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19 Nov, 7 tweets, 2 min read
"In places where there is modest SARS-CoV-2 transmission (like Denmark during these months), there is insufficient evidence to suggest wearing a mask as you go about daily errands will protect you from infection."

Let's do a thought experiment... (1/x)
Imagine you are in combat, wearing an armored vest, which covers the areas of your body you are most likely to get shot. There are not many enemies, and a small number of bullets are coming. What are the chances that you will survive? (2/x)
But remember, if there are enough bullets, one of them will eventually hit you in the throat. Now the enemy deployed a brigade and they are raining bullets on you. What are the chances that the vest will save you? (3/x)
If masks were not enough to protect the wearer in a setting where the virus spread was low, how likely is it that they will protect the wearer in places with substantial virus activity? (4/x)
I want to clarify, I have no strong feelings against masks. Some people really believe masks work and can only function when people wear them. They are afraid at no fault of their own, and I respect that. I wear one and I hope they are saving some lives. (5/x)
But, I have yet to see compelling evidence that they protect me or others. I believe in evidence-based practices. The discussion around masks is anything but evidence-based. It is deeply political and toxic, characteristics which should have no place in public health. (6/x)
Most people are against masks exactly because of mandates. A softer messaging would actually increase mask wearing. Say there is a chance they do some good, acknowledge the limitations, and plead people to wear them. More people would be on board. (7/7)

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More from @covidtweets

20 Nov
Many times, we go see a doctor or take a pill when we are feeling the worst, right before we would naturally be feeling better. Then we attribute the outcome to the intervention....

Like those who think lockdowns turned things around in Europe. (1/x) Image
Topol shows a few countries as examples to how "it can be done". He is missing one though, so I added that...

When these countries enacted restrictions, cases were already peaking. Lockdowns, again, did nothing. Below I show a few examples... (2/x) ImageImage
UK enacted LD on Nov. 5. However, cases were flat since Oct. 24, and with a minimum 7-day delay between an infection and it being counted as a case, infections were stable since mid-Oct. Lockdowns were so effective that they worked two weeks before being implemented! (3/x) Image
Read 7 tweets
18 Nov
In March, some argued that schools going remote was going to make online education more mainstream and more accepted as an effective form of instruction. I argued it was the opposite, that this was really bad for online degrees. (1/4)
Imagine being a student during all this and suffering through countless Zoom classes. Then graduating with your only online learning experience being this. Then you take on a role in which you begin making decisions about job applications. (2/4)
Then you get an application from someone with and online degree along with another a bit less qualified applicant with a traditional college degree. Which one do you give the job to? (3/4)
Read 4 tweets
18 Nov
We are currently doing what could be the closest we can get to an RCT of restrictions and mandates: North vs. South Dakota. Two very similar states, but as of last Friday, very different policies in how they approach COVID. (1/x)
On Friday, ND imposed restrictions on bars and indoor dining, indoor events, and sports. They also mandated masks. Meanwhile, SD is not changing their approach and avoiding such restrictions. Here is a look at their cases so far (source for data is CTP): (2/x) Image
Their curves are very similar, so they are starting from the same place. We will soon know if they diverge as a result of ND's interventions. However, it is important to note that they are on slightly different latitudes, so there is that. Here is hospitalizations: (3/x) Image
Read 4 tweets
16 Nov
Two states with very different policies in terms of restrictions and mandates: NC & OK. Millions making random decisions every day, some catching COVID, some don't. Some die, most survive. With this much variation, it is remarkable that these curves are almost identical. (1/3)
Virus gonna virus. I have yet to see convincing evidence that something a government has done was instrumental in suppressing transmission (maybe except for tiny and/or island nations). The only proven way to be safe is take good care of your immune system. (2/3)
BTW, kudos to OK Health Commissioner Frye for following evidence, not models: "... we had some information presented to us that looked at several different mitigation factors, and mask mandates were the one that made the least difference.” (3/3)
oklahoman.com/article/567589…
Read 5 tweets
12 Nov
This report is getting a lot of attention, rightly so. Terrible news, but very predictable.

Buried in the report, though, is one piece of information about % ED visits that we never get when the issue is COVID-like illness ED percentage. (1/4)
"The increased proportion of children’s mental health–related ED visits during March–October 2020 might be artefactually inflated as a consequence of the substantial decrease in overall ED visits during the same period..." Meaning, total number of visits is lower this year. (2/4)
When a total of 100 people normally visit ED, and five of them are CLI in 2019, that is 5%. If instead, the total number in 2020 is 50, and there are still 5 people visiting for CLI, that is 10%. The rate has doubled, but the number is the same. (3/4)
Read 4 tweets
28 Oct
I may be speaking early, but it appears this Fall wave is already starting to fizzle. Either this is not the one, or it will be smaller than feared. There is indeed reason to think this may be the case, but first, a look at NC metrics. (1/x)
In NC, the CLI has turned sharply down, percent positive, hospitalizations, and ICU have flattened. Cases are struggling to go up. (2/x)
Not surprisingly, nearby Tennessee is seeing a similar trend, once again showing us that the virus is doing its thing. Hospitalizations and ICU have flattened there as well. Cases seem to have stalled. (3/x)
Read 7 tweets

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