SCIENCE AND DATA ALERT!
MASKS: THE EMPEROR HAS NO CLOTHES
This is the big one Elizabeth! (shout out Fred G. Sanford). Almost no issue in society today is as divisive as whether or not we should be wearing masks. There seem to be, as with everything else in America today, two tribes of thought. Tribe one has great reservations and objections to being compelled to wear a mask as they see it not only as a silly, virtue-signaling gesture that doesn’t really do anything, but also as an affront to their Constitutional rights. Tribe two believes they “know” that masks are a game-changer (shout out Governor Murphy) and that people who don’t want to wear masks are stupid, selfish, science-denying grandma killers. There are no end to articles in the media telling you how “effective” masks are, or would be if we could just get everybody to wear them for, say, three months. But as I have warned on other issues concerning this pandemic, you really need to be on the lookout for the magic words of modeling or predicting; those being words such as could, would, might, will, did, believed to, projected, prognosticated, divined, and so on. Just the other day, a political hack masquerading as a “medical expert” named Sanjay Gupta reported he was told by government sources that 80-90% of COVID deaths “could have” been avoided if only everyone wore masks. A prize to whoever can recognize the magic words. This kind of nonsense only serves to stir the pot more and create more dissension between people and confusion among them.
TRIGGER ALERT: For those in tribe one if you continue reading this investigation into the actual science of masks (and other mitigation strategies) you may get more frustrated than you are right now. For those in tribe two, if you think those who don’t “believe” in masks are troglodytes and that the science of mask efficacy is irrefutably established, you may want to look away at this point. If, however, you are a member of tribe two but have the intellectual curiosity and rational capability to look at what the actual SCIENCE AND DATA has to say on the matter please continue. While informing someone recently of this information, their response was “well, I just don’t believe you.” That is simply not rational and it is this fairly pervasive lack of rational, critical thinking that has allowed for the circus that we now find ourselves living in (largely caused by misinformation and disinformation spread by our overlords and the PANIC PORN press). Again, refusal to recognize the actual SCIENCE AND DATA only leads to more confusion, fear, and ultimately a worse outcome for all of us. At some point, the facts must account for something.
So let’s take a look at this paper entitled “Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures” which can be found on the CDC’s website here: https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article
This paper was published in May of 2020 by the CDC in their Emerging Infectious Diseases Journal with the stated purpose of its existence being “…in preparation for the development of guidelines by the World Health Organization on the use of nonpharmaceutical interventions for pandemic influenza in nonmedical settings.” This paper is what’s called a meta-analysis which means the authors review all relevant scientific papers that have been published on the topic(s) of concern and see what conclusions can be drawn by examining the results of the individual papers. In this paper the authors explain “Local, national, and international health authorities regularly update their plans for mitigating the next influenza pandemic in light of the latest available evidence on the effectiveness of various control measures in reducing transmission. Here, we review the evidence base on the effectiveness of nonpharmaceutical personal protective measures and environmental hygiene measures in nonhealthcare settings and discuss their potential inclusion in pandemic plans.” They continue “…and specifically the evidence for the effectiveness of these measures in reducing transmission of laboratory-confirmed influenza in the community.” (bold emphasis mine) So this paper is published by the CDC, containing 50 cited references, with the purpose of informing the World Health Organization on the efficacy of personal protective measures which means this paper should be considered by any rational person as, if not in fact the Holy Grail of SCIENCE AND DATA on these matters, at the very least an authoritative fount of information on which rational viral transmission mitigation strategies should be based. By the way, the head of the CDC, Dr. Robert Redfield was recently testifying in front of some government panel of circus monkeys waving his mask around and telling us it may be more effective than a vaccine (not sure what this says about his confidence in a vaccine) and you will see lots of other reports “proving” mask efficacy, but they are all observational studies – the lowest form of “science”. Unfortunately people see this sort of thing and accept it as the truth. Now let’s see what this paper actually has to say about these issue.
The authors start with “Although mechanistic studies support the potential effect of hand hygiene or face masks, evidencefrom 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza. We similarly found limited evidence on the effectiveness of improved hygiene and environmental cleaning.” (bold emphasis mine) A couple of very important points here. First, the allusion to “mechanistic studies” is kind of important as these studies find what are called “surrogate markers” which are often used as proof of efficacy or causation but often (usually) don’t hold up under further scrutiny. We’ll see that play out shortly. Second, the evidence for the conclusion of this paper is drawn from looking at randomized controlled trials (RCTs) which are the gold standard of scientific investigation. So again, this is the best evidence from the best SCIENCE AND DATA available. Let’s look at some conclusions.
For hand hygiene (washing your hands): “The effect of hand hygiene combined with face masks on laboratory-confirmed influenza was not statistically significant.” “We found 6 studies in household settings examining the effect of hand hygiene with or without face masks, but the overall pooled effect was not statistically significant.” “A pooled analysis of 2 studies in university residential halls reported a marginally significant protective effect of a combination of hand hygiene plus face masks worn by all residents.” However, “…results from our meta-analysis on RCTs did not provide evidence to support a protective effect of hand hygiene against transmission of laboratory-confirmed influenza.” (bold emphasis mine) The authors do note that “Hand hygiene is also effective in preventing other infectious diseases, including diarrheal diseases and some respiratory diseases.” so there’s that.
On respiratory etiquette, which is described as “…covering the nose and mouth with a tissue or a mask (but not a hand) when coughing or sneezing, followed by proper disposal of used tissues, and proper hand hygiene after contact with respiratory secretions (30). Other descriptions of this measure have included turning the head and covering the mouth when coughing and coughing or sneezing into a sleeve or elbow, rather than a hand.” the authors conclude “… there is a lack of scientific evidence to support this measure. Whether respiratory etiquette is an effective nonpharmaceutical intervention in preventing influenza virus transmission remains questionable.” (bold emphasis mine)
As far as face masks are concerned (hold on to your bloomers!): “…we found no significant reduction in influenza transmission with the use of face masks.” “Two studies in university settings assessed the effectiveness of face masks for primary protection by monitoring the incidence of laboratory-confirmed influenza among student hall residents for 5 months (9,10). The overall reduction in ILI or laboratory-confirmed influenza cases in the face mask group was not significant in either studies” (sic) “None of the household studies reported a significant reduction in secondary laboratory-confirmed influenza virus infections in the face mask group.” “There is limited evidence for their effectiveness in preventing influenza virus transmission either when worn by the infected person for source control or when worn by uninfected persons to reduce exposure. Our systematic review found no significant effect of face masks on transmission of laboratory-confirmed influenza.” (bold emphasis mine)
For surface and object cleaning: “One RCT conducted in day care nurseries found that biweekly cleaning and disinfection of toys and linen reduced the detection of multiple viruses, including adenovirus, rhinovirus, and respiratory syncytial virus in the environment, but this intervention was not significant in reducing detection of influenza virus, and it had no major protective effect on acute respiratory illness. Another RCT found that hand hygiene with hand sanitizer together with surface disinfection reduced absenteeism related to gastrointestinal illness in elementary schools, but there was no major reduction in absenteeism related to respiratory illness.” (bold emphasis mine)
The authors conclude “In this review, we did not find evidence to support a protective effect of personal protective measures or environmental measures in reducing influenza transmission. Although these measures have mechanistic support based on our knowledge of how influenza is transmitted from person to person, randomized trials of hand hygiene and face masks have not demonstrated protection against laboratory-confirmed influenza…” (bold emphasis mine). This takes us back to this idea of surrogate markers. You can read all the articles you want about how masks decrease particulate matter from your breath cloud (hate that term) but that, according to gold standard research, does not translate into real world protection. Period. “We did not find evidence that surgical-type face masks are effective in reducing laboratory-confirmed influenza transmission, either when worn by infected persons (source control) or by persons in the general community to reduce their susceptibility.” (bold emphasis mine) So when you’re told (or when you’re telling others) that you should wear a mask to show how much you care and to protect others, maybe not so much. “Evidence from RCTs of hand hygiene or face masks did not support a substantial effect on transmission of laboratory-confirmed influenza…”
Now for all those who are ready to pounce, there are caveats about some underpowered studies and small sample sizes. And yes, this is research on influenza transmission but there is no reason to believe the transmission of coronavirus is any different. In point of fact, the authors go to some length to elucidate the fact that we really have very little knowledge when it comes to the mechanisms of viral transmissions. But the bottom line is, this is the best SCIENCE AND DATA we have and for those who are condemning their neighbors (or even loved ones) for being selfish or stupid or hateful, you might want to dial it back. Let me clear, I am certainly not saying you shouldn’t wear a mask. You do you. But this pervasive idea that we “know” masks are the answer is simply, factually, not true. Can masks hurt you? Probably not, but actually, yes they might. In the only RCT examining cloth masks (the kind we’ve all been told to wear) published in 2015, the authors state “Cloth masks resulted in significantly higher rates of infection than medical masks, and also performed worse than the control arm.” “…as a precautionary measure, cloth masks should not be recommended...” (bold emphasis mine) The control arm was people who generally wore surgical masks, but sometimes didn’t wear masks at all. Again here, this is a study of healthcare workers in higher risk settings, but this is the SCIENCE AND DATA we have.
In conclusion (and if you’ve read this far you deserve a prize), the idea that wearing a mask or washing your mail is going to slow the spread of a virus is, at best, very suspect. If one accepts the paper reviewed above as the best empirical evidence that we have as to the efficacy of our mitigation strategies (and it should), then your insistence on the use of masks must be curtailed. It’s only logical. But then again, it seems logic went out the window a long time ago. There is one other point to be made here. The focus on masks and the other evidently weak mitigation strategies diverts us from the things we do actually know (by looking at the actual SCIENCE AND DATA) can help protect you from a bad outcome from this virus. Those would be things like losing weight, reducing blood pressure, reducing glucose and insulin levels, increasing vitamin D levels, getting more sleep, etc. In other words, improving your health from the inside out so your body can better defend itself against this extinction level event. I wrote about this way back in April, but now six months later, how many of us have gained the “Quarantine 15” or the “COVID 19” or whatever other cute terms we’re using for the result of locking people in their houses, closing the gyms (and the parks!), and promoting “comfort food” while making sure the liquor stores stayed open to ease our anxiety?
- Saturated Fat
- REMAIN CALM, ALL IS WELL