“Wearing masks in the community probably makes little or no difference.” Such was the verdict of a recent Cochrane review, a systematic assessment of all medical research on masks. How much should one trust this overarching study? Medical journals say that Cochrane reviews are “recognised worldwide as the highest standard in evidence-based healthcare”, are the “best single source of highest-quality systematic reviews”, and are “regarded as the final word in the medical debate on a topic”. One adds, “The main reason is that Cochrane reviews follow a common and specific methodology to limit bias.” If only the same could be said about the public health officials at the Centers for Disease Control (CDC) and the National Institutes of Health (NIH).
Specifically, Cochrane found, “Wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness (ILI)/COVID-19 like illness” — or “to the outcome of laboratory-confirmed influenza/SARS-CoV-2” — “compared to not wearing masks.” Moreover, “The use of a N95/P2 respirators compared to medical/surgical masks probably makes little or no difference for the outcome… of laboratory-confirmed influenza infection.” Each of these claims was made with “moderate certainty”, the second highest of four certainty classifications. (“Moderate certainty” means that “the true effect is likely to be close to the estimate of the effect.”)
The mask advocates’ grasping-at-straws response to this review has been that Cochrane doesn’t know what it’s doing (despite its “worldwide” reputation for providing “the highest standard” of medical research). Or they say that Cochrane produced a fine study, but people didn’t read it correctly. Or randomised controlled trials aren’t to be trusted when it comes to masks (RCTs are universally considered the gold standard in medical research). Or we need more and better RCTs on masks, though 16 have already been conducted on surgical or cloth masks, none of which has provided compelling evidence that they work.
The mask advocates’ refusal to recognise that medical science does not support their steadfast belief is truly remarkable. Clearly, something more is going on here than a genuine debate about which healthcare measures work.
Part of it, perhaps, is that progressives don’t like it when they can’t control something. Masks let them feel as if they can control the virus — and other people, to boot, the next best thing to controlling the virus.
There’s also the matter of identity. For some, a mask conveys quasi-religious symbolism — we believe in Health — and serves as a sort of spiritual symbol, a totem. No one wants to be told that their totem is powerless.
Evidence suggesting masks’ ineffectiveness has remained relatively constant over time. In addition to the individual RCTs conducted across the years, which I discussed in detail in a 2021 City Journal essay reviewing the evidence, Cochrane published a review on November 20th 2020, that closely resembles its January 2023 review. Cochrane’s earlier review found that wearing a mask “probably makes little or no difference to the outcome of laboratory-confirmed influenza… compared to not wearing” a mask, and that using an N95 “compared to” a surgical mask “probably makes little or no difference for the… outcome of laboratory-confirmed influenza infection”. In fact, the 2023 review repeats all of this language verbatim.
Unlike the 2023 Cochrane review, however, the 2020 review didn’t make much of a splash. This may have been by design. Tom Jefferson, the lead author of both studies, says that Cochrane delayed the release of the 2020 study; it “held it up for seven months”. If not for that delay, the review would have appeared just a few weeks after the CDC profoundly reversed its masking guidance — from don’t wear masks to do wear masks — on April 3rd 2020, citing no meaningful new evidence on which to base that change. It’s certainly believable that Cochrane didn’t want to look like it was contradicting the CDC at that pivotal time.
The Australian investigative journalist Maryanne Demasi, who interviewed Jefferson, asked, “Are you suggesting that Cochrane was pro-mask, and that your review contradicted the narrative?” Jefferson replied, “Yes, I think that is what was going on”. He noted that Cochrane wrote a pro-mask editorial to accompany the study’s eventual 2020 release. “Waiting for strong evidence is a recipe for paralysis,” the editorial stated. Such a message, Jefferson observes, is “a complete subversion of the ‘precautionary principle’ which states that you should do nothing unless you have reasonable evidence that benefits outweigh the harms”.
Now the Cochrane executives are at it again. Facing criticism from influential mask advocates, Karla Soares-Weiser, Editor-in-Chief of the Cochrane Library, issued a statement on March 10th — about a month and a half after the 2023 review’s release — saying that “the review is not able to address the question of whether mask-wearing itself reduces people’s risk of contracting or spreading respiratory viruses”. This, of course, is exactly what the review addressed, and it concluded, with “moderate certainty,” that mask-wearing “probably makes little or no difference” in preventing the spread of viruses.
The most noteworthy thing about the 2023 Cochrane review is that it provides further confirmation that the two RCTs that took place after the release of the 2020 Cochrane study — one in Denmark and the other in Bangladesh — didn’t move the needle in favour of masks. In fact, the needle moved in the opposite direction: Cochrane now says that masks “probably” (2023), as opposed to “may” (2020), make “little or no difference to the outcome of influenza-like illness”. (This is in addition to Cochrane’s having previously reported that masks “probably” make “little or no difference to the outcome of laboratory-confirmed influenza”.) And in 2023, Cochrane explicitly added “COVID-19” and “SARS-CoV-2” to the list of things that masks apparently don’t prevent — and could even increase — the spread of.
How could masks increase the spread of viruses? Cochrane suggests the possibilities of “self-contamination of the mask by hands” and “saturation of masks with saliva from extended use (promoting virus survival in proteinaceous material)”. In March 2020, then-Surgeon General Jerome Adams said, “Folks who don’t know how to wear [masks] properly tend to touch their faces a lot and actually can increase the spread of coronavirus.” The authors of one RCT write, “The virus may survive on the surface of the facemasks” and “transfer pathogen from the mask to the bare hands of the wearer”. As for double-masking, the same authors write, “Observations during SARS suggested double-masking… increased the risk of infection because of moisture, liquid diffusion and pathogen retention.” In other words, masks are often moist, frequently dirty and sometimes virus-ridden. Having one stuck to your face could increase the spread of viruses — especially if you touch your mask, or if your young children touch theirs.
The mask zealots, however, remain unmoved. In an article at Health.com responding to the Cochrane review, Sarah Sloat essentially quotes three evidence-denying doctors and rests her case. One declares that masks “are an additional layer of protection” (RCTs be damned). Another asserts, “If you are putting on a mask, you are doing a great job of protecting yourself.” A third opines (with a striking lack of self-awareness), “At the end of the day, people will do what they want, and science is not going to move some people one way or the other.” He then proclaims, “But a mask does give you a big bang for the buck, and not just for COVID-19.”
In Vox, Kelsey Piper complains that the Cochrane review includes studies involving other viruses at other times, rather than just studies focused on Covid during the pandemic. She ignores how the inclusion of the two Covid RCTs resulted in Cochrane’s weighing in more strongly against masks’ effectiveness, as one of those RCTs (the one from Denmark) found no statistically significant difference between infection rates in its mask and non-mask groups, and the other (from Bangladesh) found very little difference and claimed that it was significant only because of myriad methodological flaws, which I detailed in a City Journal essay last summer. Piper, however, praises the highly problematic Bangladesh study as “finding very solid evidence”, while the Cochrane review is somewhat “scientifically irresponsible” and really “quite bad meta-analysis.”
Likewise, Lucky Tran, writing for the Guardian, criticises the Cochrane review because it includes other viruses in addition to Covid and because it evaluates masks’ effectiveness as they are actually worn, rather than trying to guess how effective masks might be if people wore them as diligently as public health officials would like. Tran calls the Cochrane review part of “the avalanche of misinformation” and proclaims, “Masks are magnificent.” He adds that masks “are a visible symbol that the pandemic is ongoing” — another apparent virtue.
Finally, New York Times columnist Zeynep Tufekci writes, without substantiation: “So the evidence is relatively straightforward: Consistently wearing a mask, preferably a high-quality, well-fitting one, provides protection against the coronavirus.” She dismisses the Cochrane review and asserts that the Danish study during Covid “found that masks helped.” This is false. The authors of that study plainly stated that “no statistically significant difference in SARS-CoV-2 incidence was observed” between the study’s mask group and its non-mask control group.
Other mask advocates claim that the problem isn’t with the Cochrane study at all. Instead, they suggest a deeper, esoteric meaning behind what it plainly says: “Wearing masks in the community probably makes little or no difference.” The Los Angeles Times published a column entitled, “Covid deniers claim a new study says mask mandates don’t work. They should try reading it.” A nurse wrote a letter in response asserting, “I have seen with my own eyes how masks protect people from acquisition and transmission of COVID-19.” People generally can’t see viruses with the naked eye, so this is an impressive claim.
Bret Stephens wrote a column in the New York Times entitled, “The Mask Mandates Did Nothing. Will Any Lessons Be Learned?” Times readers’ favourite of the 3,773 comments responding to the article claims that Stephens misrepresents the study, which the reader suggests yielded essentially no information. Their second-favourite comment blames people for not being diligent enough in their mask-wearing and then asks, “Notice how surgeries are still masked environments?” Surgical masks were designed to keep medical personnel from inadvertently infecting patients’ open wounds. Such masks were not designed to reduce the spread of viruses. As for N95s, they were designed to protect workers from breathing in dust, fumes, or smoke. To the extent that they were worn in hospitals pre-Covid, it was primarily to help prevent the spread of tuberculosis bacteria, not to protect against viruses. According to an article on the NIH website, published in the less-politicised, pre-Covid days, “Viruses are tiny, ranging in size from about 20 to 400 nanometers in diameter. … Billions can fit on the head of a pin.” More than 1,000 can generally fit on the period at the end of a sentence, which is roughly “350,000 nanometers, in diameter.” In comparison, “Bacteria are 10 to 100 times larger than viruses” and “are usually measured in microns” (with one micron equaling 1,000 nanometers, the usual measure for viruses).
It should be greatly disturbing, in light of the evidence, that so many hospitals and doctor’s offices continue to force patients to wear masks. It should make one wonder how many other times medical personnel don’t follow the medical studies on which they supposedly rely. Yet, New York Times readers aren’t disturbed at all but take comfort in mask mandates. Among the readers’ 10 favourite comments was one that says, “The [Cochrane] findings are basically nonsense. Common sense prevails here. … I was in a hospital today. Everyone has to wear a mask.”
In his recent City Journal piece on the 2023 Cochrane review, John Tierney asks, “Can anything persuade the maskaholics in the public-health establishment and the public to give up their obsession?” The answer, plainly, is no. Their faith transcends reason.
Jeffrey H. Anderson is president of the American Main Street Initiative, a think tank for everyday Americans. He served as Director of the Bureau of Justice Statistics at the U.S. Department of Justice from 2017 to 2021. This article was first published by City Journal.
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Is There No Cure For Maskaholics?
Amputation from the ankles.
Such was the verdict of a recent Cochrane review, a systematic assessment of all medical research on masks.
False – it only looked at RCTs. It deliberated excluded all observational studies.
In fact it only included one study of the effect of wearing masks on community transmission for Covid – the Bangla Desh study (the Danish study only looked at the effect of wearing masks on the wearer) which found a small benefit. It simply assumed that studies looking at flu could be combined with studies looking at Covid. (To see how dicey this is you simply have to think how misleading the study would be if as it happens masks worked for Covid but not flu)
The fact is that it is extremely hard to run a quality RCT for any kind of non-physical intervention, including masks. It is like administering a trial of a drug where you can’t blind the participants and they decide what dose to take. Which is presumably why there are so few. RCTs are in general better than observational trials but a good observational trial is better than a poor RCT.
In any case, they were only assessing the effectiveness of various types of mandate. That is quite different to the decision for an individual to wear a mask in various contexts.
Cochrane has a great and deserved reputation but that doesn’t mean the name is a guarantee of quality. That’s just an argument from authority.
These guys do multiple trials, happy to repeat it if you’re volunteering?
https://www.youtube.com/watch?v=17FaG7mLEvo
A good observational trial is better than a poor RCT.
There is no such thing as an observational trial because observation of some random set of real-word events is not a trial. Apart from that, this statement is about as sensible as A coffeepot is better than a chainsaw, except in one respect: A good observational study, ie, one selected because it shows correlations advocates of Chinese mummery want to present, is better for them than a poor RCT, ie, one whose result they regard it as poor because it’s not to their liking.
And let’s not forget Danny Altmann: Face mask advocates are a tiny group of dangerous extremists seeking to harm everyone else to the degree they’re allowed to, up to and including killing other people, for their own benefit.
You are right. I should have written observational study not trial. I am confused by your second paragraph. Observational studies may attempt to answer the same questions as RCTs. They may do this well or badly. So there seems to be a basis for comparing the relative merits.
The burden of proof is on those who demand that we radically change our behaviour in response to a trivial respiratory virus.
The people whgo told us to wear masks also told us to stay inside rather than exercise in the fresh air and sunshine: that tells us quite enough about them.
It is one thing to decide how effective masks are, another to decide what to do about it. Personally I am against making people wear them except in very specific high risk contexts.
The so-called scientific method works as follows:
1) Observe some aspect of the world
2) Formulate a theory to explain what had been observed
3) Design an conduct repeatable experiments to prove or disprove the theory
A so-called observational study encompasses 1) and 2). Hence, the outcome is an unproven theory because step 3 hasn’t been done. In medicine, 3 is provided by RCTs.
Well you just ruled out earth studies, cosmology, paleontology and large chunks of medicine. The fact is we study (I don’t care whether you call it science) many subjects where repeatable experiments are not possible. The community effect of wearing of masks in a pandemic falls into that category..
A guy named Johannes Kepler came up with the theory that orbits of planets around the sun where elliptical and not circular. This theory was proven (and that is a repeatable experiment) by enabling correct predictions about the locations of planets while the circular orbit theory couldn’t do this. That’s physical cosmology.
That said, there may be areas where unproven (and unprovable) theories are the best we have. However, I like to point out that in the area of COVID-motivated restrictions (as they should correctly be called) your unproven theories are not enough because for every X must be prohibited! theory you might come up with, I’ll come up with an equally unproven opposite theory and will ignore yours on the grounds that I don’t care for other people’s unsubstantiated opinions.
That said, there may be areas where unproven (and unprovable) theories are the best we have.
That’s a limited concept of proof. You can’t repeat evolution or the big bang but I wouldn’t describe them as unproven.
And when have you lived through a pandemic?
Community effect? Like an experiment that Derren Brown does to trick people into giving the answer he wants? Like the way he messes with your mind so that you give up your wallet after just 2 minutes? The way he scared the while audience into submission, only to be told it was an experiment?
4) – aka The Science™️… if the evidence from experiment does not prove your theory, the data is wrong.
5) Design and run a computer model to prove your theory was right after all.
The truth is there are no reliable medical trials no matter how conducted, because it is impossible to eliminate the primary variable and confounding factor – the Human individual.
We are all different, with different physiologies and behaviours, and there is no such thing as a truly randomised trial. People are selected or excluded within set predetermined parameters.
It is also impossible to remove the bias of those analysing (or paying for) the data.
Argue with them sunshine :-
https://brownstone.org/articles/the-latest-in-the-war-on-science/
So if not for for an organization that is reputed to be the most reliable and comprehensive, non-biased source for evaluating the impact of NPIs, then who are we to believe? They’ve taken around 80 of the studies designed to yield the best quality evidence (i.e. RCTs), evaluated them impartially, and concluded negligible benefit from mask-wearing (NOT mask policies). This is the best, most comprehensive meta-analysis there is, conducted by scientists internationally, and you would rather put your trust in a few non-scientific reporters from publications with obvious bias?!
We should believe our politicians without hesitation: they are the wisest, most intelligent, least corrupt people.
I call them people, but aren’t they closer to gods?
who are we to believe?
How about the people that present the best relevant evidence rather than relying an on argument from authority?
They’ve taken around 80 of the studies designed to yield the best quality evidence (i.e. RCTs), evaluated them impartially, and concluded negligible benefit from mask-wearing (NOT mask policies).
As I explained elsewhere, RCTs can yield the best quality evidence but that is not guaranteed. They can be poorly designed, irrelevant, or poorly conducted. In fact is extremely hard to conduct a good RCT for an NPI. Just 12 of the RCTs looked at masks vs nomasks. Of those, two of them looked at masks/no masks for Covid, of those two one of them looked at the effect of masks on community transmission of Covid (the Bangla Desh study). It found a small benefit but was also recognised as having several weaknesses (not really the experimenters fault – just very hard to do a good RCT).
This is the best, most comprehensive meta-analysis there is
Maybe (there are others e.g. https://www.pnas.org/doi/10.1073/pnas.2014564118) but anyway being the best doesn’t mean it is good. It is not much of a metanalysis that only includes one study looking at the key question of interest.
you would rather put your trust in a few non-scientific reporters from publications with obvious bias?!
Luckily I don’t have to. I can read the research for myself.
So out of 80 studies 80 of them were flawed?
I see.
No. But almost all of them were irrelevant to the effect of wearing of masks on Covid infectiousness. That doesn’t make them flawed. They were never intended to answer that question.
Since you are the expert why don’t continue wearing the cloth, while we move on with our normal life? It seems all studies, researches, MNT, RTR, CTR, MSY, WYS etc are flawed, and only those you choose to trust are good enough for the world? If you feel better wearing masks, go ahead. But don’t impose it on others.
Same argument as the pronoun fascists – if they say they are trans and they want the pronouns XYZ, whatever you say is not going to make any difference.
“It simply assumed that studies looking at flu could be combined with studies looking at Covid”
Given that the C1984 is simply ‘flu rebranded that seems logical.
I am sorry that is just wrong at the genetic level (flu is not a coronavirus) ad at the level of how infection happens.
Even different strains of flu vary greatly in their infectiousness.
The Bangladesh study found a difference in effect based on the color of the mask. Something clearly is awry with that.
As I keep saying, there is only one RCT looking at the effect of masks on Covid transmission, the Bangla Desh study, and it has lots of problems. We need to look elsewhere (not RCTs) for evidence.
If masks are effective, if A is wearing one, there is no need for B to wear one, or C or D, etc.
Why then do those who insist masks are effective, insist others wear them too? (And no, if masks are, say, 50% effective, A & B each wearing one does not make them 100% effective.)
Mask wearing is a mental disorder, like compulsive hand washing or wearing your lucky underpants – which never must be washed – to job interviews.
nice
cool
The thing is, we don’t need these studies to discover what is bleedin obvious.
There is no way those ridiculous, baby-blue talismans (nor their toilet-roll-white duckbilled cousins) could possibly hold all the moisture (and all it contains) which is breathed out by even the most lethargic mask advocate. Where does all that moisture go? Why, into the air! Just as if you didn’t have one on!
Exactly. No need to overthink the issue.
Most people that wore masks with great discipline ended up getting infected (I.e.testing positive), so let’s just say if COVID had been a really deadly disease, the masks would have not saved them.
I don’t care whether masks “work” or not; I’m not wearing one for a mild-for-most virus like covid or all the other viruses of a similar ilk that have been with us since time immemorial. We have to re-establish the social contract that was how human beings have always coexisted with respiratory viruses and basically carried on as normal, because normal life is what we must live and any suspension of normal life, even for a limited period, for a profoundly non-compelling reason cannot be accepted. In any cost-benefit analysis, the cost attributed to suspension of normal life needs to be some figure in the gazillions of pounds. Arguing about studies and trials and stats etc ad nauseam is just a rabbit hole and a distraction because then people like MTF come along and start saying “yes, but what about….”. We need to get on the front foot. I don’t care if lockdowns “worked” either, I’m not having it.
Hear hear. And if someone really wants to wear one, I don’t care why, and I don’t care that they do. Just LEAVE ME ALONE!
The problem with these maskholes is that they just can’t admit that they were wrong and we were right. In the same way most of them will NEVER admit that lockdowns were a catastrophe and that the Jim Jones jabs are very far from safe or effective. It would break their tiny brains.
BINGO
A mask says: “I’m a cretinous, bedwetting twat who will obey any order, no matter how absurd or harmful. What exactly was so wrong about the Hitler salutes?”
How about converting them into environmental enthusiasts, and show them where all the junk goes? They’ll soon change their minds that way!
It’s very,very,very,very,very,very simple.
No mask will work on a virus that exists only in the mind.
Well of course masks make a difference in the community because it’s a fact-checked FACT that COVID19 is NOT airborne but is mainly transmitted through droplets generated when an infected person coughs, sneezes or speaks.
You can’t argue with FACTS and you can’t argue with the World Health Organisation who clearly know the FACTS about Covid, and we all know what a FACT is:
https://twitter.com/WHO/status/1243972193169616898?lang=en
I was waiting for the punchline, that what you said is a joke. So, since I can’t find one, I am going to LOL! Facts and WHO are oxymorons. WHO told us not to worry about an innocuous virus coming out of Wuhan, and that there was no need to wear mask. WHO is one person, someone who’s beholden (draw your own conclusion) to China! Their statements are not facts. Their advice is not based on any ‘science’. They started telling the world to be scared because China wanted the world to be scared. They started telling the world to wear masks because 99.9% of masks are made in China. Also the the same for PPE. That stooge (who is still there) at WHO spews out fictions. Not Facts!
And, fact-check means ZILCH! Who are they? Where do they work from, and on what authority? Same as the sensitivity readers working for publishing houses, who are determined to ruin literature for us.
Remember that many, if not most, of the junk sold were not officially labelled as “masks”, but “face coverings”, and had tiny small font labels round the back to the effect that they are not medical equipment, or whatever. This was done to avoid potential prosecution under the trading standards act and so on. Look it up under British Standards Institution documentation. In short, most were conned into buying junk.
And billions are going to be burnt! Bonfire of Vanity!
I don’t need to read the review or another other study that claims masks work. Just look at the Japan and China – the 2 most obsessed wearers in the world. Just look at their infection + death rates. Compared to other non obsessed countries, who’s the losers?
I can assure you that there is a cure for maskaholics.
That cure is for them to invest in and wear, at all times, a proper mask that actually works:
https://www.avon-protection.com/products/fm50/5207
Enjoy!
Steve Kirsch had a piece on a study by someone who knows everything about such masks that there is to know.
The result was that only respirators from P100 upwards can give the wearer some protection against viruses.
And that only for max. 45 minutes, worn correctly (impossible with any beard), accompanied by other PPE and being quiet during that time.
Which is probably why Ebola doctors run around just like that.
Now compare that with our mask mandates, in particular in schools, and the absurdity of them becomes indisputable.
The importance of goggles (and then likely also of earplugs) to add to masks if one wanted any protection against a virus has recently become a topic again, discussed e.g. at Brownstone.
Indeed
No cure. Most of them aren’t masked up because they are waiting for the order and they enjoy being told what to do even more than they enjoy the wearing of the mask. The triumph of sado-masochism as a substitute for real meaning.
I’m afraid the maskaholics are incurable.