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Comment by merpnderp | Hacker News Reader

But was it medical science when the CDC advised people, very strongly, to not wear masks or that the virus coming out of Wuhan was of no concern to everyday Americans? How are people supposed to believe in capital 'S' science when our scientific institutions make claims based on their guts instead of just admitting they don't know (which is the only acceptable scientific answer when you can't back up a claim with reproducible experiments).

[EDIT]My point is, is the self-inflicted loss of trustworthiness not well earned by the CDC? When the CDC said repeatedly that masks would only make you catch the virus or that Americans shouldn't prepare or panic about the new virus, when that turned out to be either lies or decisions based on nothing approaching the rigor or science, why should people believe things have changed? How does the layperson understand that now the CDC is basing recommendations on 'S'cience?

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Serious question, why should we be so concerned that they were wrong the first time?

You say

> admitting they don't know (which is the only acceptable scientific answer when you can't back up a claim with reproducible experiments).

But what kind of response is that really, when there's an infectious disease and the center for disease control tells the public "We have no clue what the appropriate response is, we're going to tell you in a couple months after we've done some reproducible experiments"?

On the contrary, the ONLY ethical way for the CDC to act in the face of an emerging (potential) crisis is recommendations based on the current beliefs of the organization (which may be incorrect as they are, as you say, "based on their guts") and updating them the moment more evidence comes available (Which they did. Repeatedly.)

So in fact, I would not say I've had a loss of trust but a gain of trust by an institution acting in a very rational manner throughout the pandemic.

> On the contrary, the ONLY ethical way for the CDC to act in the face of an emerging (potential) crisis is recommendations based on the current beliefs of the organization

This is debatable, but in any case, is it excusable for the CDC to hold beliefs that are so badly wrong in the first place? Especially in the face of evidence from the rest of the world?

It probably wouldn't have been so bad if they weren't considered the profits of science and instead just experts that might have the wrong idea.

>Serious question, why should we be so concerned that they were wrong the first time?

To properly calibrate how we treat their recommendations.

I'm most sympathetic to the CDC, because everyone spreading their message are con men. In the most classic of senses, literal con men. They tell me they have the must-be-believed scoop, up until they're found out. Then they have an excuse for why I was wrong for coming away from our interaction with the perception that their preliminary statements should be taken as seriously as I did. But now, this time, today, the have the real must-be-believed scoop that I can trust.

They knew that masks worked from the get go and openly admitted that their statements about masks being ineffective were driven by fears of shortages, not lack of data. This is why their statements were effectively "masks don't work unless you are a healthcare worker". Scientific organizations should not be issuing politically motivated or economically motivated statements; they should be stating the truth to the best of their ability. It's ok to put some spin on information to achieve results, but issuing knowingly false statements immediately shreds your credibility.

> Scientific organizations should not be issuing politically motivated or economically motivated statements

How is this political or economic? It was purely public health.

At the beginning of the pandemic, we thought we could trace and contain anybody with covid, thus ELIMINATING the virus. In this view, only healthcare workers need masks! If healthcare workers go without masks because every ordinary joe stocked up on masks and toilet paper, that means that healthcare workers get infected and become the spreaders, which is the opposite of "containing".

The original PR was something like "masks don't work unless it's an N95 mask and you wear it in a very specific way, and healthcare workers need those anyways so don't buy 'em". Yeah, I can agree it feels misleading now.

But in a world where we're trying to literally ELIMINATE the virus, it makes sense: Wearing a cloth mask near someone with the virus COULD get you infected, so you're better off not being in that situation in the first place.

Once it became clear that we couldn't just have everybody stay at home until the virus is gone, the CDC changed their recommendation to wearing cloth masks. This was about 2 weeks into "lockdowns", at the very very beginning of april.

I fail to see whats so bad about the CDC's recommendations. From the point of view of public health (again, that's what the CDC is. A public health agency), these recommendations make sense in context.

> At the beginning of the pandemic, we thought we could trace and contain anybody with covid, thus ELIMINATING the virus. In this view, only healthcare workers need masks! If healthcare workers go without masks because every ordinary joe stocked up on masks and toilet paper, that means that healthcare workers get infected and become the spreaders, which is the opposite of "containing".

Healthcare workers aren't getting masks through the same supply chains as regular people; they are getting them through hospitals. If it truly was the case that hospitals were being outbid for supplies by private entities, that is a commerce regulatory problem arguably out of scope of the CDC. The government should have bitten the bullet and passed a law to forcibly route material to hospitals and / or eminent domained existing stockpiles for sale by companies or individuals and given them to hospitals. It is not the CDC's job to handle supply chain management in these contexts. If the CDC would like to get involved, it should be encouraging people to give masks to health care workers because they work and because health care workers should take priority. This preserves their credibility and shifts the responsibility to act onto the entities that should be bearing it: the president and congress.

We are now inching towards the political reality of the situation, but that is essentially what the CDC and various hospitals tried to do.

New York went to the federal government to get masks and was told to pound sand. They then ordered them from Canada and were once again impeded by the federal government[1]. So now you are in a situation where your the hospital supply chain is now gone, and you are forced to buy masks for medical workers in the marketplace, and you are now facing the real possibility that the general public may buy up all the masks before they can contain and eliminate the virus.

The CDC may have been acting in it's own best interest in the face of a federal branch who refused to believe that the virus was a big issue. If the CDC truly believed they had time to contain and eliminate the virus, I can see how telling people to not stock up on masks may have been a good idea at the time.

[1] https://www.theglobeandmail.com/canada/article-fbi-redirects...

If covid-19 were containable, then average people don't need masks. This isn't new territory: we've contained infectious diseases before, like SARS and ebola, and average Joe didn't need a mask then, either.

The CDC (and frankly every major government in the world) believed that covid-19 could be contained, and that no major outbreak would happen inside their country. This was incorrect. But if you hold this assumption, the CDC made the correct recommendation: N95 masks, properly worn, are the masks that protect against covid-19, and average people don't need them.

If covid-19 were contained why would there be a mask shortage? Transmission in the general population seems necessary to cause a nationwide shortage in first place.

>The CDC (and frankly every major government in the world) believed that covid-19 could be contained

There's plenty of photos from asian countries where mask use was immediate, wide spread, and effective.

> They knew that masks worked from the get go

Can you point to the studies that they would have used to confirm this belief?

If you insist I'm happy to go hunting for studies, but let's remember that the CDC from the start was advocating that people reserve masks for healthcare workers. If they didn't believe that masks worked, why would they do that?

I do insist. You're making the claim that WHO / CDC knew that masks work. So, let's see the evidence that you think they had.

> If they didn't believe that masks worked, why would they do that?

Because a healthcare professional stuck in a room with symptomatic people is a different situation to a member of the public walking around.

Especially because HCPs are trained to use masks, they use them in combination with other PPE and routine handwashing; their PPE is made to standards and tested to make sure it complies with those standards; HCPs are audited on their use of handwashing and PPE.

I think this, again, stems from a general misunderstanding of what science is. Science is a method of drawing conclusions about data. Sometimes, those initial conclusions can be misguided by incomplete data. The world discovered this virus less than a year ago. It takes some time to determine the different transmission vectors and risk factors associated with each. The CDC did not make a claim based on their "guts". The initial stance on masks was determined for a few reasons:

1) People often don't use masks properly. They often touch their masks and their faces. The initial thinking was that the virus spread largely through touching contaminated surfaces.

2) Mask mandates are difficult (as we are seeing now) and significant portions of the population refusing to use masks undercuts their efficacy.

3) There was a shortage of PPE when the pandemic started. The CDC and NHS didn't want to find themselves in a situation where hospitals had a hard time procuring masks because scared citizens hoarded the supply.

The anti-science issue in the US appears to have a few prongs to it. There has been a growing distrust of science for quite some time with the anti-vax and flat earth movements. I'm not sure what caused it, but it sadly appears to be a growing trend. Also, as we are seeing with the Coronavirus response, a lot of people seem to misunderstand that scientific consensus can change as new data is collected.

1) sounds like an argument looked for after the fact. Masks were recommended initially especially because they stop you from touching your face and would train you not to do so.

2) doesn't make sense to me: because masks aren't perfect and some people refusing to wear masks makes them less efficient they'd advise to not wear masks at all?

3) is a political stance, not a scientific one.

Would people have reacted differently to masks if they weren't intentionally mislead on so many levels about Covid-19 in general (the WHO losing a lot of credibility) and the efficacy of masks? When you have people who are skeptical of the government, and the government lies to them and gets caught, won't that make them even more skeptical of whatever the government says next?

I don't think there ever was a scientific consensus that masks aren't effective against airborne diseases. There was a political decision, and that can change any time, but it has nothing to do with data collection or the scientific method.

1) No, quite the opposite. It was one of the reasons cited by the CDC as to why they originally did not support widespread face mask use.

2) This ties into the fact that PPE supplies were low when the pandemic started. They did not want to declare a mask ordinance while hospitals were still having a difficult time sourcing PPE themselves. The fact that many people would either be unable to purchase masks or be unwilling to participate made it so that they would just be working against themselves at a time when supply management was critical.

3) Is sociology not a science? It is a matter of public policy. Ensuring that healthcare professionals have access to PPE is the prudent course of action when dealing with a pandemic.

>> I don't think there ever was a scientific consensus that masks aren't effective against airborne diseases. There was a political decision, and that can change any time, but it has nothing to do with data collection or the scientific method.

What are you even talking about? Mask use continues to be studied widely[1]

[1]: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...

CDC and healthcare in general are not scientific institutions.

There's two items at issue: science as a set of methodologies for understanding nature, and "Science" as a cultural totem.

As a set of methodologies, science is inherently skepticism, test, verify, etc. Nothing wrong with being wrong, it just means you gather more data and learn.

As a cultural totem, annoying liberals will say "science says" when they're clearly innumerate, and dumb conservatives will say "I don't trust them experts" when they clearly don't know better. The CDC making a mistake is a political misstep, rather than a step on the way to better understanding.

> When the CDC said repeatedly that masks would only make you catch the virus or that Americans shouldn't prepare or panic about the new virus...

Could you cite where and when the CDC said that?

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