Thank you …
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Thank you. I’m glad I’ve chosen that path, too.
I have a friend in Italy, a mom, who is a few months younger than me. We went to daycare and university together. She ended up in wheelchair after her first bout in 2021. Her son is around 9 yo old. They’ve tried to carry on, and her son came to Canada for summer camp this summer. They’ve tried to get back to normal life, despite the disability.
My friend’s 80 yo dad accompanied her son on the plane back to Rome, and he came down with Covid once he arrived. It wasn’t a horrible case that required a hospital stay, but he was very sick, He quarantined while he was there. They ate their meals outside or met in a park until the grandfather could come home to Canada safely.
I’m not telling this story to make anyone feel guilty or defensive about their choices.
I’m telling this story to remind people how much of good health is a crap shoot.
If you didn’t get extremely sick with Covid (or RSV, or Norovirus) or don’t suffer from Long Covid, you have been pretty lucky.
I don’t know how many of you had relatives who suffered, or died, from TB or Polio. My first boss walked with a bad limp due to his bout with polio. My mom’s best friend’s sister was paralyzed by polio that she caught from her boyfriend when she was in 12th Grade. I’m glad I didn’t have to live through those times.
If you end up disabled, you’ve been unlucky.
It isn’t that black and white, or course, but luck and circumstances, have a lot to do with our paths, as well as our outlooks.
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I’m one of the lucky few who have not caught COVID yet either, and I don’t want to jinx it. During the pandemic, I was 100% work from home and super cautious (always masked when in stores/on trains) - limited eating in restaurants, etc. I also live alone, which helps not to have others close by to spread to you. I am now back in an office part of the time, and like others, I’ve generally lived mask-less most days, even on packed trains now.
With the weather turning for us in the Northeast, I should and will put a mask back on in packed indoor situations at least. I’ve always had one on me as a precaution but haven’t felt the need to put once back on since about April/May of this year. Getting on the vaccines for all respiratory illnesses too.
From a coworker who had this problem, she was unlucky and lost her smell for a good 3-4 months. At about 10 months in, she confided to me that she didn’t think her smell had completely returned to normal yet, but she was also unlucky enough to get it twice! It did eventually return, but it took a while for her.
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Maybe. But we had plenty of data from decades prior (examining influenza pandemics and othe respiratory viruses) telling us that maybe forcing everyone to mask (particularly small children) was a low-efficacy, high-downside proposition.
I beg to differ. I will leave it at that.
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I know a political debate when I see one and am going to bow out now.
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(post deleted by author)
OK, I clearly can’t help myself. And I may regret this…
I’m not a doctor or an epidemiologist. But the authors of this article are, and they end with this summary after some pretty persuasive explanation - “Do Masks Work?”:
“Bottom line
The scientific ‘arc’ of mask discovery is ongoing. Science is always evolving. Do not let anyone convince you of a one word answer to the question: Do masks work? It depends.”
I think we would do well to treat the issue with nuance.
Personally when I was referencing regrets in hindsight, I was thinking specifically about the decisions to close in-person schools and daycares. At the start of the pandemic I urged our local officials to do so because it was hypothesized that children would be vectors for spreading COVID as they are for other respiratory viruses such as flu. We also worried it would be as deadly to kids as flu for the unvaccinated. These concerns didn’t materialize, but there was only limited data at decision time. Closing schools was mostly terrible for children and families, and I regret that choice.
I also kind of wish that once the adults in our household had been vaccinated, we had dropped masking and gone back to in-person indoor activities unrestricted. That’s more of a cost/benefit analysis on my part, and I understand the myriad reasons others might handle their personal situations differently. Both times my kiddo had COVID it was pretty mild, especially after he was vaccinated. I was very intent on preventing infection as long as possible, and avoiding spreading illness as long as possible, and am not sure it was worth it once all/the vast vast majority adults could be vaccinated.
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I would like to see what comes of this 20 years down the line.
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Zipping my lips.
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A safe way not to taste anything 
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Nuance is the right answer, so far as I can tell. I’m also not an epidemiologist.
But as a pharma IP lawyer who had to review hundreds of clinical trials for publication every year, I do have some experience reviewing trial results.
None of the mass masking mandates have been shown to have helped, once one weeds out confounders. This was summarized in the Cochrane review earlier this year (below).
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full?ref=svtv.org
To be clear, this study said nothing whatsoever about individual protection in masking. It may well be that for dedicated individuals, wearing a good mask in the right manner is helpful.
This review only said that mass masking of the populace did not show efficacy.
None of the mass masking mandates have been shown to have helped, once one weeds out confounders. This was summarized in the Cochrane review
Lots of people misunderstood the Cochrane review, leading the Cochrane Review to issue an apology/clarification statement.
Here’s some additional clarification, from the first few links that show up on a google search:
FactCheck website: ‘People online are touting the results of a Cochrane review to incorrectly claim that it shows masks “don’t work” against the coronavirus. But the primary conclusion of the review is that it’s uncertain from randomized controlled trials whether mask interventions in the community help slow the spread of respiratory illnesses.’
American Journal of Public Health: ‘The update was widely read and cited, becoming a point of controversy in the public debate about the efficacy of face masks, as it appeared to contradict both public health guidance and research. The appearance of controversy was in part owing to the methodological approach of Cochrane reviews, which allows inclusion of only randomized controlled trials (RCTs)… But even with these limited, additional data, the appearance of disagreement between the Cochrane review results and public health guidance disappears if infectious disease models are applied, because the models calibrate quite well to the new Cochrane data and, when extrapolated, show that masks can reduce respiratory infections significantly.’
https://ajph.aphapublications.org/doi/10.2105/AJPH.2023.307377
(US) ABC News: ‘the editor-in-chief of the Cochrane Library, Dr. Karla Soares-Weiser, issued a statement on March 10 to say the analysis had been misinterpreted and that the review didn’t find that masks do not work…’
‘“Many commentators have claimed that a recently updated Cochrane Review shows that ‘masks don’t work,’ which is an inaccurate and misleading interpretation,” Soares-Weiser wrote. “It would be accurate to say that the review examined whether interventions to promote mask wearing help to slow the spread of respiratory viruses, and that the results were inconclusive.”’
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As a lawyer in Canada , I’ve been shocked to see how many lawyers, who practice health law, personal injury law or IP law do not choose to wear masks indoors in crowded spaces.
I went to a fundraiser at a country club last October, and the only masked attendees, out of a crowd of 200 lawyers and professors, were me, a grad student, a Health Law Prof, his teenage daughter , the Ethics Prof and half the country club servers and chefs.
There’s a lot of peer pressure within the legal community to be unmasked.
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Right - I tried to be careful to say that the Cochrane review concluded only that that mass masking of the populace had not, in the studies they reviewed, shown an efficacy signal, but maybe still was not careful enough. And followed that by saying the review “said nothing whatsoever about individual protection in masking. It may well be that for dedicated individuals, wearing a good mask in the right manner is helpful.”
The problem is, humans are going to be humans. We can try to get everyone on board with a given community effort, but even with a high level of initial enthusiasm, such efforts tend to flag fairly quickly. Compound that with our inherent human sloppiness - even back when 100% of the people in groceries were masked, I’d see somewhat over 30% of them with their nose out. And an even higher percentage, perhaps half, with big gaping gaps between the mask and their cheeks.
I don’t think these folks were trying to be defiant, but I do think they were maybe not aware enough of the mechanics of the process.
The article I linked specifically addresses Cochrane at length:
“The authors of the review ultimately concluded there was no evidence of masks making a difference. On top of the limitations described above, keep in mind that “no evidence of a difference” is different from “evidence of no difference.” Don’t use an inconclusive Cochrane review to reject the value of masks, or any other intervention for that matter.” [Emphasis mine]
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I quite agree; this is a foundational principle. Carl Sagan put it this way, “Absence of evidence is not evidence of absence”, in his case meaning that just because he could not prove there were other intelligences in the universe, this in no way proved there were not. As he said, out of 100 billion+ galaxies each with some 100 million stars, pure common sense says some others should exist.
But going back to when I first got myself into this at #44, what I’d mentioned were public health interventions. And that foundational principle mentioned above is not supposed to be in play when making public health interventions. Nor is common sense which tells us something should be able to help.
Instead, the guiding principle of public health science is that for officials to undertake mass public interventions, we need real evidence of efficacy. From CDC:
- Public health interventions should be scientifically driven on the basis of established facts and data, current investigation findings, and knowledge from previous investigations and studies. Although salient sociopolitical forces (e.g., public fear or political outcry) might create pressures for rapid public health interventions, the interventions must be based on evidence.
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What clinical data was available (with enough statistical power and not anecdotal) ? Working in drug discovery we have looked obviously a lot during the pandemic to decide about masking (and many other things related) but there is hardly any scientific solid data out there.
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I don’t really get the ‘high-downside’ of wearing masks. For me there was little downside. And whether it was at my workplace or going to another workplace (a store, for example) I didn’t notice any downside for those folks either.
there was certainly a downside to closing schools or going to online learning. But for most people masks are a minor nuisance or inconvenience.
To keep this about food: When I took a roadtrip, pre-vaccination, I went to a completely rural bbq joint (Ridgewood) in East Tennessee. I was a bit nervous because there was no obvious place nearby I could take the food if I found the place unsafe. Much to my surprise, everyone had to wait outside until they could be seated, and half the tables were blocked off for social distancing. The staff all wore masks and the customers had to wear masks until they were served.
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