Board 8 > So why did the medical community bungle mask advice so badly?

(+) Yeah! (+)

In the early stages of the pandemic, organizations such as the WHO and the CDC insisted that regular use of masks by the general public was unnecessary. Now mask usage is the Holy Grail of COVID prevention. How did all these organizations completely whiff on what is apparently a very basic fact?

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It is a new viral strain. It's reasonable to expect that more will be discovered about prevention and treatment as it's studied more.

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I mean, the basic science of how viruses are transmitted is absolutely not one of the novel aspects of COVID.

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My memory of it is that masks were in incredibly short supply in the early stages of the pandemic, so the advice to the general public to not wear masks was for the sake of ensuring that medical personnel would have the masks they needed. I don't think it was ever about masks not being helpful.

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if its so basic why didnt you warn us

WHERE WERE YOU WHEN WE NEEDED YOU

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Early on, the thought was that those that are sick with it will actually appear sick, and the better thing for healthy people to do would be to properly stay home as much as they could, social distance, etc. Thus, the desire was to save the masks for the people in the health industry and to avoid people thinking they could just wear a mask and not worry about any other preventative measures.

When it became discovered that it was easy to have the disease and spread it without even knowing you have it, then masks became important to stop yourself from spreading it to others.

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Afaik the main reason was concerns of shortages for healthcare workers. There was also uncertainty about their efficacy (particularly if not worn properly), and a concern that people would be less careful about distancing if they felt like they were already protected by the mask. It was certainly a big mistake, though.

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With regards to shortages, while it did take a while for the supply of purpose built masks to catch up, almost everyone already had access to DIY options (scarves, bandannas, etc.) Those arent ideal, but they would have 110% been better than nothing.

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I remember hearing that the masks were useless to prevent the spread of this virus but I don't remember why

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You have to remember what was happening at the time. People were getting in fistfights over toilet paper across the country, there were two hour lines to get into Costco, people were losing their minds and desperate to get any kind of "emergency" supplies. Saying "and you all need to wear masks every time you leave the house!" would have thrown fuel on the fire and ensured no doctors and nurses would have been able to find any for a month.

That being said, they should have reversed and told us to wear them once supplies caught up and the initial mad supply rush was over.


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I think people also underestimated how widespread the virus already was by the end of Feb., beginning of March. Homemade masks, which is what people would have been using initially, are leaky enough that they are only advisable when the outbreak reaches a certain level, and authorities didn't think the virus was at that level yet. Another mystery is why it took NYC so long to start identifying cases. It seems clear now that their first confirmed case was identified much later in the outbreak timeline than in other areas.

IIRC, Singapore did not encourage masks at first, and they seemed to be doing well initially , so that might have misled some people as well.

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My understanding is that the medical community initially believed that only N95 masks made a difference in the rate of transmission, and because those masks were and are 1) rare, 2) expensive, and 3) required for medical workers to safely do their jobs the common advice was "don't worry about it". As understanding of the virus and how it's transmitted grew we came to realize that anything that prevents microdroplets from your nose and mouth from floating around the air would help prevent transmission of the virus.

(This isn't a flaw or a problem, by the way - this is just how science works. We had an understanding of the world, new facts emerged, from those facts we built a new understanding.)

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The answer is pretty much mask science was poor at the time. Even among countries where mask use was common there hadn't been much done in the way of actual studies.

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The Scientific Process

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Yesmar_ posted...

I think people also underestimated how widespread the virus already was by the end of Feb., beginning of March. Homemade masks, which is what people would have been using initially, are leaky enough that they are only advisable when the outbreak reaches a certain level, and authorities didn't think the virus was at that level yet. Another mystery is why it took NYC so long to start identifying cases. It seems clear now that their first confirmed case was identified much later in the outbreak timeline than in other areas.

IIRC, Singapore did not encourage masks at first, and they seemed to be doing well initially , so that might have misled some people as well.

To put this in perspective, I went on a Carribean Cruise in mid-January, and I caught a cold that knocked me on my ass for a better part of a week. When it turned out that COVID might have been present in Florida by the new year, I started suspecting that I may have caught a mild COVID infection.

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ninkendo posted...

The Scientific Process

also to prevent mask hoarding.

tbf I don't think it would have mattered what they said

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i specifically remember that we were told masks could "make it worse by increasing the viral load you're exposed to!" we were specifically discouraged from wearing masks. i remember smugly thinking that people wearing masks were doing the wrong thing and that i, avoiding touching things but sanitizing and washing my hands all the time, was doing the "right" thing.

almost 100% certain it was a deliberate lie to avoid n95 hoarding. we knew the virus spread by droplets. it made no sense that they wouldn't come out of people's breathing. maybe they didn't have great proof that masks stopped it, but they should definitely not have had said masks hurt the wearer.
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They lied to us on purpose because we were considered expendable pawns and they needed to hoard a valuable resource for the elite class.

Then it turned out the disease wasn't nearly as bad as everyone thought so they backed down.

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SeabassDebeste posted...

i specifically remember that we were told masks could "make it worse by increasing the viral load you're exposed to!" we were specifically discouraged from wearing masks. i remember smugly thinking that people wearing masks were doing the wrong thing and that i, avoiding touching things but sanitizing and washing my hands all the time, was doing the "right" thing.

almost 100% certain it was a deliberate lie to avoid n95 hoarding. we knew the virus spread by droplets. it made no sense that they wouldn't come out of people's breathing. maybe they didn't have great proof that masks stopped it, but they should definitely not have had said masks hurt the wearer.

my recollection is that health officials were concerned that people would be messing with them and touching their faces, back when the concern was that the virus spread easily to/from surfaces. Even now, some of those infectious disease experts admitted to still leaving groceries/mail/packages out for a day before touching them.


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Also there are tons of conflicting studies on masks, such that "science has proven masks work" and "science has proven masks make things worse" are both literally true statements. The correct position, from the beginning, that has not changed, is much closer to "masks probably don't do much to protect any given individual but even a small chance of a small benefit in terms of lowered transmission is enough to make it worth trying"

The main problem is that the media are really fucking stupid and attempt to politicize literally everything, so we flipped from "masks don't work and you're racist if you wear one" to "masks work perfectly and you're a mass murderer if you don't wear one" on a dime, because that's just what they do.

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Definitely an intentional lie to keep people from panic buying all the masks, coupled with an administration that didn't take this seriously until at least a month too late

SeabassDebeste posted...

i specifically remember that we were told masks could "make it worse by increasing the viral load you're exposed to!" we were specifically discouraged from wearing masks. i remember smugly thinking that people wearing masks were doing the wrong thing and that i, avoiding touching things but sanitizing and washing my hands all the time, was doing the "right" thing.

I definitely do not remember this at all.

Kenri posted...

My memory of it is that masks were in incredibly short supply in the early stages of the pandemic, so the advice to the general public to not wear masks was for the sake of ensuring that medical personnel would have the masks they needed. I don't think it was ever about masks not being helpful.

StealThisSheen posted...

Early on, the thought was that those that are sick with it will actually appear sick, and the better thing for healthy people to do would be to properly stay home as much as they could, social distance, etc. Thus, the desire was to save the masks for the people in the health industry and to avoid people thinking they could just wear a mask and not worry about any other preventative measures.

LordoftheMorons posted...

Afaik the main reason was concerns of shortages for healthcare workers. There was also uncertainty about their efficacy (particularly if not worn properly), and a concern that people would be less careful about distancing if they felt like they were already protected by the mask. It was certainly a big mistake, though.

These, though, yes.

Well you guys missed out on the Surgeon General declaring that masks make it worse!

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Reg posted...

I definitely do not remember this at all.

this may have been more of a fringe thing. i'm unable to unearth anything from google to support it. i'm certain it happened - there was a lot of anti-mas propaganda being published, and at this point, i'm sure that has been buried - but yeah, current searches do trend more toward the "masks are useless if you're a regular citizen" sort

StealThisSheen posted...

Early on, the thought was that those that are sick with it will actually appear sick, and the better thing for healthy people to do would be to properly stay home as much as they could, social distance, etc. Thus, the desire was to save the masks for the people in the health industry and to avoid people thinking they could just wear a mask and not worry about any other preventative measures.

When it became discovered that it was easy to have the disease and spread it without even knowing you have it, then masks became important to stop yourself from spreading it to others.

the scientific community 100% knew about pre-symptomatic spread well before this. in fact, shutdowns started happening during the mask denial phase.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm
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SmartMuffin posted...

They lied to us on purpose because we were considered expendable pawns and they needed to hoard a valuable resource for the elite class.

Then it turned out the disease wasn't nearly as bad as everyone thought so they backed down.

How do you take an actual true conspiracy (they did intentionally lie) and make it so stupid?

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SeabassDebeste posted...

this may have been more of a fringe thing. i'm unable to unearth anything from google to support it. i'm certain it happened - there was a lot of anti-mas propaganda being published, and at this point, i'm sure that has been buried - but yeah, current searches do trend more toward the "masks are useless if you're a regular citizen" sort

Yeah I definitely remember hearing that too. The basic idea was that virus particles would be trapped on the mask fabric and you'd be breathing them the whole time and the exposure would be worse than if you just happened to pass by virus particles cause they might not get trapped in the mask and you might luck out and not inhale them?

I never really believed it cause it didn't make sense but yeah.

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I remember a guy at Lowe's or Home Depot, during those early days when people were going crazy about buying supplies, saying that he knew a contractor that died because he couldn't get masks to protect himself from sawdust and was trapped in a room where he swallowed so much that he died.

I'm not sure that story is accurate, because it sounds a little fishy, but it still rings true to how nutso people were.

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My understanding was that we didn't realize how large a percentage of people could be asymptomatic carriers, and we didn't realize how long it took before someone was showing symptoms. Without those combined factors it would be more reasonable to suggest that you could save masks for the people who are sick. But when you have such a large group of people spreading the virus with no symptoms at all then it becomes prudent to throw a mask on everyone.

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Forceful_Dragon posted...

My understanding was that we didn't realize how large a percentage of people could be asymptomatic carriers, and we didn't realize how long it took before someone was showing symptoms.

https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html

the CDC remained mask-denying for 2 weeks after this article.
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neonreaper posted...

my recollection is that health officials were concerned that people would be messing with them and touching their faces, back when the concern was that the virus spread easily to/from surfaces. Even now, some of those infectious disease experts admitted to still leaving groceries/mail/packages out for a day before touching them.

Wait, is this not a thing? I still, like, disinfect all my groceries and try and leave mail for a few days before opening it.
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It's very unlikely people are getting the virus from surfaces, unless you're licking them or something. The idea of leaving packages outside/disinfecting them was definitely people grasping at straws early on about how the virus spreads.

I definitely remember experts saying that masks were actually worse than no mask. Which even back then was comical. Like look at countries where mask wearing is accepted (Japan, South Korea, Taiwan). It's obvious it helps. The decision to downplay mask wearing was done so purely to stop people from buying all of the N95's. When what we should have been doing was ramping up production.

Drakeryn posted...

Wait, is this not a thing? I still, like, disinfect all my groceries and try and leave mail for a few days before opening it.

As a mail carrier, it's been repeatedly stressed to us that there is zero evidence the virus is transmitted through the mail.

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azuarc posted...

I remember a guy at Lowe's or Home Depot, during those early days when people were going crazy about buying supplies, saying that he knew a contractor that died because he couldn't get masks to protect himself from sawdust and was trapped in a room where he swallowed so much that he died.

I'm not sure that story is accurate, because it sounds a little fishy, but it still rings true to how nutso people were.

Jesus how do you even slightly believe that story.

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Drakeryn posted...

Wait, is this not a thing? I still, like, disinfect all my groceries and try and leave mail for a few days before opening it.

Surfaces are a disease transmission pathway, but they account for a much smaller fraction of transmission than droplets/aerosols. Afaik it lasts particularly long on metal, so wiping down high touch metal surfaces like doorknobs would be the highest priority. I still wipe down my delivery orders since someone else was touching them minutes earlier, but leaving your mail out for days is overkill.

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