REFLECTIONS ON THE VIRUS 2: MASKING THE TRUTH

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The current crisis has raised significant questions about the use of evidence, particularly statistical evidence. One evidential dimension concerns the use of anecdotes. Anecdotal evidence is the use of selected instances of an event to either support or refute a claim. During the pandemic, the use of anecdotal evidence has occurred, in particular, when discussing death rates in care homes, and the use of Personal Protective Equipment (PPE) in healthcare settings.

On care homes, it is not surprising that death rates have been higher than in the general population. Much of the media-inspired debate has been anecdotal, focusing on particular care homes where death rates have been high. Often, little context is provided. The fact that two-thirds of care homes have apparently been untouched by the virus has not been considered newsworthy, partly at least because it does not support an anti-Government narrative.

Concern about the availability PPE has been a constant theme expressed by the medical profession, care home staff, the media, and opposition politicians. The provision of PPE has undoubtedly been a challenge, not helped by the fact that the Government did not have a readily available stockpile, and there has, not surprisingly, been huge international demand for it. 

Without wishing to minimise the potential deadly consequences of the absence of PPE in healthcare settings – and the desirability of ensuring that everyone who needs it can access it – much of the debate about PPE has been conducted through the use of anecdotal evidence. That is, a small number of highlighted cases where PPE has been absent or in short supply has been extrapolated by some to make the claim that the Government is failing to provide PPE in general. In order to justify that claim, of course, it is necessary, through empirical research, to demonstrate that PPE is absent or in very short supply in a considerable number (a majority) of healthcare settings. There is no conclusive evidence that that is the case, although the provision of PPE has been justifiably raised as an important issue.

On a related theme, the use of face coverings in general, and masks in particular, has become a regular topic of debate. Unlike public authorities in other countries, such as the United States, the UK Government has resisted the urge to compel the wearing of masks in public places. In some parts of the world – particularly the Far East – the wearing of masks was commonplace even before the coronavirus outbreak. 

Like other areas of the COVID-19 crisis – and, indeed, like many other areas of public policy – the case for an against the wearing of masks is complex and not amenable to media soundbites and Government slogans. In the UK, the Government – following scientific advice – has repeatedly stated that the benefits of using masks is not proven. To cloud the issue, this conclusion is at least partly a product of a concern that making the wearing of masks compulsory would increase demand thereby resulting a shortage for healthcare workers.

So, what is the truth about the benefit of wearing masks? Well, it strikes me that those – an increasing number – who choose to wear masks are doing the right thing but not necessarily for the right reason. That is, I suspect that most people choose to cover their mouth and nose because they think it protects them against contracting the virus (some of course might be more altruistic than I am suggesting). However, they would be wrong (in most cases). 

The reality is that only the hospital grade masks – FFP2 and 3 to use the correct terminology – have a respirator that acts to protect the wearer pretty comprehensively against contracting the virus from others. Surgical masks, and other homemade face coverings, on the other hand, may have a benefit in preventing the infection of others if the wearer has the virus, but they do relatively little to protect the wearer. In addition, the evidence suggests that those who wear masks are more likely to touch their face thereby adding to the risk of contracting the virus.

The new UK Government advice (although not a compulsion), in the first stages of the post-lockdown era, is to use face coverings in shops and public transport. This advice has been issued partly, no doubt, as a psychological device to encourage people to leave their homes more. The downside is that the use of masks might encourage complacency and risk taking which will make matters worse.

MORE TOMORROW

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