a mask for two weeks they would simply drop out of the study, which may explain why the dropout rate for the intervention arm is larger than that of the control (21% vs 13%).
Any trial using defective and effective masking?
The defective masks not noticeably different from regular N95s.(of course) By now I assume it's generally agreed that it's aerosols. So any mask less than N95 is nearly useless. AND it's required to tape the edges (especially at the top) of the mask. Visitors to Stanford med. got their masks taped at the entrances.
bc
Actually Mr. Cifu, You are all wrong because of the underlying assumption you have, that its "the masks" producing the data. You're thinking process is dead in the water before it even gets started. There does actually exist, a science that has determined the strengths of all the different mitigation controls. Guess what. Pretty much everything is stronger and overshadows masks, and Certainly everything we were doing during Covid. But if your belief in "masks doing something" derives from the lab experiments that proved they work. I'd encourage you to go look again. closer. The lab experiments were gamed. all of them. https://open.substack.com/pub/doranpeck/p/masks-the-indisputable-end-to-the?r=ygaqy&utm_campaign=post&utm_medium=web
Dear Nate,
Thanks for your interest.
The goal of my post was to try to help people make informed decisions about masking. I think mandates might make sense as an emergency measure in desperate situations, but we are not there.
As to viral infections being inevitable, so is death, but that does not mean efforts to postpone it are not worthwhile.
Finally, I'm sure you'll admit that you are unlikely to hear from the great-grandmothers who DIDN'T survive Hitler, COVID, etc.!
Let’s be serious: Randomizing a plainly visible ‘treatment’ is a joke.
And even if one is generous and polite and accepts the 3% number, it is also laughable. It’s much too small to even consider as a rationale for a population-wide measure. So quibblers can continue to go back and forth on whether or not masks are ‘useless’ or have some very small marginal effect (perhaps, and that is being incredibly accommodating and generous), but the evidence in favor of community masking is *still* paltry.
Masks are developed for hundred of years, and tested in the most dangerous jobs and situations, from labs to diving, nuclear reactors, all kinds industry, astronautics. The idea that masks generally do not work for respiratory viruses are insane.
If mask does not work, it means only one of two things (1) Mask you use is not good enough for that purpose. For god sake, don't use surgical face mask to prevent respiratory viruses. They are not made for that purpose. They can stop DROPLETS, not AEROSOL. For aerosol, use FFP1, FFP2, FFP3, P3 or better. (2) Masks are not used correctly or consistently.
Yes, it is that simple.
So the pro-mask (pro-government-overreach, pro-fascist and anti-human, in my opinion) horde is now parroting a paper from Norway, which shows, in a beautiful randomized-controlled trial, that approximately 12% of people who mask for 14 days report symptoms of respiratory viruses, compared to approximately 9% of people who don't mask.
1. Let's ignore the fact that these are not PCR-confirmed infections (or any other objective measure) but rather, simply, reports of "I have a runny nose." Let's ignore the incredible bias built into that 3% absolute risk reduction over a two-week period, which could, alternatively, be described as a 25% relative risk reduction. Leave all the "confounding" out of it. Let's just take this study in plain English as, "Over a 2-week period, approximately 10% of people reported cold-like symptoms and people who wore surgical masks reported slightly less incidents of cold-like symptoms."
2. Some of what I am thinking is a direct paraphrase of my spirit-animal, Vinay Prasad. However, even if we leave the bias and the placebo effect out of our analysis, we are still left with the following:
The math of this study seems to suggest that: masks or not, about 10% of people in this population will get a cold in a 2-week period. Slightly fewer will report that cold if they are masked. This seems to suggest, vaguely, that 100% of people will get a cold in a 20-week period.
3. You could extrapolate out, just by one trial-length (i.e. 2 more weeks) and speculate that starting with a population of 1000 people, 100 got sick in the first 2 weeks and then approximately 90 more would get sick in the next two weeks, including about 3 of the 30 people who would have, in the first 2-weeks, otherwise reported a cold but didn't, ostensibly because they wore a mask. Again, I am obviously simplifying the numbers, but extend it one more period. By the end of 6 weeks, 30% of the population has contracted the virus and, already, at least 6 of the people spared in the first 2-week period have contracted the virus. You don't need to play this thought experiment out very far until everyone, masked or not, has contracted the virus.
4. How much inconvenience, how much cost, how much pollution, how much potentially-inhaled microplastic, how much language-development loss are you willing to incur for the chance that you might postpone your inevitable infection by a few weeks or maybe months?
Subpoint 4a. Why is nobody talking about the particles being shed by the masks: microplastic, other fibers, which are almost certainly going to lead to restrictive airway disease that outweighs any benefit they could possibly offer?
5. And none of this discussion even includes the hypothetical but well-studied costs of avoiding infection. We have a well-described "hygiene hypothesis" to explain the allergic phenotype. We have at least a handful of diseases (EBV, VZV to name a couple) which are well described as better-tolerated the earlier we encounter them. We have seen the very clear age-gradient of negative outcomes for the Wuhan virus and its COVID derivatives. Furthermore, we simply don't know whether avoiding viruses is better or worse for the individual in the long-run. Could individuals raised in sterile environments ultimately be more prone to auto-immune disease or cancer? I am not suggesting the affirmative is necessarily true but we don't have proof or even evidence of the negative. Finally, we are totally ignoring the obvious, but well-obfuscated truth that masks are undeniably and obviously detrimental to children's development. I assert that emotional development and language development depend on seeing the faces of those around us and being aware that our faces are also visible. More than that, however, masks teach children that they should fear their neighbors, as they are a source of infection, rather than mutual benefit, and that they should fear the literal air that they breathe.
If we are trying to create the most iatrogenically-poisoned, neurotic, fearful and developmentally-stunted generation of Western children in recorded history, I think we are all doing a great job. If this is not what we want, it is time to put aside our tribal allegiances and consider interventions based on their merit and their actual evidence. And we should leave our kids alone.
I just wish we could get over this effective v non effective argument which will rage back and forth forever and start focussing on harms which will always outweigh any benefit, even if it could be found. https://open.substack.com/pub/valerienelson/p/updated-masks-in-care-homes-a-benefit?r=ylkfh&utm_medium=ios
I’ve sold 100’s of thousands of KN95 masks during the plandemic, but never wore them myself. After stopping selling the masks, I got very suspicious of China made PPE products so I took one of the KN95 masks and turning inside out, gently shook the mask over a microscope slide! To my horror the slide was covered in microscopic glass shards and nanoparticles!!! The CCP is Not our friend!!! See here. http://photos.adezignmerch.com/3-22-24/KN95/
I haven't read Vinay's article yet, but the biggest issue I have with using symptoms as the primary end point is it does not differentiate viral particulate matter from larger matter such as allergens or bacteria. Granted winter is not prime allergy season, but maybe that is why it's only 3% instead of 10% benefit. Further, if a few people develop a bacterial sinusitis or URI and this is confused as viral, while it may still be a benefit to the user and reduce contagion, it does not help us make good public health decisions during flu season.
In short, I do think the primary measures need to be S/S that can at least effectively r/o allergen etiologies such as fever, lymphadenopathy, serological markers.
I should also add that even if you write some substack post on the phone, before you send it, please add the reference when you later have your computer or whatever the necessary device may be.
Thank you, Adam. Your criticism and analysis are well taken, but I think Vinay's arguments, in the aggregate (not necessarily every one), are slightly better. I still very much appreciated your valuable comments. Thank you for including the reference! It is something. Vinay doesn't do it at times and he needs to do it every time. If necessary, even if written on the phone, he should add the reference later and then send the substack out.
I appreciate the public disagreement between two astute consumers of the medical literature. Physicians are human. Most people won’t read the study and at the end of the day we are all biased by our ‘priors’, values, beliefs, and preferences.
Masking isn’t worthless. I’ve worked in front door medicine for 12 years and used to spend most of every winter with a cold or flu; now I’m good about masking, that’s MUCH less likely. Also, ive started wearing FFP3s on airplanes and I haven’t caught an airplane cold in years.
It works, and if you’re in a high risk environment it’s certainly worth it.
My first pathophysiology teacher emphasized that the number one way we get colds or flus is by infecting ourselves through touch ("picking your nose" was his exact phrase) because we introduce the pathogen/s directly.
I know wearing a mask makes me way more conscious of -- and reduces -- my face-touching. It has bothered me that this possible aspect of masking has been discussed nowhere that I have seen. Let that be yet another variable to confound mask studies.
Funny thing... the only illness I had while wearing a mask was Covid -- instead of the usual 1 - 3 mild colds per years. (I masked for 3.5 years due for dental reasons, using cloth & disposable masks both.). N=1 and totally useless on a broad scale. But I currently take away 2 points:
1. Hard for me to believe any study that suggests masking will protect me from Covid since 1 of my 3 bouts happened after exposure while masking.
2. If I was, say, traveling on a plane and wanted to reduce my exposure generally, I wouldn't hesitate to wear a mask, hand-wash frequently, etc.
High quality masks work on trained healthcare workers in close contact settings? Highly possible.
Masks work in the community at large as a public health care policy? Maybe on paper, but I highly doubt it in reality.
My choice anecdote for the latter was that during the omicron wave, at one point South Korea were getting 600,000 infections a day. And if it doesn't work for them, it won't work for us.
https://news.sky.com/story/south-korea-covid-19-country-records-highest-daily-coronavirus-deaths-as-omicron-cases-surge-12568421
Most covid infections come about due to prolonged face to face contact indoors, so if you're high risk, the best option is to cut your exposure to these situations. And I would expect the viral load needed to overcome innate immunity is lower in these groups, so a leaky mask isn't a lot of good.
This is indicated as “intention to treat” meaning, I assume, that people who were told to where a mask but didn’t are counted as if they did. Right? This is not science, no matter how many doctors can talk themselves into believing it is.
But why would someone volunteer for a mask study, and then lie about wearing a mask? There was a self-reported adherence and about 20% said they wore the mask less than 50% of the time. It seems more likely to me that if someone got completely bored of wearing a mask for two weeks they would simply drop out of the study, which may explain why the dropout rate for the intervention arm is larger than that of the control (21% vs 13%).