Anecdotal evidence is not evidence. Your arguments for masks are all based on this. Masks do not, and cannot, by the laws of physics reduce respiratory infections.
But is a healthy, well-paid doctor who spends a lot of time in such settings likely to be more resistant to such infections than a sickly, old man? Yes.
Anecdotal evidence is not evidence. Your arguments for masks are all based on this. Masks do not, and cannot, by the laws of physics reduce respiratory infections.
But is a healthy, well-paid doctor who spends a lot of time in such settings likely to be more resistant to such infections than a sickly, old man? Yes.
You cannot start with, "I have always worn a mask and did not get Covid" and make it valuable. In contrast, I spent the pandemic in a building full of people with Covid, without wearing a mask and did not get Covid, either.
Was your mask the reason for my good health? Or is it more likely that we both have some sort of natural immunity against severe expressions of the common cold? My money's on the latter, because there's no chance of the former being true.
If people want to clutch at their blankie because they think it will save them from the monster under the bed and this clutching harms no-one? Let them do so. But mandates of worthless measures to placate these cowards? That's insane.
And for the record, I read a dual honors program in Chemistry and Physics at Keele University before going on to work for big pharma. I am well qualified to make accurate judgements in this field, certainly as much as any mask-wearing medic.
And finally, there is emerging evidence (and a growing base of such evidence) that not only do maks not prevent the spread of Covid, they may actually promote it. I assume this is because, though worthless in their own right, masks give people additional levels of "false confidence" to hang out with the infected. Your little chart takes no account of this at all.
I accept a mask as a talisman for those that wish or think it might help. It really might. As a senior with COPD needing supplementary O2, I have bad hearing and need to see a face in order to understand. I wear a mask when required but need additional flow to compensate. The mask also affects my peripheral vision another balance challenge.
Population level studies by Ian Miller (book Unmasked and https://ianmsc.substack.com/ but no longer on Twitter) shows the masks did not materially stop the spread. One can discount that evidence as immaterial in a given situation, but the mandates did little.
It may be that N95 or better do work with some greater degree of effectiveness, but they like their big brothers (P100+, $800+) which have been well tested are impossible for the general public. The N95's must be fit tested for the person and are horribly uncomfortable for any duration.
You're right that anecdote is not science, but many people have noticed that ever since they started masking and distancing, they have not had Covid19 or any number of other respiratory viruses like colds and flus. I'm an N of 1 too, but I'm loving not getting my usual 3-4 X/year respiratory illness. I haven't had a cold (or Covid19) in 2.5 years. (And I too regularly care for Covid19 infected patients). Masks have also been shown to work in many studies, (not perfectly, which is why when we are trying to prevent a deadly disease you have to incorporate other measures like social distancing, limiting time spent in close proximity to infected patients, and indoor gatherings). My hospital requires masks, which is why I now feel much safer at work than I do in the grocery store.
I attribute my experience to the combination of changes I have made: masking (N95's only, since they became available), social distancing (>6 feet), avoiding crowded indoor spaces, avoiding indoor restaurants (or other venues where masks cannot be worn), hand washing, avoiding touching my mask or face, avoiding air travel and in-person conferences, full PPE when seeing Covid19 patients at work, testing all patients at work for Covid status, and vaccination. I do not pretend that you can tease out which effort has had the greatest impact. I do not take supplements except Vitamin D which I was taking before the pandemic. In the past year I would have expected to be more susceptible to viruses, not less, because of severe stressors (husband's illness, death of close family member, etc.) I recognize that Covid19 is extremely contagious and that it's possible I will be infected despite my efforts. But so far my efforts have been paying off.
" I do not take supplements except Vitamin D which I was taking before the pandemic."
And there's your confounder. Vitamin D deficiency correlates tightly with groups known to have higher risk of covid mortality. And you may be part of the 40% of the population that have baseline immunity from covid. There was a test done on stored blood back in 2020 that found that out.
If you want to try to dodge a virus, knock yourself out. :)
If Vitamin D deficiency correlates with covid19 mortality (unproven but there are some suggestive studies), then that's even MORE reason for me to undertake additional mitigation strategies. Also I've been taking Vitamin D for many years as a preventative measure, so there's no reason to believe I am deficient. It is not a "cofounder" when I compare the frequency of my respiratory infections before and after the Covid19 pandemic when I started regularly masking and social distancing.
Did you change your level of vit D supplementation?
I went _years_ without a flu infection with no vitamin D supplementation. After I began supplementing, I got covid twice--both times mild and fever/aches lasted two days the second time, with just an occasional cough the first.
Maybe my D levels have been high this whole time and maybe a little extra supplementation during the pandemic prevented worse outcomes.
There are _always_ hidden confounders--it's whether you choose to look for them.
Who's to say that getting a mild case of covid now won't protect you from a worse outcome later? What is the best strategy? Maybe you are just turning yourself into dry tinder by masking. Or maybe you have a genetic phenotype that protects you from covid and vit. D and masking are irrelevant. So, is immune-boosting always a good strategy?
If your social life suffers because of masking, is that how you want to live your life? Do you wear your mask at parties, or do you avoid parties?
My experience is the opposite of yours. Since May of 2020 I have only worn masks when required, and then I wore cloth ones. I caught covid during the only period I was regularly masking with a KN95. I was abroad and knew I had to test to come back to the US. Even more ironic is that none of the people I had close unmasked contact with got it. Fact is, this virus is smarter than we are and we have not yet figured out what makes it tick.
If you were abroad traveling when you caught Covid I suspect that you were in many situations where you couldn't control your social distancing. People who travel have a tendency to catch Covid19. I haven't traveled by air or long distance since the beginning of the pandemic. I think we can both agree that cloth masks are mostly ineffective. Now that everyone has thrown their masks to the wind, and N95's are widely available, I only wear N95's. I don't typically wear any mask outdoors unless it's a crowded environment. You're right, we haven't figured out everything about this virus (or many other viruses). But I do think we know a lot about what makes it tick. And there is now much known about how we can protect ourselves and others. One last thing: ALL viruses are smarter than we are.
Your work of fiction is lovely, but not in the remotest bit interesting to the big picture.
Masks have not been shown to work in many studies, quite the opposite, in fact, they have been shown conclusively to be useless against the flu and the overwhelming weight of evidence is that they don't work for Covid (given that it's like the flu in transmission vector, no surprise) either. (The best quality studies we have - the Danish study and the Kansas study - show that masks are either useless or make you more likely to catch Covid).
This is, in fact, precisely why anecdotal evidence should not be given weight in evaluation when it comes to determining the scientific facts.
The objective is not to feed your fantasy of what is safe, it is to actually improve things and this includes a consideration of the huge social harm that masking does and which is all too often ignored by those wooh-ing in favor of masks.
What is particularly amusing, of course, is you've all forgotten why you wore masks in the first place - not to protect yourselves, but "to protect others". Because even the biggest liar when this began wasn't going to tell the lie that masks worked to protect you - your face is covered in openings for viruses to get into, your eyes are perfect, in fact, and you don't tuck them into your mask do you?
There are conflicting studies where masks are concerned and my goal in my comment was to relate my personal experience, not review the scientific literature. Masking studies are difficult because as you point out there are many variables. In my case yes I do know how many respiratory infections I got annually because they tend to knock me on my butt. I would average about 4 a year. (More in the past when grandkids were young). I have had exactly zero since the Covid pandemic started. I attribute that not to masks alone but to a combination of masking, social distancing, hand washing, not touching face until hands are washed, and avoiding prolonged indoor venues, particularly if not masking. Your last paragraph is rather ridiculous, especially since in your arrogance you have assumed that I have forgotten why primarily I mask. But the part I'll respond to is that I have mostly done all of this to protect others; specifically my husband who is over 65 with Parkinson's and cardiac disease, and my mother who was 94. Not to mention, perhaps, your grandmother, in the event I may infect you. Because protecting myself IS protecting others. And so far it has worked. As an added benefit I'm not getting the regular respiratory viruses anymore either, and I love that. With Covid19, I'm not as concerned about myself as I am my family, because I have limited risk factors and am double boosted. My main concern about my own infection is infecting others. As for eyes, my eyes are typically covered because I wear glasses. So as far as splash events I'm pretty protected. But my eyes don't suck in air, so I think the greatest risk to exposure through the eyes would probably be the tendency to rub our eyes with contaminated hands. I don't do that anymore. Hope that clarifies.
You can always spot blather - it comes from people who are so enraged when you point out their madness, that they forget what a paragraph looks like.
All the self-serving nonsense in the world will not change that there is no evidence that masks prevent Covid, flu or any other virus, except in your imagination.
And your eyes are full of fluid and that fluid? That's what viruses stick to. Your clown science notwithstanding. They're the way into your body and, specifically, your respiratory system. They don't need to "suck in air" because that's not how contagion works - your eyes are always in the air, and that means physical contact with viruses. Stop gibbering.
Perhaps, spend some time in English classes sorting out those paragraphs and then come back to spout nonsense about things you don't understand, at least then, you will prevent other people's eyes from bleeding.
Yeah. She seems to resort to personal attacks and arrogance in her HCP godhood after the argument lasts long enough. Which is great, because I'm happy to be an asshole once the first punch is thrown.
What's nonsense is your statement that eye fluid is how respiratory viruses are spread. I'd like to see your evidence of that. It's interesting that those who accuse others of blather cannot spot their own. No point in continuing discussion with you.
The pathology of influenza involves the lungs, but my readings indicated that covid pathology involves the microvasculature, although infection is via the nasopharynx. The whole body is involved when there is a covid infection, not merely the lungs.
It's a mystery to me why covid is called a respiratory infection.
The problem with your self study is reporting. Did you keep a record how how many colds you got each previous years and when? How many group gatherings you attended and when? Which years you got a flu shot? The number of visitors in your hospital each year? I'd guess you have been in fewer social situations, got vaccinated and maybe boosted, and had fewer visitors in the hospital than ever before. This is not an apples to apples comparison. There are all sorts of factors that are not accounted for, which makes it virtually impossible to assign the result (not getting a cold) to the mask versus any number of other factors. Heck, I don't remember what I at for dinner last night, never mind how many colds I've had for each of the last 10 years.
I'd also push back on your language that "masks have been show to work in many studies". This is another time our language needs to be specific. What does "work" mean? Are you talking about mechanistic data that shows filtration of particles? While positive, it's unclear what impact that has on transmission. Are you talking about observational studies that compared places with mask mandates to places without mask mandates or with self reported mask usage? Observational studies cannot provide cause & effect relationships. At best they can only say masks are sometimes correlated with less covid cases. I'd also be highly skeptical of self reporting mask usage and observational data that compares places with mandates because we're not measuring actual mask usage and we're often looking at different places at different times of the year. We know cases rise and fall over time so it's important to compare it to the different people within the same community at the same time, which almost is never the case in those observational studies, which further confounds the results. If you stick with the randomized controlled data on masking, which is the only data capable of establishing cause & effect relationships, the overwhelming majority of the studies looking at masking & respiratory transmission fail to find a statistically significant difference to not masking. Now, that doesn't mean masks "don't work". Like most things in the applied science the answer likely "depends". It depends on all sorts of factors such the type mask, if its worn properly, how long the exposure is, what environment they are in, their vaccination or immunity status, etc. But, you can't exactly say "masks have been shown to work in studies". That is a vastly oversimplified and I'd say inaccurate statement.
On average I used to get 4 respiratory virus infections per year. I kept track because I hate respiratory infections. I have had Zero since the pandemic. And you're right; the magic has been a combination of masks, (mine are fit tested), social distancing, avoiding high risk individuals and environments, and certain activities like crowded concerts and indoor restaurants, avoiding face touching, hand washing after activities like grocery stores and before face touching, etc. etc. I never meant to imply that masks will be protective enough if you rely entirely on masks, or use them improperly. I am an N of One so my experience is by no means conclusive. But I'm sticking to my plan. You are right that in order for masks to work they have to be worn and handled properly, which may be partly why the studies are so conflicting. (I rarely see people wearing them properly). Although not conclusive in all studies, there is enough evidence that N95's work. I don't see my hospital giving them up anytime soon.
I would still push back that "N95s work". I'd love the see an RCT that suggests they can make a statistically significant difference to not masking (there aren't any). This means at best all you can say is they are good at filtering particles in mechanistic studies (but unclear on transmission of disease) and at times they are correlated with places with mask mandates or self reported mask usage. But, correlation does not equal causation, so if you are implying they can stop covid transmission when you say they "work" that has not been demonstrated in the literature. Again, our language needs to be specific.
Regarding your personal N of one case I think that's great, but unfortunately it's not good evidence that it's the mask vs any of the other mitigation strategies you used or just dumb luck. Also, without a control arm you don't know if you wouldn't have had the same result if you did nothing. Maybe you could have gotten the same result with fewer or even no strategies. If you are willing to alter you life like that to avoid respiratory disease, then by all means. But, by comparison I did nothing other than was required by law, avoided no social situations (if fact got married w/ 100+ people in Sept 2020), and just lived my life as I always have, and never had a covid symptom once. Same result...but I didn't have to do anything to get mine & you had to do a lot. At this point this is where we are. If avoiding mild infection is important enough to you to do that, then do that. If you feel that's an intrusion on your life and infections are likely to be mild and unavoidable and that doesn't bother you, then just go about your life. I don't think either are wrong. The only thing I find fault in is moralizing your choice (not saying you are) or making incorrect claims that are not supported in evidence.
In the past it was both. But I don't think that currently it's about other people wearing masks because so few people seem to be doing it anymore. And as soon as the masks came off, and travel, restaurants, gatherings etc. resumed, Covid19 cases have soared amongst people I know, who had managed to avoid it for 2 years. That's why I now only wear N95's because they are the only type of mask that can protect the wearer. And protecting myself is how I protect my at-risk loved ones.
Agreed, Nick. And I'm a 24-year ER nurse on the front lines this whole time. Most of the time, mask wearing is no more than a face pacifier. There are a few exceptions (very few).
Anecdotal evidence is evidence, it's just not that compelling. But, for example in my field of exercise science where there is not a ton of research under which conditions for example best build muscle, being in the trenches lifting weights for years is extremely valid evidence. That being said, in areas where we have better evidence, we should lean on that. And, when we are considering a mandate that has both drawbacks and infringes on civil liberties, that bar of evidence should be quite high and the burden of proof to a medical intervention should be on the ones proposing the mandate. In this case anecdotal evidence is not compelling enough to support a mandate or take the choice out of the individual's hands. But, anecdotal evidence nonetheless is evidence that should not be ignored, but rather put into context with the other evidence.
No, it's not. Any individual's anecdote is not evidence. It's a story. Were you to collate thousands of stories, you would just have a bigger work of fiction.
This is how, for years, people insisted that homeopathy was a vaild treatment - the overwhelming weight of "anecdotal evidence," which has absolutely no relationship to the truth, which is, of course, that this form of treatment is worthless.
The belief that water is wet is based on stories, then. Also the belief that parachutes save lives.
And I am also trained in chemistry and physics and have done physics research.
Homeopathy has a deductive basis for some treatments. The intestines have a lot of immune function, so giving an allergen to the gut may "turn off" allergenicity in the skin and respiratory system. Apparently, there are journals of homeopathy where studies are published.
Lol. Homeopathy has been conclusively "debunked" from a scientific perspective.
Water is not "wet" based on stories, but by definition.
And parachutes can be demonstrated to save lives. And we got that way not by throwing people out of planes but by using makeshift parachutes on non-human items, so we could see how they slow the fall of an object.
I am sorry you don't understand evidence Tom, but if I were you, I would stop offering your opinion on anything until you do.
Most of our knowledge is based on observational evidence, isn't it? We don't have to get picky about the strength of evidence unless the observational evidence is doubted, such as occurs when someone has an alternative theory to explain the existing evidence.
Tom, there's nothing sadder than seeing a stupid man get desperate in his ridiculous arguments.
You have reached that point.
I pity you, but I will no longer respond to you - you have nothing of value to offer and I have no idea where you think I said you need an RCT to measure the value of a parachute? Because I didn't. That's in your La-La Land, not mine.
Run along now, I am sure you have plenty of windows that need licking.
I don't know about the rest of the readers here, but I think it is likely that you may have misunderstood one of the key ideas of this substack: civil and vigorous discussion of the ideas. You have the vigorous part, but I think you missed the civil part. I noticed that you made quite a few personal attacks on other commenters throughout this particular post of Adam's. Could you please dial it back a bit? Thanks!
While I appreciate (and agree with) your desire to focus on RCTs (and on your opinion on masks) I think it is unwise to ignore the experience of experts in the field. As Masic et. al cite "Evidence Based Medicine – New Approaches and Challenges", while EBM reduces the value of intuition, non-systematic clinical experience and pathophysiology as sufficient basis in making clinical decisions, and emphasizes the value of evidence obtained by clinical research, good doctors apply their clinical observation and experience, together with the best scientific evidence from medical literature.
They define EBM as the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information.
EBM categorizes different types of clinical evidence and ranks them according to the strength of their freedom from the various biases that beset medical research.
1. Evidences obtained by meta-analysis of several randomized controlled research (RCR).
1b. Evidences from only one RCR.
2a. Evidences from well designed controlled research RCR.
2b. Evidences from one quasi experimental research.
3. Evidences from non experimental studies (comparative research, case study), according to some, for example Textbooks.
4. Evidences from experts and clinical practice.
While it's not wise to reach conclusions on mere anecdote, it's an important first step in the process of evaluating evidence, which often leads to further inquiry, fine tuning hypothesis (which probably never ends), & eventually coming to a conclusion on better evidence.
Philosophy of Medicine thinks a little differently about EBM than most of the doctors who favor EBM. RCTs are not necessarily stronger evidence than observational studies. RCTs attempt to limit researcher bias involved in selecting subjects for treatment--RCTs have strong intrinsic linkage, but weak extrinsic linkage. Their test is great for the subject population tested, but conclusions often don't apply to the general population or to subgroups in the general population. RCTs only limit one type of bias and can be subject to many other biases. For example, designed-to-fail studies incorporate designer bias even in RCTs. Designer bias is often weightier than the bias from cherry-picking data.
I'm sure there are always different opinions. That doesn't change that meta-analysis of RCTs and RCTs themselves are widely accepted as superior to cohort studies, case control studies, cross sectional studies, case studies, & mechanistic studies.
I would certainly be prepared to use anecdotes to inform the direction of any given aspect of research but to base real world decisions on them? Nope.
And in the instance of masks, I don't need anecdotes, I have overwhelming amounts of research that conclude they don't work - no need for a physician's gut feeling that they might. They don't.
Totally agree Nick, anecdotes are not a strong basis for making decisions. And, when we have better evidence, which when it comes to masks we do, we should prioritize that over anecdotal experiences. However, it is clear anecdotal experience from experts in the field is a form of evidence that any good practitioner should take into account. Usually those experiences should trigger folks to look for better evidence to help ensure recommendations are grounded in the best evidence we have, which of course in this case we know are 1) the 2 RCTs specific to Covid (Bangladesh & Danish mask trials), and 2) the 14 RCTs on other respiratory diseases that were completed pre-covid. In total of these 16 RCTs (2 on covid & 14 on other respiratory diseases), 14 of them failed to find a statistically significant difference to not masking. That means approximately 88% of the RCTs failed to find a statistically significant difference between masking and not masking while only 12% found modest significance. This should certainly trump any anecdotal experience and is not compelling evidence to support masks can prevent transmission of respiratory disease and covid.
Aren't parachutes based on anecdotal evidence? How about the belief that the sun rises in the east and sets in the west? How about the belief that we all will die some day?
I contend that anecdotal evidence informs the vast preponderance of our beliefs. RCTs can be valuable for investigating some small fraction of controversial questions where researcher bias may be an issue. Observational studies are valuable for investigating population groups where impact is high enough relative to the data to be able to test a hypothesis adequately.
Sounds like an argument just to talk. My point was anecdotal experience from experts in the field is a form of evidence that any good practitioner should take into account. Unless you're disagreeing with that, put your comment elsewhere.
When I first read this in my email I threw it away with some amount of disgust. Then decided to come here and say something about it's lack of foundational science. It is as Nick has said; A. Cifu's point 'A' is purely anecdotal and has no business being invoked in such a discussion. As V. Prasad says over and over, "Show me the RCTs". And since he uses his point 'A' as a fundamental starting point, it negates the rest of the essay. I am very disappointed that "Sensible Medicine" would engage in just more posturing.
I think it was a great idea to write this for sensible medicine. It shows the various viewpoints and as a result exposes their strength and weaknesses.
I found the first argument pathetic, as did many of the other commenters, because it is based on anecdotal evidence. Or perhaps it is based on the parachute theory of masks.
Anyway, I found this article useful. And Dr Cifu did put a disclaimer up front for those who might not be able to stomach it...
It's very odd that Dr. Cifu assumes away the critical question for masking: does it actually work? My understanding is that, aside from N95s in healthcare settings, there's no strong evidence whatsoever that they actually prevent disease. The 2 metastudies of RCTs from the WHO in 2019 and the CDC (!) in 2020 demonstrated this quite thoroughly. Of the only 2 RCTs conducted during the pandemic, DANMASK was also negative, while the Bangladesh study (that is flawed on so many levels, but that's for another day)) only showed an effect for surgical masks for certain age groups, while showing cloth masks were ineffective. Even studies on the effectiveness of masks in operating rooms don't reveal any effectiveness. Where exactly is the evidence that supports mandating masks?
Yes, I think the article is quite dishonest. It's weasily. It's positing possible value in very strict hospital setting to silently infer value that can be carried over to society at large.
Community masking is a completely different kettle of fish than N95ing-in-one-room-for-a-few-minutes-with-one-highly-contagious-deadly-patient.
And even IF masking were effective in a community context, I'd still be against it.
The pro-life attitude so derided by progressives against right-wingers, progressives themselves practice in other age groups.
Prevention of death is wonderful a the personal level.
When death prevention becomes the be-all and end-all of policy, then it is way wrong, and deserves no more respect than pro-life attitudes a birth.
"My understanding is that, aside from N95s in healthcare settings, there's no strong evidence whatsoever that they actually prevent disease."
Agree with your comment but would add that I haven't even seen strong evidence that N95s in healthcare setting stop or reduce transmission, hospitalization or death.
Exactly this: “Anecdotal evidence is not evidence. Your arguments for masks are all based on this. Masks do not, and cannot, by the laws of physics reduce respiratory infections.” Moreover beginning an argument (position) with regard to mask policies with this assumption (which Cifu declares is not debatable), is a poor basis for imposing a mask mandate/policy, and is exactly what PH did and consequently lost all public trust. Cifu’s premise is without foundation.
Thank you Nick, I agree completely. I don't wear a tin foil hat, I'm not a MAGA, nor a member of Q Anon, uneducated, etc., etc. Masking should not be normalized.
I've been watching science be blurred for two decades. Ever notice men pretending to be women convincing governments to give them opposite sex ids so these men can barge into lesbian spaces pretending to be lesbians, demand to be placed in women's prisons after raping and killing women, taking over medal podiums in women's sports...
and such venerable magazines as Nature and American Scientist going along with the "gender craze" pretending SEX is a social construct and that liking pink or blue is a signal that we are born in the wrong body???
Science has been a mess for a long time.
Before that I wrote blood testing kits quality control results for the FDA. We lied ALL THE TIME.
Before that. in the 90s, I worked in a lab testing the effects of Monsanto on frog deformities. All negative results were conveniently shelved.
Science has been a mess for a long time. People like Dr Paul Offit and others have written about the errors of science.
If you’re conservative and are anti-mask you want to kill grandma. Same applies with the vaccine. That’s all I’ve heard for 2-1/2+ years. Covid was politicized from the beginning when Trump stopped travel from China. Shameful how off the rails it all went.
To be fair, we will all "get it" at some point. I'm also unvaxd and unmskd, I assume I've been exposed to very low viral loads here and there. My masked and vaxd younger coworkers have each had had it 2-3 times. So I KNOW I've been exposed. Yet I've not been sick. I'm assuming that my body is either dealing with it, or ejecting it (I am a monster sneezer and nose blower (post-nasal drip) but I've not been sick in a decade.
I work in health care. Despite masking with N95 I still caught Covid (delta strand) last year. It was mild. I wouldn’t even have known in had it if 1) I hadn’t had to test regularly at work and 2) I finally a week after testing + lost my sense of smell.
I believe the hubris of people believing they have more control than they do, has been magnified during this pandemic.
As for the anecdote about treating TB patients and a mask preventing the author from contracting, I have an alternative anecdote. When I was in grad school, one of my classmates who sat near me in every single class we had together & with whom I did multiple group projects with, had a horrible cough for most of 1 semester. We didn’t think anything of it, until she was hospitalized and passed away from TB towards the end of the semester. We were all required to be tested for TB on multiple occasions and none of us unmasked fellow students or instructors ever tested positive.
Me too. Multiple people symptomatically ill with positive covid-PCR tests have been around me and contaminating my work environment, yet I still haven't caught the bug without taking any stupid experimental shots or wearing the face diapers with pores many times greater size than viron particles.
Anecdotal evidence is not evidence. Your arguments for masks are all based on this. Masks do not, and cannot, by the laws of physics reduce respiratory infections.
But is a healthy, well-paid doctor who spends a lot of time in such settings likely to be more resistant to such infections than a sickly, old man? Yes.
You cannot start with, "I have always worn a mask and did not get Covid" and make it valuable. In contrast, I spent the pandemic in a building full of people with Covid, without wearing a mask and did not get Covid, either.
Was your mask the reason for my good health? Or is it more likely that we both have some sort of natural immunity against severe expressions of the common cold? My money's on the latter, because there's no chance of the former being true.
If people want to clutch at their blankie because they think it will save them from the monster under the bed and this clutching harms no-one? Let them do so. But mandates of worthless measures to placate these cowards? That's insane.
And for the record, I read a dual honors program in Chemistry and Physics at Keele University before going on to work for big pharma. I am well qualified to make accurate judgements in this field, certainly as much as any mask-wearing medic.
And finally, there is emerging evidence (and a growing base of such evidence) that not only do maks not prevent the spread of Covid, they may actually promote it. I assume this is because, though worthless in their own right, masks give people additional levels of "false confidence" to hang out with the infected. Your little chart takes no account of this at all.
If any mask works...why do n95s exist? If N95 are better why aren’t we pushing those??? Pure hypocrisy at every level.
"natural immunity" - The UK Challenge Trials (https://doi.org/10.1038/S41591-022-01780-9) found nearly half the volunteers did not get infected. The Princess Cruise lines in early days where an elderly couple in a cabin - he ill, she not. The Danmask Study (https://pubmed.ncbi.nlm.nih.gov/33205991/) and commentary (https://www.bmj.com/content/371/bmj.m4586) suggest negative mask effectiveness, likely due to poor mask handling.
I accept a mask as a talisman for those that wish or think it might help. It really might. As a senior with COPD needing supplementary O2, I have bad hearing and need to see a face in order to understand. I wear a mask when required but need additional flow to compensate. The mask also affects my peripheral vision another balance challenge.
Population level studies by Ian Miller (book Unmasked and https://ianmsc.substack.com/ but no longer on Twitter) shows the masks did not materially stop the spread. One can discount that evidence as immaterial in a given situation, but the mandates did little.
It may be that N95 or better do work with some greater degree of effectiveness, but they like their big brothers (P100+, $800+) which have been well tested are impossible for the general public. The N95's must be fit tested for the person and are horribly uncomfortable for any duration.
You're right that anecdote is not science, but many people have noticed that ever since they started masking and distancing, they have not had Covid19 or any number of other respiratory viruses like colds and flus. I'm an N of 1 too, but I'm loving not getting my usual 3-4 X/year respiratory illness. I haven't had a cold (or Covid19) in 2.5 years. (And I too regularly care for Covid19 infected patients). Masks have also been shown to work in many studies, (not perfectly, which is why when we are trying to prevent a deadly disease you have to incorporate other measures like social distancing, limiting time spent in close proximity to infected patients, and indoor gatherings). My hospital requires masks, which is why I now feel much safer at work than I do in the grocery store.
So, are you doing any supplementation now that you weren't doing 2.5 years ago? Could there be confounders to masking?
I attribute my experience to the combination of changes I have made: masking (N95's only, since they became available), social distancing (>6 feet), avoiding crowded indoor spaces, avoiding indoor restaurants (or other venues where masks cannot be worn), hand washing, avoiding touching my mask or face, avoiding air travel and in-person conferences, full PPE when seeing Covid19 patients at work, testing all patients at work for Covid status, and vaccination. I do not pretend that you can tease out which effort has had the greatest impact. I do not take supplements except Vitamin D which I was taking before the pandemic. In the past year I would have expected to be more susceptible to viruses, not less, because of severe stressors (husband's illness, death of close family member, etc.) I recognize that Covid19 is extremely contagious and that it's possible I will be infected despite my efforts. But so far my efforts have been paying off.
" I do not take supplements except Vitamin D which I was taking before the pandemic."
And there's your confounder. Vitamin D deficiency correlates tightly with groups known to have higher risk of covid mortality. And you may be part of the 40% of the population that have baseline immunity from covid. There was a test done on stored blood back in 2020 that found that out.
If you want to try to dodge a virus, knock yourself out. :)
If Vitamin D deficiency correlates with covid19 mortality (unproven but there are some suggestive studies), then that's even MORE reason for me to undertake additional mitigation strategies. Also I've been taking Vitamin D for many years as a preventative measure, so there's no reason to believe I am deficient. It is not a "cofounder" when I compare the frequency of my respiratory infections before and after the Covid19 pandemic when I started regularly masking and social distancing.
Did you change your level of vit D supplementation?
I went _years_ without a flu infection with no vitamin D supplementation. After I began supplementing, I got covid twice--both times mild and fever/aches lasted two days the second time, with just an occasional cough the first.
Maybe my D levels have been high this whole time and maybe a little extra supplementation during the pandemic prevented worse outcomes.
There are _always_ hidden confounders--it's whether you choose to look for them.
Who's to say that getting a mild case of covid now won't protect you from a worse outcome later? What is the best strategy? Maybe you are just turning yourself into dry tinder by masking. Or maybe you have a genetic phenotype that protects you from covid and vit. D and masking are irrelevant. So, is immune-boosting always a good strategy?
If your social life suffers because of masking, is that how you want to live your life? Do you wear your mask at parties, or do you avoid parties?
My experience is the opposite of yours. Since May of 2020 I have only worn masks when required, and then I wore cloth ones. I caught covid during the only period I was regularly masking with a KN95. I was abroad and knew I had to test to come back to the US. Even more ironic is that none of the people I had close unmasked contact with got it. Fact is, this virus is smarter than we are and we have not yet figured out what makes it tick.
If you were abroad traveling when you caught Covid I suspect that you were in many situations where you couldn't control your social distancing. People who travel have a tendency to catch Covid19. I haven't traveled by air or long distance since the beginning of the pandemic. I think we can both agree that cloth masks are mostly ineffective. Now that everyone has thrown their masks to the wind, and N95's are widely available, I only wear N95's. I don't typically wear any mask outdoors unless it's a crowded environment. You're right, we haven't figured out everything about this virus (or many other viruses). But I do think we know a lot about what makes it tick. And there is now much known about how we can protect ourselves and others. One last thing: ALL viruses are smarter than we are.
Your work of fiction is lovely, but not in the remotest bit interesting to the big picture.
Masks have not been shown to work in many studies, quite the opposite, in fact, they have been shown conclusively to be useless against the flu and the overwhelming weight of evidence is that they don't work for Covid (given that it's like the flu in transmission vector, no surprise) either. (The best quality studies we have - the Danish study and the Kansas study - show that masks are either useless or make you more likely to catch Covid).
This is, in fact, precisely why anecdotal evidence should not be given weight in evaluation when it comes to determining the scientific facts.
The objective is not to feed your fantasy of what is safe, it is to actually improve things and this includes a consideration of the huge social harm that masking does and which is all too often ignored by those wooh-ing in favor of masks.
What is particularly amusing, of course, is you've all forgotten why you wore masks in the first place - not to protect yourselves, but "to protect others". Because even the biggest liar when this began wasn't going to tell the lie that masks worked to protect you - your face is covered in openings for viruses to get into, your eyes are perfect, in fact, and you don't tuck them into your mask do you?
There are conflicting studies where masks are concerned and my goal in my comment was to relate my personal experience, not review the scientific literature. Masking studies are difficult because as you point out there are many variables. In my case yes I do know how many respiratory infections I got annually because they tend to knock me on my butt. I would average about 4 a year. (More in the past when grandkids were young). I have had exactly zero since the Covid pandemic started. I attribute that not to masks alone but to a combination of masking, social distancing, hand washing, not touching face until hands are washed, and avoiding prolonged indoor venues, particularly if not masking. Your last paragraph is rather ridiculous, especially since in your arrogance you have assumed that I have forgotten why primarily I mask. But the part I'll respond to is that I have mostly done all of this to protect others; specifically my husband who is over 65 with Parkinson's and cardiac disease, and my mother who was 94. Not to mention, perhaps, your grandmother, in the event I may infect you. Because protecting myself IS protecting others. And so far it has worked. As an added benefit I'm not getting the regular respiratory viruses anymore either, and I love that. With Covid19, I'm not as concerned about myself as I am my family, because I have limited risk factors and am double boosted. My main concern about my own infection is infecting others. As for eyes, my eyes are typically covered because I wear glasses. So as far as splash events I'm pretty protected. But my eyes don't suck in air, so I think the greatest risk to exposure through the eyes would probably be the tendency to rub our eyes with contaminated hands. I don't do that anymore. Hope that clarifies.
You can always spot blather - it comes from people who are so enraged when you point out their madness, that they forget what a paragraph looks like.
All the self-serving nonsense in the world will not change that there is no evidence that masks prevent Covid, flu or any other virus, except in your imagination.
And your eyes are full of fluid and that fluid? That's what viruses stick to. Your clown science notwithstanding. They're the way into your body and, specifically, your respiratory system. They don't need to "suck in air" because that's not how contagion works - your eyes are always in the air, and that means physical contact with viruses. Stop gibbering.
Perhaps, spend some time in English classes sorting out those paragraphs and then come back to spout nonsense about things you don't understand, at least then, you will prevent other people's eyes from bleeding.
Yeah. She seems to resort to personal attacks and arrogance in her HCP godhood after the argument lasts long enough. Which is great, because I'm happy to be an asshole once the first punch is thrown.
What's nonsense is your statement that eye fluid is how respiratory viruses are spread. I'd like to see your evidence of that. It's interesting that those who accuse others of blather cannot spot their own. No point in continuing discussion with you.
The pathology of influenza involves the lungs, but my readings indicated that covid pathology involves the microvasculature, although infection is via the nasopharynx. The whole body is involved when there is a covid infection, not merely the lungs.
It's a mystery to me why covid is called a respiratory infection.
Eyes are bathed in antivirals. Not so our nasopharynx.
Lesson: The immune system is a better defense than masks.
The problem with your self study is reporting. Did you keep a record how how many colds you got each previous years and when? How many group gatherings you attended and when? Which years you got a flu shot? The number of visitors in your hospital each year? I'd guess you have been in fewer social situations, got vaccinated and maybe boosted, and had fewer visitors in the hospital than ever before. This is not an apples to apples comparison. There are all sorts of factors that are not accounted for, which makes it virtually impossible to assign the result (not getting a cold) to the mask versus any number of other factors. Heck, I don't remember what I at for dinner last night, never mind how many colds I've had for each of the last 10 years.
I'd also push back on your language that "masks have been show to work in many studies". This is another time our language needs to be specific. What does "work" mean? Are you talking about mechanistic data that shows filtration of particles? While positive, it's unclear what impact that has on transmission. Are you talking about observational studies that compared places with mask mandates to places without mask mandates or with self reported mask usage? Observational studies cannot provide cause & effect relationships. At best they can only say masks are sometimes correlated with less covid cases. I'd also be highly skeptical of self reporting mask usage and observational data that compares places with mandates because we're not measuring actual mask usage and we're often looking at different places at different times of the year. We know cases rise and fall over time so it's important to compare it to the different people within the same community at the same time, which almost is never the case in those observational studies, which further confounds the results. If you stick with the randomized controlled data on masking, which is the only data capable of establishing cause & effect relationships, the overwhelming majority of the studies looking at masking & respiratory transmission fail to find a statistically significant difference to not masking. Now, that doesn't mean masks "don't work". Like most things in the applied science the answer likely "depends". It depends on all sorts of factors such the type mask, if its worn properly, how long the exposure is, what environment they are in, their vaccination or immunity status, etc. But, you can't exactly say "masks have been shown to work in studies". That is a vastly oversimplified and I'd say inaccurate statement.
On average I used to get 4 respiratory virus infections per year. I kept track because I hate respiratory infections. I have had Zero since the pandemic. And you're right; the magic has been a combination of masks, (mine are fit tested), social distancing, avoiding high risk individuals and environments, and certain activities like crowded concerts and indoor restaurants, avoiding face touching, hand washing after activities like grocery stores and before face touching, etc. etc. I never meant to imply that masks will be protective enough if you rely entirely on masks, or use them improperly. I am an N of One so my experience is by no means conclusive. But I'm sticking to my plan. You are right that in order for masks to work they have to be worn and handled properly, which may be partly why the studies are so conflicting. (I rarely see people wearing them properly). Although not conclusive in all studies, there is enough evidence that N95's work. I don't see my hospital giving them up anytime soon.
I would still push back that "N95s work". I'd love the see an RCT that suggests they can make a statistically significant difference to not masking (there aren't any). This means at best all you can say is they are good at filtering particles in mechanistic studies (but unclear on transmission of disease) and at times they are correlated with places with mask mandates or self reported mask usage. But, correlation does not equal causation, so if you are implying they can stop covid transmission when you say they "work" that has not been demonstrated in the literature. Again, our language needs to be specific.
Regarding your personal N of one case I think that's great, but unfortunately it's not good evidence that it's the mask vs any of the other mitigation strategies you used or just dumb luck. Also, without a control arm you don't know if you wouldn't have had the same result if you did nothing. Maybe you could have gotten the same result with fewer or even no strategies. If you are willing to alter you life like that to avoid respiratory disease, then by all means. But, by comparison I did nothing other than was required by law, avoided no social situations (if fact got married w/ 100+ people in Sept 2020), and just lived my life as I always have, and never had a covid symptom once. Same result...but I didn't have to do anything to get mine & you had to do a lot. At this point this is where we are. If avoiding mild infection is important enough to you to do that, then do that. If you feel that's an intrusion on your life and infections are likely to be mild and unavoidable and that doesn't bother you, then just go about your life. I don't think either are wrong. The only thing I find fault in is moralizing your choice (not saying you are) or making incorrect claims that are not supported in evidence.
I'm curious: is it other people wearing masks that has caused you not to get sick, or is it your wearing of a mask that caused you not to get sick?
In the past it was both. But I don't think that currently it's about other people wearing masks because so few people seem to be doing it anymore. And as soon as the masks came off, and travel, restaurants, gatherings etc. resumed, Covid19 cases have soared amongst people I know, who had managed to avoid it for 2 years. That's why I now only wear N95's because they are the only type of mask that can protect the wearer. And protecting myself is how I protect my at-risk loved ones.
Agreed, Nick. And I'm a 24-year ER nurse on the front lines this whole time. Most of the time, mask wearing is no more than a face pacifier. There are a few exceptions (very few).
Anecdotal evidence is evidence, it's just not that compelling. But, for example in my field of exercise science where there is not a ton of research under which conditions for example best build muscle, being in the trenches lifting weights for years is extremely valid evidence. That being said, in areas where we have better evidence, we should lean on that. And, when we are considering a mandate that has both drawbacks and infringes on civil liberties, that bar of evidence should be quite high and the burden of proof to a medical intervention should be on the ones proposing the mandate. In this case anecdotal evidence is not compelling enough to support a mandate or take the choice out of the individual's hands. But, anecdotal evidence nonetheless is evidence that should not be ignored, but rather put into context with the other evidence.
No, it's not. Any individual's anecdote is not evidence. It's a story. Were you to collate thousands of stories, you would just have a bigger work of fiction.
This is how, for years, people insisted that homeopathy was a vaild treatment - the overwhelming weight of "anecdotal evidence," which has absolutely no relationship to the truth, which is, of course, that this form of treatment is worthless.
The belief that water is wet is based on stories, then. Also the belief that parachutes save lives.
And I am also trained in chemistry and physics and have done physics research.
Homeopathy has a deductive basis for some treatments. The intestines have a lot of immune function, so giving an allergen to the gut may "turn off" allergenicity in the skin and respiratory system. Apparently, there are journals of homeopathy where studies are published.
Lol. Homeopathy has been conclusively "debunked" from a scientific perspective.
Water is not "wet" based on stories, but by definition.
And parachutes can be demonstrated to save lives. And we got that way not by throwing people out of planes but by using makeshift parachutes on non-human items, so we could see how they slow the fall of an object.
I am sorry you don't understand evidence Tom, but if I were you, I would stop offering your opinion on anything until you do.
I suspect such a put-down is not warranted. We don't know each other well enough for that.
Feel free to suspect whatever you like. It's a free country. I stand by it.
"Lol. Homeopathy has been conclusively "debunked" from a scientific perspective."
You have managed to demonstrate that you understand neither science nor philosophy of science.
You, unfortunately, don't understand that "wetness" is a sensation, not a definition.
You say that parachutes have been demonstrated to save lives, but I have yet to see a RCT proving it. All of the evidence is anecdotal.
Discoveries of new species of birds are generally based on anecdotes of sightings.
Unfortunately, your epistemology and your metaphysics are lacking rather severely. You should have taken a course or two in philosophy.
I absolutely understand your point here. This is a very good takedown of reflexive rejection of observational evidence.
Thank you.
Most of our knowledge is based on observational evidence, isn't it? We don't have to get picky about the strength of evidence unless the observational evidence is doubted, such as occurs when someone has an alternative theory to explain the existing evidence.
Tom, there's nothing sadder than seeing a stupid man get desperate in his ridiculous arguments.
You have reached that point.
I pity you, but I will no longer respond to you - you have nothing of value to offer and I have no idea where you think I said you need an RCT to measure the value of a parachute? Because I didn't. That's in your La-La Land, not mine.
Run along now, I am sure you have plenty of windows that need licking.
I don't know about the rest of the readers here, but I think it is likely that you may have misunderstood one of the key ideas of this substack: civil and vigorous discussion of the ideas. You have the vigorous part, but I think you missed the civil part. I noticed that you made quite a few personal attacks on other commenters throughout this particular post of Adam's. Could you please dial it back a bit? Thanks!
Are you the Substack police, Marlon? I checked the authors for this Substack, you're not one of them.
So, feel free to mind your own business as I debate as I see fit. Thanks.
Ok, Oh Brainiac. Are you published in Philosophy of Science? I am. I guess that makes me "stupid" somehow.
While I appreciate (and agree with) your desire to focus on RCTs (and on your opinion on masks) I think it is unwise to ignore the experience of experts in the field. As Masic et. al cite "Evidence Based Medicine – New Approaches and Challenges", while EBM reduces the value of intuition, non-systematic clinical experience and pathophysiology as sufficient basis in making clinical decisions, and emphasizes the value of evidence obtained by clinical research, good doctors apply their clinical observation and experience, together with the best scientific evidence from medical literature.
They define EBM as the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information.
EBM categorizes different types of clinical evidence and ranks them according to the strength of their freedom from the various biases that beset medical research.
1. Evidences obtained by meta-analysis of several randomized controlled research (RCR).
1b. Evidences from only one RCR.
2a. Evidences from well designed controlled research RCR.
2b. Evidences from one quasi experimental research.
3. Evidences from non experimental studies (comparative research, case study), according to some, for example Textbooks.
4. Evidences from experts and clinical practice.
While it's not wise to reach conclusions on mere anecdote, it's an important first step in the process of evaluating evidence, which often leads to further inquiry, fine tuning hypothesis (which probably never ends), & eventually coming to a conclusion on better evidence.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789163/
Philosophy of Medicine thinks a little differently about EBM than most of the doctors who favor EBM. RCTs are not necessarily stronger evidence than observational studies. RCTs attempt to limit researcher bias involved in selecting subjects for treatment--RCTs have strong intrinsic linkage, but weak extrinsic linkage. Their test is great for the subject population tested, but conclusions often don't apply to the general population or to subgroups in the general population. RCTs only limit one type of bias and can be subject to many other biases. For example, designed-to-fail studies incorporate designer bias even in RCTs. Designer bias is often weightier than the bias from cherry-picking data.
https://plato.stanford.edu/entries/medicine/#RandContTriaEvidBaseMedi
I'm sure there are always different opinions. That doesn't change that meta-analysis of RCTs and RCTs themselves are widely accepted as superior to cohort studies, case control studies, cross sectional studies, case studies, & mechanistic studies.
Sure, everyone is free to engage in dodgy philosophy and ignore the writings of philosophers.
I would certainly be prepared to use anecdotes to inform the direction of any given aspect of research but to base real world decisions on them? Nope.
And in the instance of masks, I don't need anecdotes, I have overwhelming amounts of research that conclude they don't work - no need for a physician's gut feeling that they might. They don't.
Totally agree Nick, anecdotes are not a strong basis for making decisions. And, when we have better evidence, which when it comes to masks we do, we should prioritize that over anecdotal experiences. However, it is clear anecdotal experience from experts in the field is a form of evidence that any good practitioner should take into account. Usually those experiences should trigger folks to look for better evidence to help ensure recommendations are grounded in the best evidence we have, which of course in this case we know are 1) the 2 RCTs specific to Covid (Bangladesh & Danish mask trials), and 2) the 14 RCTs on other respiratory diseases that were completed pre-covid. In total of these 16 RCTs (2 on covid & 14 on other respiratory diseases), 14 of them failed to find a statistically significant difference to not masking. That means approximately 88% of the RCTs failed to find a statistically significant difference between masking and not masking while only 12% found modest significance. This should certainly trump any anecdotal experience and is not compelling evidence to support masks can prevent transmission of respiratory disease and covid.
Aren't parachutes based on anecdotal evidence? How about the belief that the sun rises in the east and sets in the west? How about the belief that we all will die some day?
I contend that anecdotal evidence informs the vast preponderance of our beliefs. RCTs can be valuable for investigating some small fraction of controversial questions where researcher bias may be an issue. Observational studies are valuable for investigating population groups where impact is high enough relative to the data to be able to test a hypothesis adequately.
Sounds like an argument just to talk. My point was anecdotal experience from experts in the field is a form of evidence that any good practitioner should take into account. Unless you're disagreeing with that, put your comment elsewhere.
I'm interested in epistemology, generally. It has been useful during the pandemic.
When I first read this in my email I threw it away with some amount of disgust. Then decided to come here and say something about it's lack of foundational science. It is as Nick has said; A. Cifu's point 'A' is purely anecdotal and has no business being invoked in such a discussion. As V. Prasad says over and over, "Show me the RCTs". And since he uses his point 'A' as a fundamental starting point, it negates the rest of the essay. I am very disappointed that "Sensible Medicine" would engage in just more posturing.
I think it was a great idea to write this for sensible medicine. It shows the various viewpoints and as a result exposes their strength and weaknesses.
I found the first argument pathetic, as did many of the other commenters, because it is based on anecdotal evidence. Or perhaps it is based on the parachute theory of masks.
Anyway, I found this article useful. And Dr Cifu did put a disclaimer up front for those who might not be able to stomach it...
You are 100% correct. This substack author only “likes” those who agree with him, apparently. I don’t think this is the place for me.
It's very odd that Dr. Cifu assumes away the critical question for masking: does it actually work? My understanding is that, aside from N95s in healthcare settings, there's no strong evidence whatsoever that they actually prevent disease. The 2 metastudies of RCTs from the WHO in 2019 and the CDC (!) in 2020 demonstrated this quite thoroughly. Of the only 2 RCTs conducted during the pandemic, DANMASK was also negative, while the Bangladesh study (that is flawed on so many levels, but that's for another day)) only showed an effect for surgical masks for certain age groups, while showing cloth masks were ineffective. Even studies on the effectiveness of masks in operating rooms don't reveal any effectiveness. Where exactly is the evidence that supports mandating masks?
Yes, I think the article is quite dishonest. It's weasily. It's positing possible value in very strict hospital setting to silently infer value that can be carried over to society at large.
Community masking is a completely different kettle of fish than N95ing-in-one-room-for-a-few-minutes-with-one-highly-contagious-deadly-patient.
And even IF masking were effective in a community context, I'd still be against it.
The pro-life attitude so derided by progressives against right-wingers, progressives themselves practice in other age groups.
Prevention of death is wonderful a the personal level.
When death prevention becomes the be-all and end-all of policy, then it is way wrong, and deserves no more respect than pro-life attitudes a birth.
"It's very odd that Dr. Cifu assumes away the critical question for masking: does it actually work?"
When decisions have an emotional basis, this is what happens.
"My understanding is that, aside from N95s in healthcare settings, there's no strong evidence whatsoever that they actually prevent disease."
Agree with your comment but would add that I haven't even seen strong evidence that N95s in healthcare setting stop or reduce transmission, hospitalization or death.
Exactly this: “Anecdotal evidence is not evidence. Your arguments for masks are all based on this. Masks do not, and cannot, by the laws of physics reduce respiratory infections.” Moreover beginning an argument (position) with regard to mask policies with this assumption (which Cifu declares is not debatable), is a poor basis for imposing a mask mandate/policy, and is exactly what PH did and consequently lost all public trust. Cifu’s premise is without foundation.
Thank you Nick, I agree completely. I don't wear a tin foil hat, I'm not a MAGA, nor a member of Q Anon, uneducated, etc., etc. Masking should not be normalized.
And this right here is what is wrong with this country.
What? Please explain your reply I don’t understand
Comments about masking policy turn into political and even more divisive conversation unnecessarily. The two should be independent of each other.
Definitely. Weird times, the blur of Science & medicine in the political deep end.
I've been watching science be blurred for two decades. Ever notice men pretending to be women convincing governments to give them opposite sex ids so these men can barge into lesbian spaces pretending to be lesbians, demand to be placed in women's prisons after raping and killing women, taking over medal podiums in women's sports...
and such venerable magazines as Nature and American Scientist going along with the "gender craze" pretending SEX is a social construct and that liking pink or blue is a signal that we are born in the wrong body???
Science has been a mess for a long time.
Before that I wrote blood testing kits quality control results for the FDA. We lied ALL THE TIME.
Before that. in the 90s, I worked in a lab testing the effects of Monsanto on frog deformities. All negative results were conveniently shelved.
Science has been a mess for a long time. People like Dr Paul Offit and others have written about the errors of science.
We haven't had "science" for a long time.
What we have is $cience.
If you’re conservative and are anti-mask you want to kill grandma. Same applies with the vaccine. That’s all I’ve heard for 2-1/2+ years. Covid was politicized from the beginning when Trump stopped travel from China. Shameful how off the rails it all went.
To be fair, we will all "get it" at some point. I'm also unvaxd and unmskd, I assume I've been exposed to very low viral loads here and there. My masked and vaxd younger coworkers have each had had it 2-3 times. So I KNOW I've been exposed. Yet I've not been sick. I'm assuming that my body is either dealing with it, or ejecting it (I am a monster sneezer and nose blower (post-nasal drip) but I've not been sick in a decade.
I work in health care. Despite masking with N95 I still caught Covid (delta strand) last year. It was mild. I wouldn’t even have known in had it if 1) I hadn’t had to test regularly at work and 2) I finally a week after testing + lost my sense of smell.
I believe the hubris of people believing they have more control than they do, has been magnified during this pandemic.
As for the anecdote about treating TB patients and a mask preventing the author from contracting, I have an alternative anecdote. When I was in grad school, one of my classmates who sat near me in every single class we had together & with whom I did multiple group projects with, had a horrible cough for most of 1 semester. We didn’t think anything of it, until she was hospitalized and passed away from TB towards the end of the semester. We were all required to be tested for TB on multiple occasions and none of us unmasked fellow students or instructors ever tested positive.
Me too. Multiple people symptomatically ill with positive covid-PCR tests have been around me and contaminating my work environment, yet I still haven't caught the bug without taking any stupid experimental shots or wearing the face diapers with pores many times greater size than viron particles.
Plenty of anecdotal evidence on both sides.