Medical Discussion of Coronavirus

[K82]

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.

Again, I just don't get the animosity directed toward someone who is questioning this mask dogma. "Pseudo concern", "dumb stuff", the "terrible quality of the "studies" you posted", "masking as some hill to die on which is beyond lame". Wow. This is what I'm talking about. Why is this such a hot button issue? Looking at whether a mask actually helps in a viral pandemic or not shouldn't be controversial.

Anyway, I will post a few quotes from some of the studies I linked to try to show that they are not "contradicting my position".

Here is a quote from the CDC statement I linked which was looking at efficacy of masks with influenza:

"Here, we review the evidence base on the effectiveness of nonpharmaceutical personal protective measures and environmental hygiene measures in nonhealthcare settings and discuss their potential inclusion in pandemic plans. Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza."

I'll post some more as my day permits.

[K82]

Here is a quote from one of the studies I linked:

"We included 15 randomised trials investigating the effect of masks (14 trials) in healthcare workers and the general population and of quarantine (1 trial). We found no trials testing eye protection. Compared to no masks there was no reduction of influenza-like illness (ILI) cases (Risk Ratio 0.93, 95%CI 0.83 to 1.05) or influenza (Risk Ratio 0.84, 95%CI 0.61-1.17) for masks in the general population, nor in healthcare workers (Risk Ratio 0.37, 95%CI 0.05 to 2.50). There was no difference between surgical masks and N95 respirators: for ILI (Risk Ratio 0.83, 95%CI 0.63 to 1.08), for influenza (Risk Ratio 1.02, 95%CI 0.73 to 1.43)."

Interestingly, this study stated in the conclusion that they still recommended mask use even though their data showed no statistical improvement over non mask data. They were called out for that in the comment section. Maybe that's what you were referring to when you said some of my studies contradicted my questioning of mask use.

[K82]

Here's another one that said it may be helpful but the evidence is not strong enough to support wide spread use:

Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.

[K82]

Here's a quote from an NIH funded study from Europe:

"Our primary analyses were modelled in R using Baysian generalsed additive mixed models (GAMM). We found that closure of education facilities, prohibiting mass gatherings and closure of some non-essential businesses were associated with reduced incidence whereas stay at home orders, closure of all non-businesses and requiring the wearing of face masks or coverings in public was not associated with any independent additional impact."

[JWeb]

Here's another one that said it may be helpful but the evidence is not strong enough to support wide spread use:

Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.

Because the risk of wearing a mask is virtually zero while the benefits could be enormous. Despite what your cherry-picked articles say. You can't honestly think that wearing masks doesn't decrease the viral load in the air at least some. And if it doesn't, who cares, you had to wear a mask. Big deal.

[Bdoc]

Here's another one that said it may be helpful but the evidence is not strong enough to support wide spread use:

Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. However, there is enough evidence to support the use of facemasks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.

I think what he is trying to say is many studies are poorly done. Studies are hard to do well. Look at the IDSA guidelines for anti-biotics guidelines. Most are weak evidence yet we use what we have. Covid is 1.5 years old. Common sense says that if i sneeze without a mask, the particles go far. If i sneeze with a mask on, it is less so even though some particles will go through. Since there is no harm in wearing the mask and good studies regarding this are difficult, WEAR THE MASK even if evidence is weak.

And regarding discussing it; it is not harmful to discuss, but VERY harmful to cast doubt which when happens in America, many people take as the holy gospel to say everything is a farce. Which might be the answer to your question. Americans cant handle the fact that data is evolving. If certain people hear of mask doubting, just more fuel to anti-vax fire. IMO.

[K82]

Here's a quote from a study from Norway:

"Conclusion: In the current epidemiological situation in Norway, wearing face masks to reduce the spread of COVID-19 is not recommended for individuals in the community without respiratory symptoms who are not in near contact with people who are known to be infected."

Like I stated previously, maybe universal mask precautions do make a difference. I don't know, and the studies do not appear to be conclusive. I just find it very odd that unless the study results fit the narrative it gets buried or deleted like the NEJM study article. I've never seen a medical issue get so politicized.

[K82]

Because the risk of wearing a mask is virtually zero while the benefits could be enormous. Despite what your cherry-picked articles say. You can't honestly think that wearing masks doesn't decrease the viral load in the air at least some. And if it doesn't, who cares, you had to wear a mask. Big deal.

"Cherry picked articles"? I stated that there are studies showing some benefit. My point is that the studies that show no benefit don't get mentioned. If the benefits are "enormous" I think the data would be conclusive.

I do think that wearing a mask helps stop droplets from coughs or sneezes from symptomatic pts. I don't think there is strong evidence that its helpful for non-symptomatic people to wear them.

I disagree that the risk of wearing a mask is zero. I have eaten out and watched my server grabbing at their mask in the front to adjust it and then touch my water glass and menu. I think it definitely can be counter productive.

Yesterday a colleague told me he saw a guy on the golf course all by himself with a mask on. What are we creating with phobias down the road for people, especially kids with this behavior?

[K82]

I think what he is trying to say is many studies are poorly done. Studies are hard to do well. Look at the IDSA guidelines for anti-biotics guidelines. Most are weak evidence yet we use what we have. Covid is 1.5 years old. Common sense says that if i sneeze without a mask, the particles go far. If i sneeze with a mask on, it is less so even though some particles will go through. Since there is no harm in wearing the mask and good studies regarding this are difficult, WEAR THE MASK even if evidence is weak.

And regarding discussing it; it is not harmful to discuss, but VERY harmful to cast doubt which when happens in America, many people take as the holy gospel to say everything is a farce. Which might be the answer to your question. Americans cant handle the fact that data is evolving. If certain people hear of mask doubting, just more fuel to anti-vax fire. IMO.

"not harmful to discuss, but VERY harmful to cast doubt". How exactly can you discuss but not cast doubt?

[burritos]

I know it needs to be asked, but is asking the question, "Did you get the vaccine" for those who are coming down with COVID an awkward question to ask?

Kind of like asking someone who has lung cancer, "Did they smoke." The underlying message, even though it may not be true of the questioner, that they are at fault, if not partially.

[Sampter]

I don't really understand why you are getting all bent out of shape about masks. That is so July 2020. Either wear them or not. Mask mandates are not going to happen or be enforced so those that want to wear them will, those that don't, won't.

I agree about asking if they were vaccinated for patients that get Covid, does seem a little awkward. It is a little like shaming and we know that shaming people has never worked to try and improve health. However, it is important to know to track how well the vaccines are working with these variants.

[CordMcNally]

I know it needs to be asked, but is asking the question, "Did you get the vaccine" for those who are coming down with COVID an awkward question to ask?

Kind of like asking someone who has lung cancer, "Did they smoke." The underlying message, even though it may not be true of the questioner, that they are at fault, if not partially.

It’s only awkward if you make it awkward. I don’t feel awkward asking those with penile/vaginal discharge if they’re sexually active and use barrier protection. I don’t feel awkward when I ask somebody with a blood sugar in the 600s if they’re actually taking their insulin as directed. I don’t feel awkward asking someone with a broken hand who punched a brick wall if they regret it. Knowing their vaccination status gives us valuable public health information.

[G]

It’s only awkward if you make it awkward. I don’t feel awkward asking those with penile/vaginal discharge if they’re sexually active and use barrier protection. I don’t feel awkward when I ask somebody with a blood sugar in the 600s if they’re actually taking their insulin as directed. I don’t feel awkward asking someone with a broken hand who punched a brick wall if they regret it. Knowing their vaccination status gives us valuable public health information.

I only bring up the regret issue if they have to go to the OR for the fight bite...otherwise, I applaud them for punching the wall instead of someone's face!

[Zaphod]

I don't really understand why you are getting all bent out of shape about masks. That is so July 2020. Either wear them or not. Mask mandates are not going to happen or be enforced so those that want to wear them will, those that don't, won't.

I agree about asking if they were vaccinated for patients that get Covid, does seem a little awkward. It is a little like shaming and we know that shaming people has never worked to try and improve health. However, it is important to know to track how well the vaccines are working with these variants.

Exactly!

[CordMcNally]

I only bring up the regret issue if they have to go to the OR for the fight bite...otherwise, I applaud them for punching the wall instead of someone's face!

I find that the people who typically punch walls would be in much worse shape if they would have punched another person.