The Emperor’s New Mask: Where Is the Evidence?

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by Thomas Dalton, The Unz Review:

On March 10, Texas effectively eliminated all restrictions related to the Covid pandemic. The shutdown ended, restaurant capacities were restored to 100%, and perhaps most significantly for everyday life, mask mandates were lifted. Masks are the most visible, and the most individually obtrusive, aspect of the pandemic. At present, 34 states have some form of mask mandate; the 16 states without mandates include Texas plus Alaska, Arizona, Florida, Georgia, Idaho, Iowa, Mississippi, Missouri, Montana, Nebraska, North Dakota, Oklahoma, South Dakota, and Tennessee. This means that around 100 million Americans are now free to go maskless, whereas over 200 million are still under mandates.

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Among all states taking action against the virus, six are generally recognized as having been the harshest: California, Illinois, Michigan, New York, Vermont, and Washington. Of these, Michigan seems to have suffered the most, economically; 32% of its private sector businesses were closed due to the lockdown mandated by Gov. Gretchen Whitmer, the highest in the nation. This fact alone puts her in strong contention for Worst Governor in America, surpassing even such luminaries as Gavin (“The French Laundry”) Newsom and Andrew (“Strip Poker”) Cuomo. At least we don’t have to worry about her sexually harassing any female staffers—though we can’t quite say the same for Whitmer’s Jewish-lesbian AG, Dana Nessel.

Along with the Michigan business lockdown, of course, came stringent mask mandates, which were initiated on 13 July 2020 and are still firmly in place. The mask mandates in themselves warrant some investigation.

Recently, a correspondent of mine in Michigan contacted his local state representative, a Democrat, regarding the status of lifting the mask mandate. He received a terribly snarky reply from a staffer, along the lines of, “the Representative has no interest in rescinding mask mandates anytime soon.” Furthermore, added the staffer, “it is extremely unlikely that you will see any push to repeal mask mandates (by Republicans or Democrats) until the majority of our people are vaccinated and the virus is under control”—meaning, of course, say goodbye to breathing freely again in Michigan anytime soon.

To his credit, though, the staffer included a link to an actual scientific study, along with the claim that “masks have been scientifically proven to reduce the transmission of COVID and other airborne illnesses.” The report, “An evidence review of face masks against COVID-19,” makes for an excellent case study in the whole mask debate. As the one and only piece of evidence offered, it surely must be the most important. Surely Democrats in Michigan and around the nation have been instructed to point to this very study in defense of masks. It is therefore worthy of some critical examination.

A Few Preliminaries

Before looking at the study itself, let me make one initial point: It is largely irrelevant to claim that “masks have been proven to reduce transmission”—this much is obvious. Any mask, of almost any type, will, to some degree, “reduce transmission” of virus-laden droplets or aerosols. The relevant questions are: To what extent does the reduction in transmission translate into reduced human suffering? (sickness and death) and, Does this reduction offset the disadvantages and costs of mandating masks? If we don’t ask the right questions up front, we won’t reach any useful conclusions. But it is a nifty trick, to pose a false or trivial question and then easily “prove” it to be correct—something like a Straw Man fallacy in reverse. Nice try.

Let’s turn, then, to this most-important of mask studies. Timing is critical in a fast-evolving global pandemic, so let’s consider that aspect first. We see that the report was published in the prestigious PNAS on 11 January 2021—hence, nominally a very recent study. However, we note also that the paper was submitted way back on 13 July 2020. There is of course always some lag time, but amidst a global crisis, six months seems unduly excessive. (Also strange is the fact that the paper was accepted for publication back on 5 December; there is no obvious reason to wait for almost two months to publish, on-line, a study of such urgency.) Given a July 2020 submission date, all developments of the past eight months are of necessity unexamined. This is significant; as we will see, there is one recent study that certainly needs to be included in any mask discussion.

Next there is the question of authorship. The study itself has fully 19 named authors—more names make it more impressive, of course. The lead author (always the main person of the group) is one Jeremy Howard. If we look for Howard’s affiliations, we find two: “fast.ai, San Francisco,” and “The Data Institute, University of San Francisco.” Take the latter first. USF is a small, private university in central San Francisco, which indeed has a Data Institute, dedicated to “creating a new partnership between industry and academia.” And this is perfect for Mr. (not Dr.) Howard, because “industry” is what he does best. His other affiliation, fast.ai, is a small high-tech startup run only by himself and a partner, Rachel Thomas. A review of his bio (“About the team”) and his Wikipedia entry demonstrate clearly that Howard (“entrepreneur”) is in no sense a scientist or researcher; his forte is business and marketing, nothing more. Indeed, Wikipedia only indicates that he “studied philosophy” at his Australian university, apparently not even graduating with a bachelor’s degree. And this man is the lead author in a vital national, even international, study. Both PNAS and USF seem to have very low standards these days for their “scientific” researchers.

The Study that Wasn’t

Turning to the study itself, we read in the Abstract that “the preponderance of evidence indicates that mask-wearing reduces transmissibility per contact”—but again, as I said, this much is obvious. From this fact, they recommend “the adoption of public cloth mask wearing…in conjunction with existing hygiene strategies.” The Abstract closes with this: “We recommend that public officials and government strongly encourage the use of widespread face masks in public, including the use of appropriate regulation”—implying, but not explicitly calling for, mask mandates.

The study can be functionally divided into two parts. The first part covers some background and history, and then addresses the important issue of “direct evidence” for mask efficacy. Part two is an elaboration of six questions relating to mask use and impact. Let’s examine each part separately.

In part one, the authors rightly note that the best and only truly compelling scientific evidence comes from randomized controlled trials, or RCTs (or equivalently, a metanalysis of several RCTs). In an RCT, one group of random subjects is assigned to the intervention method (here, wearing a mask), and another random group is assigned as the control (here, not wearing a mask). The two groups are studied over time, and the effects are then compared. Here, we would like to know, for example, the Covid infection rates for mask-wearers versus non-mask-wearers. This would tell us if masks provide any protection to the user, and if so, how much. (In the best of all worlds, RCTs would be “double-blind,” meaning that neither researcher nor subject would be aware of who was in the test group and who was in the control. This works well for pills, because some subjects can be given a placebo. But with face masks, it is obviously impossible to run a blind test.)

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