To what extent are you still taking C19 precautions and has your lifestyle been permanently changed by the pandemic (April 2023)?

[Monkeygrinder's Organ]

I think the last Cochrane review probably settles it,

A quick look at the authors' conclusions would suggest it definitely doesn't.

 

[Monkeygrinder's Organ]

I dunno, hearing some of the reasons people were giving for not wearing them, I think many resisting adults just needed to get a bloody grip. Though in most cases I suspect the resistance to masks wasn’t really about the masks.

I think this is true but I think it's also fair to say a lot of the pro-mask sentiment wasn't purely about masks or disease prevention. It definitely took on a very visible signifier role for a lot of people.

 

[Agent Sparrow]

A quick look at the authors' conclusions would suggest it definitely doesn't.

Meta reviews are tricky things. Yes they are a great way of collating a great breadth of scientific information, but at the expense of losing context.

 

[8ball]

A quick look at the authors' conclusions would suggest it definitely doesn't.

This is how "conclusions" tend to look in analyses of this kind.
In the end, nothing is absolutely conclusive with science and grant applications are always pending, but this is the clearest evidence available that a belief in the effectiveness of facemasks should now be considered a matter of faith, and that it is equally as reasonable as believing that they actually increase the rate of transmission (as is indicated in some cases).

Scientists are often justifiedly criticised for discounting evidence that they don't want to hear. I think we are haltingly making our way to the truth of the matter on this, and if it turns out masks have any effect at all, it will be an extremely small effect right at the edge of statistical detectability, and possibly everything will need revisiting because the potential harms of masks are so poorly measured (if at all) in so many of the studies.

Sure, the idea of masks causing harm seems remote, but with such a tiny effect this needs to be taken into account if considering policy recommendations. As does the utility of recommending a measure that does almost nothing (at best) yet comes with a cognitive burden, when other measures may have a much greater effect (such as handwashing, which I must admit took a bit of a backseat to mask use and distancing with me during much of the pandemic).

 

[Aladdin]

I find it incomprehensible that people still think masks made/would make a difference.

They do. Especially n95 masks

 

[Agent Sparrow]

See 8ball , maybe it’s because I work in a social science field and am personally drawn to qualitative research, but in the case of varied studies on mask efficacy I don’t automatically think “they’re not effective” but instead “I wonder what the factors are that increase or decrease their efficacy?”

 

[8ball]

They do. Especially n95 masks

Personally I'm a little tentative about it, but the most recent evidence, if taken literally, suggests they do less than the paper surgical masks (it actually suggests the paper surgical masks do nothing and the N95's increase transmission, but I would put this down to statistical noise - admittedly just because "they do nothing" seems more plausible than "N95's make things worse").

There is evidence prior to this suggesting an effect, which I guess is what you are quoting.

Like Agent Sparrow says, some kinds of context can be lost in a large meta-analysis which is asking a very narrow question.

 

[Agent Sparrow]

Personally I'm a little tentative about it, but the most recent evidence, if taken literally, suggests they do less than the paper surgical masks (it actually suggests the paper surgical masks do nothing and the N95's increase transmission, but I would put this down to statistical noise - admittedly just because "they do nothing" seems more plausible than "N95's make things worse").

Feasibly masks could make things worse if people drop a whole load of other measures they’d be otherwise doing, and/or are using masks incorrectly (frequently fiddling with them and then not cleaning hands, for example).

 

[8ball]

See 8ball , maybe it’s because I work in a social science field and am personally drawn to qualitative research, but in the case of varied studies on mask efficacy I don’t automatically think “they’re not effective” but instead “I wonder what the factors are that increase or decrease their efficacy?”

I understand that, but I think there comes a point where you have to consider whether you'd keep wanting more analyses and nuanced research on, say, the effect of homeopathy on Covid given similar weight of evidence.

And to be clear, we are talking about rates of community spread, and in the context of considering policy regarding public mask wearing, mask wearing in surgical settings, and also in the context of potential mandates etc.
This research is dealing with a very specific question, and that question is not "do masks of any kind ever influence the transmission of Covid and similar viruses under any context".

If I was visiting a sick or elderly relative and had been mixing socially previously I think it could be reasonable to wear a mask as a precaution.

 

[8ball]

Feasibly masks could make things worse if people drop a whole load of other measures they’d be otherwise doing, and/or are using masks incorrectly (frequently fiddling with them and then not cleaning hands, for example).

Yes, this is the main argument for the potential for harm. Especially that with every measure you add there tends to be a cost in terms of compliance with other measures, which not everyone find intuitive, but is pretty well established (though some argue that this effect taper off once habits become cemented - one for the psychologists, that).

 

[Agent Sparrow]

I understand that, but I think there comes a point where you have to consider whether you'd keep wanting more analyses and nuanced research on, say, the effect of homeopathy on Covid given similar weight of evidence.

And I see your point but my view will always differ - we need the small scale, context analysing studies just as much as the larger ones, otherwise we lose so much human variation. A classic example has been rolling out CBT so widely in primary care services because studies show it works for a majority of people, without focusing why it doesn’t help the remaining (often large) minority.

If I was visiting a sick or elderly relative and had been mixing socially previously I think it could be reasonable to wear a mask as a precaution.

And it’s for this reason why I think it’s so important to be careful when throwing around claims that masks don’t work. We don’t want to stop those small behaviours that, when done properly, are not conclusively shown to be worthless.

 

[Agent Sparrow]

Yes, this is the main argument for the potential for harm. Especially that with every measure you add there tends to be a cost in terms of compliance with other measures, which not everyone find intuitive, but is pretty well established (though some argue that this effect taper off once habits become cemented - one for the psychologists, that).

There are ways of increasing motivation (both in initiating a new behaviour and maintaining it) though. And yes, health adherence behaviours do tend to reach their full potential of being maintained when they become proper habits - think of teeth brushing for most people.

 

[8ball]

And I see your point but my view will always differ - we need the small scale, context analysing studies just as much as the larger ones, otherwise we lose so much human variation. A classic example has been rolling out CBT so widely in primary care services because studies show it works for a majority of people, without focusing why it doesn’t help the remaining (often large) minority.

Yeah, I see a common element there. Also, one thing with CBT is that they have set it up to be two things - cheap and measurable. So in the end they can justify it in terms of being low cost and doing… something.

Re: your second point - maybe, but it’s also unclear whether avoiding the distraction of masks might actually be beneficial in protecting the vulnerable. I’m wary of clinging to something just because it “seems reasonable”.

edit: that reminds me of when we used to avoid going swimming for an hour after eating, which then kind of became half an hour once it turned out there was no evidence of these fatal cramp attacks - it took a long time to let go of the habit, and it didn't seem a significant sacrifice compared to the downside risk (that being death), however remote. Not that the argument is totally dead there either. I just did a quick Google and found an article advising 2-4 hours in the top few hits. Ideas that follow a kind of intuitive sense are very hard to change.

 

[krink]

I wear a mask if asked in my mam's care home. I'd wear one if asked to in other places like Dr's surgeries etc.
My life is immeasurably more boring compared to before lockdown. My town's social scene has just never recovered and I can't get anyone to go out and do things. Pubs and the like are empty even on Saturday night. I don't think people are scared, they just can't be arsed going out. They stay in and get food delivered like they did for the previous 2 years.

 

[cupid_stunt]

I wear a mask if asked in my mam's care home. I'd wear one if asked to in other places like Dr's surgeries etc.
My life is immeasurably more boring compared to before lockdown. My town's social scene has just never recovered and I can't get anyone to go out and do things. Pubs and the like are empty even on Saturday night. I don't think people are scared, they just can't be arsed going out. They stay in and get food delivered like they did for the previous 2 years.

Of course the cost of living crisis doesn't help.