@the_providence #83
This will be long due to the many quotes.
Part 1:
"[...] still not intrested in dishonest discussion, where there is no way to prove yourself right, because your opponent will never agree that he was mistaken on something."
Great! We're on the same page there. I don't know why you reiterate your bad past experiences with other people. I'm not them. I strive for an honest discussion.
You're again implying that I (well, you keep it general, "[...] [a] very sizeable amount of people") appear to "love this all". I don't know why you keep bringing that up. You already said that and I already addressed it. You are talking to me, not an angry Twitter mob.
First-off, you make a GREAT point in your second paragraph. Credit where credit is due. The pandemic naturally has an economic impact. Thus far industrialised nations have acted in self-interest, attempting to protect their own population. Because of this this their economies have suffered temporarily, although many might argue less than they would have, if unmitigated spread had been allowed to happen. It has recently become apparent what happens in such instances, I'm talking of course about India. Their latest horrendous Covid wave met an ill-prepared medical system, oxygen shortages and led to countless of deaths. In such scary situations the population will self-isolate by itself, even if the government still pretends the situation is under control. A lockdown, its proponents argue, delay and dampen the spread ('flattening the curve'), in order to avoid losing control like India recently did. That's really the main argument for a lockdown, it is meant to prevent that the medical system is overwhelmed (like it was at different times in Bergamo, Italy; Belgium; New York, USA; India, Czechia, Poland, etc.). Lockdowns will no longer be necessary when a sufficient amount of people have acquired some form of immunity (herd immunity), either by having survived a recent infection or by being vaccinated. When herd immunity is reached, the pathogen's spread is severely hampered and it no longer poses the threat to overwhelm (frail) medical systems. Then the pandemic will become endemic.
So rich countries have so far acted out of self-preservation. That the ensuing initial economic downturn can have dramatic effects in less fortunate countries has largely been ignored. Now international efforts will have to be made in order to prevent famines in developing countries (for lack of a better term). I dearly hope they will largely succeed in avoiding the worst of economic effects. That the pandemic has such horrible large scale effects is one more reason to work towards ending it as soon as possible.
Now on to the masks. Let me again start with something positive: You have provided sources. I applaud you for that as it is sadly rather uncommon in internet discussions.
However from what I can see the sources you've provided don't actually vindicate most of the assertions you make. In some cases it seems like you have not actually read your own source, otherwise you would have noticed that it doesn't actually say what you think it says. Let's look at them one by one:
First you assert that "[Masks have] been proven harmful and of little use over and over, it's simply being ignored [...]". You cite a recent peer-reviewed study. However, above the abstract there is a disclaimer that you must have overlooked: "Article Alert: View retraction". Peer-review has apparently found glaring errors with the study. The clinical trial you reference has already been retracted due to "[...] numerous scientific issues [...] regarding the study methodology, including concerns about the applicability of the device used for assessment of carbon dioxide levels in this study setting, and whether the measurements obtained accurately represented carbon dioxide content in inhaled air, as well as issues related to the validity of the study conclusions."
Read the full Notice of Retraction here:
jamanetwork.com/journals/jamapediatrics/fullarticle/2782288Next you claim "Among other things you will find studies that proved that masks reduce oxygen intake: [...]"
As a side note: 'Proved' is a difficult word. In science there is no proof (or formal definition thereof). Testable hypotheses can only be falsified. When experiment repeatedly fails to falsify a hypothesis, the scientists become more confident in their hypothesis. But it is not thereby proven. Later experiments can always shed new light on a hypothesis.
When I (and I'm not a physician) read the 'Results' and 'Discussion' section of the 2008 study you cite for this claim, a more nuanced picture emerges. I quote:
"Surgical masks may impose some measurable airway resistance, but it seems doubtful if this significantly increases the process of breathing. [...]
The surgeon's post operational blood O2 saturation level is decreased more than 1% although the variability [i.e. statistical error, annotation by me] of the saturation sensors is less than 1%. It is thought that after a very short time the barrier function of the surgical face mask is gone. Thus it is hard to believe that these masks serve as a reducer of oxygen uptake, but they may be acting as a psychological restriction over spontaneous breathing of the active surgeon.
Considering our findings, this is the first clinical investigation reporting a decrease in blood O2 saturation and an increase in pulse rates of the surgeons after the operations due to surgical mask usage. This change in SpO2 may be either due to the facial mask or the operational stress, since similar changes were observed in the group performing surgery without a mask. However, it cannot be decided whether stress plays any role on the late changes, namely pulse rate increase and SpO2 level decrease; [...]"
And in the results section it says:
"When the values for oxygen saturation of hemoglobin were compared, there were statistically significant differences only between preoperational and post operational
values (Fig. 1). [...]
In the group of surgeons who did not wear masks during primary care operations with duration of less than 30 minutes, preoperational saturation values were 97.6±0.2 while post operational values decreased to 96.3±0.3 (p=0.0006)"
That means the study found no statistically significant difference between the group of surgeons who wore a mask and the group who didn't. The only significant difference found was between pre- and post-operational oxygen saturation (it goes down during surgery, this effect is a bit more pronounced for surgeons over 35).
That's presumably the reason why there is no Figure directly comparing Group Ia (wearing a mask [n=5]) and group Ib (not wearing a mask [n=9]). Their blood oxygenation was similar. Further note that the groups are very small (fewer than 10 people per group).
The lowest value for oxygen saturation (from Fig 3a) was the post operational value of 95.8% (down from 97.2% prior to the operation) for surgeons over 35. According to the study "normal blood O2 saturation" is usually defined as a fractional saturation of 90 to 97.5%, so even the lowest recorded value is still well within the bounds of normal blood oxygen saturation (i.e. poses no danger to the surgeon's health).
Maybe you should try reading more than just the title of a study. Clinical trials are very interesting and fascinating, I highly recommend getting your teeth into the nitty-gritty details. Otherwise you'll often misinterpret the findings.
Your next claim reads as follows: "That clothe masks actually increase chances of getting viral infection: [...]"
The 'ScienceDaily' article you cite for this assertion does not actually say the same as you do. You should carefully read the sources you cite. The 2015 study discussed in the article found that health care workers (not common people) wearing ONLY cloth masks INSTEAD of masks providing better protection (like surgical masks or respirators satisfying N95, FFP2, etc. standards or higher) were more likely (than those wearing gear with better protection) to contract respiratory diseases. Surprising? I think not.
The study did not compare cloth mask wearers with no mask wearers (from what I can see). It compared healthcare workers wearing cloth masks with healthcare workers wearing medical masks. It found that cloth masks are clearly not enough to protect healthcare workers who are in contact with potentially (highly) contagious patients for their entire shifts.
I quote: "The authors SPECULATE [emphasis added by me] that the cloth masks' moisture retention, their reuse and poor filtration may explain the increased risk of infection. [...]
Additional research is urgently needed to build on our study's findings."
What seems clear is that cloth masks should not be used for extended periods of time in medical settings. They are clearly not up for that job.
Regarding covid, many (rich) European countries now recommend the use of FFP2 (≈N95) masks for indoor settings (like public transport or groceries). Medical professionals wear at least FFP2, better yet FFP3 masks (which filter even better). Cloth masks for common people are a last resort and if used should be cleaned regularly (with proper use they are probably better than no mask at all, because they at least reduce droplet infection, however SARS-Cov-2 is now known to primarily be transmissible through aerosols, which cannot effectively be stopped by a cloth mask).
For poorer countries it is clear that not everyone can use N95 type masks (and continually replace them), which is why people in poorer countries are generally at higher risk of contracting covid, have a lower probability of having access to a vaccine, etc.
International cooperation should help alleviate these problems and we should work together in order to get out of this pandemic.
In rich countries, wearing N95 type masks indoors (during an infection swell) is an act of self-preservation and solidarity and helps reduce the spread. Outdoors masks are not necessarily needed (especially when there are few current infections). An exceptions being long (more than 20 minutes) face to face discussions in close proximity (even outdoors they pose a moderate risk of transmission through droplets if no masks are worn).
Your next claim: "And countless studies to show they [cloth masks] have very little effect on viruses."
You link a Reuter's article about a study "carried out in April and May [of 2020] when Danish authorities did not recommend wearing face masks" in Denmark. In this early stage of the pandemic people mostly wore cloth masks (sometimes home made ones) because better masks were scarce. The study discussed in the article finds that those apparently provided worse than expected protection of only 15%-20%:
“The study does not confirm the expected halving of the risk of infection for people wearing face masks,” it said. “The results could indicate a more moderate degree of protection of 15-20%, however, the study could not rule out that face masks do not provide any protection.”
The findings are consistent with previous research. Health experts have long said a [cloth; annotation by me] mask provides only limited protection for the person wearing it, but can dramatically reduce the risk to others if the wearer is infected, even when showing no symptoms. Preventing the spread to others is known as source control.
The study’s findings “should not be used to conclude that a recommendation for everyone to wear masks in the community would not be effective in reducing SARS-CoV-2 infections, because the trial did not test the role of masks in source control of SARS-CoV-2 infection,” the authors wrote.
So you are right, cloth masks do not provide excellent protection for the wearer (although they might still help through source control). But that doesn't mean that they (or other superior masks and respirators for that matter) shouldn't be used at all. That's not inferable from the limited scope of this study (as the authors themselves point out).
Lastly you state that the WHO initially did not recommend them (I assume you still mean cloth masks?).
CNN reports (in the article you linked) that the WHO did not recommend that people go out and buy masks in march 2020 (very early in the pandemic), yes. There's a lot more knowledge about the pandemic and SARS-Cov-2 now than there was in march 2020. Nowadays the WHO supports mask use, higher protection masks (like N95 respirators) especially for people over 60 (or with underlying health conditions), at least cloth masks for everyone below 60 (source:
www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19-masks).
That's how science works, you find out something new, so you change your theory. In this case, the WHO has changed its recommendations.
Back then they feared private demand could drain the supplies and leave essential healthcare workers without much needed protection. In the article Dr. Mike Ryan, executive director of the WHO health emergencies program, is quoted as follows:
"There also is the issue that we have a massive global shortage [...] Right now the people most at risk from this virus are frontline health workers who are exposed to the virus every second of every day. The thought of them not having masks is horrific."
Another WHO official is quoted as: "[...] we prioritize the use of masks for those who need it most, [...] In the community, we do not recommend the use of wearing masks unless you yourself are sick and as a measure to prevent onward spread from you if you are ill, [...]"
Pretty understandable at this point in time. Though I still think it was bad public communication on part of the WHO. They should have been way more clear about the fact that masks (especially respirators like N95 and higher) are effective in slowing the spread and as protective gear (to various degrees, with N95/FFP2 upwards being highly effective), while also communicating that common people should not drain the supplies at a time where hospitals were struggling to satiate their demand for desperately needed protective gear.
So there you go, that's my take on your sources about masks. For all quotes, please see the links the_providence has provided in #83.