I totally agree with this statement. “The goal isn’t to be right. The goal is to reduce harm.” I visited Japan recently and witnessed what would be considered a social phenomena in America. People were wearing masks and no one thought any different. It’s a very different society. Thank you for your article.
I just caught your post here about masking. I’m an immunocompromised cancer patient that must travel on a plane every month. I say that just as a context for my opinion re:this comment. No disrespect— and to be sure, I support any person’s conviction and application of masking… it’s a free country.
That said— for me, the line for me regarding masking is… me. I don’t put one ounce of responsibility or expectation upon any other person in this matter. The moment expectation/responsibility transference goes into effect is where it breaks down for me.
Do I get irate on the plane as people cough and sneeze and seem to do their best to be a virus spreading machine— yes.
Again, the onus is on me… so I’ll mask. I’ll also secure pre-board seating assignment. So I can choose a from seat near the window and turn the air jets to circulate the air in an advantageous direction— all maneuvers that I believe give me the best chance to avoid trouble. But that’s ALL on me.
Period.
All the social wrangling about this issue would go away if people were educated on the benefits and limits of masking WITHOUT any expectation on others.
The onus being on the marginalized community is absolutely vile. It shows so clearly that you don’t value disabled loved (even your own) or understand what community care looks like. Very sad.
It’s impossible and unreasonable for the community to shield every person from risk. Community care can only go so far— like equal access to buildings and handicap parking—measures that can be instituted through systemic general planning. It is sad, but a part of life. I’m compromised but I don’t for a second expect every individual to live in personal awareness of my situation— that burden is mine. Many compromised people like me don’t have a visible indication as a social clue that I am ill. Would I need to wear a badge in a total risk-assessed world? How would you propose to shift total risk abatement upon the community— what would that look like?
have you considered that you are arguing this without listening to his points and his reasoning? "Ableist"? "bad faith actor"?? Start from the top and reread his comments. You are accusing and finger pointing here in an accusatory tone, seemingly without trying to understand his perspective, which he is allowed to share as immunocompromised individual (like yourself, I can only presume) without being attacked for it. Pretty shameful, IMO.
It would make more sense to take some fruit to eat on the plane. There is low oxygen so directing the air jets towards you can help but I don't see how a mask would. That is just going to cause you to breath back in air you were trying to get rid of.
It's sad that Americans can't consider the needs of other people before their own when making decisions such as masking. People in Japan have worn masks for years and years anytime they feel like they have a cold and think nothing of it because they are trying to help others. Wearing a mask doesn't hurt you, it helps others. It's basically following the golden rule.
Japanese people didn't consider other people when they wore masks. They caused a huge disaster for the world spreading this behavior using social pressure. How is it that Japan has the highest suicide rate in the world if they are so caring? No it is not care but conformity. Care is defending peoples right to breath freely.
Such a powerful and important insight! Great analogies (safer sex, healthful diets)! Expecting perfection isn't realistic and as you so clearly explain, it just makes us stop trying or resist even harder.
I don’t think it does any good- in fact I’d argue it does harm- to act like masking anything less than 100% of the time is equivalent to drunk driving. Another comparison to consider would be driving. Most of us choose to drive every day, knowing we’re significantly increasing the risk of death to ourselves and others by doing so. Anyone who views masking as a black-and-white “it’s irresponsible for anyone not to do it in all circumstances” issue should also be willing to recognize & acknowledge that they, too, do things which create risk of harm to other people and themselves every day. You probably fly on planes, buy & toss plastic garbage sometimes, buy from evil companies sometimes, despite negative climate & social impacts of all these things. Most people work at companies that contribute in some way to destroying the environment or putting people in deeper poverty. If your response is “not me, I’m without sin”, you’re missing the point. I agree fundamentally that masking is a good idea that reduces risk, but comparing it to drunk driving only serves your self-importance; it changes no one else’s behavior.
I really appreciate this article. As someone who does wear a respirator everywhere, and is often frustrated by the lack of masking in my otherwise progressive social circle, it felt useful to me to learn about psychological reactance and why masking is a harder sell. It pushed me to align my rhetoric around masking with the other issues you mapped it onto, like drug use, where I do believe in harm reduction. Thank you for sharing it. At the end of reading it, I felt a lingering frustration and I think I can name it. The choice to center the feelings of the person not masking in public makes sense, since that's who you're appealing to, and you do mention the feelings of immunocompromised people - feelings of being left behind, hurt, and exhausted - but what's absent and arguably more important than our feelings is the physical danger we're exposed to by unmasked individuals. In that way, masking doesn't map onto drug use because one person's choice to use a drug doesn't necessarily expose the person next to them to the same risk. Representing the protest from immune-compromised people as mainly emotional reads as minimization.
Tangentially, the other omission here is that many people who were not immunocompromised in 2019 now are because of repeat covid infections, though they either don't know or don't want to confront that. In this article and most mainstream discourse, "immunocompromised people" are treated as both a static population a delicate, pitiable other to be taken into consideration but never identified with. Reckoning with disability is understandably scary but there is powerful, political potential in people understanding the true scale of their own personal stake in the issue.
I'll end by clarifying that my hope is for these comments to be additive, not detractive. I appreciate the pragmatism of your perspective and the complexities you've already named that go into the choice of when and where to mask; I think we can add to the nuance and complexity of whom that decision impacts and how.
I appreciate everything about this article. As a retail pharmacist, I mask when sick, and in other situations depending on judgment. My team actually takes the same responsible approach. No one is forced to, they just choose to. As someone in a job that requires constant direct communication with an unpredictable public, it's just not practical or approachable to be masked at all times. This has made masks less of a stigma, and others seem to understand what we are trying to do, even if they wouldn't necessarily agree with it for themselves. I definitely see the benefit, since we work together in a small space for 8-10 hrs a day, and when one person falls sick, it doesn't mean the entire crew falls sick. Thank you for your insight.
I remember from school there was pretty much always 10% of the kids missing. The only time there was significantly more than that was when there was a big snow storm. People fell sick on ships and because of this sort of ideology it took 200 years before it was finally admitted scurvy was the cause. Now there is still scurvy but they label it covid, mesles, flu etc. because their medieval ideology gets in the way of any sensible advice like to eat more fruit.
I had cancer 22 years ago. I was in my early 20s (and in medschool).
The last thing on my mind was thinking EVERYONE else in the world should wear a mask to protect ME…
I was the one going through chemo, so I took the necessary precautions. I’d stay mostly at home, I’d mask when people came over, and so on.
Today, I conduct myself very much like you mention doing.
If I’m unwell, I stay at home. I mask if I must go out during that time. I am no longer in a clinical setting but if I was, I’d likely mask at bedside.
We cannot (and should not try to) control what others do or don’t do.
A few comments refer to protection of self vs protection of others from oneself. Masks are MUCH more effective at the latter - preventing onward transmission from the wearer - than they are at protecting the wearer.
That’s not an evidence-based belief. N95 respirators (which is what we mean when we say “masks”) are just as good at source control (protecting others) as they are at respiratory protection (protecting oneself).
This type of thinking was applied early in the pandemic when all we had were cloth and surgical masks, and N95 respirated are not masks.
For clarity, masks / simple respirators are considerably better at preventing onward transmission than at protecting the wearer. I would expect this not to apply to PAPR devices, but I am not up to date with the evidence base on this.
Daniel is correct. Respirator masks like N95s can be very effective at protecting the wearer. It's what they're designed for. The popular cloth and surgical masks, yeah those were (at best) mostly good at source control, protecting others.
The study looks like the masks increased the incidence of 'positive' pcr results in the green wards i.e. the wards that were not for 'covid'. See Figure 2.. For the red wards there isn't really any clear sign of the masks improving the test results with all 3 weeks being higher than a week 2 weeks earlier. If you look at figure 1 the 'cases' among health care workers swang to being higher than for community. That is obviously not any sort of sign the masks reduced 'positive test results'. The study shows the correlation with the masks in the green wards where the patients had been 'tested negative'. They have misinterpreted this data by applying some mathematical model based on dogma when the data doesn't support the infection ideology. If you look at table 1 green 'cases' were double and then more than 3 times as high as they were before the masks.
I'd like to see you try to explain how the red ward workers switching from surgical to FFP3 would cause the green ward, still in surgicals, to get infected more often. What's your mechanistic story for that?
The red ward infections were all lower than the week of 21/12, despite community infection being as high or higher than that week.
Hmm well maybe there was still some escalation on the masking in the green wards. They wouldn't have been prohibited from changing to the FFFP3 would they? Maybe previously they hadn't been wearing masks as much. It says all wards wore eye protection but it is unclear if this was newly introduced to the green wards. It says:
"Because of the rising number of admissions to CUHNFT with COVID-19, the number of red wards was increased from one at the beginning of November 2020 to seven by the week starting 11/01/21. Six wards therefore changed from green to red during the period of data collection. "
There was probably escalation outside in the community as well with masking in shops etc. If you are saying it is just some random deviation then that says the data for the red wards is far too weak to be claiming "very effective".
If the green wards were being told that their masks were no good and their colleagues were switching then they would have been negatively impacted by the nocebo effect. Since the wards had been changed from green to red during the study the stress and increased pressure to mask could have caused some spikes in 'cases' and so the period with the mask change isn't relative to red wards but relative to recently disrupted previously green wards.
On surgicals, the red ward was getting infected more than the green ward, by a lot.
They switched to FFP3, and got infected less than the green ward. This is undeniable.
You're seriously trying to argue that FFP3s _cause_ infection?
Oh wait, I just looked at your Youtube video, you're seriously arguing against germ theory. Lol, what a joke.
Why did smallpox and rinderpest go extinct? Why is polio confined to two countries now? Why was measles eliminated in the Americas, and why is it resurging -- in unvaccinated populations?
You are not wrong! N95 respirators as you call them (FFP3 in UK) do provide considerable protection to the wearer. But they are still even better at preventing onward transmission.
Maybe, but if we're comparing 99% to 99.9%, I think it's misleading to belabor the point. You're giving the idea that N95s aren't great protection for the wearer, which is false.
My objection is to the selfish idea that in risky contexts - especially when they could be the source of the risk - it's entirely the responsibility of the frightened, high risk individual to protect themselves, with no responsibility to wear a mask to protect others. Especially given that masks / respirators ARE more effective at preventing onward transmission than at protecting the wearer.
Thank you for your transparency. I am an already-masker and I mask pretty consistently, but I also do take calculated risks. In my community of like-minded almost-everywhere-maskers, I can sometimes feel fearful of sharing about my riskier behaviours for fear of being shamed or criticized. Although I felt my resistance coming up reading some of your article, I so appreciate what you've offered in support of harm reduction vs total elimination. While I'd love to live in a world where car accidents, alcohol-related deaths, and sexually transmitted diseases weren't a risk, you've given me a lot to ponder by including COVID-19 as part of these issues that we're up against when we choose to engage with the world. Safe-enough isn't always the best option, but it's the best we've got. And I'm not giving up on trying to promote safe-enough conditions for as many as possible, either. Community care can and is evolving. More people are stepping up and - more importantly - changing their minds, and I want to include myself in that camp. I'm not exempt from needing to keep an open mind, just because I've continued to take a mask-almost-everyone-almost-always stance. Thank you for hanging in and persisting.
I no longer wear a mask everywhere I go. I wear a mask in medical facilities, crowded places, when I'm sick or think I've been exposed to something, and when I'm around a person I know to be immunocompromised. My answer to the "how do I know who's vulnerable" question -- I always carry an N95 in my purse. If I see a person near me wearing a mask, I put mine on. Not perfect, but I hope it helps a bit.
I love that you just mask without asking if the other person is already masked; i mask almost everywhere and when ppl ask me if I want them to mask I get the intention but I worry they will feel inconvenienced so I usually just demur.
this is a difficult conversation 100% maskers need to have with each other, as people who live with mountains of grief in a world that cares more about feeling attacked than human lives. i appreciate that you're saving one or two lives here or there, it's better than making "tradeoffs" with the lives of 100% of the people you come into contact with, but it's clear that you do not want to admit that allowing yourself to cause harm that you understand how and have the ability to prevent is violence. accepting inconsistent masking as an end goal rather than an achievable step to building a sustained habit is not really challenging the fundamental eugenicist idea that murder is okay.
i agree with the need for the gradual approach, it's a difficult habit to build and we take our knowledge gap for granted. but... why are the people who are more afraid of feeling attacked than killing people the ones who are framed as reasonable? why are people who draw a hard, non-negotiable line against killing people on the fringes? is that a society we want to live in? is that the future we want to build towards?
@PR thank you for this reply! The disposability of the lives of the immunocompromised and disabled is so naturalized and normalized that all these people in the comments feel entirely comfortable announcing that it’s “purist” to act like the immunocompromised people deserve consistent protection, not just some of the time. But that violence is hidden to them because it is so naturalized and because they don’t want to see themselves as participating in it. Appreciate so much you pointing out the violence baked in to the casual disposability of disabled lives so many people in this conversation are buying into while simultaneously denying.
Asking for consistent solidarity is not purist, is not all or nothing. Protecting some lives, some of the time is not more “nuanced” than embodying a consistent commitment to protect those lives.
Most libs and leftists understand this when it comes to most marginalized groups of people, but when it’s immunocompromised and disabled people a whole different standard applies. Our lives are already considered and treated as disposable by the culture at large, so advocating for us to find a way to move forward from here that starts with the core commitment to not abandon the ill and disabled is defined and viewed as “purist” and unreasonable. We’re continuously being told that we’re being outrageous for asking people to consistently act as if our lives matter and deserve community protection. For asking the general public (or at least the people who claim to be on our side) to refuse to accept that the ill and disabled are disposable. For asking y’all to please embody solidarity with us, because we’re dying and being further sickened and being cut out of society over here. Like, that’s really happening, to millions and millions of human beings.
Why are your privileges to have the freedom of being barefaced in public more important than our survival and access to public life? So much so, so normalized to abandon the ill and disabled to social isolation and death, that we are defined as unreasonable for asking people to dig deeper and ask themselves why they have accepted that calculus. For asking people to treat us as if our lives mattered as much as theirs.
That’s all. That’s the crime. Asking people to base their calculations regarding mask-wearing on a commitment to protecting the lives of those who’ve been defined and treated as disposable, for those pushed hard to the margins because their needs for protection of life conflict with the western populace’s entitlements to ways of life predicated on the disposability of others.
This idea that there have to be some groups y’all still treat as disposable is an obstacle to our collective liberation. Real people are harmed with every infection that isn’t prevented.
That’s a hard truth, but it is a fact. If people are going to insist that the right to a public life without responsibility to prevent infection spread is the norm they want to base our world on, it would be nice if they’d at least admit that’s what they’re doing. It would be appreciated if they would start being willing to listen with more care to those of us shouldering the cost of those attitudes, instead of using their epistemic privilege to fuel the stigma that we’re absolutist purists lacking nuance because we won’t negotiate on the value of our lives.
The article and comments are so frustrating. People want to feel justified in largely tossing the disabled community aside framing it as “nuance” and masking as a “hard sell.” It’s vile.
I completely agree with you, thank you for taking the time to write this. Also, most of the comments praising "nuance" don't account for the fact that 40/50 % of transmission is pre/asymptomatic, rendering it virtually impossible to make situational decisions on masking.
By ignoring presymptomatic and asymptomatic transmission and how they can easily be infecting others at such times, people praising the alleged nuance of this argument are revealing that they are motivated more by the need to see themselves as good people than by solidarity with or embodied care of those impacted most. It's moral licensing.
Wikipedia defines moral licensing as "a term used in social psychology to describe the subconscious phenomenon whereby increased confidence and security in one's self-image or self-concept tends to make that individual worry less about the consequences of subsequent immoral behavior and, therefore, more likely to make immoral choices and act immorally."
I think because the great majority is engaging in this moral licensing, and generally disavowing any responsibility to think about the consequences of one's unmasked behavior on others, it's easy for people to tell themselves they couldn't be doing anything *that* bad.
I believe that the people who are praising this argument as nuanced have already accepted the norm of "we just have to abandon the most vulnerable" and so it seems reasonable to them and more "moderate" to accept that some people are gonna have to keep dying and getting disabled than it is to insist that we should never have capitulated to that violent, eugenicist norm. So we get framed as "absolutist" for insisting that we won't ever get free together if we keep normalizing the politically-constructed disposability of disabled and ill people. Or of any group.
Thank you for explaining the meaning of the expression "moral licensing". It's such an interesting lens to look through to consider people's (and my own) behaviours. I can now see it at play in other contexts as well.
I gotta say as an immunocompromised, disabled person what I hated the most about COVID was a whole bunch of people who claimed to and still continue to speak on my behalf. If you ever want input from someone this affects, happy to give it.
Thank you for this well thought out and worded response. From my perspective as an ED nurse during the pandemic the biggest mistake we made was shaming about mask use and vaccines. We created divides and mistrust that are lasting.
What is the point of this article? To rally support for your "moderate masking" because a couple people disagreed with your choices? You got it. Yours is not a difficult position for most people to support.
I'd like to suggest that when a very marginalized community gets angry, we all listen attentively instead of blaming them for being the problem.
"moderate masking" could very quickly turn into mandatory masking and a big increase in the death rate or even armagedon. Masks are strictly prohibited.
You’re saying that it’s ok for you to not mask consistently because most people don’t do so, so you shouldn’t face social consequences. That’s an appeal to majority behavior, not to evidence, and it effectively punches down on people who continue to take precautions. Just because most people don’t mask consistently doesn’t make it right. You can still choose to mask in all indoor places while promoting risk reduction without judgement.
As a science communicator who understands the cumulative harm of Covid reinfections and the threat to others, you have a responsibility to model evidence-based behavior. So by not doing so you’re indicating that your values stop at personal comfort and immediate social circle rather than extending to broader public health.
Thank you for the article. I currently only mask in medical environments and now I’m considering masking in other places as well. I believe we need to engage in more nuanced conversations like this and remember the algorithm of most social media perpetuates outrage and alienation.
“The goal isn’t to be right. The goal is to reduce harm”. Powerful statement. Thank you
I totally agree with this statement. “The goal isn’t to be right. The goal is to reduce harm.” I visited Japan recently and witnessed what would be considered a social phenomena in America. People were wearing masks and no one thought any different. It’s a very different society. Thank you for your article.
I spent a winter in Japan in 1971 and half of Tokyo wore a mask in public. It was normal.
It makes me think of one of my mom’s favorite sayings: “Do you want to be right, or do you want to be effective?”
I just caught your post here about masking. I’m an immunocompromised cancer patient that must travel on a plane every month. I say that just as a context for my opinion re:this comment. No disrespect— and to be sure, I support any person’s conviction and application of masking… it’s a free country.
That said— for me, the line for me regarding masking is… me. I don’t put one ounce of responsibility or expectation upon any other person in this matter. The moment expectation/responsibility transference goes into effect is where it breaks down for me.
Do I get irate on the plane as people cough and sneeze and seem to do their best to be a virus spreading machine— yes.
Again, the onus is on me… so I’ll mask. I’ll also secure pre-board seating assignment. So I can choose a from seat near the window and turn the air jets to circulate the air in an advantageous direction— all maneuvers that I believe give me the best chance to avoid trouble. But that’s ALL on me.
Period.
All the social wrangling about this issue would go away if people were educated on the benefits and limits of masking WITHOUT any expectation on others.
Thanks for sharing your opinion— I respect it.
Does this same lack of expectation apply to doctors and other healthcare workers, at the NICU, for example?
No. My comments were aimed at general social settings and public thoroughfares.
The onus being on the marginalized community is absolutely vile. It shows so clearly that you don’t value disabled loved (even your own) or understand what community care looks like. Very sad.
It’s impossible and unreasonable for the community to shield every person from risk. Community care can only go so far— like equal access to buildings and handicap parking—measures that can be instituted through systemic general planning. It is sad, but a part of life. I’m compromised but I don’t for a second expect every individual to live in personal awareness of my situation— that burden is mine. Many compromised people like me don’t have a visible indication as a social clue that I am ill. Would I need to wear a badge in a total risk-assessed world? How would you propose to shift total risk abatement upon the community— what would that look like?
you’re ableist and can’t see it. I’m done. You’re a bad faith actor set in colonizer thinking.
have you considered that you are arguing this without listening to his points and his reasoning? "Ableist"? "bad faith actor"?? Start from the top and reread his comments. You are accusing and finger pointing here in an accusatory tone, seemingly without trying to understand his perspective, which he is allowed to share as immunocompromised individual (like yourself, I can only presume) without being attacked for it. Pretty shameful, IMO.
It would make more sense to take some fruit to eat on the plane. There is low oxygen so directing the air jets towards you can help but I don't see how a mask would. That is just going to cause you to breath back in air you were trying to get rid of.
https://odysee.com/Mask-is-very-unhealthy-due-to-high-concentrations-of-CO2:4?view=shorts
It's sad that Americans can't consider the needs of other people before their own when making decisions such as masking. People in Japan have worn masks for years and years anytime they feel like they have a cold and think nothing of it because they are trying to help others. Wearing a mask doesn't hurt you, it helps others. It's basically following the golden rule.
The Japanese caused a disaster because they had one of the lowest rates of Covid in the world??? I don't understand your reasoning.
Japanese people didn't consider other people when they wore masks. They caused a huge disaster for the world spreading this behavior using social pressure. How is it that Japan has the highest suicide rate in the world if they are so caring? No it is not care but conformity. Care is defending peoples right to breath freely.
THIS: 'Nuance isn’t the enemy here. Pretending tradeoffs don’t exist is.'
Such a powerful and important insight! Great analogies (safer sex, healthful diets)! Expecting perfection isn't realistic and as you so clearly explain, it just makes us stop trying or resist even harder.
Another analogy is following the rules of the road, like not driving while under the influence.
I don’t think it does any good- in fact I’d argue it does harm- to act like masking anything less than 100% of the time is equivalent to drunk driving. Another comparison to consider would be driving. Most of us choose to drive every day, knowing we’re significantly increasing the risk of death to ourselves and others by doing so. Anyone who views masking as a black-and-white “it’s irresponsible for anyone not to do it in all circumstances” issue should also be willing to recognize & acknowledge that they, too, do things which create risk of harm to other people and themselves every day. You probably fly on planes, buy & toss plastic garbage sometimes, buy from evil companies sometimes, despite negative climate & social impacts of all these things. Most people work at companies that contribute in some way to destroying the environment or putting people in deeper poverty. If your response is “not me, I’m without sin”, you’re missing the point. I agree fundamentally that masking is a good idea that reduces risk, but comparing it to drunk driving only serves your self-importance; it changes no one else’s behavior.
I really appreciate this article. As someone who does wear a respirator everywhere, and is often frustrated by the lack of masking in my otherwise progressive social circle, it felt useful to me to learn about psychological reactance and why masking is a harder sell. It pushed me to align my rhetoric around masking with the other issues you mapped it onto, like drug use, where I do believe in harm reduction. Thank you for sharing it. At the end of reading it, I felt a lingering frustration and I think I can name it. The choice to center the feelings of the person not masking in public makes sense, since that's who you're appealing to, and you do mention the feelings of immunocompromised people - feelings of being left behind, hurt, and exhausted - but what's absent and arguably more important than our feelings is the physical danger we're exposed to by unmasked individuals. In that way, masking doesn't map onto drug use because one person's choice to use a drug doesn't necessarily expose the person next to them to the same risk. Representing the protest from immune-compromised people as mainly emotional reads as minimization.
Tangentially, the other omission here is that many people who were not immunocompromised in 2019 now are because of repeat covid infections, though they either don't know or don't want to confront that. In this article and most mainstream discourse, "immunocompromised people" are treated as both a static population a delicate, pitiable other to be taken into consideration but never identified with. Reckoning with disability is understandably scary but there is powerful, political potential in people understanding the true scale of their own personal stake in the issue.
I'll end by clarifying that my hope is for these comments to be additive, not detractive. I appreciate the pragmatism of your perspective and the complexities you've already named that go into the choice of when and where to mask; I think we can add to the nuance and complexity of whom that decision impacts and how.
Thank you for carefully articulating this vital addition to the conversation.
I very much appreciate your response. Thank you.
I appreciate everything about this article. As a retail pharmacist, I mask when sick, and in other situations depending on judgment. My team actually takes the same responsible approach. No one is forced to, they just choose to. As someone in a job that requires constant direct communication with an unpredictable public, it's just not practical or approachable to be masked at all times. This has made masks less of a stigma, and others seem to understand what we are trying to do, even if they wouldn't necessarily agree with it for themselves. I definitely see the benefit, since we work together in a small space for 8-10 hrs a day, and when one person falls sick, it doesn't mean the entire crew falls sick. Thank you for your insight.
I remember from school there was pretty much always 10% of the kids missing. The only time there was significantly more than that was when there was a big snow storm. People fell sick on ships and because of this sort of ideology it took 200 years before it was finally admitted scurvy was the cause. Now there is still scurvy but they label it covid, mesles, flu etc. because their medieval ideology gets in the way of any sensible advice like to eat more fruit.
I had cancer 22 years ago. I was in my early 20s (and in medschool).
The last thing on my mind was thinking EVERYONE else in the world should wear a mask to protect ME…
I was the one going through chemo, so I took the necessary precautions. I’d stay mostly at home, I’d mask when people came over, and so on.
Today, I conduct myself very much like you mention doing.
If I’m unwell, I stay at home. I mask if I must go out during that time. I am no longer in a clinical setting but if I was, I’d likely mask at bedside.
We cannot (and should not try to) control what others do or don’t do.
A few comments refer to protection of self vs protection of others from oneself. Masks are MUCH more effective at the latter - preventing onward transmission from the wearer - than they are at protecting the wearer.
That’s not an evidence-based belief. N95 respirators (which is what we mean when we say “masks”) are just as good at source control (protecting others) as they are at respiratory protection (protecting oneself).
This type of thinking was applied early in the pandemic when all we had were cloth and surgical masks, and N95 respirated are not masks.
I beg to differ. I'm away at present, but there are many studies supporting what I said.
For clarity, masks / simple respirators are considerably better at preventing onward transmission than at protecting the wearer. I would expect this not to apply to PAPR devices, but I am not up to date with the evidence base on this.
Daniel is correct. Respirator masks like N95s can be very effective at protecting the wearer. It's what they're designed for. The popular cloth and surgical masks, yeah those were (at best) mostly good at source control, protecting others.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635983/ is one study showing how powerful respirators (FFP3 in this case) can be, while working in wards full of infectious covid patients.
"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8635983/ is one study showing how powerful respirators (FFP3 in this case) can be, while working in wards full of infectious covid patients."
The study looks like the masks increased the incidence of 'positive' pcr results in the green wards i.e. the wards that were not for 'covid'. See Figure 2.. For the red wards there isn't really any clear sign of the masks improving the test results with all 3 weeks being higher than a week 2 weeks earlier. If you look at figure 1 the 'cases' among health care workers swang to being higher than for community. That is obviously not any sort of sign the masks reduced 'positive test results'. The study shows the correlation with the masks in the green wards where the patients had been 'tested negative'. They have misinterpreted this data by applying some mathematical model based on dogma when the data doesn't support the infection ideology. If you look at table 1 green 'cases' were double and then more than 3 times as high as they were before the masks.
https://odysee.com/@halloftruth:c/dr-stefan-lanka-pandemic-theater-the-history-of-the-infection-theory:7
I'd like to see you try to explain how the red ward workers switching from surgical to FFP3 would cause the green ward, still in surgicals, to get infected more often. What's your mechanistic story for that?
The red ward infections were all lower than the week of 21/12, despite community infection being as high or higher than that week.
Hmm well maybe there was still some escalation on the masking in the green wards. They wouldn't have been prohibited from changing to the FFFP3 would they? Maybe previously they hadn't been wearing masks as much. It says all wards wore eye protection but it is unclear if this was newly introduced to the green wards. It says:
"Because of the rising number of admissions to CUHNFT with COVID-19, the number of red wards was increased from one at the beginning of November 2020 to seven by the week starting 11/01/21. Six wards therefore changed from green to red during the period of data collection. "
There was probably escalation outside in the community as well with masking in shops etc. If you are saying it is just some random deviation then that says the data for the red wards is far too weak to be claiming "very effective".
If the green wards were being told that their masks were no good and their colleagues were switching then they would have been negatively impacted by the nocebo effect. Since the wards had been changed from green to red during the study the stress and increased pressure to mask could have caused some spikes in 'cases' and so the period with the mask change isn't relative to red wards but relative to recently disrupted previously green wards.
https://www.youtube.com/watch?v=foNp2-9Y8Cw
On surgicals, the red ward was getting infected more than the green ward, by a lot.
They switched to FFP3, and got infected less than the green ward. This is undeniable.
You're seriously trying to argue that FFP3s _cause_ infection?
Oh wait, I just looked at your Youtube video, you're seriously arguing against germ theory. Lol, what a joke.
Why did smallpox and rinderpest go extinct? Why is polio confined to two countries now? Why was measles eliminated in the Americas, and why is it resurging -- in unvaccinated populations?
You are not wrong! N95 respirators as you call them (FFP3 in UK) do provide considerable protection to the wearer. But they are still even better at preventing onward transmission.
Maybe, but if we're comparing 99% to 99.9%, I think it's misleading to belabor the point. You're giving the idea that N95s aren't great protection for the wearer, which is false.
My objection is to the selfish idea that in risky contexts - especially when they could be the source of the risk - it's entirely the responsibility of the frightened, high risk individual to protect themselves, with no responsibility to wear a mask to protect others. Especially given that masks / respirators ARE more effective at preventing onward transmission than at protecting the wearer.
Thank you for your transparency. I am an already-masker and I mask pretty consistently, but I also do take calculated risks. In my community of like-minded almost-everywhere-maskers, I can sometimes feel fearful of sharing about my riskier behaviours for fear of being shamed or criticized. Although I felt my resistance coming up reading some of your article, I so appreciate what you've offered in support of harm reduction vs total elimination. While I'd love to live in a world where car accidents, alcohol-related deaths, and sexually transmitted diseases weren't a risk, you've given me a lot to ponder by including COVID-19 as part of these issues that we're up against when we choose to engage with the world. Safe-enough isn't always the best option, but it's the best we've got. And I'm not giving up on trying to promote safe-enough conditions for as many as possible, either. Community care can and is evolving. More people are stepping up and - more importantly - changing their minds, and I want to include myself in that camp. I'm not exempt from needing to keep an open mind, just because I've continued to take a mask-almost-everyone-almost-always stance. Thank you for hanging in and persisting.
I no longer wear a mask everywhere I go. I wear a mask in medical facilities, crowded places, when I'm sick or think I've been exposed to something, and when I'm around a person I know to be immunocompromised. My answer to the "how do I know who's vulnerable" question -- I always carry an N95 in my purse. If I see a person near me wearing a mask, I put mine on. Not perfect, but I hope it helps a bit.
If more people did "mirror masking", that would be amazing. Thanks for that practice.
Masks release fibers into the air that cause people nearby to cough.
I love that you just mask without asking if the other person is already masked; i mask almost everywhere and when ppl ask me if I want them to mask I get the intention but I worry they will feel inconvenienced so I usually just demur.
I don't want to put people on the spot. It costs me nothing to just pop on a mask and go about my business.
this is a difficult conversation 100% maskers need to have with each other, as people who live with mountains of grief in a world that cares more about feeling attacked than human lives. i appreciate that you're saving one or two lives here or there, it's better than making "tradeoffs" with the lives of 100% of the people you come into contact with, but it's clear that you do not want to admit that allowing yourself to cause harm that you understand how and have the ability to prevent is violence. accepting inconsistent masking as an end goal rather than an achievable step to building a sustained habit is not really challenging the fundamental eugenicist idea that murder is okay.
i agree with the need for the gradual approach, it's a difficult habit to build and we take our knowledge gap for granted. but... why are the people who are more afraid of feeling attacked than killing people the ones who are framed as reasonable? why are people who draw a hard, non-negotiable line against killing people on the fringes? is that a society we want to live in? is that the future we want to build towards?
@PR thank you for this reply! The disposability of the lives of the immunocompromised and disabled is so naturalized and normalized that all these people in the comments feel entirely comfortable announcing that it’s “purist” to act like the immunocompromised people deserve consistent protection, not just some of the time. But that violence is hidden to them because it is so naturalized and because they don’t want to see themselves as participating in it. Appreciate so much you pointing out the violence baked in to the casual disposability of disabled lives so many people in this conversation are buying into while simultaneously denying.
I wrote a note in response to this article and another person’s supportive celebration of it here: https://substack.com/@biomimic/note/c-200941731?r=38nc9&utm_medium=ios&utm_source=notes-share-action
<3 solidarity forever with all people whose right to exist is seen as negotiable and left up to the whims of "personal choice"
Asking for consistent solidarity is not purist, is not all or nothing. Protecting some lives, some of the time is not more “nuanced” than embodying a consistent commitment to protect those lives.
Most libs and leftists understand this when it comes to most marginalized groups of people, but when it’s immunocompromised and disabled people a whole different standard applies. Our lives are already considered and treated as disposable by the culture at large, so advocating for us to find a way to move forward from here that starts with the core commitment to not abandon the ill and disabled is defined and viewed as “purist” and unreasonable. We’re continuously being told that we’re being outrageous for asking people to consistently act as if our lives matter and deserve community protection. For asking the general public (or at least the people who claim to be on our side) to refuse to accept that the ill and disabled are disposable. For asking y’all to please embody solidarity with us, because we’re dying and being further sickened and being cut out of society over here. Like, that’s really happening, to millions and millions of human beings.
Why are your privileges to have the freedom of being barefaced in public more important than our survival and access to public life? So much so, so normalized to abandon the ill and disabled to social isolation and death, that we are defined as unreasonable for asking people to dig deeper and ask themselves why they have accepted that calculus. For asking people to treat us as if our lives mattered as much as theirs.
That’s all. That’s the crime. Asking people to base their calculations regarding mask-wearing on a commitment to protecting the lives of those who’ve been defined and treated as disposable, for those pushed hard to the margins because their needs for protection of life conflict with the western populace’s entitlements to ways of life predicated on the disposability of others.
This idea that there have to be some groups y’all still treat as disposable is an obstacle to our collective liberation. Real people are harmed with every infection that isn’t prevented.
That’s a hard truth, but it is a fact. If people are going to insist that the right to a public life without responsibility to prevent infection spread is the norm they want to base our world on, it would be nice if they’d at least admit that’s what they’re doing. It would be appreciated if they would start being willing to listen with more care to those of us shouldering the cost of those attitudes, instead of using their epistemic privilege to fuel the stigma that we’re absolutist purists lacking nuance because we won’t negotiate on the value of our lives.
The article and comments are so frustrating. People want to feel justified in largely tossing the disabled community aside framing it as “nuance” and masking as a “hard sell.” It’s vile.
And the author is refusing to engage with my comments.
Sadly unsurprising. I’m sorry. You’ve been so thorough and thoughtful in your replies.
I completely agree with you, thank you for taking the time to write this. Also, most of the comments praising "nuance" don't account for the fact that 40/50 % of transmission is pre/asymptomatic, rendering it virtually impossible to make situational decisions on masking.
Exactly. And that's the tell.
By ignoring presymptomatic and asymptomatic transmission and how they can easily be infecting others at such times, people praising the alleged nuance of this argument are revealing that they are motivated more by the need to see themselves as good people than by solidarity with or embodied care of those impacted most. It's moral licensing.
Wikipedia defines moral licensing as "a term used in social psychology to describe the subconscious phenomenon whereby increased confidence and security in one's self-image or self-concept tends to make that individual worry less about the consequences of subsequent immoral behavior and, therefore, more likely to make immoral choices and act immorally."
I think because the great majority is engaging in this moral licensing, and generally disavowing any responsibility to think about the consequences of one's unmasked behavior on others, it's easy for people to tell themselves they couldn't be doing anything *that* bad.
I believe that the people who are praising this argument as nuanced have already accepted the norm of "we just have to abandon the most vulnerable" and so it seems reasonable to them and more "moderate" to accept that some people are gonna have to keep dying and getting disabled than it is to insist that we should never have capitulated to that violent, eugenicist norm. So we get framed as "absolutist" for insisting that we won't ever get free together if we keep normalizing the politically-constructed disposability of disabled and ill people. Or of any group.
This is heartbreaking, I'm so sorry.
Thank you for explaining the meaning of the expression "moral licensing". It's such an interesting lens to look through to consider people's (and my own) behaviours. I can now see it at play in other contexts as well.
I gotta say as an immunocompromised, disabled person what I hated the most about COVID was a whole bunch of people who claimed to and still continue to speak on my behalf. If you ever want input from someone this affects, happy to give it.
Thank you for this well thought out and worded response. From my perspective as an ED nurse during the pandemic the biggest mistake we made was shaming about mask use and vaccines. We created divides and mistrust that are lasting.
What is the point of this article? To rally support for your "moderate masking" because a couple people disagreed with your choices? You got it. Yours is not a difficult position for most people to support.
I'd like to suggest that when a very marginalized community gets angry, we all listen attentively instead of blaming them for being the problem.
Otherwise, all we're doing is punching down.
"moderate masking" could very quickly turn into mandatory masking and a big increase in the death rate or even armagedon. Masks are strictly prohibited.
https://www.youtube.com/watch?v=V9PVRfjEBTI
"mandatory masking and a big increase in the death rate or even armagedon"
This is utterly delusional.
You’re saying that it’s ok for you to not mask consistently because most people don’t do so, so you shouldn’t face social consequences. That’s an appeal to majority behavior, not to evidence, and it effectively punches down on people who continue to take precautions. Just because most people don’t mask consistently doesn’t make it right. You can still choose to mask in all indoor places while promoting risk reduction without judgement.
As a science communicator who understands the cumulative harm of Covid reinfections and the threat to others, you have a responsibility to model evidence-based behavior. So by not doing so you’re indicating that your values stop at personal comfort and immediate social circle rather than extending to broader public health.
Thank you for the article. I currently only mask in medical environments and now I’m considering masking in other places as well. I believe we need to engage in more nuanced conversations like this and remember the algorithm of most social media perpetuates outrage and alienation.