this post was submitted on 23 Oct 2023

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What Went Wrong with a Highly Publicized COVID Mask Analysis? (www.scientificamerican.com)

submitted 1 year ago by [email protected] to c/[email protected]

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[–] [email protected] 35 points 1 year ago* (last edited 1 year ago) (1 children)

I totally do not get why people have to try to prove to themselves that masks do not work. More than likely they do especially if you have a new good well fitting mask changed frequently and you use and change it properly. There is also the question who it helps more, you or the people around you.

A huge problem during the pandemic was mask availability, and people using them properly even if they had a supply to do that which mostly no one did. So result of mask use is a good question but it may say nothing about how well masks used properly work.

[–] [email protected] 23 points 1 year ago (1 children)

I totally do not get why people have to try to prove to themselves that masks do not work.

I see it as a failure of politics. It’s been a while now, but IIRC in the US as well people were told that they shouldn’t wear N95, just like we in Europe were told not to wear FFP2. That they are hard to use and best left to professionals. That having a beard makes them useless. Now there was a decent idea behind it, stocks were low and uncertain, and healthcare professionals needed respirators first. But then production ramped up, and they were everywhere, and suddenly those masks are great and everyone should wear them.

That kind of political messaging has to produce conflict.

[–] [email protected] 14 points 1 year ago (2 children)

Yes. I just wish they had been honest. Yes they are effective but please minimize use of certain classes of masks and leave for those that really need them until stocks catch up.

The whole messaging sucked. You had to know something to read between the lines. Not a problem for me but I am sure was confusing for others. Then you had those that wanted to make it confusing.

[–] [email protected] 5 points 1 year ago (1 children)

I kind of understand. "Efficiency" is a relative measure. If there's a shortage of masks, it is not efficient enough to prioritize ordinary people. Later when there is an abundance of masks, they are more efficient than not wearing masks.

In expert discussions everybody understands that. The problem is that when this gets out of experts' hands the context gets lost and there will be a hundred different messaging problems and we non-experts see chaos.

[–] [email protected] 3 points 1 year ago* (last edited 1 year ago) (1 children)

There is also who wins and who losses and who has access and who does not and why. Not easy questions and not easy for people to hear even if it is sane. Add to that access is often just because and has nothing to do with fairness.

Add to that the medical community has basically burnt any good will they had from the public by crazy pricing and poor access combined with mediocre results. Not saying every medical partipant caused that but they all get lumped together.

[–] [email protected] 1 points 1 year ago (1 children)

Add to that the medical community has basically burnt any good will they had from the public by crazy pricing and poor access combined with mediocre results.

You realize masks are generally sold by manufacturers, and not what would traditionally be referred to as the medical community. Blaming doctors and nurses for masks being expensive or hard to get seems a little ridiculous. "How dare the medical community, represented by...Home Depot...charge so much for N95 masks!"

[–] [email protected] 3 points 1 year ago (1 children)

It is not about masks. It is about crazy prices throughout the industry. Lack of both quality and price transparency. Lack of competition.

[–] [email protected] 2 points 1 year ago (1 children)

And blaming the medical community for that is as silly as blaming them for the toilet paper shortage.

[–] [email protected] 2 points 1 year ago

They are absolutely part of the problem. Expecting crazy compensation, not knowing the cost of their treatments and being transparent and cost effective, managing medical school requirements and enrollment to create a shortage rather then surplus of practitioners, creating crazy cost schedules, building crazy expensive facilities. Medical people manage much of this system and are directly involved in a lot of this. Are they the only ones... no. But they are not without blame.

[–] [email protected] 18 points 1 year ago* (last edited 1 year ago) (1 children)

Mask debates were one of those things that taught me internet people mostly have poor reading skills. I only wrote that masks alone cannot explain the decay of covid in mask-wearing Asia. >90% of redditors wrongly labeled me as an antimasker and criticized me... The phone notifications were annoying.

[–] [email protected] 17 points 1 year ago (2 children)

I am a pro-masker, but I don't like this article.

This is an article from a historian, i.e. not an expert on medicine. What is argued is that we haven't disproved that mask works.

The problem is that this doesn't mean anything. For example, we haven't disproved UFOs. We haven't disproved aliens are watching us. We haven't disproved ivermectin.

Now, we meet people who insist that UFOs exist, aliens watch us, or ivermectin is the cure for covid, and we are skeptical about them.

If you read the article, the author only writes that masks aren't disproved of their efficiency and that it was wrong to say masks don't work.

So, a good scientist would understand that there's only weak evidence for the efficiency of masks raised in this article. The author probably knows that. In that sense, he hasn't lied.

However, I suspect he also knew that ordinaries would read this article and jump to the conclusion that masks do work.

[–] [email protected] 4 points 1 year ago (1 children)

We have disproved ivermectin. Because it's an antiparasitic, not an antiviral.

[–] [email protected] 4 points 1 year ago (1 children)

No we haven't.

We don't prove negatives in science, or in medicine. We just know that in the studies we have performed, we have not noticed any meaningful effects and we can conclude there is likely no observable benefit to taking the drug for that purpose.

[–] [email protected] 1 points 1 year ago* (last edited 1 year ago)

We don’t prove negatives in science

That's simply not true as a general statement lol it very much depends on the negative in question, or what you define as a negative

[–] [email protected] 15 points 1 year ago (1 children)

Good article. Cochrane has its place but also has its issues. I like the phrase mentioned in the article "methodological fetishism" to describe their style.

[–] [email protected] 19 points 1 year ago (2 children)

The bigger issue for me is the anti-science stance so many are pushing/following now, but whenever one study comes out reinforcing what they already wanted to believe they pounce on it. That's not how the scientific consensus works and that "methodological fetishism" fed right into it. We still need experts' help to understand what's significant.

[–] [email protected] 9 points 1 year ago* (last edited 1 year ago) (1 children)

Oh I agree. I'm coming at this from the medicine side though and there's some specific concerns and criticisms for Cochrane reviews and the meta analysis method in general, though on the whole I generally agree with what they're going for. A really simplistic example but I think illustrates the point well would be this:

https://www.bmj.com/content/327/7429/1459

A meta analysis of the effectiveness of parachutes concludes there is no evidence to suggest their effectiveness, due to lack of high quality double blind randomized controlled trials.

I'm a huge proponent of evidence based medicine, but sometimes people are quick to point to a Cochrane review or other systematic review as biblical scientific dogma that cannot be defied, and don't consider the nuances of the situation. Like what went into the meta analysis and why? What data might be missing from the meta review and why? Is only including double blind randomized controlled trials the best research method to answer the specific question being addressed? Was everything included together actually comparable? Was the specific question the review asked the right question to ask? How broad can this finding actually be applied?

Part of the problem in this case though was the Cochrane reviews findings being somewhat misrepresented in the popular media by those not familiar with the format or the nuances. No doctor is gonna read that review and rip off their masks when treating covid, flu, or other airborne or droplet diseases. Masks were used in the hospital long before covid and will continue to do so, for good reason.

[–] [email protected] 3 points 1 year ago

what went into the meta analysis and why? What data might be missing from the meta review and why? Is only including double blind randomized controlled trials the best research method to answer the specific question being addressed? Was everything included together actually comparable?

The critiques / rebuttals to the masking review typcially ask these questions. This review almost falls apart after considering the answers.

If there's not enough information to form a solid conclusion, maybe they have no business analyzing it until there is. At the very least, if they're going to include partially unrelated studies, then reflect that in the title / opening statement. Don't say the analysis is of apples, then analyze fruit in general.

[–] [email protected] 4 points 1 year ago

“methodological fetishism"

On a lighter note: Hey, no kink shaming, Naomi 😸