The exact amount of effect mask wearing had on the spread of COVID may be interesting to study, but probably the most significant factor is whether people were actually wearing masks (e.g., in America, they weren't, not really, but in Taiwan, we were).
There are diseases that primarily spread through droplets where mask are more effecting in addressing coughing and sneezing. COVID was initially thought to be such diseases, but was later found to primarily spread through virus aerosol. This is why the recommendations to address covid was significantly changed in the later part of the pandemic.
In order to address medical problems you got to use the right tool for the job. In the same way you do not use antibiotic to treat viruses, different masks are effective at different diseases. In order to filter respiratory aerosol viruses that remain airborne for a long period of time over extensive distances, you need the kind of masks that generally comes with their own air source. Indoor ventilation and avoiding crowded spaces demonstrated a much better result than cloth masks could ever perform.
If I recall correctly, at the onset of the covid pandemic the general guidance was to not rush to buy masks with the goal to prevent a supply crunch that would impact first-line responders.
This guidance was quickly switched to a global recommendation to wear masks so to prevent and slow down how the disease was spreading, so that healthcare services could respond to the demand.
This all happened in the first few weeks of the global pandemic.
The original CDC statement was something like "masks have not been shown to be effective for the general population". It was technically correct, but if you weren't reading defensively you'd come away with the impression they were stating a negative suggestion rather than the null suggestion (ie nothing). So despite being technically correct, most people would consider this a lie, especially if they were misled by it.
It was definitely a black mark on the CDC response - they should have been honest with people that there simply weren't enough respirators, delay the statement by a day if the healthcare system needed more time to destock Home Depot.
But how that statement gets dragged out as an example of the government being deliberately wrong, to imply that it must have been prudent to do the opposite of what they said is also terribly misguided.
It's preferable that we have the timeline in mind.
https://www.latimes.com/science/story/2021-07-27/timeline-cd...
One key aspect of the initial guidances regarding facial masks were based on the assumption that covid was not easily transmissible, which was proven to be false. Once that fact was acknowledged, the whole world pivoted towards widespread adoption of masks and lockdowns to hinder spread.
> It was definitely a black mark on the CDC response (...)
To be fair, the initial criticism towards mask adoption were based on what little they knew then. As the pandemic progressed and observations in somewhat controlled environments started to trickle in, the focus shifted to prevent a supply crunch that affected first responders. I recall that there was also a period where health officials admitted masks were effectice, but regular people would only wear them wrong thus they wouldn't work, which was also dropped.
What matters to keep in mind is that this adaptation took place in a timespan of a couple of weeks at these start of the pandemic. Thus, it's not possible to use this to justify any anti-mask and anti-prevention militancy.
"masks have not been shown to be effective for the general population"
and something like:
"we do not know if masks are effective"
What was said was readily misinterpreted as "masks have ... been shown to [not] be effective for the general population", especially by a science-illiterate population reading with a non-individualist perspective. Whereas the second directly acknowledges the lack of understanding in an evolving situation.
Our common knowledge about how things should go or what recommendations are correct just does not apply. Nobody knew anything about anything. We had to figure everything out on the fly.
The result is that yes, we were often wrong and our guidelines were a moving target. This isn't like Polio or Measles - public health threats we understand. But, just because we changed our minds or were wrong doesn't mean anybody was lying. It means that we made mistakes.
And, doing super low-risk things like masking, even if we're not 100% sure it works, makes a lot of sense. Nobody dies from wearing a mask. So even if we think there's a chance it could save some lives, it makes absolute sense to recommend it. I mean, it's not surgery or medication.
Masks are not very effective at preventing an uninfected person from contracting Covid when in proximity to someone infected with Covid. The masks do not form a seal around the mouth and nose, allowing significant amounts of air around the mask when breathing in, as well as not being able to prevent being infected through the eyes. They do provide some protection, including possibly reducing the severity of the infection if contracted while wearing the mask, but that is not their primary benefit.
Mask are effective at preventing the spread from an infected person (either asymptomatic or symptomatic) to others. Breathing out directly into a mask allows the material to catch and trap the majority of the virus carrying condensation, and what gets out around or through the mask is slowed down significantly, allowing the droplets to be pulled down by gravity before traveling as significant distance (or fog up your glasses). Especially when combined with social distancing, this is very effective at prevent the spread of the virus. This is the masks primary benefit and is effective when there is large scale adoption, so that people that have the virus but are not aware, don’t unknowingly pass it. Its effectiveness comes as an aggregate effect similar to herd immunity, rather than an individual effect, since the vast majority of transmission comes from people unaware they are carriers.
Mask come with risks. People tend to touch their face more while wearing masks, and contracting the virus by touching your face is a primary infection mode. People tend to relax other more effective protection methods when wearing a mask, both unconsciously and due to a false belief in the protective capabilities of a mask.
So, in March we had a situation where we were running a shortage of masks. We had people wearing masks (either homemade or surgical) because they believed the mask provided good protection from contracting the virus, which is not true, and may cause people to engage in risky behavior that would put them and others at more risk. We also didn’t have enough masks to be used for their actual benefit of “herd immunity”. The assessment was that non sick people wearing masks was likely to put the individual at greater risk, and deplete the resource from places it was needed, without providing a medical benefit to the individual greater than the risks. In March, the average non sick person should not be wearing a mask.
After several months, we had a situation where we did not have a shortage of masks. We had a situation where the public has been educated through awareness campaigns on how masks work, like the “My mask protects you. Your mask protects me” campaign, so people are less likely to use the masks incorrectly and put themselves and others at greater risk. The assessment is that high compliance of mask wearing will have a greater positive effect through “herd immunity” to outweigh the risks and tradeoffs. But make no mistake, the risks are still there. In that case, the average non sick person should be wearing a mask.
If you don’t understand the underlying medical complexities of the situation, it seems like they can’t both be true. And when an expert organization is trying to provide a clear, short, easy to understand list of recommendations from analyzing and evaluating all those data, they can’t go into to a 45 min presentation every time. Dr. Fauci even tried to add context in March. He talked about how the masks don’t provide protection in the way people think they do, how it can cause people to put themselves at greater risk, both through a false sense of protection and other behaviors like face touching, and how masks primarily protect you from infecting others, not the other way around. If you go back and look at his quotes at the time, he consistently tries to bring that additional context into it, but since it is a complex issue of competing risks and benefits, it’s hard to convey how masks can be good in some cases and bad in others.
> Dr. Fauci in March 2020. “When we get in a situation where we have enough masks, I believe there will be some very serious consideration about more broadening this recommendation of using masks. We're not there yet, but I think we're close to coming to some determination. Because if, in fact, a person who may or may not be infected wants to prevent infecting someone else, one of the best ways to do that is with a mask, so perhaps that's the way to go.” [1]
> And of course his 60 Minutes interview. “There’s no reason to be walking around with a mask. When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face.”
[1] https://www.axios.com/anthony-fauci-masks-coronavirus-f77c30...