Except that such a study cannot be blind to the participants, in that participants know whether they got the treatment (mask) versus placebo (no mask), which could affect their behavior.
Also, it appears from other research that most common masks are more protective of others than the wearer. Try designing an experiment to test that.
An unvented N95 mask offers two-way protection (probably) but is very uncomfortable if it fits. A vented N95 protects the wearer but no one else, which sounds hostile if worn where others are wearing cloth masks. A vented cloth mask probably doesn’t do much of anything. If universal cloth mask wearing works, it’s a better equilibrium than some people wearing unvented N95s and others wearing nothing.
I think what you’re getting at is the possibility of what’s referred to as risk compensation in other safety contexts. The results could potentially be skewed if people wearing masks use that as an excuse to engage in riskier behavior in the context of contracting COVID-19. Knowing there is risk compensation, if it exists, would itself be useful to public health officials and policymakers.
@roethlisburger, that attitude toward human risk, if I’m reading you correctly, is nothing short of horrifying.
Serious suggestion: Find a college faculty member who does human subjects research, and ask to sit down with them sometime as they go through their triennial human subjects recertification. They might take some convincing, because doing so would probably turn a fourish-hour process into something more like eight hours, but it would at least give you the background to understand exactly why you’re on the wrong side of both ethics and history on this one.
That would be interesting to know. And, after all, you want to know how masks perform in practice, risk compensation and all.
I have heard there are some antibody tests that are very highly accurate. I think that is particularly true with some foreign country’s tests. I have no idea what they are using to test but donated blood that is used for IgG infusions is, but that blood is routinely tested for a ton of things to be sure that it doesn’t give people any illnesses spread by blood. Once they knew of Covid, they started testing for that, too. Not sure if they are testing for the antibodies or for Covid itself. I think probably testing for Covid itself. And if they are not finding Covid itself, they are also not likely to find Covid antibodies in blood products from certain time periods.
Many many states are in the “steadily dropping rate of infection” category - including all states in the northeast. Don’t just cancel studies that don’t fit your narrative.
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Northeastern states in general followed the US guidelines of trying to get massive testing and contact tracing ready (although not all have it at ideal levels), and waited for data to show the 2 week downward trend, etc. Our state was going to open certain things but when the numbers didn’t support doing so, the opening of certain things was pushed back. I think that it would make sense to compare the states that didn’t follow the recommended US guidelines closely with those that did and see how things turned out. Of course, we then had a lot of country-wide demonstrations and now the start of indoor political rallies and people not following social distancing or mask wearing as much in various places, so that makes it harder to tell what caused what. But in the NE, I think the downward trend in numbers is because of following the guidelines and doing many of the same things that countries that turned things around elsewhere in the world did.
Also, I think we have high mask compliance in the North East in general compared to what it sounds like in some other parts of the country.
There’s absolutely nothing anyone can say to convince me RCTs aren’t the gold standard for scientific research.
When I was subbing, one time I got called to a school that was hit hard by some very bad illness. I am not sure what the illness was but I started the day with a class of 5 kids and had 1 or 2 left by the end of the school day out of 26 or so kids normally in the class. I learned to be wary of sub jobs like that after that experience because not only did I get sick, I gave it to my husband and son and we were so very, very sick, it was scary. We had multiple snow storms, ran out of food and medication, all were having trouble breathing and not enough asthma meds. it was really bad. That school had so few students. It should have closed temporarily in my opinion. It doesn’t make sense to keep school going in that situation. Let kids stay home a few days or a week and break the infection cycle is what I would have chosen to do if I were in charge there. But I have personally never had a school in which I worked close due to illness. This fall and winter were the first times our school nurse was pushing for it to happen. She thinks we were seeing Covid cases back in Nov, Dec, Jan, and Feb. We haven’t had as much bad illness as we did this school year in all the time I have taught in any school anywhere. I have heard of it happening. I think it is in schools where they are above a certain percent out or can’t find enough substitutes to cover for ill teachers.
The stuff I am infusing now is from a lot from over a year ago. I think it is close to 2 years old. It isn’t processed by Red Cross but by some specialty companies and pharmacies. It isn’t red. They take everything out of it but the IgG. It’s clear fluid. It is not treated the same way as blood that is used for blood infusions for people who have been in accidents, etc.
There was luck, but there were also countries that screened people coming into their countries, tested widely, did contact tracing, and quarantined people so they contained it rather than have to go into massive lockdowns (mitigation). It wasn’t just luck.
[quote="roycroftmom;c-22860974"Even if we don’t know much about this virus, what is the general level of infection needed to achieve herd immunity against any corona virus? Or any disease? At what level of in home transmission of disease should household members move out-greater than 10%, less than 100%? These seem like basic questions not Covid 19 specific which would be helpful
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I think that question has been answered and is something like 65-70-something % of the population. I’m sure there is a lot of research going on (and exiting) regarding all the things you brought up and much more.
And there shouldn’t be!
If you (or your IRB board) genuinely felt that there was a reasonable disagreement about whether masks have some good effects, then you could persuade them to allow you to randomize people to masks or no masks. I don’t think you’d find an IRB board that would believe that. Maybe you could?
When did any of us in this discussion say anything against randomized controlled trials?
What Cardinal Fang and I and others have been saying is that they need to be done following proper ethics, and that what you proposed upthread would never get past the Institutional Review Boards that are charged with making sure that research follows ethical procedures.
You then proceeded to say that IRB processes need to be changed, because you drew the (unwarranted) conclusion that requirements for ethical science mean that science is not allowed at all.
This shows an incomplete understanding of the way human subjects research works (and thus my suggestion to learn more about it).
But to bring this completely back on topic,. this means that any experimentation that is going to be done on, e.g., masks (the issue that spawned this discussion) cannot (let me stress this again: cannot) be set up in a way such that participants would have a good chance of being exposed to a disease with no cure as a direct (or even indirect) result of the experimental protocols used.
Basically, someone can experience risk or even harm as an experimental participant, but that risk/harm must be minimal and balanced as far as possible by benefit to the participant. Basically, you can’t increase an individual’s level of exposure to a disease just because it would be the most efficient way of testing an idea about it, or even because it would be the easiest way of finding information that would benefit society as a whole.
This is because we have learned by sad experience that if we don’t have these limits in place, researchers—even completely well-meaning ones—do bad things. But you know what? Scientific advances still happen, even with these restrictions.
So no, I’m not standing for the idea that assigning research participants to a group where they are less protected from a virus with no cure means that we’re “unwilling to run experiments”, as you put it upthread. It may well mean that the experiments have to be very carefully designed and that we need more of them and even that they go more slowly, but that’s the price we pay for civilization.
This is a lot lower than what appeared to happen in China at the peak there. I wonder if that is because of closer living quarters in many places there?
I don’t think this is ethical unless you have people who would not have worn masks anyway and those same people will comply fully with mask wearing if they end up in those groups. Even then I think it is still not going to be considered ethical.
Yup. And I have family down there and I worry about them. I remember the New Rochelle super spread case and then within weeks it was going around the rest of the north east. There was the Biogen conference. What we saw was that with this virus, there is no such thing as ‘just a little virus’. It is there and then it can increase rapidly. I’d look at the ROs of the states in question. If they are above 1 and opening more, social distancing less, having more indoor events, and not having high mask compliance, then those ROs are almost certainly going to go up and cause more spread and sickness and death. And the virus won’t just stay in those states. It puts the country at risk to have it out of control anywhere. There is still a lack of testing being done in a way that would detect early, asymptomatic spread, and asymptomatic spread exists, so some of those places are even worse off than they appear by the numbers now, which look concerning.
I am looking and feeling worried and concerned for those who are going to get sick and die. I have no pleasure in that at all. Anyone who does is messed up. We are one country. I want this virus to be under control. We can do that if people took it seriously. I just saw or read a quote I can’t quite remember that was something about if we do not take the virus seriously, the virus is going to make use take it seriously.
I wanted to get a Vogmask but they only had the kind with the vents. I couldn’t feel good about getting it so I didn’t. I would breath easier and could spread to others. There are some that allow people to open and close the vents. Cambridge masks I believe do this. I would not feel right about protecting myself and possibly getting others sick. I think the answer is that there should be more masks that are protective both ways for consumers to buy. There seem to be some. (The two I mentioned claim to be, Airunum, 02 Canada, B99, Suay Sew Shop masks, and some of the 3d printer masks made to fit a person’s face exactly (one Canadian U is making these) and more. I think we could get more buy in if people felt wearing a mask protects not just others but themselves.
In Taiwan, the government forbid exporting surgical masks and funded them so that the whole country could buy them for very low cost. All were encouraged to wear actual surgical masks. Those do offer protection to the wearer as well as to others but not as high as N95s. Still, they are pretty good protection. I think more people would buy into that type of thing.
I think a good mask depends on a good fit that doesn’t leak and material that actually filters very tiny particles. It has to be that some masks are far better than others. The lack of talk about that is strange to me. I’m sure I can’t be the only one who wants a mask that both protects myself and others.
There are countries that had outbreaks slow incredibly when mask wearing started, studies that show models of how masks reduce spread, studies showing much less virus is emitted from people who wear even ill fitting cloth masks over nothing, etc. All that data already exits. I hear a chorus of epimediologists all recommending masks. I am going to stick with masks.