I will concede that there has been no peer reviewed study that explicitly tries to identity an association between mask wearing and mental health. Thus, no impact has been measured. It was not for lack of trying to find a study though. There are literally no good studies (from my cursory google scholar peek) that opined one way or the other.
> There is no evidence that a child wearing a mask causes depression or anxiety
But, saying this is not correct either. [1]
> transmission of the coronavirus is less than 1%.
These studies are strongly confounded with city policy, distancing measures, individual measures and odds of being vaccinated. It is really difficult to get exclusive numbers for mask efficacy using observational or questionnaire based studies of any kind.
As for my second claim, please evaluate it in context. Public spaces is usually taken to mean outdoor spaces or high ventilation large indoor spaces. My comments are also in time where covid's fatality has collapsed and hospitals aren't overwhelmed.
Almost every mask study I read makes assumptions of ideal wearing patterns that do not seem to be match real world observations. Even then, they project modest gains when using the most common forms of cloth masks in perfectly covid-favored situations. Vaccines can't ensure zero-covid. Masks can't ensure zero-covid. The end game is that it can become endemic or we wear masks forever.
Masks are 'useless' in the same way that seat-belts in school buses are useless. The risks for the concerned demographic are orders of magnitude lower. The ideal testing scenario is impossible to recreate in practice. It is impossible to enforce compliance. It has knock-on effects that no one seems keen to study. And lastly, if draconian measure are to be used, there are alternatives with greater effectiveness and lower social cost can should be tried first.
> Masks clearly have a measurable impact on mental health.
> Given what he know about aerosolization and cloth masks, masks are near useless in public spaces.
Both of these claims are false.
Masks have had no proven impact on mental health.[2] Masks have proven to be one of the most effective tools we have for preventing the spread of COVID-19 in public places.[2]
Mask use is science-based, as countless studies have proven. Anti-mask rhetoric is politically- and emotionally-driven hysteria.
[1] "The evidence that we have does not point us to any concern that masks affect mental health negatively." — Jeremy Kendrick, MD, assistant professor of psychiatry, Huntsman Mental Health Institute https://healthcare.utah.edu/healthfeed/postings/2021/08/_mas...
[2] "In settings of very high mask use, in-school transmission of the coronavirus is less than 1%. The best way to protect health and safety—particularly of those that are not vaccinated—is to wear a mask." — Adam Hersh, MD, a pediatric infectious disease specialist at University of Utah Health and Intermountain Primary Children’s Hospital https://healthcare.utah.edu/healthfeed/postings/2021/08/_mas...
> Stories about children either passing out or dying because they were required to wear masks.
Do you have any citations for these events, because they seem to be absurd misinformation.
The country I'm in (Singapore) has legally required masks in public since last year (as have many other countries) so everyone is wearing masks, and so far, I have not heard of a single case of people suffering due to wearing masks.
In fact, I even wear my mask when I go running and I have never felt any significant issues with breathing, even after hours of vigorous exercise.
If masks could reliably cause breathing issues in any significant way, given the number of people in the world who are wearing masks every day, we should expect a statistically significant number of such cases, not just a few cherry-picked anecdotes.
> Just in your quote it stated that the control that cloth mask use was compared to was a population with a high proportion of mask wearing. The study does not compare cloth mask usage to no mask usage, and only says that it is possible that cloth masks are harmful.
That was me debunking the “before COVID, masks were known to work” claim of the GP. That was not a study of SARS-2 but rather Influenza.
The “masks don’t work for sars-2” was in reference to sars-2 aerosol transmission, which masks mechanistically don’t protect against. There is only one RCT of sars-2 in a community setting, and it failed to demonstrate an improvement in the primary endpoint of self-infection. There is no study showing that masks slow the spread of sars-2 in a community. Yet despite the lack of any studies, various medical authorities like the CDC are issuing statements that they do exactly that, which is a classic case of an institution using its credibility to advance baseless claims
> There may not be studies specifically into covid-19 on this topic.
There is only one study that looked at cloth masks and it was completed in 2015.
> And IMO it's completely wrong to say we have no evidence tht masks work.
I never said that. I'm saying that a high standard of evidence has not been met and there isn't much interest in running trials on cloth masks. The only one I could find is in Guinea-Bissau.
> Right. No one has ever studied contagions among the community at large and the effect of masks. When you hear people say there is no evidence, this is what they are referring.
Actually, they have[1,2]. According to one study, surgical masks helped cut down the community spread of SARS in Beijing by 70%[3]:
> Always wearing a mask when going out was associated with a 70% reduction in risk compared with never wearing a mask.
But if you're specifically referring to randomised trials on mask efficacy during an on-going pandemic, you're right that there are no such studies -- because it would be unethical. So effectively all of the relevant studies are retrospective (which does introduce recall bias), but these are basically the best studies we can do ethically.
> The conclusion that cloth masks are ineffective against viruses with an airborne spread, while a properly worn n95 mask does provide real protection is hardly premature.
You're just asserting it to be true, so yes, it is.
> I've been really disappointed with my colleagues in public health for not being more clear about what can masking can do or not do.
I agree with this, but I also can't really blame them -- there's essentially no good data that community masking works at all. The best data we have (the few RCTs) are almost universally negative.
This entire issue has been driven by mechanistic theories, groupthink and the politics of symbols.
I’m not that sure. A lot of experts agree that there’s not much quality data to reach that conclusion.
Most “definitive proof” comes from mechanical studies (they measure how far your saliva is reaching with and with out mask), but that’s not the only important factor.
Masks are not designed for full day use, and by wearing them everyone is constantly touching their face, mouth and nose. This sounds to me like a way worse infection vector. Viruses like covid can survive for a long time on surfaces.
It’s hard to separate the effects of masks from that of hand sanitizer, vaccinations, or other measures taken.
> There's overwhelming evidence that mask use is effective in retarding the spread of COVID-19
It's probably not fair to phrase it as overwhelming evidence. Yes there is evidence that masks can reduce transmission, and the citations you provided included a fair amount of research supporting this idea (thanks for those references). And just thinking about it logically, it seems obvious masks would have such an effect.
However the evidence presented in OP - and the previous studies it cited - provide counter-evidence suggesting that mask usage and mandates may not have a significant beneficial impact on the overall course of a pandemic.
There are a variety of possible reasons for this, which you began to speculate on. Poor compliance, people not wearing their masks correctly, porous cloth masks, poorly ventilated indoor environments contributing to high viral load environments even with 100% mask compliance - the number of places where things can go wrong are tremendous and it begs the question of if the tradeoffs of mask mandates are worth it, or if our resources would be better spent on other viral elimination strategies.
It's not obviously false, because there were studies available at the time that showed masks did not work to protect individuals, especially members of the public.
But, again, I'd be interested to read any studies you have that were 1) available at the time and 2) showed benefit of wearing masks.
> especially since the prevailing guidance for a year now has been to wear masks to reduce airborne transmission
That is just an appeal to authority. Which has been par for course. This whole mess is built on a tower of circular references where everybody says "well, the other guy said to do it and they must have a good reason for it".
That being said, I too share a hypothesis that improperly worn masks (aka 95% of all masks being worn) do more harm than good. I'd love to see studies that show it but in this environment good luck getting it funded, much less published. Authors of such a study would probably get death threats.
Also being said, it isn't upon the skeptics to prove that masks dont work. You cannot prove something doesn't work. The burden of proof is on the people who say masks work in a way that makes them work their non-trival costs to society. Logic has been inverted the entire time this mess has been going on... somehow it is up to the skeptics to "prove" that restrictions don't work, "prove" that masks don't work, and "prove" that it is safe to return to normal. Nope. That isn't how it works.
> It seems reasonable to suggest that masks reduce disease and save lives. This may be a scientifically provable fact.
When masks are worn correctly by trained people as intended (form fitted N95s used for one short task in one room and then safely discarded), there seems to be a reasonable argument that masks are somewhat effective for reducing the spread of disease.
But in the real world; the masks are the wrong types and aren't form-fitted, people are constantly adjusting them and moving them around and touching them, many people are basically walking around half the time with their nose hanging out, people wear them not only for many hours at a time but often for days/weeks at a time without being washed and breathing in their own moist bacteria colonies, etc. I'm not sure if real-world mask usage results in a significant net-positive: they could actually have a net-negative effect when you consider the amount of bacteria people are inhaling from their own mask.
> There's never been a question about efficacy of masks.
Absolutely wrong. There is no evidence that the typical masks worn prevent any spread. There is some evidence that N95s prevent spread, but most people don't wear those.
> We have essentially no evidence that non-respirator masks, in the hands of the public, does anything at all:
This is blatant misinformation. Masks work. We've known this for over a century. Using masks to control respiratory disease is one of those cool public-health hacks that almost sounds too good to be true, but if enough people do it, the virus stops burning through the population.
You aren't so much being "censored" as just downvoted into the oblivion where a factually, empirically, and dangerously wrong statement like "We have essentially no evidence that non-respirator masks, in the hands of the public, does anything at all" belongs.
> That's a theoretical model. A hypothesis, most likely unattainable.
“Theoretical model” is a tautology.
And it really should be attainable: We’ve successfully eradicated smallpox worldwide, we are close to doing that with polio, and many other illnesses have been eradicated from certain regions via vaccination programs. This is a thing we can do if we try.
> It is not. The net is full of accounts of people telling out precisely what is wrong with masks for them
What I see is always in one of the following categories:
• People asserting that other people (never themselves) with asthma or similar breathing issues can’t wear them, even though literally everyone I know who has asthma or who uses a CPAP machine is actually fine with masks, to the extent that in many cases they get angry with anti-maskers risking giving them covid. Occasionally I also see anti-maskers also asserting that masks make it difficult for children to learn facial expressions in school, which, while superficially plausible, still seems to fail to against reality.
• People claiming that wearing masks lower blog oxygen levels despite all the evidence from e.g. surgeons, furries (two groups I would not have expected to list together before actually doing so).
It may be that all the above categories have totally overwhelmed real personal anecdotes of people who personally are unable to wear masks. I have no doubt, for example, that there is at least one person with no external nose or ear cartilage for a mask to hold against and who for whatever reason has not had plastic surgery. But this is not what I have ever seen. Always one of the above, on every occasion.
> At the moment the mechanism for increased risk is as plausible as the mechanism for decreased risk.
It does not seem to me. There is like no study that shows masks increase risk of spreading infection and I have seen multiple that show it takes it at least somehow down. (I am lazy to search it down again. In pretty much all these discussions someone linked.)
> Masks are uncomfortable and people need to adjust them during the day -- this is an increase in face touching, and masks are by definition contaminated.
Even if this was true, you are still less likely to infect others if you are asymptomatic. It is not just about you. And as someone who was wearing mask for multiple weeks (they were mandated here), it is not some kind of horrible uncomfortable.
> The only point of wearing masks is when you cannot socially distance yourself from other people. That's why masks are being pushed so hard now -- to end the lockdowns and get people back into work.
You are also meeting people in stores, in public transport, when walking on the street anywhere. Even in lockdown, people still need to eat. Sure you don't need mask when you are alone in the forrest. You dont need to wash hands there either and can touch your face as much as you like (at least not due to coronavirus).
When I am alone in my house with supplies, I dont need to do anything special and I can touch my face as much as I want. All other measures apply only when you are in space shared with other people.
> The primary transmission vector by far is nose and mouth and masks are very well established to substantially reduce infection rates.
Which doesn't at all explain all of the studies that found little to no effect to pervasive masking. If the effect is as strong as you're suggesting, then even partial masking would show an effect, even at population levels. This issue is simply not as settled as you're portraying.
> It’s that you feel that people recommending masking have placed a value judgement on people who don’t and I totally get that. But notice I did nothing of the kind.
This thread started on this premise, and I replied along those lines, and then you replied to me. I've made no assumptions about you other than you're clearly pro-mask and convinced by the evidence, and the only position I've staked is that the evidence is plausible but not as clear as you and others have been portraying.
>>Clothing is a relatively recent phenomenon in evolutionary timescales. Should we abandon that as well to optimize body temperature?
But we modify clothing based on personal comfort. It's extremely uncomfortable to wear a mask, especially as the moist air exhaled is trapped under the one/two/three layers of mask and heats up the face.
>>No, it shows you have no data to support your claim that masks harm school age kids.
Like I already pointed out, no studies have been done on this, because it's an unprecedented policy experiment. The burden of proof is on you.
>>I can point to hundreds of schools around the world that have masked for over a year and reported no developmental delays. If masks caused delays, we would know by now.
How would we know without studies? Smoking wasn't known to be harmful for decades until after it became popular.
As for anecdotes, there are plenty saying kids have become more antisocial. What we can't definitively say is whether these anecdotes are an indication of a broader trend, and whether - if there is a trend - it's due to masking, social isolation, or some combination of these factors.
> increased risk of developing a chronic illness for children
Well, there's pretty good evidence of this one given that one of the subjects in the adolescent trials for Pfizer was briefly paralyzed by the shot and still dealing with the consequences on an ongoing basis.
> literal misinformation was spread claiming that drugs that don't work were effective.
How, exactly, is it known with enough certainty that the drugs do not work as to label the claim "misinformation"? All of the controlled studies around the question have flaws one can point to, including the ones which found no effect.
> making claims that wearing masks was actually harmful
I don't know what exact harms were being claimed, but wearing a mask absolutely interrupts normal human social cues, creates a false sense of imperviousness to infection in many wearers, and for many people creates subtle sensations of claustrophobia (because it's not normal to have something strapped across your face for long periods of time). Our children go to a summer camp where it's been in the high 90s this week and one of the poor kids in attendance is being made to wear a mask by his family. Aside from the absurdity of wearing a mask outside (totally unnecessary and pointless), I guarantee he is also being harmed by this, if perhaps not permanently (but how impermanent is it if his parents apparently intend to mask forever)?
I will concede that there has been no peer reviewed study that explicitly tries to identity an association between mask wearing and mental health. Thus, no impact has been measured. It was not for lack of trying to find a study though. There are literally no good studies (from my cursory google scholar peek) that opined one way or the other.
> There is no evidence that a child wearing a mask causes depression or anxiety
But, saying this is not correct either. [1]
> transmission of the coronavirus is less than 1%.
These studies are strongly confounded with city policy, distancing measures, individual measures and odds of being vaccinated. It is really difficult to get exclusive numbers for mask efficacy using observational or questionnaire based studies of any kind.
As for my second claim, please evaluate it in context. Public spaces is usually taken to mean outdoor spaces or high ventilation large indoor spaces. My comments are also in time where covid's fatality has collapsed and hospitals aren't overwhelmed.
Almost every mask study I read makes assumptions of ideal wearing patterns that do not seem to be match real world observations. Even then, they project modest gains when using the most common forms of cloth masks in perfectly covid-favored situations. Vaccines can't ensure zero-covid. Masks can't ensure zero-covid. The end game is that it can become endemic or we wear masks forever.
Masks are 'useless' in the same way that seat-belts in school buses are useless. The risks for the concerned demographic are orders of magnitude lower. The ideal testing scenario is impossible to recreate in practice. It is impossible to enforce compliance. It has knock-on effects that no one seems keen to study. And lastly, if draconian measure are to be used, there are alternatives with greater effectiveness and lower social cost can should be tried first.
[1] https://astralcodexten.substack.com/p/the-phrase-no-evidence...
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