The RCTs I have seen with basic surgical masks also seem to focus only on protection of the wearer, whereas on a societal level wearing even a shitty mask may be helping to prevent spread by presymptomatic people. I think it is unlikely the positive outcomes in mask wearing communities are purely due to confounders, although of course they probably also play a role.
I'm not sure about that honestly. At the extreme there's definitely COVID deniers who followed no precautions, but IME most "normal" people I know felt more comfortable spending time indoors with masks than they would have otherwise. And 6 feet is really not enough spacing in many indoor environments. With things like elevators the other person could be gone and you could still be exposing yourself.
There is also precedence for some of these statistics with Asian countries during the SARS pandemic, and in these places rule following is generally much better.
And with a smaller sample size there are some case studies from restaurant transmission. Staff seem to get infected less frequently than other diners, even though they are in the space for longer. There are a few possible explanations, but the fact that staff don't take their masks off is a pretty compelling one.
> Staff seem to get infected less frequently than other diners, even though they are in the space for longer. There are a few possible explanations, but the fact that staff don't take their masks off is a pretty compelling one.
IMO that’s the least compelling reason. One big one would be the staff having way more contacts and thus higher exposure to the other circulating hCoVs as well as SARS-2 itself.
The evidence for face masks is weak at best. In my opinion they don’t even make sense theoretically unless you pretend that droplet transmission is the dominant transmission mode, which is completely unproven yet widely believed dogma (go figure)
It is possible for there to be multiple modes of transmission, and there is good evidence to suggest droplet transmission plays a meaningful role in COVID spread. How much it contributes versus airborne transmission may be debatable, but that doesn't mean taking preventative measures against droplet transmission is "dogma". Here is some discussion of evidence for droplet transmission https://jamanetwork.com/journals/jama/fullarticle/2768396
I'm also not sure why you would assume staff have had more contacts. The people that were eating at indoor restaurants in the middle of the pandemic were unlikely the type to be limiting their contacts. Most case studies also checked for antibodies after the fact, not just active COVID testing, so prior immunity would have been detected.
