Medical Discussion of Coronavirus

[burritos]

My MA's grandpa died of COVID last night. Didn't want to ask if he was vaccinated. Now we're short staff.

[MPMD]

Last night, had a whole bunch of covid, all not vaccinated this time. Seems to be picking up quite a bit here.

agree.

it's all unvax'ed people

[K82]

This topic got shut down on the Lounge, the moderator said that this thread was the place to post Covid related stuff. My post was whether masks are really doing any good. I will list the medical studies again that seem to show they don't really help at the bottom of this post. I find it so strange that a medical topic such as, "are masks really helping", has become such a hot political topic and seems to have become a religion for some. If they really do make a big difference then I'm all for it. If they don't, then I would rather not mess with them. The odd thing I see is that if studies point towards them not helping, they get deleted (recent NEJM study) or addendums get added to them to say not to use them to discourage mask use. It's bizarre. I've never seen anything like this in medicine. Anyway, here is a list of studies I have read that suggest masks don't help much:


https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article
https://www.cebm.net/covid-19/maskin...with-politics/
https://www.cidrap.umn.edu/news-pers...sed-sound-data
NEJM, May issue that made headlines due to authors stating masks didn’t help much has since been taken off NEJM website.
https://www.medrxiv.org/content/10.1....30.20047217v2
https://www.medrxiv.org/content/10.1....01.20049528v1
https://www.acpjournals.org/doi/10.7326/M20-6817
https://www.medrxiv.org/content/10.1...260v1.full.pdf
https://bmjopen.bmj.com/content/5/4/e006577
https://www.fhi.no/globalassets/doku...eport-2020.pdf

[Zaphod]

This topic got shut down on the Lounge. My post was whether masks are really doing any good. I will list the medical studies again that seem to show they don't really help at the bottom of this post. I find it so strange that a medical topic such as, "are masks really helping", has become such a hot political topic and seems to have become a religion for some. If they really do make a big difference then I'm all for it. If they don't, then I would rather not mess with them. The odd thing I see is that if studies point towards them not helping, they get deleted (recent NEJM study) or addendums get added to them to say not to use them to discourage mask use. It's bizarre. I've never seen anything like this in medicine. Anyway, here is a list of studies I have read that suggest masks don't help much:


https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article
https://www.cebm.net/covid-19/maskin...with-politics/
https://www.cidrap.umn.edu/news-pers...sed-sound-data
NEJM, May issue that made headlines due to authors stating masks didn’t help much has since been taken off NEJM website.
https://www.medrxiv.org/content/10.1....30.20047217v2
https://www.medrxiv.org/content/10.1....01.20049528v1
https://www.acpjournals.org/doi/10.7326/M20-6817
https://www.medrxiv.org/content/10.1...260v1.full.pdf
https://bmjopen.bmj.com/content/5/4/e006577
https://www.fhi.no/globalassets/doku...eport-2020.pdf

Yet here you are risking this getting shut down. People are still able to view the thread and the studies since theyre there. While some studies may not be able to get a definitive result on their own, many of these are garbled and mixed with other things and are difficult to parse. Some of the others dont say they dont work, just that everyone needs to comply, which we know, and still of course its all based on prevalence. What isnt "independently additive" in low prevalence can be so in higher prevalence and or more contagious scenarios, both of which are true now. Several of these just talk about lack of data and upcoming studies, and it seems you havent read them beyond the headlines.

So far many are saying they obviously reduce droplets, reduce slightly casual, and moderate intra household, etc...many are talking about flu, which is less infectious, ofc the result wouldnt be as obvious there. Some compare cloth masks to surgical, which was significantly different, meaning surgical works, Idk what you're trying to say these all show masks working or are of terrible quality. No one thinks cloth masks were the end all, and we are way beyond that anyway, there isnt a shortage now.

Also, like did anyone get covid in hospital when wearing basic PPE and even doing covid wing rounds? I sure had zero issues and covid was super low in hospital. Most that did get it were from social outside work things.

It is unfortunately not black and white. Masks obviously decrease particles/airborne ejected into the wild, proven by numerous rigorous studies. This isnt a question. Whether we can see a difference in actual wear is a totally different question.

The flip side of this is that it is very easy and there are no drawbacks or issues with wearing one in public, if it annoys you so much, well I just dont think anyone cares and nor should they.

Im am just as shocked as you that people keep making issues where they shouldnt exist, making them political, and making something harmless as wearing a mask into a big kerfluffle on a forum, its nuts. Even if it barely or near zero helps (which we know isnt true), the risk of doing it is zero.

Plus most people look a lot better in masks anyway, win win.

[Lordosis]

Yet here you are risking this getting shut down. People are still able to view the thread and the studies since theyre there. While some studies may not be able to get a definitive result on their own, many of these are garbled and mixed with other things and are difficult to parse. Some of the others dont say they dont work, just that everyone needs to comply, which we know, and still of course its all based on prevalence. What isnt "independently additive" in low prevalence can be so in higher prevalence and or more contagious scenarios, both of which are true now. Several of these just talk about lack of data and upcoming studies, and it seems you havent read them beyond the headlines.

It is unfortunately not black and white. Masks obviously decrease particles/airborne ejected into the wild, proven by numerous rigorous studies. This isnt a question. Whether we can see a difference in actual wear is a totally different question.

The flip side of this is that it is very easy and there are no drawbacks or issues with wearing one in public, if it annoys you so much, well I just dont think anyone cares and nor should they.

Im am just as shocked as you that people keep making issues where they shouldnt exist, making them political, and making something harmless as wearing a mask into a big kerfluffle on a forum, its nuts. Even if it barely or near zero helps (which we know isnt true), the risk of doing it is zero.

Plus most people look a lot better in masks anyway, win win.

Due to staff turnover rates being higher than normal there are people who have come and gone and I do not know what the lower half of their face even looks like!

[Zaphod]

Due to staff turnover rates being higher than normal there are people who have come and gone and I do not know what the lower half of their face even looks like!

I like that I didnt always have to shave as often as well.

[Jaqen Haghar MD]

You cant say 50/50 with people showing up and then transfer that math to the population and assess vax effectiveness. It would depend on the population level of having vax (in this case florida is actually near 50/50) but more so the vax differences within the age buckets. You'd expect more from the vaxxed community, especially as age increases even if a much higher proportion are coming from the unvaxxed population.

Just baseline rates, bayes theorem.

In the UK case, it actually fits around 90% effectiveness. The 40% vaxxed group i suspect has a bit of one shotters in it.

I was just extrapolating the Israeli numbers with Pfizer, and wondering if it will play out like that here, as time goes on and our prevalence of delta covid infections moves from low 40% to 90%+. Pfizer was 64% effective against infection, 93% effective against hospitalization for delta as reported last month, but the numbers seem to constantly change and seem to vary a lot in deferent places around the world. Their ministry of health said those numbers were actually overly optimistic, but we shall see I guess.

[K82]

Yet here you are risking this getting shut down. People are still able to view the thread and the studies since theyre there. While some studies may not be able to get a definitive result on their own, many of these are garbled and mixed with other things and are difficult to parse. Some of the others dont say they dont work, just that everyone needs to comply, which we know, and still of course its all based on prevalence. What isnt "independently additive" in low prevalence can be so in higher prevalence and or more contagious scenarios, both of which are true now. Several of these just talk about lack of data and upcoming studies, and it seems you havent read them beyond the headlines.

So far many are saying they obviously reduce droplets, reduce slightly casual, and moderate intra household, etc...many are talking about flu, which is less infectious, ofc the result wouldnt be as obvious there. Some compare cloth masks to surgical, which was significantly different, meaning surgical works, Idk what you're trying to say these all show masks working or are of terrible quality. No one thinks cloth masks were the end all, and we are way beyond that anyway, there isnt a shortage now.

Also, like did anyone get covid in hospital when wearing basic PPE and even doing covid wing rounds? I sure had zero issues and covid was super low in hospital. Most that did get it were from social outside work things.

It is unfortunately not black and white. Masks obviously decrease particles/airborne ejected into the wild, proven by numerous rigorous studies. This isnt a question. Whether we can see a difference in actual wear is a totally different question.

The flip side of this is that it is very easy and there are no drawbacks or issues with wearing one in public, if it annoys you so much, well I just dont think anyone cares and nor should they.

Im am just as shocked as you that people keep making issues where they shouldnt exist, making them political, and making something harmless as wearing a mask into a big kerfluffle on a forum, its nuts. Even if it barely or near zero helps (which we know isnt true), the risk of doing it is zero.

Plus most people look a lot better in masks anyway, win win.

First of all, I posted the list of studies here since the moderator said this was the place for it, that's why the other thread was closed.

Some of the studies compared cloth masks with surgical but the conclusion of most of the studies I listed is that neither make that much difference.

Why is it offensive to you that I bring this topic up on the forum? I find this so bizarre. Why is this so taboo? Why are studies that show no benefit to mask wearing getting squelched? Since when does medical research behave this way? If you feel more comfortable wearing a mask, go for it. Just don't force it on the rest of society if its of no benefit. And stop cancelling studies that show its of no benefit. (not you personally, the media and academia)

When the mask mandates were lifted in FL and TX there was a prediction that cases would soar. They did better than states like NY or CA that still had mask mandates. Japan also showed huge spikes of covid despite having over 90% compliance with mask wearing.

I agree that there are situations where masks would help, especially with an ill pt who is coughing. And I know there are many studies out there that show a benefit. I just don't get why both sides of the story aren't getting told.

[Sampter]

My personal opinion is the main reason masks (besides N95 + faceshield) work is that it reminds everyone to keep your distance and avoid crowds. Much less likely to be 1 foot away from someone when both wearing a mask. So less the mask and more the distancing.

[Shant]

That was roughly my conclusion as well, it worked very well to revise the culturally natural speaking distance. It was also a great reminder to brush the teeth before leaving the house in the morning , I got strong negative reinforcement the one time I forgot. 🤣

Plus there was a chance that it actually accomplished more.

[billy]

comparing NYC and tokyo to texas though is inherently biased due to population density, mass transit etc. Comparing NYC to Tokyo would ve been valid had one place been masking the whole time vs one place never masking. And well, the public wasnt too great at properly masking, nor being completely compliant.

personal opinion- surgical masks worn correctly probably cut down spread (anectodal in hospital last year observation), cloth masks without the filters or improperly worn masks don't do anything (as some of the studies with the cloth mask showed- they didnt have filters)

[Tim]

FDA :
”Surgical Masks


A surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. Surgical masks are regulated under 21 CFR 878.4040. Surgical masks are not to be shared and may be labeled as surgical, isolation, dental, or medical procedure masks. They may come with or without a face shield. These are often referred to as face masks, although not all face masks are regulated as surgical masks.

Surgical masks are made in different thicknesses and with different ability to protect you from contact with liquids. These properties may also affect how easily you can breathe through the face mask and how well the surgical mask protects you.

If worn properly, a surgical mask is meant to help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose. Surgical masks may also help reduce exposure of your saliva and respiratory secretions to others.

While a surgical mask may be effective in blocking splashes and large-particle droplets, a face mask, by design, does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures. Surgical masks also do not provide complete protection from germs and other contaminants because of the loose fit between the surface of the mask and your face.

Surgical masks are not intended to be used more than once. If your mask is damaged or soiled, or if breathing through the mask becomes difficult, you should remove the face mask, discard it safely, and replace it with a new one. To safely discard your mask, place it in a plastic bag and put it in the trash. Wash your hands after handling the used mask.”

The FDA description seems to imply that surgical masks would not be effective nor its intended use for Covid prevention. Could be interpreted as preventing spread.

This was the FDA position originally, now and probably in the future.

Like many things, off label use is permitted. The only answer available seems to be the reason CDC chose masks and repurposed them what is likely temporary. That is not judgemental. It applies to healthcare settings.

https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respirators-surgical-masks-and-face-masks

[Zaphod]

I was just extrapolating the Israeli numbers with Pfizer, and wondering if it will play out like that here, as time goes on and our prevalence of delta covid infections moves from low 40% to 90%+. Pfizer was 64% effective against infection, 93% effective against hospitalization for delta as reported last month, but the numbers seem to constantly change and seem to vary a lot in deferent places around the world. Their ministry of health said those numbers were actually overly optimistic, but we shall see I guess.

It shouldnt be long in a highly vaxxed population before the great majority of cases are vaccinated, just the math really. Hopefully bending the morbid/mortality curve is enough.

[Zaphod]

My personal opinion is the main reason masks (besides N95 + faceshield) work is that it reminds everyone to keep your distance and avoid crowds. Much less likely to be 1 foot away from someone when both wearing a mask. So less the mask and more the distancing.

To the degree they might work (n95 excluded here) it would just be that instead of a 100% viral load ejection, you get a 30% (made up amount) ejection. If everyone did that there would be a lot less infectious material in the air, and since infection is time/dose it would decrease your chances for any same time spent. Its not rocket science or magic, just kind of obvious.

Importantly, it really doesnt matter at all, unless everyone does it and is compliant. It certainly makes not much sense at all for vaccinated to have worn it (prior to delta and a surge in overall prevalence). I havent worn a mask in forever, and wouldnt outside an n95 if everyone else isnt since thats not how surgical masks work. And they did seem to work in places like clinics/hospitals where compliance was good. No crazy airborne infections with just droplet precautions. It was 100% but it clearly made a difference. Saying otherwise is kind of crazy.

[Zaphod]

First of all, I posted the list of studies here since the moderator said this was the place for it, that's why the other thread was closed.

Some of the studies compared cloth masks with surgical but the conclusion of most of the studies I listed is that neither make that much difference.

Why is it offensive to you that I bring this topic up on the forum? I find this so bizarre. Why is this so taboo? Why are studies that show no benefit to mask wearing getting squelched? Since when does medical research behave this way? If you feel more comfortable wearing a mask, go for it. Just don't force it on the rest of society if its of no benefit. And stop cancelling studies that show its of no benefit. (not you personally, the media and academia)

When the mask mandates were lifted in FL and TX there was a prediction that cases would soar. They did better than states like NY or CA that still had mask mandates. Japan also showed huge spikes of covid despite having over 90% compliance with mask wearing.

I agree that there are situations where masks would help, especially with an ill pt who is coughing. And I know there are many studies out there that show a benefit. I just don't get why both sides of the story aren't getting told.

Its not offensive the topic, which has been beaten to death. Your pseudo concern about dumb stuff like taboos and the terrible quality of the "studies" you posted, a couple of which are literally announcements that research is going to be done, others non applicable, and some directly contradicting your position. You've chose to take up "masking" as some hill to die on which is beyond lame.

Some crappy studies are out there, many of which you posted, there has been an explosion of terrible research this year in addition the the majority already being poorly done or ineffectual to real life. Nothing has changed. Mask wearing is simple and poses no dangers to anyone, that is what matters when considering it as an intervention.

As I've mentioned several times, I dont wear a mask and havent in months in any situation, but that doesnt make your takes any less bad.