Our argument is not about individual level protections (like almost every study before) but community level reduction of transmissibility—a public good, not as much an individual one. That can only be studied properly with high compliance, but you can still assemble evidence.
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To argue for universal masks, we had evidence of asymptomatic contagion; evidence of reducing egress ( like this: https://www.nejm.org/doi/full/10.1056/NEJMc2007800 …) and preponderance of evidence it won't create harm (I found no precedent or reasonable argument for harm) and then we model.
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Plus, we now have four very interesting cases. HK (masks doing heavy-lifting but some other interventions); Taiwan (case study in everything right); Japan (only masks right everything else wrong: slower spread); Singapore (everything but masks great; didn't work, they switched).
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zeynep tufekci Retweeted zeynep tufekci
Plus, we have cases like this and some new countries like Czech Republic that are seeing lower rates of deaths and cases after switching to all masks.https://twitter.com/zeynep/status/1253348619538890753 …
zeynep tufekci added,
zeynep tufekciVerified account @zeynepHospitals are very high-risk environments. Sick people concentrate there and staff can't distance. After Brigham and Women's Hospital required everyone, including patients, to wear masks staff infections dropped from 12-14 new infections per day to only 6. https://www.wbur.org/commonhealth/2020/04/23/brigham-and-womens-masks-infections … pic.twitter.com/Rrlj4CZu2TShow this thread2 replies 1 retweet 3 likes -
So now case is this: Preponderance of evidence from before; solid theory of action; lots of partial evidence (will probably never have RCT, won't be ethical). Challenge: infection control requires thinking society-level variables, not just individual outcomes. So here we are!
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Replying to @zeynep
Certainly if you leave out previous work in a survey article the evidence of one point of view piles up.
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Replying to @stevesi
We haven't left it out! We review relevant evidence to egress and community-protection, especially if it was a good study. Even there preponderance of evidence has benefits (despite really, look at the studies. No solid ones for this question).
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Replying to @zeynep
I suppose you can then ask a question for which there are "no solid studies" and review a select set of other studies (solid though they may be, they are not the question you asked) and find preponderance of evidence. I'm just a fan of science that's all.
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Replying to @stevesi
And the science is absolutely on the side of the paper and recommendations. One of our co-author from Oxford U wrote one of the key textbooks on evidence-based medicine. We're not ignoring any relevant finding. I just added some tweets with all sorts of interesting new stuff.
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I think the biggest misunderstanding, again, is that it is not "does it protect individuals from getting infected" (most previous studies) but how much will it reduce R(eff) at the community level given X level of blocking and Y level of compliance. Which we model.
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I'll just say that every week there is more evidence, new papers and new case studies. They all point in the same direction. Final paper will be even stronger. I'm a pragmatist; if there was some reason to think otherwise, I'd be very open about it. Cheers!
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