There are at least many views on the efficacy and cost-effectiveness of lockdowns. The balance of the evidence suggests that they do work, though the effect is confounded in complex ways by people spontaneously engaging in risk-reducing (but GDP-lowering) behavior.
Be that as it may, the point is becoming moot, since they are ending across most of the world. Stocks of what I called “quarantine capital” are running low, the peasants are beginning to rebel. This is political reality, like it or not.
Subsequently, the only realistic way forwards to prevent the epidemic from again hurtling out of control – and this is a near inevitability, considering that almost nowhere have we reached “herd immunity” – is to adopt universal mask wearing
It is beyond doubt the face masks are both highly efficacious at preventing coronavirus spread (see Corona-Chan Didn’t Care Until I Put on the Mask for compiled evidence), and extremely cost-effective (market price of a surgical face mask is 5 cents).
My Twitter followers, at any rate, are quite optimistic about the potential of mass mask usage (80%) to ultimately suppress the epidemic, with 66% believing they can suppress r0 to below 0.9, while another 18% think they have the potential to at least fix the rate of new infections at a more or less constant number with r0 somewhere between 0.9 and 1.1; this will, at least, flatten the curve, and perhaps a new vaccine can be introduced before half the population has to receive the gift of Corona (as implied by r0=1). Another 11% are hardcore pessimists who believe they will make no major difference.
What will r0 be if you can get 80% of First World population to wear masks & lift most formal restrictions while preserving social distancing guidelines?
— 🇷🇺 ANATꙮLY 🤔 KARLIN (@akarlin88) May 17, 2020
This sentiment may well be correct – a couple of studies published a month ago suggests that 80% mask wearing may be enough to push r0 below one just by itself. r0 plummets even under pessimistic estimates of mask efficacy.
Tian, Liang, Xuefei Li, Fei Qi, Qian-Yuan Tang, Viola Tang, Jiang Liu, Zhiyuan Li, et al. 2020. “Calibrated Intervention and Containment of the COVID-19 Pandemic.” arXiv [q-bio.PE]. arXiv. http://arxiv.org/abs/2003.07353.
We then estimate the reduction of the basic reproduction number R0 under specific disease control practices such as contact tracing, testing, social distancing, wearing masks and staying at home. When these measures are implemented in parallel, their effects on R0 multiply. For example, if 70% of the general public wear masks and contact tracing is conducted at 60% efficiency within a 4-day time frame, epidemic growth will be flattened in the hardest hit countries.
Howard, Jeremy, Austin Huang, Zhiyuan Li, Zeynep Tufekci, Vladimir Zdimal, Helene-Mari van der Westhuizen, Arne von Delft, et al. 2020. “Face Masks Against COVID-19: An Evidence Review.” MEDICINE & PHARMACOLOGY.
Reducing disease spread requires two things: first, limit contacts of infected individuals via physical distancing and contact tracing with appropriate quarantine, and second, reduce the transmission probability per contact by wearing masks in public, among other measures. The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both laboratory and clinical contexts. Public mask wearing is most effective at stopping spread of the virus when compliance is high. The decreased transmissibility could substantially reduce the death toll and economic impact while the cost of the intervention is low. Thus we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies.
In any case – we should all wear masks, especially indoors. While one can make entirely legitimate cost-benefit arguments for or against lockdowns, there are no such arguments against mask usage. Given what we already knew months ago, refusing to wear masks in places like supermarkets or public transport has long ceased to defensible under any normal ethical system.
Just realized something incredibly ironic. After half a decade of Western SJWs ranting about "toxic masculinity" and the like, it's only in the West where you have people using "macho" reasons such as not wanting "to look like a fag" or sth similarly stupid for not wearing masks.
— 🇷🇺 ANATꙮLY 🤔 KARLIN (@akarlin88) May 18, 2020
Not to mention self-defeating even by the supposed values of this motley of “sovereign citizen”/anti-government types:
A corollary is that mask wearing prevalence may well now be the single best predictor of the subsequent success or failure of nations to control the epidemic after reopening. As such, attitudes towards mask wearing practices would seem to be an important – and understudied – component of any attempt to forecast Corona’s trajectory across different countries in the coming months.
To date, the only large-scale international poll of whether people wear masks has been carried out by IPSOS.
The East Asians, as well as Italy and India, are all at ~80% or above. Vietnam tops the chart, and to date has registered just 325 cases and zero deaths. Japan was late to lockdown and easygoing about it,
The US is intermediate, with wide regional differentiation. From another poll:
The West does very well, especially California, which coupled with its early lockdown must have greatly help contain its epidemic at a very manageable level. According to Gallup, both the West and North-East are at ~70%. Lowest is the MidWest, with just 46%. Possibly they are now the biggest risk zone. The lowest numbers are in Montana at 23%. Though it’s not exactly that they need them – 600,000 people in a territory 50% larger than the UK, which makes the latter’s <20% all the more shocking.
The other European nations are much lower, with the UK at the very bottom, where just 16% say they are likely to wear masks. No wonder that the epicenter of the epidemic has shifted from Northern Italy to South England.
Consequently, I remain bullish on East Asia’s prospects of continuing to contain Corona, bearish on North-West Europe, and 50/50 on the United States (perhaps the West coast will succeed, while the eastern parts fall).
I would also stress that even in mask-disrespecting countries the situation can still be salvaged. Even 20% adaptation will jump up to 90% if it is legally mandated and backed by hefty fines. Will it create resentment? Perhaps, but far less so than prolonged lockdowns.
As the lockdowns peter out, many of us live in countries that are once again heading into what might be a patently avoidable tragedy.
Are these numbers accurate? I think they are – at the very least, they are generally backed by the observations of corresponding friends and acquaintances in various countries.
Duran chief editor Alexander Mercouris in London, who wrote an excellent review of the coronavirus situation a couple of weeks ago for Consortium News, wrote to me on April 16:
Clearly there is a very deep cultural bias in the West against face covering… I don’t fully understand it myself… In my part of London, where the death toll has been very high (London accounts for around a quarter of British deaths, which are very high by every standard) I would guess that only around 15-20% of people wear face masks when they go out. Moreover because of the – entirely premature – softening of what was already a very soft lockdown, my impression is that the percentage of people who wear face masks in my part of London is actually falling.
The move to ease lockdowns is grossly premature. If it was accompanied with a mandatory requirement to wear face masks when in public, and a well designed system of testing and contact tracing, it might not be so bad. But in the UK nothing like that exists, and nor does it in any other European country that I know of. Even in Germany – which started well, and where I have many contacts – the lockdown has been lifted too early, wearing of face masks is sporadic, and after a very strong start testing has run out of steam. I am sorry to say that I expect a big spike in infections and deaths in Europe this autumn. Lockdowns will have to be reimposed, and morale at that point may start to collapse.
Alexander’s estimate perfectly dovetails with poll results. The observation that mask wearing is actually on the decline in London has been confirmed to me by a second observer.
On May 20, he added:
The parks are now packed with sunbathers and day trippers. I saw no masks and no attempt to maintain social distancing. Elsewhere, in the general area of my house, the streets are full of people, social distancing appears to have been abandoned, and I would guess that the percentage of people who now wear masks has fallen below 5%. Moreover I get hard looks and taunts from some people (mainly young people) precisely because I wear a mask and maintain social distancing rules. In theory social distancing is still mandatory and London is supposed to be still in some form of lockdown. However the government’s messaging is wholly inconsistent and the police are making no attempt to enforce anything anymore.
The number of excess deaths in the UK (which I am sure is due to Covid-19) is now 54K. However most people at least in London think the Covid-19 epidemic is over. Note that the confirmed figure of 54K deaths is up to 8th May 2020. Most estimates assume that the true number is over 60K. If the UK has lost this number of people during a war there would be a huge political crisis. Yet because it is a pandemic and because most of the people who die are old the fact barely registers. I still find that fact staggering.
Looks like the limeys are dedicated Nurgle worshippers.
An Irish friend writes:
The Chad Ireland is probably at 5%.
An Indian acquaintance, who also happens to have once been an expat in Russia, writes (also appending the following image):
Indians have just started venturing out and they are very likely – probably more than 90% will have a mask or a gamcha. Traditionally – and this goes back unknown times, Indians cover their face and mouth for hygienic reasons. They use a special hand-women cloth which goes into washing end of day. It is called a gamcha, Office people are already wearing surgical masks and all the rest of population is wearing this handmade gamcha. Modi has been wearing it on all his public TV appearances and country follows that example. In North India it also protects from dust and sand and when there is a heat wave, much like the Arabs, we cover our face with cotton cloth. South India and Western states follow different practices.
India is not a rich country, very crowded, can’t do lockdowns for long. It may thus be the ultimate test of masks’ efficacy under harsh, overcrowded Third World conditions.
I estimated that public mask wearing incidence topped out at ~33% of Muscovites by early April, rising from 25% in late March. (Our lockdown measures began in Moscow began on March 18).
Then it remained stuck at this level for the next month – 30%, I suppose, is Russia’s “steady state” level of mask wearing without government decree. While some other regions of Russia introduced mandatory mask wearing regimes, to seemingly good effect (though I have not done a formal analysis), Moscow’s usually competent Mayor Sobyanin dallied until May 12 to order mandatory masking (and gloving – which I consider needless, and which AFAIK only Romania amongst other countries has done).
Throughout this April, I was frustrated over what I saw as a bizarre commitment to the WHO’s criminal anti-mask recommendations. The Visegrad nations, Austria, and Ukraine – which all did introduce mandatory masking early on – seem to have done better than Russia, to the extent that comparisons can be made (there is no megapolis on Moscow’s scale there; OTOH, all of them have much greater travel links with Europe, and Ukraine had accepted back 100,000’s of returning Gastarbeiters). I am not sure that the Moscow detonation would have happened in the absence of this “West worship.”
Nor was Putin without blame – he delegated most of the responsibility for managing the outbreak to the regions (the non-systemic opposition, which I am hardly a fan of, spun it as an abdication of responsibility – and I can’t say I entirely disagree), and didn’t make at least a centralized federal recommendation (if not outright decree) to implement masking regimes across the country.
I later learned that the Moscow City government acquired Russia’s largest mask producer back in March, where it doubled production up through May. So as it turns out, Sobyanin was “maskpilled” after all, which made the lack of masking recommendations a “white lie” as opposed to blind worship of the West (or rather its ossified and Euro-supremacist public health bureaucracy). Though I still do not agree with its logic. Thing is, masks are easy to DIY. Sew one, or heck, cut up a Tshirt. Surgical masks can be reused – not good for personal protection, but protects others, which over time translates into the same thing.
This must be true due to convexity effects, a point that has incidentally often been made by Nicholas Nassim Taleb in recent months.
One comment about masks and nonlinearities that these imbeciles are not getting.
Reducing exposure to viruses by 30% thanks to an "imperfect" mask does not mean reducing risk of contracting the disease by just 30%. By convexity, it must be more than 30%, can even be 95%.
— Nassim Nicholas Taleb (@nntaleb) April 12, 2020
As of the time of writing, I would estimate that public mask wearing has increased to 60-70%.
Considering that transmissions outdoors seem to be very rare, this might not be that relevant. In supermarkets, they are at close to 100%, even if a few of the least socially responsible elements pull down their masks while walking about.
American friends/acquaintances confirm that well more than 50% of people at least wear masks in supermarkets in the MidWest, and that’s supposed to be the worst region – so I suppose that’s good.
Finally, another open question is the extent to which people will continue to respect masking regimes in the future, whether they are largely “socially generated” (as in the Japan or the US), or legally mandated (e.g. Austria, Poland, now most of Russia).
I do not know the answer to this question.
Presumably, most people will continue to mask if they can be fined for declining to do so. Although whether a country like the US can keep it up is open to question – the example of its apathetic British brethren is not encouraging.