Danmask-19

Government Forces Schoolchildren to Wear Masks in Classrooms Again Despite Studies Showing No Benefit

Masks are back for schoolchildren in Year 7 and above, who from the start of term will be required to wear them throughout the day including in classrooms. The Telegraph has the story.

Secondary school pupils will be asked to wear face masks in classrooms again as ministers draw up contingency plans to keep schools open amid fears of widespread teacher absences.

The measure will apply to students across the country in Year 7 and above, with the Government issuing new guidance just 48 hours before millions of pupils are due to start returning after the Christmas holidays.

It brings England in line with Wales and Scotland, with mask guidance already in force for staff and pupils when walking through corridors and communal areas.

Defending the decision to reimpose masks in classrooms for the first time since May last year, Nadhim Zahawi said it was designed to help “maximise the number of children in school” and would remain only as long as needed.

Writing for the Telegraph, the Education Secretary said face-to-face teaching would be the “expected norm” heading into the new term, and confirmed that all exams in January would “go ahead as planned”.

“The Prime Minister could not be clearer: education is our number one priority and we will do everything in our power as a government to minimise the disruption to schools,” he said.

However, the Telegraph can also disclose that officials in the Department for Education (DfE) have begun discussing proposals that could see heads asked to prioritise primary, GCSE and A-level pupils for face-to-face teaching should schools be hit by widespread staff absences, with others taught remotely.

Other potential guidance that could be issued in a worst-case scenario includes grouping multiple classes together in sports and assembly halls. The department is also looking at “flexible staff models” should absences hit 10%, 15% or 25%, but insiders say schools are likely to “tip over” at 30%.

Worth reading in full.

The controversial move comes despite the two randomised controlled trials (RCTs) for the use of masks against COVID-19 finding no robust evidence of benefit. The Danish Danmask-19 study found no statistically significant reduction in COVID-19 incidence from the use of surgical masks (the study didn’t look at the even less effective cloth masks that are common among school pupils). The Bangladesh mask study also found no benefit from cloth masks and the reported benefit from surgical masks was just 11%, with a 95% confidence interval that included zero (meaning we can’t even be 95% sure there was any benefit at all). The mask intervention in Bangladesh was also accompanied by an awareness raising campaign, among other issues that confounded the findings.

Masks are ineffective at preventing the spread of COVID-19 largely because SARS-CoV-2 is an airborne virus and cloth and surgical masks do not prevent people breathing, or filter particles small enough to prevent sufficient virus particles passing in and out.

But why let scientific evidence get in the way of a political gesture and a sop to the unions?

Comprehensive Review of Face Mask Studies Finds No Evidence of Benefit

The Cato Institute has published its latest working paper, a critical review of the evidence for face masks to prevent the spread of Covid. Entitled “Evidence for Community Cloth Face Masking to Limit the Spread of SARS‐​CoV‑2: A Critical Review” and written by Ian Liu, Vinay Prasad and Jonathan Darrow, the paper is an admirably thorough and balanced overview of the published evidence on the efficacy of face masks. While even-handedly acknowledging and summarising the studies that show benefit, the authors’ overall conclusion is that: “More than a century after the 1918 influenza pandemic, examination of the efficacy of masks has produced a large volume of mostly low- to moderate-quality evidence that has largely failed to demonstrate their value in most settings.”

At 61 pages in length, however, not everyone will make it through to the end, so here’s a TL;DR, with some key quotes to serve as a handy overview. The paper is, of course, worth reading in full, though.

Here’s the authors’ own summary from the abstract:

The use of cloth facemasks in community settings has become an accepted public policy response to decrease disease transmission during the COVID-19 pandemic. Yet evidence of facemask efficacy is based primarily on observational studies that are subject to confounding and on mechanistic studies that rely on surrogate endpoints (such as droplet dispersion) as proxies for disease transmission. The available clinical evidence of facemask efficacy is of low quality and the best available clinical evidence has mostly failed to show efficacy, with fourteen of sixteen identified randomised controlled trials comparing face masks to no mask controls failing to find statistically significant benefit in the intent-to-treat populations. Of sixteen quantitative meta-analyses, eight were equivocal or critical as to whether evidence supports a public recommendation of masks, and the remaining eight supported a public mask intervention on limited evidence primarily on the basis of the precautionary principle. Although weak evidence should not preclude precautionary actions in the face of unprecedented events such as the COVID-19 pandemic, ethical principles require that the strength of the evidence and best estimates of amount of benefit be truthfully communicated to the public.

The authors open by recalling the initial advice on masks from the WHO and others and the pre-Covid evidence it was based on.

Until April 2020, World Health Organization COVID-19 guidelines stated that “[c]loth (e.g. cotton or gauze) masks are not recommended under any circumstance”, which were updated in June 2020 to state that “the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence”. In the surgical theatre context, a Cochrane review found “no statistically significant difference in infection rates between the masked and unmasked group in any of the trials”. Another Cochrane review, of influenza-like-illness, found “low certainty evidence from nine trials (3,507 participants) that wearing a mask may make little or no difference to the outcome of influenza-like illness (ILI) compared to not wearing a mask (risk ratio 0.99, CI 0.82 to 1.18).”

Another Study Claims to Show Masks Work Against Covid – But Does No Such Thing

A new study has appeared claiming that cloth masks work to reduce the spread of COVID-19 – provided they’re made of three layers of cotton. The Mail reports on its findings.

Researchers at the Indian Institute of Science used synthetic cough droplets to model how well different mask types stand up to coronavirus particles.

They found that surgical and N95 masks are still the most effective at stopping coronavirus spread.

Cloth masks may be a suitable alternative if these masks only if they have at least three layers and are made of cotton, the team found.

These findings may be particularly useful for lower-income countries like India, where surgical masks are not easily accessible to the general population.

In fact, though, the study has not shown anything about the effectiveness of cloth masks to prevent infection. It is not a study of real-world transmission at all but a laboratory test of how masks stop synthetic droplets. These droplets are around 500 micrometres in diameter, so not aerosols, which are typically considered to be much smaller (certainly less than 100 micrometres and possibly less than five). It therefore hasn’t even considered how well the masks impede aerosol transmission, which is one of the main modes of transmission.

A recent study, the Bangladesh mask study, did look at the real-world effectiveness of cloth masks. It found a slight reduction from 0.76% antibody prevalence in control villages (no masks) to 0.74% prevalence in cloth mask villages, though this was not statistically significant. There were numerous problems with this study, not least than it was confounded by additional interventions (an awareness campaign) and did not properly measure initial antibody and prior infection levels. However, even with these limitations it still indicates very little discernible difference.

The Danish mask study, Danmask-19, found no statistically significant effect on infection from wearing surgical masks either. This is in line with pre-Covid evidence on the lack of effectiveness of masks in protecting from respiratory infection and transmission.

When will the mask zealots admit that their pet intervention is a dud?

Journal Retracts Study Showing Masks Don’t Work Claiming Science “Clearly Shows” Masks Work, But Fails to Cite Any Evidence

The peer-reviewed study “Facemasks in the COVID-19 era: A health hypothesis” by Dr Baruch Vainshelboim has been retracted by the journal Medical Hypotheses on the instruction of the Editor-in-Chief.

The study argues that neither medical nor non-medical facemasks are effective in blocking transmission of viral and infectious disease such as SARS-CoV-2, and that in the long run they are likely to damage individual health.

The retraction notice reads:

This article has been retracted at the request of the Editor-in-Chief.

Medical Hypotheses serves as a forum for innovative and often disruptive ideas in medicine and related biomedical sciences. However, our strict editorial policy is that we do not publish misleading or inaccurate citations to advance any hypotheses.

The Editorial Committee concluded that the author’s hypothesis is misleading on the following basis:

1. A broader review of existing scientific evidence clearly shows that approved masks with correct certification, and worn in compliance with guidelines, are an effective prevention of COVID-19 transmission.

2. The manuscript misquotes and selectively cites published papers. References #16, 17, 25 and 26 are all misquoted.

3. Table 1. Physiological and Psychological Effects of Wearing Facemask and Their Potential Health Consequences, generated by the author. All data in the table is unverified, and there are several speculative statements.

4. The author submitted that he is currently affiliated to Stanford University, and VA Palo Alto Health Care System. However, both institutions have confirmed that Dr Vainshelboim ended his connection with them in 2016.

A subsequent internal investigation by the Editor-in-Chief and the Publisher have determined that this article was externally peer reviewed but not with our customary standards of rigour prior to publication. The journal has re-designed its editorial and review workflow to ensure that this will not happen again in future.

If there are errors in the paper, the question is why these were not picked up and addressed with the author prior to publication in the usual manner. If some were missed and subsequently came to light, the journal could have asked for revisions to the paper to address the criticisms. That it chose to retract it completely suggests the move is political (though the allegations of dishonesty in affiliations may have played a part). There is no indication in the notice of any correspondence with the author in the matter.

The strangest criticism is the first: “A broader review of existing scientific evidence clearly shows that approved masks with correct certification, and worn in compliance with guidelines, are an effective prevention of COVID-19 transmission.” This is just a restatement, without references, of mask orthodoxy. Given that Dr Vainshelboim had provided a wide range of references in his review of the evidence, a rebuttal should surely have come in the form of a similar rigorous academic exercise, marshalling further evidence, not a bald 28-word sentence about what the evidence “clearly shows”. This is not the way robust academic research happens or science advances. The editors could have published a response, or another study drawing on further evidence that comes to a different conclusion. That they instead retract the article on account of criticisms from unnamed correspondents, drawing on unspecified evidence, is a disgraceful way to treat peer-reviewed scientific research and the scientists who produce it.

What exactly is this uncited evidence that “clearly shows” masks reduce transmission? Certainly not the only randomised controlled trial, Danmask-19, which found no significant protection for the wearers of surgical masks. And certainly not the real-world evidence comparing countries or states with mask mandates to those without.