Excellent post. Particularly appreciate the pubmed footnotes.

That said, the epistemology of public health practitioners is fundamentally different from that of front line clinicians. Public health folk focus on the course of illness in populations; clinicians focus on the course of illness in an individual patient. And there are overtones of the epistemic difference between lawyers and scientists: lawyers believe that truth comes from the process of argument by skilled advocates before a disinterested judge or jury; scientists believe that truth comes from rigorous, reproducible experimentation reported to and evaluated by the scientific community.

Which explains the antipathy between physicians and lawyers, and the truly odd behavior that ensues when lawyers and physicians interact in trials.


So, the public health crowd sees that health care workers (HCW) fail often to correctly use ppe. Fail to choose to use it all, choose a type unsuited to the pathogen or procedure, or fail to follow donning and doffing procedures, All this despite aggressive training, retraining, policy and procedure, and some very threatening pathogens.
Dealing with untrained users, they fall back on two very reliable infection control practices: distance and hand washing. Cheap, effective, and the foundation of all infection control. Because nothing works without program compliance, and the program needs to be as simple as possible.

So, if my friend wants to obtain a firearm for personal protection, I might suggest a medium caliber revolver, or a single barrel shotgun. Not maximally efficient, but effective and with a pretty brief manual of arms. Shorter training period, shallower learning curve, better choice. And there are friends t whom I have recommended a baseball bat. Depends on the friend.

I am a hcw, so the public-facing position of the CDC regarding civilian use of masks seems manipulative and counterfactual to me, too. But it makes perfect sense to the politicians and public health types. Which is reassuring, because much of the stuff done by pols and political docs seems manipulative and counterfactual. But their intentions are good.

The road to Hell is paved with good intentions.








HCW compliance with ppe usage standards

HCW respiratory protection practices