coronavirus

[cherrypoptart]

"I want the person with covid to be wearing the mask."

And the problem from the beginning, the totally obvious problem that our CDC was too oblivious to admit to the public even though it was readily apparent, is that nobody knows who has it because so many with it are asymptomatic.

And that's why everyone needs to be wearing a mask.

The vaccinations had the same problem in America because nobody could tell who was really vaccinated and who wasn't and that was even before it became obvious that vaccinations weren't stopping the spread of delta.

Y'all are just too generous about the mistakes our government has made. They seemed obvious enough to everyone else in the world especially in Asia. Do people really think our guys are smarter than everyone else or that we knew and still know something that they didn't and don't?

That seems very unlikely compared to the possibility that our government often operates with politics in mind more than public safety.  That goes many times over for Republicans compared to Democrats but the Democrats are guilty of it too. I give none of them a pass. And we see the results of their mistakes in the infection rates, hospitalizations, and death.

Our government's primary concern is always the same: Don't create a panic. That overrides everything else. Facts. Truth. Common sense. Don't worry about any of that. The main thing is "Don't create a panic." The panic might be worse than the disaster itself. That's a very common theme in disaster fiction shows and movies and boy do they get that part right. Seeing it in action though in real life just gets incredibly frustrating when the lies (like masks won't help you) and the motivation behind them are just so transparent.

There's only so much you can do about Republican states like Florida and Texas but Hawaii was having great success doing everything right and then the CDC came along passing out rose colored glasses to everyone instead of tests and masks and we see the results.

[alai]

I expect that the effectiveness of masks will probably be linked to the details of the indoor space in which they're used. In a small office with a lot of foot traffic, or even a classroom with 30 students, the aerosolized particles can probably become dense enough to create a risk, such that reducing the absolute quantity of them with masks will make a difference. In a larger space such as a grocery store, cafeteria, or even larger office space, the density of particles may be dispersed enough that the air circulation can more or less keep the amount in the air in check. That would be my guess, anyhow, as I've not looked for data on this. But it could explain why certain amounts of mask use might not have much of an effect on the total infection numbers and deaths, which is not the same as saying masks are useless. In some more closed environments I think you'd be pretty crazy to want to be near unmasked, potentially infectious sick people, no matter the ailment.

There's a whole lot of potential variables here, and I'd want to see some sort of factoral study or at least a detailed modeling exercise before I idly expended too much mental effort trying to second-guess how it might break down.  But if you're going to measure "mask effectiveness" as person-hours spent wearing them as a ratio against reduction in cases (or aggregated case-severity if you want to get fancier), then possible contributions to this might be:-

• Over-cautious mask-wearing.  Wearing them when there's great ventilation, good social distancing, no cases (teh irony), and so on.  Harmless, and for me "nice problem to have", but is doing to have the effect of diluting the pro-rata benefit, if that's how you're looking it.
• Mask-induced lack of caution.  This was an early worry, and it might still be a factor, but I suspect it's more than countervailed by the 'perceived risk; clustering effect:  the people that see themselves at risk (or otherwise give a damn, but people being people, risk to oneself is the main driver) are broad-spectrum careful about masks, distancing, hygiene, vaccination, etc, and contrariwise the broad-spectrum reckless.
• Poor mask hygiene and incorrect use.  If you're sloppy about using them, you can reduce the effectiveness, and if you try really hard, you can misuse them to the point of increasing the spread of the virus.

[ScottF]

https://www.medrxiv.org/content/10.1101/2021.08.10.21261726v1

Science that shows masking reduces spread in schools.

It shows no such thing. Keep in mind, I'm not disputing the underlying claim which could very well be true.

Show me science based on real-world RCT data and I'd be much more persuaded. I stopped buying into model-driven "science" over a year ago when the IHME models around hospital and ventilator demand were so wildly wrong it was staggering.

[ScottF]

One indeed has to choose one's words carefully and specifically to avoid the large heffalump traps of lots of evidence on the effectiveness of masks, by declaring things like "RCT or it didn't happen", "not conclusive", etc.

Nah, we don't even need RCTs to reach that conclusion - just have to look at the wild variance in case results across countries and states with similar/disparate levels of mask mandates and compliance. It's self-evident that mask mandates have not been conclusively proven to have a material difference in the spread.

Again, not even arguing whether masks "work". Just looking at real-world trends and concluding there is literally no direct correlation in the benefits of mask mandates that can't be countered with data showing they have no effect.

[ScottF]

I seem to recall some around here being adamant that vaccines obviously offered better protection than natural immunity.

Here's some non-model based "science" that indicates otherwise.

"The newly released data show people who once had a SARS-CoV-2 infection were much less likely than vaccinated people to get Delta, develop symptoms from it, or become hospitalized with serious COVID-19."

“It’s a textbook example of how natural immunity is really better than vaccination,” says Charlotte Thålin, a physician and immunology researcher at Danderyd Hospital and the Karolinska Institute who studies the immune responses to SARS-CoV-2. “To my knowledge, it’s the first time [this] has really been shown in the context of COVID-19.”

https://www.sciencemag.org/news/2021/08/having-sars-cov-2-once-confers-much-greater-immunity-vaccine-no-infection-parties

[Fenring]

[li]Over-cautious mask-wearing.  Wearing them when there's great ventilation, good social distancing, no cases (teh irony), and so on.  Harmless, and for me "nice problem to have", but is doing to have the effect of diluting the pro-rata benefit, if that's how you're looking it.[/li][/list]

It's not really a question of how *I'm* looking at it. I was responding to a discussion about a claim that data may suggest mask vs non-mask has no discernible difference in net effect by population. The reason to look at pro-rata benefit is only to inspect a claim like this and try to explain it.

• Mask-induced lack of caution.  This was an early worry, and it might still be a factor, but I suspect it's more than countervailed by the 'perceived risk; clustering effect:  the people that see themselves at risk (or otherwise give a damn, but people being people, risk to oneself is the main driver) are broad-spectrum careful about masks, distancing, hygiene, vaccination, etc, and contrariwise the broad-spectrum reckless.

Again, you can take a look at micro-effects that will vary person to person, but ScottF was reflecting on how only the actual real-world results matter. The sort of micro-analysis you just provided won't provide anything in terms of explain widespread population-level effects; or at least not in an intelligible way.

• Poor mask hygiene and incorrect use.  If you're sloppy about using them, you can reduce the effectiveness, and if you try really hard, you can misuse them to the point of increasing the spread of the virus.

This actually ends up being an argument against masks, rather than for masks. Blaming a net zero mask effect on user error just means it's an ineffective measure, if this is indeed a significant factor. In fact the more significant a factor it is, the more it argues against masks since they won't be employed properly. This could only be remedied by large-scale training and standard-enforcing programs which are...not going to happen.

[alai]

And the problem from the beginning, the totally obvious problem that our CDC was too oblivious to admit to the public even though it was readily apparent, is that nobody knows who has it because so many with it are asymptomatic.

Not from the beginning.  There was much discussion before there was any strong evidence and consensus on this, at least that it was occurring to any large degree.

Y'all are just too generous about the mistakes our government has made. They seemed obvious enough to everyone else in the world especially in Asia. Do people really think our guys are smarter than everyone else or that we knew and still know something that they didn't and don't?

Rest of the world here (though not Asia), and we didn't say that.  Much less do it.  Though full disclosure, generally speaking you do kinda seem to act that way.  "We do things differently here because everyone else is wrong."  Even in cases where judging by results, you're the people who're wrong, and even in cases where you don't actually do things differently at all!

But in all fairness, I've seen a lot of the world make a lot of the same mistakes the US made on covid.  You even have a few rivals for making them all at once, and a few more besides.  (Looking at you, Bolsonaro, Lukashenko, etc.)  And on masks, the initial science -- or best available initial guesses of scientists in the field, TBF often the 'first rough draft' of science -- on this really was unclear.  There's one prominent (as in barely off the TV and the radio here) Irish scientist, Luke O'Neill, who initially was pretty strongly against masks.  When the evidence on that changed, he equally prominently publicly changed his mind on that.  Which is correct practice for any scientist, and a pretty good life skill for humans generally.  Less common in both than you'd hope, it must be said.

There's only so much you can do about Republican states like Florida and Texas but Hawaii was having great success doing everything right and then the CDC came along passing out rose colored glasses to everyone instead of tests and masks and we see the results.

Had a wry chuckles to myself at that image.  I guess the rose-tinted specs might have a small value as eye-guards?  Those of you with hay fever will testify that is a route of infection (rather than transmission), as it's all plumbed together back there.  Like those people who when asked by stores to wear a "face covering", instead of a simple cloth or paper mask don an elaborate and near-useless plastic visor.  Which they then make entirely ineffective by tilting up to a rakish 60 degrees from the vertical.

[ScottF]

Blaming a net zero mask effect on user error just means it's an ineffective measure, if this is indeed a significant factor. In fact the more significant a factor it is, the more it argues against masks since they won't be employed properly. This could only be remedied by large-scale training and standard-enforcing programs which are...not going to happen.

Yup.

[alai]

I seem to recall some around here being adamant that vaccines obviously offered better protection than natural immunity.

Sauce please?  I've seen some "adamant that it was obvious" posts on this topic, but entirely from the "natural" (as they insist on incorrectly using to describe "acquired through catching the disease") immunity boosterists.

Here's some non-model based "science" that indicates otherwise.

Hey, I realize it's only a preprint (meaning for those uninitiated in the eldritch mysteries of academic publishing, not formally published yet, generally due to non-completion of peer review), but not clear why "science" would need scarequotes here.  Perhaps this was a poorly targeted attempt at further snark about modelling?  (Bonus hint, not everything that's not an RCT is "modelling".)

[alai]

Again, you can take a look at micro-effects that will vary person to person, but ScottF was reflecting on how only the actual real-world results matter.

I think ScottF was, more accurately, looking to exclude pretty much any sort of evidence he didn't care for.  Including observational studies (which are eminently "real-world" but not RCTs), as well as anything that might be dubbed tainted by the sin of Modelling.

This actually ends up being an argument against masks, rather than for masks. Blaming a net zero mask effect on user error just means it's an ineffective measure, if this is indeed a significant factor.

What net-zero mask effect?  I'd have to be shown to exist for me to want to explain it!  I was pretty explicitly talking about factors that dilute the overall benefit.

In fact the more significant a factor it is, the more it argues against masks since they won't be employed properly. This could only be remedied by large-scale training and standard-enforcing programs which are...not going to happen.

My expectations about the likely benefits of information and enforcement are modest, but maybe not quite as rock-bottom as yours.  People that haven't got the basics by now likely aren't going to (or indeed, don't want to), and if I were a store employee on a very modest wage, I'm not sure I'd be keen on picking fights with (possible angry culture-warrior) people who, having at least been badgered into kinda-sorta wearing a mask, are then not effectively covering their airways with it, are merrily (potentially) cross-contaminating from it, etc.

[alai]

Nah, we don't even need RCTs to reach that conclusion - just have to look at the wild variance in case results across countries and states with similar/disparate levels of mask mandates and compliance. It's self-evident that mask mandates have not been conclusively proven to have a material difference in the spread.

Well, it's certainly evidently some of us don't.  Some of us may have reached that destination before any evidence whatsoever put its socks on in the morning, much less left the house.

Again, not even arguing whether masks "work". Just looking at real-world trends and concluding there is literally no direct correlation in the benefits of mask mandates that can't be countered with data showing they have no effect.

I already gave you (peer-reviewed, published) research on this:  counter away.  Thus far we're just getting anecdotes, narrative, linguistic hedges ("significant", "material", "conclusive" -- i.e. there's evidence, but I can move the fuzzy goalposts to ignore it), and assertions.  My parsnips remain entirely unbuttered.

[Fenring]

What net-zero mask effect?  I'd have to be shown to exist for me to want to explain it!  I was pretty explicitly talking about factors that dilute the overall benefit.

We were afaik responding to ScottF making a claim that real-world numbers show mask vs non-mask using has a net zero effect. You appeared to be responding to that by suggesting reasons it could be so. So that's the claim we're talking about. I don't know if it's accurate...I'm not the world.

[alai]

We were afaik responding to ScottF making a claim that real-world numbers show mask vs non-mask using has a net zero effect.

Ah, but that wasn't his claim!  It was that:  "There is no conclusive science or data that indicates mask mandates have had any significant effect on the spread of the virus. Notice I'm very careful and specific with my words here."  And while he wasn't being in the least bit specific, I think "careful" part pretty was telegraphed.  If something true, and there's evidence that it's true, but you wish the minimise that appearance, saying "no conclusive evidence that it's significantly true" is a useful worm of words.

You appeared to be responding to that by suggesting reasons it could be so. So that's the claim we're talking about.

Nope, I was indirectly talking about the claim actually made, and directly about your statement about what "the effectiveness of masks will probably be linked to".

[alai]

Meanwhile in mask news. One judge has ruled the DeSantis anti mask order to be unconstitutional. This seems far more impaction than non binding recommendations by cdc or the biden administration that DeSantis ignored in this case.

Interesting!  DeSantis immediately of course goes on a 'so-called judges' rant, and blusters that he'll have better luck next time.  (OK, that part's not at all interesting, and we could have written that for him for any day of the week, on any issue.)  But apparently relief granted to the plaintiffs on three of their six requested grounds, including DoE exceeding its authority (pesky Big Gubmint overreach!) and that the order undermines school safety.  So much for the evidence on masks not being good enough -- good enough that court, at least.

[cherrypoptart]

One guy I'm specifically talking about with the early mask issue is George Gao.

https://www.sciencemag.org/news/2020/03/not-wearing-masks-protect-against-coronavirus-big-mistake-top-chinese-scientist-says

"Not wearing masks to protect against coronavirus is a ‘big mistake,’ top Chinese scientist says

By Jon CohenMar. 27, 2020

...Q: What mistakes are other countries making?

A: The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others...."

And as I stated back then it was obvious that our government was lying about the issue because they said that masks won't help you but they'll help medical personnel.

All of this was known early on. Well known and very early. Stories like this one document it. Pretending that we didn't know doesn't fly very well.

And the problem is our government is lying again on masks, spreading dangerous misinformation, saying that the vaccinated don't need to wear them and if they do need to wear them it's only in hot spots with lots of cases. That's just not true. They need to be wearing them everywhere they were before, nationwide. Israel noticed that ten days after they made the mistake our government did. Our government noticed it too but decided not to admit it or correct the mistake promptly and properly.

It was obvious that this fellow George Gao knew what he was talking about but our government lied because they didn't want to panic the people. It was obvious as it was happening and it's even more obvious in retrospect. Sorry if I'm like a pit bull on a bone here.

The problem is we see the same thing happening all over again now. Politics before truth and safety.

[alai]

George Gao is indeed a Chinese scientist.  Not a rest-of-the-world-ese one.  Asia, or more specifically East Asia and Southeast Asia (the Default Asias in AmEng, I understand) definitely have a different starting position on masks, given their fairly general use in response to other URI outbreaks, or even routinely in some places and situations.  It's unreasonable to expect that to just suddenly become the default everywhere without more in the way of concrete evidence.  (Evidence people are still arguing the toss over 20 months hence in these very august pages, let's not forget.)

The "obvious the government was lying" trope doesn't remotely stand up.  Medical personnel use different grades of mask in different situation.  Medical personnel are trained in their proper use.  It was entirely unknown at that point whether transmission was by 'large' droplet or by true fine aerosol, which would hugely affect the effectiveness (or counterproductiveness) of masks, and of what mask-grade would be required.  Behavioural factors were (and as I pointed out at length, to an extent still are) an additional complication of this.

Here's a blast from the past from early 2020, a very similar timeframe from the one you mention:  https://twitter.com/RTELateLateShow/status/1233536177438969856  Now, I apologise for the low-brow medium here (a chat with a smarmy chat show host, via twitter!), but this is the Prof. Luke O'Neill previously mentioned.  Chair of Biochemistry and Immunology at Ireland's most Notions of Itself university, Fellow of the Royal Society, Member of the  European Molecular Biology Organisation, Member and Gold Medal awardee of the Royal Irish Academy, recipient of the Boyle Medal and the European Federation of Immunology Societies Medal.  Which lavish list of honours I mention not by way of traditional credentialism to prove he must always be right, but that people with a fine academic pedigree could be sincerely wrong about this.  (Unless your theory is that he's part of a Vast Conspiracy to facilitate the US government lying to you.)

No 'pretending' required.  (Tapping the sign again?)

[cherrypoptart]

I got to the point 56 seconds into that clip and he had already hit the jackpot.

He said the facemasks are effective if you're the one who is infected.

That's been the whole point all along and with asymptomatic spread that's why everyone needs to wear them, not just people who are worried about getting infected. You probably weren't reading all this way back then but that point was definitely made often, but I don't mind going over it again and again. That much is obvious already.

As I put it back then and still feel good about my analogy now, asking just the people who are worried about getting infected to wear masks is like asking people who are worried about getting hit from the sky by random celebratory gunfire shot off a mile away not to shoot their own guns up into the air. Or like asking people who are worried about getting killed by a drunk driver not to drink and drive.

I wholeheartedly agree that the facemasks, especially non N95 or KN95 ones, are of limited value in protecting you from getting infected when there are loads of viral particles in the air. The benefit is in keeping infected people from spewing all those spittle riding droplets into the air in the first place. For one thing, as the Chinese doctor who died after warning the world about the virus said, he thinks he probably got infected through his eyes.

I also like to make the point about how even inferior face masks are still better than nothing for reducing droplets in the air with a simple demonstration. Just ask a willing subject to stand a couple of feet away and while you are wearing a facemask you spit in their eye. Then try the same thing again without a facemask and see if they feel any difference. If you know any people who you feel like you need an umbrella to talk to them because of all the spittle flying the test also works with them and just talking. You can really feel the difference. Sometimes I feel like I should ask my wife to try this talking only face mask on and off test too especially when she's angry or excited and talking but fair warning you should be careful about the people you perform these tests with and judge their personalities for handling it well first.

So you kind of made my point there with that video. All of this was known. If there are any experts who didn't know this then they aren't experts but incompetents. They shouldn't be in charge of anything involving human safety and that includes Fauci.

We saw kind of a similar thing with Ebola (well actually when I think about it kind of totally different buy anyways) in the states but in that case I don't make the same claims that we knew or should have known better and lied about it. We were just totally ignorant but what happened was that medical personnel in Africa kept getting infected and the "experts" said that they weren't using their protective gear properly. Then American nurses started getting infected and they finally realized that it wasn't because of not using protective gear properly but because much more stringent measures were required to prevent infection, like the full-on spacesuits. But with Covid I'm going to stand by my opinion, and everyone is free to leave it instead of take it if they want, that we knew or should have known better and the excuses made for our mistakes our inexcusable.

The celebratory gunfire fatalities probably aren't a thing in Europe but they probably happen every year in the states. Well here's a story from Europe so I guess it's not as American as I thought.

https://www.theguardian.com/world/2011/aug/24/how-dangerous-is-celebratory-gunfire

[alai]

Jeebus, did at least you watch the other two whole minutes?  Or bale out immediately once you had that point to entirely miss at length?

This was, as is pretty clear from that short clip even without recalling the date, from before asymptomatic spread was known to be an issue.  Hence he was (again, in good-faith contemporaneous error) suggesting use by people sick with symptoms, not generally.  So is he 'proving your point', or is he an 'incompetent'?  Your narrative is trying to have it one way, and then the other, as best as I can tell.  Now I'd be happy to seize on any maladministration by or under the Former US Regime -- though one if spoilt for choice, it must be said -- but when all sorts of eminent non-US scientists were saying much the same thing, you're pretty clearly barking up the wrong tree on this one.  Or are both smarter at immunology than all such laureled immunologists and you've unearthed (unmasked?) a vast multinational conspiracy single-handed.  I know which my money is on.

You subsequently -- or rather, interleavedly -- go back to talking about the present, which is an entirely different matter.  I should at those points step out of the way and let you and ScottF knock lumps out of each other, as it seems superfluous to add much.

CDC currently says, among other guidance, with my emphasis addded, "if you are fully vaccinated, to maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission."  Seems fair enough to me.  Perhaps your beef should be with assorted state-level bad actors.

[cherrypoptart]

It was grossly incompetent and negligent for any so called "experts" to make the assumption by that point that it wasn't being spread asymptomatically.

Truth is I wrote most of my post right after I got to that spot in the video so your powers of observation are spot on but then I did go back and watch the whole thing and so edited my post to include the bit about asymptomatic spread because as you note that is the key.

But in the states even after everyone knew about asymptomatic spread we still didn't get good advice to go to masking because our powers that be were worried about the medical community not having enough of the quality masks they needed. The best play at that time would have been to tell people to use inferior quality masks indoors in crowded places and save the N95s for medical personnel but that was not done and it cost us. They probably thought if they said that masks actually were useful at all that people wouldn't save any of the good ones for the doctors and nurses and would horde them. That's a point but the counterpoint is that by then pretty much the total supply of those masks were being sent to hospitals anyway and they were not available for purchase by the general public so going to other lesser quality masks for the general public that keep the virus in more than out was the smart play. Sadly, we had dumb people in charge.

They eventually went to it months later and it made a difference but obviously would have made a much bigger difference, maybe even a decisive one, if we'd done it at the very beginning the way it was being done in Asia.

To your specific point, then right after asymptomatic spread was confirmed we should have gone to mandatory masks even if they are makeshift, right? And did we? No, we didn't, at least not in America.

And when we finally did the contradictory messages and early on lies were less than helpful, to borrow some of the British penchant for understatement.

[ScottF]

Yes if we had jumped on masks right away and higher compliance, say ~80% like Japan, we'd would have been in much better shape.

https://www.reuters.com/world/asia-pacific/japan-set-extend-covid-19-state-emergency-lockdown-sept-12-2021-08-17/

It's almost like the disease doesn't give a $!t about people wearing masks.

[cherrypoptart]

Japan covid deaths are at less than 16,000 for a population of 126 million.

American covid deaths are at 636,000 for a population of 328 million.

Just doing some quick back of the envelope calculations, if their deaths were at a similar ratio to ours they'd be looking at 244,317 dead right now instead of less than 16,000.

Their vaccination rate is only less than 27% now compared to ours at over 52% so it's not the vaccines that are making the difference for them.

They also have a much higher population density with greater use of mass transit. I'm not going to look it up but the ... nevermind just looked it up and their number of smokers relative to their population is much higher than ours with 20 million smokers compared to our 34 million, over 15% to ours at about 10%.  Now their obesity rate is only about 3.6 percent compared to ours at 32 percent. So there are confounding variables in play and obesity is huge (hehe) but still to say that masking isn't helping them substantially compared to us just doesn't add up.

For anyone not believing that our government wouldn't go for masking even if they knew about asymptomatic spread as happened early on in the pandemic, I'll just remind you that they are doing it right now knowing about how the vaccinated asymptomatically spread delta and yet we still don't have the right call being made on masks.

Now we still have to look at infection rates and that's tough to know since so many people who do get infected don't show symptoms and don't have a problem, but that's another almost certain benefit of masking. If you do get infected in a highly masked environment your initial viral load will certainly be much lower so you are much less likely to get seriously ill and when you do recover if people are right about recovery giving you greater and longer lasting immunity or resilience to the virus then that's a much better way to go about it, kind of like getting a live virus vaccine but in a weakened state. Well not exactly of course but still a better way to get infected if you have to choose between exposing yourself to a high initial viral load or a lower one.

[cherrypoptart]

"CDC currently says, among other guidance, with my emphasis addded, "if you are fully vaccinated, to maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission."  Seems fair enough to me.  Perhaps your beef should be with assorted state-level bad actors."

They are getting closer, much closer, but they are not quite there yet.


https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html

"Added a recommendation for fully vaccinated people to wear a mask in public indoor settings in areas of substantial or high transmission."

They just need to take out the part about the areas of substantial or high transmission and then they're golden. So close and yet still so far.

We see the results with the state level bad actors, clear as the difference between night and day. Most of the focus though has been on vaccination rates but it's quite possible and I'd say even very likely that masking rates make an even bigger difference than vaccines as we see in Japan. Of course the highest rates possible of both are ideal.

[ScottF]

Japan covid deaths are at less than 16,000 for a population of 126 million.
American covid deaths are at 636,000 for a population of 328 million.

Just doing some quick back of the envelope calculations, if their deaths were at a similar ratio to ours they'd be looking at 244,317 dead right now instead of less than 16,000.

Wait, I thought the topic was about masks preventing transmission? Are we now talking about how majority-obese populations die at a higher rate when infected? If so, I agree.

Their vaccination rate is only less than 27% now compared to ours at over 52% so it's not the vaccines that are making the difference for them.

Based on Isreal and UK data, I don't think vaccines will ultimately make the difference most people hoped they would.

Now we still have to look at infection rates and that's tough to know since so many people who do get infected don't show symptoms and don't have a problem, but that's another almost certain benefit of masking.

I....think you are trolling. In fact looking back I think you've been playing a well-executed mask-long-con on most of the folks here. So congrats on that I guess

[cherrypoptart]

Also interesting is their elderly population ratio is much higher than ours too with Japan being at over 28% aged 65 and up while our ratio is about 16.5%.

Yeah I've been playing the long game on masks. I was for them even before Trump and Fauci were against them. When our people at the very start were being processed to return home and the government employees bringing them back were wearing no protective gear at all despite it being obvious how transmissible the virus was I knew that was insane just based on the Chinese response. Whatever they didn't tell us in words they showed us by their actions about the seriousness of the virus. They warned us and we didn't want to cause a panic so we buried our heads.

They don't even have to be great masks to make a difference. Even relatively comfortable cloth masks that are easy to breathe through are much better than nothing. Having a few to get you through the day and just throwing them in the washer when you get home is fine too. All of that jazz about how you're going to infect yourself if you touch your mask without a hazmat suit on was always just mumbo-jumbo nonsense. So is the whole thing about the virus being so small that a cloth mask is like trying to stop a mosquito with a chain link fence. Yeah, maybe if most mosquitoes rode around on flying baseballs like the virus rides around on water droplets.  The key though is that everyone needs to be wearing them indoors in crowded areas.

[TheDeamon]

Hey, I realize it's only a preprint (meaning for those uninitiated in the eldritch mysteries of academic publishing, not formally published yet, generally due to non-completion of peer review), but not clear why "science" would need scarequotes here.  Perhaps this was a poorly targeted attempt at further snark about modelling?  (Bonus hint, not everything that's not an RCT is "modelling".)

It is also common for people to put things in "air quotes" to denote they're being sarcastic, rather than trying to scare someone.

[TheDrake]

Actual scientific examination found that mask wearing in Japan contributed to their lower transmission rates, but notes other factors and concludes that mask use was not a particularly strong factor. Did it help? 100% it did, no question. But it doesn't look like the star atop a Christmas tree, it's just one of the better ornaments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207161/

[alai]

Actual scientific examination found that mask wearing in Japan contributed to their lower transmission rates, but notes other factors and concludes that mask use was not a particularly strong factor.

As this thread demonstrates in its own multifactorial manner, actual science is no match for "I know better than the experts!" and "that doesn't fit my preconceptions, so I'll raise the evidentiary bar to exclude it!"  (InB4 "it's only an observational study, not an RCT!")

Actually that paper seems to be commendably open that they haven't fully and successfully analysed all the contributory factors.  Again, compare with the relentless confidence in their own favoured rationale by some parties.  Lots of small factors are fine, though, objectively, if they add up to getting there.  Politically, of course, they don't do well against low-brow populist slogans.  IF X WORKS WHY DO I ALSO NEED Y.  Gimme silver bullet Z instead, even though that's actually completely useless snake-oil.

It is also common for people to put things in "air quotes" to denote they're being sarcastic, rather than trying to scare someone.

I feel, as Lisa Simpson might say, that was implied by what I said.  Scarequotes are generally that or thereabouts, and never in my experience ever about scaring people.  I can only conjecture that the writer misplaced his, or was being sarcastic about his own sarcasm in some unsuccessful manner.

Are we now talking about how majority-obese populations die at a higher rate when infected?

We?  Plainly we were not.  You, given half a chance despite no reasonable contextual excuse, and your spectacularly unsuccessful attempt to do so earlier, no doubt!

Based on Isreal and UK data, I don't think vaccines will ultimately make the difference most people hoped they would.

Based on what about the Israel and UK data?

This is of course a complete non-statement.  "Carefully worded" or otherwise.  Whatever difference they make, it's available to you to spin this as "oh, but people hoped they'd be more effective still".  Care to make your claim in any way usefully operable?

I....think you are trolling.

This must the the 11th commandment from the OA high-minded mission statement that I've not been been privy too as a mere furrin noob.  "Whimsically accuse your fellow Ornernies of being trolls for shizzles and giggles."

[alai]

They just need to take out the part about the areas of substantial or high transmission and then they're golden. So close and yet still so far.

If only they had the benefit of your expertise!  But look at the map:  https://imgur.com/a/l8YCeOl  The distinction is largely moot at this point.  Unless you're worried about dangerously unmasked tumbleweeds in northern and western Nebraska, or whatever the majority population is out there.

Now which is the better messaging is hard to say.  If you change the guidance too quickly or at too small a scale, more chance people will be genuinely confused.  If you just say "mask everywhere, always" the pouty "but ma fweedums" brigade will complain there's "no substantial or high transmission" near them, they don't wanna, they don't needta, they don't gonna.

Most of the focus though has been on vaccination rates but it's quite possible and I'd say even very likely that masking rates make an even bigger difference than vaccines as we see in Japan.

But that's not what we see in Japan.  Vaccines are possibly something like 50-70% effective against retransmission.  Masks alone aren't remotely likely to be anything like that effective.

It was grossly incompetent and negligent for any so called "experts" to make the assumption by that point that it wasn't being spread asymptomatically.

It's the job of scientists to form working models based on the data available to that point.  That's not "negligent assumption".  How much "erring on the side of caution" you want to build in on top of what there's actual evidence for is public question, not an immunological one.  (Or worse, social science!)

But in the states even after everyone knew about asymptomatic spread we still didn't get good advice to go to masking because our powers that be were worried about the medical community not having enough of the quality masks they needed. The best play at that time would have been to tell people to use inferior quality masks indoors in crowded places and save the N95s for medical personnel but that was not done and it cost us. They probably thought if they said that masks actually were useful at all that people wouldn't save any of the good ones for the doctors and nurses and would horde them. That's a point but the counterpoint is that by then pretty much the total supply of those masks were being sent to hospitals anyway and they were not available for purchase by the general public so going to other lesser quality masks for the general public that keep the virus in more than out was the smart play. Sadly, we had dumb people in charge.

I think there was some of that.  The 'mask supply' consideration, that is, rather than the 'dumb people' upsum.  (Which I don't dispute on certain case-by-case bases, but if you find yourself applying it on too vast a scale, like most conspiracy theories, it rather falls apart.)  As soon as you declare "they're essential but you can't have any" you have instant market failure.  Or given the stories about people going into hospitals and stealing them, instant black-market success I suppose.

They eventually went to it months later and it made a difference but obviously would have made a much bigger difference, maybe even a decisive one, if we'd done it at the very beginning the way it was being done in Asia.

In (US default E and SE) Asia they did a great deal more than just have mask mandates.  Some extremely tight lockdowns, some extremely effective track-and-trace system.  And that was when there was a relatively less infectious virus type in circulation.

To your specific point, then right after asymptomatic spread was confirmed we should have gone to mandatory masks even if they are makeshift, right? And did we? No, we didn't, at least not in America.

As we've been over a couple of times now, it's a little more complex than that.  Droplet size, behavioural issues, yadda.  Our hero in the clip earlier loudly and publicly announced he'd been wrong on masks and that the evidence was in, in favour of them, by (or before June 2020).  It was mandatory to wear them in shops or on public transport by that August.  (And still is, unlike in the UK.)

[TheDrake]

The letters were sent to officials in Iowa, South Carolina, Utah, Oklahoma and Tennessee, all of which bar local districts from mandating masks. The letters allege that these states may be preventing districts from meeting the needs of students with disabilities who are at heightened risk for severe illness should they contract the coronavirus.
The move follows up on President Biden’s promise earlier this month that the Education Department would use its authority to try to stop states from interfering with school districts that want to require masks. Governors argue that masking should be a personal choice for parents and families, and over the last few weeks, the disputes have reflected the larger national pandemic debate over personal freedom vs. public health.

Want to give biden an attaboy, cherry?

[alai]

My client's counter-offer is a "whatabout" and a "doesn't go far enough"!

[cherrypoptart]

So how is the cafeteria going to operate?

We know that a lot of our community spread is in restaurants.

How effective is it to wear masks in class all day and then go to the cafeteria, keep wearing the mask until you sit down to eat, and then take it off to eat and while eating talk loudly with your friends so you can be heard over everyone else talking loudly to theirs?

Just saying that they'll be people wearing masks in schools may not be enough. The devil is in the details.

So alai is right; what about the eating situation?

One thing that might help there and in general that I've brought up before is maybe people just need to shut up. We mentioned it as another difference between America in Japan, that being that people tend to speak more quietly. We also saw with the church choir situation that volume makes the spread worse. So you're eating in a cafeteria or a restaurant and it's crowded. Everyone takes their masks off to eat and then while eating they are talking, loudly. Maybe don't. So you take off your mask to eat and while the mask is off you don't talk. You eat. Then you put it back on and say what you need to say.

Now of course I realize our culture can't handle this and it'll never happen. And so we're pretty much doomed.

I wouldn't be surprised if just wearing a mask over the mouth without covering the nose is substantially better than no mask at all. It'd be nice to see some science on that but there are people who are refusing to wear masks at all just because they don't want to cover their noses. At least if it covers your mouth then when you talk it helps captures the droplets the virus rides on. Probably better than nothing. Our problem is we lack a good sense of practicality.

[alai]

So alai is right; what about the eating situation?

Waitwhat?  Much as I like being told I'm right -- more, more! -- I don't recall saying anything at all about 'the eating situation'.  I confuse now.

Bear in mind this isn't entirely a 'weakest link' sort of problem.  Risks sum, you don't just take the maximum.  This is the logical flaw in 'if we can do X, then surely we can also do Y!', but as usual, bad logic is no impediment to a good talking point.  If an activity is important, you may decide to have to suck up those risks, while trying to reduce others, even if they are actually individually lower.  But this is also the logic for "household mixing", "bubbles" and "cohorts" restrictions.

Now of course I realize our culture can't handle this and it'll never happen. And so we're pretty much doomed.

Well, 'doomed' is maybe a slight exaggeration.  It'll 'find its level' sooner or later, however grim that it.  But if you were running a book, you'd have closed it by now on hundreds of thousands more dying in developed, highly vaccinated countries -- never mind millions around the world.  It's not -- touching wood -- showing any prospects of being a human extinction event, or the Black Death, hopefully not 'even' the Spanish Flu, though that's getting further into 'depending on which countries we give a damn about' territory, at the more pessimistic end of the predictions.

I wouldn't be surprised if just wearing a mask over the mouth without covering the nose is substantially better than no mask at all. It'd be nice to see some science on that but there are people who are refusing to wear masks at all just because they don't want to cover their noses.

Maybe.  It's not a gimme, as there's the possibility that the smaller (but logically still existing) benefit as a Sneeze Guard is at that point more than countervailed by the opportunity for hand-contamination.  (If I were guessing, I'd put a small stake (given decent odds) on you being right here, as the hands/surfaces thing doesn't seem to be as huge of a deal as initially estimated, even back before we knew that asymptomatic spread was a thing and weren't sure about masks in the first place.)

I think the better solution is better masks.  Not as in more effective-better, but as in more comfortable.  Like those "singing masks" I linked to earlier, to get very fancy about it.  Or even just mask inserts, that allow you to wear a more-or-less standard mask, but not have the sensation of if directly against your nose and your mouth.

[TheDrake]

Costco has a cafeteria too, so I guess we won't need masks there either. So do most office buildings, as well as lunch rooms. If you were going to be exposed to radiation would you forgo the lead vest if it were only offered part time.

If you Google school cafeteria covid you'll see that your concern is far from novel and solutions include social distancing, staggered lunch times, and lunch delivery to home rooms. In many parts of the country the kids could take a sack lunch out to the playground.

You'll have to try harder to justify why you want to give biden zero credit for a strong pro mask policy.

[cherrypoptart]

If you compare Biden's mask policies to the mask policies of many governors along with Trump's for the longest time especially the way he made fun of them for a long while Biden was onboard from the beginning then the difference is stark and I give Biden credit where it's due. He's better than most Republicans on the mask issue.

I'll just leave that full stop for now and maybe get to the "but" later on just so the admission can be savored and relished for a while.

[TheDrake]

If you compare Biden's mask policies to the mask policies of many governors along with Trump's for the longest time especially the way he made fun of them for a long while Biden was onboard from the beginning then the difference is stark and I give Biden credit where it's due. He's better than most Republicans on the mask issue.

I'll just leave that full stop for now and maybe get to the "but" later on just so the admission can be savored and relished for a while.

Appreciated, and there's clearly room for criticism as well, and that can't get glossed over even if someone is "generally better"

[alai]

He's better than most Republicans on the mask issue.

Now that's some almost invisibly faint praise your damning him with!

I think you can understand Biden's politics on most things in terms of him being a pragmatic centrist.  Bipartisan, even, when that actually is the pragmatic thing to do, as opposed to an opportunity to bang one's head endlessly against the wall.  Is he going to trend sane and science-based on masks, vaccines, etc?  Yes.  Is he going to get three miles out in front and pick fights he can't possibly hope to win, and that he can't afford the political capital to even fight?  No.

It's sad that these things have become any sort of "culture war" issue, but that's the way of it.  We have our own pound-shop versions of anti-vaxers, anti-maskers, it's-all-a-hoaxers here too, if it's any comfort by way of schadenfreude/shared misery.  Mostly not at the elected representative level, though there are definitely some on the "screw everyone else, this is the thing I want, and here's a vague semblance of a rationale as to why I should get it" spectrum.

[msquared]

Well we hit 75% of the 18 and over population in the US with at least one shot yesterday. We are over 53% of the total population fully vaccinated.

Only 2 months after Biden's goal.

[cherrypoptart]

https://news.yahoo.com/biden-bold-covid-plan-prescription-015226256.html?fr=sycsrp_catchall

Biden's 6 point Covid plan is another swing and a miss.

He still won't do what was already proven, what was working just fine before he scrapped it, and that is the CDC recommending masks for pretty much everyone in all indoor crowded places, including the vaccinated. And not just in hot spots.

They are going to keep blaming the wrong thing which means they'll never fix the problem. They are going to keep blaming the unvaccinated when the bigger problem is they said the unvaccinated (and left unsaid but understood that the vaccinated too) could take off their masks. And right after that all hell broke loose.

If these people can't make such a simple connection there's just no hope left.

They're trying to troubleshoot a live-wire electrical fault and they keep electrocuting themselves because they can never figure out what the real issue is. If it wasn't so deadly serious it would be comical.

[msquared]

Ok so with the new rules for large companies to require either vax or test now in place, companies such as Fox and NewsMax are following those rules and do not plan to fight them, even as their shows continue to rail about how they are so bad.

In fact Fox has had vax or test rules in place since July and Aug.  A great example of Do as we say not as we do.

[cherrypoptart]

I haven't seen anyone complaining about testing. The problem comes in for people not when it's vax or test but when it's just vax or... no other option, just vax or get fired.

[msquared]

If only there were laws in place that could keep a company from firing you for any reason they wanted.   Too bad Republicans have been fighting for years against rules like that and supporting laws that allow companies to do just that.

[TheDrake]

It's almost like they are just now realizing that "right to work" really means "right to fire".

[oldbrian]

When we were applying for our adoption 10 years ago, we needed a letter from work saying that our jobs were stable and we would continue to be employed.  My HR refused to put that in writing, because they hold the right to fire us at any moment for any reason - or no reason at all.  And nobody even blinked at that.

[Fenring]

When we were applying for our adoption 10 years ago, we needed a letter from work saying that our jobs were stable and we would continue to be employed.  My HR refused to put that in writing, because they hold the right to fire us at any moment for any reason - or no reason at all.  And nobody even blinked at that.

Honestly that seems like a problem with the adoption agency, more than anything. Why didn't they also ask you to get a doctor's note saying "they are in good health and will continue to be in good health."

[cherrypoptart]

The companies aren't the ones doing this though. It's Biden. Single-handedly. Get jabbed or get fired. During the campaign he said he wouldn't do this. Has anyone started counted his lies yet?

"I don't think it should be mandatory. I wouldn't demand it be mandatory but I would do everything in my power... just like I don't think masks have to be made mandatory nationwide."

https://www.youtube.com/watch?v=ob3ER7fKeDs (1:55)

Kind of like when you're a little kid and your parents ask if you want to go to the store with them. You say no I'll just stay home and they say no you're coming with us and you ask them why did they pretend like you had a choice and they say well you did have a choice but only if you made the right one. True story.

[msquared]

So the Mississippi Gov is opposed to the Biden vaccine mandates. Even though his state has one of the strictest vaccine mandates for schools in the country, not even allowing for religious exemptions.

https://www.yahoo.com/news/gop-seethes-biden-mandate-even-114322019.html

What a bunch of hypocrits.  Of course they crow about how high their vax rate is for the "accepted" vaccines are. They lead the country since they do not allow for "philosophical, moral or ethical" exemptions. And now they have an issue.

[msquared]

Cherry

When he was elected, the Delta variant was not around.  With science things can change as the situation changes. The situation has changed.

[Fenring]

When he was elected, the Delta variant was not around.  With science things can change as the situation changes. The situation has changed.

I'm not exactly sure how delta changes anything on this particular topic. The calculus is more or less the same with or without delta; do you allow people to put themselves at risk, while the vaccinated are more or less protected. Delta puts the unvaccinated more at risk, including through the vaccinated, but again that's their risk calculation in not taking it.

[yossarian22c]

When he was elected, the Delta variant was not around.  With science things can change as the situation changes. The situation has changed.

I'm not exactly sure how delta changes anything on this particular topic. The calculus is more or less the same with or without delta; do you allow people to put themselves at risk, while the vaccinated are more or less protected. Delta puts the unvaccinated more at risk, including through the vaccinated, but again that's their risk calculation in not taking it.

The calculus is different with Delta because it is about 5x times as infectious as the original strain. So 70% vaccination rates doesn't stop the spread, we need 85+% vaccination rates to protect society from the pandemic.

[Fenring]

The calculus is different with Delta because it is about 5x times as infectious as the original strain. So 70% vaccination rates doesn't stop the spread, we need 85+% vaccination rates to protect society from the pandemic.

I understand that it makes total herd immunity harder, so that maybe it won't be eradicated outright, but I was already operating on the assumption that that wouldn't happen anyhow. And so has everyone else, by the way, since the talk of booster shots preceded any talk about delta. So to me delta doesn't change the situation much once you recognize that covid may be around for a while in some form or another; at that point the question just becomes whether to accept a bit of sickness among the vaccinated, and for the spread to continue among the unvaccinated. I don't think the hospital capacity issue will remain as relevant going forward, so really it's just a question of whether to tolerate that it will be part of life for a while. And btw, even if America did get herd immunity, even that wouldn't help stave off the whole issue of what to do about preventing outsiders bringing it in. It's not like the U.S. had mandatory quarantines and tests like Canada did for travelers entering the U.S. (although Vermont did, interestingly).