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Face Masks

wareyin said:
Your argument essentially boils down to: "If wearing masks as a policy were effective, the policy would already exist."
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I would boil it down to "if medical professionals, as a body, thought their lives depended on ABM, they'd be doing ABM already."

I remember how the medical profession was pretty adamant about increased PPE requirements during the pandemic, so it's not like they just get blindly complacent and stay that way. They're demonstrably capable of recognizing unacceptable risks and refusing to accept them. From this I infer that maybe - just maybe - masks aren't as critical as some laypeople believe.

When The Atheist suggests that Always Be Masking is the new wisdom, I think it's significant that the medical profession, as a profession, doesn't seem to agree with him.
 
theprestige said:
I would boil it down to "if medical professionals, as a body, thought their lives depended on ABM, they'd be doing ABM already."
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As I pointed out, your argument is circular logic. You are using the absence of a policy to prove the tool is ineffective, and then using the "professional consensus" (which is just the absence of a policy) to justify the absence of the policy.

If we applied that same logic to handwashing, we would have to conclude it isn't effective either, since medical professionals as a body still fail to do it consistently despite 150 years of data. You are confusing a return to comfortable habits with a reasoned scientific conclusion.
 
wareyin said:
As I pointed out, your argument is circular logic. You are using the absence of a policy to prove the tool is ineffective, and then using the "professional consensus" (which is just the absence of a policy) to justify the absence of the policy.
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First, I'm not trying to prove the tool is ineffective. I'm saying that the consensus of the medical profession seems to disagree with The Atheist (and other ABMers) about the efficacy versus the inconvenience, as a general rule.

Second, I'm not trying to justify the absence of a policy. I'm sayig that the consensus of the medical profession seems to suggest that such a policy might not be as justified as ABMers think it is.



wareyin said:
If we applied that same logic to handwashing, we would have to conclude it isn't effective either, since medical professionals as a body still fail to do it consistently despite 150 years of data. You are confusing a return to comfortable habits with a reasoned scientific conclusion.
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I'm not seeing a reasoned scientific conclusion here.
 
theprestige said:
I'm not seeing a reasoned scientific conclusion here.
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That is exactly the point. The return to the status quo is not a reasoned scientific conclusion based on new data. It is a social and behavioral shift back to comfort.

You are trying to have it both ways. You argue that we should trust the professional consensus because doctors have a better idea of the risks. Then you admit that their choice to abandon the tool is not a reasoned scientific conclusion.

If their behavior is not based on science, then it is based on habit and social pressure. This brings us back to the handwashing example. The profession knows it works, yet they still fail to do it consistently. The "consensus of the profession" is a demonstrably poor way to measure whether a safety measure is effective.
 
So, I don't see a lot of evidence in this thread. Maybe I missed it. The OP included an article about a group that says clinicians should be wearing respirators rather than masks whenever they are in a therapeutic setting. Seems like we all agree that not even masks are all that common anymore.

There's some cited information that respirators to block more pathogens, I have no reason to doubt that but is there data that shows they actually reduce the spread of disease hospitals, clinics and what not? If so, by how much? If its like, IDK, one life a year around the world, I wouldn't begrudge health professionals choosing not to. If its like 5 lives a day, less certain. 10/year probably should be wearing respirators.
 
wareyin said:
That is exactly the point. The return to the status quo is not a reasoned scientific conclusion based on new data. It is a social and behavioral shift back to comfort.

You are trying to have it both ways. You argue that we should trust the professional consensus because doctors have a better idea of the risks. Then you admit that their choice to abandon the tool is not a reasoned scientific conclusion.

If their behavior is not based on science, then it is based on habit and social pressure. This brings us back to the handwashing example. The profession knows it works, yet they still fail to do it consistently. The "consensus of the profession" is a demonstrably poor way to measure whether a safety measure is effective.
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I'm not seeing a scientific conclusion in the other direction, either.

And no, I'm not arguing that we should trust the professional consensus. I'm arguing that we shouldn't necessarily trust the lay fringe, especially when it dissents from the professional consensus.
 
What is the real object of FFP2 mask wearing? Is it to reduce spread of infection from medical staff to patients or vice versa? From Covid studies suggest that infections in patients were from other patients and visitors. Infection in staff were from other staff, in rest rooms etc. when they were not masked. Actually although FF2 masks might theoretically be better, simple masks worked well. Wareyin claims 'even a poorly fitting FFP2 has works' but does it work any better than a surgical mask, and for what protecting the wearer? Or protecting others.

Simple surgical masks work well at protecting others, if the object is to prevent staff infecting patients then simple masks are effective. If the object is to protect staff then getting patients to wear masks is effective. The real challenge will be getting visitors to wear masks.

The aerosol science may be goos but what is needed is the evidence that FFP2 masks worn by staff? or by patients? or by visitors? Worn badly so they aren't really FFP2 masks will deliver the theoretical benefit to justify the cost.

The bare below the sleeves policy was cost saving (and the real justification) because there was no empirical evidence for it. (The one RCT I am aware of comparing 'infrequently washed white coats vs. 'bare below the elbows' favoured infrequently washed white coats. The cost saving was not buying and laundering white coats. Staff are expected to launder their own uniforms.

Most of the serious hospital infections aren't airborne but are contact spread; yes, handwashing is important, cleaning surfaces, having single rooms etc.

I am not convinced that the theoretical advantages of FFP2 mask wearing is a cost effective intervention. Certainly I haven't seen a clear and detailed description of who and how they would be used that could be studied in a real world situation.
 
I love the way the simplest and most obvious ideas manage to attract disagreement.

The science is abundantly clear: masks work in reducing disease spread.

This means that medical personnel wearing them would benefit in two important ways.

There would be far fewer illnesses among staff, reducing pressure at times of greatest need, and there would be fewer infections passed on to vulnerable patients.

If a hospital has a measles patient, complete infection controls are put in place, and totally unremarkably, the infection doesn't spread.

I'm not advocating that for daily use, but masking up will unquestionably reduce infections among medical employees, to the benefit of everyone.

Please continue...
 
The Atheist said:
I love the way the simplest and most obvious ideas manage to attract disagreement.

The science is abundantly clear: masks work in reducing disease spread.

This means that medical personnel wearing them would benefit in two important ways.

There would be far fewer illnesses among staff, reducing pressure at times of greatest need, and there would be fewer infections passed on to vulnerable patients.

If a hospital has a measles patient, complete infection controls are put in place, and totally unremarkably, the infection doesn't spread.

I'm not advocating that for daily use, but masking up will unquestionably reduce infections among medical employees, to the benefit of everyone.

Please continue...
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You are making the incorrect assumption that the risk to staff is from patients with known infections. The major risk to staff is from other staff in non-clinical areas such as canteens and break areas and most of all their family. You would have to make staff wear the masks when out and about and at home to prevent them acquiring respiratory infections. The highest risk to patients is not the staff, but visitors, family memebers and other patients.

The best intervention is for the person with an infection to wear a simple mask, as has been admitted these are very effective at preventing the infected person transmitting an infection. The question is then how much more effective would making them wear an FFP2 / N95 mask be, partcularly if not wearing it correctly. What would be the added cost / life saved. Money spent on masks is money not being spent on another intervention.

You may not be advocating for daily use, but others are advocating for universal wear. Mostly I suspect people who haven't actually worn FFP masks for 12 hour shifts seven days a week. Then we haven't addressed the beards issue, lip reading, etc.
 
Rather than everyone going round doing Darth Vader impressions, perhaps we should pony up for proper ventilation in public buildings such as hospitals and schools?

As for the risk to medical staff being their family I disagree. I call my GP wife Typhoid Mary because she gets a sniffle and I get full blown man-flu.

Low level exposure is good for the immune system.
 
The Atheist said:
I love the way the simplest and most obvious ideas manage to attract disagreement.

The science is abundantly clear: masks work in reducing disease spread.

This means that medical personnel wearing them would benefit in two important ways.

There would be far fewer illnesses among staff, reducing pressure at times of greatest need, and there would be fewer infections passed on to vulnerable patients.

If a hospital has a measles patient, complete infection controls are put in place, and totally unremarkably, the infection doesn't spread.

I'm not advocating that for daily use, but masking up will unquestionably reduce infections among medical employees, to the benefit of everyone.

Please continue...
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I'm pretty sure medical professionals in general, and medicine as a profession, has a good understanding of how medical personnel would benefit from masking.
 
Planigale said:
You are making the incorrect assumption that the risk to staff is from patients with known infections. The major risk to staff is from other staff in non-clinical areas such as canteens and break areas and most of all their family. You would have to make staff wear the masks when out and about and at home to prevent them acquiring respiratory infections. The highest risk to patients is not the staff, but visitors, family memebers and other patients.

The best intervention is for the person with an infection to wear a simple mask, as has been admitted these are very effective at preventing the infected person transmitting an infection. The question is then how much more effective would making them wear an FFP2 / N95 mask be, partcularly if not wearing it correctly. What would be the added cost / life saved. Money spent on masks is money not being spent on another intervention.

You may not be advocating for daily use, but others are advocating for universal wear. Mostly I suspect people who haven't actually worn FFP masks for 12 hour shifts seven days a week. Then we haven't addressed the beards issue, lip reading, etc.
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Having actually been forced to wear a hospital gown and mask on ten hour shifts I know how much it sucks. We were in an industrial laundry sorting soiled hospital stuff, in 80F heat.
I had done it for a year before without and we all survived. We were incredibly resistant to the cold season.

No way I go back.
 
Both my phlebotomist and my eye doctor were wearing masks today. Not required for everyone at the hospital, some areas are optional. but considering both jobs require much closer face-to-face contact, I can see why they'd opt in.
 
The Atheist said:
Since you started your post with an incorrect assumption I didn't bother reading the rest of it.
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Are you really asserting that the highest risk for the source of respiratory infections in hospital staff / clinicians is from patients with known respiratory infections? those are the patients that respiratory precautions will be taken. Most of the time, closest contact will be from friends and family, not at work. Those of us with children still get infected by infant vectors not by the transient contacts we have with patients.

Live in the real world.
 
Planigale said:
Are you really asserting that the highest risk for the source of respiratory infections in hospital staff / clinicians is from patients with known respiratory infections
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You actually quoted the post where I said that was false, so repeating it seems asinine to me.

But do continue...
 
The Atheist said:
You actually quoted the post where I said that was false, so repeating it seems asinine to me.

But do continue...
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Ignorance is not a sin, failing to fact check your claim that what I say as an expert is false is foolish.

COVID-19 Infections in Health Care Personnel by Source of Exposure and Correlation With Community Incidence - PMC

This study suggests that risk of exposure to COVID-19 in healthcare personnel approximates community risk levels, provides support for safety measures in the workplace and emphasizes the need for prevention in the community. Keywords: COVID-19, ...
pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov
Household (27.1%) and community (15.6%) exposures were the most common sources of infection. Occupational exposures accounted for 3.55% of HCP infections.
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Community and co-worker contacts are important sources of viral respiratory illness in healthcare personnel, while exposure to patients with recognized respiratory infections is not associated.
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