[HN Gopher] An analysis of studies pertaining to masks from 1978...
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       An analysis of studies pertaining to masks from 1978 to 2023
        
       Author : ohshit
       Score  : 29 points
       Date   : 2024-05-23 20:20 UTC (1 days ago)
        
 (HTM) web link (www.medrxiv.org)
 (TXT) w3m dump (www.medrxiv.org)
        
       | ohshit wrote:
       | Background from one of the authors:
       | https://twitter.com/TracyBethHoeg/status/1709371816479952993.
        
       | reify wrote:
       | This is the correct way to do science
       | 
       | A superb example of poor science in practice!!!!!!!!!
       | 
       | This study did not receive any funding. I wonder why?
       | 
       | Conclusions and Relevance:
       | 
       | MMWR publications pertaining to masks drew positive conclusions
       | about mask effectiveness over 75% of the time despite only 30%
       | testing masks and <15% having statistically significant results.
       | 
       | No studies were randomized, yet over half drew causal
       | conclusions.
       | 
       | The level of evidence generated was low and the conclusions drawn
       | were most often unsupported by the data. Our findings raise
       | concern about the reliability of the journal for informing health
       | policy.
       | 
       | So many people still wearing masks in their cars while driving
       | alone.
        
         | vkou wrote:
         | > So many people still wearing masks in their cars while
         | driving alone.
         | 
         | Many of them do it because they have various degrees of social
         | anxiety, not because they are afraid of the 'Rona.
        
           | thaumasiotes wrote:
           | Why would that be relevant to their behavior while alone?
        
             | xboxnolifes wrote:
             | If you can see them wearing a mask while driving, are they
             | really alone?
        
             | vkou wrote:
             | Unless your windows are tinted way past the legal limit,
             | you aren't really alone when driving.
        
               | u32480932048 wrote:
               | Unfortunately, even illegal levels of window tint aren't
               | enough to stop COVID - the glass must also be mirrored so
               | that the COVID bounces off of it and sticks back to you.
        
           | u32480932048 wrote:
           | Once, I left a store, got into my car, and made it to the
           | light before realizing I still had my mask on. I've never
           | felt more ashamed in my life.
        
         | tokai wrote:
         | >This study did not receive any funding. I wonder why?
         | 
         | You don't need funding to do a literature review.
        
           | jampekka wrote:
           | A bit like you don't need funding to write software.
        
         | majormajor wrote:
         | > So many people still wearing masks in their cars while
         | driving alone.
         | 
         | Where do you live that you see this regularly?
         | 
         | Don't think it's happening in southern California.
        
           | amluto wrote:
           | It would have been an excellent idea in Southern California
           | not that long ago -- a good mask massively reduces PM2.5, and
           | PM2.5, especially on So Cal freeways, was quite high.
        
             | jerlam wrote:
             | Cabin air filters, which are in many if not most modern
             | cars, should already have removed the particulates already.
        
               | amluto wrote:
               | "Should have" is, at best, wishful thinking. In air
               | filtration, a good rule of thumb is that, if an actual
               | quantitative spec isn't given, then the filter doesn't
               | filter. I've seen this with expensive commercial systems
               | with stamped plans, I've seen it with very fancy European
               | IAQ systems, and I've seen it with cars. Seriously, go
               | look for a stated spec for a cabin air filter, which you
               | generally won't find, then drive on a freeway, bring a
               | PM2.5 meter, and compare windows open to windows closed.
        
           | burningChrome wrote:
           | I live in Minneapolis - I see it all the time. Several times
           | a day in fact. I still see people in outside settings wearing
           | them as well. By now, if I see a person wearing one my only
           | two thoughts are: a) this is an act of virtue signaling
           | (Minneapolis is a VERY progressive city) or b) you are
           | immunocompromised and or wearing it for medical or health
           | reasons.
           | 
           | Since both of these are on opposite ends of the spectrum, I
           | just hope its for medical reasons and being cautious as
           | opposed to the former and get one with my day.
        
             | amluto wrote:
             | Don't forget option C: in cold, dry weather, a disposable
             | mask can be an impressive comfort improvement. And you can
             | throw it away when it gets disgusting. They often
             | outperform balaclavas.
             | 
             | Or option D: allergies. A well fitted disposable mask
             | removes allergens, at least until it collects so many that
             | it starts triggering allergies all by itself. Achoo!
        
               | Bognar wrote:
               | I discovered option D during covid and it's like a
               | superpower. I have allergies even through double dosing
               | OTC medicine, but a good mask does wonders for me in
               | spring.
        
       | sfblah wrote:
       | The mask thing was all theater and political logrolling. Beyond
       | it being anti-science, three other concerning factors:
       | 
       | * It decreased trust in government by backing a policy that most
       | now understand wasn't science-based.
       | 
       | * It increased the partisan divide in the country for no benefit
       | by encouraging people on both sides to label those on the other
       | side as "nutters."
       | 
       | * It probably caused some amount of real harm by causing people
       | to think that, if they wore a mask, they were protected. This
       | probably meant some elderly and immunocompromised people put
       | themselves at risk when they could have avoided the risk by
       | staying outdoors.
        
         | pessimizer wrote:
         | The most embarrassing part is that it started off by declaring
         | that the science was against masks, and silencing all
         | dissenters; then moved to declaring the effectiveness of masks,
         | demanding their universal use, and silencing all dissenters.
         | 
         | The problem is with the _official_ silencing, not with masks.
         | You can 't even figure out whether masks work when you can't
         | trust any of the sources of information to not be some sort of
         | partisan religious police. The hydroxychloroquine fraud being
         | published in the Lancet is something that political, wedge
         | issue science will never recover from. It was like an awful
         | sequel to the Wakefield incident, and a one-two death blow to
         | the general acceptance of vaccines writ large. Now people will
         | just believe the studies that their political party tells them
         | to believe.
        
         | leptons wrote:
         | Why do you think that suggesting to wear a mask during a global
         | pandemic was "all theater"?
         | 
         | If you had to go into an ebola ward, and someone handed you a
         | mask, would you really refuse to wear it?
        
         | standardUser wrote:
         | You're throwing in a truly decadent load of assumptions in a
         | few short words before you make your points. Just because you
         | can craft rhetoric that is tiring to untangle does not mean it
         | has any merit.
        
         | threeseed wrote:
         | > The mask thing was all theater and political logrolling
         | 
         | And yet every government around the world from all political
         | persuasions pushed for mask wearing.
         | 
         | Wonder how you reconcile this with your intellectually lazy and
         | factually baseless "this was all for partisan reasons"
         | rhetoric.
        
       | downWidOutaFite wrote:
       | The authors were very publicly biased against masks before this
       | paper. It's hard to take it objectively.
        
         | IncreasePosts wrote:
         | Sure, but on the other other hand, it might be difficult to
         | expect someone who really believes in masks to try to prove
         | they don't work. Or, to publish their data if they find that
         | masks don't work(because they believe they have some flaw in
         | their logic, or they think there are social benefits to mask
         | wearing not covered in their study, etc).
        
           | marcosdumay wrote:
           | The people that believe in masks should be the ones testing
           | if they work. The situation you are describing is a messed-up
           | environment that puts politics above science.
           | 
           | The people that don't believe masks work should be busy
           | testing something they believe in.
        
             | IncreasePosts wrote:
             | Believing masks to be slightly effective at preventing
             | airborne illnesses seems like a pretty common sense default
             | viewpoint though. No barrier provides no benefit, a
             | completely impermeable barrier like wearing a fish tank on
             | your head would provide 100% benefit. So it makes sense
             | that a partially permeable barrier would provide some
             | benefit.
        
               | leptons wrote:
               | Most anti-maskers say "masks don't work" without trying
               | to understand that masks are not a 100% solution, and
               | nothing in life is. But even if a mask is 50% effective
               | (not a scientifically proven number, just an example),
               | I'll take that mitigation over 0% of not wearing a mask
               | (not a random number, wearing no mask actually provides
               | no protection at all), every single time.
        
               | zeroonetwothree wrote:
               | But surely the amount matters. What if it's only 1%
               | better?
        
               | leptons wrote:
               | If you think we're still in the "what if" stage of
               | knowing that masks are effective, then you're either
               | willfully ignorant about mask efficacy, or you're
               | attempting to argue disingenuously.
        
             | burningChrome wrote:
             | >> The situation you are describing is a messed-up
             | environment that puts politics above science.
             | 
             | This has been going on for a while and just came into sharp
             | focus during the pandemic. Its horrifying to think science
             | is now so politically based that any study that contradicts
             | what the gov is telling you is somehow suppressed because
             | they know better? Do you remember when the Canadian Health
             | Minister said people should ignore any information that
             | isn't coming directly from the government?
             | 
             | Our dystopian future arrived during the pandemic and
             | science went from using a rigorous established methodology
             | to allowing the government to tell us that science is now
             | decided as a popularity contest like a survey. "99% of
             | doctors recommend the vaccine so you should trust "the
             | science" and get it or you're going to kill your grandma!"
        
               | marcosdumay wrote:
               | > Do you remember when the Canadian Health Minister said
               | people should ignore any information that isn't coming
               | directly from the government?
               | 
               | On that environment, with several groups spreading lies
               | everywhere, and with a public health issue that couldn't
               | possibly turn into a political hot topic, that statement
               | made a lot of sense. That is not suppression of
               | scientific speech. (Suppression of scientific speed
               | happened a lot less than popular press manipulation.
               | Still happened, though.)
               | 
               | Personally, I am much more afraid about how people
               | managed to turn covid into a political hot topic.
        
               | adamomada wrote:
               | I remember how in Ontario the actual science, pardon me,
               | the Science Advisory Table, was some meeting that
               | absolutely could not be public and Science(tm) only
               | occurred in the back room secret meetings, with the
               | Premier coming out once in a while to give updates,
               | telephone-game style
        
         | u32480932048 wrote:
         | Absolutely none of this has ever been objective, or even based
         | in reality, let alone evidence, so I find it hard to care.
         | 
         | The issue was never about masks, but of two highly-polarized
         | groups (few of them having any real knowledge on the subject)
         | dehumanizing the other under color of Science(tm).
         | 
         | It was purposefully misunderstanding and sloganizing
         | Science(tm) into simplistic, unscientific statements like
         | "Masks work" and "Masks don't work" [for what? for whom? etc].
         | Objective science isn't sold as bumper stickers and lapel pins
         | on Etsy.
         | 
         | It ignored completely and purposefully the two extremely basic
         | and fundamentally different modes of operation: protecting the
         | wearer from inhaling Bad Things (Masks Don't Work) and
         | protecting people other than the mask wearer from what the
         | mask-wearer is exhaling (Masks Work).
         | 
         | The Science(tm) on this hasn't really changed in any meaningful
         | way, and the whole subject is tiresome. People who can't think
         | past Mask Good or Mask Bad might think otherwise, but their
         | opinions are perhaps even less valuable than this study.
         | 
         | Besides, if you're not a physician or have a PhD in maskology,
         | how could you possibly begin to evaluate this evidence anyway?
         | It's so very complicated and technical, see. You should be
         | Trusting The Experts(tm).
        
       | majormajor wrote:
       | > 77 studies, all published after 2019... 23/77 (29.9%) assessed
       | mask effectiveness, with 11/77 (14.3%) being statistically
       | significant, but 58/77 (75.3%) stated masks were effective. Of
       | these, 41/58 (70.7%) used causal language. Only one mannequin
       | study used causal language appropriately (1.3%). 72/77 (93.5%)
       | pertained to SARS-CoV-2 alone. None cited randomized data. 1/77
       | (1.3%) cited conflicting evidence.
       | 
       | Bit hard to follow here since the talk about "studies that didn't
       | actually study it" seems like a valid critique of _study quality_
       | but not of mask effectiveness. (But where does the 1978 year in
       | the title come from?)
       | 
       | Seems like of 23 studies, 11 of them found statistically
       | significant evidence of improvement; only 1 saw conflicting
       | evidence.
       | 
       | Sounds like room for further study and investigation but possibly
       | suggestive of differences in mask quality, correct usage, etc, so
       | deeper dives would certainly be interesting.
       | 
       | Obviously in some situations and disciplines nobody questions the
       | value of quality masks, so the "it can't possibly be effective"
       | crowd seems even more unjustified than the "it's effective [even
       | if just 11 out of 23 of the studies said so]" crowd.
        
         | kristjansson wrote:
         | > study quality
         | 
         | And even more specifically, quality of studies (re)published by
         | a single journal, albeit an important one.
        
         | kbelder wrote:
         | "Are masks effective" is the completely wrong question, anyway.
         | The question should be "how effective are masks?"
         | 
         | Preferably, "How effective are masks against X under Y
         | circumstance?"
         | 
         | In relation to Covid, I think it's likely masks reduced
         | transmission. But, under normal social environments, did they
         | reduce it by 5% or by 50%? It makes a big policy difference. It
         | seems that studies are coalescing around masks having a 'real
         | but small' effect, but I get it's a hard thing to study.
        
           | marcosdumay wrote:
           | > did they reduce it by 5% or by 50%
           | 
           | Either one would cause a dramatic reduction on the
           | (exponential) virus spread.
           | 
           | For the actual policy, it shouldn't make a difference. It had
           | feedback mechanisms anyway, because the conditions always
           | change.
        
             | frognumber wrote:
             | Well, no. It makes a big difference:
             | 
             | 1) If the exponent is >1, it doesn't make much difference.
             | Everyone will catch "it," for whatever disease.
             | 
             | 2) It makes sense to have interventions prioritized by ROI
             | 
             | 3) Many interventions are individual, and there is no
             | exponent. Should I, as a [doctor / immuno-compromised-
             | individual / patient / etc.] wear a mask?
        
               | marcosdumay wrote:
               | > It makes sense to have interventions prioritized by ROI
               | 
               | The thing about masks is that the investment is minimal.
               | Those 5% are still an incredibly large number that makes
               | it a non-brainier.
               | 
               | If it decreases another order of magnitude, it may need
               | some analysis. The OP has a point, but it's way beyond
               | the plausibility window.
        
               | zeroonetwothree wrote:
               | As an individual I would not wear a mask to reduce
               | infection risk by 5%. If it's more like 90% then that's
               | something.
        
               | threeseed wrote:
               | But those who are the most likely to be affected i.e.
               | older and vulnerable people would.
               | 
               | So in fact whether you wear one or not is far less
               | relevant.
        
           | postepowanieadm wrote:
           | > I think it's likely masks reduced transmission
           | 
           | And your belief is based on what?
        
             | warcher wrote:
             | Common sense? Restricting exhalation to reduce transmission
             | of airborne disease? Have you never been taught to cover
             | your mouth when you sneeze or cough?
             | 
             | Like it would be remarkable if it did nothing. THAT would
             | be a blockbuster result.
             | 
             | The thing worth studying is if the effect is worth the
             | trouble or not. It could be worth doing or it could
             | effectively be a waste of time due to whatever other
             | factor.
        
               | pandaman wrote:
               | Many people have been taught to say "Bless you!" when
               | somebody sneezed too, would it also surprise you that it
               | doesn't affect any airborne virus?
        
               | neilwilson wrote:
               | Common sense says if you put your hand over your mouth
               | and breath out you will be able to. That says the
               | pressure is overcoming the blockage.
               | 
               | The other way round is far more difficult.
               | 
               | If you leak then you are wasting your time because in a
               | static air environment you'll delay the critical level
               | build up by a few minutes at most.
               | 
               | Medicine doesn't like aerosolisation because it sounds
               | too much like miasmia theory.
               | 
               | So we have too much focus on droplets and fomites.
               | 
               | Fundamentally this should have been sorted with a
               | properly designed trial with the correct protocol of
               | sufficient size to answer the question. Given what was on
               | the line why has it not been done?
        
           | u32480932048 wrote:
           | This simple "Masks Work" vs. "Masks Don't Work" paradigm is
           | insufficient and almost meaningless, which probably explains,
           | in part, why it came to dominate the conversation.
           | 
           | The sad thing is that the people who should have known
           | better, by virtue of their professed intelligence and
           | education, didn't allow any nuance whatsoever. Masks Work,
           | Masks Good, in every sense and situation. Anyone who didn't
           | chant the slogan verbatim was painted as a puppy-kicking
           | grandma killer.
           | 
           | Meanwhile, all those deplorable schmucks in the trades,
           | who've been lectured to death about choosing the right
           | respiratory protection for the job, were able to comprehend
           | that big mask hole and tiny virus is a Bad Choice. You want
           | the mask holes to be smaller than the Bad Thing. Therefore,
           | "Masks Don't Work".
           | 
           | But they do work to keep the mask-wearer from spitting on
           | others when they talk, and there's something to be said for
           | that. A clear explanation of the different modes of
           | operation, and framing it as a polite thing to do (akin to
           | covering your mouth/nose when you cough or sneeze), probably
           | would have been sufficient.
           | 
           | Instead of getting everyone on the same page, they resorted
           | to threats and violence, often accompanied by factually-
           | incorrect arguments, which only made it seem all the more
           | tyrannical.
           | 
           | We need to stop "believing" in Science and start
           | "understanding" it, even when it doesn't fit in a headline or
           | tweet.
        
             | supplied_demand wrote:
             | == Instead of getting everyone on the same page, ==
             | 
             | Your post seems to be continuing this trend. Nobody called
             | anyone "deplorable schmucks" or "puppy kicking grandma
             | killer" but you. Your victimhood really comes out in the
             | language you choose to describe others.
        
               | throw-the-towel wrote:
               | FWIW I remember this very forum flinging this kind of
               | accusations in 2020.
        
               | supplied_demand wrote:
               | Even without any examples, I don't see how revisiting it
               | today gets anyone on the same page. It feels like a way
               | to play the victim.
        
               | ipaddr wrote:
               | Retros are common in our industry this is a mini-retro.
               | Many things by experts and leaders were false and caused
               | many deaths and still are causing deaths. The follow your
               | government officials crowd got it wrong. Those who got
               | fooled want to move on and not face reality are now
               | calling other victims in an attempt to silence and shame.
               | Shame on you for trying to hide your collective cowardly
               | actions.
        
               | ceejayoz wrote:
               | While we're on the subject of retrospection, did you ever
               | figure out which news sources you consume led to your
               | belief that George Floyd was murdered by "black
               | supremacists"?
               | https://news.ycombinator.com/item?id=35069871
        
               | pfannkuchen wrote:
               | I have no opinion on this thread but I find it weird when
               | people dig through others' comment history and try to use
               | it as an argument.
               | 
               | If you read the rest of that thread GP states that he was
               | thinking of a specific different police brutality case
               | and mistakenly referred to the George Floyd case instead.
               | I also have no idea what he means by black supremacists
               | there but the ridiculous part of your quote was
               | essentially a typo by GP (allegedly anyway).
        
               | supplied_demand wrote:
               | == Shame on you for trying to hide your collective
               | cowardly actions.==
               | 
               | I needed a reminder on my I stopped posting here. This
               | type of arrogant indignation is the perfect example. It
               | completely cuts off actual discourse and makes a host of
               | negative assumptions about others while demanding that
               | others treat your ideas with care and nuance.
               | 
               | Shame on me for trying to have a discussion. Back to your
               | flamewars!
        
               | threeseed wrote:
               | > this very forum
               | 
               | Specific individuals not "this forum".
        
               | contingencies wrote:
               | The parent seeks to convey the zeitgeist irrational
               | emotional response of the populace to alternate
               | perspectives during the COVID era and to my mind does so
               | successfully.
               | 
               | As someone who not only mapped the rise of COVID for
               | Wikipedia before it was mainstream media acknowledged in
               | January 2020 -
               | https://github.com/globalcitizen/2019-wuhan-coronavirus-
               | data - but also had the unique fortune of experiencing
               | (catching) COVID in all of China, Australia and the US,
               | while all countries had irrational response I would
               | classify Australian social paranoia as some of the worst.
               | Absolutely, people were being shamed and attacked and
               | removed from society, employment, etc. if they did not
               | have vaccinations or refused to wear masks. While all
               | countries had irrational response, Australia's was
               | certainly "up there". Furthermore, they turned the whole
               | country in to a prison (you needed 'special permission'
               | to leave, even as an Australian citizen), and virtually
               | nobody complained.
               | 
               |  _There are no such people so hopelessly enslaved as
               | those who believe they are free._ - Goethe
               | 
               | I personally found the recent withdrawl of some of the
               | vaccines - which people were hounded and shamed in to
               | taking in to their bodies - with proven mortality risk,
               | as something of a vindication. None of my family had any
               | vaccines, not because we are against them per se, but
               | because we didn't encounter a legal requirement to do so
               | as we visited the US right after the requirement for
               | travelers was dropped, and had already developed natural
               | resistance through repeated exposure. If we were dealing
               | with a more vicious pathogen, we would have been first in
               | line.
        
               | supplied_demand wrote:
               | My problem is the person engaging the exact things they
               | accuse the other side of doing, all while lamenting the
               | inability to "get people on the same page."
        
             | ceejayoz wrote:
             | > Meanwhile, all those deplorable schmucks in the trades,
             | who've been lectured to death about choosing the right
             | respiratory protection for the job, were able to comprehend
             | that big mask hole and tiny virus is a Bad Choice. You want
             | the mask holes to be smaller than the Bad Thing. Therefore,
             | "Masks Don't Work".
             | 
             | It's interesting that you stop here, and not go further to
             | the next level of relevant knowledgeableness, which is that
             | the virologists and materials engineers who work on masks
             | know something the tradespeople don't, which is a) that
             | viruses rarely travel around as single viral particles and
             | b) that this is why we make surgical and N95 masks
             | electrostatically charged.
             | (https://www.wired.com/story/the-physics-of-the-n95-face-
             | mask...)
             | 
             | (For a clear example of why a) matters, try peeing through
             | your pants. The water molecules are, after all, far too
             | small to be blocked!)
             | 
             | > A clear explanation of the different modes of operation,
             | and framing it as a polite thing to do (akin to covering
             | your mouth/nose when you cough or sneeze), probably would
             | have been sufficient.
             | 
             | This was very widely attempted.
        
               | timr wrote:
               | > which is that the virologists and materials engineers
               | who work on masks know something the tradespeople don't,
               | which is a) that viruses rarely travel around as single
               | viral particles and b) that this is why we make surgical
               | and N95 masks electrostatically charged.
               | 
               | Right. Which is why we saw a great many "virologists"
               | (who are not "maskologists", btw, so I'm not sure where
               | we get this idea that they "work on masks" [1]) blindly
               | assert that it didn't matter what kind of mask you wear,
               | then for a long time defended the silly notion of a
               | 6-foot rule (remember "ballistic droplets"? I do!), then
               | said, _" OK, cloth masks probably don't do much, but
               | 'swiss-cheese model!'"_, and so on and so forth.
               | Literally anything than just be intellectually honest
               | about what the data says.
               | 
               | This entire debate has been insipid, and OP is correct: a
               | great many people who _should have known better_ shifted
               | their brains into neutral and allowed slogans to drive
               | the conversation. The entire point of the linked article
               | is that the CDC has historically used crap studies to
               | make causative arguments that wouldn 't work in any other
               | scientific debate.
               | 
               | [1] ...and let's not forget people like _Jeremy Howard_
               | (philosophy major; Kaggle guy) and _Zeynep Tufecki_
               | (librarian) somehow get cited as  'mask experts' and
               | publish total gibberish in PNAS and other high-profile
               | journals, despite having zero relevant experience.
        
               | russdill wrote:
               | Looking at the data on other respiratory illnesses showed
               | that _something_ certainly worked. Really hope we get
               | good at figuring out the relative effectiveness of
               | different measures before the next pandemic.
        
             | wpietri wrote:
             | I think one needs to have different standards for an
             | academic discussion versus a public health campaign.
             | 
             | For example, taking drinking and driving. If we're talking
             | academically, it's an incredibly nuanced topic, and I'm
             | sure the actual risk depends a ton on the individual, their
             | skills, their reaction times, their built-up alcohol
             | tolerance, and many other factors.
             | 
             | But if we're talking about actual individuals getting
             | hammered and then grabbing the keys, then "Don't Drink And
             | Drive. Ever." is about the right level for the discussion.
             | 
             | And I think part of the reason that it's so important to
             | hammer home messages like that is that the people who want
             | to do the thing that's dangerous for others will seize upon
             | the nuances of the academic discussion, use anything that
             | gives them permission, and absolutely ignore the rest of
             | it. That's true of drunk drivers for sure. It was also true
             | of smokers before they lost that battle. And of course the
             | Andrew Wakefields of the world are great at building a
             | whole grift around that.
        
             | russdill wrote:
             | N95 style and other similar masks don't work by making
             | holes that are smaller than the particles they are meant to
             | filter, they filter smaller particles primarily with
             | electrostatic effects.
        
           | 580515975 wrote:
           | https://journals.aps.org/rmp/abstract/10.1103/RevModPhys.95..
           | .. is one article that provides some insight. It describes
           | the nature of viral particles exhaled in different
           | activities, and explains how effective different masks are at
           | preventing these particles from being inhaled.
           | 
           | Separately, I was surprised to see that OP's article looked
           | at studies starting in 1978, since modern electrostatic
           | filtering masks were only patented in 1995--so I'm not sure
           | how meaningful it is to lump studies on older mask
           | technologies in with modern masks.
        
           | chaostheory wrote:
           | Another question most of these studies fail to ask is what is
           | the effectiveness of each type of mask? An N95 mask is going
           | to have a big difference in efficacy vs a surgical mask
           | without a seal.
           | 
           | Another issue is that most of these studies are just surveys.
           | Did participants actually use their masks for x hours? Did
           | they use their masks correctly?
        
         | jampekka wrote:
         | It's probably more addressing the "it can't possibly be
         | ineffective" crowd.
        
         | greasegum wrote:
         | >But where does the 1978 year in the title come from?
         | 
         | This seems to come from the fact that although MMWR has been in
         | publication since 1978, 100% of papers they have published on
         | the topic has been in the past 3.5 years.
        
         | efitz wrote:
         | Actually the authors interpretation is very different if you
         | read the very next sectio ("Conclusions"):
         | 
         | > "Conclusions and Relevance MMWR publications pertaining to
         | masks drew positive conclusions about mask effectiveness over
         | 75% of the time despite only 30% testing masks and <15% having
         | statistically significant results. No studies were randomized,
         | yet over half drew causal conclusions. The level of evidence
         | generated was low and the conclusions drawn were most often
         | unsupported by the data. Our findings raise concern about the
         | reliability of the journal for informing health policy."
         | 
         | I watch Dr Prasad on YouTube and he is pretty interesting IMO.
         | He's an oncologist but spends a lot of time analyzing medical
         | studies.
        
           | standardUser wrote:
           | With language like that, there's no way to not see this as a
           | hit piece.
        
             | admissionsguy wrote:
             | Yea, a hit piece on bad science
        
           | majormajor wrote:
           | Yes, I noted that the authors are largely focused on _study
           | quality_ vs actual conclusions about which sorts of masks are
           | what level of effective.
           | 
           | And critiquing sloppy science is very necessary. But it's
           | being extended by many to be "masks not useful, full stop"
           | despite largely being about "most studies suck." And the
           | phrasings chosen by the authors make it look like that mis-
           | read/extension is an effect they desire.
        
         | ano-ther wrote:
         | > But where does the 1978 year in the title come from?
         | 
         | Was curious about that too -- it's a slightly unfortunate
         | headline:
         | 
         | > Our search, spanning the years 1978 to 2023, identified 83
         | MMWR published studies on PubMed, all of which were published
         | after 2019.
        
       | 9cb14c1ec0 wrote:
       | One of the single most frustrating things about Covid was the way
       | media coverage almost entirely ignored the 100 years of studies
       | on the varying effectiveness of various types of masks against
       | various threats. Every bit of media attention on masks that I
       | read treated it like it was some new cutting-edge area of
       | research, when nothing could be further from the truth.
       | "Effectiveness of masks" is a very deep and nuanced subject, but
       | unfortunately most talking heads don't seem interested in nuance.
        
         | spondylosaurus wrote:
         | It also seemed very American/Euro-centric how it was treated as
         | some kind of novel idea that no one had ever tried before.
         | Meanwhile in most East Asian countries it's been common
         | courtesy for ages to wear a mask during cold/flu season.
        
         | dboreham wrote:
         | From a US perspective it was much worse than that. People
         | seemed to 1) divide into two groups: you like the idea of
         | masks, or you hate the idea of masks. Then 2) invent reasons to
         | justify that position. The media simply followed along with
         | this, providing pseudo-justification for one position or the
         | other depending on political color. Disclosure: I liked the
         | idea of avoiding breathing pathogens on other people, and I
         | loved 2 years not catching any cold or flu. It has been really
         | unpleasant to once again be having back-to-back colds every
         | time I travel by plane.
        
           | stevenwoo wrote:
           | Why do you not just wear a mask on a plane? It's pretty
           | effective for Covid-19 and presumably all other airborne
           | vectors even if you take it off for the meals.
           | https://www.mdpi.com/1660-4601/21/6/654
        
       | taeric wrote:
       | I confess the criticism of randomized control trials (RCTs) in
       | the previous paper hit me the wrong way. Anyone that tries to
       | build a case against RCTs has a pretty heavy hill to climb. There
       | are weaknesses, of course, but it is by far the strongest method
       | we know of at the moment for things where you can't isolate all
       | other factors.
       | 
       | That said, I also confess that I look forward to a time we aren't
       | seeing writers seeming to just take pot shots at each other. I
       | get that talking past each other is a common problem in life, it
       | still sucks that it has seemed to dominate so much discourse
       | recently.
        
       | ok_dad wrote:
       | I live in a place where masking isn't a big deal, people wore
       | masks all the time before covid if they felt sick to prevent
       | transmission. During covid, our rates were quite low, and the
       | rates of countries like Japan where they mask routinely were
       | lower.
       | 
       | How do "anti-maskers" (for lack of a better term) explain this?
       | If masks only work for 5 or 10 percent reduction, then it still
       | helps and with little downside.
       | 
       | I don't understand what's so bad about wearing a mask, other than
       | wanting to buck the system trying to tell you what to do.
       | 
       | I don't understand why you'd look at someone with a mask on and
       | judge them today, even, as you don't know their story or what
       | their health is like.
        
         | taeric wrote:
         | I think the problem with the mask discussion is both sides over
         | represent what the other side is saying. Proponents likely
         | don't view it as a panacea, just as opponents probably could be
         | convinced it is a good idea to try.
         | 
         | To be clear, there were and are people that are in the
         | extremes. People having meltdowns over being asked to wear a
         | mask did happen. And that doesn't make sense.
         | 
         | However, it also takes rather high confidence to think that
         | masks were meaningful impacts on school transmission. And
         | getting either side that is invested in a position here to
         | discuss with the others is difficult. I'm not clear why.
         | 
         | So, people will talk over each other and not actually engage
         | with the discussion, but the weakest form of the discussion
         | that they can dominate.
         | 
         | For myself, I don't understand it, either. Agreed that masking
         | was not a big deal. But, literally everyone I knew that made a
         | big deal of masking all of the time were the most likely people
         | I knew to have covid. Usually several times in the year. It
         | made literally no sense. (My guess is they were the most likely
         | to test all of the time, and odds are high they had a few false
         | positives?)
         | 
         | Now, as indicated by my comment on schools, I also think it was
         | pointless to try and get preschools and such with masking
         | policies. Happy to be shown I'm wrong on that, but the
         | messaging around kids and covid was abysmal.
        
           | vundercind wrote:
           | Preschool's probably hopeless, but I happened to get to see a
           | somewhat-nice (doctors and fancy lawyers send their kids
           | there) local private elementary and a bunch of local public
           | elementaries handle Covid.
           | 
           | The public schools re-opened later and had terrible
           | transmission rates the whole first year. Kids and teachers
           | were sick constantly. Masking was nominally mandated but
           | compliance in all grades was terrible, mostly due to
           | attitudes from and modeling at home (i.e. their parents were
           | chin-maskers who complained about masking a ton at home in
           | front of their kids) and then social effects of having quite
           | a few like that, causing even more to mask poorly. Kids
           | routinely came to school with fevers and got everyone sick
           | with what always seemed to turn out to be _yet more goddamn
           | covid_.
           | 
           | The private school opened sooner, but had very-good air
           | purifiers in every room that ran whenever possible (too loud
           | when class actively working) and practically perfect masking.
           | Kids didn't come to school sick. Despite re-opening sooner,
           | they did a _ton_ better. Any extra costs were more than made
           | up by not having to pay for as many substitute days. Even
           | first graders and kindergarteners masked decently well--
           | because their parents did, and didn't complain constantly
           | about masking and talk about how it's pointless and watch
           | media complaining about masking in front of their kids. The
           | parents' attitudes made most of the difference as far as
           | masking goes.
        
             | taeric wrote:
             | I'd wager that opening sooner versus later is almost
             | certainly more pertinent than you realize there. It is
             | comical how rapidly families get sick when they first start
             | something like preschool. The longer it has been since they
             | were exposed, the more rapidly they get sick.
             | 
             | That said, I'm happy to see data backing this. Last time I
             | recall the claim getting looked at, it didn't have anything
             | actionable. Private school was something like 1/20th the
             | size of typical public schools and the numbers were inline
             | with what you would expect for such a smaller population.
             | 
             | Our kids in public similarly saw a ton of reported cases.
             | Around here, though, masking compliance was pretty good.
             | I'm still finding stashes of masks we had in convenient
             | locations for when we were out.
        
         | s1artibartfast wrote:
         | >I don't understand what's so bad about wearing a mask, other
         | than wanting to buck the system trying to tell you what to do.
         | 
         | Mostly this. I like eating ice cream. If someone told me to eat
         | ice cream or they would shoot me in the face, I would resent
         | it.
         | 
         | I much prefer to be offered ice cream, or asked politely to
         | have some.
        
           | ok_dad wrote:
           | What about vaccinations? I'm talking about for mumps and
           | stuff, things we should all agree are necessary. Those are
           | more invasive yet we accept them today as a requirement for
           | most of society.
           | 
           | I just don't understand (cause I'm autistic I think) that if
           | you think a mask might help, but it was mandatory anyways,
           | why you would get angry then versus if they asked politely
           | and you did it. Is that your ego or something? I totally
           | don't understand, but like I said, around here it was the
           | exception for someone to not wear a mask, and those who
           | didn't had good reasons and were very careful to shop when
           | less people were around and stuff like that. We care about
           | each other where I live.
        
             | s1artibartfast wrote:
             | Happy to explain further, but first I need to know more
             | about what you can relate to.
             | 
             | How do you feel about the ice cream analogy? Would you just
             | be happy for the opportunity to eat ice cream and not be
             | bothered by the gun to your head?
        
               | ok_dad wrote:
               | I guess maybe I just won't get it, it seems like nothing,
               | to me, to wear a mask if requested, so I don't get the
               | push back. Do you feel like it's being too submissive or
               | something? I prefer explanations of how you feel and what
               | your internal dialogue is when a mask is mandatory at,
               | say, the grocer. Vaccinations are a decent corollary but
               | those are riskier than an N95 by far, so it's not
               | perfect. Wearing a mask basically costs nothing, IMO,
               | unless you're a very specific case where it's harmful.
        
               | s1artibartfast wrote:
               | You refused to answer the question. I clearly stated it
               | was a pre-requisite for an explanation.
               | 
               | I dont know if you would get it or not.
        
               | ok_dad wrote:
               | The ice cream analogy was stupid, that's what I think.
               | Ice cream isn't a virus, it's not even the same stakes!
               | Do 1/100 to 1/250 people die from new ice cream
               | varieties?
        
               | s1artibartfast wrote:
               | Eating ice cream is an analogy for wearing a mask, not
               | the virus.
               | 
               | It is something that isn't a big deal, and that I would
               | normally enjoy doing. I guess you didnt get it
        
           | lachaux wrote:
           | I would say this is false analogy fallacy.
        
             | s1artibartfast wrote:
             | You might be surprised at how many Americans feel the
             | analogy is quite accurate.
        
       | jl6 wrote:
       | > the conclusions drawn were most often unsupported by the data
       | 
       | This is damning. What's the purpose of an allegedly-scientific
       | paper if it draws conclusions not supported by the data? It's no
       | better than an opinion column.
        
       | jhp123 wrote:
       | There is also no good study showing that parachutes prevent death
       | when falling from an airplane. The best we have is observational
       | "evidence" where there are many uncontrolled variables, such as
       | people whose parachutes failed (but they may be unlucky or
       | careless in other ways, or incompetent fallers). And then
       | speculative physics models involving rates of acceleration and
       | energy transfer, which can hardly be assumed to carry over to the
       | real world in the absence of a proper large-scale randomized
       | test.
        
         | thedrbrian wrote:
         | >parachutes
         | 
         | Very easy and simple demonstration though. With a high
         | confidence value.
         | 
         | Whether masks make a 1% or 0.07653 difference or whatever is
         | very difficult.
        
           | ceejayoz wrote:
           | It's very tough to do a good double-blind parachute RCT.
           | 
           | https://www.bmj.com/content/363/bmj.k5094
        
             | timr wrote:
             | ....which, again, you don't need to do, because the effect
             | size of parachutes is enormous. You _must do them_ when the
             | effect size is measured in single-digit percent (or less,
             | as in the case of mask mandates).
             | 
             | You're not making a responsive argument to the parent.
        
               | jhp123 wrote:
               | how do you get an "effect size" or "confidence interval"
               | without a properly controlled trial? I could claim that
               | the "effect size" of umbrellas leading to rain is
               | absolutely enormous, billions of gallons of it drop from
               | the sky! You parachute believers are really something
               | else.
        
       | swader999 wrote:
       | Timely, we are about to enter a new election cycle.
        
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