In Medicine: You Have to Prove Your Intervention Helps
In Medicine: You Have to Prove Your Intervention Helps
You don't do it until someone proves harm
Recently there was a debate online about whether masking kids (for years) harms their language and social development. The truth is we don’t know with certainty. Part of that is because no society on earth would take healthy children and mask them for 3 years. No one is that stupid. Well, no one was.
Some online ‘experts’ argue that blind people can speak just fine, ergo seeing faces is not needed for language and social development, but this is an absurd argument. Part of communication is silent cues, including reading someone’s mood and intent from their face in the absence of audible sounds. People who are blind are not able to do this. People who are sighted are able to do this. With prolonged deprivation of seeing faces, it is possible sighted people will not do it as well. We don’t know because, as noted, no one was stupid enough to mask kids for years.
But this debate is entirely misguided. In medicine you don’t do things to people until someone proves it is harmful; you do things to people AFTER you prove there is a benefit. When it comes to masking kids, no one has shown this.
No one has ever shown that masking kids slows the spread of sars-cov-2. Observational studies are hopeless as masking is entangled with many other differences. This substack has repeatedly debunked bad obs studies.
No one even tried to test this; There are 0 randomized trials; NIAID, WHO and many others failed society by not generating evidence, and lying about the confidence of the recommendation.
Cloth masks don’t work in adults in cluster RCT.
Kids 2-4 often nap for 1-2 hours a day in the same room without a mask (making it highly unlikely to work)
Then there are reasons why slowing spread doesn’t even make sense any more in 2022
Most kids (»>75%) have had covid already
Vaccines are available for anyone who wants, but most parents don’t want for young kids (<12)
All kids will eventually get COVID (in the short term) no matter what you do.
Finally, there are issues of proportionality
Adults face the greatest risk from the virus; kids face the lowest risks, particularly with BA5 and particularly now that most have had covid already
Adults are partying and subject to essentially no mandates; ergo, it would be inappropriate to subject kids to anything stricter
When you put these facts together, the answer is clear. It probably was always unjustified, but it is now clearly totally nuts to compel kids to mask. We should worry about harms, as all medical interventions have harms, only some have benefits and only a rare few have benefits exceeding harms.
No one has hitherto proven masking kids for years is harmful because, let me repeat, there was no one on earth so stupid that they would mask millions of kids for 3+ years. If you never had a society that irrationally anxious and stupid, you cannot the study the harms.
No society ever cut off children’s hands, or made them wear noise cancelling headphones for hours a day, so we don’t have proof that is harmful either, but the burden to recommend interventions is not that you lack evidence of harm, but you have evidence of benefit.
Debates around masking kids have merely confirmed that most people in medicine have a poor grasp of evidence and how it is used. Some draw analogies to parachutes. But who could possibly think that masking works like a parachute? Masks had a 1/6th of 1% effect in Bangladesh; parachutes have a 99.9999% effect size. Do you think that is the same?
In 2022, we truly run the risk that a handful of vocal, irrational zealots might torpedo common sense, evidence based medicine and science entirely. Let’s try to keep that from happening.
Vinay, Everything you say is true. In March 2020 I noted that masking, which despite your caution early on in expressing this known fact has long been known to be largely ineffective vis-à-vis respiratory viruses (and which was the long-standing, well rooted in RCTs policy of both the US and the WHO until April 2020) was the FIRST LIE and that if they got away with that, they would just pile them on.
That is exactly what characterizes virtually all of the reporting ("scientific" and press) on Covid since. Very few truths have been out there and most of the truth-tellers have been squelched. It is only now when the damage is becoming un-hideable, that people are modestly retreating. But the masking has always been ridiculous for ANYONE -- most of all children. But so were virtually all of the other NPIs. All a fraud perpetrated by a politically captured bureaucracy, press, and academia.
I am thrilled you keep exposing this. Masks were NEVER bioplausible...their failure to perform was well documented in RCTs with influenza over many decades. But there are now religious believers in masking who will impose it on anyone they can. Many of them are irremediable as are most religious zealots. The remainder will pay virtually no attention to any public health announcement ever again -- and they are probably right.
The saddest part is many patients will now also pay far less attention to their own physicians who dutifully in service to the government parroted the untruths. Luckily, there is a far greater spectrum in the practitioner class, and some of us have stridently opposed most of this in our own little corners (and you more widely, eventually) but many patients will never forget nor forgive. This will have endlessly bad implications for health care (not just public health) for generations. And this is beyond the learning disabilities that we are foisting on children because loud-mouthed, medically wrong people have been supported by a captured public health apparatus in suborning virtually all of education.
Keep speaking out. Get more strident. Anything that gets anyone's attention will be a leap forward at this point.
Saw this quote the other week and it just keeps being relevant. 'Man is not a rational animal; he is a rationalizing animal.' --Robert A. Heinlein, Assignment in Eternity