Tag: coronavirus

The cure for COVID is …

Eric Boehm:

It takes a lot to make a libertarian look forward to the next election.

Like, say, two years of miserable government mandates ignored by some of the very people imposing them. Like watching over 70,000 maskless adults (and many celebritiespartying at a major sporting event in a city where children are required to wear medical-grade masks to school and keep them on while playing sports. Like imposing border controls on immigration and travel meant to stop the spread of COVID-19, and then keeping them in place (with no off-ramp) long after the virus is spreading here.

For once, we can be thankful that another election season is already upon us since politics is the last realm where the pandemic is dominating decision-making. The economy emerged from the omicron wave in better shape than expected. Sunday’s Super Bowl was the latest signal that lots of Americans are done with the health theatrics of the past two years. But even the political class’ commitment to COVID policy is wavering. The Centers for Disease Control and Prevention (CDC) and President Joe Biden might be refusing to offer much hope that COVID-related mandates should be lifted soon, but they are increasingly being undone by rank-and-file Democrats who are looking at favorability ratings that are falling nearly as fast as COVID case counts.

The CDC’s facemask failure

Jacob Sullum:

new study published by the Centers for Disease Control and Prevention (CDC) supposedly shows that wearing a face mask in public places dramatically reduces your risk of catching COVID-19. The CDC summed up the results in a widely shared graphic that says wearing a cloth mask “lowered the odds of testing positive” by 56 percent, while the risk reduction was 66 percent for surgical masks and 83 percent for N95 or KN95 respirators.

If you read the tiny footnotes, you will see that the result for cloth masks was not statistically significant. So even on its face, this study, which was published in the CDC’s Morbidity and Mortality Weekly Report on Friday, did not validate the protective effect of the most commonly used face coverings—a striking fact that the authors do not mention until the end of the sixth paragraph. And once you delve into the details of the study, it becomes clear that the results for surgical masks and N95s, while statistically significant, do not actually demonstrate a cause-and-effect relationship, contrary to the way the CDC is framing them.

A story Facebook doesn’t want you to read

Wisconsin Right Now posted on Facebook:

We have a new article posted on https://www.wisconsinrightnow.com/ that deals with an issue that is being censored. Since we are already on super-secret double probation and have been threatened with the complete removal of our pages and profiles for our coverage of the KR trial, we have chosen not to share the story on FB.

The article is from Stephanie Soucek:

“We had to do this! It was life or death!” He took the first dose and started to feel better within a few hours. 

As we look around the world and even right here in the United States of America, it is clear that there has been an overall effort to take away our freedoms under the guise of keeping us safe. When it comes to COVID, only the government-sanctioned experts know best—even though they’ve been wrong and flip-flopped many times the past two years. One could easily argue that more harm than good has been done by restricting our freedoms in order to “keep us safe.”

It is alarming when debate about what treatments work best is shut down and the government will decide what doctors and “science” you should trust and listen to. alternative COVID treatments including inexpensive repurposed drugs like Ivermectin and hydroxychloroquine that have been approved for human use by the FDA for decades have been suppressed and made difficult to obtain for the purposes of treating COVID.

And expensive treatments like Remdesivir are pushed as one of the only drugs used for the treatment for COVID. Yet in November 2020 the WHO came out with a study claiming Remdesivir should not be used to treat COVID patients in hospitals because it was ineffective.

According to an article from NBC News: “In light of the interim data from the WHO’s ‘Solidarity’ trial — which included data from more than 11,200 people in 30 countries — “remdesivir is now classified as a drug you should not use routinely in Covid-19 patients,” the president of the European Society of Intensive Care Medicine, Jozef Kesecioglu, said in an interview with Reuters.” Yet it’s the main drug still being pushed by the CDC and many hospitals in the US today. Why?

I suppose nothing has disturbed me more than hearing about the first-hand accounts of patients being refused alternative COVID treatments they request, even after being told by the hospital that nothing else can be done for them and they will likely die. On top of that, some of these hospitals have refused to release patients when they or their families request to be released in order to get a second opinion or alternative COVID treatments somewhere else. Second opinions have saved people’s lives at times and a patient has the right to get a second opinion or try another treatment in order to potentially save their lives.

There are stories right here in Wisconsin of families who have suffered because of hospital protocols. One such story comes from a woman who shared the heartbreaking story of her husband, who died last year at the age of 55 after being admitted into a Milwaukee area hospital. Out of respect for her family’s privacy she asked to remain anonymous. Her husband became sick in late September 2021 and tested positive for Covid shortly after.

After about a week of not getting better on his own she took her husband to the hospital. Shortly after being admitted his oxygen levels dropped and he was transferred to the ICU. She says she was unable to go into the hospital to be with him during this time and the communication between her and the hospital was poor. He was given 4 treatments of Remdesivir before his liver started being negatively affected. She requested they stop using Remdesivir and try other potential alternative COVID treatments such as ivermectin, hydroxychloroquine, and monoclonal antibodies but was told that wasn’t allowed because of hospital protocol (based on the CDC guidance).

She says once she became power of attorney she requested to have a meeting of care for her husband but the doctor refused. They continued with four more treatments of Remdesivir. A little more than a week after being admitted to the ICU he was put on a ventilator. His kidneys were failing, which is a potential side-effect of Remdesivir. Disagreements occurred among doctors about whether or not he should be transferred and he ended up being transferred to another hospital and sadly died the next day.

She believes (with good reason) that treating him with Remdesivir and the hospital not being willing to try alternative COVID treatments is what truly took his life. She hopes telling her husband‘s story will help raise awareness and help other people avoid similar tragedies.

Another woman I talked to named Debbie tells the story of her father who was diagnosed with Covid and Pneumonia last year December. He wasn’t doing well so he was admitted into a hospital in northeast Wisconsin where he was sent to the ICU and put on oxygen, plus they started treating him with Remdesivir.

He started to get worse and the family was told he would likely need to be put on a ventilator soon. The family was distraught and thought he would likely die based on everything happening. They asked to stop treatment of Remdesivir and asked if the hospital could try an alternative COVID treatment like Azithromycin with Ivermectin. The family was told it wasn’t approved and it doesn’t work.

But this family was desperate and decided to get a prescription for ivermectin along with a Z pack from a doctor in Michigan. They couldn’t get the prescription filled initially because the pharmacy they went to refused, so thankfully they found a pharmacy out of town that would fill it.

They ended up hiding the treatment for her dad with some of his belongings they sent into the hospital. When recalling what they did Debbie’s words were “We had to do this! It was life or death!” He took the first dose and started to feel better within a few hours. He took a second dose the next day and within 24 hours his oxygen levels were improving and he was ready to go home within days of taking the treatment and was home by Christmas.

The family strongly believes that had they not given him the treatment they snuck into the hospital he likely would have died. How sad that they had to hide what they were doing because the hospital refused to allow this type of treatment.

As I am writing this article, two men on ventilators—Daniel Pisano, 70, in Florida and Stephen Judge, 69, in Arizona—died within a day of each other, even as their families were still fighting with hospitals for the chance to try alternative treatments including Ivermectin.

There are many great healthcare facilities and doctors out there. But there are many other stories like this of families battling hospital protocol over their loved one’s lives.

We have to ask ourselves why isn’t there more of a willingness to try alternative COVID treatments, especially when other efforts have failed? Why are some hospitals ignoring the family‘s wishes and telling them “it’s protocol directed by the CDC” as if there’s no other choice?

Why is our government working with big tech to suppress the voices of doctors, scientists, and others who disagree with certain government protocols, even as those protocols fail at times?

According to an editorial in the Association of American Physicians and Surgeons, “The CARES Act provides incentives for hospitals to use treatments dictated solely by the federal government under the auspices of the NIH, providing hospitals with bonus incentive payments for all things related to COVID-19 (testing, diagnosing, admitting to hospital, use of remdesivir and ventilators, reporting COVID-19 deaths, and vaccinations) and (2) waivers of customary and long-standing patient rights by the Centers for Medicare and Medicaid Services (CMS).”

We have to ask ourselves why these incentives were put in place.

Thomas Jefferson once said, “Every government degenerates when trusted to the rulers of the people alone. The people themselves, therefore, are it’s only safe depositories.” We should not be putting such blind faith in what our government or big tech tells us is right. Our government has too much control over what we can watch and listen to, what we must inject into our bodies, and what type of treatments we are allowed to use even if our own doctors disagree with the government’s protocols.

I wonder how many lives could have been saved if alternative COVID treatments and information weren’t being suppressed. We must demand more transparency and accountability from our government, and we must fight for our liberties before it’s too late.

You don’t have to believe anything you just read to ask the question of why the government is handling COVID as it is.

How COVID should have been (and should be) handled

James Taranto:

The Omicron surge has triggered a mutation in the conventional wisdom about Covid-19. The virus “is here to stay,” oncologist Ezekiel Emanuel and two other experts who advised the Biden transition proclaimed in a Jan. 6 article for the Journal of the American Medical Association, “A National Strategy for the ‘New Normal’ of Life With Covid.” That means no more “perpetual state of emergency”: “The goal for the ‘new normal’ . . . does not include eradication or elimination.”

Joseph Ladapo reached the same conclusion almost two years earlier. “Please don’t believe politicians who say we can control this with a few weeks of shutdown,” Dr. Ladapo, then a professor at UCLA’s medical school and a clinician on Covid’s frontline, wrote in USA Today on March 24, 2020. “To contain a virus with shutdowns, you must either go big, which is what China did, or you don’t go at all. . . . Here is my prescription for local and state leaders: Keep shutdowns short, keep the economy going, keep schools in session, keep jobs intact, and focus single-mindedly on building the capacity we need to survive this into our health care system.”

“That was before it became political,” Dr. Ladapo, 43, says in an interview conducted in person, indoors and unmasked. An orthodoxy soon hardened in the medical establishment and most of the media. He says his UCLA faculty colleagues’ reactions to his commentaries went from “Thanks, Joe, for providing us another perspective” to “How can we make Joe stop writing?” He believes USA Today “would never have published anything along that vein later in the pandemic.” But the Journal would: Since April 2020, I have accepted a dozen of Dr. Ladapo’s articles for these pages. One of them, in September 2020, was headlined “How to Live With Covid, Not for It.”

As policy makers’ views began to converge with Dr. Ladapo’s, he became a policy maker. His writings caught the attention of Florida Gov. Ron DeSantis, who in September 2021 appointed him surgeon general, the state’s top health official. “It’s fun that I’m sitting here because of you,” Dr. Ladapo tells me—though he’s also sitting here because Mr. DeSantis had been quicker than most politicians to see the folly of lockdowns and the necessity of living with Covid.

The governor declared a state of emergency in early March 2020, followed in April by the first in a series of executive orders reopening the state. Restaurants, bars, gyms and movie theaters were back in business by June 2020, and public schools were in session that fall. In May 2021 Mr. DeSantis suspended all local Covid-19 restrictions, including mask mandates, and signed legislation ending them permanently. Last summer’s Delta wave hit Florida hard, but the Sunshine State imposed no new restrictions. The state became a punching bag for journalists and other enthusiasts for harsh Covid policies. The hashtag #DeathSantis periodically trended on Twitter.

In Florida as elsewhere, Omicron has brought an unprecedented explosion in reported cases but a considerably smaller increase in severe ones. “It’s been really a blessing that the Omicron variant is less virulent,” Dr. Ladapo says, though he cautions: “We don’t know what’s around the corner, because these case counts are still very high.” Florida recorded an average of 65,551 cases a day for the week ending Jan. 12, up 165% from the Delta wave’s August peak. But hospitalizations of Covid-positive patients, at 10,526, were 41% lower than the August high.

One way to bring the case count down is by testing fewer people. “Historically in public health, for respiratory viruses in the general population, we consider ‘cases’ to be people who have symptoms, not a PCR test,” Dr. Ladapo says. “But during the pandemic, you can have a positive PCR and be completely healthy but be considered a case and be required to behave like a case, which is to isolate and those types of things.”

On Jan. 6 Dr. Ladapo issued guidance that only people who have Covid symptoms and a risk factor (old age, certain diseases, or current or recent pregnancy) “should” get tested. Those with symptoms but no risk factors are advised to “consider” a test. For the asymptomatic, the guidance discourages testing, saying it “is unlikely to have any clinical benefits.”

“A test is most valuable when it’s most likely to lead to a change in a decision, a change in management,” he says. “I mean, that’s so basic.” To keep hospitalizations down, he adds, the state has made clear “that we expect clinicians to treat patients with risk factors” using therapies including monoclonal antibodies, new antivirals from Pfizer and Merck, and fluvoxamine and inhaled budesonide, two medications that have shown promise in off-label use against Covid-19.

He describes the asymptomatic as “a very special group, because this group—you can’t feel any better than not having symptoms. So this group can only be harmed from treatment”—not to mention the “personal downside to them” of being expected to isolate.

Pandemic logic

Michael Smith:

Perhaps I am unique in this, but I find the arguments around the pandemic panic induced vaccine hysteria quite interesting, not for what they appear to be, but what the arguments really are about.

The arguments, as popularly stated, are allegedly based on the selfishness and ignorance of the people who choose not to be vaccinated. They begin from the premise that the unvaccinated present not only a serious risk to the vaccinated, but a potentially deadly risk.

“Do the right thing for your community”, the self-righteous vaccinated say. “Get your poke and put on your mask, go back to social distancing, and stay at home or we are all gonna die!”

It never dawns on them that making this argument is the very reason people see the vaccinations as a sham. The new “Paper of Record” in America, the Babylon Bee, summed this up in a headline a few weeks ago, writing “To Defeat Delta Variant, Experts Recommend Doing All The Things That Didn’t Work The First Time”.

A little application of basic reasoning would lead a rational person to say, “Whachu talkin’ ‘bout, Willis?”

We get the shots, but are still vulnerable to the virus, plus we are going to be required to do the same things we did before we got the shot? What’s the damn point?

Those questions have nothing to do with the efficacy of the vaccine or anything else other than trying to resolve the contradictions in the statements of the government and those of the vaccinated scolds.

Given these unresolvable contradictions, one must consider that there are other motivations at work here. Some I have deduced are, but not limited to, the following:

  • A desire to be socially validated by other vaccinated cool kids
  • A desire to be validated by the authorities
  • An irrational fear of risk and how to manage risk
  • A fundamental lack of understanding data
  • A fear that the vaccines don’t really work
  • A fear that if the vaccines don’t really work and the vaccinated person gets sick, there will not be a hospital resources available for them
  • A desire to be seen as superior to others – smarter, more moral, more fit for participating in “modern” society

Every one of the preceding motivations does indicate a state of selfishness, but not on the part of the unvaccinated – it is the vaccinated who are the selfish.

There was a particular letter to the editor in our local paper, the Park Record, that included the statement, and I quote: “Personal freedom ends when it puts another at risk.”

Dear God. This person took the time to write this down and email it to the editors. Too bad they didn’t think about what it really means before they did.

Imagine this applied to the flu or even to driving a car.

Brain dead morons. They walk among us – and they are hangry.

More dangerous to kids: COVID or Milwaukee?

Dan O’Donnell asks that question posed in the headline:

On the whole, human beings aren’t especially great at risk assessment.  Far-fetched, exotic terrors fill us with dread, but we all but ignore the dangerous yet mundane.  We fret, for instance, about an upcoming flight but drive to the airport with one eye on our phone and one hand on a burrito.

The COVID-19 pandemic has drawn this phenomenon into sharp relief, especially as it pertains to the disease’s impact on children.  We closed schools almost instantly, cancelled play dates and extra-curricular activities by the millions, and forced children to wear masks nearly everywhere they went.

Even now, we panic because younger children aren’t eligible for the COVID vaccine and obsess over the rising rate of pediatric hospitalizations to the point that we have blinded ourselves to the truth: COVID-19 is far less dangerous to children in Wisconsin than the streets of Milwaukee.

COVID-19 has yet to kill a single child younger than 10 in this state.  10 children under 10 have been murdered in Milwaukee since the start of 2020.  Among children older than 10, three have died with or from COVID, while 35 have been the victims of homicide over the past 21 months.

Put another way, a child has died of COVID in Wisconsin every 208 days, but a child has been murdered in Milwaukee once every two weeks.  An additional 149 children have been injured in nonfatal shootings, meaning that a child is 65 times more likely to be shot or killed in Milwaukee than to die of COVID.

Guess which issue Wisconsin’s media and policymakers have focused on and which they have largely ignored.  Their obsession with school closures and mask mandates may have succeeded in convincing a percentage of parents that COVID is a grave danger to their children, but the statistics simply don’t support the fearmongering.

As of this writing, a total of 120,247 children have been infected with COVID-19.  Three have died.  That’s a death rate of 0.025 percent.  A child in Wisconsin has a 1-in-40,082 chance of dying from COVID-19, but a 1-in-15,000 chance of being struck by lightning at some point in his or her life.

Not only is COVID almost universally survivable for Wisconsin’s children, it has also not hospitalized them in overwhelming numbers.  Just 1,376 children have been hospitalized with COVID out of the more than 120,000 who have been infected—a hospitalization rate of 1.1 percent.

What’s more, new research suggests that the real percentage might be far lower.  A Harvard University study published this week indicates that that “roughly half of all the hospitalized patients showing up on COVID-data dashboards in 2021 may have been admitted for another reason entirely or had only a mild presentation of disease.”

pair of earlier studies of pediatric patients published in the journal Hospital Pediatrics “found that pediatric hospitalizations for COVID-19 were overcounted by at least 40 percent.”

In one study, researchers concluded that 45 percent of hospitalizations “were unlikely to be caused by SARS-CoV-2” and were actually due to “surgeries, cancer treatment, a psychiatric episode, urologic issues, and various infections such as cellulitis, among other diagnoses.”

In the second study, “the authors classified 40 percent of patients as having ‘incidental’ diagnosis, meaning there was no documentation of COVID-19 symptoms prior to hospitalization.”  The obvious conclusion is that the patients were not hospitalized for COVID-19, but rather tested positive once they visited the hospital for treatment of some other malady.

Extrapolating these studies to Wisconsin’s pediatric hospitalizations would suggest that only about 550 children were actually hospitalized with severe cases of COVID-19, not the 1,376 that the Department of Health Services has logged.  It would also mean that the actual child hospitalization rate in Wisconsin is closer to 0.046 percent.

This is not to suggest that COVID-19 cannot be a serious disease for children, but it is not at all likely to be.  Only a small percentage of those who contract it had to be hospitalized for it and three died either with or of it.

With the emotional school board battles over masks in the classrooms accompanied by a constant drumbeat of media doomsaying, one can be forgiven for thinking COVID is a far greater threat to children than it is.

The data, though, is conclusive: COVID-19 is nowhere near as dangerous to children as we have been led to believe it is.

FOreverVID

Philip Klein:

Most people have at some point in their lives been asked to entertain a version of the cheesy question, “If you knew you had one day to live, what would you do?” It’s often posed as a playful game or essay topic or used by self-help gurus to prod people into trying to get a deeper sense of their priorities. But it’s time for everybody to start asking themselves a different question: If COVID-19 will be here forever, is this what you want the rest of your life to look like? In this case, it’s not an idle or theoretical exercise. It will be central to how we choose to live and function as a society for years or even decades to come.

Ever since the onset of COVID-19, we have more or less been living under an illusion. That illusion was that it would reach some sort of natural endpoint — a point at which the pandemic would be declared “over,” and we could all more or less go back to normal. The original promise of taking “15 days to slow the spread” or six weeks to “flatten the curve” has long since been reduced to a punchline.

In March of 2020, the outside estimates were that this coronavirus period would come to an end when safe and effective vaccines became widely available. Even the infamous Imperial College London report, viewed as draconian at the time for its estimate of up to 2.2 million deaths in the U.S. absent sustained intervention, predicted that its mitigation strategies “will need to be maintained until a vaccine becomes available.” Yet vaccines have been available for anybody who wants one for nearly six months, and our leaders have ignored the obvious off-ramp. The CDC backtracked on guidance and said that vaccinated people must wear masks in public, and many people and jurisdictions have listened. For example, Montgomery County, Md., has an extraordinarily high vaccination rate — with 96 percent of the eligible over-twelve population having received at least one dose and 87 percent of them being fully vaccinated. By its own metrics, the county has “low utilization” of hospital beds. Yet the county requires masks indoors — including in schools. In Oregon, vaccinated people are required to wear masks even outdoors. And it isn’t just liberal enclaves. A new Economist/YouGov poll found that eight in ten Americans report having worn a mask in the past week at least “some of the time” when outside their homes, with 58 percent masking “always” or “most of the time.” If masking has remained so widespread among adults months after vaccines became widely available, why will it end in schools after vaccines become available for children?

When operating under the assumption that there is a time limit on interventions, it’s much easier to accept various disruptions and inconveniences. While there have been ferocious debates over whether various mitigation strategies have ever been necessary, we should at least be able to agree that the debate changes the longer such restrictions are required. People making sacrifices for a few weeks, or even a year, under the argument that doing so saves lives is one thing. But if those sacrifices are indefinitely extended, it’s a much different debate.

There are many Americans who willingly locked themselves down and who still favor some restrictions. But what if this were to drag on for five years? Ten years? Twenty years? Do you want your children to be forced to wear masks throughout their childhoods? Do you want to bail on weddings if some guests may be unvaccinated? Skip future funerals? Ditch Thanksgiving when there’s a winter surge? Keep grandparents away from their grandkids whenever there’s a new variant spreading? Are you never going to see a movie in a theater again?

These are not wild scenarios. The Delta variant has led to surges throughout the world months after vaccines became widely available. Despite being a model of mass vaccination, Israel has been dealing with a significant Delta spike. To be clear, vaccines still appear to be quite effective at significantly reducing the risk of hospitalization and death. But if the virus continues to adapt and people need to get booster shots every six months or so, it seems there’s a good chance that the coronavirus will continue to spread for a very long time. So the question is how we, as individuals, and society as a whole, should adapt to this reality. Instead of thinking in terms of policies that may be tolerable for a very short period of time, it’s time to consider what would happen if such policies had to continue forever.

Whatever arguments were made to justify interventions early on in the pandemic, post-vaccine, we are in a much different universe. There is a negligible statistical difference in the likelihood of severe health consequences between vaccinated people who go about their business without taking extra precautions, and those who take additional precautions. Yet having to observe various protocols in perpetuity translates into a reduced quality of life. Put another way, the sort of question we need to start asking ourselves is not whether we can tolerate masking for one trip to the grocery store, but whether we want to live in a society in which we can never again go shopping without a mask.

People may ultimately come to different conclusions about the amount of restrictions they want to accept, regardless of the time frame. But at a minimum, we need to dispense with the framework that assumes the end of COVID-19 is just around the corner and instead recognize that it’s likely here to stay.

The vaccine scolds

Dr. Richard Menger of the University of South Alabama:

I practice medicine in an emerging Covid-19 hot spot in a state with one of the lowest vaccination rates. Last year I saw Covid at its worst when I deployed to New York to take care of patients in an overflow intensive-care unit. I am vaccinated. I wouldn’t say I “believe in science,” because science doesn’t work that way, but I trust the scientific process. Yet when it comes to trust and persuasion, the medical profession isn’t always winning the Covid-19 battle, and it’s worth understanding why.

The current attempts at persuading people to get the vaccine follow the typical trinity of persuasion put forth by Aristotle —logos, pathos and ethos. Social media and government platforms focus on data (logos), such as the stark disparities in serious illness between the vaccinated and the not. Then it turns into emotional pleas (pathos), with personal stories of lost patients or loved ones. Advocates talk about a moral duty of getting a vaccine (ethos).

But when the desired response doesn’t materialize—when a substantial portion of the country still refuses a shot—the calls devolve into histrionic and condescending pleas. Many people respond by digging in their heels. Plenty of research shows that once people make a decision and attach a strong moral identity to it, they ignore contrary data.

The medical community needs to confront the ugly reality of distrust, especially in my state. The Tuskegee Syphilis Study is a living memory. Between 1932 and 1972, government researchers actively withheld treatment for syphilis while promising free medical care, meals and burial insurance. Some reluctance in blindly trusting a new vaccine is understandable.

It is also cause for pause that the government appears willing to coerce Americans to take a vaccine that doesn’t have full approval from the Food and Drug Administration. President Biden has considered a $100 payment for vaccination. Such fiscal rewards will likely have the biggest sway on the vulnerable populations. But the government can use sticks as well as carrots. Is it morally acceptable to tax the unvaccinated $100? How would you feel if the government applied this tactic to something you strongly disagreed with?

The best way to change minds is to talk to people and treat them with respect and dignity. I understand a lot of my healthcare colleagues are frustrated and tired, but a sensationalist, sanctimonious narrative driven by social media doesn’t help anyone. This is part of our job: persuading people to take medicine they don’t want to take.

Healthcare professionals have a challenging obligation to work to understand where people are coming from, build a relationship, address their fears to help them understand, gently correct information that is wrong, admit when medicine was wrong and medical authorities misled people, motivate them based on their needs, and develop networks of support in the community.

Using this approach and more, Jacqueline Brooks, superintendent of the Macon County, Ala., School District, helped lead the charge that resulted in universal vaccination among the district’s custodians, bus drivers, and lunchroom workers. Macon County includes the city of Tuskegee.

Ms. Brooks engaged in personal conversations, reduced barriers to appointments, formed a partnership with a local medical center, made sure people were comfortable with the decision, and praised them for making a “sacrifice” and “taking on risk” for the community. Most important, when an initial cohort was in a “wait-and-see” mode, she acknowledged the risk, didn’t pressure them, and offered reassurance and data as more people they knew became vaccinated. The results speak for themselves.

Vaccines and facemasks, and being wrong

Jacob Sullum:

Like many Americans, I do not like wearing a face mask, which hurts my ears, fogs my glasses, and makes my bearded face itch. And while I think businesses should be free to require face coverings as a safeguard against COVID-19, I am skeptical of government-imposed mask mandates, especially in K-12 schools.

At the same time, I recognize that my personal peeves and policy preferences are logically distinct from the empirical question of how effective masks are at preventing virus transmission. From the beginning, however, the Great American Mask Debate has been strongly influenced by partisan and ideological commitments, with one side exaggerating the evidence in favor of this precaution and the other side ignoring or downplaying it.

Last September, Robert Redfield, then the director of the Centers for Disease Control and Prevention (CDC), described masks as “the most important, powerful public health tool we have,” going so far as to say they provided more protection than vaccines would. In a 2020 New York Times op-ed piece, Michigan Gov. Gretchen Whitmer asserted that “wearing a mask has been proven to reduce the chance of spreading Covid-19 by about 70 percent”—a claim that even the CDC said was not scientifically justified.

The CDC invited skepticism about the value of general mask wearing by dismissing ituntil April 2020, when the agency suddenly began recommending the practice as an important weapon against the pandemic. Although that memorable reversal supposedly was justified by evolving science, the main concern that the CDC cited—asymptomatic transmission—was a danger that had been recognized for months.

When the CDC changed its advice, research on the effectiveness of face masks in preventing virus transmission was surprisingly sparse and equivocal. Although laboratory experiments supported the commonsensical assumption that almost any barrier to respiratory droplets, including DIY cloth coverings, was better than nothing, randomized controlled trials (RCTs) generally had not confirmed that intuition.

A January 2021 review of the evidence in the Proceedings of the National Academy of Sciences found “no RCT for the impact of masks on community transmission of any respiratory infection in a pandemic.” The article, which also looked at observational studies, said “direct evidence of the efficacy of mask use is supportive, but inconclusive.”

The authors then considered “a wider body of evidence,” including epidemiological analyses, laboratory studies, and information about COVID-19’s transmission characteristics. “The preponderance of evidence,” they concluded, “indicates that mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts.”

In a “science brief” last updated on May 7, the CDC says “experimental and epidemiological data support community masking to reduce the spread of SARS-CoV-2.” But it acknowledges that “further research is needed to expand the evidence base for the protective effect of cloth masks.”

Where does that leave Americans who are unpersuaded by the existing evidence? Banned from major social media platforms, if they are not careful.

YouTube recently suspended Sen. Rand Paul’s account because of a video in which the Kentucky Republican said “most of the masks that you can get over the counter” have “no value.” Those statements ran afoul of YouTube’s ban on “claims that masks do not play a role in preventing the contraction or transmission of COVID-19,” which is similar to policies adopted by Facebook and Twitter.

While conceding that “private companies have the right to ban me if they want to,” Paul said he was troubled by the fact that the leading social media platforms, partly in response to government pressure, seem to be insisting that users toe the official line on COVID-19. He has a point.

Paul’s criticism of cloth masks was stronger than the science warrants, reflecting a broader tendency on the right to dismiss them as mere talismans without seriously addressing the evidence in their favor. But rational discourse entails rebutting arguments by citing contrary evidence instead of treating them as too dangerous for people to consider.

Robby Soave:

Officials at the Centers for Disease Control and Prevention (CDC) now think that many Americans will need booster shots in the coming months, and the Biden Administration has plans to make that happen. While the vaccines still provide remarkable protection against severe disease and death, recent studies suggest that an additional shot will help decrease transmission of the more infectious delta variant and prevent breakthrough cases.

For vaccine-hesitant rightwing people—who constitute a substantial proportion of the anti-vax movement, though by no means the whole thing—the need for booster shots has been met with considerable opprobrium and even suggestions that this means the vaccines don’t work. Former President Trump called booster shots a “crazy” idea.

“The whole thing is just crazy,” he said in a recent interview on Fox News. “It doesn’t—you wouldn’t think you would need a booster.”

These comments will undoubtedly contribute to vaccine hesitancy and undermine confidence in booster shots; as such, this sort of talk is deeply irresponsible. It’s as if the former president doesn’t know any better, or just can’t help himself.

So what’s The New York Times‘ excuse?

Astonishingly, the paper of record has opted to give support to this Trumpian denial of vaccine efficacy. A recent news story by Times reporter Apoorva Mandavilli—whose articles on the pandemic have constituted some of the most fear-driven and pro-restriction writing appearing anywhere in the mainstream media—cast doubt on the need for boosters and suggested that people could “easily” obtain the same level of protection by wearing a mask instead.

Mandavilli quotes Boston University epidemiologist Ellie Murray in opposition to booster shots for the general population:

Dr. Murray said boosters would undoubtedly boost immunity in an individual, but the benefit may be minimal — and obtained just as easily by wearing a mask, or avoiding indoor dining and crowded bars.

The administration’s emphasis on vaccines has undermined the importance of building other precautions into people’s lives in ways that are comfortable and sustainable, and on building capacity for testing, she and other experts said.

“This is part of why I think the administration’s focus on vaccines is so damaging to morale,” she added. “We probably won’t be going back to normal anytime soon.”

Note the agenda here: The “experts”—i.e., overly cautious epidemiologists picked by The New York Times to give weight to Team Blue’s quixotic COVID-19 mitigation preferences—think the focus on vaccines is damaging because it comes at the expense of a pro-lockdown, pro-masking, pro-social-distancing strategy. Vaccination, broadly speaking, lets most people live their lives like normal again; this is somehow viewed as a bad thing.

These policy preferences are completely contrary to the reality of the human social experience. The health benefit of a booster shot is not “obtained just as easily by wearing a mask or avoiding indoor dining or crowded bars,” because wearing masks and eschewing conversation with other people is much more taxing than getting a shot. Many normal people actually like talking to people in bars and seeing human faces, so forgoing this indefinitely is not a trivial matter. (Note that the Times recently ran an op-ed piece titled: “Actually, Wearing a Mask Can Help Your Children Learn.”)

If Trump deserves criticism for failing to urge his base to get their shots—and he does—then why should The New York Times get a pass for suggesting to its readers that regular masking is an effective substitute for booster shots? The Biden Administration frets constantly about COVID-19 misinformation being spread by right-wing accounts on social media. But Mandavilli is guilty of the same: She called the delta variant “as contagious as chicken pox” in an article that preached doom and gloom about the current state of the pandemic. It later turned out that this claim, sourced to an internal CDC document, originally appeared in an inaccurate NYT infographic.

I wrote previously that the media’s enthusiasm for mask mandates is so strong that it occasionally seems as if some liberal and mainstream writers prefer masks to vaccines, even though the latter is a vastly superior tool for defeating COVID-19. Now The New York Times has said it quite explicitly: Who needs booster shots when experts say we can just wear masks forever?

To mask, or not

Jeffrey H. Anderson:

“Seriously people—STOP BUYING MASKS!” So tweeted then–surgeon general Jerome Adams on February 29, 2020, adding, “They are NOT effective in preventing general public from catching #Coronavirus.” Two days later, Adams said, “Folks who don’t know how to wear them properly tend to touch their faces a lot and actually can increase the spread of coronavirus.” Less than a week earlier, on February 25, public-health authorities in the United Kingdom had published guidance that masks were unnecessary even for those providing community or residential care: “During normal day-to-day activities facemasks do not provide protection from respiratory viruses, such as COVID-19 and do not need to be worn by staff.” About a month later, on March 30, World Health Organization (WHO) Health Emergencies Program executive director Mike Ryan said that “there is no specific evidence to suggest that the wearing of masks by the mass population has any particular benefit.” He added, “In fact there’s some evidence to suggest the opposite” because of the possibility of not “wearing a mask properly or fitting it properly” and of “taking it off and all the other risks that are otherwise associated with that.”

Surgical masks were designed to keep medical personnel from inadvertently infecting patients’ wounds, not to prevent the spread of viruses. Public-health officials’ advice in the early days of Covid-19 was consistent with that understanding. Then, on April 3, 2020, Adams announced that the CDC was changing its guidance and that the general public should hereafter wear masks whenever sufficient social distancing could not be maintained.

Fast-forward 15 months. Rand Paul has been suspended from YouTube for a week for saying, “Most of the masks you get over the counter don’t work.” Many cities across the country, following new CDC guidance handed down amid a spike in cases nationally caused by the Delta variant, are once again mandating indoor mask-wearing for everyone, regardless of inoculation status. The CDC further recommends that all schoolchildren and teachers, even those who have had Covid-19 or have been vaccinated, should wear masks.

The CDC asserts this even though its own statistics show that Covid-19 is not much of a threat to schoolchildren. Its numbers show that more people under the age of 18 died of influenza during the 2018–19 flu season—a season of “moderate severity” that lasted eight months—than have died of Covid-19 across more than 18 months. What’s more, the CDC says that out of every 1,738 Covid-19-related deaths in the U.S. in 2020 and 2021, just one has involved someone under 18 years of age; and out of every 150 deaths of someone under 18 years of age, just one has been Covid-related. Yet the CDC declares that schoolchildren, who learn in part from communication conveyed through facial expressions, should nevertheless hide their faces—and so should their teachers.

How did mask guidance change so profoundly? Did the medical research on the effectiveness of masks change—and in a remarkably short period of time—or just the guidance on wearing them?

Since we are constantly told that the CDC and other public-health entities are basing their recommendations on science, it’s crucial to know what, specifically, has been found in various medical studies. Significant choices about how our republic should function cannot be made on the basis of science alone—they require judgment and the weighing of countless considerations—but they must be informed by knowledge of it.

In truth, the CDC’s, U.K.’s, and WHO’s earlier guidance was much more consistent with the best medical research on masks’ effectiveness in preventing the spread of viruses. That research suggests that Americans’ many months of mask-wearing has likely provided little to no health benefit and might even have been counterproductive in preventing the spread of the novel coronavirus.

It’s striking how much the CDC, in marshalling evidence to justify its revised mask guidance, studiously avoids mentioning randomized controlled trials. RCTs are uniformly regarded as the gold standard in medical research, yet the CDC basically ignores them apart from disparaging certain ones that particularly contradict the agency’s position. In a “Science Brief” highlighting studies that “demonstrate that mask wearing reduces new infections” and serving as the main public justification for its mask guidance, the CDC provides a helpful matrix of 15 studies—none RCTs. The CDC instead focuses strictly on observational studies completed after Covid-19 began. In general, observational studies are not only of lower quality than RCTs but also are more likely to be politicized, as they can inject the researcher’s judgment more prominently into the inquiry and lend themselves, far more than RCTs, to finding what one wants to find.

A particular favorite of the CDC’s, so much so that the agency put out a glowing press release on it and continues to give it pride of placement in its brief, is an observational (specifically, cohort) study focused on two Covid-positive hairstylists at a beauty salon in Missouri. The two stylists, who were masked, provided services for 139 people, who were mostly masked, for several days after developing Covid-19 symptoms. The 67 customers who subsequently chose to get tested for the coronavirus tested negative, and none of the 72 others reported symptoms.

This study has major limitations. For starters, any number of the 72 untested customers could have had Covid-19 but been asymptomatic, or else had symptoms that they chose not to report to the Greene County Health Department, the entity doing the asking. The apparent lack of spread of Covid-19 could have been a result of good ventilation, good hand hygiene, minimal coughing by the stylists, or the fact that stylists generally, as the researchers note, “cut hair while clients are facing away from them.” The researchers also observe that “viral shedding” of the coronavirus “is at its highest during the 2 to 3 days before symptom onset.” Yet no customers who saw the stylists when they were at their most contagious were tested for Covid-19 or asked about symptoms. Most importantly, this study does not have a control group. Nobody has any idea how many people, if any, would have been infected had no masks been worn in the salon. Late last year, at a gym in Virginia in which people apparently did not wear masks most of the time, a trainer tested positive for the coronavirus. As CNN reported, the gym contacted everyone whom the trainer had coached before getting sick—50 members in all—“but not one member developed symptoms.” Clearly, this doesn’t prove that not wearing masks prevents transmission.

Another CDC-highlighted study, by Rader et al., invited people across the country to answer a survey. The low (11 percent) response rate—including about twice as many women as men—indicated that the mix of respondents was hardly random. The study found that “a high percentage of self-reported face mask-wearing is associated with a higher probability of transmission control,” and “the highest percentage of reported mask wearers” are found, unsurprisingly, “along the coasts and southern border, and in large urban areas.” However, as the researchers note, “It is difficult to disentangle individuals’ engagement in mask-wearing from their adoption of other preventive hygiene practices, and mask-wearing might serve as a proxy for other risk avoidance behaviors not queried.” Moreover, achieving greater “transmission control” is not remotely the same thing as ensuring fewer deaths. For example, per capita, Utah is in the top ten in the nation in Covid-19 cases and the bottom ten in Covid-19 deaths, while Massachusetts is in the bottom half in cases and the top five in deaths.

An additional observational study, but one that the CDC does not reference in its brief, is a large, international Bayesian study by Leech, et al. It finds that mask-wearing by 100 percent of the population “corresponds to” a 24.6 percent reduction in transmission of the novel coronavirus. Mask mandates correspond to no decrease in transmission: “For mandates we see no reduction: 0.0 percent.” Like all observational studies, however, this study is ill-equipped to show causation, to separate out the effects of just one variable from among other, frequently related, ones.

Mask supporters often claim that we have no choice but to rely on observational studies instead of RCTs, because RCTs cannot tell us whether masks work or not. But what they really mean is that they don’t like what the RCTs show.

The randomized controlled trial dates, in a sense, to 1747, when Royal Navy surgeon James Lind divided seamen suffering from similar cases of scurvy into six pairs and tried different methods of treatment on each. Lind writes, “The consequence was, that the most sudden and visible good effects were perceived from the use of oranges and lemons.”

The RCT eventually became firmly established as the most reliable way to test medical interventions. The following passage, from Abdelhamid Attia, an M.D. and professor of obstetrics and gynecology at Cairo University in Egypt, conveys its dominance:

The importance of RCTs for clinical practice can be illustrated by its impact on the shift of practice in hormone replacement therapy (HRT). For decades HRT was considered the standard care for all postmenopausal, symptomatic and asymptomatic women. Evidence for the effectiveness of HRT relied always on observational studies[,] mostly cohort studies. But a single RCT that was published in 2002 . . . has changed clinical practice all over the world from the liberal use of HRT to the conservative use in selected symptomatic cases and for the shortest period of time. In other words, one well conducted RCT has changed the practice that relied on tens, and probably hundreds, of observational studies for decades.

A randomized controlled trial divides participants into different groups on a randomized basis. At least one group receives an “intervention,” or treatment, that is generally tested against a control group not receiving the intervention. The twofold strength of an RCT is that it allows researchers to isolate one variable—to test whether a given intervention causes an intended effect—while at the same time making it very hard for researchers to produce their own preferred outcomes.

This is true at least so long as an RCT’s findings are based on “intention-to-treat” analysis, whereby all participants are kept in the treatment group to which they were originally assigned and none are excluded from the analysis, regardless of whether they actually received the intended treatment. Eric McCoy, an M.D. at the University of California, Irvine, explains that intention-to-treat analysis avoids bias and “preserves the benefits of randomization, which cannot be assumed when using other methods of analysis.”

Such other methods of analysis include subgroup, multivariable, and per-protocol analysis. Subgroup analysis is susceptible to “cherry-picking”—as researchers hunt for anything showing statistical significance—or to being swayed by random chance. In one famous example, aspirin was found to help prevent fatal heart attacks, but not in the subgroups where patients’ astrological signs were Gemini or Libra.

“Multivariable analysis,” writes Marlies Wakkee, an M.D. and Ph.D. at Erasmus University Medical Center in the Netherlands, “only adjusts for measured confounding”—that which a researcher decides is worth examining. (Confounders are extra variables that affect the analysis; for example, eating ice cream may be found to correlate with sunburns, but heat is a confounding variable influencing both.) She adds, “This is a significant difference compared to randomized controlled trials, where the randomization process results in an equal distribution of all potential confounders, known and unknown.”

Per-protocol analysis departs from randomization by basically allowing participants to self-select into, or out of, an intervention group. McCoy writes, “Empirical evidence suggests that participants who adhere [to research protocols] tend to do better than those who do not adhere, regardless of assignment to active treatment or placebo.” In other words, per-protocol analysis is more likely to suggest that an intervention, even a fake one, worked. Of these three departures from intention-to-treat analysis, per-protocol analysis is perhaps the most extreme.

With these different methods of analysis in mind, it becomes easier to evaluate the 14 RCTs, conducted around the world, that have tested the effectiveness of masks in reducing the transmission of respiratory viruses. Of these 14, the two that have directly tested “source control”—the oft-repeated claim that wearing a mask benefits others—are a good place to start.

A 2016 study in Beijing by MacIntyre, et al. that claimed to find a possible benefit of masks did not prove very informative, as only one person in the control group—and one in the mask group—developed a laboratory-confirmed infection. Much more illuminating was a 2010 study in France by Canini, et al., which randomly placed sick people, or “index patients,” and their household contacts together into either a mask group or a no-mask control group. The authors “observed a good adherence to the intervention,” meaning that the index patients generally wore the furnished three-ply masks as intended. (No one else was asked to wear them.) Within a week, 15.8 percent of household contacts in the no-mask control group and 16.2 percent in the mask group developed an “influenza-like illness” (ILI). So, the two groups were essentially dead even, with the sliver of an advantage observed in the control group not being statistically significant. The authors write that the study “should be interpreted with caution since the lack of statistical power prevents us to draw formal conclusion regarding effectiveness of facemasks in the context of a seasonal epidemic.” However, they state unequivocally, “In various sensitivity analyses, we did not identify any trend in the results suggesting effectiveness of facemasks.”

With the two RCTs that directly tested source control providing essentially no support for the claim that wearing a mask benefits others, what about RCTs that test the combination of source control and wearer protection? By dividing participants into a hand-hygiene group, a hand-hygiene group that also wore masks, and a control group, three RCTs allow us to see whether the addition of masks (worn both by the sick person and others) provided any benefit over hand hygiene alone.

A 2010 study by Larson, et al. in New York found that those in the hand-hygiene group were less likely to develop any symptoms of an upper respiratory infection (42 percent experienced symptoms) than those in the mask-plus-hand-hygiene group (61 percent). This statistically significant finding suggests that wearing a mask actually undermines the benefits of hand hygiene.

A multivariable analysis of this same study found a significant difference in secondary attack rates (the rate of transmission to others) between the mask-plus-hands group and the control group. On this basis, the authors maintain that mask-wearing “should be encouraged during outbreak situations.” However, this multivariable analysis also found significantly lower rates in crowded homes—“i.e., more crowded households had less transmission”—which tested at a higher confidence level. Thus, to the extent that this multivariable analysis provided any support for masks, it provided at least as much support for crowding.

Two other studies found no statistically significant differences between their mask-plus-hands and hands-only groups. A 2011 study in Bangkok by Simmerman, et al. observed very similar results for both groups. A CDC-funded 2009 study in Hong Kong by Cowling, et al. observed that the hands-only group generally did better than the mask-plus-hands group, but not to a statistically significant degree. Subgroup analysis by Cowling, et al., limited to interventions started within 36 hours of the onset of symptoms, found that the mask-plus-hands group beat the control group to a statistically significant degree in one measure, while the hands-only group beat the control group to a statistically significant degree in two measures. Summarizing this study, Canini writes that “no additional benefit was observed when facemask [use] was added to hand hygiene by comparison with hand hygiene alone.”

So, if masks don’t improve on hand hygiene alone, what about masks versus nothing?

Various RCTs have studied this question, with evidence of masks’ effectiveness proving sparse at best. Aside from a 2009 study in Japan by Jacobs, et al.—which found that those in the mask group were significantly more likely to experience headaches and that “face mask use in health care workers has not been demonstrated to provide benefit”—only two RCTs have produced statistically significant findings in intention-to-treat analysis, and one of those studies contradicted itself.

The previously mentioned 2011 study in Bangkok by Simmerman, et al. found that the secondary attack rate of ILI was twice as high in the mask-plus-hand-hygiene group (18 percent) as in the control group (9 percent), a statistically significant difference. (The ILI rate was 17 percent in the hand-hygiene-only group.) Finding essentially the same thing in multivariable analysis, the researchers wrote that, relative to the control group, the odds ratios for both the mask-plus-hands group and the hands-only group “were twofold in the opposite direction from the hypothesized protective effect.”

Subsequently, a small 2014 study—with 164 participants—by Barasheed, et al. of Australian pilgrims in Saudi Arabia, staying in close quarters in tents, found that significantly fewer people in the mask group developed an ILI than in the control group (31 percent to 53 percent). Unlike the exact fever specifications utilized in other RCTs, however, this study accepted self-reporting of “subjective” fever in determining whether someone had an ILI. Lab tests revealed opposite results, with twice as many participants having developed respiratory viruses in the mask group as in the control group. These lab-test findings were not statistically significant; still, the lab tests’ greater reliability makes it far from clear that the masks in this study provided any genuine benefit.

Other RCTs found no statistically significant benefit from masks in intention-to-treat analysis. A 2008 pilot study by Cowling et al. in Hong Kong observed that secondary attack rates, using the CDC’s definition of ILI, were twice as high in the mask group (8 percent) as in the hand hygiene (4 percent) or control (4 percent) groups, but these observed differences were not statistically significant.

Other methods of analysis, deviating from intention-to-treat analysis, found the following.

A per-protocol analysis of a 2009 study in Sydney by MacIntyre, et al. found a significant effect when combining the surgical-mask group with a group wearing N95 hospital respirators. However, the authors write, a “causal link cannot be demonstrated because adherence was not randomized.”

In subgroup analysis of 2010 and 2012 studies in Michigan by Aiello, et al., limited to the final several weeks of the respective studies, each study’s mask-plus-hands group had significantly lower rates of ILI than its control group, while its mask-only group did not. In 2010, the results for the mask-only group also hinted at a slight benefit, reducing ILI by an observed (but not statistically significant) 8 percent to 10 percent. In 2012, the authors concluded, “Masks alone did not provide a benefit.” They nevertheless recommended the combination of mask use and hand hygiene, despite not having tested whether that combination works better than hand hygiene alone.

A multivariable analysis of a smallish (218 participants) 2012 study in Germany by Suess, et al. found that combining the mask group and mask-plus-hands group, while limiting analysis to interventions begun within 48 hours, produced a finding of significantly lower levels of lab-confirmed influenza (but not of ILI) in that combined group (but not in either group separately). The authors, from Berlin, recommended masking and hand hygiene, while opining, “Concerns about acceptability and tolerability of the interventions should not be a reason against their recommendation.”

The only RCT to test mask-wearing’s specific effectiveness against Covid-19 was a 2020 study by Bundgaard, et al. in Denmark. This large (4,862 participants) RCT divided people between a mask-wearing group (providing “high-quality” three-layer surgical masks) and a control group. It took place at a time (spring 2020) when Denmark was encouraging social distancing but not mask use, and 93 percent of those in the mask group wore the masks at least “predominately as recommended.” The study found that 1.8 percent of those in the mask group and 2.1 percent of those in the control group became infected with Covid-19 within a month, with this 0.3-point difference not being statistically significant.

This study—the first RCT on Covid-19 transmission—apparently had difficulty getting published. After the study’s eventual publication, Vinay Prasad, an M.D. at the University of California, San Francisco, described it as “thoughtful,” “useful,” and “well done,” but noted (with criticism), “Some have turned to social media to ask why a trial that may diminish enthusiasm for masks and may be misinterpreted was published in a top medical journal.”

Meanwhile, the CDC website portrays the Danish RCT (with its 4,800 participants) as being far less relevant or important than the observational study of Missouri hairdressers with no control group, dismissing the former as “inconclusive” and “too small” while praising the latter, amazingly, as “showing that wearing a mask prevented the spread of infection”—when it showed nothing of the sort.

Each of the RCTs discussed so far, 13 in all, examined the effectiveness of surgical masks, finding little to no evidence of their effectiveness and some evidence that they might actually increase viral transmission. None of these 13 RCTs examined the effectiveness of cloth masks. “Cloth face coverings,” according to former CDC director Robert Redfield, “are one of the most powerful weapons we have.”

One RCT tested these masks that so many high-profile public-health officials have touted. This “first RCT of cloth masks,” in the trial’s own words (it is apparently still the only one), was a 2015 study by MacIntyre, et al. in Hanoi, Vietnam. A relatively large study, with over 1,100 participants, it tested cloth masks against surgical masks and did not feature a no-mask control group. The trial tested the protection of health-care workers, instructing them to wear a two-layer cloth mask at all times on every shift (“except in the toilet or during tea or lunch breaks”) across four weeks.

The study found that those in the cloth-mask group were 13 times more likely (2.28 percent to 0.17 percent) to develop an influenza-like illness than those in the surgical-mask group—a statistically significant difference. The trial also lab-tested penetration rates and found that while surgical masks were “poor” at preventing the penetration of particles—letting 44 percent through—cloth masks were “extremely poor,” letting 97 percent through. (N95 hospital respirators let 0.1 percent through.)

The authors write that wearing a cloth mask “may potentially increase the infection risk” for health-care workers. “The virus may survive on the surface of the facemasks,” they explain, while “a contaminated cloth mask may transfer pathogen from the mask to the bare hands of the wearer,” which could lead to hand hygiene being “compromised.” As for double-masking, the authors write, “Observations during SARS suggested double-masking . . . increased the risk of infection because of moisture, liquid diffusion and pathogen retention.” Absent further research, they conclude, “cloth masks should not be recommended.”

MacIntyre and several other authors of this study, perhaps under pressure from the CDC or other entities with similar agendas, released what the CDC calls a “follow up study,” in September 2020. This follow-up isn’t really a study at all, certainly not a new RCT, yet the CDC cites it favorably while disparaging the original study, which, the CDC asserts, “had a number of limitations.” This 2020 follow-up pretty much amounts to publishing the finding that when hospitals washed the cloth masks, health-care workers were only about half as likely to get infected as when they washed the cloth masks themselves. Still, the 2020 publication says, “We do not recommend cloth masks for health workers,” much as the 2015 one said.

Other reviews of the evidence have been mixed but generally have come to similar conclusions. Certain masking advocates admit that the RCT evidence is “inconclusive” but cite other forms of evidence that have held up poorly. A study for Cochrane Reviews by Jefferson, et al. that examines 13 of the 14 RCTs discussed herein (all but the Denmark Covid-19 study) notes “uncertainty about the effects of face masks” and writes that “the pooled results of randomised trials did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks during seasonal influenza.” Meantime, a study by Perski, et al., which performed a Bayesian analysis on 11 of the 14 RCTs discussed herein, concluded that when it comes to “the benefits or harms of wearing face masks . . . the scientific evidence should be considered equivocal.” They write, “Available evidence from RCTs is equivocal as to whether or not wearing face masks in community settings results in a reduction in clinically- or laboratory-confirmed viral respiratory infections.”

In sum, of the 14 RCTs that have tested the effectiveness of masks in preventing the transmission of respiratory viruses, three suggest, but do not provide any statistically significant evidence in intention-to-treat analysis, that masks might be useful. The other eleven suggest that masks are either useless—whether compared with no masks or because they appear not to add to good hand hygiene alone—or actually counterproductive. Of the three studies that provided statistically significant evidence in intention-to-treat analysis that was not contradicted within the same study, one found that the combination of surgical masks and hand hygiene was less effective than hand hygiene alone, one found that the combination of surgical masks and hand hygiene was less effective than nothing, and one found that cloth masks were less effective than surgical masks.

Hiram Powers, the nineteenth-century neoclassical sculptor, keenly observed, “The eye is the window to the soul, the mouth the door. The intellect, the will, are seen in the eye; the emotions, sensibilities, and affections, in the mouth.” The best available scientific evidence suggests that the American people, credulously trusting their public-health officials, have been blocking the door to the soul without blocking the transmission of the novel coronavirus.