Evidence

Why Does Your Doctor Want to Keep You Masked?

There follows a guest post by Paul Stevens, who is part of the Smile Free campaign to end forced masking in the U.K., which is currently inviting signatures to its open letter to the NHS Chief Executives to remove the mask requirement from healthcare settings.

Walk into your General Practitioner surgery and what will you see? Notices demanding that you ‘wear a mask’ and people with ill-fitting face coverings, most of which having been frequently touched, reused, rarely washed and improperly stored.

By contrast, in public spaces such as hospitality venues, retail settings and transportation hubs, you’ll find a lack of signage and a marked reduction in mask-wearing. More and more, people aren’t wearing them.

It’s as if we are living in two worlds: one where we have begun to return to a rational unmasked normality; and one, in healthcare settings including GP surgeries, where we are instructed to remain featureless and compliant with the facemask diktats of nameless NHS bureaucrats.

To understand how, and why, these worlds co-exist we need to start by looking at the frame of reference within which GPs operate. As independent contractors, for all intents and purposes GPs work within the NHS; and many are members of a single body, the British Medical Association (BMA). The NHS and BMA, one guiding and enabling the other, have played major parts in establishing and maintaining masking within healthcare settings.

The NHS has been a major advocate of masking and, as published on the Government’s “COVID-19: Infection prevention and control” (IPC) webpages, its current guidance for mask-wearing within health and care settings remains that facemasks for staff and facemasks or coverings for all patients and visitors are “recommended”.

Mask Study Finds No Impact on Covid Infections From Mask-Wearing and an INCREASE in Deaths

Mask-wearing had no discernible impact on the spread of COVID-19 in Europe during winter 2020-21 and may actually have increased mortality, a study has found.

The peer-reviewed study by Professor Beny Spira from the Department of Microbiology at the University of São Paulo, published in the journal Cureus, looked at the correlation between the rate of mask-wearing in the population and the number of reported infections and deaths from October 2020 to March 2021 in 35 European countries. All European countries, including Western and Eastern Europe, with more than one million inhabitants were included, encompassing a total of 602 million people. All the countries experienced a peak of COVID-19 infections during the six months – the winter 2020-21 wave.

The results are shown in the graphs above, where a positive correlation can be seen in the case of both infections and deaths, i.e., greater mask-wearing went hand-in-hand with more infections and deaths, the opposite of the intended effect of masks. In the case of reported infections the correlation was not statistically significant, so may have been by chance. In the case of deaths it was statistically significant, particularly in Western Europe, opening up the possibility that wearing masks actually made things worse.

The Face Mask Cult

There follows a guest post by Hector Drummond, a former academic who worked in risk, who says when he came to research his new book The Face Mask Cult on the effectiveness of masks against COVID-19 the evidence was threadbare.

In 2021 I decided to write an FAQ on all aspects of Covid, lockdowns and non-pharmaceutical interventions (NPIs). I started with face masks, as they seemed to be the easiest issue to deal with, thinking that the whole mask situation could be summed up in five to six pages. After a few days work I had twenty pages of text, and another twenty pages of reminder notes on further aspects of face masks that I needed to consider and research. Those notes ballooned out in the next few weeks, and I realised that the use of face masks to prevent the spread of COVID-19 was a far bigger topic than I had appreciated, and would require substantial amounts of writing, and months of research and literature-reading.

It took until the next year before I decided I’d written enough on the topic. I had read an enormous number of scientific papers and other articles on masks, and gone through some of them with a fine-tooth comb (see Part 3 of the book, for instance). I had spent considerable time analysing, synthesising and rewriting, and my short FAQ article had become a comprehensive 400-page book that tackled all aspects of the issue, as well as a unique resource with its extensive scientific literature review section.

In all my researches I failed to come across very much in the way of convincing evidence that masks work. The papers that were supposed to show that they did all turned out to be poor pieces of science. None were randomly-controlled peer-reviewed trials. Some were observational studies, with inadequate controls for dealing with the possibility of faulty or biased recollection. Some were ‘modelling’ studies, in which a computer program was used to ‘model’ the effect of face masks on disease spread. Modelling studies are generally hopeless at providing any confirming evidence for the effectiveness of face masks as they require the modellers to make assumptions about how effective the masks are when writing their programs. Some were mannequin studies, in which a dummy in a lab with artificial breathing functions, rather than a real person in the real world, was used. Some were simply tests of the porosity of various materials in regard to salt aerosols.

The Evidence that Omicron Was Made in a Lab

Dr. Danny Altmann, Professor of Immunology at Imperial College London, has admitted that the emergence of the highly immune-evasive SARS-CoV-2 variant Omicron came as a surprise to most experts in the field. He writes in the Guardian:

The onslaught of highly immune-evasive variants was, for most of us in immunology and virology, unforeseen. We’d come to think of the coronavirus family as being rather more stable – less error-prone in terms of mutations – than many viruses… Omicron and the subvariant BA.2 have managed to mutate almost every amino acid residue targeted by protective antibodies, escaping protection.

He doesn’t mention the possibility, but this unexpected nature of Omicron is clearly compatible with the hypothesis that the variant is not of natural origin. Earlier in the year, Noah Carl looked at the evidence that the variant might have leaked from a lab. I recently came across the website of biochemist Dr. Valentin Bruttel, which sets out the evidence for this lab origin in detail (though be aware it has been translated from German, so the text contains a few language mistakes).

The first piece of evidence is Omicron’s evolutionary history – its most recent common ancestor was a strain extinct in the wild and last seen around April 2020.

Medicine is Corrupted By Dominance of Big Pharmaceutical Companies, Which Suppress Negative Results and Hide Adverse Effects, Says Peer-Reviewed BMJ Article

Evidence-based medicine has been corrupted by corporate interests, failed regulation and commercialisation of academia, which act to suppress negative trial results, conceal adverse events and withhold raw data from the academic research community, according to a peer-reviewed article in the British Medical Journal by Jon Jureidini of the University of Adelaide and Leemon B. McHenry of California State University.

Medicine is largely dominated by a small number of very large pharmaceutical companies that compete for market share, but are effectively united in their efforts to expanding that market. The short term stimulus to biomedical research because of privatisation has been celebrated by free market champions, but the unintended, long term consequences for medicine have been severe. Scientific progress is thwarted by the ownership of data and knowledge because industry suppresses negative trial results, fails to report adverse events, and does not share raw data with the academic research community. Patients die because of the adverse impact of commercial interests on the research agenda, universities, and regulators.

The pharmaceutical industry’s responsibility to its shareholders means that priority must be given to their hierarchical power structures, product loyalty, and public relations propaganda over scientific integrity. Although universities have always been elite institutions prone to influence through endowments, they have long laid claim to being guardians of truth and the moral conscience of society. But in the face of inadequate government funding, they have adopted a neo-liberal market approach, actively seeking pharmaceutical funding on commercial terms. As a result, university departments become instruments of industry: through company control of the research agenda and ghostwriting of medical journal articles and continuing medical education, academics become agents for the promotion of commercial products. When scandals involving industry-academe partnership are exposed in the mainstream media, trust in academic institutions is weakened and the vision of an open society is betrayed.

The corporate university also compromises the concept of academic leadership. Deans who reached their leadership positions by virtue of distinguished contributions to their disciplines have in places been replaced with fundraisers and academic managers, who are forced to demonstrate their profitability or show how they can attract corporate sponsors. In medicine, those who succeed in academia are likely to be key opinion leaders (KOLs in marketing parlance), whose careers can be advanced through the opportunities provided by industry. Potential KOLs are selected based on a complex array of profiling activities carried out by companies, for example, physicians are selected based on their influence on prescribing habits of other physicians. KOLs are sought out by industry for this influence and for the prestige that their university affiliation brings to the branding of the company’s products. As well paid members of pharmaceutical advisory boards and speakers’ bureaus, KOLs present results of industry trials at medical conferences and in continuing medical education. Instead of acting as independent, disinterested scientists and critically evaluating a drug’s performance, they become what marketing executives refer to as “product champions.”

I suspect the authors’ confidence in Government and public funding to free medicine from predetermined agendas is misplaced, as the Government propaganda during the pandemic (and on numerous other issues) has shown. But the points about the corruptions that the dominance of big pharmaceutical companies bring to the development and testing of medicine deserve to be taken seriously.

Worth reading in full.

Neither ‘Noble Lie’ Nor ‘New Evidence’ Can Justify Chris Whitty’s Mask U-Turn

We’re publishing today a new piece by Dr. Gary Sidley, a retired NHS Consultant Clinical Psychologist and co-founder of the Smile Free campaign. Dr. Sidley is glad to see the mask mandates being lifted, but worries that without a clear admission from leaders that imposing face masks was unethical, ineffective and harmful, and ought never to be done again, the measure will quickly resurface next time a threat from a similar contagious disease is perceived. Here’s the introduction:

For those of us at the Smile Free campaign – and the many other people campaigning to remove all mask mandates – it has been a positive few weeks. On January 20th, secondary school children in England were liberated from the requirement to wear face coverings in the classroom, followed, a week later, by the removal of all mask mandates in England. A similar easing of mask restrictions was announced by Nicola Sturgeon on February 22nd (although this reprieve for the Scottish people will not happen until March 21st). And even London mayor, Sadiq Khan, has conceded that masks will no longer be a condition of carriage on the capital’s transport system. Although this news is all very welcome, it is not good enough for our politicians to claim that these measures are being relaxed solely because of the currently reduced risk of harm associated with the Omicron variant; such a rationale means that masking the healthy, the most insidious of all the COVID-19 restrictions, will be imposed again at the first hint of another viral threat. What we require is a clear and unambiguous acknowledgement that our political leaders, with support of Government scientists, inflicted an intervention on the British people that was unethical, ineffective and harmful and – importantly – their commitment never to do so again.

This is a big ask. Those seeking to retain power over us rarely admit to mistakes. However, the likelihood of such an occurrence would increase if more of us could recognise that mask diktats were introduced for reasons other than viral control. In a previous article, I made the case for masks primarily being imposed as a compliance device, a means of keeping the British public responsive to any restrictions (current or future) the Government might wish to enforce in pursuit of its agenda, whatever that might be. To highlight further the evidence consistent with this assertion, I posed some questions I would like to ask Professor Chris Whitty (England’s Chief Medical Officer) about the reasons for his U-turn in spring 2020 from mask sceptic to mask advocate. The bulk of responses to this article were supportive, but a few of the comments raised objections – three in total – that I will now address.

Worth reading in full.

The Evidence That Vaccine Passports Are Worse Than Useless

As the scale of the Commons rebellion over the Government’s imposition of ‘Plan B’ measures grows ahead of the vote on Tuesday, at the Daily Sceptic we thought we’d take a look at the evidence for vaccine passports.

Regrettably, the measures are likely to pass regardless of the size of rebellion owing to Labour support, but the number of rebels currently looks large enough to mean the Government will be relying on opposition votes – yet another sign of Boris Johnson’s weakness and the precariousness of his position.

The Government’s ‘Plan B’ measures include expanding the mask mandate to most indoor venues except hospitality and the reintroduction of guidance to work from home. But by far the most egregious aspect is the introduction of vaccine passports for nightclubs and larger venues, the first time these have been imposed in England. If the vote passes, the passports will be mandatory from Wednesday.

The Scottish Government last month published a report which supposedly backed up the case for continued use of vaccine passports north of the border, first introduced on October 1st. The Spectator‘s data journalist Michael Simmons went through it, however, and found its case paper-thin. It provided no evidence that vaccine passports increased vaccine uptake, stating: “The rate of overall increase in first and second doses, has been similar across four U.K. nations”. Indeed, following introduction of the passes, uptake in England actually outpaced that in Scotland among adults (passports did not apply to children), increasing 1.6% in England to Scotland’s 1.3%.

Simmons points out that according to the latest ONS data, as of November 15th, 95.3% of adults in England have antibodies to SARS-CoV-2, slightly higher than in Scotland where it’s 95%, despite the vaccine passes. It’s hard to see how these could get much higher, however draconian the vaccine coercion becomes.

Stay-at-Home Lockdowns Made No Difference to Covid Deaths in U.S. States – Study

A new study from the Harris School of Public Policy at the University of Chicago has analysed the impact of stay-at-home orders on infections and deaths in U.S. states and found they made no difference.

The peer-reviewed study, published in the scientific journal PNAS, found stay-at-home orders (also known as shelter-in-place orders or SIPs) were not associated with lower infections or deaths; furthermore, they were actually associated with a slight increase in infections and deaths, although this was not statistically significant. The results are summarised in the charts below, where dots above the dashed line indicate an increase and dots below a decrease. Red dots are statistically significant results.

The authors suggest that stay-at-home orders have no impact on infections or deaths because they have little to no impact on mobility. Isolating the impact of stay-at-home orders from existing mobility trends, they estimate that the orders themselves contributed a reduction in mobility of just 0.7% compared to pre-pandemic levels. This is largely, they say, because people were already reducing their mobility as much as they were able or willing to.

The mobility data (from mobile phone movement) for U.S. states, with the date of the stay-at-home order shown as a dashed line ands its removal as a dotted line, are shown below.

Government Evidence on Masks is Weak and a Mess

Matthew Sweet has written in UnHerd about the importance of following footnotes in studies to find out if the references actually say what the studies claim they say and genuinely back up the argument being made. He suggests this indicates whether or not the study should be considered reliable.

One of his examples is the mask study by Dr Baruch Vainshelboim, now retracted, that I wrote about yesterday. He says a number of the footnotes are misrepresented (this criticism was part of the retraction notice).

If Dr Vainshelboim did misrepresent the papers he cites he would not be the first. As noted yesterday, a recent peer-reviewed study in PNAS claimed surgical masks filter out 95-99% of aerosol droplets. Yet the two papers it cites to back up this claim say nothing of the sort. One concludes: “None of these surgical masks exhibited adequate filter performance and facial fit characteristics to be considered respiratory protection devices.” This is not to defend Dr Vainshelboim’s misrepresentation of course, but to highlight the double standards applied to those who challenge political orthodoxies.

Today I thought I would follow Matthew Sweet’s advice for the Government’s own evidence. We learned yesterday that face masks may continue after June 21st, with no indication of when the mandate may be lifted or what conditions may trigger it. What scientific evidence is this seemingly permanent coercive public health measure based on? After all, the real world evidence for masks preventing outbreaks is feeble, to say the least, as Yinon Weiss has dramatically illustrated.

The Government has often been slow to publish evidence for its supposedly scientifically based interventions. But in January its scientific advisory group SAGE published a paper in which it set out its current evidence on masks. This included an important admission that masks give no real protection to the wearer, saying: “They may provide a small amount of protection to an uninfected wearer; however, this is not their primary intended purpose (medium confidence).” They say they are “predominantly a source control”.

Face coverings worn in public, community and workplace settings are predominantly a source control, designed to reduce the emission of virus carrying particles from the mouth and nose of an infected person. This may have measurable benefits in reducing population level transmission when worn widely, through reducing the potential for asymptomatic or pre-symptomatic people spreading the virus without their knowledge. Analysis of regional level data in several countries suggest this impact is typically around 6-15% (Cowling and Leung, 2020, Public Health England 2021) but could be as high as 45% (Mitze et al., 2020).

This is the key paragraph in terms of providing evidence for the effectiveness of face masks, and on closer inspection it is a mess. It says: “Analysis of regional level data in several countries suggest this impact is typically around 6-15%.” Yet the 6-15% figure comes from the Cowling and Leung paper, which is not an analysis of regional level data but an editorial article drawing on a December 2020 review paper by Brainard et al. The Brainard paper reviews 33 studies including 12 randomised controlled trials (RCTs), but none of these is an analysis of regional level data.

The Mitze paper actually is an analysis of regional level data, but only in Germany not in several countries. It was submitted in July 2020 and is based on data from the decline of the spring wave. As infections were falling then anyway it is very hard to distinguish the possible effect of masks from natural decline. In any case, the mask mandate in Germany did not prevent the winter surge, as the graph above depicts.

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.