Can you link to the papers that were available in March 2020 that showed that masks are effective?
Use any definition of "mask" and "effective" you want, but preferably effective should include some concept of "prevents spread of respiratory disease".
Covid is a serious illness. Far too many people have been told, and believe, that they can continue their normal day to day life so long as they put mask on. This is untrue, and this advice has driven mass infection and death.
This is a pandora's box. My recollection of the events is this: around March 2020, there were some links to somewhat shoddy studies of effectiveness of masks in case of other diseases, but the official statement was that masks were not proven to be effective - but that's because there was no randomized control trial performed to check mask effectiveness against SARS variants, and how could there be?
This spins off into a whole discussion of how evidence-based medicine can lead you off the cliff when you follow its letter, and not spirit, because despite something being bloody obvious, there is no RCT proving that.
> but that's because there was no randomized control trial performed to check mask effectiveness against SARS variants, and how could there be?
The argument was not "we can't do tests because this is new", the argument was "we've got dozens of studies across a range of settings and respiratory diseases (which we expect to act similarly to covid) and we struggle to see any benefit, until we drop the quality of the research down".
IIRC the argument was "we can't say it works because we have no relevant tests at all". That's what I remember from March, but I may be misremembering.
No, I can't. Can you link to papers that show flossing is effective? Probably not, but the mechanism is so obvious that essentially all dentists will tell you to floss.
Further, mask-wearing was already a well-established practice in medical settings to prevent the spread of respiratory disease from practitioners to patients.
> believe that they can continue their normal day to day life so long as they put [a] mask on. This is untrue
Combined with some coordination on travel restrictions and quarantines, it seems Taiwan has been able to keep that normal day-to-day life for the majority of Taiwanese.
> Further, mask-wearing was already a well-established practice in medical settings to prevent the spread of respiratory disease from practitioners to patients
We don't see much benefit there, either. See the "clean surgery" papers.
> We concluded that household use of face masks is associated with low adherence and is ineffective for controlling seasonal respiratory disease.
"Do masks work, if you use the right type of mask and wear it properly?" isn't particularly controversial (the answer is probably "yes") but it's a stupid question because we don't care about optimal use, we care about real world use. And in the real world people might improperly wear a mask and go outside when they're symptomatic.
We don't have much good quality evidence for that, but here's a study that showed people were prepared to do things like wear masks, but were less prepared to self-isolate or book a test if they had symptoms: https://www.medrxiv.org/content/10.1101/2020.09.15.20191957v...
"However, during a severe pandemic when use of face masks might be greater, pandemic transmission in households could be reduced."
Later: "Although our study suggests that community use of face masks is unlikely to be an effective control policy for seasonal respiratory diseases, adherent mask users had a significant reduction in the risk for clinical infection. [...] Adherence with treatments and preventive measures is well known to vary depending on perception of risk and would be expected to increase during an influenza pandemic. [...] Therefore, although we found that distributing masks during seasonal winter influenza outbreaks is an ineffective control measure characterized by low adherence, results indicate the potential efficacy of masks in contexts where a larger adherence may be expected, such as during a severe influenza pandemic or other emerging infection."
I've posted links before, and I'll try to find them when I'm not on my phone. But you're right.
It was an open question, but the general opinion before 2020 was that masks would not be particularly useful. Sketchy results started appearing in March with better days in April and May. Several experts said, "we were wrong."
Medical grade masks are very useful. Others are less so. But they primarily prevent you from giving the virus to others.
There's been ongoing debate about the effectiveness of masks to prevent the spread of the influenza virus for years now. There were a lot of studies after the H1N1 pandemic since mask wearing was "recommended" but to my knowledge no state or federal mask mandate was put in place.
Our review highlights the limited evidence base supporting the efficacy or effectiveness of face masks to reduce influenza virus transmission. An important concern when determining which public health interventions could be useful in mitigating local influenza virus epidemics, and which infection control procedures are necessary to prevent nosocomial transmission, is the mode of influenza virus transmission between people and in the environment.
The interesting thing is everything they recommend, we've adopted during COVID, including physical barriers and front line workers additional PPE equipment:
Physical barriers would be most effective in limiting short-distance transmission by direct or indirect contact and large droplet spread, while more comprehensive precautions would be required to prevent infection at longer distances via airborne spread of small (nuclei) droplet particles [19]. In healthcare settings, stringent precautions are recommended to protect against pathogens that are transmitted by the airborne route, including the use of N95-type respirators (which require fit testing), other personal protective equipment including gowns, gloves, head covers and face shields, and isolation of patients in negative-pressure rooms
In this community-based, randomized controlled trial conducted in a setting where mask wearing was uncommon and was not among other recommended public health measures related to COVID-19, a recommendation to wear a surgical mask when outside the home among others did not reduce, at conventional levels of statistical significance, incident SARS-CoV-2 infection compared with no mask recommendation.
People are already debunking this Danish study but here's a CDC study showed even when people do wear masks, they were still getting sick:
In the 14 days before illness onset, 71% of case-patients and 74% of control participants reported always using cloth face coverings or other mask types when in public,” the report stated.
In addition, over 14 percent of the case-patients said they “often” wore a face covering and were still infected with the virus. The study also demonstrates that under 4 percent of the case-patients became sick with the virus even though they “never” wore a mask or face covering.
Personally I feel like masks aren't stopping the spread mainly because people either use one or two masks continually without cleaning them daily, or put them on dirty surfaces thinking its ok and then putting them back on, or simply not wearing them over their nose. Masks would probably be effective if people wore them properly and only used them once. Hoping 300 million people all follow those simple rules is a bit hopeful to say the least.
> Hoping 300 million people all follow those simple rules is a bit hopeful to say the least.
There seems to be something different about the US population than, say, the Taiwanese population regarding mask usage. I don't have a good explanation for it, because I think blaming "culture" is lazy research.
Use any definition of "mask" and "effective" you want, but preferably effective should include some concept of "prevents spread of respiratory disease".
Covid is a serious illness. Far too many people have been told, and believe, that they can continue their normal day to day life so long as they put mask on. This is untrue, and this advice has driven mass infection and death.