So many "misinformation censorship" proponents seem to have quickly forgotten just how much literally everyone in public health has spread misinformation this pandemic. It's unavoidable being wrong and often the cost of making claims without unimpeachable evidence is higher than the cost of being wrong. Name me a public health official who regularly made recommendations this pandemic and I'll show you misinformation.
The real issue here, in my opinion, is attributing malice so quickly and with extreme prejudice. Tensions are high and it seems to have become commonplace to assign ill-intent to the other tribe way too easily. In my opinion the answer to all of these problems is compassion and statistical thinking. Most people mean well and often times the only way you can get people to go to extremes is to negatively reinforce them into deeply entrenched tribal thinking.
It will always be a safer assumption to assume somebody means well even when they are wrong. Humans did not become the dominant species on this planet without cooperation and pro-social behaviors.
There is a difference between "malice" and "intentional misinformation".
Authority figures are not accurately representing risks and rewards of different actions and have deliberately shaped their messaging to achieve outcomes.
Direct from the horse's mouth: https://twitter.com/cdcgov/status/1233134710638825473 "CDC does not currently recommend the use of facemasks to help prevent novel #coronavirus. Take everyday preventive actions, like staying home when you are sick and washing hands with soap and water, to help slow the spread of respiratory illness." from 27 Feb 2020.
They weren't saying this because they thought face masks were ineffective, they said this because they were worried about supplies for healthcare workers. (obvious by reading subtext)
This is a repeated pattern. Making recommendations and sharing "facts" omitting important details in order to push for an unshared outcome.
Nobody is properly sharing how risks have changed, nobody is making premeditated decisions about which risks will be associated with which mitigating actions. The goalposts are constantly shifting to match present feelings instead of setting limits based on reason and sticking to them.
The censorship problem comes in when publishers are half-way committing to a narrative which changes by the week, failing to shut down people who are just saying things a subset wants to hear in order to get money and actively shutting down others who are actively trying to engage in reasonable debate.
The fundamental problem is this:
People have different risk tolerance and different priorities when it comes to personal risk, and individual actions affecting the community. These differences in this case are ultimately fairly small but getting blown out of proportion because it's profitable to get people upset.
It is all a moot point now and nobody seems to be able to articulate or admit it yet.
There is very little community protection left available by vaccinating. Vaccinated people can carry and spread the disease, the new variants are a lot less deadly, and a sizable proportion of the population already has natural immunity from getting the actual virus (~75M confirmed cases in the US for ~330M population, with estimates that there may have been as many as 4x as many cases which went uncounted)
It's over, we lost, the outcome we have is what we got and there is very little leverage to change it at this point because the vast majority of what was going to happen has already happened and the prevention tools we have are mostly ineffective at curbing spread.
Ok then, why is it bad to prioritize healthcare workers, who put their lives on the line in the face of a new unknown disease? That was only for a very short while. I think the behavior of people rushing to buy toilet paper shows that, indeed, had the CDC promoted masks at that point, it would have prevented nurses and doctors from getting the most basic protection while exposing themselves to infection to an incomparable degree.
It's not bad to prioritize healthcare workers, there are plenty of levers the CDC and governments have to do so.
It is bad to prioritize healthcare workers by sculpting messages i.e. manipulating the population.
A message for Feb 2020: "Masks will likely help curb infection for you and transmission for others, masks are most important for healthcare workers and the medically vulnerable, wearing them when you're around people is a good idea, but we need to make sure they get into the hands of people who need them most first"
They essentially decided to borrow against future trust in order to achieve a desired near term outcome. That may have been the option which led to the fewest deaths, or maybe vaccination rates would be ?% higher if they hadn't undermined their own credibility. It was (and still is) impossible to know, but I don't think thats the kind of call we want scientists to be making.
If lies slow down the progress of society and progress continues curing disease and saving lives - there isn't an argument as to whether you save move lives, obviously you save more lives with trust if we agree on the axioms that trust is necessary for progress and that progress will increasingly save lives over time.
> They weren't saying this because they thought face masks were ineffective, they said this because they were worried about supplies for healthcare workers.
This doesn't pass the smell test because governments could easily have banned the private sale of masks.
Many governments have used their powers to confine us to home arrest without a trial and they expect us to believe they couldn't have confiscated all the masks?
While protecting the supply of masks may have been part of the point, the CDC also believed (along with much of the medical community) that masks did little against viruses because of old research. It took quite a bit of scientific discussion and bickering for them to revise that opinion.
I largely agree with the rest of your points - particularly the outcome we have found ourselves in. Barring the emergence of some horrific new variant (Imagine Omicron with 10x the fatality rate), this is just another bug we can no longer avoid without effectively destroying our existing society - time to move on and live with it.
Our whole family had mild delta two months ago, even then we are now finishing quarantine after everyone catching omnicron. Neither vaccines or previous infection seem particularly effective at stopping re infection. The virus seems significantly different to previous iterations meaning it might as well be a different virus altogether.
It felt like a medium flu for the adults and just bounced off the kids.
It’s malice when the CDC again and again lied that natural immunity to covid was inferior to naive vaccine immunity, even cherry picking data to prove their point. Only recently after dozens and dozens of papers having had refuted their narrative has the CDC changed its official position on natural immunity, not that it ever got media attention.
The anti mask, anti N95 masks with exhalation valve stuff has been the worst here I think.
If you would let folks wear N95 with exhalation valves (highly comfortable) it just makes it easier for folks to protect themselves (and indirectly others).
And for those who don't care, let's distinguish slightly between making sure those who want to protect themselves as much as possible can, and the need to force people down a path which for the < 29 year olds really doesn't not have hi mortality rates, and for whom vaccination does not eliminate the disease the way it might something like smallpox etc.
My own view is the battle is largely lost already by the health authorities. Locally we have an indoor mask mandate including offices with all staff fully vaxed, and the natural desire to comply with this has gotten lower and lower if you are pretty spread out in large cubicals etc.
This is a bit of a tangent, but I don't understand generalized masking. At best they flatten the curve, which I think at this point I believe flattening the curve is dangerous. We have pretty well defined risk demographics and if we could have covid seasons come and go quickly I think it gives the high risk demographics the best chance of applying multi-layered defenses against a shorter season of risk.
There is of course the "overcrowded hospital" issue, but I have a hard time coming to terms with that being a real problem - if it were a real problem why has hospital capacity been in decline this entire pandemic? Is it an unsolvable problem or is it just not a real problem outside of fantastically clickable headlines? I lean heavily towards the latter but I could be convinced otherwise.
The issue for me is I have elderly parents one of which does have a health condition (serious) that makes some breathing and other issues hard. They wanted to fly out to visit me. The absolute best way to avoid covid for yourself in my view is an N95 masks with a vent, because you can actually wear that thing for hours comfortably.
I have friends who treated folks with covid wearing N95's and did not get covid.
So I really wish we could let folks make the personal health decisions here a bit more. If you want to wear a bubble helmet with filters in it - go for it. The full respirator (almost always with an exhalation valve)? Go for it. The N95 with an exhalation valve? Go for it.
Instead, delta airlines says no full cover, no N95 with exhalation etc. So now you have people who don't want to wear masks forced to wear them, and they are preventing folks who really DO want to be protected (while on a flight) from fully protecting themselves. This is all in the name of "science" which really is not science but "public health" mumbo jumbo.
It goes back to this issue of basically not realizing folks have different risk profiles / tolerances. If I'm allowed to wear my N95 with an exhalation valve for 4 hours, I frankly don't care if the guy 2 rows back has his mask off his nose.
This mistake is lecturing everyone (often with bad info) and then blocking folks from solving their own problems. remember when the anti-body rapid tests had to have a chip, an iphone app and a medical professional in the mix?
And no, I don't believe in those cloth masks, and surgical masks on a plane for 5 hours? Hard to imagine that being highly effective.
The most mindbogglingly dumb part about masks on planes is that there's still meal service on longer flights, at which point everyone takes off their masks at the same time to eat the food. Are we supposed to believe that the virus takes a little nap while everyone eats, and then only goes back to spreading itself when everyone has finished eating?
Detailed rules always lead to insanity. The best way is always to be upfront about the risks, how to mitigate them, and then let people make their own risk assessment and do whatever they're comfortable with.
But instead of saying "Flying carries a risk of exposure to this virus and others, here's what you can do", we're saying "If everyone engages in this piece of safety theater, flying is perfectly safe and fun for everyone!"
Exactly. That's all I want to be able to do. Skip the meal, wear my "medical professionals only" N95 mask with exhalation valve so I am comfortable.
Then I won't care if someone has their mask on their chin while they eat some food.
Instead, I can't wear the mask I want, and we play this stupid game of forcing folks to wear ineffective masks in a highly closed off space who don't care / don't want to / have already had covid and don't believe the doctors claims that there is no element of natural protection as a result.
I would imagine if the flight is 5 hours long and the eating time is only 0.5 hours, then there would only be 0.5 hours of breathing virus into the air than 5 hours of it. That being said, yes, most would be unmasked at that time and likely to breathe it in, I guess I just see overall as limiting the total amount of virus breathed into the air by requiring masks most of the time.
Half an hour is long enough to get infected, we know this.
If masks work, they work on a mechanistic, physical, level. They filter air, and if you use your masks wrong, or take them off, they stop filtering air.
But if you look at how people are actually using their masks, they pay zero attention to the mechanics of it, and 100% attention to the appearance of it.
Someone who wants to wear an N-95 mask for the duration of the entire flight, and who won't remove it for eating, understands the mechanics of how they work. That behaviour is not theatre.
Someone who wears whatever because they're told to, crams it in their pocket now and then, removes it while eating, and still believes they work, do not in fact understand how masks work. And whoever is making rules and mask mandates that allow for this behaviour also clearly do not understand how masks work. It's all theatre. It's masks as make-belief lucky rabbit's foot talismans, and yet we're supposed to believe that the rules are based in science.
I still don't see it as all theatre—maybe I just see it more like a probability function. 100% of people won't use them properly, no matter how much instruction or how foolproof the design is (because one way to fix improper usage is to improve designs instead of blaming the user). Will 50%? Maybe 10%? OK, if 10% use them 100% properly, what if another 30% use them at 50% effectiveness? I'm making up these percentages but just showing that I don't believe it's all theatre if not 100% of the people comply 100% perfectly.
So yes, people can get infected at half an hour. Are their odds much higher to get infected at 5 hours than 0.5 hours? I'd assume yes.
Heck, even people who wear it over their mouth but don't cover their noses, yes, they're potentially leaking covid out of their nose and breathing it in thru their nose. But if they cough, I imagine a percentage of the covid comes out their mouth and gets trapped in the mask...even despite them not wearing it 100% properly.
I'm saying that some of it may be theatre, or maybe much of it is (by theatre being ineffective but trying to appear effective), but I don't think it's all theatre.
Personally I don't think any kind of mask works on people who don't want to wear them. I hypothesize the reason general population shows little or no benefit with masks is because wearing masks effectively is significantly more tedious than just having one on most of the time where people require them.
People who don't want masks aren't getting fitted properly for n95's, they aren't shaving, they aren't behaving consciously in the many ways you can behave that render masking ineffective.
Agreed. I laugh because folks have masks on their necks, off their noses etc, when eating, when drinking etc. I don't blame them, a lot of masks fog up glasses etc if they actually are restrictive and don't have an exhalation valve.
I shave (this comes from scuba diving where shaving provides similar benefits). I have my own reasons not to want to get covid. So I like doing some things that I'm confident reduce my risk meaningfully. But I don't lecture others, I solve my own problem here.
What is this "it" you're referencing specifically? I'm not sure which point you're asking about, but any of the points aren't like to have great data. Not many masking studies go outside of modeling and the lab and the ones that do aren't that detailed (that I can recall).
> People who don't want masks aren't getting fitted properly for n95's, they aren't shaving, they aren't behaving consciously in the many ways you can behave that render masking ineffective.
Maybe you weren't saying not shaving renders an n95 ineffective.
I appreciate you sending the source. I guess I still have the same argument. A LOT less effective does not equal ineffective. Or maybe I just see certain words like "ineffective" as binary words, either it works or it doesn't, and have a reaction to that. It may be a lot less effective to have facial hair while wearing an n95 compared to no facial hair and a properly fit n95, but is that still much much more effective than not wearing any face mask?
ineffective is not binary - it depends on your endpoint, which is subjective.
If your endpoint is to not catch covid and someone ineffectively wears their mask such that they would not have caught covid if they wore it correctly - then the mask was ineffective even if statistically they _maybe_ had lower chances of catching covid than without wearing a mask at all.
and I say maybe very strongly here...we do not understand transmissible diseases nearly as well as many would like to think - there are plenty of observable datapoints that correlate mask usage with increased transmission...my gut feeling would be to explain those away with confounding variables, but my gut feeling is not science and no substitute for a testable understanding of the problem and solution
Ah, yeah, I think it was just a misalignment on the word ineffective. I think when I hear many people use it, I assume they mean pointless, ineffective for all, whereas in you saying it, it sounds like you meant ineffective in that particular instance based on what the outcome was. I see you seem to have a lot more nuance in your perspective than I may had been assuming. I'm sorry. Thank you for clarifying.
Its pretty noticeable, If I shave, I get a tight suction feel on an indrawn breath. This is same experience you get with a scuba mask.
That's interesting there is some protection, I could believe still better than things like cloth and surgical because the strapping tends to be tighter.
The rule was not made to protect passengers, but to protect the crew who are stunk in a tin can with hundreds of different people every day. The risks will add up over time.
Also, male doctors and nurses are require to shave before donning their masks for a shift because even the slightest overnight stubble will ruin the seal. The chances of general public wearing an N95 correctly to get the most benefit out of it is close to nil.
Hospitals have been jam packed the entire time. There is data everywhere to support this. Tons of procedures are not being done due to beds and ICUs being full. Ask anyone who works in a hospital. Call one if you'd like.
This is second hand from someone close, but not too close in the military, so details are off but the narrative is on track:
The Mercy was deployed after some communication between New York hospitals, and the understanding at least was that it would mostly be handling emergency, trauma, and routine patients (what military docs are good are at as a stereotype), and free up capacity for the hospitals to deal with COVID. The "normal" medical stuff promptly dropped in demand with lockdown, between fewer accidents and deferred care. So there wasn't much for the Mercy to do, the few covid patients sent over were about all of an "unknown air transmissible virus" (working theory at the time) that it was really equipped to handle, because that wasn't the mission they were expecting.
That makes sense in New York but we knew more about the situation when she was in LA and when the USNS Comfort was in New York later on. (Also I put USS Mercy when it should be USNS Mercy)
"Another of the Navy’s two hospital ships, the USNS Comfort, was sent to New York City to treat non-coronavirus patients. However, after treating only a few dozen patients, the Comfort changed its rules to allow coronavirus-positive patients on the ship.
The Comfort had been docked in New York Harbor in Manhattan since March 30 but departed last month for its Norfolk, Va., home port after treating just 182 patients."
ICUs are at max capacity all the time pre-pandemic. In fact a study done in 2013 IIRC showed that you could pick any random date and any random hospital in the U.S. and there was a 16% chance it was at max capacity.
So again, my question is this - if hospital capacity is truly a crisis, why have staffed beds been in decline since the beginning of the pandemic? Half a million healthcare workers have left their jobs since just the start of the pandemic. If this is a crisis, why isn't there any initiative to get them back? Instead the only initiative we've seen with regards to healthcare workers is massive layoffs firstly because of lockdowns, but then later also massive layoffs because of vaccinate rules.
So either this is a terrible problem with no solution, or the problem is exaggerated and it's not really a crisis.
Thats just not true. I found the study you're referencing and it says in 2013 mean ICU occupancy was 68%. If you zoom out on the map you'll see the US avg is 83%. Did you even look at it? Some states are like 9/10 at 100% capacity.
Staffed beds are not in decline, and of course hospitals are trying to get more workers, they are offering crazy pay incentives right now.
the dark gray represents ICUs in the studied time window (which wasn't 2013, it was a study done in 2013, the study measured ICUs from 05-07)
Here's an interesting fact[1]. 2020 hospital capacity in the US after the start of the pandemic never even got up to the projected capacity as projected using data from 2015-2019. So no, I don't believe these scary-tale anecdotes I've been reading the entire pandemic. They are not backed in data they are backed, at best, in bullet points without context designed to scare the ignorant.
I like how the public health folks don't connect the dots. MEDICAL PROFESSIONALS are tired of the stuff they are hearing.
I know some folks who had covid, and just don't want to trigger their bodies systems again with a series of shots.
For some reason, if you have other diseases your immune system likely provides some protection against re-infection, but we are being told covid is different. This just seems so likely to be a lie its mind boggling.
Let healthcare works test their blood for cross-reactivity with omicron / antibodies. If you are equal or better than some threshold (pfizer vaccine from 10 months ago) you get a card and are good to go.
> For some reason, if you have other diseases your immune system likely provides some protection against re-infection, but we are being told covid is different. This just seems so likely to be a lie its mind boggling.
I don't know what you're talking about. There is some protecction, it's not enough to make things safe, what's the lie?
If you're talking about those people still having to get a vaccine, that's a whole mess of tradeoffs but also not based on lying.
> if it were a real problem why has hospital capacity been in decline this entire pandemic
We filled hospitals over capacity and burned out healthcare workers. They decided to quit rather than work in such conditions. Don't overwork healthcare workers and maybe they won't burnout so quickly.
It should be the other way around: non-essential-workers only leaving the home for groceries and other essentials reduces it from 7 to 1.5, keeping distance at the grocery store reduces it from 1.5 to 1.1, wearing masks at the grocery store reduces it from 1.1 t o 0.8. Something like that. Made-up numbers.
My personal interest is filtering on ingress. I can feel the pressure when I breathe in, the air is going through the mask for sure.
On egress, just a quick look at the valve, it's going to stop the velocity and either block or drop particles - however ineffective that might be on egress there is NO WAY it is worse then what I see others wearing (surgical / thin cloth etc), mask off the nose, mask off while they eat etc.
Finally - folks historically have a natural "self interest" motivation. Ie, if you let folks act in a self interested way - personal protection, personal comfort - you are likely going to be better off policy wise.
You can do a rough risk computation yourself I guess. Both ingress and egress is worse if you have a valve though. Does seem like egress is still a bit better than what other people do (in this model at least - which could be wrong), but one shouldn't set one's standards by "what other people do".
"one shouldn't set one's standards by "what other people do""
In policy matters one can and should.
This is the stupidity I think of the scientists here.
If others are wearing surgical and little cloth masks, only wearing them a little bit, but then they say I can't wear my valved N95 (which I do very carefully) it's both totally arbitrary and unfair (my exhalations are still equal too or less others).
They also miss that the tradeoff might not be between my 5 hours of N95 use in a relative high workrate environment and something perfect, but that I will join with just about everyone else and ignore what they say, or go down to something like a surgical mask for comfort. Or take my mask off more for comfort to "drink" etc.
I'm convinced many folks on HN sit behind computers in empty rooms alone and NOT wearing a mask. If you have to wear a mask every day - these issues would matter a lot more.
The perception, of course, is that you are not filtering egress. Since the objective is/appears to be to filter egress, people will obviously take askance.
This can't be resolved without a bunch of additional training.
Of course if we'd done THAT, we wouldn't be in this situation in the first place, and the whole discussion would be moot. %-/
p.s. I worked on-site at a factory doing industrial automation for a lot of the time; I really liked FFP2 masks because they fit better and my glasses didn't cloud up.
Masks with valves were available (because part of one's regular PPE at times before the pandemic), but no longer permitted.
Yeah, that said FFP2's I think are per WHO only supposed to be for medical professionals - so use is discouraged outside that setting.
"This said, the World Health Organization does not recommend the use of FFP2 for everyone, stating that non-medical face coverings should be used by the general public under the age of 60 who do not have underlying health conditions. FFP2 masks are best used as personal protective equipment (PPE) by healthcare workers or those caring for someone who may have Covid-19 in a community setting. "
The real issue here, in my opinion, is attributing malice so quickly and with extreme prejudice. Tensions are high and it seems to have become commonplace to assign ill-intent to the other tribe way too easily. In my opinion the answer to all of these problems is compassion and statistical thinking. Most people mean well and often times the only way you can get people to go to extremes is to negatively reinforce them into deeply entrenched tribal thinking.
It will always be a safer assumption to assume somebody means well even when they are wrong. Humans did not become the dominant species on this planet without cooperation and pro-social behaviors.