The Debate

There’s a rather fascinating debate going on about a subject you might have thought thrashed out to death—to wear a facemask to prevent the transmission of COVID-19 or not? What got the ball rolling was apparently this post analyzing the Bengladeshi study which is, apparently, the largest one of the use of masks in a non-healthcare setting and to which Scott Alexander reacted earlier.

A few days ago Tyler Cowen entered the lists with this post, following up with this response from the author of the first post linked and there’s a rather sharp post from Greg Piper summarizing it all at Just the News.

Tyler’s view approximates my own:

To be clear, I am fine with wearing masks myself, I am used to it, and I dislike it but I don’t hate it. On this issue, I am not one of those people translating his or her own snowflake-ism into some kind of biased policy view.

and I did want to highlight what I found to be Tyler’s most astute observation:

Any good assessment of mask efficacy has to be radically intertemporal in nature, and I mean for the entirety of the pandemic. “Not getting infected” now may well raise your chance of getting infected later on, and that spans for longer than any feasibly designed RCT.

Said another way it’s not enough to measure the effectiveness in preventing contracting the disease today. Just how important delaying contracting the disease for two weeks, four weeks, or a year when you will, ultimately contract it is important as well. It seems to me that the honestly remarkable pace at which new treatments are being introduced makes delaying when you will contract the disease that much more important rather than less.

I find that the weakness of the supportive evidence casts a bit of a pall on mandates to wear masks but IMO mask mandate by presidential executive order is itself problematic since

  • I do not believe that a mask mandate is within the authority of the president even under emergency conditions
  • Although such a mandate might be within the power of the Congress as a temporary emergency measure, a permanent mandate or one of unspecified duration is outside the Congress’s power and
  • Such mandates are within the power of the states

As usual I think the underlying problem is not COVID-19 but the Congress and in this instance the torpidity of state governments. That echoes all sorts of other issues much in the news these days including anthropogenic climate change and abortion.

Under the circumstances G. K. Chesterton’s wisecrack rings true to me: it is terrible to contemplate how few politicians are hanged in this country.

7 comments… add one
  • PD Shaw Link

    Illinois is one of six states with a mask mandate and the Governor always said that he would stop emergency orders once everyone had an opportunity to get vaccinated. Whether his emergency orders were lawful is one question, but the metric seemed sound, it was confounded by growing infections among the young, so the vaccination window expanded. And then it expanded due to a desire to get infection rates low before the holidays, and now its possibly never going to end.

    The treatments sound good, but my impression is that they require early detection to be effective (at least to the extent they are anti-viral) and wonder how useful they will be without frequent testing (which may reduce their usage to certain institutional settings).

  • CuriousOnlooker Link

    Pfizer’s trial and result was conditioned on being treated 3 days after onset of symptoms.

    Lets wait for the updated data from the Pfizer trial. Merck’s trial went from 50% effective at initial press release to 30% on FDA submittal (and almost a rejection by FDA advisors).

  • steve Link

    Just specifically on the mask issue I think that Cowen also made the good point that masks dont need to work 100% of the time to be valuable. What we need is for them to be effective enough to reduce R below 1 and they are effective enough to achieve that much of the time. Then I thought that Tabarrok made a good point the following day. Too many people focus on individual papers when what you should be following is the whole body of literature. Ultimately if you have a view on masks that is anything other than masks work 100% of the time or they never work it is hard to discuss online.


  • Grey Shambler Link

    It’s easy to forget that the original purpose was not primarily to prevent illness and death, it was the specter of hospital’s having to turn away patients, the experience of Italy and New York.
    Now we accept, like the frog in slowly warming water, as mandates and policy gently tighten around us.
    It’s for our own good I’m sure .
    Freedom is not safe.

  • Drew Link

    “It seems to me that the honestly remarkable pace at which new treatments are being introduced makes delaying when you will contract the disease that much more important rather than less.”

    As I’ve been saying since early days. This is the argument to make. It would apply especially so to high risk profile people. I think the data on masks is piss poor, and highly suspect, but this is at least a rationale that hangs together.

    Steves R<1 argument would be fine, but its an academic one. Controlling for proper mask utilization and all the other variables is simply not feasible.

    As of this writing I am in New York. They are bat shit crazy here. Mask rules and zealots everywhere. My Boston based partner reports it is the same there. Its fascinating. I will be back in SC tomorrow where they almost don't know what a mask is at this point, in all sorts of public and tight venues. Yet no one asks why the maskless are not dropping like flies. Its the same in FL and GA.

    You know that political leaders and Fauci don’t believe in it. Too many maskless pics.

  • Jan Link

    I have read articles sorting the effectiveness of masks that go both ways – from effective to ineffective/harmful. However, the small size of viruses cannot be captured in the masking attempts by a compliant public. Therefore, IMO, the masks most people wear are not that beneficial except for circumventing criticism of those who love/need masks to feel “safe.”

    In the meantime what is completely ignored is the down side of long term mask wearing. Learning social cues is being hindered in children’s early development, because so much of the face giving these cues is hidden by a mask. A mask is also socially isolating. Facial rashes, headaches are common after hours of use, such as being on a plane or in a classroom/work environment. Finally, lab studies have been done on masks indicating a slew of bacteria that collect on the exhaled side of the mask.

  • steve Link

    Masks are not 2 dimensional. Brownian motion applies. Lab studies confirm.


Leave a Comment