1. So much hostility and confusion from people who saw me (on a Zoom) wearing a mask in my office this week! The question is: Am I crazy, am I virtue signaling, am I fear mongering, or is there some rationale to wear a mask in a private office? Let’s discuss! 🧵
2. Let’s start with the basics. Here’s a screenshot an angry critic took and shared. You can see I am wearing an N95. I work at a mask-optional university, so no one is making me do it. You can also see I need to clean up my office, but that’s a separate topic.
3. I like to keep my door open whenever possible, so students or faculty can pop in. My office is also right outside of the bathrooms, which helps to ensure that I see a lot of people during the day. Part of having a good in-person university experience.
4. COVID is transmitted through the air via aerosols, and can linger for a long time. So just because a person isn’t there now doesn’t mean there is no COVID in the air.
5. We have multiple ways to remove COVID from the air, including ventilation and filtration. Unfortunately I work in an older building that doesn’t have everything needed to optimally reduce indoor concentrations. So masks are more important (portable HEPA too).
6. Now, there are 2 reasons to wear a mask - to protect me from you, and to protect you from me. My wife treats COVID patients, many unmasked, and my kids go to mask-optional schools. So I could be a source at any point, and I would rather not infect my department.
7. Of course, I want to also protect myself, as well as my family and community. My N95 helps. We can argue about the merits of cloth masks right now, but a well-fitting N95 reduces the amount of virus you inhale.
8. The question you might ask is: Come on, is it really worth it? How high is the risk of getting or giving COVID in your office?
What I would say is that the price to pay is very small, and the benefit hard to estimate in probability but very high in impact.
9. What price do I pay? The N95 costs me about a quarter per day of use (I use them around 3 times before discarding, and pay around $0.75 each). It’s really comfortable and I don’t notice it most of the time. People can hear me easily in person or on Zoom.
10. Sure, people miss my winning smile, and once on a Zoom, I was talking for a couple of minutes before realizing the other person had sound problems and couldn’t hear me (and didn’t know I was talking). But that’s no big deal. And I can handle occasional mockery.
11. So very low cost, and if it keeps a round of COVID out of my family, very large benefit. I guess what people should ask themselves is why they are so enraged to see someone perfectly happy in a comfortable yet protective mask while working outside of the house.
12. This isn’t virtue signaling, since most people don’t see me doing this on a typical day. And a lot of it is about me trying to do my job as well as possible and keep myself and my family healthy, which is me-focused.
13. It isn’t fear mongering. It is a rational decision to do something low-cost to protect against a novel virus that can have short-term and long-term effects. And we shouldn’t fear COVID, but we shouldn’t ignore it either.
14. Am I crazy? Perhaps. After all, I am crafting a thread about masks while sitting at a kids’ soccer game. But I think this is more about the fact that this brings up 2 specific things that drive me crazy.
15. The first is that you can’t know by looking at someone if they are immunocompromised, live with someone who is, or has something else that makes them higher risk if they get infected. Does that describe me? As my 8 year old says, “None ya”. As in “None of your business”.
16. No one should be required to reveal personal and private information about their health, or the health of their families. We should have some grace and assume those wearing masks when not required have a reason to do so.
17. The second is the fact that we are in the midst of a pandemic that has killed more than 1 million Americans. The mockery of mask wearing is connected to a broader public narrative that denies the current reality.
18. My guess is that people get upset to see a visible sign of the pandemic, which we would all like to forget.
19. What many would counter is that I am perfectly free to do what I choose, even if it seems crazy to them, but no one should be required to do the same. What I would say is that there are times when that is right and times when that is wrong.
20. When conditions are good, there shouldn’t be mask mandates. But when conditions are bad, we need them temporarily. On ramps and off ramps both, driven by data in both directions.
21. Ok, enough tweeting. The soccer game is about to start. And let’s do what we can to stay safe while still living our lives.
Wow, this blew up! Now I wish I had cleaned my office before that Zoom.
But seriously, thanks to those trying to make a difference even when it’s not popular to do. Let’s be guided by data and compassion to nimbly add and remove public health protections as best we can.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
1. Yesterday’s @MassGovernor quote reacting to the “high” COVID designation of many MA counties by CDC isn’t just “spin” - it combines the obviously false, the vaguely misleading, the correct, and the correct but myopic. Let’s parse it! 🧵
2. First, background - every week on Thurs, @CDCgov updates its “Community Levels” designation by county. The methods, data, and designations are publicly available.
1. When we officially record the millionth death from COVID in the US in the coming days, it should lead to collective introspection about our failures as a country and an articulation of lessons learned for future pandemic control. But it won’t.
2. Don’t get me wrong. There will be some great commentaries and excellent ideas put forward. But I used the word “collective” deliberately. I fear that many have learned one primary lesson from the pandemic - look away.
3. If someone is reasonably protected as an individual and ignores what happens to others, it’s easy to pretend there is no pandemic. It’s even easier if those at risk don’t live near you or run in your social circles. That’s a consequence of an individual-focused response.
1. When I took logic in high school, my favorite logical fallacy (yes, I had one - don't judge) was "argument of the beard". I actually think it informs some of the current arguments about masks, airplanes/buses/trains, and other aspects of pandemic response. 🧵
2. First off, I know I'm not a philosopher or logician. My understanding of "argument of the beard" comes from a high school logic class in the 1980s. So don't dunk on me if I don't grasp the subtleties or misuse the fallacy a bit.
3. But my simple understanding is this - if you pluck one hair from a beard, obviously it is still a beard, right? Pluck one more, still a beard. But if you make that argument for every hair, eventually you will say that a clean-shaven person has a beard.
1. With the BA.2 wave here in MA, it is worth asking what the @CDCgov "community levels" tells us to do, when it will tell us to do something different, and what this means. I'll look at Suffolk County, which includes Boston. 🧵
2. Right now Suffolk County is "medium", because cases are > 200 per 100K. At that level, CDC says to talk to your health care provider if you are "at high risk for severe illness" to ask about wearing a mask. So, do nothing. It would be "high" using the old scheme.
3. What triggers "high" in the new scheme? Hospital admissions >10 per 100K. It's 5 now. So once admissions double, we enter the red zone.
Will that happen? Probably. When? Hard to say. But hospitalizations up 30% in the past week on CDC website. 3 more weeks of 30% gets there.
1. Something interesting is happening with #COVID19 in MA, where case incidence appears much higher right now in wealthier suburbs. My guess is one of two things is happening, neither of which bodes well. 🧵
2. First, the data. We are seeing average daily rates > 20 per 100K in towns like Manchester, Sherborn, Wayland, Concord, and Wellesley. In contrast, it’s <= 5 in Chelsea, Lawrence, and Brockton. This isn’t a formal analysis and there are counterexamples, but you get the idea.
3. Hypotheses 1: This is the #UrgencyOfNormal crowd. Wealthy suburbs with high vaccination and booster rates are dropping pandemic precautions at a faster rate. This is certainly happening anecdotally ⬇️
1. I’m trying to better understand the implications of the new @CDCgov Community Levels #COVID19 system. So I took a look at what it would have told us to do here in Boston during the Omicron wave.
TL/DR - looks ok if we live in the past, not good if we plan for the future
🧵
2. First off, I know you don’t evaluate a model on one data point. And this is based on the eyeball test, not formal analysis. And it’s hard to capture a counterfactual future scenario with historical data. But bear with me…
3. If I understand the new system, it is based on case counts, hospital admissions, and % of staffed inpatient beds occupied by COVID patients. I used the data from the @CDCgov COVID data tracker, since that is what they would use.