Key conclusion: "observational studies of interventions with small to moderate effect sizes are prone to bias caused by selection and omitted variables."
Surprisingly few interventions are so good that you don't need fancy statistics to justify them. Really good treatments (e.g. antibiotics) are so effective as to be obvious to all.
> Surprisingly few interventions are so good that you don't need fancy statistics to justify them
To me the real story is that the CDC, which is supposed to be the public health authority in the US, decided not to use said "fancy statistics" and instead chose to only include data that supported their policies. It's the CDC, they should have access to tons of data. Why such small sample sizes?
>Surprisingly few interventions are so good that you don't need fancy statistics to justify them. Really good treatments (e.g. antibiotics) are so effective as to be obvious to all
You mean like the HCQ cures covid research and studeis in March 2020 that "showed" a 100% cure rate that was pushed hard by Elon Musk and an entire political wing? And so many people still believe it, even on HN, it's crazy.
I don't understand why people would have believed otherwise in the first place.
It's clear that masks are effective at preventing transmission for passing encounters. But I have operated under the assumption that if you are sharing space with someone for 8 hours a day - you're basically still going to spread Covid.
Yes, masking works in degrees. It's not hard to understand that.
Where schools break down, however, is during lunchtime. Kids - like adults - drop their masks to eat and drink (of course) and carry on as if there is something magical about holding a sandwich in front of their faces. After 30 minutes of much needed socializing, the masks go back on.
To be clear, at my both of my kids' schools in Seattle masks are 100% voluntary, yet there is a culture to wear them (even on the sidewalks while walking home from school - not joking).
It's not like the masked schools are 100% solid, no, so the tests are wobbly to say the least. Yet, my kids don't sit next to every student in the school during lunch, so their exposure is also teeny tiny. But we're anecdotally seeing cases rise at work and school here in Seattle over the past 3 weeks unlike any time I can remember during the past 2 years. Every area is different... It used to be, "Do you know anyone who has caught it?" And now I know several.
I sometimes think the UK has it right. People there have simply accepted it and deal. They have a big spike every 2 months but carry on with packed pubs, covid be damned.
Most people I know have had Covid by now, regardless of where they live or what the mask mandate situation is/was.
That being said, it's fascinating to see how masking has become almost entirely a cultural phenomenon. I live in the New York City area. In many places here masks are still mandated, while in others masks aren't mandated but masking is nearly universal. I have a friend that lives "upstate" (about 40 miles north of the city). When I visit him, there is nary a mask in site. We hang out in packed bars and restaurants and it is exactly like Covid never existed. Nobody talks about it and nobody is concerned with it. Doubtless there is some level of awareness about the ~1 in 100,000 chance for someone up there to get seriously ill or die, but, unlike New York City, it isn't something that people dwell on or think much about at all. Just another one of the infinitesimally small risks entailed in daily life.
Maybe. Or maybe because your odds of dying from Covid if you are under 85 and not morbidly obese or suffering from a long list of other health problems are less than your chances of dying in a car accident on the way to work or falling off of a ladder.
Lots of people under 85 survived with oxygen and ventilators in hospitals and ICUs with proper staffing. If no one wore masks the survival rate would have gone down a lot.
"More" is not a majority. Every bit of data points to the fact that the risk of Covid to young people was, and is, extremely low - almost non-existent among young people with comoribities and other serious pre-existing health problems. The odds of dying in a car accident, of a drug overdose, or of suicide are orders of magnitude higher for young people than dying of Covid.
Masking is effective until a person has breathed out enough particles into the room that anyone taking a breath will get enough virus particles into their lungs to statistically chance catching the disease.
Even with a well-fitting mask, a sick person will saturate a rom with virus particles given enough time. When you account for lousy cloth masks with only 10-20% effectiveness that rapidly drops to effectively zero combined with n95 masks NOT being recommended for children, of course infections would occur. Put them into a little room and in close proximity all day, and we should probably be surprised that the infection rates weren't even higher.
>It used to be, "Do you know anyone who has caught it?"
I think I personally knew maybe one person at the very start who probably had it. In the last month or two, I'm not sure I know dozens who have gotten it but it's quite a few.
What consequences? Ones that aren't near as bad as the economic and sociological destruction that the lockdowns brought?
What's really disgusting is the health "leadership" have shot their wad overplaying COVID. God help us if there ever is a contagion worthy of all the fuss because half the people are going to extend a middle finger no matter how valid. And it's not their fault for feeling that way either.
Credibility - incredibly hard to earn, very easy to piss away. Once pissed away on frivolous shit, it's even harder to earn back.
It may be helpful to read them both together. As the authors emphasize, the statistical analysis of these phenomena is quite difficult, but one thing that stuck out to me: there is practically no correlation with population density, before or after controlling for the community vulnerability index.
I suspect, to the degree we ever actually know, that a lot of seemingly sensible interventions and behaviors may have made some difference at the margins--and if people had done nothing outcomes would almost certainly have been worse. But vaccinations and improved treatments aside, it seems fairly clear there weren't silver bullets.
Studies like this will only be compounded by those attempting to quantify how harmful removing an entire nation's children from school for almost 2 years, to socially isolate them from their community while mongering fear of other people fared against their psychological well being. How many hacker news users were aggressively throwing shade at anyone who deign so much as offer an iota of dissent against the status quo's reaction to mandates? Funny how a dubious analog to shoving your head in the sand became a conduit of intolerance for people with beliefs that differ from our own. I was shocked how quickly everyone glommed onto a narrative so easily appropriated by special groups with direct conflicts of economic interests, while aggressively shaming anyone who stepped out of line to point that out or ask whether one policy or another was effective, or harmful. I have read about a lot of dumb things humanity has done throughout history, but our reaction to covid is probably the dumbest I'm likely to see in my lifetime. More studies like this to come, rest assured.
>The Centers for Disease Control in the U.S. have released multiple observational studies suggesting that school mask mandates significantly reduce case rates.
>however, incorporating a larger sample and longer period showed no significant relationship between mask mandates and case rates.
>Our study demonstrates that observational studies of interventions with small to moderate effect sizes are prone to bias caused by selection and omitted variables. Randomized studies can more reliably inform public health policy.
I think the big story here is that the CDC is promoting bad science, while being treated as the gold standard by "fact checkers".
Perhaps this is a condemnation of how poor indoor air quality is in most schools (and office spaces) more than anything.
While there are plenty of studies showing efficacy of masks in indoor environments, we're barely recirculating air in indoor spaces to the point where CO2 levels become a major problem for cognition.
The combination of proper ventilation and air exchange plus masks should be the real winner for prevention of spread.
We people are stupid and keep repeating the same mistakes! Didn't we make billions of people obese because we put all fats in one bucket? Now, we're repeating the same mistakes with "masks"! A filthy soggy cloth breeding germs and not preventing any infection is a "mask" just like a kids' KF94/KN95 one!!! Even if it's certified mask - if it's not worn by the specs, it does extraordinarily little!
I'm not a scientist or a doctor but it seems that forcing kids to mask for 6 hours a day is useless when they leave school and go to sporting events, movie theaters, restaurants, shopping malls, and even their classmates homes, all without a mask. Does Covid only spread in a classroom?
And protecting the teachers and staff isn't a justified reason either because the vast majority of them are removing the masks when they leave the school also.
Are children of immunocompromised caregivers doing all of those activities?
Unlikely, since it could kill said caregivers.
> And protecting the teachers and staff isn't a justified reason either because the vast majority of them are removing the masks when they leave the school also.
That implies they’re removing their masks and being unsafe. Citation needed.
> School districts that choose to mandate masks are likely to be systematically different from those that do not in multiple, often unobserved, ways.
From my purely anecdotal observations, regions with higher rates of COVID are more likely to adopt masking requirements as a countermeasure. That correlation alone would explain why the benefits of masking become unclear when measured on a large scale.
Yeah, it's kind of weird to do this kind of analysis when you have data that you include on a chart which clearly demonstrate the variable by which the groups you are concerned with are systematically different that you need to control for, and not include that among your controls, and then have a conclusion that is basically “research is hard, these groups must be systematically different in some way we haven't controlled for, but who knows what it might be”.
Places that adopted mask mandates had higher baseline pediatric infection rates which were erased within six weeks.
Worse than that - there are several highly contagious respiratory diseases common to children. Yes, let's force them to concentrate and re-breath their moist breath.
That's what is (still) the most galling about all of this; that any discussion of alternative solutions was immediately shouted down as you being a neanderthal science denier.
A bunch of people espousing "science", yet with no apparent understanding of what science actually means.
its probably part of a pipeline to make a reliably isolated and scared voting base that will always vote to give big brother more power because they don’t know how to socialize so they are more susceptible to propaganda
> its probably part of a pipeline to make a reliably isolated and scared voting base that will always vote to give big brother more power because they don’t know how to socialize so they are more susceptible to propagand
No.
1. You're describing a deliberate conspiracy, but providing zero evidence for it. It's not enough to show that the policy will lead to the results you allege (which I do not grant you), but that the policy was deliberately chosen for that reason and not another.
2. From what I've read, the actual result of masking and COVID has been increased behavior problems and acting out in students, not increased compliance.
I still wear a mask today - specifically when I am going to encounter a lot of people at once (like ordering food at a cafeteria), interacting with someone who through their job has to come face to face with hundreds of people a day (like a barista), or just passing through a shared area (like walking from the cafeteria to my desk with my food). Other than that I take the mask off if I am sitting relatively by myself.
I am still waiting to feel this fear that the right wing media has hammered into people's heads as a legitimate talking point. I think there are at least two comments here already citing this fear. I don't feel afraid when I have the mask on or when my mask is off and wearing a mask does not change any of my other behavior.
What was scary was in 2020 when I went to the ER with COVID. That was actually scary.
It looks almost too stupid to believe they really assumed pediatric cases will be different. Vast majority of covid cases among kids are asymptomatic and never detected, masking for kids is not about protecting them, it's about protecting their parents and especially grandparents from the covid infection they could bring from school.
The parents and grandparents should just get vaccinated.
The virus will never go away. There's no reason to live in perpetual fear.
Masks may work, but mask mandates don't work. You can't force people to do something they don't like 24/7. They will take off the mask when you're not looking, or they will wear it in a bad way on purpose. Specially when it comes to kids.
I find this take obnoxious. I don't live in perpetual fear of busses, but I also don't go for a casual twilight stroll in the middle of a bus lane.
I'm not sure what the end-game for COVID is, but I'm exceedingly willing to take some minor precautions while cases and hospitalizations are rising and hundreds of Americans are dying daily.
>I find this take obnoxious. I don't live in perpetual fear of busses, but I also don't go for a casual twilight stroll in the middle of a bus lane.
>I'm not sure what the end-game for COVID is, but I'm exceedingly willing to take some minor precautions while cases and hospitalizations are rising and hundreds of Americans are dying daily.
I find this take obnoxious. I'm not sure what the end-game for COVID is, but I'm exceedingly unwilling to carry out performative charades that have not been scientifically proven to have any impact on my health or the health of my fellow Americans.
Did you read the parent article? Do you realize your "citation" is from people who self-reported? Do you realize that the "study" you cite shows that reduction in transmission from the use of "cloth masks" (the kind that are mandated) in this 534 person self-report "study" are listed as "not statistically significant"?
The proper way is to educate people on losing weight. Obesity is probably the #1 cause for covid fatalities. In the past 2 years, everyone who is obese could have lost weight and come within or very close to the normal range.
> You can't force people to do something they don't like 24/7.
Unpopular but necessary laws exist. Also, I’m pretty sure that mask mandates weren’t rejected by a majority of the population, but a vocal minority instead.
You can't force this top down. It has to come bottom up.
Famously alcohol ban didn't work in America. Famously the left argues that laws against drugs don't work. Famously the left says that if you ban abortion it will just go underground.
It seems ridiculous to claim the police can't possibly be involved in any kind of legal matter. I dated a girl who once had a panic attack, and because of some policy, the hospital she first went to called the police and they literally handcuffed her inside a van to take her to a different hospital.
edit: I guess I do agree with you that they should not be involved. But my point is that laws tend to give police "justification" to use force, whether they're supposed to or not. I am not an anarchist, we do need laws, but I think it's important that we remember who will be enforcing them when new ones are suggested.
Police enforce EVERY law. Even the most minor infractions are ultimately backed up with the idea that the police will force you to comply. We have plenty of examples up to and including little kids getting tasered and arrested for minor or even imaginary infractions.
Throughout history, there has been no law so vile that police cannot be found who are willing to enforce that law.
But in the larger sample size, the incidence of COVID was just as high, if not sometimes higher, amongst masked children. I found this surprising, but if true, parents and grandparents aren’t really being protected by kids being masked at school.
Again though, the findings of their study is that forced masking in schools did not do anything to slow community spread. If your kid wore a mask, they still probably brought Covid home with them.
so if my kids see their grandparents once a year and me and my wife don't want our kids to protect us, can my kids be exempted from mask mandate? because nobody asked us, all the time I heard how we are saving grandma, yet one grandma lives 10 hours by plane on different continent and other one 3 hours drive by car, but according MSM everyone is babysit by grandparents on daily basis
Vaccine efficacy drastically gets cut as weeks and months past, especially with newer variants. However, N95 masks stay at 95% efficacy no matter what the variant. It may be practical for grandparents to wear masks occasionally around their grandchildren and when they go into public indoor spaces, but it’s much less practical for parents since most live with their children.
Widespread immunity leads to overall lower levels of sickness. Vaccines aren't just to protect the individual being vaccinated, they benefit the larger population.
I would pay an increase in taxes to pay the immunocompromised to stay home. I’m so sick of people bringing this up as if it’s a justification for us to wear masks forever
Adults aren't being forced to wear masks, but young children are in many places when they go to school. No criteria has been set that I'm aware of for when this will stop, and there's no indication that covid is ever going away.
I have a 3 year old that is starting preschool in a few months in California. It's not at all clear that mask requirements will be removed for young children here anytime in the next couple of years.
I'm liberal on most issues and supported early covid interventions, but at this point, frankly, I feel that her wellbeing is being sacrificed for the sake of superstitious/quasi-religious beliefs.
It is anti science for sure. Literally the only ones wearing masks in NY public schools are the students at lowest risk — who also hurt the most from the socialization barrier.
It looks like one community in MA reinstated the mask mandate for town-owned buildings some time after the mask mandate had been lifted. That's different than being forced to wear a mask everywhere in public in perpetuity. If a person doesn't like wearing a mask, then they're free to not wear one and free to not go to town-owned buildings.
there was even better study published recently about how significant part of "long COVID" patients have various mental issues similar to people you works previously call hypochondriacs
"Increased risk for PASC (long COVID) was noted in women and those with a history of anxiety disorder."
Surprisingly few interventions are so good that you don't need fancy statistics to justify them. Really good treatments (e.g. antibiotics) are so effective as to be obvious to all.