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I think you’re right. I don’t understand the general tendency of assuming malice when a combination of uncertainty about the virus, poor supply chains, and not-very-good underlying data would do just as well.

It’s also unclear what “masks” meant in the initial phases. An N95 respirator? A surgical mask? A homemade cloth mask? Each of these has different uses and effects. I seriously doubt most people knew the difference in early March, I only had a vague notion. The surgeon general likely is thinking of respirators, because all MDs in hospitals get fitted for it. They know how hard it is to put it on and take it off safely, and know how critical it is for it to be a good tight fit. None of those things are going to be true for most people in early March 2020. If that’s your frame of reference, then it makes total sense that you’d recommend people not buy masks.

Everyone going out and buying N95s when they’re not particularly useful to most people unless in a close confined space is a bad thing. It doesn’t actually save many lives, but does make it harder for people who need it (docs/nurses in close confined spaces, particularly with patients on respirators that aerosolize the virus).

People wearing surgical or cloth masks may help some, probably mostly in enclosed spaces and mostly for exhalation rather than preventing you from inhaling a virus from someone else.

Even then, it’s my understanding that the data isn’t awesome here. Many of the papers I’ve seen are under fairly odd scenarios (for example an airplane, lots of the same air, recycled all over, for hours, where the paper showed positive mask benefit). We don’t have much for bandanas, or masks that were washed 3 weeks ago, or masks that are tighter, masks that are looser. I’d wager it helps, a little, especially indoors.

In other words, this shit is complicated, why assume lying when instead we could just say, “it’s complicated, they didn’t get it 100% right.”

I'd be much more OK with this explanation about how complicated it is and how hard it is to get it right if on any disagreement with the same experts one wouldn't get yelled at as "science denier" and accused in willing to murder millions of people by his stupidity. I mean I get it, there's a complex question whether masks help (depends on which mask, in which circumstance, how long is the contact, how skilled you are in wearing masks, etc.) But isn't that why we are paying the CDC guys - to have clear guidelines about such stuff?

OK, let's say CDC guys screwed up and got caught with their pants down (oh man did they...) and now we have no clear guidelines about it. Then come down from the ivory tower and tell us what you have and let us decide without politicians yelling at us and jerking it around - one day you are an idiot murderer because you're wearing mask, next day you're an idiot murderer because you don't. It just breeds contempt for the whole setup.

I completely agree that the rhetoric around “Science!” has gotten increasingly more toxic. I say this as a trained scientist, we really do at bad job of communicating. This is made worse by a media and a general public that isn’t used to thinking in scientific terms.

By that I mean we spend so much time as scientists living with and making decisions about which course of action to take in the context of uncertain data. Other fields obviously do too, but for a bench scientist, every day is is a constant tradeoff on which data you buy, what experiments will you run to confirm/exclude it, and what’s the downside of that decision. The best rarely speak in full certainty, they talk about probabilities.

Contrast to public messaging or journalism which is, “do this, not that.” This has led to people holding “science” as an identity, a talisman of righteousness. That’s not how science works, but people want to feel better by judging people so here we are.

I personally would have preferred a short, coherent statement on what we know for sure and what we don’t, how confident we are about the same, and to treat people as adults.

This isn't complicated at all, it's only been made to look so by governments and organizations caught with their pants down.

Not wearing a mask offers zero protection from an illness which is mainly transmitted through droplets and aerosols.

Wearing a mask offers some protection, ranging from little to very good depending on the type of mask. In the mean time we know that surgical masks offer pretty good protection in particular, but there were studies about SARS, MERS and influenza going back years showing that both FFP2/N95+ and surgical masks do help. We even have studies comparing incorrect, partly incorrect vs correct usage.

The conclusion is inescapable: even if people on average wear masks incorrectly and even if the masks they wear aren't even close to 95% effective, they reduce the rate of transmission. Why on Earth would you not want to reduce the rate of transmission even if by a few percent?

You are assuming that people’s behaviors are identical when wearing and not wearing masks.

This is what we do not know (still).

There are plenty of results in life science far more counterintuitive than the hypothesis, “people are less strict about social distancing when wearing masks.”

There are countries - including in the EU - which made masks mandatory or highly recommended them. If "we" do not know how people behave when wearing masks, we could simply ask them.

Although we don't strictly need to ask them, since the head of the Chinese CDC said more than a month ago that using masks is essential and that he doesn't understand why Europe doesn't do it. KCDC specialists said much of the same thing, although I don't know if they expressed concern at Europe's lax attitude toward masks.

And finally here's a couple of anecdotes:

* people in supermarkets seem a bit more careful now, since the masks have been introduced. But keeping 1.5-2m distance at all times is hard and this is certainly not always respected. That's the whole point of why one needs masks instead of relying on distancing - distancing doesn't always work, but having a mask on is pretty simple. And even if the wearer screws up, at least they don't easily infect the others.

* before the mandatory mask thing people generally got out of my way when they saw me with my mask on.

I think on balance you’re right masks probably don’t hurt, and this is a change from my initial views. I don’t think they’re quite as magical as people seem to think. For example if you wear glasses you’ll notice how easy it is to have them fog up with a mask that doesn’t fit well. Those are your droplets shooting vertically into the air. We don’t know how reused masks perform either esp. when they get dirty. Still, probably helps overall.

Where it does cause harm is early on if everyone gets N95s and the docs can’t get enough (which absolutely happened) then that actually kills more people (docs, nurses, and the people they would have saved).

The right message in retrospect should have been, “don’t go buy masks, save those for people who need the highest performance, but wear a cloth mask when indoors. Wash it frequently.” We screwed up, but it’s not malice and it is complicated.

The problem with summing up a multi-dimensional tradeoff as simplistic negative advice is that it creates FUD that sticks with us indefinitely. Instead of acknowledging the goal we needed to work towards and getting everyone onto the same page, we end up arguing over a trivial issue as the nonsensical advice continue to echo. The biggest benefit to everyone wearing masks would be that we could finally stop talking about masks.

Remember spending a few weeks agonizing over how to ramp up ventilator production, rather than focusing on masks? And then finally coming around to masks could be useful, with everyone championing DIY cloth masks? We're four months into this thing and most everyone is still proudly wearing those ersatz face-rags, even spending effort to "improve" them as as fashion accessories. Meanwhile a proper N95 costs around $3 to produce and distribute - I thought we were supposed to be an industrialized society!

There was definitely no malice or intent to mislead by health authorities in this regard and the claim that there was has always struck me as a bizarre result of selective reporting.

You can go back a few months and the WHO went on record plenty of times regarding a couple of points

- Health workers really need good PPE and there is a shortage

- When infected people wear a mask, it reduces transmission

- The benefits of a non-infected person wearing a mask are not super well understood/studied and this topic doesn't really come up much because our main audience is healthcare professionals

So they said at one point, focus on getting the masks to health care workers, and then as mask supply increased they said the infected should wear them too, and now that cloth/paper masks are easy to obtain they say everyone should wear them.

It was always a question of supply and availability, there was no conspiracy.

If you looked beyond the headlines and looked at the context it was pretty clear.

The recommendation against masks was probably a knee-jerk reaction. Or maybe a bureaucratic "we know better than you" reaction

At the same time the amount of people that think that have the mask below the nose or just at the chin or mishandling it because it feels "uncomfortable" to them is astounding. I'm not sure but I believe an intubation is more uncomfortable (and yes these are predominantly people at risk ages)

This is so very, very annoying. I saw my parents-in-law yesterday, and both of them were wearing masks incorrectly.

It's just so pointless to go to the bother of getting a mask and then wear it in such a way that you get no benefits from it.