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There is an astounding amount of BS surrounding COVID-19. In part because of that, we have nearly 300k Americans dead, and more to come. In this episode, Xander and Erik arm you with what you need to convince anti-maskers to get with the program.

  1. This show will be different in one key way: we’re going to be very firm that there’s a right answer when it comes to thinking about COVID-19 and your duty regarding it
    1. We only “take a stand” on matters fundamentally American and apolitical; this is one of those: we are taking a stand. This isn’t political, there are no two sides. There’s clear right and wrong, and it is deadly serious and on a massive scale.
    2. (Thesis, right?) Wearing a mask and practicing social distancing is ethically obligatory and minimally inconvenient; not doing so is ethically abhorrent.
  2. Why: because we face a pandemic with an extremely contagious virus that is uncommonly deadly, and sufficiently taxing on the medical system.  Uncontrolled spread can lead to the deaths of perhaps millions of Americans (let alone the rest of the world!) and risks the collapse of the US medical system (leading to the deaths of many more from both covid and non-covid illnesses because medical services / materials are all consumed and being rationed). This is proven fairly simply and from many reputable sources, which we will link here. 
    1. We will also discuss some of the risks and likely outcomes over the winter and spring 
    2. Because of this, choosing not to wear a mask, social distance, and take other reasonable precautions is contributing directly to unnecessary deaths of fellow Americans and is both irresponsible and ethically unjustifiable 
      1. maybe this is a good opportunity for an ethical conversation! I remember writing an article way, way long ago: “Should the flu vaccine be mandatory?” Talked some statistics about how many people it could save. So clearly there’s some sort of matter of magnitude that matters here. Does everyone need to wear a mask to save one person? Probably not. 10 million? Certainly. So we hit this, “how many grains of sand to make a lump?” problem. Any thoughts?
      2. Basically, how much cost (such as lockdowns) for how many lives? How do we make that decision? The sad reality is that we need to confront this tradeoff again. The problem is, very early on in the pandemic the issue was framed as if these are the only two choices: lives or the economy. And the partisan tribal talking points fell into line. But this was a fundamental misframing that looks a LOT like how we have come to cover other issues. It’s a misframing because the best way to both save the economy and lives at the same time is to take basic precautions – wearing a mask and not having parties is such a low cost that it’s much easier to make. But instead, people got careless, the virus has spread, and now the economy will be shocked again and people will die needlessly. The only ethical choice here is clear regardless of whether you place greater weight on the health of the economy or saving lives.
  3. First let’s cover the magnitude of what’s happening and how bad it’s likely to get, and why that builds a case to obligate us to protect our fellow Americans
    1. [Too add somewhere – didn’t have to be this way. Then review the 3 possible cases from that May stats news article, b/c it’s pretty clear we’re in scenario 3 now and it’s unavoidable, but we can still limit the damage]
    2. How bad it’s been
    3. How bad it’s going to get (models, which have had great records so far)
    4. The risk to the hospital system as a whole, and what that means for everyone else who gets sick between now and March of injured from anything that isn’t covid too
    5. In short, this is incredibly important and the vaccine will not be fast enough to contain the damage in the next three or four months.
  4. What are some of the arguments people make to justify not taking the pandemic seriously, or not wearing a mask? And why are they silly? (We’re going to ignore some of the nuttier conspiracy theories such as 5G, Bill Gates and tracking chips) 
    1. “It’s not that big a deal. It’s like the flu.”
      1. (Xander to pull comparison stats from his piece on COVID vs Flu)
      2. Eriik: “this is where the matter of magnitude really matters–we’re talking way way worse than 10x. PLUS there are long-term effects from Covid that we still don’t fully understand that are not even comparable to the flu.
    2. “There aren’t actually more excess deaths / or not enough more”
      1. (I think this is just a hoax, see Snopes)
      2. The models have done a pretty good job so far (let’s look at some) – if we had done this right early on, it would have been few excess deaths, and that would have been the _point_
    3. “There is a conspiracy to inflate the actual numbers”
      1. The common version of this is because of co-morbidities, so you see people post that it’s people dying with covid, not of covid
      2. This is a simple misunderstanding at first, but then was used maliciously… essentially, most people who die of COVID have comorbidities or pre-existing conditions because they’re so much higher risk
        1. But this has been falsely shared as saying that these people died from those other diseases (high blood pressure, diabetes, obesity, immunocompromised, etc etc) rather than of COVID, and that’s just simply not true. Respiratory failure from viral infection killed them; that’s what the doctors called when they died. It’s simple: Pre-existing conditions make people weak, and when these folks contracted covid, they got pneumonia or lungs failed and they died. That’s the covid, not the underlying conditions.
    4. “This infringes on my rights”
      1. Let’s talk a bit of logic: is having to wear pants an infringement of your rights? We’ve all tacitly agreed that it’s not, because there are public decency laws all over the country where if you go around nude you will be fined or apprehended. No one is up in arms about these laws.
      2. Let’s dive into what’s legal during states of emergency in different states
      3. [positive vs negative liberty, right from something. That freshman year phil class sure is carrying its weight all these years on]
    5. “Masks aren’t effective at preventing transmission”
      1. Oxygen/CO2 molecules are <1000x the size of the virus so it’s fairly simple to make something that blocks one and not the other
      2. Masks are old as the hills in medicine–are you really saying that surgeons around the world, for hundreds of years, just don’t understand germ theory as well as you do?
      3. Plenty of studies but if you need to be convinced, are you going to believe the study?
    6. “Masks cause me to suffer CO2 poisoning”
      1. Again, some simple logic here: the masks you’re being asked to wear, professionals have worn for 12-hour days for decades (medical professionals, construction folks, anyone working with chemicals or dust or sawdust, etc etc etc)
      2. But also plenty of good studies on this. But if studies aren’t your thing, then from personal experience Erik and I have both worn masks for many hours at a time all throughout this year and known people who have had to wear them all day long and they’ve been fine. No one’s died from CO2 poisoning from wearing a mask. Over a quarter of a million people have died from Covid.
    7. “I feel fine”
      1. Came across this quote today from a CDC research report: “Masks are primarily intended to reduce the emission of virus-laden droplets (“source control”), which is especially relevant for asymptomatic or presymptomatic infected wearers who feel well and may be unaware of their infectiousness to others, and who are estimated to account for more than 50% of transmissions.1,2”
      2. Put simply: it doesn’t matter if you feel fine, because half or more of the transmission is taking place from people who feel fine. But, of course, you should know that already! This is old information on Covid at this point
    8. “My body, my choice” or “we should only quarantine sick people”
      1. The problem with this argument is that the nature of this virus is that it spreads easily, in the air, even when you don’t know you’re sick–so it’s not actually about you and your safety. Most are asymptomatic but still contagious, etc
      2. Part of living in a free society means that other people are free from your actions having a harmful effect on them. In a free society, you have the right to your own actions to the extent that they don’t impact others! When they do, then we need to come to an agreement on what those rules and regulations are. Others have the right to not die from a contagious disease when going about their daily lives because others are purposefully reckless with their mask wearing. 
        1. Libertarianism and externalities/non aggression principle
    9. “Masks don’t really help me, only other people.”
      1. One of the most challenging aspects of keeping up to date with pandemic developments is how much we are constantly learning about this new virus. It’s tough – in a crisis situation, you have to learn as you go. Which means that advice given even recently can stick in our minds for longer than it may be useful. Not that it’s wrong – just that we can learn something new about it.
      2. For example, earlier in the year, the CDC said something like: “masks are good, but don’t wear n95 masks in public, just cloth masks. Cloth masks may not protect you, but they will protect other people.”
      3. This isn’t true any more. 
        1. “In a review9 of observational studies, an international research team estimates that surgical and comparable cloth masks are 67% effective in protecting the wearer.”
        2. “In unpublished work, Linsey Marr, an environmental engineer at Virginia Tech in Blacksburg, and her colleagues found that even a cotton T-shirt can block half of inhaled aerosols and almost 80% of exhaled aerosols measuring 2 µm across. Once you get to aerosols of 4–5 µm, almost any fabric can block more than 80% in both directions, she says.” (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext)
          1. And while you need to block more than the 4-5 um range to be 100% effective, many of the air droplets that carry covid are that size, and are therefore blocked by fabric masks: 
          2. “More relevant are the pathogen-transporting droplets and aerosols, which range from about 0.2 µm to hundreds of micrometres across. (An average human hair has a diameter of about 80 µm.) The majority are 1–10 µm in diameter and can linger in the air a long time, says Jose-Luis Jimenez, an environmental chemist at the University of Colorado Boulder. “That is where the action is.” (Nature.com)
        3. In fact, as we still learn more about the virus, it may turn out that in most cases fabric masks work just almost as well as n95 masks: “Benn worked with Danish engineers at her university to test their two-layered cloth mask design using the same criteria as for medical-grade ventilators. They found that their mask blocked only 11–19% of aerosols down to the 0.3 µm mark, according to Benn. But because most transmission is probably occurring through particles of at least 1 µm, according to Marr and Jimenez, the actual difference in effectiveness between N95 and other masks might not be huge.”
        4. Interestingly, wearing a mask may not only protect you from Covid-19, it may also prevent you from getting a severe case of it if you do catch it: “The findings provide justification for the emerging consensus that mask use protects the wearer as well as other people. The work also points to another potentially game-changing idea: “Masking may not only protect you from infection but also from severe illness,” says Monica Gandhi, an infectious-disease physician at the University of California, San Francisco.”
    10. “The experts don’t really know what they’re talking about” / “medical professionals and government want to control me”
      1. [Erik doesn’t know quite what to do with this]
      2. The best advice I have for this problem is one that I know most people won’t want to do: always go to the primary source material. It doesn’t matter if NY Times, or Fox, or Washington Post or NY Post – if they’re citing something, don’t take their word for it. Assume that details will be missed, and go look yourself. You’ll be surprised at how quickly you get used to the slightly denser writing – it’s definitely a skill you can learn. And once you can go to the source material, you can check for yourself whether other people are pulling blinds over your eyes. Realistically though, if you’re not doing this, then you are letting the pundits do the thinking for you. Always, always, always find the primary source. Take the time, it’s worth it.
      3. There’s a little bit of occam’s razor to use here (see: Dan Carlin)
    11. “People shouldn’t be afraid”
      1. Let’s compare to 9/11. 3000 people died. What were we willing to do (TSA, other infringements of rights), what were we willing to spend, how many of our soldiers were we willing to send to die in the sand, to prevent that from ever happening again?
      2. We’re just short of having a 9/11 worth of people die EVERY SINGLE DAY.
      3. Xander’s made this point before, but if your counterargument to the 9/11 comparison is: “that’s completely different, one was a conscious attack the other is an unconscious virus”, then that may imply that you overweight violent threats are worse than viral ones. There’s nothing fundamentally wrong with that. BUT, nearly 90x as many people have died from Covid as 9/11, and I don’t think you can make a reasonable argument that the threat from violent actors is two orders of magnitude more “important/scary/worth spending on” (comes back to that cost-benefit analysis) as things that can kill us without being conscious. If you DO think that violent threats are worth 2 orders of magnitude more in resource allocation, I’d like to hear your argument email me at [email protected]
    12. “iT’S AboUt COnTrOL!”
      1. The government literally has access to your exact location at all times (cell phone), who you call and when; they know how much money you make and take precisely as much as they want; they license you for everything… etc etc–yes the government does indeed control a lot. What the fuck does a mask have to do with it? Why aren’t you mad about mass surveillance instead? There’s plenty of crazy ways the government tracks and controls you that maybe you should be upset about. Get a grip, Karen.
    13. …but ultimately, people have heard all of this. What’s a bit disheartening is that we don’t actually understand what really explains someone’s vehement opposition to, or politicization of, wearing a mask, except… following leaders who have made it a marker of cultural/tribal identification for their own purposes (such as to blame the other party). 
      1. A grand irony of this year is that if Trump had, in February or March, gone public and said “look folks this is a big deal it’s your patriotic duty to wear a mask”, he could have potentially saved tens of thousands of lives (or more!) and won re-election for managing the pandemic better. Why he refused to take a stand that would have actually helped him in the short run is hard to rationalize, but Xander’s OPINION is that it probably has to do with his unwillingness to be wrong about something publicly. 
      2. This is not unique to the President and is worth thinking about for a minute, and introspecting on: would I personally be more willing to get something wrong in public than to let someone else die? What’s the threshold at which point our ego really doesn’t (or at least shouldn’t) matter anymore?
  5. Some examples of gross dereliction of leadership by folks who should know better, but have made this worse, as part of wedging political behavior:
    1. Trump videos saying, “it’s going to go away on its own” like 8 times [let’s consider splicing some of these into the podcast, source material always makes for stronger content]
      1. https://www.youtube.com/watch?v=3y_eB-_V4XA
      2. https://www.youtube.com/watch?v=vdAn95tGYUA
      3. https://www.youtube.com/watch?v=uXxuUJJz4VE
      4. https://www.youtube.com/watch?v=7qbtqew-CI8
      5. https://www.youtube.com/watch?v=rzZgJZgFZbU
    2. Ted Cruz video saying that “as soon as the election is over…”
  6. We’ll post lots of resources for you in case you have someone you can have a real conversation with someone who’s on the fence

Sources/links:

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