Aye, there is a lot to unpack about the "do masks work, and why or why not?" issue. I have never much liked the "mosquito flying through a chain-link fence analogy" myself, since as you point out those mosquitos are riding on aerosol particles. So maybe it is more like ants riding on balls trying to get through a chain-link fence? Of course then one has to wonder what balls... tennis balls? Lacrosse? Ping-pong?
I think the Fauci "No need for masks. SYKE!" was the worst part, although the "No, any mask will do! Wrap a hankie around your face, that's fine" was probably close in terms of "Did anyone bother to test this at all?" I know lots of people who were sewing masks to help people, and good on them, but did those masks actually do anything other than lull people into a false sense of security? Was claiming cloth masks were ok just a move from "no masks is ok," something known to be false but got people to do what they wanted?
My sense is that only the higher quality masks make much of a difference, and only if they are worn perfectly for relatively short periods of time (no reusing), such that 80+% of what we were forced to do was zero value.
But then again, some people's common sense said slam on a mask, maybe multiple, and fear and loathe anyone who doesn't. I don't think we will know until some more serious studies happen instead of the stupid "well, we simulated this" crap we keep getting. Otherwise we might as well be handing out tube sock condoms.
If masks worked, we'd have seen an unambiguous signal in the data by now. To the contrary, infection numbers and hospitalizations are blissfully independent of whether a given district had a mask mandate (or any other "non-pharmaceutical intervention", for that matter). There's also the Danish mask study, which found no statistically significant effect with a very large N, as well as numerous previous studies which likewise found that masks are ineffective (there are a few recent studies that did find a tiny effect, but given current political incentives I'm just a touch skeptical of the purity of the researchers' intentions in this cases.)
The absence of compelling evidence for the effectiveness of masks suggests that the basic inference that viral particle diameter << mask weave gap ,'. masks are ineffective is probably true, and arguments to the contrary are basically just cope to avoid the conclusion that we've all been taken for an utterly futile ride for two years.
Literally none of what you just wrote has anything to do with whether mask mandates can be effective at a population level. The simple truth is they weren't. You can split hairs and try to find copies for why akshually your own neurotic, high-conscientiousness behavior was effective, and the only reason they didn't work at a population level is that people are stupid. So, ok? Maybe? But at the end of the day any efficacy is buried down at the level of statistical noise so you're basically grasping at straws and the zeroth-order, Occam's razor explanation for that is that viral particles are really, really tiny and masks do diddly to prevent their circulation. But hey if it helps your self-image and faith in authorities cope away my man.
Do masks work? Both of you say no if we stipulate they are not worn perfectly. John says they don't work period, although I think he would agree that some of the more unpleasant to wear masks do something while most of the masks people actually wear don't do much. WiP says N95 work, and maybe lesser masks, if they are worn carefully.
I say that is down to an empirical question that requires testing to determine how well they actually work to stop aerosols. It isn't the sort of thing we can really logic out through first principles, because we are talking about whether the effectiveness is 90% or 9% or somewhere in between. Our big open world test tells us they don't work as well as we might hope, but there are tons of confounds in play, so we can't be sure if they don't work at all, don't work if they aren't worn right, or only really restrictive types work. We do know that mask mandates didn't work, but we don't know how much of that is because masks don't work or mandates don't work. I lean more on "masks are less effective than people believe" but there is lab work to be done.
That surgeons in mask point is making me think a little. When did surgeons start wearing masks? Did they start living longer at that point, or die young before? Didn't surgeons mostly wear masks to keep them from infecting the patient's new open concept body, not themselves? What would cause a surgery patient to spray aerosolized juices around? Electric bone saw? Is the main need for keeping arterial spray off the surgeon's face?
Regarding surgeons specifically, I recall reading that there were studies done comparing patient outcomes with and without the team wearing surgical masks, which found that there was no particular benefit in that case, either. That said, I haven't read those studies myself, and don't know what their quality level was. The implication though was that it was more of a courtesy than anything - no one wants the surgeon's spittle in their open wound, ick.
That raises an interesting question: do viruses need to hitch a ride on droplets or aerosolized particulates, or can they be free-floating? Which is an entirely different question from "can they". They obviously can, and that is obviously a (not necessarily the) transmission mechanism, and that is obviously how they will generally be expelled from an animal body into the environment since our bodies are basically big water sacks. But it doesn't follow that they need to. Thinking of them as just another type of particulate matter, a free-floating virion should have no more difficulty floating in the air than any other particulate, and indeed should remain suspended longer than a droplet. On the other hand, there could be other environmental factors e.g. chemical reactions between the gaseous components of the atmosphere and the viral envelope that denature the latter more rapidly than would be the case if not protected in a droplet (although the fact that virii survive longer on dry than on moist surfaces argues against that). There's also the detection of viral particles at extremely high altitudes, where droplets certainly don't exist (but, there is a bit of dust, e.g. from meteor precipitation).
Anyhow I just spent several minutes poking around trying to get a clear answer, and couldn't, so for me that remains an open question. If you're aware of evidence demonstrating that viral particles cannot survive in aerosolized form unless hitching a ride on something, I'm interested to see it.
Back to masks and droplet transmission, though. It's true masks will catch the droplets. Without a mask, the droplets enter the air directly and settle fairly rapidly to the ground, thus removing the trapped virii from the air. With a mask, the trapped moisture evaporates in the mask weave, and subsequent breathes can then plausibly push the viral particles into the atmosphere. If they can survive without a droplet, that can then become a transmission mechanism. Similarly, infected droplets landing on the mask could lead to inhalation of viral particles following evaporation. I don't know if that is the case, but if so it could explain why masks are ineffective at a population level: one vector basically gets replaced with another, and the two effects cancel out.
That actually makes me wonder how much masks make you more likely to infect yourself.
Imagine you get a small viral load the normal way. Some get stuck in your various mucous defenses, and some get into your respiratory track and start multiplying as they do.
Then you put on your mask and go about your day, coughing into the mask, getting a little nose butter in there, etc. Assume for the sake of argument that the mask stops everything from getting out.
Then you breath back in, and suck those bits of spit and snot back in, along with any little particles of virus that dried out. Instead of the normal situation where your body would have expelled the little buggers and they would have wound up on the floor or wherever, now they get a second chance at infecting you, increasing your viral load compared to not wearing the mask.
That's kind of a funny thought... not haha funny exactly, but the sort of thing people might not think to test but could be a big issue if people are wearing the same mask for hours on end, and possibly over multiple days. If the body's first layer of protection is catching viruses and ejecting them from the body, putting a cover over the ejection port might be a bad idea conditional on having already gotten the virus.
Thinking more, that might be a real concern when treating patients or isolating at home: wearing a mask when you are self quarantining might make you sicker over time? Hmmm...
That lack of correlation between mandates and infection rates bothers me too. I can see there being a lot of noise, between the crappy testing, horrible death tally’s, improper mask types, and masks improperly worn, etc. but still, you’d expect something better than “eh... maybe it looks like they helped a tiny bit?” If the effect is small enough to get swamped it makes me think it almost certainly wasn’t worth the trade off, although admittedly that is a lot of swamp to get lost in. Some proper scientific studies would seem in order, because you know the next time there is a bad flu season mask mandates are coming back. Maybe this time they will recommandate we duct tape all the edges down for a proper seal, and maybe add some over the mouth and nose just to be sure :)
That is a little bit more of a rabbit hole than intuition would have us believe. I don't know a whole lot about the matter, other than some of what Ivar Cummings and the bloke over at Naked Emperor has written, but a few things seem to be in play there.
1: Masks help a bit.
2: People were super careful to isolate themselves when they had flu like symptoms, far more than usual.
3: People weren't going to many group functions and events, far fewer than usual. Lots of people were working from home, too.
4: The second kids had any sort of symptom the schools sent them home.
5: Lots of flu cases might have gone undiagnosed as people couldn't go to the doctor with them, and just stayed home.
6: COVID and the flu are competitors in the same space, and COVID pushed the flu out.
1-5 are basically "people were super careful, in a way that would be called over the top paranoid with regular flu seasons, so didn't get the flu at a high cost where we usually accept some flu at much lower costs."
Number 6 is where it gets interesting and I don't know enough outside of Cummings and N.E.'s writing, but would like to know more. Apparently it is pretty standard for types of cold and flu to push each other out over time; that's one reason why there is a different flu shot to get every year. It isn't just the same virus mutating a little bit, but a lot of viruses doing similar things, rather more like lions and hyenas competing for the same territory and food source and pushing each other out in some cases. That can't be a great analogy, but that's what I've got.
If that's the case, it might be that the niche of "human upper respiratory infections" has been largely taken over by COVID and will continue to be: COVID IS the new flu. We had a flu season, and COVID was its name. O.
Again, I am not well versed in the facts there, and numbers 1-5 are definitely doing a lot of work to mitigate the normal flu season numbers. Still, the notion that endemic COVID might look like flu season that ignores children and is slightly rougher on older people is interesting, and might be a positive change on net.
Looked up the Huxley quote, and it seems to be real.
Speaking of quotes, this by CS Lewis seems relevant to your closing remarks:
"Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience."
Perhaps I should have remphasized more strongly that, indeed, learning how to do science effectively requires quite a bit of study and training, precisely because naive intuition can yield nonsensical predictions when applied in overly novel contexts. This piece is an important qualifier that people should certainly keep in mind.
Ugh that quote is guilting me into writing draft 7 of the THS / 1984 piece.... thanks for reminding me and everyone else of it. Lewis is really under rated.
A bit late to the party here. This issue - science vs. common sense - is one of those questions where the brain kind of jumps around from one aspect to the other, and kind of helplessly comes to the conclusion: well, urm, yes and no... Or so it seems to me.
Just to add 2 thoughts here: first, maybe learning is not so much (or not only) about applying certain things to other things, but more like "tuning into something" with the help of a teacher, book, etc. That's been my understanding of McGilchrist's quote, and also my experience.
Second, I think we are somewhat handicapped by the fact that "all men are equal" has been drilled into us for a long time. It is just not true. Hence, what one man calls common sense can be sheer lunacy, while another's man's common sense can be the expression of timeless knowledge from the depths of his soul, which we should give precedence over any "study" or scientific thought until we have matured enough to really grasp what this guy is saying and to be able to think it through based on the right mindset. I think this makes many studies in psychology problematic, because you can have a group that wildly differs in wisdom and deep, intuitive understanding, something which is hardly measurable and controllable. (I would call it spiritual development, but you don't have to go down that route if you don't like.)
Gash, I just made it even more complicated I guess.
Aye, there is a lot to unpack about the "do masks work, and why or why not?" issue. I have never much liked the "mosquito flying through a chain-link fence analogy" myself, since as you point out those mosquitos are riding on aerosol particles. So maybe it is more like ants riding on balls trying to get through a chain-link fence? Of course then one has to wonder what balls... tennis balls? Lacrosse? Ping-pong?
I think the Fauci "No need for masks. SYKE!" was the worst part, although the "No, any mask will do! Wrap a hankie around your face, that's fine" was probably close in terms of "Did anyone bother to test this at all?" I know lots of people who were sewing masks to help people, and good on them, but did those masks actually do anything other than lull people into a false sense of security? Was claiming cloth masks were ok just a move from "no masks is ok," something known to be false but got people to do what they wanted?
My sense is that only the higher quality masks make much of a difference, and only if they are worn perfectly for relatively short periods of time (no reusing), such that 80+% of what we were forced to do was zero value.
But then again, some people's common sense said slam on a mask, maybe multiple, and fear and loathe anyone who doesn't. I don't think we will know until some more serious studies happen instead of the stupid "well, we simulated this" crap we keep getting. Otherwise we might as well be handing out tube sock condoms.
If masks worked, we'd have seen an unambiguous signal in the data by now. To the contrary, infection numbers and hospitalizations are blissfully independent of whether a given district had a mask mandate (or any other "non-pharmaceutical intervention", for that matter). There's also the Danish mask study, which found no statistically significant effect with a very large N, as well as numerous previous studies which likewise found that masks are ineffective (there are a few recent studies that did find a tiny effect, but given current political incentives I'm just a touch skeptical of the purity of the researchers' intentions in this cases.)
The absence of compelling evidence for the effectiveness of masks suggests that the basic inference that viral particle diameter << mask weave gap ,'. masks are ineffective is probably true, and arguments to the contrary are basically just cope to avoid the conclusion that we've all been taken for an utterly futile ride for two years.
Literally none of what you just wrote has anything to do with whether mask mandates can be effective at a population level. The simple truth is they weren't. You can split hairs and try to find copies for why akshually your own neurotic, high-conscientiousness behavior was effective, and the only reason they didn't work at a population level is that people are stupid. So, ok? Maybe? But at the end of the day any efficacy is buried down at the level of statistical noise so you're basically grasping at straws and the zeroth-order, Occam's razor explanation for that is that viral particles are really, really tiny and masks do diddly to prevent their circulation. But hey if it helps your self-image and faith in authorities cope away my man.
I think you guys are in violent agreement here.
Do mask mandates work? Both of you say no.
Do masks work? Both of you say no if we stipulate they are not worn perfectly. John says they don't work period, although I think he would agree that some of the more unpleasant to wear masks do something while most of the masks people actually wear don't do much. WiP says N95 work, and maybe lesser masks, if they are worn carefully.
I say that is down to an empirical question that requires testing to determine how well they actually work to stop aerosols. It isn't the sort of thing we can really logic out through first principles, because we are talking about whether the effectiveness is 90% or 9% or somewhere in between. Our big open world test tells us they don't work as well as we might hope, but there are tons of confounds in play, so we can't be sure if they don't work at all, don't work if they aren't worn right, or only really restrictive types work. We do know that mask mandates didn't work, but we don't know how much of that is because masks don't work or mandates don't work. I lean more on "masks are less effective than people believe" but there is lab work to be done.
That surgeons in mask point is making me think a little. When did surgeons start wearing masks? Did they start living longer at that point, or die young before? Didn't surgeons mostly wear masks to keep them from infecting the patient's new open concept body, not themselves? What would cause a surgery patient to spray aerosolized juices around? Electric bone saw? Is the main need for keeping arterial spray off the surgeon's face?
Anyway, an interesting comment.
Regarding surgeons specifically, I recall reading that there were studies done comparing patient outcomes with and without the team wearing surgical masks, which found that there was no particular benefit in that case, either. That said, I haven't read those studies myself, and don't know what their quality level was. The implication though was that it was more of a courtesy than anything - no one wants the surgeon's spittle in their open wound, ick.
That raises an interesting question: do viruses need to hitch a ride on droplets or aerosolized particulates, or can they be free-floating? Which is an entirely different question from "can they". They obviously can, and that is obviously a (not necessarily the) transmission mechanism, and that is obviously how they will generally be expelled from an animal body into the environment since our bodies are basically big water sacks. But it doesn't follow that they need to. Thinking of them as just another type of particulate matter, a free-floating virion should have no more difficulty floating in the air than any other particulate, and indeed should remain suspended longer than a droplet. On the other hand, there could be other environmental factors e.g. chemical reactions between the gaseous components of the atmosphere and the viral envelope that denature the latter more rapidly than would be the case if not protected in a droplet (although the fact that virii survive longer on dry than on moist surfaces argues against that). There's also the detection of viral particles at extremely high altitudes, where droplets certainly don't exist (but, there is a bit of dust, e.g. from meteor precipitation).
Anyhow I just spent several minutes poking around trying to get a clear answer, and couldn't, so for me that remains an open question. If you're aware of evidence demonstrating that viral particles cannot survive in aerosolized form unless hitching a ride on something, I'm interested to see it.
Back to masks and droplet transmission, though. It's true masks will catch the droplets. Without a mask, the droplets enter the air directly and settle fairly rapidly to the ground, thus removing the trapped virii from the air. With a mask, the trapped moisture evaporates in the mask weave, and subsequent breathes can then plausibly push the viral particles into the atmosphere. If they can survive without a droplet, that can then become a transmission mechanism. Similarly, infected droplets landing on the mask could lead to inhalation of viral particles following evaporation. I don't know if that is the case, but if so it could explain why masks are ineffective at a population level: one vector basically gets replaced with another, and the two effects cancel out.
That actually makes me wonder how much masks make you more likely to infect yourself.
Imagine you get a small viral load the normal way. Some get stuck in your various mucous defenses, and some get into your respiratory track and start multiplying as they do.
Then you put on your mask and go about your day, coughing into the mask, getting a little nose butter in there, etc. Assume for the sake of argument that the mask stops everything from getting out.
Then you breath back in, and suck those bits of spit and snot back in, along with any little particles of virus that dried out. Instead of the normal situation where your body would have expelled the little buggers and they would have wound up on the floor or wherever, now they get a second chance at infecting you, increasing your viral load compared to not wearing the mask.
That's kind of a funny thought... not haha funny exactly, but the sort of thing people might not think to test but could be a big issue if people are wearing the same mask for hours on end, and possibly over multiple days. If the body's first layer of protection is catching viruses and ejecting them from the body, putting a cover over the ejection port might be a bad idea conditional on having already gotten the virus.
Thinking more, that might be a real concern when treating patients or isolating at home: wearing a mask when you are self quarantining might make you sicker over time? Hmmm...
That lack of correlation between mandates and infection rates bothers me too. I can see there being a lot of noise, between the crappy testing, horrible death tally’s, improper mask types, and masks improperly worn, etc. but still, you’d expect something better than “eh... maybe it looks like they helped a tiny bit?” If the effect is small enough to get swamped it makes me think it almost certainly wasn’t worth the trade off, although admittedly that is a lot of swamp to get lost in. Some proper scientific studies would seem in order, because you know the next time there is a bad flu season mask mandates are coming back. Maybe this time they will recommandate we duct tape all the edges down for a proper seal, and maybe add some over the mouth and nose just to be sure :)
That is a little bit more of a rabbit hole than intuition would have us believe. I don't know a whole lot about the matter, other than some of what Ivar Cummings and the bloke over at Naked Emperor has written, but a few things seem to be in play there.
1: Masks help a bit.
2: People were super careful to isolate themselves when they had flu like symptoms, far more than usual.
3: People weren't going to many group functions and events, far fewer than usual. Lots of people were working from home, too.
4: The second kids had any sort of symptom the schools sent them home.
5: Lots of flu cases might have gone undiagnosed as people couldn't go to the doctor with them, and just stayed home.
6: COVID and the flu are competitors in the same space, and COVID pushed the flu out.
1-5 are basically "people were super careful, in a way that would be called over the top paranoid with regular flu seasons, so didn't get the flu at a high cost where we usually accept some flu at much lower costs."
Number 6 is where it gets interesting and I don't know enough outside of Cummings and N.E.'s writing, but would like to know more. Apparently it is pretty standard for types of cold and flu to push each other out over time; that's one reason why there is a different flu shot to get every year. It isn't just the same virus mutating a little bit, but a lot of viruses doing similar things, rather more like lions and hyenas competing for the same territory and food source and pushing each other out in some cases. That can't be a great analogy, but that's what I've got.
If that's the case, it might be that the niche of "human upper respiratory infections" has been largely taken over by COVID and will continue to be: COVID IS the new flu. We had a flu season, and COVID was its name. O.
Again, I am not well versed in the facts there, and numbers 1-5 are definitely doing a lot of work to mitigate the normal flu season numbers. Still, the notion that endemic COVID might look like flu season that ignores children and is slightly rougher on older people is interesting, and might be a positive change on net.
Looked up the Huxley quote, and it seems to be real.
Speaking of quotes, this by CS Lewis seems relevant to your closing remarks:
"Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience."
Perhaps I should have remphasized more strongly that, indeed, learning how to do science effectively requires quite a bit of study and training, precisely because naive intuition can yield nonsensical predictions when applied in overly novel contexts. This piece is an important qualifier that people should certainly keep in mind.
Ugh that quote is guilting me into writing draft 7 of the THS / 1984 piece.... thanks for reminding me and everyone else of it. Lewis is really under rated.
Guy was a prophet. Have you read the space trilogy?
A bit late to the party here. This issue - science vs. common sense - is one of those questions where the brain kind of jumps around from one aspect to the other, and kind of helplessly comes to the conclusion: well, urm, yes and no... Or so it seems to me.
Just to add 2 thoughts here: first, maybe learning is not so much (or not only) about applying certain things to other things, but more like "tuning into something" with the help of a teacher, book, etc. That's been my understanding of McGilchrist's quote, and also my experience.
Second, I think we are somewhat handicapped by the fact that "all men are equal" has been drilled into us for a long time. It is just not true. Hence, what one man calls common sense can be sheer lunacy, while another's man's common sense can be the expression of timeless knowledge from the depths of his soul, which we should give precedence over any "study" or scientific thought until we have matured enough to really grasp what this guy is saying and to be able to think it through based on the right mindset. I think this makes many studies in psychology problematic, because you can have a group that wildly differs in wisdom and deep, intuitive understanding, something which is hardly measurable and controllable. (I would call it spiritual development, but you don't have to go down that route if you don't like.)
Gash, I just made it even more complicated I guess.