The "against mask wearing" argument here is *so* bad. It is literally just that we need to stop wearing masks some day.... so let's just do it now? How does that actually address your premise of balancing benefits and costs of pandemic mitigation measures at all?
Matt is usually the person who can take a step back, evaluate an argument on the merits, and come to reasonable conclusions. Unfortunately, on the mask front, Matt seems to have zero ability to critique his own emotion-driven position.
I largely agree with this. I have three young kids, one in school and two in daycare. One or another has been quarantining for a long time now. My wife and I can't work, we can't take them anywhere that's inside and it's too cold outside. The kids are stir crazy and unhappy. It's bad for our mental health. It's rough all around. I'm sick of this and I'm more than ready to go back to normal life. This just can't go on forever.
I also went to the trouble to read the "hit piece". It's garbage. It's completely empty of substance--almost nothing but innuendo. ('Many say some of his pieces go too far, but they're afraid to go on the record about a Pulitzer prize winning journalist' Oh barf.)
That said, you should take the time to examine the other side and consider their position. This shouldn't go on forever, but it seems to me there is an argument for going a little longer. First, there just wasn't enough PPE, and there weren't enough vaccine doses. Now there are. But were still not really done. It can be hard to get a hold of home tests when you need them. There are pills to treat the infection, but there aren't enough to go around now. The vaccines still haven't been quite worked out for under 5's (two of my kids). These things haven't been worked out yet, but they will be.
In the interim, omicron is so contagious that cases are spiking right now, well beyond the previous waves even in the lefty college town where I live (with some of the highest vaccination rates). I get daily emails from my oldest's principal; they get ~5 new cases a day in a school of a few hundred, where almost all the kids are vaccinated, despite wearing masks all day at school, eating outside while distancing, etc. Imagine the scenario without all that. Those kids could spread the disease further. Despite omicron being milder and having a lower hospitalization rate, the hospital is filling up. They have to postpone elective treatments for non-COVID patients. That entails real costs, too.
Omicron will pass and the logistical issues will get straightened out. It shouldn't take too long. Meanwhile, it is sensible to try to maintain NPI as much as possible. I should say that I haven't been on twitter or facebook in years :-), so I don't know if the above points are what shouters are yapping about. Still, the public health community doesn't need such vilification. They feel under siege and unappreciated (I know some). If you want to win hearts and minds here, you might consider pandering to their perspective a little.
I looked through a lot of comments and I'm surprised not to see a single one about hospital capacity. But I think it's precisely where the public health and individual risk perspectives conflict most strongly.
Now maybe the argument is: the unvaccinated also won't comply with NPI, so trying to reduce community transmission among us vaccinated/boosted folks is a waste of time.
But healthcare impact needs to at least enter the cost-benefit calculation, doesn't it?
Definitely. And I'd be curious to know what are effective and workable steps that would help with hospital capacity beyond a) encouraging/mandating where possible vaccination, and b) scaling up hospital capacity.
Vaxxed, boosted people wearing cloth masks to the grocery store or while they get up to go to the bathroom at a restaurant (but not to their family parties, or in their offices, or while sitting at a bar or while "consuming food" at a basketball game)... does not seem to make much of an impact on hospital capacity.
We seem to have two examples of really "effective" ways to dramatically reduce COVID risk: 1) extremely strict quarantine rules (not half-ass stuff), and 2) vaccination. I don't think there's much appetite for #1.
"I know plenty of people who got breakthrough Omicron cases that made them feel somewhere between 'eh, it’s like a regular cold' to 'ugh, I feel pretty awful.'”
I'm older than you, and the people I know who have had breakthrough cases lately have gotten really, really sick.
"... set a date much earlier than the beginning of the fall school year and make that the day that the mask mandate for airplanes ... ends."
Sure, masks in restaurants are dumb, but our elementary school has provided students KN-95 masks and has had great uptake. Considering how omicron is ravaging our state right now — and how it's a pain in the ass to be sick even for the vaccinated — I'm curious if this NPI is passé for this crowd.
I trust Leondhart a lot more than I trust other self-described “smart generalists,” including the author of this substack. I still haven’t seen a good explanation for why the average person should trust Matt any more than Rogan that doesn’t rely on the credentialism all the “smart generalists” complain about.
BUT, as I said, having read Leondhart for many years, I trust him to have a reasonable take. I’m still going to wear my N95 at restaurants and clubs, though. If other people want to ditch their masks, I am not going to stop them.
That sounds pretty reasonable! (Though I would say that if you're particularly concerned it would make more sense to avoid restaurants than to wear N95s there, since you have to take them off anyway - but you do you IMO)
I saw a tweet the other day that said "Before I do anything nowadays I ask myself: is this how I want to get covid?"
I got a breakthrough in December after seeing House of Gucci in the theatre (worth it), but this is pretty much how I'm living my life now. It's worth the risk to me to go to parties with vaccinated people, not so much to eat inside a restaurant rather than sit outside/get takeout.
The problem is that there are some places that aren't really optional for me or for lots of other people -- the grocery store, public transit, school, etc. -- where you can't weigh the benefits of going against the risks posed by unmasked, unvaccinated people. I live in DC, so this usually isn't much of a problem for me, but I was recently in a small-town Maryland grocery store with zero masking, in a county with a 65% vaccination rate, and it angered me to no end that I might get covid because I had to pick up aspirin and the other patrons couldn't be bothered to put on masks. My girlfriend is a teacher and we're both anti-remote teaching, but it would make me angier if she got covid because the school rescinded its mask mandate. It would make me angriest of all if my grandmother, who has cancer and a bad heart, died because some idiot couldn't sacrifice their comfort for 20 minutes in line at the pharmacy.
The only way I'm supporting getting rid of mandatory masking in these sorts of places is if we replace it with mandatory vaccination.
Thanks so much for this one Matt. You’re articulating what a lot of liberals are thinking but are afraid to say out loud for fear of being painted a psycho by the hawks. My dad, who I think has unfortunately become overly paranoid by watching too much MSNBC, literally called me a “conservative antivaxxer” the other day after I expressed my frustration with mask mandates (I’m triple vaccinated).
We need to end this charade. Cases are plummeting in the Northeast. It’s now or never for Biden.
Cases are plummeting in the Northeast? If there was some agreement in when the masks would need to come back, that’s a good metric. But we’ve clearly been in a surge and trough environment for over a year now, so just because cases are plummeting doesn’t mean much for the future.
I was just in a seminar with the Secretary of Ag. He was part of a panel. The panelists were seated about 6 feet apart and when it was his turn to speak, he removed his mask. I think that is a good sign of a thawing.
Just two days ago, a colleague of mine sent out an article condemning people who unnecessarily traveled or went to in-person gatherings for being eugenicists and feeling entitled to the deaths of disabled people. We're in one of the most-vaccinated counties in the nation with extremely low hospitalization numbers. There definitely are people here who believe that the hypervigilance should be ceaseless.
"And it’s on the second point where I think a lot of public health analysts have lost the plot. “Don’t do X for some defined period of time after which X will become dramatically safer” is a very different piece of advice than “don’t do X indefinitely.”"
As a public health analyst, I'm a bit discouraged that you think we all have the same point of view. I think it's an important distinction that the public health analysts you're referencing are the ones that get communicated through the media you consume.
I liked this piece a lot! One question I have from it is in regards to the kid that had to stay home despite being asymptomatic due to a positive test. Does anyone know what the latest consensus is on asymptomatic spread? Is it a thing? Is it not? On it's face, having a kid stay home until he tests negative doesn't seem too unreasonable to me. That being said, if the consensus is that spread is severely limited by asymptomatic people maybe just staying home for like 2 days or whatever would be fine. I am in COMPLETE AGREEMENT about the close contact and negative test quarantine rules are just INSANE at this point. As a father to a 3-year old having to use a bunch of sick days or PTO to care for a perfectly healthy little kid is beyond frustrating.
I think the thing that the pro-NPI crowd always leaves out is what they think the NPIs will achieve... basically the argument is "you oppose school closures and masks so you must want people to die."
But the real point the anti-NPI people are making is:
1. Omicron has an r0 of something like 8 without any mitigation (vs. original Covid which was like 3).
2. With extremely high societal buy-in, we were able to drive r0 from 3 to about .8 in May of 2020, about a 75% reduction in transmissability(?).
3. More "manageable" restrictions like work from home for office workers and widespread masking we can have an undetermined impact on spread but generally even pre-Omicron this resulted in broad spread from time to time.
4. Now we have a variant that is twice as contagious as the original and also a lot of people who can't or won't comply with NPIs. Thus the impact of school remote days and masks might be to bring r0 to like 4 or 5 (a 50% reduction)... but ultimately how much good does that do?
I wish the NPI advocates would be explicit about how much they think masks and school closures will reduce spread in the real world rather than just saying David Leonhardt doesn't care about 2k people dying or whatever.
> And it’s on the second point where I think a lot of public health analysts have lost the plot. “Don’t do X for some defined period of time after which X will become dramatically safer” is a very different piece of advice than “don’t do X indefinitely.”
This, this, so much this.
Also, sorry to hear your Chicago trip got canceled. The average temperature here is currently hovering at a few degrees above absolute zero, so hopefully your trip gets rescheduled for a nicer time of year.
The "against mask wearing" argument here is *so* bad. It is literally just that we need to stop wearing masks some day.... so let's just do it now? How does that actually address your premise of balancing benefits and costs of pandemic mitigation measures at all?
Matt is usually the person who can take a step back, evaluate an argument on the merits, and come to reasonable conclusions. Unfortunately, on the mask front, Matt seems to have zero ability to critique his own emotion-driven position.
I largely agree with this. I have three young kids, one in school and two in daycare. One or another has been quarantining for a long time now. My wife and I can't work, we can't take them anywhere that's inside and it's too cold outside. The kids are stir crazy and unhappy. It's bad for our mental health. It's rough all around. I'm sick of this and I'm more than ready to go back to normal life. This just can't go on forever.
I also went to the trouble to read the "hit piece". It's garbage. It's completely empty of substance--almost nothing but innuendo. ('Many say some of his pieces go too far, but they're afraid to go on the record about a Pulitzer prize winning journalist' Oh barf.)
That said, you should take the time to examine the other side and consider their position. This shouldn't go on forever, but it seems to me there is an argument for going a little longer. First, there just wasn't enough PPE, and there weren't enough vaccine doses. Now there are. But were still not really done. It can be hard to get a hold of home tests when you need them. There are pills to treat the infection, but there aren't enough to go around now. The vaccines still haven't been quite worked out for under 5's (two of my kids). These things haven't been worked out yet, but they will be.
In the interim, omicron is so contagious that cases are spiking right now, well beyond the previous waves even in the lefty college town where I live (with some of the highest vaccination rates). I get daily emails from my oldest's principal; they get ~5 new cases a day in a school of a few hundred, where almost all the kids are vaccinated, despite wearing masks all day at school, eating outside while distancing, etc. Imagine the scenario without all that. Those kids could spread the disease further. Despite omicron being milder and having a lower hospitalization rate, the hospital is filling up. They have to postpone elective treatments for non-COVID patients. That entails real costs, too.
Omicron will pass and the logistical issues will get straightened out. It shouldn't take too long. Meanwhile, it is sensible to try to maintain NPI as much as possible. I should say that I haven't been on twitter or facebook in years :-), so I don't know if the above points are what shouters are yapping about. Still, the public health community doesn't need such vilification. They feel under siege and unappreciated (I know some). If you want to win hearts and minds here, you might consider pandering to their perspective a little.
Thanks for holding the center. It's lonely here and I appreciate your voice.
I looked through a lot of comments and I'm surprised not to see a single one about hospital capacity. But I think it's precisely where the public health and individual risk perspectives conflict most strongly.
Now maybe the argument is: the unvaccinated also won't comply with NPI, so trying to reduce community transmission among us vaccinated/boosted folks is a waste of time.
But healthcare impact needs to at least enter the cost-benefit calculation, doesn't it?
Definitely. And I'd be curious to know what are effective and workable steps that would help with hospital capacity beyond a) encouraging/mandating where possible vaccination, and b) scaling up hospital capacity.
Vaxxed, boosted people wearing cloth masks to the grocery store or while they get up to go to the bathroom at a restaurant (but not to their family parties, or in their offices, or while sitting at a bar or while "consuming food" at a basketball game)... does not seem to make much of an impact on hospital capacity.
We seem to have two examples of really "effective" ways to dramatically reduce COVID risk: 1) extremely strict quarantine rules (not half-ass stuff), and 2) vaccination. I don't think there's much appetite for #1.
"I know plenty of people who got breakthrough Omicron cases that made them feel somewhere between 'eh, it’s like a regular cold' to 'ugh, I feel pretty awful.'”
I'm older than you, and the people I know who have had breakthrough cases lately have gotten really, really sick.
"... set a date much earlier than the beginning of the fall school year and make that the day that the mask mandate for airplanes ... ends."
Thereby banishing older people from airplanes.
Sure, masks in restaurants are dumb, but our elementary school has provided students KN-95 masks and has had great uptake. Considering how omicron is ravaging our state right now — and how it's a pain in the ass to be sick even for the vaccinated — I'm curious if this NPI is passé for this crowd.
I trust Leondhart a lot more than I trust other self-described “smart generalists,” including the author of this substack. I still haven’t seen a good explanation for why the average person should trust Matt any more than Rogan that doesn’t rely on the credentialism all the “smart generalists” complain about.
BUT, as I said, having read Leondhart for many years, I trust him to have a reasonable take. I’m still going to wear my N95 at restaurants and clubs, though. If other people want to ditch their masks, I am not going to stop them.
That sounds pretty reasonable! (Though I would say that if you're particularly concerned it would make more sense to avoid restaurants than to wear N95s there, since you have to take them off anyway - but you do you IMO)
Editing feedback: I think it would have been helpful to say who David Leonhardt is in the first paragraph
I saw a tweet the other day that said "Before I do anything nowadays I ask myself: is this how I want to get covid?"
I got a breakthrough in December after seeing House of Gucci in the theatre (worth it), but this is pretty much how I'm living my life now. It's worth the risk to me to go to parties with vaccinated people, not so much to eat inside a restaurant rather than sit outside/get takeout.
The problem is that there are some places that aren't really optional for me or for lots of other people -- the grocery store, public transit, school, etc. -- where you can't weigh the benefits of going against the risks posed by unmasked, unvaccinated people. I live in DC, so this usually isn't much of a problem for me, but I was recently in a small-town Maryland grocery store with zero masking, in a county with a 65% vaccination rate, and it angered me to no end that I might get covid because I had to pick up aspirin and the other patrons couldn't be bothered to put on masks. My girlfriend is a teacher and we're both anti-remote teaching, but it would make me angier if she got covid because the school rescinded its mask mandate. It would make me angriest of all if my grandmother, who has cancer and a bad heart, died because some idiot couldn't sacrifice their comfort for 20 minutes in line at the pharmacy.
The only way I'm supporting getting rid of mandatory masking in these sorts of places is if we replace it with mandatory vaccination.
If you wear a KN95 or N95 mask you're personally protected wherever you go. It doesn't matter what everyone else does.
Thanks so much for this one Matt. You’re articulating what a lot of liberals are thinking but are afraid to say out loud for fear of being painted a psycho by the hawks. My dad, who I think has unfortunately become overly paranoid by watching too much MSNBC, literally called me a “conservative antivaxxer” the other day after I expressed my frustration with mask mandates (I’m triple vaccinated).
We need to end this charade. Cases are plummeting in the Northeast. It’s now or never for Biden.
Cases are plummeting in the Northeast? If there was some agreement in when the masks would need to come back, that’s a good metric. But we’ve clearly been in a surge and trough environment for over a year now, so just because cases are plummeting doesn’t mean much for the future.
Now or never to do what?
I was just in a seminar with the Secretary of Ag. He was part of a panel. The panelists were seated about 6 feet apart and when it was his turn to speak, he removed his mask. I think that is a good sign of a thawing.
Just two days ago, a colleague of mine sent out an article condemning people who unnecessarily traveled or went to in-person gatherings for being eugenicists and feeling entitled to the deaths of disabled people. We're in one of the most-vaccinated counties in the nation with extremely low hospitalization numbers. There definitely are people here who believe that the hypervigilance should be ceaseless.
"And it’s on the second point where I think a lot of public health analysts have lost the plot. “Don’t do X for some defined period of time after which X will become dramatically safer” is a very different piece of advice than “don’t do X indefinitely.”"
As a public health analyst, I'm a bit discouraged that you think we all have the same point of view. I think it's an important distinction that the public health analysts you're referencing are the ones that get communicated through the media you consume.
He did say "a lot of."
I liked this piece a lot! One question I have from it is in regards to the kid that had to stay home despite being asymptomatic due to a positive test. Does anyone know what the latest consensus is on asymptomatic spread? Is it a thing? Is it not? On it's face, having a kid stay home until he tests negative doesn't seem too unreasonable to me. That being said, if the consensus is that spread is severely limited by asymptomatic people maybe just staying home for like 2 days or whatever would be fine. I am in COMPLETE AGREEMENT about the close contact and negative test quarantine rules are just INSANE at this point. As a father to a 3-year old having to use a bunch of sick days or PTO to care for a perfectly healthy little kid is beyond frustrating.
I think the thing that the pro-NPI crowd always leaves out is what they think the NPIs will achieve... basically the argument is "you oppose school closures and masks so you must want people to die."
But the real point the anti-NPI people are making is:
1. Omicron has an r0 of something like 8 without any mitigation (vs. original Covid which was like 3).
2. With extremely high societal buy-in, we were able to drive r0 from 3 to about .8 in May of 2020, about a 75% reduction in transmissability(?).
3. More "manageable" restrictions like work from home for office workers and widespread masking we can have an undetermined impact on spread but generally even pre-Omicron this resulted in broad spread from time to time.
4. Now we have a variant that is twice as contagious as the original and also a lot of people who can't or won't comply with NPIs. Thus the impact of school remote days and masks might be to bring r0 to like 4 or 5 (a 50% reduction)... but ultimately how much good does that do?
I wish the NPI advocates would be explicit about how much they think masks and school closures will reduce spread in the real world rather than just saying David Leonhardt doesn't care about 2k people dying or whatever.
> And it’s on the second point where I think a lot of public health analysts have lost the plot. “Don’t do X for some defined period of time after which X will become dramatically safer” is a very different piece of advice than “don’t do X indefinitely.”
This, this, so much this.
Also, sorry to hear your Chicago trip got canceled. The average temperature here is currently hovering at a few degrees above absolute zero, so hopefully your trip gets rescheduled for a nicer time of year.