Australia Britain Ethics Health Politics USA

Letter from Australia 73 –  To Mask or Not to Mask – That is the Question

Dear brothers and sisters,

We are in a state of panic here in Northern Sydney.  After weeks of no community transmission – as of the time of writing we now have 68 – and this number is likely to go up.  The virus probably came in through an air crew from the US a couple of weeks ago.  The next couple of days will see whether NSW’s much praised ‘track and trace’ system will be enough to contain the spread.  But walking around this weekend there is no doubt that there is a palpable sense of fear.  You can feel the panic.  Of course, dramatic headlines and doomsday predictions from ‘experts’ keen to get their names in the headlines (‘doomed, we are all doomed unless you follow my advice’) – just fuel the increasing sense of impending apocalypse.

(Of course, I am aware that those of you reading this from the UK and US will wonder what the fuss is all about.  68 cases is nothing (and we have none of them in hospital and zero deaths).  Meanwhile you are faced with the depressing cycle of lockdown, release, lockdown …until the vaccine kicks in.  I feel your pain!)

Part of the problem is that we have believed the myth that governments can control this disease.  Therefore if they don’t it must be someone’s fault.  In fact, for many state authorities this has become like some kind of virility test. Above everything else they must be seen to be in control of Covid – everything else can be sacrificed to this goal. Don’t get me wrong.  Covid 19 is serious and governments, churches, companies, local communities and individuals should do what we can to limit its spread and effects.  The question is what can we do?  And what are the cost/benefits of the measures that we take?

But even asking that question gets people outraged – they think it is callous to speak in such a way.  But we do it all the time because we don’t live in a world where there is no disease, and no one ever dies.   For example, there is something that governments could do that would save tens of thousands of lives every year.  Should they do it?  Of course – who does not want to save tens of thousands of lives?   So why not reduce the speed limit to 5 miles per hour?

The trouble is that when people (and governments) panic and believe in their own power to control everything – they look for simple solutions – solutions which can be limited to a tweet and fed to a population whom our rulers think are incapable of thinking for themselves and acting appropriately.

And so to facemasks.  A subject I have been reluctant to write about because I wanted to find out more before writing, but mainly because it seems to invoke a visceral reaction and is seen as a shibboleth test for your view of politics, life and morality.  For some wearing a mask is seen as the mark of being a decent human being who cares for others and follows the science.  For others wearing it is a sign that you are subservient sheep giving in to the dictates of an authoritarian regime.   I find myself in despair that even something as simple as this can be so divisive – and even more so in terms of the simplistic slogans that are spouted as self-evident, all comprehensive facts.  There is no room for nuance, or questioning.

I have been trying to read up  on this – not least to determine my own behaviour.  Should I wear a mask?  Where? When?    I have read numerous articles (and a couple of scientific studies) from many different angles and sources and to say the least the subject is confusing!    This is what I have discovered so far.

  1. Wearing a mask is now seen as a simple solution to the spread of Covid 19.

The politician Chris Christie writing in The Wall Street Journal makes the following point: When you get this disease, it hits you how easy it is to prevent. We are asked to wear cloth over our mouth and nose, wash our hands and avoid crowds. These minor inconveniences can save your life, your neighbours and the economy. Seldom has so little been asked for so much benefit.  Here in Sydney journalists are asking why don’t you just mandate wearing masks?   They ask it is such a way that they may as well just add “you heartless idiot’ at the end of the question.  After all wearing a mask is the sensible and simple thing to do.

 But as Anders Tegnall points out.

“Face masks are an easy solution, and I’m deeply distrustful of easy solutions to complex problems” 

Of course this does not stop politicians making unscientific claims in the name of ‘the’ science.  Joe Biden for example claimed that wearing masks would save 100,000 American lives by the end of the year and would be the means to getting us back to a ‘normal’ life.   Not ‘might’, nor ‘could’,  but ‘would’.  There is little evidence for that remark – at best it is a series of unproven assumptions which are only as reliable as the imperfect information fed into the model.  Of course, the more apocalyptic the better – for the headline writers and the politicians seeking to influence others behaviour and justify their own.   

2) Masks can help but the Scientific evidence that masks substantially prevent the spread of Covid 19 is limited.

 There have been very few peer reviewed studies on the subject.  The assumption is that because Covid 19 can spread through airborne particles anything that reduces the spread of those will reduce the spread of Covid must work.  The trouble is that most people work on the assumption that masks are a barrier, when they are in fact a filter.  The only really effective filters are surgical masks which are not designed to be worn outside the operating theatre or for long times.

The largest controlled study is the Danish one – which because of its results had difficulty getting published.  Its scientific conclusions did not suit the general establishment consensus and it was feared that its publication would harm ‘public health’.  So much for being led by the science!

The basic results of the Danish study are interesting.  The headline result was that masks do little or nothing to lower the infection rate – for those who wear them.  Those who wear masks because they think it will protect them are just wrong. The main author of the study, Dr Henning Bundgaard, a cardiologist at the University of Copenhagen, “Our study gives an indication of how much you gain from wearing a mask: Not a lot.”

However, the key issue is whether they prevent spread.    As far as I am aware have been no peer reviewed empirical studies which demonstrate that.   Wearing masks appears to have done little to prevent the surges in countries like the US, Italy and the UK.

But even if the evidence is limited and at best only suggests that wearing masks may be a factor in helping prevent the spread – even if it saves one life, surely it is worth doing?  After all there is no harm in wearing a mask is there?  Which leads me on to the most surprising aspect –

3) Wearing Masks can also have a negative effect.

Psychological effects – There was the initial concern expressed by the WHO (until they were got at for political reasons and changed their advice) that masks encourage a false sense of security and will encourage people to think they are immune and ignore more effective measures like handwashing and social distancing. Irresponsible statements like that of CDC director Dr Robert Redford have not helped.  “: “I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine.”We are encouraged to wear masks because it makes others feel comfortable.  It also gives the sense of caring and that we are doing something.  However, there is a negative psychological effect.  We don’t get to see the human face.   Why stop with masks that cover mouth and nose?    A study published in The Lancet also suggested eye protection was helpful in stopping the spread of Covid.  Why not wear protective glasses?   What about hands?  Should we never go out without surgical gloves?   In fact, the safest thing would be for each of us to go out totally covered in plastic.

 

 

 

 

 

 

 

 Physical effects – There is a fascinating book called The Case Against Masks: Ten Reasons Why Mask Use Should be Limited by Judy A. Mikovits and  Kent Heckenlively.    They point out both the benefits and dangers of wearing masks.  These three quotes are helpful:

The best-case scenario is that evidence that masks work is scarce. Common sense would seem to suggest that a strong case can be made for the use of masks to avoid respiratory droplets from individuals with respiratory infections. If you are displaying even mild symptoms, or worry that you might have been exposed, it’s probably a good idea to avoid contact with other people. If you are not sick, but going into a high-risk area, like hospitals, nursing homes, or a crowded store, the temporary use of a mask in those situations could be a reasonable response.”

There is another danger to wearing these masks on a daily basis, especially if worn for several hours. When a person is infected with a respiratory virus, they will expel some of the virus with each breath. If they are wearing a mask, especially an N95 mask or other tightly fitting mask, they will be constantly rebreathing the viruses, raising the concentration of the virus in the lungs and nasal passages. We know that people who have the worst reactions to the coronavirus have the highest concentrations of the virus early on. And this leads to the deadly cytokine storm in a selected number.’ 

“There seems to be multiple factors that are critical in the spread of SARS-CoV-2 and the development of COVID-19. Different individuals, if infected, will expel different amounts of virus, likely due to the loudness of their speaking or singing, their closeness to other individuals, and the time they’re together. Cold temperatures are more likely to support the spread of the virus than warm temperatures, if only by increasing the possibility that an infected person will cough or sneeze. Sunlight is a potent killer of this virus. Another factor may be that even if infected there is a relatively brief time in which a person is more infectious. This time period can be enhanced by cold temperatures or lack of exposure to UV light. Does universal masking make sense when we consider all these factors? Actually, consideration of these factors suggests universal masking increases the risk of spreading the infection.”

There is another wider environmental effect.   All that avoidance of plastic cups, straws and bottles has now been negated by the millions of plastic throwaway masks being dumped into the environment!

Political effects – Now that masks have been politicised, they have become even more dangerous. Instead of being a matter of science and healthcare they have now become a political badge and belief in them has become a matter of doctrinal faith – not science.  Sometimes this is just a matter of virtue signalling, but at other times it takes a more sinister turn.  Camus declared “The welfare of humanity is always the alibi of tyrants.”  In the name of public health politicians sometimes grab more power and curb civil liberties.   You can see this in so many ways – the police who arrest you in Victoria for not wearing a mask when you are walking in the open air on your own.  The pastor in the US who was arrested after being reported by a neighbour for not wearing a mask when he was sitting in his church on his own without a mask.  The politicians who go on camera with a mask, even though they are not within 2m of anyone and immediately take it off as soon as they are off camera. In addition to this I find the mandating of wearing masks in church an abuse of governmental authority and an unnecessary intrusion into the public worship of God.  Governments can advise and churches can choose to follow that advice, but the government telling us what we can and cannot do in public worship is a step too far. 

The book I mentioned above appears to have now been banned on Amazon.  It’s not enough to ‘follow the science’ – you have to follow the politically acceptable science.  Which of course means that it is not science at all – because the very definition of science means that it must be falsifiable and open to question.  Once the big media corporations start telling you what science is acceptable and what is not then science has become corrupted.   Every politician now has it as part of their mantra that wearing masks is the thing to do, and to question mask wearing puts you in the same category as a holocaust denier, a climate change denier and a flat earther even if you are a scientist such as Dr Simon Clarke, associate professor of cellular microbiology at the University of Reading who recently wrote:  “I don’t think masks are all that great at stopping transmission in either direction.  The decisions to change policy were made by politicians.  It first happened in Scotland where Nicola Sturgeon stood up and said she thought they were needed.  Then Boris Johnson said he thought there was evidence for their effectiveness.  I’ve yet to see that evidence.  I’m not entirely sure that I’ve been convinced.  But that ship has sailed, in many respects”. 

Conclusion:

 So where does that leave me?  I hate wearing a mask, but will do so when mandated (like entering the Apple Store, or if I have to in order to go to church).  If the government makes it illegal for me to go out without a mask, I will wear it – under protest.   I would wear it on public transport if I am in a crowded situation.  I won’t wear it to show I ‘care’, but I would if I was in a culture where not to wear a mask would be considered impolite.   I would wear a mask if I had any symptoms or thought I had Covid – but then I wouldn’t need to, because I wouldn’t go out and certainly would not be in touch with other people.  Today when I go to work, I will respect the government’s request not to go on public transport without wearing unmasked – by not going on public transport.  I will cycle to work and breath freely!

Hopefully see you next week.  Have a great Christmas –  remember Boris and Nicola can’t cancel the real Christmas.   May you know The Light in the Darkness,

David

PS.  Here is another article which I found really informative – https://www.aier.org/article/the-year-of-disguises/

Letter from Australia 72 – The Photo and Wedding of the Year!

Corona False Alarm?

 

 

 

 

 

 

 

34 comments

  1. There do seem to be a lot of people who think masks provide a high degree of protection despite there being no real evidence for it. The best I could find saw a 5% reduction in transmission in an area that changed from no masks to masks inside & in crowded areas outside. That sounds kind of reasonable to me but many seem to think its much more effective than that. A security blanket perhaps but grasped by many with religious zeal.

  2. Well, golly. I wonder why surgeons and all the others in a surgical suite wear masks during surgery? It must be because someone made a rule and I guess they just follow it because of that. No deeper understanding than that… it’s a rule. So, obviously, there isn’t any compelling evidence for them to follow this rule and do this across every surgical suite in the world… even when they’re not N95s. I mean, isn’t that what the Danish study really concludes?

    So I’m sure no one should mind when this standard practice is lifted when the latest ‘freedom from government oppression’ anti-masker undergoes a surgical procedure because, you know, well, because some of the people in the surgical suite don’t feel like it and they have civil rights, donchaknow, so these patients should suck it up and cope. cast your bread upon the waters, so to speak.

    I’m almost sure the patients like those writing about this issue for the public during a pandemic of an aerosolized virus to impede its human-to-human chain of transmission would be absolutely fine with this individual choice by their surgical team because the evidence of efficacy of wearing masks is not strong or robust, especially when there is some evidence that wearing masks can potentially cause an increased risk to the wearer! So this issue for and against is equivalently strong. Right? These ‘issues’ regarding efficacy are actually equivalent, aren’t they? That’s why you’re questioning it.

    Come on…

    1. As the article surgeons wear surgical masks which are designed to prevent transmission of virus’s within a surgical ward. They do so not because of a political order or someone made a rule but because the science supports that. The fast majority of masks being used are not surgical masks – in fact the public are discouraged from using them.

      I would suggest that the next time you want to comment – avoid the snide, superior, mocking comments and deal with the actual issues raised in the article. And try to provide information for your case. Try to avoid the sarcasm, read the article you are responding to – and respond to the points it makes – not to what you feel or what your personal politics are.

      1. You have used confirmation bias to support your position. You have then presented your opinion within a false equivalency. This is demonstrated when you consider the use of masks by medical professionals who know the most about masks. And you will see a very clear pattern: medical professionals wear them when the transmission of anything aerosolized is in question. There’s your answer by those who know. The fact that you are waving all this knowledge and medical practice away as if reasonable to do to raise your points of doubt means you do not understand how airborne transmission occurs in fact nor appreciate the overwhelming role of masks by medical professionals in reducing airborne contagion. But you do think/assume/suggest that the anti-mask opinions of others who wish to cast doubt about their wider use have an equivalent position of knowledge as the entire medical profession. They don’t. So this framing of the issue that pretends an equivalency where none exists to bolster your own position of doubt is the very hubris that invites a more snide response.

      2. I have not used confirmation bias – mostly because I have no bias on masks to confirm! I don’t particularly care about the issue so thought I would look at various bits of evidence and the literature to see what all the fuss was about. If there was evidence that masks are effective in preventing the spread then there is no problem. I know many medical professionals – and yes they do wear them at work when it is necessary. Many of these professionals state that masks are of limited value. I have presented the facts in the article. All you have done is just made up arguments and distorted what I said and made up my motives. You have presented no evidence and instead just sneered then justified your sneering. It’s the lowest form of discourse and sadly all too prevalent on the internet. Please try to do better. And avoid the smug self-righteous superiority.

      3. You’re not following your own stated line of reasoning here, that you, “have no bias on masks.” I don’t think that’s the case at all and I’ll explain why. But look at the words you use to describe the, “various bits of evidence and the literature” you have selected!

        You say, “If there was evidence (therefore you are suggesting there is doubt here where none exists in fact) that masks are effective in preventing the spread…” You start off with the significant term: IF. Is there evidence that masks are effective? Well, yeah. That’s why medical professionals wear them! The evidence for them to do so is, in fact – and not an IF whatsoever – overwhelming. In other words, you are manufacturing doubt where none exists in common medical practice. This puts you at an extreme edge of the issue right off the bat. I call that ‘bias’. What do you call it, when you miss this huge amount of medically informed evidence throughout medical literature? Coincidence? Is NONE of this readily available information on best practices in medicine available to you? You reference talking with medical people, but how can it be that none of them were able to help direct you to this library of knowledge? Funny, that. I suspect you didn’t bother to look or ask.. not because it isn’t available but because it didn’t matter. That’s just my suspicion, of course. But it aligns with the following.

        I say this because you then use another diminutive term, limited when discussing what YOU say these medical people told you (are you sure you’ve got the right order here>?), namely, that the efficacy of surgical masks in reducing aerosol spread was and is ‘limited‘. Limited compared to what? To not wearing a mask? That’s the ONLY metric that matters here. In fact, no medical person I know and I talk to them every day, would ever, ever, ever suggest wearing a surgical mask INCREASES the risk of spreading an aerosolized contagion. If it did, medical people would not wear one in surgery. Yet that is EXACTLY what they do, EXACTLY what the article claims they should NOT do, given that, “consideration of these factors (built almost exclusively on the the N95s rebreathing issue for an infected individual) suggests universal masking increases the risk of spreading the infection.”

        You are saying one thing that sounds reasonable – you’re ‘looking’ for answers – but then rejecting what is right there in front of you by every medical practitioner: good evidence that masks work. Instead, you reprint a conclusion that is diametrically opposed to what the entire medical profession thinks is knowledge-based practice. That is why I know you have selected ONLY that material which seems to bolster a pre-existing anti-mask opinion and does so by using an article that reaches an anti-scientific conclusion while, at the same time, using diminutive terms to describe what is actually true and widely available to anyone who is honestly looking for the preponderance of evidence.

        The facts are that masks unquestionably, undoubtedly interfere with the full expansion by reducing the velocity of exhaled air AND masks indisputably capture larger droplets. The tighter the weave, the more they capture. This means masks interfere with the size of concentration clouds over time. That’s why 2 meters is the suggested distance for contact in public. Farther is better. No contact is the best. To suggest all of this is unknown or limited or questionable is not reasonable and deserves no ‘IF… for anyone honestly seeking evidence through a compilation of literature on the subject. One has to carefully select such an article as you’ve presented here that is so contrary to facts and diametrically opposite to medically endorsed best practices.

      4. You;ve done it again! You keep repeating statements which a) argue against what I have not said b) presume motives and c) offer no evidence. I’ve been patient with you – unless you can come up with something substantial next time it won’t be posted. Just to refresh your memory – the question is not whether surgical masks are useful in surgeries and hospital settings – but whether mask wearing in general is effective in stopping transmission of Covid 19. Your absolute certainty (without evidence) that no medical professional has any doubt about this is negated by the medical professionals cited in the article and the fact that the WHO up until a few months ago cautioned that masks were not the panecea. It would also help if you got your facts right. 2 m is the suggested distance in the UK. In Australia scientists say 1.5m – in some other countries it is one metre. It seems as though your mind is made up and you don’t want to be confused with facts. Try to understand that not everything is black and white and that there are legitimate differences between ‘wearing masks will end Covid’ and ‘wearing masks are useless at all times in all places.’…If you just want to rant – then feel free to do so on your own blog…

  3. Yes, it was kind of Nicola to “allow” Christmas this year. There’s two things I am grateful for in her doing that. I’ve now had it brought to my awareness that she decides whether we have Christmas or not and that she has decided to allow us to have it.

    I’ve heard similar said about the wearing of masks as you have David. And it does make sense I think to conclude that this has become politicised. I wouldn’t go as far as you have done to regard wearing a mask “under protest”. Yes we have rights but following Christ sometimes requires that we surrender some rights as the apostle Paul did in being a Jew to the Jews, Gentile to the Gentile etc so that nothing be a hindrance to the gospel of Jesus. So for example engaging in ritual washing in Jewish contexts. We also have the “obedience to authorities” in “whoever rebels against the authority is rebelling against what God has instituted, and those who do so will bring judgment on themselves” (Rom 13:2).

    So we are to be obedient to authorises while at the same time our struggle is against authorities and rulers in this dark world. So my take on this is if my rights are not being abused by an authority then I am obedient to it. Of course if the government is so off track as to be oppressive then it may be than non-deferral to the law would be required, as Martin Luther King advocated about a court injunction in the civil rights movement in the 60s.

    I don’t perceive our civil liberties being infringed upon to that extent in mandatory mask warning. However that’s not to say that they couldn’t be or that there may not be exceptions to the principle of being obedient to authorities in the present. After all, Jesus was not “obedient” at times e.g. picking corn on the Sabbath.

  4. This is an excellent essay to read, which flags up legitimate questions, and provokes thought or further debate. A wordsmith who can distil complexity into something more penetrable for ordinary people does society a service. A Belfast group, called The Centre for Christianity in Society, have a superb essay on Covid vaccination from a Christian angle by Dr Paul Coulter. His 50 minute on-line talk examines the questions in greater depth. Both Paul’s communication, and the essay above, rest easily with the principle of-‘informed consent’-arising in healthcare. In the UK the Re:-C case lays out the need for an individual 1) To hold and retain the facts given to them 2) To weigh up the facts 3) To communicate their decision on how to respond. Do the blanket wearing of masks, or mass uptake of vaccines (which can be embryo cell derived or tested), allude to a situation where some leaders do not always feel great compulsion to fully justify their policies?

  5. David, this is an interesting article although there are a few dubious rhetorical flourishes (banned by Amazon – really?, the Danish study had difficulty getting published because of its conclusions – where’s the evidence? – journals usually love to publish papers like this).

    When commenting on medical matters I urge you to go beyond books and single studies. The Cochrane Library is the definitive source of high-quality, independent evidence and is freely available to all Australian residents thanks to Australian Government funding (it is also available to UK residents under similar arrangements). The Cochrane review of Physical interventions to interrupt or reduce the spread of respiratory viruses looks at the total body of published evidence and concludes that ‘We are uncertain whether wearing masks or N95/P2 respirators helps to slow the spread of respiratory viruses..’

    1. Yes – the book is now banned by Amazon (its not available any longer on Kindle or in the UK, US and Australia). The Danish study had enormous difficulty getting published – three journals refused to take it – and the authors were apparently compelled to moderate some of their conclusions and language. It took several weeks to get published. Your paragraph sounds like you are accusing me of lying and making things up. I don’t do that.

      Thanks for your last paragraph. That’s useful information. I’m afraid I don’t have time, or the relevant medical knowledge to read many research papers – but I tend to trust the experts who do – and always try to take a variety of views. Just being told ‘the science says’ usually by people who then can’t tell me what the science is – I find somewhat unhelpful!

    2. From a none medic who worked in the NHS , being a delegate a a conference by Dr Muir Grey an institagtor of the Cochrane, Library to seek to ensure effective , rather than poor or none peer review I’d support its use.
      Right or wrong, I don’t know but somewhere in the history of Covid 19 I seem to recall some opposition to peer reviewed studies to inform Public Health policy.
      Having also worked in Public Health in the NHS I’m a little wary of its influence, as it contains none medics, epidemiologists, some of whom do not take broader views. Some Public Health officials that I ‘ve personally come across have taken the broader view that public health embraces far more than the purely medical with economic and social factors. There will be internal conflicts and pressures within Public Health, and now that at the local level into comes within Local Authorities, there is more scope for politisation, though that localisation seems to have given way to National command and control, that was not favoured during the swine flue episode over a decade ago.
      Seasonal factors that are always present in the NHS are also being brought into play to support more stringent measures. That brings into play far more factors, such as workforce planning as well as NHS budgets within its overall capacity.

  6. Thanks David. I certainly wasn’t accusing you of lying. The Danish study seems to have had the same problems getting published as 99% of medical journal submissions (pandemic notwithstanding) – I speak from experience. What is interesting is that the study, when published by the Annals of Internal Medicine, was accompanied by a justification for publication by the journal as an editorial, acknowledging concern about the flawed methods used (you can read it here: https://www.acpjournals.org/doi/10.7326/M20-7499). As for Amazon, yes, that is a mystery. It has vanished without trace.

  7. Thanks for your article raising some very important questions and providing some very useful insights.

    A.
    . . . . I find the mandating of wearing masks in church an abuse of governmental authority and an unnecessary intrusion into the public worship of God. Governments can advise and churches can choose to follow that advice, but the government telling us what we can and cannot do in public worship is a step too far.

    B,
    . . . I hate wearing a mask, but will do so , , , if I have to in order to go to church . . .

    Can you explain how B follows from A? Is it that the church/denomination you are part of has mandated mask wearing rather than the government?

    On a side issue Grace Community Church in LA has now been meeting every Sunday, morning and evening, as normal with no social distancing and no masks since the middle of July. Leaving aside their decision not to comply with government restrictions how do we explain the lack of infections – as far as we know – with up to 7000 people assembling every Sunday in a State which has a stay-at-home order in place because of a rise in ‘cases’? Is this not a pretty clear example of a real world randomised control trial?

  8. Perhaps that book is ‘fascinating’. Perhaps it’s even a good read. Perhaps you will condemn me for revealing my prejudices, but I would be unlikely to read or take seriously a book with either a lurid cover or a title like that. I’m afraid also that a bit of elementary research on the Internet is sufficient to confirm that any such suspicions are probably justified. If they have removed it, Amazon may well be right, though the evidence of other UK sites imply that it may just have sold out.

    Judy A. Mikovits has a Wikipedia page which describes her as “a former American research scientist who is known for her discredited medical claims”. The American Association for the Advancement of Science has fact-checked her and some of her claims about coronavirus on its website. Their article is uncomfortable reading.

    As indicated by the letters JD, Kent Heckenlively is a lawyer. He’s not a scientist or practitioner of medicine at all.

    Both are apparently also in their home country notorious anti-vaxxers.

    Like you, I’m not that persuaded by masks. I wear them because I’m told that I’ve got to. I think they probably do some good in protecting other people from one’s own breath, but are largely worthless in protecting oneself from theirs. However, referencing these two and their book lowers the persuasive force of any case they are pleaded in support of.

  9. Thank you for this, David.

    That’s a great and perceptive comment from Albert Camus, who was extremely prescient in so many ways.

    In general, Romans 13 indicates believers submission to authorities (in Paul’s case, the Emperor Nero who comes very close to winning the booby prize of being the worst Roman Emperor) … unless that submission would cause us to deny, disobey or dishonour Christ. In the latter case, followers of Christ are obligated to refuse to submit, and I would hold to resist using all proportionate means.

  10. The government cannot tell us what we can and cannot do during worship services.

    With this line of reasoning, any imam can call for violence against infidels and apostates without consequences and possibly bad results I. feel somehow reassured when there is some governmental control on these kind of issues.

    Also I have the felling (but I cannot prove it, and I could be wrong) that this attitude of what the governemtn can and cannot tell us regarding church, is an issue for people who come from countries that were once largely Christian. I don’t hear many people complaining about this in societies where church is in the margines for a very long time already, and was persecuted at some point. And why would they. They are already happy enough when they can worship freely. If it has to be with a mask, and only a limited number of people (or no one at all) singing, so be it. Even if it doesn’t seem to make much of a difference for the spreading.

    Let’s just count our blessings. There are many. They outweigh the annoyance (and it really is nothing more serious than an annoyance) of wearing a mask.

    Ps. One point about the safety of masks. In some countries you also have to wear them outside. If I followed that law to the letter, I would constantly be walking with fogged up glasses, which would be quite dangerous when crossing the street.

  11. Those above arguing for the use of masks because of their effectiveness in a surgical setting miss the point. A surgical setting is a time-limited situation during which the patient is highly vulnerable to infection due to the would through which surgery is being performed. Just about everyone would accept masks as necessary in that environment.

    However, that is very different to their use in day to day life when the very nature of long term infection protection rests upon background exposure to many different kinds of microbes. Ordinary life is by definition not a surgically clean environment. Moreover, ordinary life involves the need to balance the debatable marginal benefits of wearing a mask vs the psychological and communication benefits of being able to see facial expressions, together with the intangible sense of feeling more detached from someone in a mask. Hyper-mask wearing advocates do not appear to take these factors into account at all. Moreover, some mask advocates appear to be people who do not understand and appreciate the soft factors in human contact and communication. That in itself is a gap in their understanding which they need to recognise when setting out their position.

    1. The idea that masks stop – or must stop to be justified – the spread of Covid-19 is a straw man. argument. Contact with an infected person is the risk multiplied by the amount of time spent sharing air. So the more contacts, the higher the risk. To mitigate contracting the virus in any setting is accomplished by a series of actions. These do not eliminate the risk in any way, shape, or fashion. But they DO mitigate contracting it. Masks mitigate contagion. There is absolutely no doubt of this fact because it’s straight up physics. The kinds of masks do so in various ways. But the fact of the matter is physics. The same is true for distancing. The same is true for circulation. Again, simply physics.

      Now, the level of mitigation is very close to zero outside and distanced where there is enough air circulation. Therefore masks are almost useless given these conditions. What matters here is proximity and air exchange. Again, these only mitigate the chance of contracting the contagion and do not reduce the risk one iota. Risk is based on the number of contacts. Reduce contacts, reduce the risk.

      So when people DO have to come into contact, DO have to come into proximity of others, then the more mitigating you can do, the better. Wear a mask when you’re around other people – not to protect yourself from them (that’s the role of N95s) but to protect them from YOU. That’s why medical people wear surgical masks – to protect their patients from them. If they didn’t work effectively to do this, they wouldn’t wear them. But the evidence is overwhelming that they do exactly this – regardless if one is in a surgical suite, in the dentist’s chair, at the optometrist’s. And that’s why each of us should feel an obligation to help our neighbours when we come into proximity with them and share air… by wearing a mask ands keeping distant from them, to not enter places where air must be shared and spend time in such places. It is not just polite but based on physics and is not political/anti-whatever at all. Masks work to mitigate, not eliminate, whatever risk we have to take on. The better the quality of the mask, the better they do this job, the better we are as caring and concerned and responsible people doing OUR part to protect others from us. Asking for simple reciprocity is not unreasonable. I think it the least we can do for others until a vaccination can be received..

      1. Thanks – thats helpful. The idea that masks stop or not Covid is not a strawman argument. It is the justification for wearing them. And whether masks stop Covid 19 is not a matter of straight physics. There is considerable disagreement about how effective they are.

        I agree completely with your points about social distancing and limiting the number of contacts. If we have any symptoms, or live in an area with high contagion, then of course we should wear a mask when we are in an inclosed space with others. Today I am just about to go on the train – and because of the situation here with people in a bit of a panic, I will wear a mask. When I was in SOuth Korea – I wore one – largely because it was culturally expected. But there is a down side to wearing masks – as the WHO, Swedes and many others pointed out – when people wear masks they get a false sense of confidence and so reduce social distancing.

      2. “The idea that masks stop or not Covid is not a strawman argument. It is the justification for wearing them.”

        No it’s not.

        From the CDC:

        “Your mask helps protect those around you.”

        “Masks are “critical” to controlling the spread of coronavirus.”

        “Consistent and correct use of face masks is a public health strategy critical to reducing respiratory transmission of SARS-CoV-2, particularly in light of estimates that approximately one half of new infections are transmitted by persons who have no symptoms.”

        Nowhere from any legitimate health authority can I find any reference to what you are claiming, namely, that masks stop Covid, with the exception of full PPE including an N95 mask. Wearing anything that reduces droplets going from you to others is the ENTIRE reason for wearing a mask, even though there is now growing evidence that masks can impede you inhaling a sufficient concentration of virus to become infected and that’s why tighter weaves and/or multiple layers can offer some protection. But this is not a substitute measure to avoid getting the virus, which is why I continue to say it’s nothing more than a mitigating factor of risk and that greater contact increases the risk regardless of any mitigating factors. You wear a mask to do your small part in helping to protect others. And that’s why those people who don’t wear masks are exponentially increasing their ability to infect others with every contact, thus eliminating your rights to be protected from the harm others inflict on you. If we carry this into small mask-less and indoor gatherings where we know infection rates soar, we soon have massive community spread when these folk then go into the public domain mask-less, some – perhaps many – are already but unknowingly contagious, and so this mask-less behaviour maximizes the virus’ spread prior to someone exhibiting any symptoms. Because people who enter the public domain and refuse to wear a mask are therefore a known threat to public health (in the aggregate), many jurisdictions decide that threat – that attack against the rights of others to be free from such harm – justifies mandatory wearing and enforcement.

        Now here’s the thing: public health authorities in many jurisdictions actually have the power to command exactly this from civil authorities. I know this is the case in Canada and several other Commonwealth countries whose citizens otherwise have civil rights to refuse other kinds of civil authority. By legislation, however, public health authorities in times of pandemic actually and legally trump civil authorities and are empowered to demand enforcement.

      3. I think you have misunderstood. The reason for wearing masks (other than psychological or political) is to prevent the spread of Covid. The question then becomes how effective they are. Which is all I am asking. It would be good to have some evidence that masks actually make a significant difference to the spread of Covid. On the surface it appears that that is not working too well in countries like the US, UK etc who have a lot of mask wearing…

  12. “The largest controlled study is the Danish one – which because of its results had difficulty getting published. Its scientific conclusions did not suit the general establishment consensus and it was feared that its publication would harm ‘public health’.“

    Do you have any proof for that statement? It is a fairly conspiratorial statement when it may have just had difficulty getting published because it’s methodology limited its usefulness. Not that it was a bad study.

    What level of proof would satisfy you for mask wearing? The post seems to start on the assumption that masks are useless and then looks for proof to confirm that.

    1. I’m sure you can google it.

      Re mask wearing all I am doing is asking for evidence. The post does not start on the assumption that masks are useless (there are more positions than ‘masks are useless’ or ‘masks will save us’ – nuance is important).

  13. This paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191274/ looks at 7 community-based randomised control trials done on masks (see section 3 table 1). Six (including Danmask) show no significant benefit. Two show a statistically significant benefit for community mask wearing for secondary infections, that means in a household when there is a sick person. So the data is spotty and inconsistent. Which is why we were told by the experts repeatedly up-to the end of April, that the evidence for the effectiveness of masks was not strong. The only trial done since then was the Danmask study.

    1. You say, “spotty and inconsistent.” The study – compiling study data alone between March and April of 2020 only – concludes, “that community mask use by well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic. The studies of masks as source control also suggest a benefit, and may be important during the COVID-19 pandemic in universal community face mask use as well as in health care settings.” There’s nothing ‘spotty and inconsistent’ about this.

      We instituted an aerosol study back in April of 2020 specifically for wind instruments to see if we could figure out a way to perform during the pandemic safely. The recommendations that came from that study tell us even masking wind instruments significantly reduces aerosol distance but not enough to lower concentrations over time. This is important to understand so that one grasps that wearing a mask helps protect others from you for a short period of time. As that time increases, the concentration of cloud particles increases. For spreading a virus, the latter part is the dangerous part, which is why 2 meters is suggested for short encounters and to try to reduce contact exposure as much as possible. This is why lock downs work, to reduce the number of contacts, which translates into fewer opportunities for the virus to use the human chain for transmission. Masks will not stop the transmission or protect people from getting the virus but will help reduce the cloud concentration, and it requires a concentration of virus to be inhaled to infect the next person. Larger droplets carry more virus. But the virus itself expelled by exhaled water droplets of much smaller size can pass the mask barrier but in much reduced concentration compared to exactly the same exhaled breath with no mask. Masking increases the time necessary to reach the same level of concentration, air from which nearby humans can inhale sufficient concentrations of virus to become a carrier.

      So there is absolutely no debate anywhere in any scientific literature that claims wearing masks somehow fails to reduce aerosol spread to the point of being a “spotty and inconsistent” practice. They work as intended. I think it’s the least we can do for our neighbours whenever we have to be in their proximity.

      1. Note the words ‘could be beneficial’. ‘suggest’ and ‘may be’. That is precisely what I’m saying. That gets translated by the media and politicians into ‘is’ …..

        Lockdowns don’t work. Masks have not stopped the UK, US and others having accelerating rates….and there is considerable debate within scientific literature (read the WHO’s latest report in December).

      2. I think the problem here understanding what the term ‘works’ means (as in ‘the mask works’) and then determining if it is good or poor or hopeless public policy.

        Different masks work in different ways. You seem to constantly refer to numbers of infections and deaths over time in locations where masks have been mandated as if this indicates how well or poorly masking as a public policy ‘works’ and then use these higher numbers as if to explain a supposedly ‘failed’ public mask policy. This comparison is absolutely the wrong way to go because it can and has mislead you.

        Earlier, I introduced the evidence of surgical masks worn by medical people – from dentists and their assistants and hygienists to optometrists to First Responders to local doctors to community nurses. You waved all this compelling evidence away as if these masks only worked in a ‘medical’ setting but missed the point entirely: they wear these masks BECAUSE they reduce infection rates between these people and their patients in all kinds of settings outside of the surgical theatre. In other words, in their close contact with people. If masks did not work as today’s public policy says they do – to REDUCE the risk of infection if worn around other people in close even if temporary contact – these people I mentioned would not wear them! But they do wear them as part of their best practices because they DO work as advertised: they REDUCE the spread of infection…. just like Covid-19.

        Nowhere in this proper use of a mask do you see any public policy that says they will stop the RISK of infection. Here’s why:

        Risk, properly understood, means the number of close contacts that elevates the likelihood of coming into contact with an infected person who carries the virus (hence the public policy to REDUCE these close contacts as much as possible). The higher that number of CONTACTS in close proximity (especially sharing air that has higher concentration levels of previously inhaled and exhaled air, meaning air that does not get quickly exchanged with fresh), the greater the risk. All a mask does to ‘work’ as advertised is REDUCE whatever that risk number may be. It does not eliminate it. It does not protect someone from getting the virus. It REDUCES that risk number by some measure.

        Here’s the problem:

        You may want specific percentages for this reduction but failing to get those is then used by you to reject the efficacy of masks as a mitigation factor. This is the same as saying because we cannot measure the actual weight of every bird in the world to your satisfaction, therefore we can and should doubt that birds weigh anything. Although the actual efficacy in the numbers you raise are not known regarding public mask policies, this does not mean that we can and should doubt that masks mitigate anything. Unquestionably, masks – just like weight of birds – really do mitigate but not eliminate the risk encountered. They work as advertised. That’s why masks are best practices for people in close contact with others in situations where the risk is higher for possible infection. This is good public policy for an airborne and highly contagious virus as is social distancing as is reducing the number of close contacts as much as possible.

      3. There needs to be more RCTs done with the a focus on measuring secondary infections in the community. I’ve read the reasons why mask proponents say they should work. Sadly most RCTs (6/8) show they have no significant benefit in the community. Lab tests can be useful, but the gold standard are RCTs. As for cloth masks the Vietnamese study (hospital based https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/) showed cloth masks had worse outcomes than no mask. So I repeat ‘spotty and inconsistent’.

  14. When an intervention has significant downsides people will demand stronger evidence. When an intervention has few downsides people will say ‘well the evidence is mixed but hey there’s no downside to doing, so I’ll do it’. Masks fall into the first category. Hand sanitising, falls into the second category.

    Downsides to masks:
    * significant degradation of human to human communication
    ** cannot see smile, seeing the expressions round the eyes and mouth are vital to effective communication
    ** we all subconsciously lip read to improve comprehension
    * Needing to stand closer to the masked person to hear them, so breaking social distancing
    * More face touching
    * Litter, masks lie discarded and no one picks them up for fear of ‘getting germs’

    I have poor hearing and find it very hard to have conversations with mask wearers.

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