Thread by @ToshiAkima

Rephrasing this argument, I'd say that RCTs should be demanded for the more high-risk strategy eg to prescribe a drug, to deprescribe a precautionary public health mandate. Demasking is the higher-risk strategy so RCTs need to be demanded from those wanting to proscribe it

https://twitter.com/ToshiAkima/status/1441566504097517584

There is mechanistic aerosol physics & observational data pointing to lives saved from masking. The burden of proof in running RCTs should fall on those asserting it is safe to demask the populace during COVID-19. Ditto for accepting their claims of mask harm

The reason we demand RCTs before approving new drugs is that the higher-risk strategy is to prescribe novel drugs. The burden of proof must fall on those proposing the riskier strategy. So this isn't a capricious reversal of the burden of proof at all. Safety first

You therefore can't demand RCTs showing efficacy from those imposing a lockdown during a pandemic. True, no RCT exists showing lockdowns work but lockdown remains necessary based on the precautionary principle. RCTs should be demanded of those claiming lockdowns don't work

Also true is that we have no placebo-controlled RCTs showing the efficacy of antibiotics for bacterial community-acquired pneumonia. The burden of proof should fall on those who advocate not giving antibiotics for pneumonia because it is the riskier strategy. Safety comes first