This statement by Robert Redfield, director of the Centers for Disease Control, quoted at CNN, illustrates in just a few short words a number of my peeves about the public pronouncements about the COVID-19 pandemic:
“The time is now,†Dr. Robert Redfield, director of the CDC, said during an interview with the Journal of the American Medical Association’s Dr. Howard Bauchner. “I think if we could get everybody to wear a mask right now I think in four, six, eight weeks we could bring this epidemic under control.â€
The issues include fallacies, misstatements, and exaggerations. Rosy scenario, blaming the patient, tertium non datur, hedging, kicking the can, undeclared assumptions, non-falsifiability, and circularity.
The hedging is obvious. Would it take four weeks or eight weeks to “bring this epidemic under control”? That’s a considerable difference. Keep doubling it and he’s bound to be right eventually.
The circularity works this way. Eight weeks go by. The epidemic is still not under control. That is taken as proof that not enough people are wearing facemasks. That also illustrates the non-falsifiability of the the statement.
The actual science does not support the statement. I’ve now read all of the studies I’ve found. Not one supports the claims of effectiveness that are being made here. I’m prepared to believe that wearing masks might slow the spread of contagion a little. I’m not prepared to believe that contagion can be prevented enough to bring the epidemic under control even with 100% compliance. I can only speculate that he’s making some assumptions. In particular, I think he’s assuming that, if he buys a little time, a safe, effective vaccine can be developed, produced, and deployed in sufficient quantity to end the pandemic. The DJIA notwithstanding I doubt it.
I wear a facemask. I do not do so because I believe it will keep me from contracting the virus (the evidence does not support that belief). I don’t have COVID-19 so it won’t keep me from spreading it to someone else. Why do I wear it? I am modeling the behavior I expect from others. That’s why President Trump should wear a facemask in public and why you should, too.
Will that “bring this epidemic under control”? I doubt it. Maybe it will help a little.
In practice, almost no country (with the exception of New Zealand, Taiwan) has been able to keep case counts from uncontrolled growth by using only face masks, and contact tracing.
Even successes like Hong Kong, Australia, South Korea, Germany have various forms of social distancing, mandated business closures, bans of large gatherings.
On the other hand; the outbreaks in most of the US is very serious; that masks is about the minimal thing to do.
I do think Dr Redford should be more straightforward to the public. That control without a vaccine or therapeutic requires big changes in behavior; but the alternative is a ghastly death and injured toll. Also that as a society, there needs to be priorities on what is important enough to risk COVID spread and what is not; it is not binary.
i.e.
how important that in-person access to government services
how important for in-person access to education
Sadly, the political / cultural situation makes it hard to have a reasoned discussion on this.
The entire response to COVID-19 has been burdened by unexplainable decisions. That all government workers were essential. That stores that sold clothing must clothes but stores that sold food and clothing were essential and could continue to sell clothing. That all parcel service drivers were essential whatever they were delivering.
To people without reliable Internet connections (or even reliable postal service) in-person access to government services could be pretty important. To some students in-person access to education could be pretty important, too.
The way I’ve seen it is that what is easy to administer is being chosen preferentially over a more difficult to administer but better alternative. That’s exactly what you’d expect from a bureaucracy.
” I’ve now read all of the studies I’ve found.”
There are well over 70 studies that I have found. Many are behind paywalls. Not sure how to assess some of the older studies. We do know that it has been very successful in hospitals for sure, even when you dont use the higher level masks like the N 95s. Kind of suggests (actually studied in some papers) that compliance is maybe the issue. (To which I guess you make your usual comment that just because it works in hospitals doesnt mean it will work elsewhere. However, I am concentrating on whether or not masks actually work. No medicine or therapy works of people dont use it. In past studies where compliance was poor the people in the studies had no real reason to believe the masks would work.)
All that said, I agree that claiming masks alone will bring Covid under control is bizarre. I think they are a big help, but we need more ethan that.
Steve
That’s the point. Maybe masks will reduce infections by 80%, maybe by 50%, maybe by 10%. We don’t really know. But not 100%.
For his statement to make sense either he’s got to be making some assumptions, he has some data that none of the rest of us have, or something.
One of the first papers really looking at seasonality that I have seen. Also some more stuff out on T cells recently but small studies. Really hope it is true as it would be great news for all those down south getting hit so hard. Why former and future staff say they are getting hit pretty hard.
https://www.medrxiv.org/content/10.1101/2020.07.11.20147157v1
Steve
Talked with my former employee who left us to go back and do a critical care fellowship in Miami yesterday. He thinks things are getting pretty bad down there. Being young it really bothers him that they arent able to give good care to everyone.
https://www.nbcnews.com/news/us-news/florida-hospitals-face-icu-bed-shortage-state-passes-300-000-n1233899
Steve