Metropol

I think my main concern right now is for your keyboard which you must be wearing out typing these incredibly long posts.

No most people don’t use masks “properly” but most people aren’t in hospital settings. The point is they are good enough to get the rates down in the outside world.

The problem, consistently, has been the government either being too keen to cut the restrictions and thus undoing all the progress, or failing to properly manage border control which is odd given the obsession with immigration they used to have.

The problem with the soufflé isn’t the recipe or technique of the chef, the problem is the person who keeps barging in and opening the oven door too early.

Pete wrote: Wed 21 Jul, 2021 20.03 I think my main concern right now is for your keyboard which you must be wearing out typing these incredibly long posts.

IBM Model M. Mechanical switches :)

No most people don’t use masks “properly” but most people aren’t in hospital settings. The point is they are good enough to get the rates down in the outside world.

The thing is right at the start of the pandemic I was listening to a very angry Doctor on LBC furious at perfectly healthy people buying up face masks and then her patients who actually needed masks for specific conditions couldn't get them. We went through the entire first wave and first lockdown, not only without mandatory masks, but with constant reminders that there was no evidence they were necessary. Initially, that might have been to try and manage the chronic shortage of PPE, but even after that was resolved still no compulsory mask wearing. Of course it may have been learnt that was wrong which is fair enough in a fast moving situation, but all I recall on masks was a change of message followed by a change of policy with really no justification presented. Now 'we know they cut transmission' with no data I recall ever being presented despite the myriad amount of modelling presented at lengthy press conferences. Exactly what peer-reviewed mask wearing studies have been done to determine they are actually having any significant impact on rates?

Indeed, ISTR that they were first introduced as a requirement shortly after shops & hospitality reopened in order that the then low infection rates stayed that way...based on what has happened since last July, that certainly didn't work out as hoped.

The problem, consistently, has been the government either being too keen to cut the restrictions and thus undoing all the progress, or failing to properly manage border control which is odd given the obsession with immigration they used to have.

Whilst I understand the idea of introducing restrictions with the aim of getting the virus under control, how exactly does it work that we must then keep restrictions to keep the control over the virus that's been gained? I mean, obviously I know how that works in terms of the virus, but in that case if the only way to keep a lid on it is literally to keep a lid on the people too, how do you ever get back to normal? As things are now, the current lockdown was ended over a period of time exceeding 4 months. If that's still going too fast, how slow do you go or how long do you keep restrictions for? If you're going to say 'as long/as slow as is necessary to keep the virus under control' (and of course notwithstanding further new variants) then that rather plays into the arguments I've made. There is no end to it unless a line as to how long Covid can be top priority for is drawn.

And even if we get cases down to a manageable level and managed to keep it there with some combination of testing and vaccination rather than restrictions, what sort of spike becomes unacceptable? If we say get cases down consistently to < 1000 / day, do we then accept 1500 / day as readily as we would now? Countries that have done somewhat better in terms of cases are now obsessed with keeping it that way. In Australia, their initial success with tight border controls and a strict lockdown has left them in a position where the ceiling for acceptable cases is zero. They've now got half the country back in lockdown over case rates we can only dream of and only one death this year.

I'm not sure in what situation cwathen is operating where they would need an entire box of masks to last one day of mask wearing. I have always used the masks as single use, and the short time I used reusable masks I carried enough to don a new one each time.

cwathen wrote: Wed 21 Jul, 2021 19.13 The effects of the attempts to control the virus HAVE and WILL CONTINUE to cause death, whether that's directly or indirectly from reduced life expectancy after people having their lives destroyed or being pushed into poverty from the huge tax increases we will all see to pay for this.

Definitely, my cousin's husband was diagnosed with terminal cancer last autumn, after several months of being fobbed off with phone and e-consultations, and when he did finally get to see a doctor they dragged their heels on getting the test results (they were only finally chased up when a he told a doctor he was seeing for other reasons how he's spent weeks trying to get these test results back and that doctor saw how ill he was), all under the excuse of covid- even though this was over the summer when cases and hospitalisations were low, but doctors surgeries were still like fort knox to get into.

It's a very fast growing, aggressive cancer (prostate cancer that spread to his bones and lymph nodes), and we're all stuck wondering if the doctor had actually seen him properly when he first sought help it could have made a significant difference to his prognosis. Sadly he's now deteriorating, was put on morphine last week and has a few months left at best. Of course it may have been like this anyway, but a three month gap between him first seeking help and finally getting the test results is going to endlessly leave us asking what if.

Admittedly the doctors were fast and very good once they finally realised what they were dealing with, but it was the several months of them barely wanting to know, trying to fob him off with questions over the phone and not following up on the test results once he finally did get a face to face appointment that really sticks in our throat, despite him repeatedly trying to make it clear to the GP that he knew something was badly wrong. Doctors quite simply can't do their job properly from a distance, and I know mine is far from the only similar story that's going to come out of the last 18 months or so as a result of covid being placed above all else, even at times of low prevalence.

cwathen wrote: Wed 21 Jul, 2021 20.33Exactly what peer-reviewed mask wearing studies have been done to determine they are actually having any significant impact on rates?

https://gh.bmj.com/content/5/5/e002794
https://www.cdc.gov/mmwr/volumes/69/wr/mm6928e2.htm
https://pubmed.ncbi.nlm.nih.gov/33087517/
https://www.tandfonline.com/doi/full/10 ... 20.1862409
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327717/
https://advances.sciencemag.org/content/6/36/eabd3083
https://pubmed.ncbi.nlm.nih.gov/32525850/
https://pubmed.ncbi.nlm.nih.gov/32931726/
https://www.thelancet.com/journals/land ... 4/fulltext

Just a couple

I thought my posts were long!

Let's see where we are by September. Deaths may jump again perhaps for the last time, but does that require a lockdown? I don't think so. The population will be vaccinated, unlike before.

On the London tube its 70% wearing masks and the rest not, this seems to be true of the other population settings. We are heading back to to normal for the moment at least. Let us hope we can reach the goal.

I have genuine hope that this will be over soon.

bilky asko wrote: Wed 21 Jul, 2021 20.49

cwathen wrote: Wed 21 Jul, 2021 20.33Exactly what peer-reviewed mask wearing studies have been done to determine they are actually having any significant impact on rates?

..

Just a couple

I will read them

EDIT - I have dutifully read the lot. I'm sure if I didn't reply at all that would be proof of me being a dick and a genocidal maniac and you have dealt with this by posting a long list of links, and if I do reply that will be evidence of me being a dick trying to prove a point by actually bothering to read your long list of links and comment on them rather just accepting that as an argument and move on. If you read my original post, it's acknowledging that masks aren't that much of an imposition, nor do I claim that they have no utility since they existed before. It's just that demonstrably based on how high peaks have been with masks suggests they ain't really doing much in the real world given that they are generally not used properly, not always new/clean, and many of the rules that existed don't even mandate them for much of the time (eg walk into pub with mask on, sit down, remove mask, spend entire time in the pub unmasked, but must put mask on to leave - what exactly is the mask supposed to be doing in the 40 seconds total it is being worn for? Yet this is compliant). It was also about the wider issue that if masks stay than everything can stay and we'll never get out of this. This was never meant to be a mask debate, but here we go...

https://gh.bmj.com/content/5/5/e002794

Article about transmission within households where continuous contact times are going to be measured in hours or days not minutes. Not directly related to effectiveness in reducing transmission in brief contact with people you don't know such as walking around a shop. And also, we don't even recommend wearing masks within your own household. Based on this we should.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6928e2.htm

Article about Salon workers working in close contact with clients. Average duration of exposure between two individual people was > 19 minutes. Again, not directly comparable with walking around a shop. The inference is that Stylist B caught Covid from Stylist A but they were both wearing masks...in a paper supporting mask wearing. Only about half of the clients actually had negative transmission confirmed with a test, the other half refused and so their report of having had no symptoms has been taken verbatim as evidence of lack of transmission despite it being known that a lot of infected people have no symptoms. Draws a direct correlation between almost everyone wearing masks and (a flawed claim of) no secondary transmission from the infected worker to the clients must mean the masks prevented this. But there is no control to show what would happen without a mask since this is not a controlled study. However...the masked up Stylist B caught symptomatic Covid but the two clients who didn't wear a mask either didn't verified by a test or did not have symptoms but were untested and for the purposes of this paper are assumed to have not caught Covid even without a mask. The only close contacts of Stylist A who tested positive lived with her. Yes presumably unmasked, but *lived with her*. Stylist B's close contacts did not become symptomatic but nothing is said about whether or not they were tested so actual (presumably unmasked) transmission from Stylist B's close contacts is unknown. Was this thing actually peer reviewed? I don't think everything on CDC is, and would suggest this was not.

https://www.tandfonline.com/doi/full/10 ... 20.1862409

This is a lab test, not a real world study. However does show that in the test basic surgical masks block 59% of cough particles. I'll be honest, didn't think it would be that high. However that's very different to 'reduces Covid transmission by 59%'. What is very interesting though, is that in the UK we are touting face shields as being equivalent to masks for people who can't wear them. No one's risk assessment or door greeter policy will bat an eyelid at a face shield. And yet this study finds that they only blocked 2% of particles vs the surgical mask. In a lab test under ideal conditions. Seems to conclude that face shields do absolutely shit all in the real world. If we're following the science, why are they a thing treated as equivalent to masks? It does actually show how effective an N95 mask is with it stopping 99% of the tested particles. Which brings us back to the question of if masks are so important to wear briefly whilst walking around a shop, why aren't we spending money making better masks easily available and then requiring them as the standard for mask wearers?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327717/

Another lab test on simulated cough particles, not a real world study. And again, not every cough particle is transmitting Covid. The control is a completely uncovered cough. As opposed to one with a hand or hanky covering it. Shows effectiveness of commercial masks in stopping cough particles but notably concludes that a bandana (which would be considered totally acceptable as a face covering under UK face covering rules) can still allow cough particles to transmit over 1 metre, so if we still had '1 metre plus' by this study a person coughing with a bandana can still infect a metre away from them even though face covering and social distancing rules were being followed.

https://advances.sciencemag.org/content/6/36/eabd3083

Whatdayaknow, another lab test. Different and better approach to the test actually as it is based on risk from being around someone speaking to you rather than coughing into your face. However this is based on droplets remaining in the air in the immediate vicinity of the speaker and the potential exposure that might follow for 20 seconds after that. Again, not relevant to walking through a shop. Not really sure though how scientifically valid taking pictures with an off the shelf Galaxy S9 without sign off from Samsung that the phone is suitable for this use and putting the results through some software (PyMieScatt - that's a name!) which cites usage by the author and others but doesn't actually seem to be accredited by anyone. The paper acknowledges being 'proof of principle', and that it could be a base for further studies. This is actually really interesting work but it's hardly evidence of anything. Does draw basically the same conclusions though, which is that an N95 which hardly anyone wears is a good mask, and a completely UK-compliant bandana style face covering does not work,

https://pubmed.ncbi.nlm.nih.gov/32525850/

Finally, analysis of an actual outbreak of Covid. Unfortunately it's 5000 people on an aircraft carrier living in close quarters. Transmission was still at 55% through the covering vs 80% without. Shows a relative reduction of 37.5% from a face covering, in a very crowded environment with very long periods of exposure, and also worth noting this outbreak occured in March 2020 when Covid was very new, no vaccines existed and there was almost no natural immunity making almost everyone a vector for transmission in a way they aren't now. Extrapolate that out to walking around Sainsbury's for 10 minutes in July 2021 and I doubt you'll have much left.

https://pubmed.ncbi.nlm.nih.gov/32931726/

More of a sociology piece, finds that mask wearers are more likely to practice social distancing and as such likely to remain >1m from others, keep close contact to <15 mins from others, frequently wash their hands and as such are at lower risk of infection, with masks being part of that lower risk. Umm...yeah not really much to argue with there, just not sure how it supports the argument that masks are a necessary and seemingly vital tool bringing about significant reduction in transmission in themselves which was the question.

https://www.thelancet.com/journals/land ... 4/fulltext

Well interpolated data and really good sample size, but not any sort of controlled study. Just attempts to draw a link between self-reported use of masks *AND* physical distancing, and the probability of relative transmission.

Australia's issue is one of complacency, the fact the Federal Government bungled the vaccine rollout. If they had similar vaccine rates to the UK or even the US, they wouldn't be having lockdowns and their quarantine system is not to task.

I think once vaccination rates for the adult population is high enough and we start vaccinating teenagers, things will get easier and supply is something we'll have an abundance of if the Novavax, Valneva and GSK/Sanofi vaccines get approved although I expect some of those will be donated to poorer countries.

I've mentioned oral treatments before which to me to key to any future handling of Covid for the general population much they do when you get the flu. Vaccines are crucial for preventing moderate and severe disease but a treatment that can cut the time that you're ill is just as important. There will always be outbreaks in certain settings but you can keep a lid on it if the treatments are in place.

As a thought does wearing face coverings reduce transmissions of Covid (and other germs) by causing people to subconsciously change their behaviour? Potentially wearing a mask yourself and/or seeing others wearing masks may alter what you choose to do, which in turn could help reduce the rate at which it spreads.

Jonwo wrote:Australia's issue is one of complacency, the fact the Federal Government bungled the vaccine rollout. If they had similar vaccine rates to the UK or even the US, they wouldn't be having lockdowns and their quarantine system is not to task.

You know what, I think they still would. Vaccination will never stop every case, every hospitalisation and every death. Australia is still pursuing a zero-Covid policy long after virtually every country on earth accepts that's unachievable. Every single case is a cause for concern and lockdowns are being called over single digit numbers of cases. Nobody died in Australia for about 9 months, and I know ideologically you can say that any death is one death too many, but in Australia they literally are working on a policy that any death is one death too many and action must be taken. Even adjusting for the population size, virtually every other country on earth would be treating the pandemic as being over on case rates that Australia is going into lockdowns for.

Charlie Wells wrote:As a thought does wearing face coverings reduce transmissions of Covid (and other germs) by causing people to subconsciously change their behaviour? Potentially wearing a mask yourself and/or seeing others wearing masks may alter what you choose to do, which in turn could help reduce the rate at which it spreads.

Undoubtedly in some people who might view the masks as meaning things are more serious leading to them to do the same, but we can't really have policies run on abstract bits of social engineering theory. I have also seen the reverse - people deriving a false sense of security from their masks and then no longer being as hot on physical distancing as they were previously. In fact back in the early days of the pandemic when few people wore masks there was a clear subset of then mask wearers who seemed to think it was akin to wearing a hazmat suit and started getting very close to people back when diligently staying 2 metres apart was the norm.

cwathen wrote: Thu 22 Jul, 2021 21.31
You know what, I think they still would. Vaccination will never stop every case, every hospitalisation and every death. Australia is still pursuing a zero-Covid policy long after virtually every country on earth accepts that's unachievable. Every single case is a cause for concern and lockdowns are being called over single digit numbers of cases. Nobody died in Australia for about 9 months, and I know ideologically you can say that any death is one death too many, but in Australia they literally are working on a policy that any death is one death too many and action must be taken. Even adjusting for the population size, virtually every other country on earth would be treating the pandemic as being over on case rates that Australia is going into lockdowns for.

Australia's issue and it applies to an extent to NZ is that they have little to no natural immunity to Covid so the wave they're having in NSW would be devastating if it was allowed to let rip. Once they have high enough vaccination rates and I think they'll get there by the end of the year or early 2022, the premiers of the various states have already said that it'll be time to look at reopening to the rest of the world. They know that lockdowns can't be used as a tool once those rates are high in the long term and keeping the borders shut both internally and externally hurts the economy,

They put their eggs in one baskets with AstraZeneca whereas other countries including the UK decided to buy multiple vaccines to spread the risks in case one fell through or fell behind schedule and not spending the money on proper facilities for isolation, the cost to build these facilities is far lower than what it cost to keep cities in lockdown.