Tag Archives: Mask Mandates

The Great Unmasking: Take Back Your Stolen Face!

28 Friday Jan 2022

Posted by in Masks, Pandemic

≈ Leave a comment

Tags

, , , , , , , , , , , , , , , , , , , , , , , , ,

Right at the start of the pandemic, Dr. Anthony Fauci insisted that masks were unnecessary, which was in line with the preponderance of earlier evidence. Later, he sowed confusion — and distrust — by claiming he said that to discourage a run on masks, thus preserving supplies for the medical community. That mix-up put a stain on his credibility among those who were paying attention, and the reversal was simply bad policy given what is well established by the evidence on mask efficacy.

No Mas, No Mask!

Despite my own doubts about the efficacy of masks, I went along with masking for a while. It gave me a chuckle to see people wearing them outside, especially runners, or solo drivers. We knew by then that contracting Covid outside was highly unlikely. I was also amused by the idiotic protocols in place at many restaurants, where it was just fine to remove them once you walked a few feet to sit at your table, as if aerosols indoors were bound within narrow bands of altitude. Finally, I had reservations about the health consequences of frequent masking, which have certainly been borne out. Restricting air flow is generally not good for human health! Neither is trapping bits of sputum and hot, exhaled moisture rich in microbes right up against one’s muzzle. Still, I thought it polite to wear a mask in places of business, and I did so for a number of months.

In time it became apparent that the cloth and paper masks we were all wearing were a waste of effort. Covid is spread via fine aerosols and generally not droplets. That’s important because the masks in common use cannot block a sufficient level of Covid particles from escaping nor from penetrating through gaps and through the fiber itself. Neither can N95s if not fitted properly, as so many are not. And none of these masks can protect your eyeballs! When tens of thousands of tiny beads of aerosol are released with each cough or exhalation, a mask that stops 70% of them will not accomplish much.

The evidence began to accumulate that mask mandates were completely ineffective at “stopping the spread” of Covid. I then became an ardent anti-masker. I generally don’t wear them anywhere except medical buildings, and then only because I refuse to defer normal medical care, the consequences of which have been tragic during the pandemic. I have told clerks “I don’t need a mask”, which is true, and they have backed off. I have turned on my heal at stores that refuse to give on the issue, but like masks themselves, the signs on the doors are usually more for show than anything else. So I walk right past them.

Now, the Biden Administration has decided to provide to the public 400 million N95 masks — on the taxpayer! It’s a waste of time and money. But the timing is incredible, just as the Omicron wave crashes on it’s own. It will be one more worthless act of theatre. But don’t doubt for a moment that Joe Biden, when no one remembers the timing, will claim that this action helped defeat Omicron.

Mask Varieties

What is the real efficacy of masks in stopping the spread of Covid aerosol emissions? Cloth masks, including bandanas and scarves, are still the most popular masks. Based on casual observation, I suspect most of those masks aren’t washed as frequently as they should be. People hang them from their rear view mirrors for God knows how long. Beyond that, cloth masks tend to fit loosely and protect from aerosols about as well as the disposable medical or surgical masks that are now so common. Which is to say they don’t provide much protection at all.

But can that be? Don’t surgeons think they help? Well yes, because operating rooms can be very splattery places. Besides, it’s rude to sneeze into your patient’s chest cavity. Protection against fine aerosols? Not so much. “Oh, but should I double mask?”, you might ask? Gross! Just Shut*Up!

Face shields are “transparently” useless, offering no barrier against floating aerosols whatsoever except a fleeting moment’s protection against those blown directly into the wearer’s face. Then there are respirator masks: N95 and KN95, which are essentially the same thing. The difference is that KN95s must meet Chinese performance standards rather than U.S. standards. Both must filter and capture 95% of airborne particles as small as 0.3 microns. Covid particles are smaller than that, but the aerosol “beadlets” in which they are swathed may be larger, so the respirators would appear to be a big step up from cloth or surgical masks. R95 and P95 masks are made for protection against oil-based particles. They seem to be better overall due to thicker material and tighter fit with an overhead strap and extra padding.

Measuring Mask Efficacy

A thorough assessment of these mask types is documented in a 2021 paper published in The Physics of Fluids. Here are the baseline filtration efficiencies measured by the authors with an ideal mask fit relative to exhalation of 1 micron aerosols:

  • Cloth_______40%
  • Surgical____47%
  • KN95_______95%
  • R95_________96%

These are simply the filtration efficiencies of the respective barrier materials used in each type of mask, as measured by the researcher’s tests. Obviously, cloth and surgical masks don’t do too well. Unfortunately, even the N95 and KN95 masks never fit perfectly:

“It is important to note that, while masks … decrease the forward momentum of the respiratory jet, a significant fraction of aerosol escapes the masks, particularly at the bridge of the nose.”

Next, the authors assess the “apparent” filtration efficiencies of masks measured by relative aerosol concentrations in an enclosed space, measured two meters away from the source, after an extended period. This is a tough test for a mask, but it amounts to what people hope masks can accomplish: trapping aerosols containing bits of crap on material surrounding the nose and mouth, and for many hours. Here are the results:

  • Cloth___________9.8%
  • Surgical_______12.4%
  • KN95__________46.3%
  • R95____________60.2%
  • KN95-Gap______3.4%
  • KN95-Valve____20.3%

Cloth and surgical masks don’t do much to reduce the aerosol concentrations. Both the KN95 and R95 masks capture a meaningful share of the aerosols, but the R95 is a bit more effective. Remember, however, that the uncaptured share is a stand-in for the many thousands of virus particles that would remain suspended within the indoor space, so the filtration efficiency of the R95, while far superior to cloth or surgical masks, would do little to mitigate the spread of the virus. The KN95-Gap case is a test of a more “loosely fitted” mask with 3 mm gaps, which the authors say is realistic. Under those circumstances, the KN95 is about as good as nothing. Finally, the authors tested a well-fitted KN95 equipped with a one-way discharge valve. While its efficiency was better than cloth or surgical masks, it still performed poorly. The authors also found that various degrees of air filtration were far more effective in reducing aerosol concentrations than masks.

On the subject of mask fit, I quote Dr. Robert Lending, who has regularly chronicled pandemic developments for patients in his practice since the start of the pandemic:

“N95 type masks cannot be worn by men with beards. They must be so tightly fitted that they leave deep creases in your face. Prior to Covid-19, when hospital employees had to wear them for TB exposure prevention, they were told not to wear them for more than 3 hours at a time. They had to be fit-tested and gas leak-tested. … The N95 knockoffs such as the KN95s are not as good. N95 with valves do not protect others from you. There are now many counterfeit N95s for sale. … Obviously, N95s were never meant to be worn for 8-12 hours; and certainly not by youth and school children. If you are wearing an N95 and you can smell anything, such as aroma in a restaurant when you walk in, perfume, cologne, coffee, citrus, foul odors, etc.; then your fit is not correct and that N95 is worthless.”

Other Evidence

Another kind of evidence on mask efficacy is offered by randomized control trials (RCTs) in mitigating transmission of the influenza virus across a variety of settings, including hospital wards, schools, and neighborhoods of varying characteristics. A meta-analysis of 44 such RCTs published in the Cochran Library in late 2020 found that surgical masks make little or no difference to the spread of the virus. In a small set of RCTs from health care settings, the authors found that N95 and P95 masks perform about as well as surgical masks in limiting transmission.

An excellent review of research on mask efficacy appeared in City Journal last August. The author, Jeffrey H. Anderson, was fairly awestruck at the uniformity of RCT evidence that masks are ineffective. One well-publicized RCT purporting to show the opposite relied on effects that were negligible. Meanwhile, other research has shown that state-level mask mandates are ineffective at reducing the spread of the virus. Finally, here is a nice “cheat sheet” containing links to a number of mask studies.

Children

Children in many parts of the country are forced to wear masks at school. It’s well-established, however, despite wailing from teachers’ unions, that Covid poses extremely low risks to children. And there is no shortage of evidence that constant masking has extremely negative effects on children. The stupidity has reached grotesque proportions. Now, some school districts are proposing that children wear N95 masks! This is unnecessary and cruel, and it is ineffective precisely because children will be even less likely to use them properly than adults, who are generally not very good at it. From the last link:

“If N95s filter so well, why are respirators an ineffective intervention? Because masking is a behavioral intervention as much as a physical one. For respirators to work, they must be well fitting, must be tested by OSHA, and must be used for only short time windows as their effectiveness diminishes as they get wet from breathing.

“Fit requirements and comfort issues are untenable in children who have small faces and are required to wear masks for six or more hours each day. For these reasons, NIOSH specifically states that children should not use respirators, and there are no respirators that are approved for children. These views are shared by the California Department of public health. Concerns about impaired breathing and improper use outweigh potential benefits. There are no studies on the effectiveness of respirators on children because they are not approved for pediatric use.”

Rip It Off

At this point in the Omicron wave, which appears to have crested, we’re basically dealing with a virus that is less lethal than the flu and, for most people, comparable to the common cold. It’s a good time for the timid to shed their masks, which don’t help contain the spread of the virus to begin with. And masks do more harm than has generally been acknowledged, especially to children. So stop the bullshit. Take off your mask, and leave it off!

Mask Truths and Signals

26 Tuesday Oct 2021

Posted by in Coronavirus, Public Health

≈ 6 Comments

Tags

, , , , , , , , , , , , , , , , , , , ,

It’s been clear since the beginning of the pandemic that your chance of getting infected with COVID outside is close to zero. (Also see here). Yet I still see a few masked people on the beach, in the park, on balconies, and walking in the neighborhood. Given the negligible risk of contracting COVID outdoors, the marginal benefit of masking outdoors is infinitesimal. Likewise, the benefit of a mask to the sole occupant of a vehicle is about zilch. Okay, some individuals might forget to remove their masks after leaving a “high-risk” environment. Sure, maybe, but cloth masks really don’t stop the dispersion of fine aerosols anywhere, indoors or outdoors. Of course, the immune-compromised have a reasonable excuse to apply the precautionary principle, but generally not outside with good air quality.

The following link provides a list of mask studies, and meta-studies. Several describe randomized control trials (RCTs). They vary in context, but all of them reject the hypothesis that masks are protective. Positive evidence on mask efficacy is lacking in health care settings, in community settings, and in school settings, and the evidence shows that masks create “pronounced difficulties” for young children and “emotional interference” for school children of all ages. Here’s another article containing links to more studies demonstrating the inefficacy of masks. Also see here. And this article is not only an excellent summary of the research, but it also highlights the hypocrisy of the “follow the science” public health establishment with respect to RCTs. Compliance is not even at issue in many of these studies, though if you think masks matter, it is always an issue in practice. Even studies claiming that cloth masks of the type normally worn by the public are “effective” usually concede that a large percentage of fine aerosols get through the masks… containing millions of tiny particles. In indoor environments with poor ventilation, those aerosols remain suspended in the air for periods long enough to be inhaled by others. That, in fact, is why masks are ineffective at preventing transmission.

Another dubious claim is that masks are responsible for virtually eliminating cases of influenza in 2020 and 2021. Again, to be charitable, masks are of very limited effectiveness in stopping viral transmission. Moreover, compliance has been weak at best, and areas without mask mandates have experienced the same plunge in flu cases as areas with mandates. A far more compelling explanation is that viral interference caused the steep reduction in flu incidence. The chance of being infected with more than one virus at a time is almost nil. Simply put, COVID outcompeted the flu.

Again, I grant that there are studies (though only a single randomized control trial out of India of which I’m aware) that have demonstrated significant protective effects. Even then, however, the mixed nature of this body of research does not support intrusive masking requirements.

Nevertheless, masks are still mandated in some jurisdictions. Those mandates usually don’t apply outdoors, however, and not in your own damn car! Mask mandates contribute to the general climate of fear surrounding COVID, which is wholly unjustified for most children and healthy working-age people. Public health messaging should focus on high-risk individuals: the elderly, the obese, and those having so-called comorbidities and compromised immune systems. Those groups have obvious reasons to be concerned about the virus. They have excuses to be germaphobic! Still, they are at little risk outdoors, the value of masks is doubtful, and breathing deep of fresh air is good for you in any case!

The incidence of COVID has declined substantially in many areas since early September, but the virus is now almost certainly endemic and is likely to return in seasonal waves. However, the Delta wave was far less deadly than earlier variants, a favorable trend many believe will continue. These charts from the UK posted by Michael Levitt demonstrate the improvement vividly. Perhaps the mask craze will fade away as the evidence accumulates.

The pandemic has been a moment of redemption for germaphobes, but no reasonable assessment of risk mitigation relative to the cost, inconvenience, discomfort, and psychological debasement of face jackets can prove their worth outdoors. Their value indoors is nearly as questionable. Yet there remains a stubborn reluctance by public health authorities to lift mask mandates. There are far too many individuals masking outdoors, and to be nice, perhaps it’s mere ignorance. But there are still a few would-be tyrants on Twitter presuming to shame others into joining this pathetic bit of theatre. I believe Anne Wheeler nailed it with this recent tweet:

“This is one of the first things you learn in OCD therapy – you don’t get to make people participate in your compulsions in order to lesson your own anxiety. It’s bizarre that it’s been turned into a virtue.”

There’s also no question that masks are still in vogue as a virtue signal in some circles, but a mask outdoors, especially, is increasingly viewed as a stupid-signal, and for good reason. I’ll continue to marvel at the irrationality of these masked alarmists, who just don’t understand how foolish they look. Give yourself permission to get some fresh air!

In Praise of Voluntary Vaccination

31 Tuesday Aug 2021

Posted by in Coronavirus, Vaccinations

≈ Leave a comment

Tags

, , , , , , , , , , , , , , , , ,

I was vaccinated in March and early April and I’m damn glad to have done it. I have certain co-morbidities, and I’m of an age at which contracting COVID seems like a very bad idea, I felt a little run-down on the day after my second jab, but that was my only side effect, notwithstanding the unending litany of antivax hysterics to which we’ve all been subjected (even on certain sites to which I contribute).

Freedom Without Misinformation

In the context of the pandemic, it’s important to take a stand for liberty. In that spirit, I oppose the imposition of mandates requiring face masks and vaccinations against COVID. Furthermore, vaccination is at best unnecessary for those having acquired immunity from infection and for those at low risk, especially children. In fact, the younger, healthier, and fitter you are, the less important it is to be vaccinated.

It’s disappointing, however, to see completely innumerate people cite statistics purporting to show that COVID-19 vaccines are deadly or even particularly dangerous to those lacking contra-indications. Far worse, and far more idiotic, is to suggest that a conspiracy is afoot to kill large numbers of people via vaccination! I’m truly embarrassed to hear individuals who otherwise share my libertarian ideals say such irresponsible bullshit.

While the COVID vaccines seem to have more frequent side effects than earlier vaccines, they are not particularly risky. I’ll discuss the safety of the COVID vaccines in what follows. Even minuscule risks are unacceptable to some individuals, which of course is their right. However, others find these risks acceptable considering the far greater dangers posed by the early strains of COVID and even the more recent but less deadly Delta variant.

Unverified Adverse Events

The vaccine scaremongers often quote statistics from the CDC’s Vaccine Adverse Reporting Events System (VAERS). Here’s a disclaimer about the system from the CDC’s web site:

“Healthcare providers, vaccine manufacturers, and the public can submit reports to VAERS. While very important in monitoring vaccine safety, VAERS reports alone cannot be used to determine if a vaccine caused or contributed to an adverse event or illness. The reports may contain information that is incomplete, inaccurate, coincidental, or unverifiable.”

All kinds of reports are submitted alleging adverse events. For example, one observer cites the following reports from the system:

The link above refers to the following report as “Hulk Syndrome”, which was alleged to have been a side effect of the MMR vaccine:

Finally, we have this report related to the Pfizer COVID vaccine:

In case that’s hard to read, it claims that a COVID vaccine caused a third arm to grow from the reporting individual’s forehead, which constantly slaps him or her while trying to sleep. This report is a case of wonderful sarcasm, but it was submitted to VAERS! The real lesson is that the VAERS system collects many unverified accounts of side effects, so the aggregate counts of adverse events are not reliable, even by the CDC’s admission.

A More Sober Risk Assessment

Therefore, the VAERS system has obvious limitations. But even stipulating the use of VAERS reports, the risks of the COVID vaccines are vanishingly low. For example, roughly 198 million people in the U.S. have received at least one dose of a vaccine. As of last week, there had been about 13,600 reports of post-vaccination death in VAERS. The raw number is very high, and I don’t wish to minimize the seriousness of those losses. Nevertheless, if those deaths were all attributable to vaccination, and that is a BIG “if”, the risk of death from vaccination to-date is just 0.007%. That is seven thousandth of 1%. 

To put those VAERS deaths into perspective, I should first add the caveat that I am highly skeptical of the COVID case and death statistics. Nevertheless, let’s take the official U.S. COVID death toll of 646,000 at face value. I’m also treating reported vaccine deaths from VAERS at face value, which is a huge stretch. So, we have COVID mortality of 0.2% of the U.S. population, which is more than 28 times the risk of death from vaccination. I grant you the risk posed by COVID is lower going forward than in the past, which is due both to vaccinations and the declining virulence of the virus itself.

There are a range of vaccine side effects reported in VAERS, from pain near the injection site to such alarming conditions as anaphylaxis, Bell’s Palsy, and myocarditis/pericarditis. VAERS would attribute over 54,000 hospitalizations to the vaccines, a rate of 3 hundredths of one percent of those receiving at least one dose. Like COVID deaths, the number of COVID hospitalizations is likely inflated. Still, at 1.9% of the U.S. population, the risk of hospitalization from COVID is 68 times that of hospitalization from vaccine side effects reported in VAERS.

A large share of VAERS reports, covering all adverse events, are from middle aged individuals. It’s unclear how concentrated that reporting is among those with co-morbidities, including obesity, but I suspect they are heavily represented.

Coincidental Events

Perhaps less obvious is that many sincere reports to VAERS from both the public and health care providers represent coincidental events. A number of states have given heavy vaccine priority to the elderly and those with co-morbidities, and demand from those groups has been disproportionate in any case. Most of the VAERS-reported deaths also happen to be among the elderly and co-morbids.

For example, more than 38% of VAERS death reports come from the 80+ age cohort, accounting for roughly 5,200 deaths. That’s four hundredths of one percent of the 12.9 million people of ages 80+ in the U.S., most of whom have been vaccinated. Well over 1.2 million 80+ year-olds can be expected to die each year under normal circumstances. That a few would occur within days, weeks, or months of a vaccination should be expected. Furthermore, it would not be surprising, given the controversy surrounding vaccines and the suggestive power of antivax propaganda, for families or some caregivers to imagine a connection between vaccination and subsequent death. File a report! Who knows? Perhaps a class action award might be in it someday.

This is not to deny that a small number of individuals could be in such weakened states, or perhaps have unknown vulnerabilities, that the vaccines have catastrophic consequences. No doubt there are a few deaths precipitated by COVID vaccines in combination with other conditions. However, a large share of the deaths reported to VAERS are likely to have been coincidental. Likewise, people develop conditions all the time… sore joints, rashes, coughs, and headaches. It runs the gamut. Some of the VAERS reports of a less serious nature are undoubtedly coincidental, and perhaps some are due to the vivid imaginations of a subset of those having consented to the vaccine with great reluctance.

What Kills and What Doesn’t

Everything comes with a risk, and tradeoffs between risks must be balanced. The COVID pandemic was deadly, and I’ll be the first to admit that I underestimated its potential to kill. However, its deadliness was magnified by the non-pharmaceutical interventions imposed in many jurisdictions. Lockdowns and closures took a massive toll on the health of the population, cutting short many lives due to economic and personal despair as well as deferred and cancelled health care. While those interventions were deadly, I do not believe that kind of harm was intended. I do suspect the concomitant assault on liberty was welcomed in certain circles.

There are certainly downsides to the COVID vaccines. There have been more side effects and deaths than have ever been reported relative to earlier vaccines. It’s also a shame that public health authorities refuse to recognize the superior effects of natural immunity and the heightened risk of vaccinations to those with prior infections. And it’s a travesty that “vaccine passports” are now being demanded for various forms of travel, entertainment, and entry to some places of business. Despite these issues, it’s blatantly false to assert that the vaccines are generally harmful. Many more of the remaining vaccine-hesitant can benefit from vaccination. Let’s advocate for better assessments of risk by age and co-morbidity, and simply avoid the vaccines if that is your preference.

Addendum: I just came across this nice piece entitled “A Statistical Analysis of COVID-19 Breakthrough Infections and Deaths“. I thought I should share the link in case anyone supposes that so-called breakthrough infections somehow invalidate some of the comparisons I made above. This chart is particularly revealing:

Vax Results, Biden Boosters, Delta, and the Mask Charade

19 Thursday Aug 2021

Posted by in Coronavirus, Public Health, Uncategorized, Vaccinations

≈ Leave a comment

Tags

, , , , , , , , , , , , , , , , , , , , , ,

If this post has an overarching theme, it might be “just relax”! That goes especially for those inclined to prescribe behavioral rules for others. People can assess risks for themselves, though it helps when empirical information is presented without bias. With that brief diatribe, here are a few follow-ups on COVID vaccines, the Delta wave, and the ongoing “mask charade”.

Israeli Vax Protection

Here is Jeffrey Morris’ very good exposition as to why the Israeli reports of COVID vaccine inefficacy are false. First, he shows the kind of raw data we’ve been hearing about for weeks: almost 60% of the country’s severe cases are in vaccinated individuals. This is the origin of the claim that the vaccines don’t work. 

Next, Morris notes that 80% of the Israeli population 12 years and older are vaccinated (predominantly if not exclusively with the Pfizer vaccine). This causes a distortion that can be controlled by normalizing the case counts relative to the total populations of the vaccinated and unvaccinated subgroups. Doing so shows that the unvaccinated are 3.1 times more likely to have contracted a severe case than the vaccinated. Said a different way, this shows that the vaccines are 67.5% effective in preventing severe disease. But that’s not the full story!

Morris goes on to show case rates in different age strata. For those older than 50 (over 90% of whom are vaccinated and who have more co-morbidities), there are 23.6 times more severe cases among the unvaccinated than the vaccinated. That yields an efficacy rate of 85.2%. Vaccine efficacy is even better in the younger age group: 91.8%. 

These statistics pertain to the Delta variant. However, it’s true they are lower than the 95% efficacy rate achieved in the Pfizer trials. Is Pfizer’s efficacy beginning to fade? That’s possible, but this is just one set of results and declining efficacy has not been proven. Israel’s vaccination program got off to a fast start, so the vaccinated population has had more time for efficacy to decay than in most countries. And as I discussed in an earlier post, there are reasons to think that the vaccines are still highly protective after a minimum of seven months.

Biden Boosters

IIn the meantime, the Biden Administration has recommended that booster shots be delivered eight months after original vaccinations. There is empirical evidence that boosters of similar mRNA vaccine (Pfizer and Moderna) might not be a sound approach, both due to side effects and because additional doses might reduce the “breadth” of the antibody response. We’ll soon know whether the first two jabs are effective after eight months, and my bet is that will be the case.

Is Delta Cresting?

Meanwhile, the course of this summer’s Delta wave appears to be turning a corner. The surge in cases has a seasonal component, mimicking the summer 2020 wave as well as the typical Hope-Simpson pattern, in which large viral waves peak in mid-winter but more muted waves occur in low- to mid-latitudes during the summer months.

Therefore, we might expect to see a late-summer decline in new cases. There are now 21 states with COVID estimated reproduction rates less than one (this might change by the time you see the charts at the link). In other words, each new infected person transmits to an average of less than one other person, which shows that case growth may be near or beyond a peak. Another 16 states have reproduction rates approaching or very close to one. This is promising.

Maskholes

Finally, I’m frustrated as a resident of a county where certain government officials are bound and determined to impose a mask mandate, though they have been slowed by a court challenge. The “science” does NOT support such a measure: masks have not been shown to mitigate the spread of the virus, and they cannot stop penetration of aerosols in either direction. This recent article in City Journal by Jeffrey H. Anderson is perhaps the most thorough treatment I’ve seen on the effectiveness of masks. Anderson makes this remark about the scientific case made by mask proponents:

“Mask supporters often claim that we have no choice but to rely on observational studies instead of RCTs [randomized control trials], because RCTs cannot tell us whether masks work or not. But what they really mean is that they don’t like what the RCTs show.”

Oh, how well I remember the “follow-the-science” crowd insisting last year that only RCTs could be trusted when it came to evaluating certain COVID treatments. In any case, the observational studies on masks are quite mixed and by no means offer unequivocal support for masking. 

A further consideration is that masks can act to convert droplets to aerosols, which are highly efficient vehicles of transmission. The mask debate is even more absurd when it comes to school children, who are at almost zero risk of severe COVID infection (also see here), and for whom masks are highly prone to cause developmental complications.

Closing Thoughts

The vaccines are still effective. Data purporting to show otherwise fails to account for the most obvious of confounding influences: vaccination rates and age effects. In fact, the Biden Administration has made a rather arbitrary decision about the durability of vaccine effects by recommending booster shots after eight months. The highly transmissible Delta variant has struck quickly but the wave now shows signs of cresting, though that is no guarantee for the fall and winter season. However, Delta cases have been much less severe on average than earlier variants. Masks did nothing to protect us from those waves, and they won’t protect us now. I, for one, won’t wear one if I can avoid it.

Herd Immunity To Public Health Bullshitters and To COVID

16 Monday Aug 2021

Posted by in Coronavirus, Herd Immunity, Uncategorized

≈ Leave a comment

Tags

, , , , , , , , , , , , , , , , , , , , , , , ,

My last post had a simple message about the meaning of immunity: you won’t get very sick or die from an infection to which you are immune, including COVID-19. Like any other airborne virus, that does NOT mean you won’t get it lodged in your eyeballs, sinuses, throat, or lungs. If you do, you are likely to test positive, though your immunity means the “case” is likely to be inconsequential.

As noted in that last post, we’ve seen increasing COVID case counts with the so-called Delta variant, which is more highly transmissible than earlier variants. (This has been abetted by an uncontrolled southern border as well.) However, as we’d expect with a higher level of immunity in the population, the average severity of these cases is low relative to last year’s COVID waves. But then I saw this article in ScienceAlert quoting Sir Andrew Pollard, a scientist affiliated AstraZeneca and the University of Oxford. He says with Delta, herd immunity “is not a possibility” — everyone will get it.

Maybe everyone will, but that doesn’t mean everyone will get sick. His statement raises an obvious question about the meaning of herd immunity. If our working definition of the term is that the virus simply disappears, then Pollard is correct: we know that COVID is endemic. But the only virus that we’ve ever completely eradicated is polio. Would Pollard say we’ve failed to achieve herd immunity against all other viruses? I doubt it. Endemicity and herd immunity are not mutually exclusive. The key to herd immunity is whether a virus does or does not remain a threat to the health of the population generally.

Active COVID infections will be relatively short-lived in individuals with “immunity”. Moreover, viral loads tend to be lower in immune individuals who happen to get infected. Therefore, the “infected immune” have less time and less virus with which to infect others. That creates resistance to further contagion and contributes to what we know as herd immunity. While immune individuals can “catch” the virus, they won’t get sick. Likewise, a large proportion of the herd can be immune and still catch the virus without getting sick. That is herd immunity.

One open and controversial question is whether uninfected individuals will require frequent revaccination to maintain their immunity. A further qualification has to do with asymptomatic breakthrough infections. Those individuals won’t see any reason to quarantine, and they may unwittingly transmit the virus.

I also acknowledge that the concept of herd immunity is often discussed strictly in terms of transmission, or rather its failure. The more contagious a new virus, like the Delta variant, the more difficult it is to achieve herd immunity. Models predicting low herd immunity thresholds due to heterogeneity in the population are predicated on a given level of transmissibility. Those thresholds would be correspondingly higher given greater transmissibility.

A prominent scientist quoted in this article is Paul Hunter of the University of East Anglia. After backing-up Pollard’s dubious take on herd immunity, Hunter drops this bit of real wisdom:

“We need to move away from reporting infections to actually reporting the number of people who are ill. Otherwise we are going to be frightening ourselves with very high numbers that don’t translate into disease burden.”

Here, here! Ultimately, immunity has to do with the ability of our immune systems to fight infections. Vaccinations, acquired immunity from infections, and pre-existing immunity all reduce the severity of later infections. They are associated with reductions in transmission, but those immune responses are more basic to herd immunity than transmissability alone. Herd immunity does not mean that severe cases will never occur. In fact, more muted seasonal waves will come and go, inflicting illness on a limited number of vulnerables, but most people can live their lives normally while viral reproduction is contained. Herd immunity!

Sadly, we’re getting accustomed to hearing misstatements and bad information from public health officials on everything from mask mandates, lockdowns, and school closings to hospital capacity and vaccine hesitancy. Dr. Pollard’s latest musing is not unique in that respect. It’s almost as if these “experts” have become victims of their own flawed risk assessments insofar as their waning appeal to “the herd” is concerned. Professor Hunter’s follow-up is refreshing, however. Public health agencies should quit reporting case counts and instead report only patients who present serious symptoms, COVID ER visits, or hospitalizations.

CDC Wags Finger; Diners Should Wag One Back

09 Tuesday Mar 2021

Posted by in Coronavirus, Public Health

≈ Leave a comment

Tags

, , , , , , , , , , , , , , , ,

The CDC’s new study on dining out and mask mandates is a sham. On its face, the effects reported are small. And while it’s true most of the reported effects are statistically significant, the CDC acknowledges a number of factors that might well have confounded the results. This study should remind us of the infinite number of spurious and “significant” correlations in the world. Here, the timing of the mandates (or their removal) relative to purported effects and seasonal waves is highly suspicious, and as always, attributing causality on the basis of correlation is problematic.

On one hand, the CDC’s results are contrary to plentiful evidence that mandates are ineffective; on the other hand, the results are contrary to earlier CDC “guidance” that masks and limits on indoor dining are “highly effective”. Nevertheless, the latest report has massive propaganda value to the CDC. The media lapped up the story and provided cover for Democrats eager to pass the COVID (C19) relief package. Likewise, the Biden Administration is apparently committed to the narrative of an ongoing crisis as cover for continued attempts to shame political opponents in states that have elected to “reopen” or remain open.

Right off the bat, the study’s authors assert that the primary mode of transmission of C19 is from respiratory droplets. This is false. We know that aerosols are the main culprit in transmission, against which cloth masks are largely ineffective.

Be that as it may, let’s first consider the findings on dining. There was no statistically significant effect on the growth rate of cases or deaths up to 40 days after restrictions were lifted, according to the report. In fact, case growth declined slightly. There was, however, a small but statistically significant increase after 40 days. The fact that deaths seemed to “respond” faster and with greater magnitude than cases makes no sense and suggests that the results might be spurious.

The CDC offers possible explanations the long delay in the purported impact, such as the time required by restaurants to resume operations and early caution on the part of diners. These are speculative, of course. More pertinent is the fact that the data did not distinguish between indoor and outdoor dining, nor did it account for other differences in regulation such as rules on physical distancing, intra-county variation in local government mandates, and compliance levels.

Finally, the measurement of effects covered 100 days after the policy change, but this window spans different stages of the pandemic. There were three waves of infections during 2020, which correspond to the classic Hope-Simpson pattern of virus seasonality. One was near year-end, but as each of the first two waves tapered (April-May, August-September), it should be no surprise that many restrictions were lifted. Within two months, however, new waves had begun. Karl Dierenbach notes that most of the reopenings occurred in May. Here’s how he explains the pattern:

“The map on the left shows counties where there was no on-premises dining (pink) in restaurants as of the beginning of May (4/30). … The map on the right shows that by the end of May, almost the entire country moved to allow some on-premises dining (green).”

“In the 100 days after May 1, cases nationwide fell slightly, then began to rise, and then plateaued.”

“And what did the CDC find happened after restaurants were allowed (changing mostly in May) to have on-premises dining? … Surprise! The CDC found that cases fell slightly, then began to rise, and then plateaued.”

The summer “mini-wave” is typical of mid- and tropical-latitude seasonality. Thus, the CDC’s findings with respect to dining restrictions are likely an artifact of the strong seasonality of the virus, rather than having anything to do with the lifting of restrictions between waves.

What about the imposition of mask mandates? The CDC’s findings show a much faster response in this case, with statistically significant changes in growth during the first 20 days. Another indicator of spurious correlation is that the growth response of deaths did not lag that of cases, but in fact deaths have reliably lagged cases by over 18 days during the pandemic. Again, the CDC’s caveats apply equally to its findings on masks. A large share of individuals adopted mask use voluntarily before mandates were imposed, so it’s not even clear that the mandates contributed much to the practice.

It’s a stretch to believe that mask mandates would have had an immediate, incremental effect on the growth of cases and deaths, given probable lags in compliance, exposure, and onset of symptoms. Moreover, a number of mask mandates in 2020 were imposed near the very peak of the seasonal waves. Little wonder that the growth rates of cases and deaths declined shortly thereafter.

We’ve known for a long time that masks do little to stop the spread of viral particles. They become airborne as aerosols which easily penetrate the kind of cloth masks worn by most members of the public, to say nothing of making contact with their eyes. The table below contains citations to research over the past 10 years uniformly rejecting the hypothesis of a significant protective effect against influenza from masks. There is no reason to believe that they would be more effective in preventing C19 infections.

The CDC’s report on dining restrictions and mask mandates is a weak analysis. They wish to emphasize their faith in non-pharmaceutical interventions (NPIs) to minimize risks. They do so at a time when the vaccinated share of the most vulnerable population, the elderly, has climbed above 50% and is increasing steadily. Thus, risks are falling dramatically, so it’s past time to weigh the costs and benefits of NPIs more realistically. The timing of the report also seemed suspicious, coming as it did in the heat of the battle over the $1.9 trillion COVID relief bill, which subsequently passed.

It’s also a good time to note that zero risk, including “Zero COVID”, is not a realistic or worthwhile goal under any reasonable comparison of costs and benefits. Furthermore, NPIs have proven weak generally (also see here); claims to the contrary should always make us wary.