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Masks


Covid-19 has made masks a major issue. I should write more on that. A basic idea is to submit to silliness in order to ease the minds of our silly friends. Other ideas: 1. Don’t believe experts; they have told us they lie all the time. 2. Common sense carries you a long ways– the experts probably don’t know more than you in any case. 3. You need to trade off cost against benefit. 4. The usual masks are not as effective as people seem to think. 4. If people are wacked out of their minds with fear, you don’t need to defer to them. 5. People are amazingly scared of tiny probabilities of death, which maybe means they are scared of Hell– it is hard to explain. 6. If you’re in a risky situation, get a real mask, like the 3M 6500 series with the P100 filter, even if it’s reasonable for most people not to wear a mask at all.

The 3M 6500 series vs. the simple surgical mask
The 3M 6500 series vs. the simple surgical mask

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Romans 14 is the key passage on masks. If your brother is foolish and stupid, just remember that he is your brother, and if it is something ethically neutral, don’t sweat it. As they say,”Don’t sweat the petty stuff, and don’t pet the sweaty stuff.”

14:1 Him that is weak in the faith receive ye, but not to doubtful disputations. 2 For one believeth that he may eat all things: another, who is weak, eateth herbs. 3 Let not him that eateth despise him that eateth not; and let not him which eateth not judge him that eateth: for God hath received him. 4Who art thou that judgest another man’s servant? to his own master he standeth or falleth. Yea, he shall be holden up: for God is able to make him stand. 5 One man esteemeth one day above another: another esteemeth every day alike. Let every man be fully persuaded in his own mind. 6 He that regardeth the day, regardeth it unto the Lord; and he that regardeth not the day, to the Lord he doth not regard it. He that eateth, eateth to the Lord, for he giveth God thanks; and he that eateth not, to the Lord he eateth not, and giveth God thanks. 7For none of us liveth to himself, and no man dieth to himself. 8For whether we live, we live unto the Lord; and whether we die, we die unto the Lord: whether we live therefore, or die, we are the Lord’s. 9For to this end Christ both died, and rose, and revived, that he might be Lord both of the dead and living.
10 But why dost thou judge thy brother? or why dost thou set at nought thy brother? for we shall all stand before the judgment seat of Christ. 11 For it is written, As I live, saith the Lord, every knee shall bow to me, and every tongue shall confess to God. 12 So then every one of us shall give account of himself to God.

1 3Let us not therefore judge one another any more: but judge this rather, that no man put a stumblingblock or an occasion to fall in his brother’s way. 14I know, and am persuaded by the Lord Jesus, that there is nothing unclean of itself: but to him that esteemeth any thing to be unclean, to him it is unclean. 15 But if thy brother be grieved with thy meat, now walkest thou not charitably. Destroy not him with thy meat, for whom Christ died. 16 Let not then your good be evil spoken of: 17For the kingdom of God is not meat and drink; but righteousness, and peace, and joy in the Holy Ghost. 18For he that in these things serveth Christ is acceptable to God, and approved of men. 19 Let us therefore follow after the things which make for peace, and things wherewith one may edify another. 20 For meat destroy not the work of God. All things indeed are pure; but it is evil for that man who eateth with offence. 21 It is good neither to eat flesh, nor to drink wine, nor any thing whereby thy brother stumbleth, or is offended, or is made weak. 22 Hast thou faith? have it to thyself before God. Happy is he that condemneth not himself in that thing which he alloweth. 23And he that doubteth is damned if he eat, because he eateth not of faith: for whatsoever is not of faith is sin.

15:1 We then that are strong ought to bear the infirmities of the weak, and not to please ourselves. 2Let every one of us please his neighbour for his good to edification. 3 For even Christ pleased not himself; but, as it is written, The reproaches of them that reproached thee fell on me. 4 For whatsoever things were written aforetime were written for our learning, that we through patience and comfort of the scriptures might have hope. 5Now the God of patience and consolation grant you to be likeminded one toward another according to Christ Jesus: 6That ye may with one mind and one mouth glorify God, even the Father of our Lord Jesus Christ.
7 Wherefore receive ye one another, as Christ also received us to the glory of God.

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Since there is so much lying, I’m looking for what people were saying about masks before 2020.
Unmasking the Surgical Mask: Does It Really Work?
by Crystal Phend, Senior Staff Writer, MedPage Today, October 5, 2009, says

The modern surgical mask, successor to the crude gauze strips those early doctors and nurses employed, is still primarily designed to prevent the passage of relatively large particles, such as sputum droplets and hair.

A high tech version — the so-called N95 respirator — seals tightly around mouth and nose and is made of material certified to block 95% of particles 0.3 μm or larger in diameter, roughly the size of a single virus. There’s something resembling agreement that, worn properly, these do their job.

That study involved nearly 2,000 emergency and respiratory ward nurses and physicians in Beijing who were cluster-randomized to wear surgical masks, fit-tested N95 respirators, or non-fit tested N95 respirators during all work hours for four consecutive weeks during the cold and flu season.

Consistent use of N95 respirators prevented 75% of respiratory infections, while consistent surgical mask use was no better than low use for prevention of clinical respiratory illness (6.7% versus 9.2%, P=0.159) or of influenza-like illness (0.6% versus 1.3%, P=0.336).

The case against old-fashioned surgical masks seemed clear.

“To me it would not seem justifiable to ask healthcare workers to wear surgical masks,” MacIntyre said in an interview.

Then another shocker. A second head-to-head study appeared, this time in the Journal of the American Medical Association. It’s conclusion: surgical masks were just as good as N95 respirators.

The 478 emergency department, medical unit, and pediatric nurses in this Canadian study who were randomized to use a surgical mask when providing care to patients with febrile respiratory illness during the flu season caught seasonal flu at about the same rate as those who wore fit-tested, N95 respirators (23.6% versus 22.9%, P=0.86).

For H1N1 influenza, surgical masks again met noninferiority criteria versus the N95 respirator (8.0% versus 11.9%, P=0.18).

That second study is Surgical Mask vs N95 Respirator for Preventing Influenza Among Health Care Workers: A Randomized Trial, Mark Loeb, Nancy Dafoe, et al. JAMA. 2009;302(17): 1865-1871. It didn’t try to test whether wearing some kind of mask was better than wearing no mask at all.

Those two studies are for health care workers who are trained in how to wear masks and are a select group of especially responsible people, not typical of the population– but who are also experienced at taking care that patients don’t infect them by, e.g., suddenly sneezing in their faces. There is some evidence that masks help in taking care of a sick family member at home— but only during the first two days of symptoms:

The only high-level evidence for efficacy of masks in the community was a trial from Hong Kong — published online last month in the Annals of Internal Medicine — involving flu patients who were randomized to hand hygiene alone or in combination with surgical masks.

Compared with controls, employing hand hygiene alone or with face masks tended to reduce transmission of the flu to those living in the same house, but not significantly so.

However, when these interventions were initiated within 36 hours of symptom onset, face masks plus hand hygiene reduced risk of transmission by a very significant 67%.

It’s not reassuring that surgical masks, though universally worn by surgeons, have been found in the main three big studies to be useless for their original purpose: surgery. Yet doctors keep wearing them anyway!

Three large, randomized controlled trials were conducted in the 1980s to determine once and for all if surgical masks actually did prevent surgical wound infection.

Here, where bacteria were the major concern in wound infection, the enemy targets were larger and might not require the fine filtration necessary to keep a respiratory virus away, researchers theorized.

But the trials “showed absolutely no efficacy” for that original purpose, MacIntyre noted.

“Really, the surgeon might as well wear nothing on their face,” she said.

Still, the CDC recommends a mask in the operating room, citing long-standing tradition and the benefits of protecting nose and mouth from splashes of blood and other bodily fluids.

MacIntyre noted that a face shield is a better option against splashes because surgeons have to wear eye protection with a mask anyway.

But mask wearing “is so inculcated into the practice of medicine that it’s going to be very hard to change,” said John G. Bartlett, MD, former chief of infectious diseases at Johns Hopkins.

Tradition and aesthetics play a role in the issue. Patients would not accept a surgeon who doesn’t wear a mask because they are so ingrained as a symbol of a safe surgical environment, Bartlett said.

And since the masks are fairly inexpensive and easy to wear, it hasn’t been worth challenging the status quo, he declared.

The kind of studies discussed here have very limited usefulness. That’s because the chief use of masks is probably for people who aren’t in the studies: the slobs. Slobs, or superspreaders, are the people who never cover their sneezes, and who cough right in their face. They’re people who know they have covid-19 but, like George Floyd, the black man who was killed, go right on walking around inside stores and travelling in cars with their friends. They interact with hundreds of people and don’t care whether they infect anybody else in the slightest, even to the extent of sneezing into their hand instead of into the nose of the person they’re talking with. If we can get the slobs to wear masks and keep them on, we’ve gained a lot.

Of course, it isn’t really that we want them to wear a mask. What we really want is for them to be polite. We want them to cover their mouth when they cough and their nose when they sneeze, and not to spit on the floor after they clear their throat, and to wash their hands after they sneeze on them instead of wiping them off on the bathroom doorknob. The obvious policy would be to make sneezing in public a misdemeanor and coughing in public when you have covid-19 a felony. For some reason, people aren’t interested in that, though. They’d rather have everybody wear masks.

Note, too, that there’s no reason for anybody who’s already had covid-19 to wear a mask. They can’t get it, and they can’t transmit it. “Oh, but they might still be able to get it and transmit it!” people say. Yes, it could be that covid-19 is unlike all other viruses (“all”, advisedly– probably you can find some exotic virus, some minor illness people catch in Kirgizhstan, for which this is not true). “Do you have any evidence that people can get covid19 twice in one year?”, I ask. I’ve heard of such claims, but the obvious explanation is that they didn’t have covid-19 as their first or second illness, since the tests do have a false positive rate of more than 0.0000%?

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Pastor Doug Wilson:

Everything rides on whether the masks actually protect anybody, including your neighbor. If they don’t, then the issue is whether you should make sure to look like you are loving your neighbor. The fact that we live in a hypocritical generation can be seen in the fact that appearances suffice for all.

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