“Masks don’t work” is a proposition, like all propositions, that carries implicit definitions. In this case it means mask mandates don’t reduce the spread of respiratory diseases. It does not mean that a thick impenetrable rubber body suit with Jacques Cousteau-like air filtration and oxygen delivery system cannot slow infection rates.
This has to be said because there’s always some frightened ackhusally guy out there who believes he has found a loophole in the first proposition, and so can continue to demand all must wear flimsy paper, plastic, and cloth patches on their chins so as to quell ackshually’s fears.
Now that that’s out of the way, there are several more papers of interest, showing again what we have known for a century. Masks don’t work. Take them off and breathe free.
This is great news! Those who have been living in fear don’t need to. We can all take our masks off—all of us, the whole world over?
Surely this joyful news will be greeted everywhere with happiness.
The first is from, if you can believe it, the ruling class’s own Cato. “Evidence for Community Cloth Face Masking to Limit the Spread of SARS-CoV-2: A Critical Review” by Ian T. Liu, Vinay Prasad and Jonathan J. Darrow. Thanks to Stephen Shipman for the tip.
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 theater 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 (3507 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 (RR) 0.99, 95% confidence interval (CI) 0.82 to 1.18).”
If you updated these models to their predictive form, which all models should be to be taken seriously, those intervals would be even wider. Masks don’t work.
Just as we saw last week, with rulers saying “Of course vax mandates will never and should never happen” before they dictated them, we have the WHO (and the Fabulous Fauci, among others) saying don’t bother with masks, before they demanded them.
Ah, such is modern life. Everybody does their best to tell the truth, until they see it pays to lie, then off we go.
Liu also says (as you’ve heard me say a hundred times) “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.”
Whenever you see a proxy endpoint, get ready for the epidemiology fallacy to hit you smack in the kisser with a wee p-value. Phwabip!
Any evidence for masks? Well, only things like this:
A Cochrane meta-analysis of 7 of the above case-control studies conducted during the SARS-CoV-1 epidemic found that 39.4% (268/681) of cases reported mask wearing compared to 62.0% (1573/2535) of controls. 251 The authors concluded that “simple mask-wearing was highly effective (OR 0.32),” but also cautioned that 6 of the 7 studies had a medium or high risk of bias, and these 6 studies provided over 96% of the total number of cases and controls in the meta- analysis.
You have to laugh. But if you’re wearing a mask, it will sound like you’re gasping for air.
And they looked at papers like Alfelali et al. from 2019 (first in their Table 3), a “cluster randomized trial” from which they quote ““[A]llocation to facemask use was not associated with reduced laboratory-confirmed viral respiratory infections or clinical respiratory infections.”
All the way through Al-Asmary et al. (last in Table 3) from 2007: ““The common practice among pilgrims and medical personnel of using surgical facemasks to protect themselves against ARI [acute respiratory infections] should be discontinued.”
Read for yourself. On and on it went. Masks don’t work.
“But Briggs, if masks don’t work, then why do surgeons ackshually wear them? Huh? Huh? You’ve been deboonked!”
Glad you asked. Let’s look at “Is a mask necessary in the operating theatre?” by Orr in the Annals of the Royal College of Surgeons of England. I quote the entire abstract:
No masks were worn in one operating theatre for 6 months. There was no increase in the incidence of wound infection.
The statistics are as reported. No difference after thousands of operations compared. From the discussion:
The effectiveness of a mask in reducing contamination varies with the mask’s shape, the materials of which it is made, and the way it is worn (io-ii). While it has been shown that facial movements behind a mask can increase wound contamination (I2), it has not been shown that wearing a mask makes very much difference to the contamination of the theatre environment (13) or that the number of airborne bacteria can in any way be correlated with wound infection (I4,I5).
We see the dangers of proxy end points here. What counts is whether the patient suffers from the surgeon’s lack of mask, and it’s not important what happens to some weird measure. Infections count, and they didn’t change.
“But Briggs, ackshually, wounds are infected by bacteria, not viruses. Gotcha!”
You mean viruses which are lighter and much smaller than bacteria, and which therefore go through and around masks much easier than bacteria, and bacteria aren’t causing infections from maskless surgeons, are proof that masks stop viruses?
Never mind. Don’t answer. It would depress me if you did.
THAT’S NO MAN
For fun, I end (today) with “Experimental investigation of indoor aerosol dispersion and accumulation in the context of COVID-19: Effects of masks and ventilation” in Physics of Fluids by Shah et al. From the Abstract:
The present study experimentally investigates the dispersion and build-up of an exhaled aerosol modeled with polydisperse microscopic particles (approximately 1?μm mean diameter) by a seated manikin in a relatively large indoor environment.
A seated whatdidtheysay?
Now this paper is just silly, the natural result of scientists wanting to get on the latest hot thing.
Even so, in their enormously ridiculous nothing-like-real-life artificial setting, they “discovered” this:
The results demonstrate that the apparent exhalation filtration efficiency is significantly lower than the ideal filtration efficiency of the mask material. Nevertheless, high-efficiency masks, such as the KN95, still offer substantially higher apparent filtration efficiencies (60% and 46% for R95 and KN95 masks, respectively) than the more commonly used cloth (10%) and surgical masks (12%), and therefore are still the recommended choice in mitigating airborne disease transmission indoors.
On immobile manikins with nicely fitted masks, the highest rate of filtration was a mere 60%, and next to zero for cloth and surgical masks.
It necessarily follows that in actual practice—ackshually, if you will—all masks will be worse, even much worse, if there is any movement or touching.
And since mask mandates can only specify “face covering”, they are useless, utterly useless, even in highly contrived settings.
You have to mummmfmmammmfammamm.
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