It’s definitely too nuanced for Twitter, but there is something interesting about what counts as evidence, and how to make decisions when you don’t have all the evidence you’d like. RCTs if possible are great, but they’re not the *only* source of evidence.
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Replying to @BillHanage @zeynep
I think some of the issue is that most academics aren’t courageous enough to take a stand on the evidence without a gold standard RCT to back them up. The sum total of the evidence backs up
@zeynep’s points. But too many are afraid of the very small chance masks could backfire.2 replies 0 retweets 2 likes -
Replying to @ZoeMcLaren @zeynep
I think you’re probably right for at least some academics. I would always prefer high quality evidence myself, but recognize it may not be available on the time scale I need
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Replying to @BillHanage @ZoeMcLaren
Disagree a bit. The quality of the "for" evidence needed is related to the evidence for harms. Almost all the alleged harms were either baseless, or there was evidence to the contrary (from decades of research). We had enough "for" evidence—especially given lack of harms.
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Why? The evidence of harms in a complex system can be far more difficult to prove b/c you don't know where the risk comes from with so many variables. Hence the precautionary principle be very cautious with any intervention b/c chances are you will probably not forsee the risk.
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Precautionary principle in a middle of a deadly pandemic says you go ahead with basically zero risk interventions that have a preponderance of evidence under a very plausible mechanism—source control. (I mean, I can make up dangers from hand-washing too, if I really tried).
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I am not saying you shouldn't take risk at all. However the quality of evidence should be on the side of the desired effect and how much it contributes should be weighed in a context of unkown risk. Hand washing isn't a new "mechanical" intervention in western society, masks are
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"Western society" how on earth is that relevant? Why does a virus care? Masks are a scientific, widespread and common public health intervention in large, advanced and quite successful societies without any demonstrated or plausible mechanisms for harms. What a weird statement.
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Well behaviour people in the West might use masks differently than in Asia (F.E. self contamination b/c we aren't used to it). It can backfire. Masks got all the attention but there is research on the effects of f.e. nose hair. Why do you think masks are the most effective means?
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Replying to @Simon_Veldt @zeynep and
The reason for the focus on masks: they were in the line of sight. Other effective means didn't get attention while f.e. ventilation interventions might have saved lives. Considering all possible means equally is of the upmost importance. Confirmation bias clouds this perspective
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https://www.preprints.org/manuscript/202004.0203/v2 … and lots of research has come out since. It’s kind of shocking that people can dismiss possibly the lowest hanging fruit despite extensive Southeast Asia expertise. (Exercise left to reader why self-contamination isn’t the issue in community settings).
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So is opening a window or keeping nose hear (nk). Those got no attention b/c influental academics focused solely on masks. Only now we starting to think about ventilation 4 months later. Masks might prove to be 1 of the least effective means but had the highest research priority.
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Replying to @Simon_Veldt @zeynep and
Thank you for this I learned from it. Though next time I would prefer it if remarks like "shocking/weird" aren't made. Or that own work is used to make your case. Keep in mind that scientists who do have experience in this field are still researching it.https://clinicaltrials.gov/ct2/show/NCT04337541?cond=Face+mask+covid&draw=2&rank=1 …
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End of conversation
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