Upon the advent of the COVID-19, the mask quickly became an underlying part of daily life. The mask soon developed from being a voluntary safety measure into a compulsory moral imperative. Around the world, thousands of people have been berated, shunned, and even arrested for their simple refusal to wear a mask.
In light of such commotion, surely our leaders have embarked on this path for a reason, right? We are told that the science is settled. We are told that masks are the weapon with which we can fight the virus! We are told that any individual who fails to comply is guilty of a heinous crime - a threat to our collective public good!
Naturally, the burden of proof for such a radical change to your personal life should be on the advocates, should it not? However, we have seen astonishingly little effort by bureaucrats and "experts" in properly justifying their new restrictions. What an unfortunate missed opportunity for the "science" advocates! Unless of course, the evidence in favor of their programs is practically non-existent. Still worse it would be if their policies had precisely the opposite of their intended affect.
Side note: I intend to focus on cloth and surgical facemasks since they have found the most widespread use in the community.
Lets dive straight into the evidence. Many different types of scientific studies exist to help scientists gain a better understanding of the world.
Ultimately, the Randomized Controlled Trial (RCT) is considered to be the gold standard of scientific evidence where it can be properly applied. Among the scientific community, to cite an observational study in refutation of an RCT would get you laughed out of the room.
When respectable institutions want to conduct a serious analysis of the evidence, they will perform a systematic review including the best available RCT's while excluding lower quality RCT's. Both the U.S. Center for Disease Control and the World Health Organization have conducted systematic reviews of RCT's evaluating mask effectiveness. I can think of no better place to start.
Here is the systematic review from the CDC:
"In our systematic review, we identified 10 RCT's that reported estimates of the effectiveness of face masks in reducing laboratory-confirmed influenza virus infections in the community"
"In pooled analysis, we found no significant reduction in influenza transmission with the use of face masks"
"One study evaluated the use of masks among pilgrims from Australia during the Hajj pilgrimage and reported no major difference in the risk for laboratory-confirmed influenza virus infection in the control or mask group"
"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. the overall reduction in ILI or laboratory-confirmed influenza cases in the face mask group was not significant in either studies"
"Study designs in the 7 household studies were slightly different" 1 study provided face masks and P2 respirators for household contacts only."
"Another study evaluated face mask use as a source control for infected persons only"
"-and the remaining studies provided masks for the infected persons as well as their close contacts"
"None of the household studies reported a significant reduction in secondary laboratory-confirmed influenza virus infections in the face mask group"
How could this be? It seems at least intuitively plausible that covering ones face would prevent viral spread, but the science does not look settled at all - and it certainly doesn't look settled in favor of masks!
We must remember how complicated reality is, and how easily our kneejerk intuition can be taken advantage of. Dr. Ted Noel helps us correct our false intuition with a vape.
The fact of the matter is that human beings need to breath. One way or another, oxygen must enter the lungs via nose/mouth and carbon dioxide must exit via nose/mouth. Whether particles go directly through the mask or out the sides of the mask, we can only conclude that reality is far less cartoonish tends to be presumed.
This is why randomized controlled trials measuring actual clinical outcomes are so important. There is no better way to account for the millions of complexities that we may not have thought of, plaguing our assumptions about reality. Mask advocates will often cite laboratory studies demonstrating how cough particles do not travel as far (in one direction: forward) when the subject is wearing a mask. As Dr. Noel demonstrated, this is a wild oversimplification. What of the particles exiting the sides of the mask? What of the extra aerosols being produced when your spit makes contact with the mask and subsequently blows out the sides?
Such fallacious pro-mask arguments have consolidated into the narrative of "source control". "My mask protects you and your mask protects me!" The evidence to support this assertion is limited to lower-level lab and observational studies. What do the RCT's say?
In summary: Of 811 participants undergoing elective surgery...
46/401 (11.5%) got infections in the masked group
37/410 (9.0%) got infections in the non-masked group
Another RCT:
In summary: Of 3,088 patients operated on...
73/1,537 (4.7%) got infection in the masked group
55/1,551 (3.5%) got infections in the non-masked group
If trained hospital staff wearing masks in a controlled environment can't demonstrate the efficacy of masks as source control, how can we possibly expect the average citizen to utilize masks more effectively? Obviously, we can't. Furthermore, how can we be sure that such high expectations wont lead to increased transmission and infection?
Speaking of increased risk of infection...
At this point, some will argue about the difference between statistical significance and clinical significance. One could make the case that despite not finding any statistical evidence favoring masks, their benefits could still be clinically significant for the small amount of benefits they allegedly provide for the user. Omitting the fact that this is a far step back for widespread mask arguments, it is still rather sloppy to simply assume that weak correlations we find in some RCT's are proof of your assertions, especially when conversely many RCT's find precisely the opposite negative weak correlations!
Clinical significance is a real concept, but it would be fallacious to apply it in this instance.
Here are a few more RCT's assessing masks and viral transmission:
"When the analysis to households where the index patient was allocated to intervention less than 24 hours from symptom onset, Influenza-Like Illness occurred in...-"
15 of 83 (18.1%) contacts in the intervention arm
17 of 108 (15.7%) contacts in the control arm
When the analysis was limited to an event that appeared more than 24 hours after inclusion...-"
12 Influenza-Like Illnesses (9.2%) were reported in 130 contacts in the intervention arm
13 Influenza-Like Illnesses (9.4%) were reported in 138 contacts in the control arm
Compare the secondary attack ratios of influenza contacts in the face mask group and control group for the various intervals between symptom onset and intervention (masking). A higher secondary attack ratio means more spread.
The Center for Evidence-Based Medicine at Oxford University summarized six international studies.
My focus on RCT's is certainly not to imply that there is not a wealth of lower-level observational studies also coming to the same conclusions.
An article from the New England Journal of Medicine:
More studies (not necessarily RCT's):
(2001) "Surgical face masks worn by patients during regional anaesthesia, did not reduce the concentration of airborne bacteria over the operation field in our study. Thus they are dispensible."
(2001) "The evidence for discontinuing the use of surgical face masks would appear to be stronger than the evidence available to support their continued use"
(2015) "overall there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination."
(2020) "We do not recommend requiring the general public who do not have symptoms of COVID... to routinely wear cloth or surgical masks because there is no scientific evidence they are effective in reducing the risk of SARS-COV-2 transmission"
(2010) On the Swedish discontinuation of face masks for anesthesiologists in the operating room - "Our decision to no longer require routine surgical masks for personnel not scrubbed for surgery is a departure from common practice. But the evidence to support this practice does not exist."
(2015) "there is a lack of substantial evidence to support claims that facemasks protect either the patient or surgeon from infectious contamination"
(2020) German analysis - "A mask gives a false sense of security, and a false sense of security is always a security risk."
We have already talked about viral transmission occurring out of the sides of unsealed masks, but what of the front? There is a case to be made that the tiny viral particles (much smaller than bacteria) will simply go through the mask. Dr. Noel demonstrated it, but do your lying eyes deceive you? Lets ask the CDC:
This may seem like an inconsequential point. The immediate retort is that virus does not exist floating by itself, it is contained within moist droplets that are caught in the mask when we cough or breath. However, we must remember that viral particles also exist in aerosols. By way of forced filtration or dispersion, coughing into a mask can actually create more aerosolized particles and thus more airborne virus. This is one possible explanation for studies that counter-intuitively find increased transmission among masked groups.
For more on this, click here for rational ground's response to the CDC's 'sloppy' scientific brief.
The epidemiological case against masks is even clearer. Places with strict mask mandates are often indistinguishable from places with no such edicts like Sweden and Georgia. Often, strictly masked locations vastly underperform unmasked areas! To compare The Federalist and Rational Ground have done phenomenal work collecting the data for and creating the below graphs.
Upon being exposed to this information, mask-advocates will immediately defer to dozens of excuses for such abject failure of their policy. Typically, the first instinctual reaction is to blame low compliance! "We couldn't possibly be bothered to re-examine our assumptions about mask effectiveness, so it must be those stupid civilians refusing our edicts!" However, this argument quickly falls apart once we examine the mask compliance statistics coming from three reputable sources.
For the US, mask compliance is upwards of 80%
Here is the data for other countries:
Additionally, mask mandates have no visible impact on the reproductive rates of COVID-19 wherever they are implemented.
"Experts" everywhere who wag their finger at anyone questioning their policies refuse to admit they were wrong under any circumstances. Any success is credited to them, but any failure is credited to non-compliance.
This is the unfortunate mental trap many people have easily fallen into. Confirmation bias at its finest. Best visualized here:
None of this information should come as a surprise to those didn't quickly cast the pandemic preparedness playbook aside (can you believe the CDC made one of those?!). In the 2006 Nonpharmaceutical Interventions for Pandemic Influenza, National and Community Measures report, the CDC states - "Mask wearing by the general population is not expected to have an appreciable impact on transmission". So much for the "following the science" crowd who have chosen to outright abandon it.
It should be fairly clear by now why public health officials and governors prefer to cite lame infographics of their own creation, observational studies with no control group, and inadequate lab experiments. There is simply no scientific justification for implementing mask mandates.
Today, mask-advocates have been reduced to citing ridiculous models with the assertion of mask effectiveness simply baked into the model. "See! Masks will help prevent 130,000 deaths! I know because this model that assumes masks work said so!"
Scientific/medical journals have even refused to publish RCT evidence that presumably questions the efficacy of face masks in the fight against COVID-19.
-=UPDATE=-
The Danish Mask Study has just been published as of November 18th, 2020. As expected, this large-scale study found NO SIGNIFICANT DIFFERENCE between Sars-Cov-2 infections among the masked vs unmasked groups.
Of ~6,000 participants, half given masks and instructed on use and half not recommended masks, 1.8% of mask wearers became infected and 2.1% of non-mask wearers became infected. The 95% CI is compatible with a 46% reduction to a 23% increase in infections. In other words, the study found no obvious benefits for mask use. What a surprise!
How come nobody was willing to publish this study until now? I'm guessing it needed to be editorialized into oblivion:
Why on Earth should the the RCT's results, which found no evidence favoring masks, "motivate widespread mask wearing"? Why should we "refrain from using this as evidence" against widespread mask use? This reads like they have a gun to their head.
Why would the Annals of Internal Medicine go to such lengths to spin the study to the point of doublespeak? This is a perfect example of the hyper-politicization of science.
How strange it is that the "pro-science" bureaucrats have to consistently censor and ignore the most rigorous scientific evidence available. It would be one thing if public health officials chose to present all of the evidence, but instead they choose to cherry pick whatever shallow evidence they can find favoring their policies. (see CDC's brief) What clearer indication could there be of a larger agenda?
The CDC should be embarrassed at their biased, hyper-politicized treatment of masks. They so desperately want them to work but no tangible evidence will stick. To this day they cite the same nonsense observational hairstylist study they've used since day one, among other valueless citations:
Always remember how these lab experiments are conducting. Does it resemble real life?
What's even scarier is the willingness with which the public has accepted the mask without serious consideration for the consequences of doing so. They have readily imposed the mask upon their neighbors and their children based on little more than a hunch. Not age nor risk changes society's draconian expectation that you accept the new all-encompassing normal.
To reiterate, masks decrease oxygen intake. Masks are a moist, microbiome filled with growing bacteria (why do you think nurses change them all the time?) which is constantly rebreathed. Masks suppress four of the five senses. To say nothing of the profound ramifications for social development of the young.
Who would stand for such obvious and unnecessary abuse of children? In todays world, we are quickly learning that there is no limit to what people are willing to accept to appease to God of "collective good" to which we sacrifice on the alter of "public health".
However, once we understand the sad reality of human psychology, its easy to see why so many wear masks with religious fervor and have bought the mask narrative hook, line, and sinker:
Everyone is expected to cover their face in complete uniformity. Individuality is not important. Social interaction is not important. Your freedom to make medical decisions with informed consent is not important. What's important is that you comply with the hivemind's desire that you conform to their anti-scientific expectations or face retribution.
Social enforcement of masks is almost more dangerous than state enforcement. There is a culture of virtue being wrapped around fear. To be fearful of the virus is to be virtuous and the mask (among other things) is one method of communicating your fear/virtue. When people equate fear with virtue they will inevitably find reasons to be fearful, thus leading to a self-perpetuating cycle of heel digging as in the case of masks - it doesn't matter how much evidence you throw at them.
It's much easier to enslave people when they accept their own enslavement. The mask is tacit consent to the restrictions suffocating the world around us. It is your implicit agreement that there is some disaster afoot that requires drastic government intervention. There's nothing bureaucrats love more than a job to do - guaranteeing increased funding and income. No wonder there's nothing more permanent than a government program. Furthermore, if you can convince people that they are at risk of death, you can do whatever you want with them.
If the new normal is not met with intense resistance, it will become permanent. Your liberties that so many generations fought and died to uphold will continue to be depleted for nothing more than the appeasement of power-hungry bureaucrats, justified by pseudo-scientific garbage. If they can so easily implement policy in complete contradiction to the scientific evidence, then they have the ability to implement anything so long as its propagated effectively. If you think they will stop at masks, you are dead wrong. That is why this issue matters.
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