A few more thoughts on a tumultuous epidemic week in Minnesota. Thanks to the mask mandate, we can expect the epidemic to be completely ending soon, so I will finally be able to stop posting on it, or at least that is the message I got from the Dictator’s announcement. The Dictator has organized a “spontaneous” expression of gratitude from the state’s business partners for the mask mandates, including sending draft emails to them, with the clear understanding that they will send them in to support his order. The Dictator continues to plumb the leadership depths, resorting to Nazi, Communist, totalitarian tactics. Support the state or else. He needs to do that because there are plenty of people who are very upset with his actions and he is on shaky ground from an evidence perspective. But it is simply a pathetic move to try to gin up fake support, kind of like a pro sports team putting “yell and clap” up on the JumboTron.
The Dictator will also try to find a way no matter what happens to claim victory. It is tricky to ascertain cause and effect with so many moving parts. But assuming everything else was being held equal, the usual incubation period for an infection is around 3 to 5 days. So if there is truly a significant effect from wearing masks, we will begin to see it in a week, not 3 or more weeks as the Dictator said. The effect should be immediate. Now I will tell you why we won’t see it. First, you have to look at the pre-existing trend–which way were cases going. Then you have to compare the trend afterward, again, trying to keep everything equal. That is hard to do.
But more importantly, and here we can cut the Dictator some statistical slack, the prevalence of infections is so low that it is going to be hard to show any effect. Of course that low prevalence is why there is no reason to have a mandate. Right now 1 out of 8000 to 10,000 Minnesotans is being infected a day. It would be hard for any intervention to show effectiveness at that prevalence level. Because very few infections are actually being transmitted in stores or other indoor environments, and a large number are transmitted in a person’s residence, the prevalence where masks are supposed to make a difference is even lower.
And here is another statistical wonder to consider. Let us assume that based on a combination of type of mask worn and wearing it properly, a mask would prevent even 75% of infections in the environments where it is worn when the wearer encounters a infectious person. That is being very generous about masks’ effectiveness, based on actual research, not the phony kind the Dictator uses. That means that one out of four times when that encounter occurs, you are going to be infected. I think most people have more than four encounters in a day. But let’s don’t let logic get in the way of a good and pointless mask mandate.
Something that really bugged me from the Dictator’s press conference on masks was the claim that Minnesota got some recognition for having the best coronavirus reporting. I am not going to fact check that, but it can’t be true. What Minnesota often does is obfuscate trends that don’t fit the Dictator’s fear-mongering messaging. Here are some things that Minnesota doesn’t do, that some other states or sources do. In regard to cases, every cohort should be tracked for outcomes, so we understand how those outcomes, like hospitalization and death, relate to a specific set of cases. Do it by day, or by week, but don’t mix up time periods. Minnesota reports tests by date of specimen collection, but it is not clear how the reported cases relate to those test dates. Another testing issue is that we have been told nothing about contact tracing–how many tests have been done as a result of that and what the positivity rate is and which direction the transmission went. I suspect that the positivity rate from tests resulting from contact tracing is higher than that arising from other circumstances, so they should be broken out. And the state keeps telling us that young people are infecting older people, but gives us no results to validate that claim. I strongly suspect that this is because there isn’t any evidence of that in the contact tracing.
The hospitalization data is terrible. We don’t get actual number admitted on a specific day or discharged on a specific day, we don’t get average length of stay, we don’t suspected versus confirmed hospitalizations. These are all issues. Finally, we don’t get information on deaths by date of death instead of date of report. Other states provide that information and the CDC does as well. That is the accurate picture of this outcome and how it changes over time. The state also hasn’t told us where coronavirus fits on the death certificate, was it an underlying cause or the immediate cause. This also is important. And we get no information on all the lockdown-related harms–suicides, drug overdoses, missed health care, etc. So Minnesota actually doesn’t provide a lot of needed data, all of which is in its possession.
Finally, the epidemic has really declined here, in fact it is not clear it even qualifies as an epidemic at this point. Why is that? Is it some seasonal factor? Did a lot more people get infected than we believed, or do Minnesotans have unusually high levels of pre-existing immune defenses? Something accounts for it, and if it is seasonality, the virus will be back and little seems to stop it, especially in more densely populated areas. Masks won’t. We should be really working on these questions instead of wasting our time with a mask mandate and its enforcement.