Do Masks Really Work? Public Health Officials Have Ignored Substantial Evidence that They Don't
And the relatively scant evidence that has been put forward to support mask mandates is not nearly enough to justify requiring all people to wear them.
One reason I’m skeptical of the effectiveness of masks is how quickly science was said to support their use in April, even after years of studies failed to show that they made a significant difference in reducing the spread of viral illness. For example, in an extensive 2019 report entitled “Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza,” the WHO concluded that “there was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza.” Combine this statement with statements from the U.S. surgeon general in late February that strongly recommended against masks and statements in early March from Dr. Fauci discouraging masks because they could have “unintended consequences — people keep fiddling with the mask and they keep touching their face,” and I think it’s reasonable that people might question how quickly the recommendations changed.
To be fair, it is true that recommendations can and should change if new evidence emerges that would support different actions (like mask-wearing); however the scientific evidence that was put forward by the CDC (and cited by the surgeon general and others) to support universal mask-wearing for the general public seems relatively weak when compared to the 2019 WHO review of multiple RCTs (not to mention other RCTs that have shown no real benefit). I addressed the CDC’s studies earlier this summer:
“The CDC cites 20 studies on its webpage that recommends cloth face coverings; however, 13 out of these 20 studies do not discuss masks (they instead discuss asymptomatic transmission and modes of transmission). Of the remaining 7 that do discuss masks, two of them deal with types of materials for making cloth masks but do not explore the efficacy of cloth (or other) masks in real life. One of the studies provided promising results, but this study only covered surgical facemasks, and the conclusions applied to symptomatic spread. Another study examined 9 individuals, and while the results there were promising for surgical and N95 masks, cloth masks were not mentioned (there were some other limitations on this study as well). Still another study examined only commercially available surgical masks worn by simulated contagious patients (nothing on cloth masks).
Only 2 of the 20 studies discussed the efficacy of cloth masks. The first of these two studies examined the use of commercially available masks as well as homemade masks, but the homemade masks evaluated in this study were “made of four‐layer kitchen paper (each layer contains three thin layers) and one layer of polyester cloth.” These are substantially different than many of the cloth masks people are wearing today. The authors provide this caution on the cloth masks many are currently wearing:
“It is worth noting that the homemade masks shall be of less blocking efficacy if made of fewer layers of kitchen paper. Other types of homemade masks, especially those made of cloth alone, may be unable to block the virus and thus confer no protection against the virus" (emphasis added).
Finally, the authors of this study note that this was not a randomized controlled trial, and they recognize that “[s]ome randomized controlled trials (RCTs) did not support the efficacy of medical masks because medical masks could not reduce infection rates of some viral respiratory diseases.”
As to the second article that evaluated homemade cloth masks, here is what the authors wrote in their concluding paragraph:
‘An improvised face mask should be viewed as the last possible alternative if a supply of commercial face masks is not available, irrespective of the disease against which it may be required for protection. Improvised homemade face masks may be used to help protect those who could potentially, for example, be at occupational risk from close or frequent contact with symptomatic patients. However, these masks would provide the wearers little protection from microorganisms from others persons who are infected with respiratory diseases. As a result, we would not recommend the use of homemade face masks as a method of reducing transmission of infection from aerosols.’ ”
If individuals decide to wear a mask either for their own benefit or for the benefit of others, they should have the right to do so. However, the relatively scant evidence that has been put forward to support mask mandates is not enough to justify requiring all people to wear them; what’s more, such measures should not be required (and should not be viewed as the morally superior position) when there are (1) genuine risks of mask-wearing (including *increasing* the risk of infection) and (2) when observational data increasingly shows that communities and countries with mask mandates (or high percentages of voluntary mask use) do not fare better than communities or countries with no mask mandates (and little voluntary mask-wearing). I hope to address these last two points in future posts.
UPDATE:
This post prompted the following dialogue that is worth adding below:
Commenter 1:
“Whenever I see these posts, I think back to all of the times I have been in the operating room--which has been numerous times--and every time, every person in that room was wearing a mask. Was that to protect them or me?”
Response:
Thank you so much for your thoughtful comment! The intent of medical personnel wearing them during surgery would primarily be source control to protect the patient as well as to offer protection to medical personnel from bodily fluids, etc. Interestingly, though, as I began looking at a lot of these studies over the summer, there are some studies that actually suggest that masks do not lead to a lower incidence of infection during surgery but can actually increase those risks (and other risks to the patient). Here’s one of those studies:
https://pubmed.ncbi.nlm.nih.gov/1853618/
The result of this study (and others) was counterintuitive to me, as my assumption would be that surely masks would help; however, the evidence does not really bear that out (or is at the very least conflicting).
Along these same lines, I understand that the stated purpose of cloth masks and surgical masks for general public use is to protect others and not as much the wearer, but the evidence has not really shown universal masking to reduce the risk to others (I’ll share more of what I’ve found in the coming days, Lord-willing). Moreover, masks may actually be doing harm to many people. I personally know of multiple instances where people have been harmed, and there is a low level of harm that many may be experiencing without realizing it (not just increased infection risk but adverse effects to the immune system, among other harms). In light of these potential risks that have not really been discussed by most in the media (or even acknowledged by some health officials), my aim is to relay these concerns so that others can make the best decisions for themselves and their families.
Commenter 1:
“I am not a scientist; however, I do know that when I sneeze or cough while holding my laptop, I see the droplets hit my screen about 10 to 12 inches away from my screen. If I have on my mask, that does not happen. Obviously, the flu and numerous other viruses have spread much the same way.
Response:
You are exactly right on a mask catching many droplets in the scenario you describe. The same happens for me if I cough into my arm, shirt, etc. This is why I assumed masks would be very effective (and why I purchased a lot of masks back in January when it seemed things might spread quickly). I was genuinely surprised when so much of the research concluded that masks were not effective at reducing viral spread. Part of the reason is that the type of masks (cloth and surgical) simply are not that tightly sealed and are too porous for viral particles. Another reason is that people tend to touch their faces more when wearing a mask (thus increasing spread, which is what Fauci expressed concern about in March). And another reason (according to a very recent study) is that the smaller openings around the sides or top of many masks can actually result in particles spreading further because the air is forced out a smaller opening.
In all, I want to do whatever is most helpful to others, which is why I’ve sought to look into this more. And I personally know of multiple people who have become sick (bacterial infections, etc.) from wearing masks, which is a more specific reason I wanted to share what I’ve found. That said, I know that you are more at risk, and I want to do whatever I can to care well for you and for others. If you would want them or need them, I have several N95 masks that you can have that I get to you on Monday. Thankful for you!
Commenter 2: