This mask business is downright silly. Don't all doctors and nurses wear masks when they go into surgery to preserve a sterile environment? So they must do something. How would you feel if you were about to have a six hour coronary bypass and the staff came in talking and coughing and not wearing masks?
In terms of the AP Black Studies course, the Board says they had already streamlined the course before DeSantis made his censoring demands. Is the College Board trying to save face or is it true they had already revised the course to make it possible to complete in one semester? The headlines definitely make it look bad for them and good for DeSantis. Very unfortunate. I hope more reporting comes out on this.
Robert, I offer a rebuttal to the study suggesting masks may be useless: https://wwwnc.cdc.gov/eid/article/29/3/22-1314_article. The abstract of the study in the Centers for Disease Control and Prevention's Emerging Infectious Diseases Journal says: "In a cohort of essential workers in the United States previously infected with SARS-CoV-2, risk factors for reinfection included being unvaccinated, infrequent mask use, time since first infection, and being non-Hispanic Black. Protecting workers from reinfection requires a multipronged approach including up-to-date vaccination, mask use as recommended, and reduction in underlying health disparities."
The results are based on two studies of frontline workers in eight locations (my colleagues at Abt Associates run one of the studies). In terms of rigor, it doesn't get any better. Every week, the 4,707 participants send in nasal swabs and respond to surveys about their behavior (such as mask wearing and social distancing), as they have since July 2020. They do this regardless of symptoms so that we capture mild and asymptomatic cases. Considering the mental, emotional, and physical strain these workers have faced since 2020, it is more evidence of their heroism that they have religiously done this important task to provide critical data about COVID-19 transmission and vaccine effectiveness among those most exposed to the virus.
By the way, evidence of the rigor is that a separate study of families with the same protocols showed that children are as susceptible to the virus as adults. Again, we captured mild and symptomatic cases among children, which were the norm. Larger studies of millions of health records didn't pick up children's infections because the kids' cases were so mild they never went to the doctor.
COVID deaths have doubled since the end of November to just under 4,000 a week. Do the math. That's nearly 200,000 deaths a year. Please, please wear masks when in a crowd indoors to protect yourself and others. I hate to make this partisan, but if Republicans want to commit suicide by making a political statement about masks, there's nothing we can do. If DeSantis wants to murder his base, there's nothing we can do. What we can do is protect ourselves and our loved ones.
First: the College Board's decision in not insulting only to Balck Americans. It is insulting to every thinking, feeling citizen who cares about our country and who cares about teaching critical thinking to our children. Second, that metadata 'study' is ridiculous and I will continue to mask. Third: of course McCarthy has nothing; that is all they have: a big fat nothing!
In the winter of 2020-21, when masks were fairly widely worn, there was no "flu season" to speak of. The N95 masks I wear are 95% effective in keeping out various germs and in preventing me spreading any. I always fit them tight to my face, it's not hard to do.
People who believe the masks are ineffective are the fooking morons who SHOULD die in pandemics as we try to re-start evolution and lower the percentage of morons in the population.
As to the College Board's cowardly response on the AP course in Black History, this is merely the most recent demonstration of the complete, total, and continuing corruption of what passes for "higher miseducation" in America for the past 50 years.
Recent success by the Republicans in winning state and local elections, e.g. school boards, is an accomplishment deserving of much more Dem focus. De-fanging local school boards and electing rational and reasonable judges is critical.
Robert, your take on GOP intransigence is enthralling. I believe that common sense may prove to be a bit more common than recent events had led me to believe. Biden is rational, and so are most Americans.
You hit two extremely important points today. The College Board has embarrassed itself and left the future of its credibility in question.
Despite the Cochrane paper, we know that masks work. Other studies done properly clearly support this and empirically if they didn’t work, health care workers should have been decimated by now. Everybody is tired of wearing masks, not the least those of us in the front line of care. The truth is, we may be wearing masks for a long time to come.
Dr. Osterholm, a highly regarded epidemiologist, who has been delivering Covid updates from the very beginning, has been repeating the difference between cloth face masks and n95 respirators. Cloth masks are, indeed, ineffective against a respiratory virus, whereas an n95 respirators (mask, but distinguished as a respirator) is highly effective. Otherwise, why do health care professionals, treating Covid patients, wear them? And there are well-run tests that prove their efficacy. The confusion has always been about the “masks” (cloth…not good) and “respirators” (n95) which are very good. Once again, lack of clarity from the start about all of this has caused great harm, and continues to.
I am a physician, and meta-analysis outcomes are very often determined by the studies the authors choose to include, and those they don't. Part of the Cochrane problem is that they often do not look critically at the studies they do include, so the adage, garbage in, garbage out is applicable. Also, having looked many times at their reports, they are biased toward reporting inclusive evidence for a positive effect, when many times a reasonable person who is familiar with the literature would conclude just the opposite. An example from my specialty of anesthesiology is instructive. One of their reports a few years ago concluded that epidural blood patching had low evidence for effectiveness. Their definition of effectiveness aside, epidural blood patching is the most effective means of relieving the side effects of post dual puncture headache in a majority of patients. If you read their report, and didn't know otherwise, you'd likely abandon its use. People will suffer. In the case of masking in the presence of air borne lethal disease, the negative outcomes of failure to mask are more severe - more people die than would otherwise. Finally, like all interventions, risk and benefit analysis is the most appropriate way to answer this sort of question. Putting a mask on entails almost no risk. Even if the effectiveness was low, a prudent person would do it for a very low increase in benefit. And the benefit of masking in air borne disease is often very high. Curtis Baysinger, MD
The contradiction in the effectiveness of masks “mega-study/analysis” seems glaring to me. Hasn’t the recent surge and prevalence of RSV virus and flue been attributed to the fact that many HAVE worn masks and so the general population did not build up the usual immunity (from exposure) to those illnesses? And to state the obvious, why would medical workers, sanitation workers, and construction workers wear masks if they didn’t protect them from bacteria, viruses, and contaminants?
This questionable study is more fodder and ammunition for the right.
Feb 2, 2023·edited Feb 2, 2023Liked by Robert B. Hubbell
After reading about the College Board's so called pre-Desanctimonious changes to the African American AP course, I looked up the CB and wrote them saying, in effect, that their change is a slap in the face of Americans who have strived for generations to achieve equality and that they should be ashamed of themselves for kowtowing to the racist, antisemitic underbelly of America.
Below is the link to their Contacts page. Take a moment, give them a piece of your mind and then share the link with a friend or friends! Also you can call them at US 866-630-9305 or
International +1-212-713-8000 (but don't expect them to pick-up!)
It used to be said that all text books were written for Texas because of the purchasing power of the Texas State Board of Education. It looks like DeSantis is now positioning Florida to take the lead as the most benighted state in the union. I am not an academic, but if I were I would be starting a movement among institutions of higher learning to no longer accept AP credits for entering freshmen. AP would then have to make a choice which master to serve, DeSantis or the Truth. This is a perfect example of why conservatives were so adamant in their opposition to the Common Core movement. But if we sacrifice truth to politics, especially when it comes to white washing our history, we pay a political price the tab for which will be picked up by our children.
Thanks, Rob for the end comments about how what we Dems are doing are good things. I totally agree. The GOP is just looking for things to dig up and criticize and there are very few to find so .... they’re making some up. What a surprise!
And thanks for including Kamala Harris’ remarks at Tyre Nicols funeral. I don’t usually read much of what she has said but what you quoted was excellent, important and worth noting. Especially because she was our CA Attorney General so she know what she is speaking of. She sounds strong in the quote and it was good to hear from her.
It's important to understand that meta-analysis is a technique by which one takes different studies with very different sizes, null hypotheses, control techniques, and aggregates the already-collected information into one conclusion.
It has become a very popular methodology for one simple reason: It's far cheaper, easier, and faster to take others' research and rework the data than to do one's own.
There are many excellent critiques of this methodology.
Its fundamental flaw is that the results of a meta-analysis are highly contingent on its boundary conditions - that is, what studies you choose to include or exclude have a major impact on your results. As a result, there are tremendous built-in biases -- publication bias, selection bias, unwitting confirmation bias.
I was part of a consortium in the South Puget Sound of Behavioral Pediatric specialists that met monthly for years. There was an early meta-analysis published by a group in Oregon that showed "definitively" that there was zero advantage of any other stimulant medication over plain old ordinary short-acting Ritalin in the treatment of kids with ADHD. That conclusion flew in the face of all of our collective experiences, and I was tasked to read the research and give a summary. I found that as part of the boundary conditions, the authors had excluded virtually every study including other medications. The other studies were "too small"; the methodologies were "inadequate"; they were "contaminated" by having been funded by pharmaceutical corporations. It was a self-fulfilling analysis. The state wanted to use the results to eliminate more expensive meds - and did so over our combined protests.
There is no question that meta-analysis has a role in summarizing the state of the art...but it should not be mistaken for a definitive source for public health action. It is no substitute for prospective, randomized controlled trials.
Also, one comment about Cochrane. That platform suffers from many of the same problems. It also has inherent biases because of their decisions regarding which information is worthy of acceptance - that is, has sufficient evidentiary weight. The problem? Often their own recommendations are based on "expert opinion" (the lowest evidentiary standard) because there simply isn't enough information available....yet they publish it as definitive.
RE: Masks
In this context, Stan Crock's post (below) is excellent. Prospective studies beat meta-analyses every time. There are MANY prospective studies demonstrating the effectiveness of masks. One can argue about the relative merits - which is more important, the protection of the wearer or the protection of the other - but the efficacy of masks overall should not really be in dispute.
This mask business is downright silly. Don't all doctors and nurses wear masks when they go into surgery to preserve a sterile environment? So they must do something. How would you feel if you were about to have a six hour coronary bypass and the staff came in talking and coughing and not wearing masks?
In terms of the AP Black Studies course, the Board says they had already streamlined the course before DeSantis made his censoring demands. Is the College Board trying to save face or is it true they had already revised the course to make it possible to complete in one semester? The headlines definitely make it look bad for them and good for DeSantis. Very unfortunate. I hope more reporting comes out on this.
Robert, I offer a rebuttal to the study suggesting masks may be useless: https://wwwnc.cdc.gov/eid/article/29/3/22-1314_article. The abstract of the study in the Centers for Disease Control and Prevention's Emerging Infectious Diseases Journal says: "In a cohort of essential workers in the United States previously infected with SARS-CoV-2, risk factors for reinfection included being unvaccinated, infrequent mask use, time since first infection, and being non-Hispanic Black. Protecting workers from reinfection requires a multipronged approach including up-to-date vaccination, mask use as recommended, and reduction in underlying health disparities."
The results are based on two studies of frontline workers in eight locations (my colleagues at Abt Associates run one of the studies). In terms of rigor, it doesn't get any better. Every week, the 4,707 participants send in nasal swabs and respond to surveys about their behavior (such as mask wearing and social distancing), as they have since July 2020. They do this regardless of symptoms so that we capture mild and asymptomatic cases. Considering the mental, emotional, and physical strain these workers have faced since 2020, it is more evidence of their heroism that they have religiously done this important task to provide critical data about COVID-19 transmission and vaccine effectiveness among those most exposed to the virus.
By the way, evidence of the rigor is that a separate study of families with the same protocols showed that children are as susceptible to the virus as adults. Again, we captured mild and symptomatic cases among children, which were the norm. Larger studies of millions of health records didn't pick up children's infections because the kids' cases were so mild they never went to the doctor.
COVID deaths have doubled since the end of November to just under 4,000 a week. Do the math. That's nearly 200,000 deaths a year. Please, please wear masks when in a crowd indoors to protect yourself and others. I hate to make this partisan, but if Republicans want to commit suicide by making a political statement about masks, there's nothing we can do. If DeSantis wants to murder his base, there's nothing we can do. What we can do is protect ourselves and our loved ones.
Stan
First: the College Board's decision in not insulting only to Balck Americans. It is insulting to every thinking, feeling citizen who cares about our country and who cares about teaching critical thinking to our children. Second, that metadata 'study' is ridiculous and I will continue to mask. Third: of course McCarthy has nothing; that is all they have: a big fat nothing!
In the winter of 2020-21, when masks were fairly widely worn, there was no "flu season" to speak of. The N95 masks I wear are 95% effective in keeping out various germs and in preventing me spreading any. I always fit them tight to my face, it's not hard to do.
People who believe the masks are ineffective are the fooking morons who SHOULD die in pandemics as we try to re-start evolution and lower the percentage of morons in the population.
As to the College Board's cowardly response on the AP course in Black History, this is merely the most recent demonstration of the complete, total, and continuing corruption of what passes for "higher miseducation" in America for the past 50 years.
Recent success by the Republicans in winning state and local elections, e.g. school boards, is an accomplishment deserving of much more Dem focus. De-fanging local school boards and electing rational and reasonable judges is critical.
Robert, your take on GOP intransigence is enthralling. I believe that common sense may prove to be a bit more common than recent events had led me to believe. Biden is rational, and so are most Americans.
You hit two extremely important points today. The College Board has embarrassed itself and left the future of its credibility in question.
Despite the Cochrane paper, we know that masks work. Other studies done properly clearly support this and empirically if they didn’t work, health care workers should have been decimated by now. Everybody is tired of wearing masks, not the least those of us in the front line of care. The truth is, we may be wearing masks for a long time to come.
Dr. Osterholm, a highly regarded epidemiologist, who has been delivering Covid updates from the very beginning, has been repeating the difference between cloth face masks and n95 respirators. Cloth masks are, indeed, ineffective against a respiratory virus, whereas an n95 respirators (mask, but distinguished as a respirator) is highly effective. Otherwise, why do health care professionals, treating Covid patients, wear them? And there are well-run tests that prove their efficacy. The confusion has always been about the “masks” (cloth…not good) and “respirators” (n95) which are very good. Once again, lack of clarity from the start about all of this has caused great harm, and continues to.
I am a physician, and meta-analysis outcomes are very often determined by the studies the authors choose to include, and those they don't. Part of the Cochrane problem is that they often do not look critically at the studies they do include, so the adage, garbage in, garbage out is applicable. Also, having looked many times at their reports, they are biased toward reporting inclusive evidence for a positive effect, when many times a reasonable person who is familiar with the literature would conclude just the opposite. An example from my specialty of anesthesiology is instructive. One of their reports a few years ago concluded that epidural blood patching had low evidence for effectiveness. Their definition of effectiveness aside, epidural blood patching is the most effective means of relieving the side effects of post dual puncture headache in a majority of patients. If you read their report, and didn't know otherwise, you'd likely abandon its use. People will suffer. In the case of masking in the presence of air borne lethal disease, the negative outcomes of failure to mask are more severe - more people die than would otherwise. Finally, like all interventions, risk and benefit analysis is the most appropriate way to answer this sort of question. Putting a mask on entails almost no risk. Even if the effectiveness was low, a prudent person would do it for a very low increase in benefit. And the benefit of masking in air borne disease is often very high. Curtis Baysinger, MD
Judd Legums and 2 other scholars offers the BEST analysis I’ve seen yet on College Board’s cowardly gutting of the African American History AP. https://open.substack.com/pub/popularinformation/p/why-the-college-board-watered-down?utm_source=direct&r=3fzdh&utm_campaign=post&utm_medium=web
The contradiction in the effectiveness of masks “mega-study/analysis” seems glaring to me. Hasn’t the recent surge and prevalence of RSV virus and flue been attributed to the fact that many HAVE worn masks and so the general population did not build up the usual immunity (from exposure) to those illnesses? And to state the obvious, why would medical workers, sanitation workers, and construction workers wear masks if they didn’t protect them from bacteria, viruses, and contaminants?
This questionable study is more fodder and ammunition for the right.
After reading about the College Board's so called pre-Desanctimonious changes to the African American AP course, I looked up the CB and wrote them saying, in effect, that their change is a slap in the face of Americans who have strived for generations to achieve equality and that they should be ashamed of themselves for kowtowing to the racist, antisemitic underbelly of America.
Below is the link to their Contacts page. Take a moment, give them a piece of your mind and then share the link with a friend or friends! Also you can call them at US 866-630-9305 or
International +1-212-713-8000 (but don't expect them to pick-up!)
https://form.collegeboard.org/f/send-message
PS. Don't forget to add your credentials: High School name and year of graduation!
It used to be said that all text books were written for Texas because of the purchasing power of the Texas State Board of Education. It looks like DeSantis is now positioning Florida to take the lead as the most benighted state in the union. I am not an academic, but if I were I would be starting a movement among institutions of higher learning to no longer accept AP credits for entering freshmen. AP would then have to make a choice which master to serve, DeSantis or the Truth. This is a perfect example of why conservatives were so adamant in their opposition to the Common Core movement. But if we sacrifice truth to politics, especially when it comes to white washing our history, we pay a political price the tab for which will be picked up by our children.
How can we protest the College Board decision? Anyone we can write to? To give that much power to a dictator/king/emperor wannabe is horrifying.
Thanks, Rob for the end comments about how what we Dems are doing are good things. I totally agree. The GOP is just looking for things to dig up and criticize and there are very few to find so .... they’re making some up. What a surprise!
And thanks for including Kamala Harris’ remarks at Tyre Nicols funeral. I don’t usually read much of what she has said but what you quoted was excellent, important and worth noting. Especially because she was our CA Attorney General so she know what she is speaking of. She sounds strong in the quote and it was good to hear from her.
A comment on meta-analysis:
It's important to understand that meta-analysis is a technique by which one takes different studies with very different sizes, null hypotheses, control techniques, and aggregates the already-collected information into one conclusion.
It has become a very popular methodology for one simple reason: It's far cheaper, easier, and faster to take others' research and rework the data than to do one's own.
There are many excellent critiques of this methodology.
Its fundamental flaw is that the results of a meta-analysis are highly contingent on its boundary conditions - that is, what studies you choose to include or exclude have a major impact on your results. As a result, there are tremendous built-in biases -- publication bias, selection bias, unwitting confirmation bias.
I was part of a consortium in the South Puget Sound of Behavioral Pediatric specialists that met monthly for years. There was an early meta-analysis published by a group in Oregon that showed "definitively" that there was zero advantage of any other stimulant medication over plain old ordinary short-acting Ritalin in the treatment of kids with ADHD. That conclusion flew in the face of all of our collective experiences, and I was tasked to read the research and give a summary. I found that as part of the boundary conditions, the authors had excluded virtually every study including other medications. The other studies were "too small"; the methodologies were "inadequate"; they were "contaminated" by having been funded by pharmaceutical corporations. It was a self-fulfilling analysis. The state wanted to use the results to eliminate more expensive meds - and did so over our combined protests.
There is no question that meta-analysis has a role in summarizing the state of the art...but it should not be mistaken for a definitive source for public health action. It is no substitute for prospective, randomized controlled trials.
Also, one comment about Cochrane. That platform suffers from many of the same problems. It also has inherent biases because of their decisions regarding which information is worthy of acceptance - that is, has sufficient evidentiary weight. The problem? Often their own recommendations are based on "expert opinion" (the lowest evidentiary standard) because there simply isn't enough information available....yet they publish it as definitive.
RE: Masks
In this context, Stan Crock's post (below) is excellent. Prospective studies beat meta-analyses every time. There are MANY prospective studies demonstrating the effectiveness of masks. One can argue about the relative merits - which is more important, the protection of the wearer or the protection of the other - but the efficacy of masks overall should not really be in dispute.
Please wear masks to protect us all.