July 29, 2020 - 7:00am
I learned a new word today: inoculum (in-KNOCK-yew-lum).
It’s a medical term for the amount of a virus or bacterium one gets infected with (or, in the case of a vaccine, deliberately inoculated with).
We know that with some disease-causing organisms the size of the inoculum makes a crucial difference to whether one getS sick or not, and how badly. The big question right now is the extent to which this applies to Covid-19. As yet, we don’t have all the answers (experimenting on people with different doses of a novel and deadly pathogen is ever-so-slightly unethical).
However, this uncertainty is precisely why we ought to take sensible precautions. We should, of course, try to avoid infection altogether. But, failing that, we should do what we can to downsize the viral dose we get hit with — and thus give our bodily defences a fighting chance.
A new paper from a team led by Monica Gandhi of the University of California (h/t @post_liberal) suggests that mask-wearing could be important in this regard — producing benefits not just for those who might otherwise be infected by the mask wearer, but also for the mask wearer him-or-herself — by helping to reduce the “viral inoculum”.
One of the most intriguing pieces of evidence in the paper is from a comparison of what happened aboard the Diamond Princess with a more recent cruise ship outbreak (in which N95 masks were issued to passengers and crew):
Throughout the pandemic there’s been conflicting evidence as to the virulence of the disease. Infection fatality rates (and, less grimly, the chances of asymptomatic infection) appear to vary from time-to-time and place-to-place. That has been put down to various factors including differences in demographic composition and medical treatment. But contextual variations in just how much virus people get infected with may prove to be the most important factor.
That’s something that the lockdown sceptics ought to think about. If they’re right, and the virus can’t be eradicated, then our best hope (short of a vaccine) is a build-up of immunity in the population through asymptomatic or slightly symptomatic exposure to the virus. In which case, the inoculum issue would become central to the strategy.
The sceptics will never persuade us to ‘live with’ the virus unless they can explain how we won’t have to live (and quite possibly die) with too much of it.
So how about a bit more open-mindedness on masks?
Peter Franklin is Associate Editor of UnHerd. He was previously a policy advisor and speechwriter on environmental and social issues.
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SubscribeThe curve has been crushed. The all cause death rate has been below the five year average for five weeks. Both hospital admissions and deaths ‘with COVID’ are both in decline. Now is the time to be removing restrictions not adding to them.
The context-less ‘case count’ should not be the driving metric, especially as the test itself can detect viral fragments up to 80 days after infection.
I feel rather sorry for you at this point. You are evidently being pushed to produce more articles than you have opinions, and have decided that the easiest way is to troll those of us with legitimate concerns about mask-wearing. Am I to understand from this article that I am closed of mind if I object to the entire population being forced to wear surgical-grade masks at all times? Because that appears to be the thrust of your argument.
Judging from the comments regarding mask wearing, wouldn’t it be more sensible to provide freedom of choice. If shops wish to ask their customers to wear masks that’s fine. Suggesting that masks be worn on public transport is also fine. If one is at high risk, wear a mask that actually offers protections such as KN95, N95 or FFP3.
But insisting that masks be worn in the fresh open air, as has been done in certain US cities is just insane and counter-productive.
Yes. Ridiculous.
Precisely. If the wearing of masks is mandated, under what circumstances will such a mandate be rescinded?
I quite agree. However, I have to admit, some people I know do look better wearing a mask.
Steady Jean I’m one of them! Really fetching in my light blue surgical mask. Makes my daughter laugh though – real downer. Dad you look pretty stupid!
You could, of course, have written an article about face masks increasing the dosage of the virus. The theory being that an effective mask will trap & return the virus to an already infected person.
Also there is the problem of mask etiquette – how often do I need a new mask – perhaps a new one for every shop visited, a new one for every time I go out the house, etc?
I have been shopping in the same supermarket for 4 months now and seeing the same staff – they have not being dying like files! Only a very few shoppers have been wearing masks. Now, apparently, shops are a death trap without masks.
What has really changed? I am very sceptic of a government saying they are no use, and later on saying they are wonderful.
With you on that. I’m in southern Italy. The government has at least fixed the price at 50 cents a mask but, even so, I can’t afford to buy a new one for every time I go out. And neither can anyone else. So we just buy one and keep using it for days, or even weeks. Most small shops have given up insisting on a mask at all (they don’t wear them either). The rule seems to be, ‘If there’s a chance a government inspector might come over and fine a shopkeeper, they’ll ask you to put one on’. But otherwise … We keep our distance; we continue to kiss close friends but not people we don’t know well.
What impresses me is that, finally, that sense of panic and fear has subsided and we are just getting on with life. This virus is being seen as another disease that, like many others, you could be unfortunate enough to get, and maybe even die from. Elderly people, realising this, are electing to stay home rather than (possibly) die in hospital, isolated from their families.
I realise that, at the beginning, we had no idea how everything would pan out so it was sensible to be ultra-cautious. But now … well, enough. Just be sensible. Don’t drive too fast, don’t smoke (like I do) etc.
Would not care to count the times others have made the above observation. Same staff, usually unmasked (overheard one staff member at Asda today – ‘If they make me wear one I’m leaving. Can’t breath, feel dizzy. Bloody stupid’. Real anger and frustration. The wearing of face masks is still not evidenced based and needlessly divisive. As always back to hub of the problem with covid – it remains a mild illness for the majority. The reaction to it is issue, lacking maturity and pragmatism. I feel a more critical issue is being missed here transcending covid; its is a diktat from Government controlling our behaviours without conclusive evidence that it achieves anything. That people have been so submissive is rather disturbing.
Mind cannot help laughing and generally have this stupid grin on my face when shopping (not that you can see it). Upshot – hardly going to the shops now. The masks make my nose run! Upper lip quickly starts sweating. Find myself touching my face and the mask. Even my daughter, sixteen, has gone off shopping! What next – gloves, gas masks, body suits, getting disinfected as you enter, UV scanned, walk backwards so the virus hits the back of your head, shoe covers, nose plugs, ear plugs, and perhaps best of all disinfectant mouthwashes. Monty Python returns.
skeptics do not need to persuade you to “live with virus”. Human beings have been living with viruses from the dawn of time. It is only in the last 6 months has western civilisation forgotton this ! DUH! Don’t believe me ? Then please, Peter, publish Covid DEATHS (NOT cases) alongside Flu deaths, pneumonia deaths, domestic accident deaths, all cause deaths etc etc and make sure to include last years figures to avoid any 2020 Covid distortions.
Shocking comparison isn’t it, begging the questions : why have we turned into pathetic scared people.
An interesting curve to observe is the pneumonia curve on the all cause graph on the ONS weekly deaths report. Up to March it tracked almosr exactly the 5yr average. Since then it has tracked significantly below the 5yr average. Could this be something to do with death reporting? If someone dies with pneumonia and covid then covid is the cause of death. Note that a test is not required. If current trends continue it’s likely that the all cause excess death tally will be lower than the death tally from covid as reported by the ONS.
Nope, it’s simpler than that. COVID is the new pneumonia. ONS doesn’t report which strain of pneumonia, or influenza casued the death, and in 5 years time COVID won’t be on a separate line either
Could very well be correct. It’s also interesting to look at the flu stats. The annual deaths from flu can’t be reported more accurately that somewhere between 280k and 660k globally. (That’s from memory so ballpark at best without looking it up again)
So the author has learned a new word.
Following that we get a deceptive advocacy piece telling us on the basis of one new paper, and the innuendo that lockdowns had a positive effect, that we should all start wearing masks.
One study does not (proverbial) spring make – the Diamond Princess was a strange case to start with. And a trove of international data makes mincemeat out of the contention that lockdowns had any positive effect on spread or fatalities. Reality is that we still do not have the foggiest about the actual number of people who got infected – the crucial without-which nada denominator.
Instead, there is a rapidly growing body of epidemiological and statistical evidence that 1) herd/community is far more prevalent than assumed – looking for B cell mediated antibodies missing the crucial role of T cell memory will do that. And b) that because of the T cell component, the actual level of herd/community immunity required is far lower than the 60% originally anticipated.
Until we have credible/repeated evidence that there is a direct causal relationship between the quantity of inoculum and the severity of the viral infection, wearing a face mask is best viewed as virtue signalling.
Is this another example of a Govt/medical investigation where they start with the result they want and then look for some “evidence” to publish a report to ‘prove’ it?
It would be good practice to clearly state whether the paper you cite is a pre-print or properly peer reviewed. Otherwise any claims it makes are not much better than opinion journalism with little weight. The evidence either for or against masks seems slight either way.
“That [difference in infection fatality rates] has been put down to various factors including differences in demographic composition and medical treatment. But contextual variations in just how much virus people get infected with may prove to be the most important factor.”
While I’m certainly open to the idea that the last point makes a difference, it’s essentially impossible that it’s a bigger difference than demographic composition.
In the U.S., about 1/3 of reported COVID deaths are among people 85 years or older. That age group comprises 2% of the U.S. population. 26% of U.S. COVID deaths are among people ages 75 to 84, who comprise about 5% of the U.S. population.
Conversely, the 31% of the U.S. population under age 25 accounts for only 0.2% of U.S. COVID deaths. The 27% of the U.S. population ages 25-44 accounts for only 2.6% of U.S. COVID deaths.
And all of the above is before we even start to take into account underlying conditions, where we see stats such as COVID death rates ~10x higher among people in their 40’s with a known serious underlying condition (a laundry list including heart disease, chronic lung disease, Type II diabetes, severe obesity defined as BMI>40, compromised immune system, etc.). (These comparisons are from a U.S. CDC study based on a review of known cases, and the increased risk may therefore actually be *understated* if healthier people with COVID are less identified as “cases” due to generally milder symptoms.)
These figures are all per the U.S. CDC. I don’t have similar statistics from other countries readily at hand, but my understanding is that it’s basically the same story in other countries (at least in Western Europe).
This is just a paper presenting an opinion, it’s not a scientific study containing a peer reviewed, reproducable result. It’s not a metastudy of the other studies referenced in the paper, and the authors have not conducted an actual study of their own. The authors have produced a desktop paper with a (yet unproven) theory, yet they come to the sweeping conclusion that “leading politicians will need to endorse and model mask-wearing”. That’s a startling conclusion to make on such flimsy evidence.
Meanwhile, back in the real world, there is no current concensus of evidence that face masks are effective at stopping viral transmission.
( https://swprs.org/face-mask… )
Studies put the infection fatality rate for SARS COV2 is in the range of 0.1% to 0.3% ( https://swprs.org/studies-o… ). This is in the range of normal flu or slightly higher.
It is a growing problem in media that single papers, opinions and studies are presented as established fact and are actually used for decision making, a recent example would be the Surgisphere scandal which passed “peer review” in both the Lancet and New England Journal of medicine, and was used to discredit HCQ setting the stage for much more expensive yet dubiously “effective” medication (Remdesvir) and mass-vaccination.
In these days, the “science” we are presented is oftentimes politicized and biased, so caveat lector.
Except it’s not deadly for those who aren’t otherwise infirm. Hence flu season death rates no higher than in many previous years when no one even noticed accustomed as we are to the aged and otherwise ailing being seen off by respiratory viruses. Only this year for some reason we’re supposed to ‘fight it’. As if anyone is more concerned with strangers dying now than at any point before on account of media sponsored fear p*rn…