How Is Covid-19 Impacting Life in Your City?

[the urban politician]

Originally Posted by Pedestrian

That's all you need to say. Smarter people than you are requiring you to and thank G*d.

I am just stunned by a doctor who doesn't appear to accept the basics of infection control.

^ What a crock, do you think that your tired “You aren’t a good doctor!” bit is really going to be effective? I understand this stuff as well, perhaps better than your retired out of date old self does. I’m reading, attending the lectures, recertifying, etc. you are utterly full of garbage if you don’t understand that a LOT of doctors have different opinions on how we’ve handled Covid. Get over yourself.

Like 90% of this forum, you are misrepresenting and dumbing down my position and attacking it (along with your tiny entourage of goofy supporters).

[the urban politician]

Reminder:

Taking the most scared position does not make you smart.

I know that YOU think it makes you smart. I know that it makes you insecure when people criticize that, and you rationalize that position by saying “I’m doing the ‘smart’ thing by taking this position”. But it’s a lie that you are telling yourself.

[someone123]

I keep hearing about how great mask wearing is but few people address the data that's available, the differences in recommendations in different jurisdictions, or the effect that say vaccination or other measures might have on outcomes.

There have unfortunately not been many real-world high-quality (e.g. cluster randomized controlled) trials of masks. There was the Bangladesh study as one example and it showed the effect of cloth masks was down around the noise level while there were some narrow effects for surgical masks. This was in a completely unvaccinated population. Studies like this seem to have had no effect on the beliefs of most people; for example the staunch mask advocates for the most part still seem happy with cloth masks and they satisfy the mandates.

I'm not anti mask. In fact I would have preferred that mask wearing have a strong verifiable effect on reducing spread. Masks are really nothing like airbags or seatbelts. Seatbelts are much easier to study (collect data on traffic accidents and who was or wasn't wearing a seatbelt). Population-level viral transmission is much subtler than whether or not the occupants of a vehicle die in a crash. Even if a mask is 100% effective while you wear it, it may have no real-world impact if you have to take it off sometimes (like when eating in an indoor restaurant, something allowed in many places with mask mandates) and then you get infected.

This dynamic is at play with almost all of the covid interventions. There are lots of people yelling at each other over whether or not poorly understood measure X was a good pandemic response. The big shining exception is the vaccines, which have been well studied.

[chris08876]

FDA Approves Pfizer’s COVID-19 Vaccine For Kids 5 To 11

• Video Link

The FDA has authorized Pfizer’s low-dose COVID-19 vaccine for children ages 5 to 11. Around 28 million kids could be eligible for their first shot as early as next week after final sign-off from the CDC.

[Pedestrian]

Originally Posted by someone123

I keep hearing about how great mask wearing is but few people address the data that's available, the differences in recommendations in different jurisdictions, or the effect that say vaccination or other measures might have on outcomes.

There have unfortunately not been many real-world high-quality (e.g. cluster randomized controlled) trials of masks. There was the Bangladesh study as one example and it showed the effect of cloth masks was down around the noise level while there were some narrow effects for surgical masks. This was in a completely unvaccinated population. Studies like this seem to have had no effect on the beliefs of most people; for example the staunch mask advocates for the most part still seem happy with cloth masks and they satisfy the mandates.

I'm not anti mask. In fact I would have preferred that mask wearing have a strong verifiable effect on reducing spread. Masks are really nothing like airbags or seatbelts. Seatbelts are much easier to study (collect data on traffic accidents and who was or wasn't wearing a seatbelt). Population-level viral transmission is much subtler than whether or not the occupants of a vehicle die in a crash. Even if a mask is 100% effective while you wear it, it may have no real-world impact if you have to take it off sometimes (like when eating in an indoor restaurant, something allowed in many places with mask mandates) and then you get infected.

This dynamic is at play with almost all of the covid interventions. There are lots of people yelling at each other over whether or not poorly understood measure X was a good pandemic response. The big shining exception is the vaccines, which have been well studied.

A technical review of face mask wearing in preventing respiratory COVID-19 transmission

Abstract
Since the outbreak of the COVID-19 pandemic, most countries have recommended their citizens to adopt social distance, hand hygiene, and face mask wearing. However, wearing face masks has not been well adopted by many citizens. While the reasons are complex, there is a general perception that the evidence to support face mask wearing is lacking, especially for the general public in a community setting. Face mask wearing can block or filter airborne virus-carrying particles through the working of colloid and interface science. This paper assesses current knowledge behind the design and functioning of face masks by reviewing the selection of materials, mask specifications, relevant laboratory tests, and respiratory virus transmission trials, with an overview of future development of reusable masks for the general public. This review highlights the effectiveness of face mask wearing in the prevention of COVID-19 infection.

https://www.sciencedirect.com/scienc...59029421000017

An evidence review of face masks against COVID-19
Jeremy Howard, Austin Huang, et. al.
PNAS January 26, 2021 118 (4) e2014564118; https://doi.org/10.1073/pnas.2014564118
Edited by Lauren Ancel Meyers, The University of Texas at Austin, Austin, TX, and accepted by Editorial Board Member Nils C. Stenseth December 5, 2020 (received for review July 13, 2020)

Abstract

The science around the use of masks by the public to impede COVID-19 transmission is advancing rapidly. In this narrative review, we develop an analytical framework to examine mask usage, synthesizing the relevant literature to inform multiple areas: population impact, transmission characteristics, source control, wearer protection, sociological considerations, and implementation considerations. A primary route of transmission of COVID-19 is via respiratory particles, and it is known to be transmissible from presymptomatic, paucisymptomatic, and asymptomatic individuals. Reducing disease spread requires two things: limiting contacts of infected individuals via physical distancing and other measures and reducing the transmission probability per contact. The preponderance of evidence indicates that mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts. Public mask wearing is most effective at reducing spread of the virus when compliance is high. Given the current shortages of medical masks, we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies. Because many respiratory particles become smaller due to evaporation, we recommend increasing focus on a previously overlooked aspect of mask usage: mask wearing by infectious people (“source control”) with benefits at the population level, rather than only mask wearing by susceptible people, such as health care workers, with focus on individual outcomes. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.

https://www.pnas.org/content/118/4/e2014564118


https://jamanetwork.com/journals/jam...rticle/2776536

Mask use in community settings in the context of COVID-19: A systematic review of ecological data
Nathan Ford, Haley K. Holmer et. al.
Published:July 18, 2021
DOI:https://doi.org/10.1016/j.eclinm.2021.101024

Abstract

Background

The wearing of medical and non-medical masks by the general public in community settings is one intervention that is important for the reduction of SARS-CoV-2 transmission, and has been the subject of considerable research, policy, advocacy and debate. Several observational studies have used ecological (population-level) data to assess the effect of masks on transmission, hospitalization, and mortality at the region or community level.

Methods

We undertook this systematic review to summarize the study designs, outcomes, and key quality indicators of using ecological data to evaluate the association between mask wearing and COVID-19 outcomes. We searched the World Health Organization (WHO) COVID-19 global literature database up to 5 March 2021 for studies reporting the impact of mask use in community settings on outcomes related to SARS-CoV-2 transmission using ecological data.

Findings

Twenty one articles were identified that analysed ecological data to assess the protective effect of policies mandating community mask wearing. All studies reported SARS-CoV-2 benefits in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes. Few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing, and information about compliance to these policies was lacking.

Interpretation

Ecological studies have been cited as evidence to advocate for the adoption of universal masking policies. The studies summarized by this review suggest that community mask policies may reduce the population-level burden of SARS-CoV-2. Methodological limitations, in particular controlling for the actual practice of mask wearing and other preventive policies make it difficult to determine causality. There are several important limitations to consider for improving the validity of ecological data.

https://www.thelancet.com/journals/e...304-7/fulltext

[someone123]

Yes, your list is a good example of a bunch of limited studies that don't really add up to much. It does not mean much if there are masked patrons who went to a hair salon in Missouri and didn't get covid, with no controls. Repeat a similar quality of study 20-30x and unfortunately you still don't get good quality evidence.

Your Lancet article includes a bunch of limitations that you've quoted. They can't say much about causality because they just monitored mask wearing or mandates over time while a bunch of different factors changed. If you put in a bunch of public health measures and communicate risk widely to the public their behaviour may change in many different ways and it's hard to know exactly what impacted the spread or by how much. Sometimes factors aside from human behaviour have an impact too.

My impression is this is an evidence bar that hydroxychloroquine or ivermectin covid treatments would pass. Proponents will cite observational studies or even some small randomized controlled trials that show a positive effect. Yet we know now that the hydroxychloroquine people were most likely wrong and ivermectin is dubious.

I think there is a real positive effect for mask wearing but it's limited for cloth masks, modest for the other types, and can be completely undone by other behaviours , e.g. you wear a mask in the mall but you go party with friends later on and you end up with covid anyway. Such an effect may or may not be helpful individually or from a public health perspective. I will leave it to others to speculate about the effect size although most of the people who are completely convinced masks are great don't talk about the effect size or difference between mask types (cloth masks okay? only N95s? 2-5 year olds wear or don't wear?). In the past one opinion was that the pandemic would be over if only people would wear their %^&*@#$ mask which I think has been falsified at this point.

[Acajack]

Originally Posted by chris08876

I agree with this as well. The elementary kids. I mean a year behind is a big deal, especially when gamma waves in the brain are high and little kids are like sponges. They absorb everything. I forget the age range but there's an age range where learning becomes very important. Kind of why little kids can pick up languages quicker in some cases than adults. Gamma brain waves!

But aside from learning fractions and critical reading, something most adults can't do anyways, the disruptions on the social skills and possibly loneliness might cause damage; social adaptation, EQ of the generation, ect.

I feel bad for the teachers. And the principals who are going to get their ear chewed off when the test scores for the schools come back. They might need to drink some alcohol after but due to the aluminum shortage, might not be in stock as much.

I actually don't know anyone (family, friends, neighbours, work colleagues, etc.) who has elementary school kids who thinks that kids learning online was in any way equivalent to having them in class.

By all accounts it was a handful keeping even the most motivated, serious, well-behaved kids on track during that time.

Also, people on here who wear their hearts on their sleeves and weep for the widow and the orphan should also be concerned because kids who were disadvantaged before the pandemic will be even further behind as a result of this.

The pandemic in terms of its educational impacts didn't impact all social classes equally.

[10023]

^ That’s very true.

I have a friend who is a teacher at a fairly disadvantaged public high school on Long Island, and one who teaches at an elite private school in England (you all know the one). Even the latter has kids who are on scholarship and not from wealthy families, of course. Both of them said there was an enormous difference right from the start in terms of how richer and poorer kids could manage, even just on internet speed and bandwidth.

[the urban politician]

It was rough for our kids, but we had the fortune to be able to have a tutor at home with our kids a few evenings per week to help them keep up.

But the loss of social interaction was, of course, immeasurable

[Acajack]

Some will denounce this is a stereotype but it's also pretty obvious that more affluent families generally keep closer tabs on their children's learning. In both good and bad times.

[10023]

All this said, I hope that remote learning remains an option at times because my wife and I, if we have kids, both want to be able to move around during the year. I would actually have no intention of being in one place from the start of September until end of May.

But of course, that would be a “hybrid” model where the kids would be remote for like 6 weeks or so, and they’d still be doing sports or whatever for social interaction.

[Crawford]

Originally Posted by someone123

Yes, your list is a good example of a bunch of limited studies that don't really add up to much. It does not mean much if there are masked patrons who went to a hair salon in Missouri and didn't get covid, with no controls.

Why wouldn't there be lots of controls at this point? The entire globe is basically experimenting with masks v. no masks.

In the U.S. K-12 education system, go district by district and compare similar districts with mask requirements to those with no such requirements, and, so far, it appears that the mask requirements lead to much better outcomes. Of course there are confounding factors and it's much more complex than just comparing districts, but I have no doubt there's some valuable data under review at this time.

[10023]

Originally Posted by Crawford

Why wouldn't there be lots of controls at this point? The entire globe is basically experimenting with masks v. no masks.

In the U.S. K-12 education system, go district by district and compare similar districts with mask requirements to those with no such requirements, and, so far, it appears that the mask requirements lead to much better outcomes. Of course there are confounding factors and it's much more complex than just comparing districts, but I have no doubt there's some valuable data under review at this time.

Define “better”.

It’s time to ditch masks because Covid is as under control as it can be in most places (leaving aside countries like Russia where their vaccine doesn’t actually work).

[someone123]

I think if Donald Trump had kept up a message like "everybody wear masks, they'll stop the virus dead in its tracks, it's gonna be great!" in the spring of 2020 opinions wouldn't have flipped (since there is so much wiggle room since the data is poor) so much and focusing on limitations of masks like the efficacy of cloth mask in preventing aerosol transmission would feel more reasonable to more people. To most people this is mostly sentiment based, with the covid interventions they do or don't like being like picking a sports team (and it's social/tribal in the same way you might want to follow the local sports team).

Like I said I do think the masks have some effect and it depends on the person. So maybe if you are older and worried you should wear an N95 (cloth not being good enough) while if you're low risk and vaccinated cloth is okay (just to satisfy the mandate, but it's probably not doing much).

I agree as usual the end goal is not really clear. Just as most people pick their preferred regime based on sentiment, politicians monitor public sentiment to decide what to do, and there is not necessarily much rhyme or reason to how it will evolve. Some people seem to want indefinite mask wearing, others argue it should be done while we are in crisis mode and we seem to be in perpetual crisis. Not sure what the cutoff should be here but I don't think it makes sense to wait for 0 covid because there is no clear path to 0 covid and it may never happen.

[JManc]

Originally Posted by 10023

All this said, I hope that remote learning remains an option at times because my wife and I, if we have kids, both want to be able to move around during the year. I would actually have no intention of being in one place from the start of September until end of May.

But of course, that would be a “hybrid” model where the kids would be remote for like 6 weeks or so, and they’d still be doing sports or whatever for social interaction.

Might I suggest not having kids then. You have to make a lot of sacrifices and one of them is not being able to come and go like you want. They need stability.

[TWAK]

Originally Posted by 10023

Define “better”.

It’s time to ditch masks because Covid is as under control as it can be in most places (leaving aside countries like Russia where their vaccine doesn’t actually work).

Plenty of places have ditched the mask, to include the whole northern portion of my state. Are the masks too itchy or what?

[10023]

Originally Posted by JManc

Might I suggest not having kids then. You have to make a lot of sacrifices and one of them is not being able to come and go like you want. They need stability.

They don’t need anything of the sort, it’s just a norm, and stability doesn’t necessarily come from their physical geographic location. Plus there’s a lot to be gained by experiencing different cultures and places as a child.

It’s just the damn schools that are an issue.

[10023]

Originally Posted by TWAK

Plenty of places have ditched the mask, to include the whole northern portion of my state. Are the masks too itchy or what?

Yes, actually (I have a beard), as well as hot. They’re also de-humanizing. You can’t really meet and get to know someone when one or both of you are wearing a mask.

[TWAK]

Originally Posted by 10023

Yes, actually (I have a beard), as well as hot. They’re also de-humanizing. You can’t really meet and get to know someone when one or both of you are wearing a mask.

Move somewhere that doesn't require masks, or has a mandate against masks.
There are plenty of states that don't follow the science, and are actively pursuing litigation against these measures.

[chris08876]

Originally Posted by Acajack

I actually don't know anyone (family, friends, neighbours, work colleagues, etc.) who has elementary school kids who thinks that kids learning online was in any way equivalent to having them in class.

By all accounts it was a handful keeping even the most motivated, serious, well-behaved kids on track during that time.

Also, people on here who wear their hearts on their sleeves and weep for the widow and the orphan should also be concerned because kids who were disadvantaged before the pandemic will be even further behind as a result of this.

The pandemic in terms of its educational impacts didn't impact all social classes equally.

I think E-learning is great for adults or maybe people in college who have developed brains and if they are serious, will take advantage of the material. In some cases, E-learning can in a way be tougher, material wise but this will depend on the exams or material present (at least if its a well developed e-version of a course).

I don't know the effectiveness of it with kids though. I think some might of reaped the benefits but might prove challenging with the spastic and ADHD kids who can't sit still.

Some parents have told me horror stories, sitting there, forcing thier kids to watch a cartoon giraffee hopped up on acid and PCP teach the kids reading comprehension. Oh... and the music... the music with some of these courses. Sort of like Sesame Street from hell. I know of a few parents that are so happy their kids are back to school, in-person.