DenebianSlimeMolds OP t1_j9vh94t wrote on February 24, 2023 at 9:15 PM

Reply to comment by Romarion in What are the best alternatives to a double-blind RCT if blinding is impossible: example you cannot have a double-blind RCT to test the effectiveness of masks against covid. What is the best way to test if masks, as worn in real life, are effective? by DenebianSlimeMolds

Thank you for the entirety of your answer, very helpful

Regarding this

> You also need time, space, and money to do such an experiment, and in 2020 that would not have been an ethical experiment so it could not be done. It MIGHT be an ethical experiment in 2023 with the current variants of COVID, but even that is unclear.

I am curious what the ethical issues you see are, and if they are alleviated with the use of informed, healthy volunteers....

If an RCT of masks is not ethical, what are the ethics of a mask mandate especially on young children?

believe it or not, I really wasn't trying to make this about masks themselves, but I was intrigued when I heard a scientist mentioning that some tests can't be blinded but that there were alternatives, what he was referring to

Romarion t1_j9w8v8h wrote on February 25, 2023 at 12:26 AM

The lethality of COVID in 2020 before much was known (released?) about it would make exposure to even healthy willing volunteers problematic; some young healthy people died from COVID, so a study where one of the reasonably foreseeable outcomes is death for the participant is not ethical.

The death rates FROM COVID in 2023 are now (as best I know, I haven't looked specifically but I do work in an busy emergency department and the last sick person I've seen who was sick from COVID is quite a while ago) much lower as the virus has mutated, so it would probably be reasonable to do actual masking studies with young healthy volunteers. You can approximate the efficacy of masks by using non-infectious particles, like radioactive substances that are the size of the virus and track where they go when someone talks, coughs, etc, but the uncertainty around how infectious that substitute "viral load" would be is pretty high. And all you could really get is a measure of how effective the various masks are at decreasing the exposure rather than decreasing the infection rate.

The choice of mask mandates for children was always farcical on its face. Reasonable data from Sweden, who did not lock down and did not stop in person school, followed shortly thereafter with pretty good data from the US, all pointed to no benefit for masking children (or ending in person school...). But by then the politics had taken over.

If President Trump said XX, the media, CDC, NIH etc said NOT XX. Science was not involved even when scientists were making recommendations. There is no other way to explain the banning of one of the most well-studied and safest medications available to POTENTIALLY treat COVID, namely Ivermectin. The number of medications used in the US off-label is staggering, and the regulation of that phenomenon is generally left to doctors and their patients. That was not the case with Ivermectin despite a fair amount of data that suggests it is better than most of the (poorly studied) anti-virals pushed by the FDA over the course of the height of the pandemic.

DenebianSlimeMolds OP t1_j9wa5nx wrote on February 25, 2023 at 12:36 AM

Thank you, and with my layman's understanding of the issues, I agree (fwiw). I have to note how sad it seems that your answer requires a bit more honesty than I see around reddit and elsewhere...

Very frustrating how everything gets so polarized these days and often everyone is wrong in large part because they don't have enough humility to recognize what you wrote in your very first paragraph: "understanding that the answers have some amount of uncertainty is the mark of good scientists. "

Romarion t1_j9ypykn wrote on February 25, 2023 at 3:30 PM

The primary issue (IMO) is the remarkably large number of scientists and physicians who abandoned facts and science in favor of ideology. A large number did not abandon their patients, but their voices were ignored or silenced. Which of course takes us back to the death of journalism, but that is another topic.