“Jason Abaluck is a Yale behavioral economist and the co-author of a study of masking interventions in Bangladesh that provided the single largest randomized controlled trial we have that looks at the effects of encouraging people to wear masks during the Covid pandemic. His research found a significant reduction in Covid cases in the villages that encouraged masking.
When I talked with him this week, he emphasized that his finding — even if it’s eventually supported by further research — is only one piece of the puzzle when it comes to figuring out masks.
“There’s a couple distinct questions that are getting conflated here,” he told me. Here are some of them:
“If you wear a mask while there’s a pandemic, are you less likely to get sick?”
“If you wear a mask while you have a respiratory illness, are you less likely to infect other people?”
“If you make people less likely to get sick during a pandemic, does that have lasting benefits to them, or does it just delay an infection without significantly changing their long-term health outcomes? Does it reduce transmission enough to change the overall dynamics of the pandemic?”
“If you tell people to wear masks, will they actually wear masks correctly and reliably?”
“If you mandate that people wear masks, will they actually wear masks correctly and reliably?”
“What are the costs, to the median person and to a person who is unusually affected by wearing masks, of wearing masks?””
“Laboratory experiments provide good reason to believe that masks, especially N95s, can reduce the risk that someone will be infected or infect other people. But those experiments are conducted in idealized conditions that may not resemble the real world, where people often choose low-quality cloth masks and do not necessarily wear masks properly or consistently.
Observational studies, which look at infection rates among voluntary mask wearers or people subject to mask mandates, can provide additional evidence that general mask wearing reduces infection. But such studies do not fully account for confounding variables.
If people who voluntarily wear masks or live in jurisdictions that require them to do so differ from the comparison groups in ways that independently affect disease transmission, the estimates derived from observational studies will be misleading. Those studies can also be subject to other pitfalls, such as skewed sampling and recall bias, that make it difficult to reach firm conclusions.
Despite those uncertainties, the CDC touted an observational study that supposedly proved “wearing a mask lowered the odds of testing positive” by as much as 83 percent. It said even cloth masks reduced infection risk by 56 percent, although that result was not statistically significant and the study’s basic design, combined with grave methodological weaknesses, made it impossible to draw causal inferences.”
…
“If wearing a mask had the dramatic impact that the CDC claimed, you would expect to see some evidence of that in RCTs. Yet the Cochrane review found essentially no relationship between mask wearing and disease rates, whether measured by reported symptoms or by laboratory tests. Nor did it confirm the expectation that N95s would prove superior to surgical masks in the field. The existing RCT evidence, the authors said, “demonstrates no differences in clinical effectiveness.””
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“Does the Cochrane review prove that masks are worthless in protecting people from COVID-19? No. But it does show that the Centers for Disease Control and Prevention (CDC) misled the public about the strength of the evidence supporting mask mandates”
“The U.S. Department of Energy has concluded that the most likely origin of COVID-19 is a lab leak.
The federal agency reviewed new intelligence, which prompted officials to revise their position that it’s unclear how the virus emerged. The White House and certain members of Congress also reviewed the intelligence, The Wall Street Journal reports.
The Energy Department’s conclusion is made with “low confidence,” according to The New York Times, which was quick to point out that “U.S. spy agencies remain divided over the origins of the virus.” The FBI previously concluded with “moderate confidence” that intelligence pointed to a lab leak origin; other agencies have been skeptical or undecided.
The shifting consensus on this issue should be a cautionary tale for all the would-be censors who thunderously objected to such talk. In the first year of the pandemic, the idea that COVID-19 might have emerged from a coronavirus research facility in Wuhan, China, was widely branded a racist conspiracy theory. Social media companies such as Facebook vigorously suppressed discussion of the lab leak thesis, partly because U.S. health officials and mainstream news outlets expressed absolute confidence that COVID-19 emerged as a result of zoonotic spillover.”
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“Health officials and intelligence experts may not have enough information to conclusively determine COVID-19’s origins. But the push to not merely decry the lab leak theory but to actively prohibit discussion of it—as was the case on Facebook—has not aged well.”
“”We find that excess inflation is significantly correlated to each country’s own domestic stimulus and to various exposures of foreign stimulus,” concluded a trio of economists at the St. Louis Federal Reserve in a report published last month. In the U.S., they found that “fiscal stimulus during the pandemic contributed to an increase in inflation of about 2.6 percentage points.”
That’s a significant increase, even if it doesn’t account for the full run-up of inflation that took place during the past 18 months. Price increases accelerated in late 2021 and throughout 2022, ultimately peaking at an annualized rate of 9.1 percent in June.
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“Other recent reviews of COVID-era stimulus bills have come to a similar conclusion. In a paper published in September, economists at Johns Hopkins University and the Chicago Federal Reserve said “fiscal inflation” accounted for “approximately half” of the recent price increases.
That’s troubling, they added, because “fiscal inflation tends to be highly
persistent…When inflation has a fiscal nature, monetary policy alone may not provide an effective response.”
So far, the chief response to inflation has been a monetary one.””
“The wearing of masks to prevent the spread of COVID-19 and other respiratory illnesses had almost no effect at the societal level, according to a rigorous new review of the available research.
“Interestingly, 12 trials in the review, ten in the community and two among healthcare workers, found that wearing masks in the community probably makes little or no difference to influenza-like or COVID-19-like illness transmission,” writes Tom Jefferson, a British epidemiologist and co-author of the Cochrane Library’s new report on masking trials. “Equally, the review found that masks had no effect on laboratory-confirmed influenza or SARS-CoV-2 outcomes. Five other trials showed no difference between one type of mask over another.”
That finding is significant, given how comprehensive Cochrane’s review was. The randomized control trials had hundreds of thousands of participants, and made useful comparisons: people who received masks—and, according to self-reporting, actually wore them—versus people who did not. Other studies that have tried to uncover the efficacy of mask requirements have tended to compare one municipality with another, without taking into account relevant differences between the groups. This was true of an infamous study of masking in Arizona schools conducted at the county level; the findings were cited by the Centers for Disease Control and Prevention (CDC) as reason to keep mask mandates in place.”
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“While individual mask wearers might get some benefit for a while if they consistently, perfectly wear masks, this does not comport with the aggregate experience.”
“That review, published by the Cochrane Library, an authoritative collection of scientific databases, analyzed 18 randomized controlled trials (RCTs) that aimed to measure the impact of surgical masks or N95 respirators on the transmission of respiratory viruses. It found that wearing a mask in public places “probably makes little or no difference” in the number of infections.”
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“The authors suggest several possible explanations for these results, including “poor study design,” inconsistent or improper mask use, “self-contamination of the mask by hands,” “saturation of masks with saliva,” and increased risk taking based on “an exaggerated sense of security.””
“Warp Speed deserves substantial credit for saving lives in the early pandemic. Companies making crucial parts for the vaccine have credited Warp Speed’s special authorizations with getting their power turned back on in minutes after an outage and convincing vendors to cut their production times from 75 days to 7. Negotiated partnerships for every part of the supply chain — from glass vials to syringes to packaging for shipping — enabled a rapid rollout. Even the Defense Department got involved in logistics, flying equipment and vaccines from place to place.”
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“Immunologist Moncef Slaoui, who headed Warp Speed under the Trump administration, spent years before the pandemic advocating for a simple, cheap measure that would have made it possible to develop vaccines even faster: maintaining idle capacity so the country can respond to emergencies.
As he told Science in a 2021 interview:
“The whole concept—after we went through the flu pandemic, the Ebola outbreak, the Zika outbreak—was to say, “Listen, the problem is always the same, which is there are no manufacturing facilities sitting there idle, waiting to be used. Even if we had one, we would have trouble because we would have to stop manufacturing other vaccines, which are essential for saving people’s life. So we thought, “Why don’t we take a dedicated facility and have them work on discovering vaccines against known potential outbreak agents, one after the other?” They would become incredibly skilled and trained at going fast, discovering vaccines. The company was prepared to make available the facility and ask just for the cost of running it. Unfortunately, it didn’t fly.””
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“That investment? Didn’t happen. Before the pandemic, some of this country’s smartest experts spent years telling us that a pandemic was coming and would be catastrophic, but that we could prepare and substantially mitigate the harms. We didn’t.
During the pandemic, we developed significant expertise in vaccine development and distribution, which we easily could have leveraged into maintaining capacity for rapid vaccine development to prevent the next pandemic. We didn’t.”
“Infectious disease experts knew this year might be an outlier. Covid-19 has been the biggest disruption to the normal cycle of disease in a century, and we know from prior experience that major pandemics can be followed by a year or two of chaotic viral behavior before settling into a more normal pattern. It happened with both the 1918 flu and the 2009 H1N1 pandemic.
For RSV and influenza, the past two years have been aberrations; it is reasonable to expect more normal patterns will resume in the future as immunity builds back up. (Still, every cold-and-flu season will be different — variation from season to season is a constant.)
“My guess is that this is entirely temporary and things will settle down into more routine patterns in coming seasons as typical population immunity gets back on track,” said Richard Webby, an infectious disease researcher at St. Jude Children’s Research Hospital.
Covid-19 is trickier to project, given its continuing evolution toward more transmissibility. So far, the protection from prior infection and vaccines seems to be effective for most people, at least in preventing them from ending up in the hospital. But it also continues to pose a threat to the unvaccinated, the elderly, and the immunocompromised — and yearly surges when the conditions are more favorable for viral spread (i.e., the winter) are to be expected.”