The Really, Really Nuanced View on Masks
By: Bj Campbell
Tags: Politics, Terrorism, Covid 19, Masks, Love

Sit with me while I spin a captivating yarn of true love, Covid-19 masks, and international terrorism that spans two decades. This yarn will incorporate dramatic historical events, cutting edge medical science, proletariat freakoutery, media bias, social media “fact checker” tampering, social superoganismic behavior, and brand-new additions to the English language itself, such as “superorganismic.” And by the time we’re done with this yarn, you may finally be privy to my personal headspace on masks, which is that mask mandates as currently implemented do almost literally nothing against Covid-19, but we should all wear them anyway.

The yarn begins when I kissed my late wife at the threshold, on the winter solstice of 2001.

Part One: Exploding Shoes

When my wife and I got home from the wedding, we were understandably exhausted. Barely had time to appropriately pack the wedding dress into its requisite storage box for decades to come, when our future daughter might maybe wear it. The next day we slept in and packed. That night we went to watch the Lord of the Rings movie du jour, which I have very strong and uncomplimentary feelings about to this day. The following morning we flew out to Belize.

From Hartsfield Atlanta International Airport. By way of Miami International.

Miami was a dead zone. Not only was this very recently after the 9–11 attacks, it was coincidentally the very morning after jet liner FAA designation N384AA, American Airlines Flight 63 was almost destroyed by the silliest terrorist in the history of terrorism, Richard Reid, as he attempted to blow the plane up with a shoe.

A shoe.

The seminal British comedy troop Monty Python couldn’t have written a more absurd terror attempt in their wildest dreams, which stands to reason because Richard Reid was some British white dude (let’s say three quarters white) who fell into Islamic Street Extremism in London because it was more interesting than Street Graffiti. And because American Airlines Flight 63’s flight plan was Charles De Gaullle to Miami International, Miami was locked down tighter than a Mormon’s sphincter when Buffy and I tried to make our connecting flight.

There were a lot of very helpful ladies and gentlemen with M-4 carbines and camouflage uniforms instructing us where to find our gate, though, which was fun. Made me feel like I was in Jerusalem or Lagos or somewhere. We watched CNN at the gate, discovered what all the fuss was about, caught our connecting flight, and then spent our honeymoon in the jungle, exploring caves to get ideas for our next Dungeons and Dragons game. I proposed to her swimming in a flooded cave full of bats. On our honeymoon. It’s weird, we used to do things backwards.

And every day since that day, I and every other United States American Citizen and visiting foreign national has taken our shoes off in the TSA line.

You do it. The guy in front of you does it. The lady behind you does it. The other thousand people stacked in the Hartsfield Latoya Jackson Intergalactic Space Port and Nail Emporium security line do it. You’ll do it on the way home. You do it because Richard Reid, the World’s Silliest Terrorist had a silly idea, and his silly idea stuck in the minds of the muggles.

It doesn’t matter that his shoe bomb probably wouldn’t worked even if he wasn’t such a silly person. It doesn’t matter that a smart terrorist could easily build a better shoe bomb that could get through security, or better yet, shove a bomb up his butt to get it through the X-Ray machines. It doesn’t matter that terrorists can scare and kill a lot more people with much more mundane means, such as shooting up a nightclub with a gun, or mowing down twice as many people with a rental van. It doesn’t matter that the entire process is nothing more than “security theater.” We do it anyway. We do it because that’s the only way to get the muggles on the airplane.

Because, follow me here because this is important, getting the muggles on the airplanes is an important thing.

There was no real or good reason to change TSA protocol after the world’s silliest terrorist tried to blow something up with a shoe, in any objective sense, but changing policy meant that the morass of sheep that consent to be sheared on their way to get on the airplane would still get on that airplane. In short, the “theater” part of “security theater” has actual, measurable value. And so, I take my shoes off every time I go to the airport. As do you. There is value in making the muggles feel safe. Shelf that lesson, we will tap it later.

Part Two: Covid Masks, Science and Censorship

Reason.com did a piece on masks a few days ago, that was pretty comprehensive, and generally summarized the available science pretty well, except for one very important omission. I’ll summarize bluntly, starting with the HWFO.

Early on, there was a lot of good science published saying masks were stupid. There were smart people who said masks were stupid. Then there was some other stuff that filtered in saying masks weren’t stupid. And as the government switched from “masks are stupid” to “masks aren’t stupid,” a large portion of the social media population pivoted to “not wearing a mask makes you an evil murderer.” Because that’s how the social media mechanics of Handwaving Freakoutery work.

Reason cites some of the major studies that say masks aren’t stupid in their article. There’s a fascinating study where they infected a bunch of hamsters with Covid-19, masked half of them up, and let them run around and try and kill each other with germs. 66% of the unmasked hamsters got Covid, 17% of the masked ones did.

Science says masks protect hamsters.

There were two studies cited by Reason that did fluid mechanics experiments with different types of masks. Misinterpretations of these are what led to a brief “Covid Shaming” eruption on Facebook where “everyone who wears one of those neckerchiefs is an evil murderer.” Reason also highlighted a couple of others. Generally speaking, these studies were about aerosol transmission, and we generally agree at this point that Covid-19 is an airborne pathogen embedded in aerosols.

Science says masks are awesome when an infected person sneezes or coughs.

But these sorts of studies don’t necessarily prove or disprove the efficacy of community wide, government enforced mask mandates. Reason does list a couple of studies which might be useful answering that question.

A pair of Randomized Control Trials (RCTs) were done on pilgrims to Mecca, on general pre-Covid respiratory infections. Each of these was inconclusive, and the researchers blamed failure to adhere to protocol. A RCT in Vietnam in 2015 compared surgical masks to cloth masks for pre-Covid respiratory infections, and found 2.3% infection rate for the cloth masks as compared to 0.7% for the surgical masks, but they didn’t include a “no mask at all” group as a control, so that doesn’t help us much either.

Science says surgical masks beat cloth, and that poor compliance spoils the data.

Reason cites a meta-analysis of existing RCTs that seems to think that masks should help, but this meta-analysis is an analysis of other analyses, and it came to the conclusion that masks help by throwing out the conclusions of studies where they deemed compliance was poor. Reason references a 2017 CDC report that includes facemasks as a possible influenza outbreak deterrent, but if you follow the bibliography, they’re talking about surgical masks, not cloth.

Science says surgical masks may work, part two. Science says that poor compliance spoils the data, part two.

Reason cites a pair of longitudinal studies that followed US states or Canadian provinces which had lower Covid-19 spread after mask mandates compared to their peer states/provinces who didn’t have a mandate. But neither of these studies measured the compliance rates within the mandated area, nor controlled for the mandate’s effects on general isolation and distancing behavior before and after the mandate. Did the masks work, or did the mandate itself scare enough people inside that they got a positive result from fear?

Science says mask mandates helped, but doesn’t explicitly state why.

Reason includes some more studies, which basically repeat the same points above. The gold standard would be a randomized controlled trial of mask use during the Covid-19 epidemic, and no such study is listed by Reason. But one does exist, and its results are very controversial, to say the least.

The Danmask-19 Trial is that exact gold standard. Go read it. Researchers ran it in Denmark in April and May of the outbreak. They sampled six thousand people who spend more than three hours per day outside the home without occupational mask use. They encouraged all members to social distance, gave half of them surgical masks, and instructed them how to use them. There was no statistically significant difference in outcomes between the two groups.

Science says wearing a mask doesn’t protect you from Covid-19.

And Facebook censored the study.

We should be honest about the two biggest limitations with the Danmask-19 Trial. One, compliance was poor, much like many of the other studies Reason cited. Two, they didn’t check to see whether anyone in their groups spread Covid-19 to their families or to other people, and “source control” is half of the narrative behind the mask mandates. The researchers stated that limitation up-front, and if you are one of the many people who is internally screaming that “source control is the whole point,” I grant you that, but I refer you Part 3 below.

However, if you follow the Facebook Fact Check Link, you’ll see a laundry list of other reasons they’re censoring it that don’t add up. Like the 6,000 person study size being too small to be statistically significant, for instance. That sample is larger than any of the other studies Reason cited, and yet those studies aren’t being censored.

Nor is the CDC website censored, which states explicitly that cloth masks provide personal protection, and Danmask-19 proved that false.

(CDC screenshot, taken 11/20/2020)

This claim by the chief disease bureau of the United States Government is more specious and misleading than the censored article above, if the fact checking standards used against the Spectator link were used against the CDC.

This sort of thing has been happening all summer.

This one instance is yet another stick on a giant pile of social media censorship tinder in the name of the prevailing narrative, set to light. It does as much to obscure the truth and spark division as anything else, because people don’t like having their thoughts controlled. When they see this behavior by their social media outlets, they distrust all the other fact-checks as well, and actual false things start to sound plausible, eventually leading you to buy a “Birds Aren’t Real” T-Shirt.

Most specious claim in that video: “Memphis is the Paris of the West”

Part Three: Let Them Eat Virus Cake

We know a lot about Covid-19 at this point. We know that it’s actually a blood disease, that can take up residence in different organs and cause lots of really divergent problems in different people. My ex-girlfriend down in Chile was Patient Zero in her town, was laid out a month with it, and never coughed once. It was entirely gastrointestinal for her. We know median symptom onset is four and a half days, with half the cases quicker than that, but with some rare cases onset takes as long as two weeks. We know that the infection fatality rate (IFR) of Covid-19 is eight times higher than influenza for people over the age of 50, but three times lower than influenza for people under the age of 25. We know it’s spread in the air, which is why prepubescent kids don’t generally spread it to their families or classmates when they catch it, because their lung capacity is small. We know it’s spread largely in confined spaces, where you share your air with someone else pre-symptomatic, asymptomatic, or if you’re an unlucky health care worker, symptomatic. We know spread in grocery stores or open-air events is relatively small.

Given what we know about this disease, there is a world in which every link Reason cited in the prior section, as well as the Danmask-19 study, is true simultaneously, and that world is the world that we see out of our own eyes right now.

The United States, generally speaking, is running a program of “as much social distancing as we feel we can manage while still continuing a somewhat normal lifestyle.” This is a spectrum, and different people fall different places on that spectrum, but the median of that spectrum is “wear a mask in Home Depot but don’t wear a mask when you have houseguests, and the mask you do wear in Home Depot is made of cloth.” You know this behavior. You do it. It’s the behavior that avoids the largest amount of Covid Social Shaming while still letting you buy a hammer.

This behavior puts masks on our faces when they are least important, and removes them when they are most important, presuming the only scientific benefit of masks is source control. So even if mask mandates would work, they don’t work, because of the nature of Covid-19 and the nature of humans.

But two sections back I promised you we’d talk about bombs in shoes.

spot the WMD

Part Four: The Societal Efficacy of Muggle Manipulation

If we know that the only point of masks is source control, and they only give any benefit when they’re worn by infected people, and testing is so common as to be ubiquitous, then the only people we need to mask are the Covid positive people. All we really need to do are cover the sick, and quarantine the sick, and be done with it. Median symptom onset is four and a half days, and you’re probably only infections for two of those, so the Typhoid Mary problem is very likely to be overblown and most of the infectiousness we see with this thing flows from it being ‘novel.’

One of the best early evidence reviews of the whole Covid Mask thing was released in April, a preprint with a gaggle of contributing authors. Buried in that literature review is this passage, which I think is extremely important:

For many infectious diseases, including, for example, tuberculosis, health authorities recommend masks only for those infected or people who are taking care of someone infected. However, research shows that many sick people are reluctant to wear a mask if it identifies them as sick, and thus end up not wearing them at all in an effort to avoid the stigma of illness (60, 61). Stigma is a powerful force in human societies, and many illnesses come with stigma for the sick as well as fear of them, and managing the stigma is an important part of the process of controlling epidemics as stigma also leads to people avoiding treatment as well as preventive measures that would “out” their illness (62). Many health authorities have recommended wearing masks for COVID-19 only if people are sick; however, reports of people wearing masks being attacked, shunned and stigmatized have already been observed (63). Having masks worn only by the suspected/confirmed infected also has led to employers in high-risk environments like grocery stores and prisons, and even hospitals, banning employees from wearing one sometimes with the idea that it would scare the customer or the patients (64, 65).

Universal mask wearing provides a social benefit that’s not measured in pathogen transmission. When I wear a mask to the grocery store, I’m protecting no one, because I don’t have Covid-19. I’m not protecting me, and I’m not protecting you. But if I don’t, and nobody else does either, and the only mandate is for the sick, the sick become social pariahs. People might not let them in the grocery store at all. And they need groceries so they don’t starve. When you wear a mask to the grocery store, you’re basically running cover for the sick so they can do what they need to do — grocery shop. And running cover for them is a nice thing to do.

Further, the social group most fearful of Covid-19 was screaming for “lockdown until a cure” in the early summer. These people were willing to completely destroy the economy to placate their fears, closed grade schools with no scientific justification, and are now pivoting into a nebulous “War Against Thanksgiving.”

a joke only the gun owners will get

If a combination of erroneous messages on the CDC website and social media censorship convinces these people that masks protect them, and placates their fears enough that they get on with the economic activities we need them to join in to survive, then the erroneous messages and disproportionate censorship have societal efficacy, and I am absolutely willing to play along.

When my school district was debating closing down this fall, there was one group that wanted them closed, one group that wanted them open, and then a subgroup of the ‘open’ contingent that didn’t want to mask their kids either. All three battled with each other viciously and nastily. I told all of these people, “I don’t care if I have to dress my kids in Mad Max helmets and assless chaps, as long as I can put them on the school bus.” Just like I don’t care if I have to take off my shoes, pants, shirt, whatever, to get on that airplane.

Taking your shoes off in the TSA line is security theater. It is a performance we all endure, to purvey an illusion of safety to the fearful. But we do it. Wearing a mask in the grocery store may be no different. But even if it has no clinical benefit, there’s a strong case we should all do it anyway.