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Some measures obviously do work. Australia’s number of deaths is still under 20,000 and the death rate is similar to most Asian countries rather than European and American. Probably the strict international border closures helped the most but also were the most socially harmful.
I do not believe masks made much difference here even though overall people were very compliant with the rules. Children were not required to wear masks and most spread happened within families. Then we had the amusing situations where masks on trains were only required, at times, in greater Sydney. So when the interurban train would reach Bargo, being on the boundary, the commuters would just remove their masks.
Then there was the absolutely ridiculous situation on the border on NSW and Queensland, when free travel was not allowed into QLD. We were staying in a hotel right above the police border post, where all those with passes had to queue every day in their cars to, in most cases, drive home to QLD from their workplace in NSW. So we strolled along the street about half a mile and kept walking, then realised we were on the QLD side and could have continued as far as we wished.
I'm talking about the USA. States like NY, California, New Jersey had strict business closures, COVID policies, masks and Florida didn't (from summer 2020), however Florida didn't fare worse, it fared better or roughly the same as California.
Australia is another kettle of fish. You locked down early, you closed your borders. Everything else I'm guessing is the same. The USA/Europe did everything you did but really close borders - travel in and out was common place. Asia also tightly shut their borders. There is also another important difference. COVID was spreading around the world since Dec 2020 - which is your summer. So it was spreading far slower in the southern hemisphere and tropical asian countries (like Taiwan) than the northern hemisphere. Because of this, when you shut your borders in spring 2020, there was very little virus in your country and all of it could be isolated through contact measures. Meanwhile, the USA and Europe already were swamped with it by February.
Those are not retrospective studies. The meta-analysis only used RCTs and CRTs. As I mentioned, there were 78 RCTs total, 6 during COVID.
A subset of those RCTs were in HCW. But some were CRTs in entire areas like Bangladesh where they looked at if villages with masks given out (higher use) than villages where no masks were given out (less use) had different incidences of COVID19.
In sum total, there is no evidence masking works. If you're advocating for an intervention you need to show it works.
They were controlled with regard to who wears a mask and who doesn't wear a mask. We can agree with that. Everything else was uncontrolled once they went home or went to parties after work. If the measurable outcome was who got infected then there were no controls over infection exposure except for the hospital environment.
...because the masks 99% of people wore (paper, cloth, bandanas, etc.) are useless against tiny viral particles; it says so right on the box of the paper ones they still hand out in doctors' offices. Why is this simple fact so hard for everyone to grasp???
That's the problem with studies on "masks". In most studies masks are not defined. An N95? Good protection. A bandana? Not good.
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Those are not retrospective studies. The meta-analysis only used RCTs and CRTs. As I mentioned, there were 78 RCTs total, 6 during COVID.
A subset of those RCTs were in HCW. But some were CRTs in entire areas like Bangladesh where they looked at if villages with masks given out (higher use) than villages where no masks were given out (less use) had different incidences of COVID19.
In sum total, there is no evidence masking works. If you're advocating for an intervention you need to show it works.
Why is it worse? States that carried out their interventions through 2021, didn't do better than Florida when adjusted for age. That shows the interventions - lockdowns, mask theater, business closures, capacity limits - did not work. If they did, Florida would be on the higher end of the age adjusted mortality ranking from COVID19.
Interventions did not work because they were largely ignored.
I'm talking about the USA. States like NY, California, New Jersey had strict business closures, COVID policies, masks and Florida didn't (from summer 2020), however Florida didn't fare worse, it fared better or roughly the same as California.
Australia is another kettle of fish. You locked down early, you closed your borders. Everything else I'm guessing is the same. The USA/Europe did everything you did but really close borders - travel in and out was common place. Asia also tightly shut their borders. There is also another important difference. COVID was spreading around the world since Dec 2020 - which is your summer. So it was spreading far slower in the southern hemisphere and tropical asian countries (like Taiwan) than the northern hemisphere. Because of this, when you shut your borders in spring 2020, there was very little virus in your country and all of it could be isolated through contact measures. Meanwhile, the USA and Europe already were swamped with it by February.
IF you adjust for all your elder population. I would say states, cities, households should adjust for the age group and the susceptibility they have, not weight the results differently. If you have a greater susceptible group, you take more precautions.
This wouldn't fly if we had to weight the results for children being the ones more at risk.
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I'm flattered, but it's not my meta analysis. I didn't do it.
Second, there is no use poking holes in that meta analysis when your [mask] side has not produced 2 RCTs or 2 CRTs showing the intervention works. You're asserting it works based on observational studies and anecdotes and bioplausibility, no clinical trials.
The meta analysis just shows that there is no evidence from RCTs/CRTs that masks work. And that's correct, the studies are linked, you can go through them 1 by 1 if you want.
IF you adjust for all your elder population. I would say states, cities, households should adjust for the age group and the susceptibility they have, not weight the results differently. If you have a greater susceptible group, you take more precautions.
This wouldn't fly if we had to weight the results for children being the ones more at risk.
Age adjusted means everyone is adjusted by age for the diseases death rate in that rate. Children included.
I'm flattered, but it's not my meta analysis. I didn't do it.
Second, there is no use poking holes in that meta analysis when your [mask] side has not produced 2 RCTs or 2 CRTs showing the intervention works. You're asserting it works based on observational studies and anecdotes and bioplausibility, no clinical trials.
The meta analysis just shows that there is no evidence from RCTs/CRTs that masks work. And that's correct, the studies are linked, you can go through them 1 by 1 if you want.
My point was acknowledging that FL has a large vulnerable population to Covid, which makes his statement that "we stopped taking infection control measures in 2020" particularly ruthless.
Think about how that sounds when you change it if it was children that it killed the most. "hey if you take remove all the kids that died, our numbers were good!"
It would sound the same -- it would sound like you're being emotional over a simple adjustment for a confounding variable (in this case, age). And I do get your point. It's an emotional point, though. You're holding Florida to a higher standard, because emotions.
I think in terms of how many deaths would be expected in one population versus another, and what actuals were compared to expectations. I did actuarial work for a while, so I'm used to looking at numbers coldly like this.
Do we want to know to what extent the interventions work, or don't we? You're never going to know if you just pretend gigantic confounding variables don't exist. If you serve a different kind of cake to each side of the room at a luncheon, and then you see a lot of one kind of cake go in the trash, you can only conclude that that kind of cake was less appealing if you have reasonable confidence the two groups had roughly the same affinity for cake to begin with. If one entire side of the room was diabetic or had celiac disease and you didn't know about it, well boom, you've reached a faulty conclusion because you've ignored a major confounding variable.
Once we make reasonable adjustments so that the populations are similar from state to state, then we should see a clear signal of lower deaths in states that had strict interventions, IF THE INTERVENTIONS WORKED. I would actually argue there are confounding variables in addition to age that should be addressed next in this progression, particularly obesity. Make some reasonable adjustment for obesity (or maybe diabetes, something like that) and then see which states are on top, which are in the middle, and which are on the bottom. Rinse, wash, repeat until it looks like your analysis matches reality.
We're not doing as complete or rigorous of a process here, but we can still make a reasonably informed conclusion, after adjusting for only one major confounder (leaving other confounders still un-adjusted!) and seeing Florida (which had a conspicuous lack of restrictions) in the same general tier on the chart as California, Illinois, Michigan, and Pennsylvania, all of which had governors known for their aggressive Covid restrictions, that Covid restrictions just don't make a whole hell of a lot of difference with respect to Covid deaths.
Last edited by tribecavsbrowns; 02-09-2023 at 05:41 PM..
I skimmed it. Many of the issues they brought up are known, adjusted for or admitted to as being a limitation. Others are a fair bit spurious.
But that's not the point. There is no use debating that meta-analysis because we don't have 2 RCTs showing masks work. Where is the evidence masks work? We're not weighing two meta-analysis side by side to see which is superior. We have a bunch of studies that are basically null on mask effectiveness, and a bunch of people screaming the studies are not 'good' enough without providing a study of their own - clinical trial.
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