The efficacy of masks

[BostonCard]

Disappointing study from Denmark which suggests that wearing a mask doesn't protect the wearer.

https://www.acpjournals.org/doi/10.7326/M20-6817

The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.

Now, the study was underpowered, and wouldn't preclude a moderate effect:

Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.

BC

[DocSavage87]

I'm not sure this is any different than what we've believed earlier.  In the face of "uncommon general mask use", wearing a mask will reduce infection rates by less than 50%.  I don't have the time to look through notes, but my impression was that wearing a mask gave you maybe a 20-40% decreased risk and there was some possibility that it could make your illness less severe (i.e., the UCSF Variolation commentary).  Too bad the study above didn't assess the degree of illness of those infected.

[BostonCard]

Point estimate is that it reduces chances of infection by 15% (on a relative basis), but as I mentioned, the results are broadly compatible with a reduction of almost 50% all the way to no effect whatsoever (or even a small increase in risk).

BC

[Goose]

Point estimate is that it reduces chances of infection by 15% (on a relative basis), but as I mentioned, the results are broadly compatible with a reduction of almost 50% all the way to no effect whatsoever (or even a small increase in risk).

BC

Even 15% is better than nothing. Granted, since the study is under powered it cannot determine the effect with great precision. I think we are all still examining the effect of masking in reducing the spread of COVID-19 in both directions. Obviously, it has been tricky to get data and the data that we do get has to be peeled apart from other effects. It would seem probable, given the studies we actually have seen, that the effects of masking are non-trivial but not overwhelming, in the 25% range maybe. That level of effectiveness is obtained with essentially no downside, and is therefore very worth having.

One factor that makes the evaluation of masking difficult is that it is often coupled with social distancing. Clearly, in the case of health care professionals, there is reason to believe masking is protective and quite effective (and data to show this as I understand it). It is probable that masking is much less important when there is significant social distancing going on and close contact is infrequent. It makes doing studies lots harder.

[M T]

Disappointing study from Denmark which suggests that wearing a mask doesn't protect the wearer.

https://www.acpjournals.org/doi/10.7326/M20-6817

By "disappointing study", was your comment about how it was designed & executed, or about an interpretation of its results "that wearing a mask doesn't protect the wearer"?

As I read it, they weren't measuring whether wearing a mask protects the wearer.  The were measuring whether a recommendation to individuals to wear masks resulted in protection of the individuals.

If you go by the beliefs often espoused on this board, such a study's recommendation (to wear masks) to Republicans would result in a different outcome than for Democrats, because of external factors.  

Personally, I think this is a pretty stupid study.  What force (the head of the church? the President/Prime Minister/Queen? the head MD in the country? the best soccer player?) is behind the recommendation?  What beliefs do you have to overcome?

Does this study convince anyone here that President Trump's comments or the CDC's recommendations about mask wearing made little difference in the cases of COVID in the US?   Somehow, I doubt it.

[fanofourforebears]

Disappointing study from Denmark which suggests that wearing a mask doesn't protect the wearer.


BC

Hi, thought I would add another resource to take a look regarding masks compiled by a Doctor on my side of the pond.  It is supported, even if it might go against the grain ... just food for thought. I tried to upload, it did not work so here is a link https://www.vernoncoleman.com/harmthangood.pdf
Just a comment, but it seems many here are focusing on the dangers of not doing all we can, but what about the dangers of what has and is being done? I know there are things Dr. Coleman mentions that will appear to have been debunked, but he has support for his take, so who knows? Who decides and are we sure we want to give so much power over things to the State? As someone who has COPD and lower oximeter readings than even some of the older guys here, I can say that for me masks wearing has had some ill effects. For instance I breathed in some fibers and that required a Doctor visit and precautionary anti-biotics when my pulse oximeter kept beeping at levels at 93 percent and below. It is better now and I haven't had a reading below 94 the past couple days.

However, what about our rights and how long should we have "Public Health officials" and Governor's and others able to exert such potentially tyrannical powers that may or may not always be for the good of those they now use these powers over? I for one consider our right to breathe and exhale a God given and inalienable right. It really is the best way for most to breathe without this process being infringed upon. Yes, I would, have and will continue to voluntarily give it up to protect others. However, is it something that any of us should have to give up or have taken away by mandates or fines, over any extended period of time? And how about for those of us who have a greater need to breathe in and out freely like athletes in competition, older guys working out, young children with their active minds, and old guys like me with COPD??
Mike

[M T]

FanOfOurForebears, welcome to The Cardboard!

For those who truly have breathing problems, mask wearing is not required, and is not recommended.  All the requirements for masks that I've seen have exceptions for this and other situations. (CA, SMC, KS)

To minimize chance that someone misunderstands the situation, you might want to get a note from your doctor indicating that you have a medical condition that prevents you from wearing a mask, as well as a copy of whatever order requires wearing a mask that also has the exemptions for those with breathing issues.  Some business might not want to let you in at first; such documents should clarify that you are not required and are not recommended to wear a mask. (To clarify: In the orders I've seen, you are not required to carry such documentation. I just think it might make things easier if someone isn't aware of the exceptions. If it was me, I might get a button: "SORRY, I can't wear a mask. Thank you for wearing yours.")

There are different reasons for low PO2.  I rarely see mine get up to 96, mostly 92-94, but mask wearing isn't an issue for me as long as I stay out of oxygen debt.  But then, I don't have COPD.

[BostonCard]

I agree with your points.  I don't mean to post the above to suggest that people should not wear masks, although the paper will undoubtably be used by mask opponents for that purpose.  I do hope that we have a realistic discussion of what masks can and cannot do.  It is a tool, that should be used in conjunction with other social distancing measures, but people should not assume it is a panacea.

BC

[lex24]

Basically educated guesswork.  Always has been.  But there is no downside to wearing a mask. So I do.
The discussion should be one of risk-benefit. As opposed to trying to shame. Which is essentially how it goes now. Based on politics. That doesn’t work. And won’t.

I said before, I’ll say again, I’d be bombarding with PSA’s not from politicians - people are so sick of politicians they wanna vomit. And Newsom just became exhibit A on that front (along with all those folks who are going to be partying on the lobbyists dime in Hawaii for a week or so). Put on athletes, models, entertainers, rock stars, rap stars, country western singers, Saban, etc. etc. etc. wearing masks doing PSA’s and putting it as simply as possible:

“The evidence is masks help slow the spread. If that’s right maybe we get our lives back to normal quicker. And you can go to a ballgame, concert, play, bar, movie. Etc again. If you want normal faster; wear a mask. It’s easy. And it’s the right thing to do.

Every televised sporting event should have PSA’s from the top players and coaches.


This should’ve been the plan along time ago instead of having politicians and health directors get on TV and drone on forever and ever and ever. Or saying wear a mask or granma dies. People tuned out on that by Memorial Day.

[Goose]

The following link has some comments regarding this study. I like much of what is said here, FWIW.

https://www.medpagetoday.com/blogs/vinay...definition

---

Basically educated guesswork.  Always has been.  But there is no downside to wearing a mask. So I do.

The discussion should be one of risk-benefit.  As opposed to trying to shame.  Which is essentially how it goes now.  Based on politics.  That doesn’t work. And won’t.



I said before, I’ll say again, I’d be bombarding with PSA’s not from politicians - people are so sick of politicians they wanna vomit. And Newsom just became exhibit A on that front (along with all those folks who are going to be partying on the lobbyists dime in Hawaii for a week or so).  Put on athletes, models, entertainers, rock stars, rap stars, country western singers,  Saban, etc. etc. etc. wearing masks doing PSA’s and putting it as simply as possible:

I guess I am just not from the right generation. The idea that people can and should determine their health care strategies based on PSAs from "celebrities" appalls me. It may well be true that that type of "advertising" is what works, but I can't bring myself to advocate advising the public that way, even if the advice is "good". The problem is that the ability to give advice can then be purchased by anyone, and the results aren't necessarily good. The public needs to learn/know that baseball players are not virologists and what the baseball player advises about health decisions is NOT the way to make your decisions.

[lex24]

The following link has some comments regarding this study. I like much of what is said here, FWIW.

https://www.medpagetoday.com/blogs/vinay...definition

---

Basically educated guesswork.  Always has been.  But there is no downside to wearing a mask. So I do.

The discussion should be one of risk-benefit.  As opposed to trying to shame.  Which is essentially how it goes now.  Based on politics.  That doesn’t work. And won’t.



I said before, I’ll say again, I’d be bombarding with PSA’s not from politicians - people are so sick of politicians they wanna vomit. And Newsom just became exhibit A on that front (along with all those folks who are going to be partying on the lobbyists dime in Hawaii for a week or so).  Put on athletes, models, entertainers, rock stars, rap stars, country western singers,  Saban, etc. etc. etc. wearing masks doing PSA’s and putting it as simply as possible:

I guess I am just not from the right generation. The idea that people can and should determine their health care strategies based on PSAs from "celebrities" appalls me. It may well be true that that type of "advertising" is what works, but I can't bring myself to advocate advising the public that way, even if the advice is "good". The problem is that the ability to give advice can then be purchased by anyone, and the results aren't necessarily good. The public needs to learn/know that baseball players are not virologists and what the baseball player advises about health decisions is NOT the way to make your decisions.

They have used athletes and entertainers for  PSA’s forever. There’s nothing new about this. Sorry goose you are not representative of the general public. The  people on this board generally aren’t. And PSA‘s are just that public service announcements. They have to be approved before going forward. 

I get you’re being apalled – I think it’s sad as well that people will listen more to celebrities etc. But the bottom line is a hell of a lot of the public does. So do you want to move forward towards solutions? Or do you want to not do this because it’s “appalling”

[Goose]

They have used athletes and entertainers for  PSA’s forever. There’s nothing new about this. Sorry goose you are not representative of the general public. The  people on this board generally aren’t. And PSA‘s are just that public service announcements. They have to be approved before going forward. 


I get you’re being apalled – I think it’s sad as well that people will listen more to celebrities etc. But the bottom line is a hell of a lot of the public does. So do you want to move forward towards solutions? Or do you want to not do this because it’s “appalling”

As far as PSAs being "approved", could you give me some links and that? A quick google didn't find me any.

Your point regarding "moving forward to solutions" has been discussed forever. Is it better to achieve public "virtue" by manipulating the public or to forgo that option and possibly fail because you actually tried to convince them with facts/logic? Who defines "virtue" or "solutions"? We aren't going to solve this question here and now. FWIW, I think that in the US we have pandered to the public for so long that we now have a public that will latch on to unfounded conspiracy theories if they are presented by a well-known "celebrity". We are getting what we deserve when it becomes a battle of PR and not facts.

However, I would suggest there is a middle ground. A year ago probably not even 1% of the population knew who Tony Fauci was. Now he is at least a minor "celebrity". Do your PSAs with Fauci. Create more younger Fauci types who the public recognizes. Everybody knows who Sanjay Gupta is. We could use a few public figures who actually know something about their business. It works for Generals, why not scientists?

[lex24]

They have used athletes and entertainers for  PSA’s forever. There’s nothing new about this. Sorry goose you are not representative of the general public. The  people on this board generally aren’t. And PSA‘s are just that public service announcements. They have to be approved before going forward. 


I get you’re being apalled – I think it’s sad as well that people will listen more to celebrities etc. But the bottom line is a hell of a lot of the public does. So do you want to move forward towards solutions? Or do you want to not do this because it’s “appalling”

As far as PSAs being "approved", could you give me some links and that? A quick google didn't find me any.

Your point regarding "moving forward to solutions" has been discussed forever. Is it better to achieve public "virtue" by manipulating the public or to forgo that option and possibly fail because you actually tried to convince them with facts/logic? Who defines "virtue" or "solutions"? We aren't going to solve this question here and now. FWIW, I think that in the US we have pandered to the public for so long that we now have a public that will latch on to unfounded conspiracy theories if they are presented by a well-known "celebrity". We are getting what we deserve when it becomes a battle of PR and not facts.

However, I would suggest there is a middle ground. A year ago probably not even 1% of the population knew who Tony Fauci was. Now he is at least a minor "celebrity". Do your PSAs with Fauci. Create more younger Fauci types who the public recognizes. Everybody knows who Sanjay Gupta is. We could use a few public figures who actually know something about their business. It works for Generals, why not scientists?

I may be wrong on the “approved”. As for Fauci - again he’s associated with politics.  Goose, who do you think more Americans recognize - LeBron James, Tom Brady, Carrie Underwood, Snoop Dog, Bruce Springsteen, Meryl Streep, Saban or Tony Fauci/Sanjay Gupta.

 I understand your point – and frankly I agree with it to a large extent. It shouldn’t be this way. But it is. And we should be working towards doing everything we can to slow this thing down.  Fine also run them within with Fauci and Gupta as well. We should be running them a lot. But I still say that getting entertainers etc. involved will help. And that more people will take their direction from the list I indicated that they will from Tony Fauci. Is that right? Of course not. But frankly at this stage - I don’t give a damn. I just want to see this thing start to decline.

And the statements they should make ARE based on facts and logic.

[BostonCard]

Apropos celebrity messaging...

https://www.fiercepharma.com/marketing/h...d-campaign

HHS cancelled its ad campaign:

The Department of Health and Human Services (HHS) Wednesday nixed a controversial $15 million contract that sought to use celebrity messages to drive responsible pandemic behavior. However, the larger $250 million campaign will go on, albeit with a “new approach.”

"Controversial" is probably understating it if you look at the details.

BC

[magnus]

Apropos celebrity messaging...

https://www.fiercepharma.com/marketing/h...d-campaign

HHS cancelled its ad campaign:

The Department of Health and Human Services (HHS) Wednesday nixed a controversial $15 million contract that sought to use celebrity messages to drive responsible pandemic behavior. However, the larger $250 million campaign will go on, albeit with a “new approach.”

"Controversial" is probably understating it if you look at the details.

BC

I thought this attempt died with Caputo's departure.  Didn't realize the $250 million campaign is still going on though their new vision does seem more appropriate.

“The new approach would create a dynamic relationship with public health infrastructure, build on established messaging, and develop a comprehensive, consistent, coordinated, and science-based public education campaign with rigorous evaluation and regular impact reporting to inform decision making,” HHS said.

[fanofourforebears]

FanOfOurForebears, welcome to The Cardboard!

For those who truly have breathing problems, mask wearing is not required, and is not recommended.  All the requirements for masks that I've seen have exceptions for this and other situations. (CA, SMC, KS)

To minimize chance that someone misunderstands the situation, you might want to get a note from your doctor indicating that you have a medical condition that prevents you from wearing a mask, as well as a copy of whatever order requires wearing a mask that also has the exemptions for those with breathing issues.  Some business might not want to let you in at first; such documents should clarify that you are not required and are not recommended to wear a mask. (To clarify: In the orders I've seen, you are not required to carry such documentation.  I just think it might make things easier if someone isn't aware of the exceptions.  If it was me, I might get a button: "SORRY, I can't wear a mask.  Thank you for wearing yours.")

There are different reasons for low PO2.  I rarely see mine get up to 96, mostly 92-94, but mask wearing isn't an issue for me as long as I stay out of oxygen debt.  But then, I don't have COPD.

Thanks M T. 
How are you doing with your lower pulse oximeter readings?  Why so low?  My average sitting or laying down can drop down to your level if I am not careful to focus on my breathing, otherwise it averages around 95 lying down or sitting and 96-97 when walking around and has hit 98 when exercising..   In regards to all of this, we need to be wary of what we are told by just about everyone... there is much propaganda and misinformation out there, i might be holding on to some and others as well.  Always enjoyed the contributions of BC, outsiderfan and so on regarding football, but it is hard to enjoy football for the moment and just hoping we don't have many more false positives like those that kept Davis Mills and Connor Weddington out of the Oregon game.  OT(off topic), but ... Does any one know the standard amount of times things are multiplied before getting to a positive, inconclusive or negative test result in California vs.. say New York or the UK or France using PCR testing?  Also how about testing options as alternatives to the nasal swab?  I ask because a friend who is an MD got hurt by one not being used quite right and due to nasal issues both my wife and I also have, like deviated septum's.  There seems to be some variability regarding the multiple used for testing.  I have heard as low as 33X and as high as 45X. This can, has and continues to lead to much different results depending the multiple used. And then there is the issue of exactly what part or whole of the new virus has been isolated and how this lines up with what is being identified and tested for.  Then there are the for me the strange standards for how we view the spread based upon population, such as the color coding for CA. It seems there should be many more confirmed cases of daily infections for the widespread designation, maybe we need a wider range for the colors? And then there is the meddling by the authorities in limiting what Doctors can do with patients, including all the politics over this or that treatment.  I for one would like to see Doctors be given more freedom to treat patients on an individual basis, with a focus on safety and reducing death rates as well as the over all well being of each patient and of course preventing any large opportunistic bacterias that seem to accompany what we is being reported as Covid 19, much like they did the Spanish Flu. And another things.. back to point.. the fear... it seems to be created thru the way all of this has been covered. It is tangible in many and when people have that fear in their eyes it is hard for me to not put that mask on so that they are not so afraid. I have actually been the subject of people urging me to lift it over my nose and seen others required by bus drivers and others if they want to take public transportation or enter certain venues. I am concerned that society is changing to a fear based one and just hope we can get back to being more brave and less fearful and media and celebrities could help if so inclined, not saying any illness or plague is not dangerous, but sometimes it just might be our biggest enemy could be fear itself.. and so on... even public health could be our enemy if not done correctly considering the powers those in authority in public health now wield.

[Publius]

The lack of efficacy of masks in this society could be due to risk compensation.  The people who wear masks may feel more protected so go outside their home more often.

[M T]

The lack of efficacy of masks in this society could be due to risk compensation.  The people who wear masks may feel more protected so go outside their home more often.

Good point.  It can also be that those that HAVE to go out among others (and so are at more risk) are more likely to wear masks.  For instance, an EMT probably spends more time in masks but is also at greater risk.