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UK face coverings discussion

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Domh245

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I had no trouble wearing my mask for my 12 and a half hour shift (though it was a lot colder and draughtier in the NHS building compared to the hot muggy northern line train!)

That's the key difference I expect! It was manageable (although when I got to Morden I was very glad to get the mask off and get a lungful of cold air) but definitely not something I'd want to do for much longer. Possibly would have also been more tolerable with one of the lighter, disposable type masks as opposed to the reusable one I was using
 
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initiation

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Wouldn't you take antibiotics or painkillers if you needed them?

This argument comparing it to antibiotics is deeply flawed.
1. We don't mandate that everyone has to take antibiotics whether or nor they have the disease.
2. For we don't give antibiotics to people who are asymptomatic or show only mild symptoms.
3. Antibiotics have been robustly tested before being rolled out and proven to work against infections.
4. If antibiotics are employed they are on a time limited basis as prescribed by a doctor.
5. If at the end of the course the situation has not improved, or got worse they don't say "ah what we need is to employ more of the same antibiotic" - they go away, reevaluate, and try a different course of action/diagnosis.
 

Domh245

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2. For we don't give antibiotics to people who are asymptomatic or show only mild symptoms.

Whilst notionally true, I thought there was a developing issue were doctors/vets were far too keen to just prescribe a course of antibiotics which was exacerbating the issue with antibiotic resistant bacteria like MRSA?
 

initiation

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Whilst notionally true, I thought there was a developing issue were doctors/vets were far too keen to just prescribe a course of antibiotics which was exacerbating the issue with antibiotic resistant bacteria like MRSA?

Definitely. Particularly in certain countries where doctor's are more relaxed about their usage. I believe China and the USA also use much higher quanities in the food chain.
It highlights that even when a treatment clearly can work, it can have a negative.

There has been a push in the UK to get antibiotics usage down (6% overall decrease in human usage from 2013-17 despite an increasing population).

In anycase, they are definitely not prescribing them to people who haven't even gone to the doctors and have no symptoms.
 

DustyBin

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Please feel free to direct me to the relevant papers

I posted this a while back:


Conclusions This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.

Obviously the trial was conducted in a healthcare setting but it's reasonable to accept that cloth masks will perform even more poorly in a community setting for the reasons discussed at length on this forum. This research was conducted before masks were politicised which for me at least is important.

One of the main problems with Trisha Greenhalgh's research is that it's all theory. She appears to rely heavily on modelling and best case scenarios which don't play out in reality. Suggesting everybody should launder their masks on a daily basis is great, but how many people do that? Which brings us back to the problem of people walking around with damp, dirty and highly infectious pieces of cloth stuck to their faces....
 

Bantamzen

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I posted this a while back:




Obviously the trial was conducted in a healthcare setting but it's reasonable to accept that cloth masks will perform even more poorly in a community setting for the reasons discussed at length on this forum. This research was conducted before masks were politicised which for me at least is important.

One of the main problems with Trisha Greenhalgh's research is that it's all theory. She appears to rely heavily on modelling and best case scenarios which don't play out in reality. Suggesting everybody should launder their masks on a daily basis is great, but how many people do that? Which brings us back to the problem of people walking around with damp, dirty and highly infectious pieces of cloth stuck to their faces....

You do have to keep in mind that most of this modelling is based on use in medical / laboratory settings. Out in the wider world people are not going to be following the sort of protocols that more scientific / medical scenarios demand.
 

DustyBin

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You do have to keep in mind that most of this modelling is based on use in medical / laboratory settings. Out in the wider world people are not going to be following the sort of protocols that more scientific / medical scenarios demand.

Yes absolutely, that's the problem with most if not all of the research presented in support of masks. Theory and reality are two different things....
 

35B

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Isn't she the one who recommended them despite acknowledging the lack of evidence? That's the hallmark of a witch-doctor, not a scientist.
That article is sufficient to convince this layman that, on a balance of probabilities, general mask wearing is likely to do more good than harm because it focuses on suppressing transmission rather than preventing inhalation. 5 months on, I would also like to see more data to verify or refute her analysis.
 

DB

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That article is sufficient to convince this layman that, on a balance of probabilities, general mask wearing is likely to do more good than harm because it focuses on suppressing transmission rather than preventing inhalation. 5 months on, I would also like to see more data to verify or refute her analysis.

Doesn't the fact that there is no evidence at all of it making any difference anywhere say something?
 

DustyBin

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That article is sufficient to convince this layman that, on a balance of probabilities, general mask wearing is likely to do more good than harm because it focuses on suppressing transmission rather than preventing inhalation. 5 months on, I would also like to see more data to verify or refute her analysis.

Out of interest, did you look at the article linked in post #5795?
 

35B

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Doesn't the fact that there is no evidence at all of it making any difference anywhere say something?
I don't accept the argument you make that the absence of a clear change in gradient concurrent with interventions means that those interventions had no effect. On the annotated graphs (and I notice the graph users shouting about a drop in hospitalisations a week ago have been very quiet about the hospitalisations graph used last night), the argument for no intervention seems to be that the absence of a downward change in a curve proves ineffectiveness, but there is no consideration of whether that intervention itself prevented the curve steepening more drastically. I would however like to see more up to date data from monitoring the widespread use of masks.
Out of interest, did you look at the article linked in post #5795?
I hadn't. But reading it briefly now, it and the quote Greenhalgh paper are looking at two completely different things. Greenhalgh is arguing for a protective benefit to the population at large by using masks to limit transmission by mask wearers; the BMJ paper is measuring the effectiveness of cloth face coverings at protecting health care workers from respiratory viruses exhaled by their patients.
 

MikeWM

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Interesting how her vast expertise of literature reviewing processes seems to have completely missed all of the Randomised control trials on the subject, and instead focused on hastily implemented mechanistic studies.

Indeed. If her writings on how to analyse evidence are indeed actually required reading for prospective doctors, I hope she did a better job with those than with her analysis of masks ('do as I say, not as I do'). If not that's quite a terrifying prospect.
 

DB

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I don't accept the argument you make that the absence of a clear change in gradient concurrent with interventions means that those interventions had no effect. On the annotated graphs (and I notice the graph users shouting about a drop in hospitalisations a week ago have been very quiet about the hospitalisations graph used last night), the argument for no intervention seems to be that the absence of a downward change in a curve proves ineffectiveness, but there is no consideration of whether that intervention itself prevented the curve steepening more drastically. I would however like to see more up to date data from monitoring the widespread use of masks.
I hadn't. But reading it briefly now, it and the quote Greenhalgh paper are looking at two completely different things. Greenhalgh is arguing for a protective benefit to the population at large by using masks to limit transmission by mask wearers; the BMJ paper is measuring the effectiveness of cloth face coverings at protecting health care workers from respiratory viruses exhaled by their patients.

The 'well, it would have been worse without masks' argument is nothing more that speculation - there is no supporting evidence, and we are back to basically another variant on the view that it's fine to mandate masks because it can't be absolutely proven that they don't work. This is a fundamentally flawed process for making policies. If something cannot be demonstrated to have any benefit, it should never be mandated.
 

yorkie

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Wouldn't you take antibiotics or painkillers if you needed them?
People thinking they need antibiotics is causing major problems actually.
The threat is real, there is no conspiracy regarding hospital admissions and wearing a mask is hardly a difficult thing to do for the majority of adults for hopefully some degree of transmission reduction.
But this ignores the concerns I have raised previously surrounding the mandating of masks. If you are talking about voluntary mask usage then I have no issue, but telling people they must wear masks causes all sorts of issues, which this point does not address.
Damage to the economy is also real...
Can you provide evidence that strict mandating of masks correlates to a better performing economy? Are Italy and Spain doing better than Sweden? (I think not)
Even if masks prove to be a very small part of transmission reduction, even a small reduction could give benefit due to the mathematics of exponential growth. If it was a choice between masks or lockdown, which would you choose?
If that was a genuine choice I'd choose masks, but that isn't the choice!

The 'well, it would have been worse without masks' argument is nothing more that speculation - there is no supporting evidence....
Quite!
 

The Ham

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I posted this a while back:




Obviously the trial was conducted in a healthcare setting but it's reasonable to accept that cloth masks will perform even more poorly in a community setting for the reasons discussed at length on this forum. This research was conducted before masks were politicised which for me at least is important.

One of the main problems with Trisha Greenhalgh's research is that it's all theory. She appears to rely heavily on modelling and best case scenarios which don't play out in reality. Suggesting everybody should launder their masks on a daily basis is great, but how many people do that? Which brings us back to the problem of people walking around with damp, dirty and highly infectious pieces of cloth stuck to their faces....

Two points, firstly that's comparing cloth masks and medical masks in medical settings over whole shifts, so it's not surprising that the advice isn't to wear cloth masks and, therefore by extension, to wear medical masks.

Point two is that there's been a Covid-19 update which confirms that it's not saying don't wear any mask :


Health workers are asking us if they should wear no mask at all if cloth masks are the only option. Our research does not condone health workers working unprotected. We recommend that health workers should not work during the COVID-19 pandemic without respiratory protection as a matter of work health and safety. In addition, if health workers get infected, high rates of staff absenteeism from illness may also affect health system capacity to respond. Some health workers may still choose to work in inadequate PPE. In this case, the physical barrier provided by a cloth mask may afford some protection, but likely much less than a surgical mask or a respirator.


It is important to note that some subjects in the control arm wore surgical masks, which could explain why cloth masks performed poorly compared to the control group. We also did an analysis of all mask wearers, and the higher infection rate in cloth mask group persisted. The cloth masks may have been worse in our study because they were not washed well enough – they may become damp and contaminated. The cloth masks used in our study were products manufactured locally, and fabrics can vary in quality. This and other limitations were also discussed.


There are now numerous reports of health workers wearing home made cloth masks, or re-using disposable mask and respirators, and asking for guidance. If health workers choose to work in these circumstances, guidance should be given around the use.

== Doublepost prevention - post automatically merged: ==

Well, given we have masks AND lockdown anyway, I'd have zero qualms about ditching masks

Seems there is little chance of catching covid on the tube or bus...

There's growing evidence that surfaces are not a significant source of infections, in that where they can be traced it's always to someone with it rather than touching something that someone who's infected touched and left before being picked up by those who got infected.

Although that could be in part due to significant numbers being fairly good with the cleaning of their hands.
 

35B

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The 'well, it would have been worse without masks' argument is nothing more that speculation - there is no supporting evidence, and we are back to basically another variant on the view that it's fine to mandate masks because it can't be absolutely proven that they don't work. This is a fundamentally flawed process for making policies. If something cannot be demonstrated to have any benefit, it should never be mandated.
No, it is the same argument as that the line that was followed "proves" that they made no difference. Neither proves anything in themselves; the challenge with preventative measures being how you measure what did not happen.
 

AM9

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This argument comparing it to antibiotics is deeply flawed.
1. We don't mandate that everyone has to take antibiotics whether or nor they have the disease.
2. For we don't give antibiotics to people who are asymptomatic or show only mild symptoms.
3. Antibiotics have been robustly tested before being rolled out and proven to work against infections.
4. If antibiotics are employed they are on a time limited basis as prescribed by a doctor.
5. If at the end of the course the situation has not improved, or got worse they don't say "ah what we need is to employ more of the same antibiotic" - they go away, reevaluate, and try a different course of action/diagnosis.
You have omitted the fact that people take (or even wrongly ask for) antibiotics because they think that they will benefit from them, whereas requests or rules for the wearing of face coverings are primarily there to protect others. That has a key behavioural impact on some, hence the statements so often heard, e.g. "well it doesn't protect me so I don't bother".
 

DB

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No, it is the same argument as that the line that was followed "proves" that they made no difference. Neither proves anything in themselves; the challenge with preventative measures being how you measure what did not happen.

No, it isn't - in is normal in any scientific field to have to prove the positive, not the negative - i.e. someone proposing that a particular measure is effective should demonstrate that, and is not up to those who think otherwise to "prove" that it doesn't. And there appears to be no evidence that masks make any difference abd therefore no justification to mandate their use.
 

bramling

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You have omitted the fact that people take (or even wrongly ask for) antibiotics because they think that they will benefit from them, whereas requests or rules for the wearing of face coverings are primarily there to protect others. That has a key behavioural impact on some, hence the statements so often heard, e.g. "well it doesn't protect me so I don't bother".

I haven't heard that statement once. The general feeling is they don't seem to protect anyone.
 

DustyBin

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I hadn't. But reading it briefly now, it and the quote Greenhalgh paper are looking at two completely different things. Greenhalgh is arguing for a protective benefit to the population at large by using masks to limit transmission by mask wearers; the BMJ paper is measuring the effectiveness of cloth face coverings at protecting health care workers from respiratory viruses exhaled by their patients.

You're quite right, but if the face covering provides little filtration I can't see how it can protect anybody, regardless of the setting? The study also touches on correct use and mask hygiene which again are equally relevant in a community setting. These are my main concerns which Greenhaulgh doesn't address.

Two points, firstly that's comparing cloth masks and medical masks in medical settings over whole shifts, so it's not surprising that the advice isn't to wear cloth masks and, therefore by extension, to wear medical masks.

Point two is that there's been a Covid-19 update which confirms that it's not saying don't wear any mask :


It is (comparing cloth masks and medical masks) but there is also a control sample who appear to have spent a lot of time maskless, yet fared better than those wearing cloth masks. The question, to which I don't know the answer, is why? It raises the question of whether wearing cloth masks for long periods of time is unhygienic and leads to self-infection. If so, this would apply in any setting.

Your second point is interesting, I did read the update myself. I find it strange that they'd change their stance in this way, possibly a case of simply going with the flow (similar to the WHO)?

None of this is conclusive and I'm not claiming it is, but as there are no RCT's of masks in a community setting we can only look at what evidence there is, both for and against. My overriding concern is that the pro-mask research ignores the incorrect usage and poor hygiene I witness on a daily basis.
 

jumble

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I had no trouble wearing my mask for my 12 and a half hour shift (though it was a lot colder and draughtier in the NHS building compared to the hot muggy northern line train!)
Good for you
I can't do what you suggest as my spectacles steam up
Do you wear glasses?
In my job if anyone tries to make me wear a mask I can't work and they won't be working either
Fortunately I have yet to meet anyone who is so stupid.
 

35B

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No, it isn't - in is normal in any scientific field to have to prove the positive, not the negative - i.e. someone proposing that a particular measure is effective should demonstrate that, and is not up to those who think otherwise to "prove" that it doesn't. And there appears to be no evidence that masks make any difference abd therefore no justification to mandate their use.
But you are now changing your argument - you and others have used graphs to "prove" that interventions have had no effect, but have made no allowance in that analysis for the possibility that the graph reflects the consequences of an intervention.

As it happens, I tend to agree that the burden of proof is on those proposing an intervention to justify that it will work. But your argument goes beyond the suggestion that there is the absence of proof to asserting the proof of absence; that extra step is unsupported by the evidence you adduce.
You're quite right, but if the face covering provides little filtration I can't see how it can protect anybody, regardless of the setting? The study also touches on correct use and mask hygiene which again are equally relevant in a community setting. These are my main concerns which Greenhaulgh doesn't address.
That is a question of degree, and I'm not aware of anyone seriously arguing that face coverings do any more than reduce transmission, rather than prevent it outright.

When I wear a mask, I do so in conjunction with observing distancing, hand hygiene, etc, on the basis that if I do these things reasonably well, I will minimise the chance that if I am infectious, others will be infected by me. That seems to me to be a reasonable trade-off against the minor inconvenience mask wearing causes me.
 

DB

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But you are now changing your argument - you and others have used graphs to "prove" that interventions have had no effect, but have made no allowance in that analysis for the possibility that the graph reflects the consequences of an intervention.

As it happens, I tend to agree that the burden of proof is on those proposing an intervention to justify that it will work. But your argument goes beyond the suggestion that there is the absence of proof to asserting the proof of absence; that extra step is unsupported by the evidence you adduce.
That is a question of degree, and I'm not aware of anyone seriously arguing that face coverings do any more than reduce transmission, rather than prevent it outright.

OK, let's look at what you suggeste then. The trajectory of the infection graphs when masks have been introduced in various countries and settings show no flattening, but you suggest that they could have prevented a steepening. For this to hold, it would require that in every case where masks were introduced (at various times and in various settings in different countries) the graph was about to steepen otherwise.

Just how likely is that? We are back to the impossibility of proving a negative again, but the chances of it holding true in every one of these cases, or even the majority, is very small indeed - about as close as it's possible to get to demonstrating that they are having no effect.
 

big_rig

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But you are now changing your argument - you and others have used graphs to "prove" that interventions have had no effect, but have made no allowance in that analysis for the possibility that the graph reflects the consequences of an intervention.

As it happens, I tend to agree that the burden of proof is on those proposing an intervention to justify that it will work. But your argument goes beyond the suggestion that there is the absence of proof to asserting the proof of absence; that extra step is unsupported by the evidence you adduce.
That is a question of degree, and I'm not aware of anyone seriously arguing that face coverings do any more than reduce transmission, rather than prevent it outright.

When I wear a mask, I do so in conjunction with observing distancing, hand hygiene, etc, on the basis that if I do these things reasonably well, I will minimise the chance that if I am infectious, others will be infected by me. That seems to me to be a reasonable trade-off against the minor inconvenience mask wearing causes me.

Honestly I think this is a ridiculous, circular argument if the position is now that people should have to prove something doesn't work, instead of those mandating it (why not mandate goggles or snorkels too then?), but it should be made absolutely clear that the reason you and I wear a mask is because if we do not we will be fined up to £6,400 - it is not a voluntary act.
 

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... but it should be made absolutely clear that the reason you and I wear a mask is because if we do not we will be fined up to £6,400 - it is not a voluntary act.
If this "you" means anybody other than 35B, you aren't speaking for me and I suspect quite a few others. I don't like wearing a face covering, - it's inconvenient and uncomfortable sometimes, but the threat of a fine makes no difference to me. I'm no libertine and I don't need to get involved in trying to justify by some byzantine argument why I should (or shouldn't) comply as a demonstration of my 'human rights'.
 

DB

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If this "you" means anybody other than 35B, you aren't speaking for me and I suspect quite a few others. I don't like wearing a face covering, - it's inconvenient and uncomfortable sometimes, but the threat of a fine makes no difference to me. I'm no libertine and I don't need to get involved in trying to justify by some byzantine argument why I should (or shouldn't) comply as a demonstration of my 'human rights'.

Objecting to a nonsensical law which has no supporting evidence does not make someone a 'libertine'.
 

AM9

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Objecting to a nonsensical law which has no supporting evidence does not make someone a 'libertine'.
A "nonsensical law" is your (and certainly others on here) opinion, but don't assume that it applies to everybody, - clearly it doesn't.
 

35B

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Honestly I think this is a ridiculous, circular argument if the position is now that people should have to prove something doesn't work, instead of those mandating it (why not mandate goggles or snorkels too then?), but it should be made absolutely clear that the reason you and I wear a mask is because if we do not we will be fined up to £6,400 - it is not a voluntary act.
You mix up two points. The first is that, as a piece of policy, I support the view that there should be reasonable information behind it to give confidence that it will work. Reasonable people will differ as to whether that data was present at the time the policy was introduced; no sensible person would argue that the case for is absolutely open and shut. I have said that, on balance, I give credence to the case for; I also assert that the case against made by those annotated graphs does not convince me - all the more so when those arguing against intervention show their statistical carelessness by leaping on a single data point, then falling very silent when it becomes clear that data point is an outlier on a very different trend.

My challenge is to those who use those graphs to "prove" that interventions have not worked - masks and others. The "proof" offered is no such thing, but an arbitrary and circular assertion that because the graph followed the ultimate curve, the intervention was ineffective. That truly is circular reasoning and, in the absence of any other arguments or data proves nothing about the role of the intervention under discussion, for or against masks.

As for whether I wear a mask, the fear of a fine has yet to enter my head. I do so because my judgement is that wearing a mask is on balance more likely to good than to do harm, and because I respect the existence of the law. And, where somewhere requests me to wear that mask, with or without the law behind them, because they reasonably consider it to be for their protection, I further respect their request. That does not mean that I will not be relieved to be able to bin my masks.
Objecting to a nonsensical law which has no supporting evidence does not make someone a 'libertine'.
I'm fascinated that you conflate objection to a particular law with the arguments of some on here that generally being awkward and non-compliant is somehow a demonstration of civil disobedience. The tone of many of the comments on here reminds me more of snarky schoolkids, bigging up their bloody minded non-compliance with claims to being an act of protest.
 

big_rig

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No, I mix nothing up actually. You wear a mask because it's the law, and because if you don't follow the law you will be fined £6,400. Trying to pretend otherwise would be like me saying the reason I pay tax is because I'm a very generous person and have great compassion for my fellow citizens. I pay tax because it gets automatically deducted from my salary every month. I'm not dressing it up as something it isn't.

In that vein I would also note that the tone of some of these comments reminds me of snarky schoolkids, bigging up their desire to appear moderate and reasonable in their support for masks to hide their slavish support of the things :rolleyes:

Of course, the way to settle this would be for masks to be made voluntary, and then we could separate the altruistic and generous (who weirdly enough were not wearing masks in any great number in any setting prior to them being made mandatory) from the callous and sociopathic (as the chief mask obsessive Greenhalgh describes people who don't want to wear the things).
 

DB

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You mix up two points. The first is that, as a piece of policy, I support the view that there should be reasonable information behind it to give confidence that it will work. Reasonable people will differ as to whether that data was present at the time the policy was introduced; no sensible person would argue that the case for is absolutely open and shut. I have said that, on balance, I give credence to the case for; I also assert that the case against made by those annotated graphs does not convince me - all the more so when those arguing against intervention show their statistical carelessness by leaping on a single data point, then falling very silent when it becomes clear that data point is an outlier on a very different trend.

My challenge is to those who use those graphs to "prove" that interventions have not worked - masks and others. The "proof" offered is no such thing, but an arbitrary and circular assertion that because the graph followed the ultimate curve, the intervention was ineffective. That truly is circular reasoning and, in the absence of any other arguments or data proves nothing about the role of the intervention under discussion, for or against masks.

As for whether I wear a mask, the fear of a fine has yet to enter my head. I do so because my judgement is that wearing a mask is on balance more likely to good than to do harm, and because I respect the existence of the law. And, where somewhere requests me to wear that mask, with or without the law behind them, because they reasonably consider it to be for their protection, I further respect their request. That does not mean that I will not be relieved to be able to bin my masks.
I'm fascinated that you conflate objection to a particular law with the arguments of some on here that generally being awkward and non-compliant is somehow a demonstration of civil disobedience. The tone of many of the comments on here reminds me more of snarky schoolkids, bigging up their bloody minded non-compliance with claims to being an act of protest.

As has been repeatedly pointed out, the norm is for those proposing that something works to be required to provide reasonable evidence - not for others to "prove" that it doesn't work.

Although proving a negative is likely to prove impossible, the evidence does very strongly suggest that masks have no effect on transmission.
 
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