Cases might rise soon. "We better close schools/ mask up, " says worst policy makers ever

Ignorance is the new guide to health policy

I have been saying for some time that cases may yet again rise.

Feb 10 - What Happens When Cases Go Up?

March 10 - When Covid Cases Climb

Now wastewater data, early counts from some US cities and recent experience from Europe has scared some people into thinking it is possible.

In response to their fear, there have been calls to reconsider drastic actions NOW! We need to reinstitute mask mandates! We should think about school or business closures pre-emptively! These are bad ideas.

Why is the only response to cases: reflective, unproven restrictions? These are restrictions for which we have no credible data and little idea how much they help. Not only do we not know the effect size, we do not know if they only work at certain cases counts etc.

Instead, the wisest thing to say at this moment is to push interventions where we have robust data of benefit: We need to vaccinate all non-immune older people ASAP, and boost the vulnerable, the elderly and nursing home residents. We also need to expand hospital capacity by hiring back workers who were wrongly fired by vaccine or booster mandates. PS: we don’t need to worry about boosting healthy 12 year olds. That’s a misguided policy focus.

Next, if you think business closures are possible in the USA you are living in a delusion. Perhaps only in liberal strongholds where outdoor n95 masking is still popular (SF) would there be any political will for closure, but most of America would defy any such orders.

When it comes to re-instituting mask mandates, I am perennially disappointed in people’s appraisal of the evidence. People uncritically tweet deeply flawed studies. People make up bold, implausible claims that cloth masks have effect sizes of 60+%. These claims are disproven by the one cluster RCT run this pandemic. At this point, I have to conclude most people are political ideologues on this issue. I am a progressive-liberal, but I interpret data for a living, and I am confident the evidence is weak. PS this is also the conclusion of Cochrane

It looks like Cochrane also agrees with me that we needed cluster RCTs. Perhaps now more should see the wisdom of running cluster RCTs— we now enter year 3 and have no data pertinent to high income nations. Moreover, compliance may have waned and effect sizes may diminish. No trials examined masks effectiveness post-vaccine. We are recommending something that is incredibly polarizing with no clear evidence. This will not age well.

In short: there is logical and sound policy and illogical and tribal policy. Social media is dominated by the latter. It is going to be a problem as cases rise, and calls for silly policy proposals (make 4 year olds wear n95s!) intensify. God help us.