Pro mask or anti mask?

@Abstraction I think you're confusing policy with science

@SW-User I'm not confused, I'm educated. thanks for playing and confirming my last point. 0/10.

@Abstraction A person can be educated and still be wrong. Most government advice refers to the 'effectiveness of masks' when used as part of a comprehensive toolbox of other measures' - which is a neat way of saying that in the public domain, as currently used, they do very little at all (which isn't suprising given the conditions, qualifications and limited applicability you yourself allude to).

@Abstraction And are you sure you mean your last point?

"If discovering I was wrong is the pathway to discovering what is correct, how does that hurt me?"

@SW-User Yes, I really do. I don't care if I'm wrong, I don't have a political buy-in on this issue either way.
It could be a neat way of saying that, but in fact it's just you saying that.
Sure, we could have a debate about the word 'effectiveness' but I define it to mean that in the context of COVID that it plays a role vs it has virtually no effect. I don't think anyone would posit that a mask is the entire protection, I'm not sure anyone would suggest that other than as a straw man. Here is one part of a broader review of evidence:
"The study looked at the reduction of secondary transmission of SARS-CoV-2 in Beijing households by face mask use. It found that face masks were 79% effective in preventing transmission, if they were used by all household members prior to symptoms occurring."
(Y. Wang et al., Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: A cohort study in Beijing, China. BMJ Global Health 5, e002794 (2020) sourced from https://www.pnas.org/content/118/4/e2014564118#ref-10

79% does not equal 'very little at all.'
I'm not going to sit and list study after study - it's there in the link.

@Abstraction was prepared to be wrong but while the study says that it is the first evidence of the effectiveness of face masks (out of thousands of studies you've cherry picked this one). The article itself cites:
"World Health Organization and Public Health England recommend against UFMU on the grounds that there is little evidence from randomised controlled trials to support this. Some experts suggest that in a pandemic, the precautionary principle should be used"

That's a clue as to the standard of evidence required for something to be proven scientifically. A standard this study makes no pretence to meet and if the 'review' you read is relying on studies of this calibre to try and prove something it isn't worth a lot.

The results are:

The secondary attack rate in families was 23.0% (77/335). Face mask use by the primary case and family contacts before the primary case developed symptoms was 79% effective in reducing transmission (OR=0.21, 95% CI 0.06 to 0.79) and not significantly protective after symptom development

That's a very odd finding and a red flag that something isn't adding up here.

What were they doing wearing masks inside before the person knew that they were sick?

I have a number of methodical issues with the study, namely for a retrospective study relying on retrospective interviews, I cannot see how they would be able to separate out social distancing from hand hygiene from mask use, or quantify these in a meaningful way in a household setting. Nor determine exactly when people were infected.

Any type of mask? How often was it worn and in what conditions? None of these things are answered.


In design it is more anecdotal than scientific. Also if you're relying on this study to justify mask mandates globally, in which the vast majority of people forced to wear them are perfectly healthy (hint: role in reducing COVID spread in people without COVID is ZERO), shouldn't it have an n of more than 350 people and shouldn't it be in more than one very specific context?

Another way of reading the the reported findings is that 'mask wearing' in this context is many 100s of times less effective than keeping a basic distance, which was found to be 1800% effective in reducing transmission.

But thank you for clarifying just how great the lack of scientific evidence is. Cheers!

@SW-User
You quote a study by WHO. Here is their retraction:
https://www.reuters.com/article/factcheck-covid-masks-idUSL1N2LF1Y9
'Since the beginning of the pandemic, however, swathes of evidence have emerged suggesting that mask-wearing does reduce transmission of COVID-19. The WHO changed its guidance in favour of masks on June 5, 2020, stating: “We have new research findings…that if this is done properly it can provide a barrier ... for potentially infectious droplets.”

'The most up-to-date WHO advice on masks from Dec. 2020is clear that: “Masks are a key measure to suppress transmission and save lives.

“Masks should be used as part of a comprehensive‘Do it all!’approach including physical distancing, avoiding crowded, closed and close-contact settings, good ventilation, cleaning hands, covering sneezes and coughs, and more.”

The WHO advises that masks should be worn by the public in crowded settings or rooms with poor ventilation,but adds: “If you have any doubts,it’s safer to simply wear a mask.”

What I looked for was whether there is significant scientific evidence that masks are effective. I quoted one of the many studies incorporated into this document. Since you criticised the study by cherry picking an out of context statement of why there is only one such study ("Cochrane (7) and the World Health Organization (8) both point out that, for population health measures, we should not generally expect to be able to find controlled trials, due to logistical and ethical reasons") let's look at the rest of the study and its conclusions and sources:
"The science around the use of masks by the public to impede COVID-19 transmission is advancing rapidly. In this narrative review, we develop an analytical framework to examine mask usage, synthesizing the relevant literature to inform multiple areas: population impact, transmission characteristics, source control, wearer protection, sociological considerations, and implementation considerations. A primary route of transmission of COVID-19 is via respiratory particles, and it is known to be transmissible from presymptomatic, paucisymptomatic, and asympt omatic individuals. Reducing disease spread requires two things: limiting contacts of infected individuals via physical distancing and other measures and reducing the transmission probability per contact. The preponderance of evidence indicates that mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts. Public mask wearing is most effective at reducing spread of the virus when compliance is high. Given the current shortages of medical masks, we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies. Because many respiratory particles become smaller due to evaporation, we recommend increasing focus on a previously overlooked aspect of mask usage: mask wearing by infectious people (“source control”) with benefits at the population level, rather than only mask wearing by susceptible people, such as health care workers, with focus on individual outcomes. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation."

Then if you were like me and viewing whatever the evidence might say instead of simply trying to prove your point, you would have looked at the 141 references that they sourced.

Do I feel completely safe in the masks? Absolutely not, I've read sufficient studies to know the limitations. I've read enough to wear them in crowded places - you consider it would make no difference. We disagree, that's fine. You seem determined to prove either there is no evidence, or at least to prove me wrong. Perhaps I offended you and I confess I was tired and my first comment in retrospect was rude. I do apologise for that.

@Abstraction Well, that's ok because I didn't mean what you thought I meant, or say what I meant to say, which is why you thought I meant what I didn't mean
🤪 (my bad).

I had previously looked at the review study you talk about and dismissed it on the grounds that its inputs are individually flawed, and its unscientific agenda obvious, as I pointed out to you by actually looking at the methodology of the individual study you chose to highlight.

The WHO is a political organisation who if you listen to what they are actually saying, are admitting they're moving to a position whereby it is better to wear a cloth mask than not because it MIGHT make a difference. The evidence in laborotary and clinical setting can't just be applied to real world settings ... as they initially acknowledged.

I wasn't citing the WHO I was citing the study citing the WHO (the one you chose to highlight from the review article), and then showing how they systematically ignored what the WHO said would be needed to constitute scientific evidence for the effectiveness of masks on a population level. We are not talking a creative adaptation to get around the problems of obtaining real world data...

The study you chose to demonstrate a 78% protectiveness from mask wearing was a retrospective interview of 350 people, full of questionable methodology. The fact your review study included it should lead you to question their credibility and agenda. Garbage in, garbage out.

There have been 10s of thousands of studies done. 10s of thousands they could have chosen from.

You should question why they are strongly advocating government mandates, outside of the clinical and laboratory settings of the studies they looked at

If you process the section you yourself highlighted they recommend "increasing focus on a previously overlooked aspect of mask usage"

You don't think that's putting the cart before the horse somewhat?

They are essentially saying:

"We strongly recommend mask mandates in everyday public settings for whole populations AND that the missing evidence for this is found."

The fact the WHO later walked back their criteria for scientific evidence, isn't surprising.

These are the guys who told us not to shut our borders and that COVID wasn't infectious.

But governments are going way beyond WHO recommendations.

My issue is that they are being mandated in areas that there is clearly no evidence for, as COVID related beliefs become more and more cult-like, like wearing them outside.

When things become a matter of cult rather than science, scientific principles tend to get thrown out the window. The studies are being comissioned to find the evidence, rather than find the truth. The review study authors also acknowledge there is a significant body of research, showing the ineffectiveness of masks. And yet they strongly promote the use of cloth masks, despite the fact that studies showing masks can reduce droplets (and therefore likely spread) aren't based on cloth models, nor daily life conditions.

The precautionary principle, enough of a stretch in itself, has morphed into the "well we know it won't make a difference but it will help people remember that there is a pandemic." That's appallingly bad logic for a mandate!

Or healthy children are forced to tie dank bacteria breeding material to their faces for several hours a day despite the fact kids are more at risk from the flu.

And no, I think there is evidence medical grade masks can reduce transmission in certain settings, a crowded indoor place is probably one of them, if used correctly

Those are huge qualifications. The likelihood an untrained person using a mask correctly in daily life conditions when mandated for all situations outside a home are next to zero, especially when the use is not voluntary.

I am asking myself if the chances of someone having COVID in that setting is 0.03% and my chances of getting COVID from a passing encounter is 1 in 100, and wearing a medical grade mask correctly would cut that risk by say 20% -80% how many years am I willing to keep wearing a mask for, after say, already reducing the risk in a far more significant manner by getting vaccinated? For an endemic virus that if I experience symptoms at all, I'm unlikely to get seriously ill from?

The answer is zero, willingly. I'm already re- wearing reusable masks several times and the masks get damp within minutes.

Another real world reality check. Masks, even medical grade, dont work once damp.

I have also been in several situations where social distancing is sacrificed because people are moving closer to try and figure out WTF I'm saying under the muffling of the mask.

Similar logic can be applied for 'protecting others'