“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.””
“Late last year, the owner of snowmobile rental business Canyon Adventures filed a complaint with the code compliance office of Gallatin County, Montana, against the nearby Corral Bar and Steakhouse. It alleged the bar’s own snowmobile rental business wasn’t allowed by the property’s zoning.
The county’s code compliance office agreed that the snowmobile business wasn’t allowed by the zoning code. But rather than slapping the Corral Bar owners with a fine or shutting them down, the Bozeman Daily Chronicle reported yesterday that the county closed the case without taking any enforcement action.
The reason? According to a sweeping law passed by the Montana Legislature in April 2021 aimed at prohibiting mask mandates, the county can’t compel “a private business to deny a customer of the private business access to the premises or access to goods or services.” It also can’t adopt ordinances that deny customers the same access to those goods and services.
Importantly, H.B. 257 also stops governments from applying fines, revoking licenses, filing criminal charges, or bringing “any other retributive action” against business owners for not complying with a law forcing them to reject customers.
The language of the new state law is broad. So broad that, in a number of instances, Gallatin County officials have interpreted it to mean they can’t penalize businesses for violating the county’s zoning code.
“Each individual circumstance is going to be judged on its own,” says Gallatin County Attorney Marty Lambert to Reason.
He declined to speculate on the full extent of H.B. 257. But, Lambert says, when there’s a county law or regulation that falls within the scope of H.B. 257 and has the effect of forcing a private business to refuse a customer, then the county can’t take “retributive action” against the business for servicing that customer anyway.
In those cases, the county is forbidden from using any “remedies that might be available under the ordinance,” he says. “[H.B. 257] is all-encompassing, and it was meant to be all-encompassing.”
In the Corral Bar case, county officials reasoned that they couldn’t punish the bar for running an unpermitted snowmobile rental because that would involve compelling it to deny customers a service in violation of H.B. 257.
The Chronicle reports that Gallatin County officials have declined to bring enforcement actions in at least eight zoning cases because of H.B. 257’s restrictions, including ones involving illegal Airbnbs and a summer camp that opened up in a residential zone.”
“The Biden administration is betting that Covid infections for most people are now so mild that it’s safe for much of the country to go maskless, a strategy helping the White House avoid political backlash against stricter safety requirements.
But that strategy comes with the risk that millions of Americans, including the healthy and vaccinated, could suffer long-term health effects from Covid infections.
The policy could leave millions with a lifetime of little understood disease or medical complications. Those who get infected are at higher risk of brain shrinkage, blood clots, heart disease, strokes and diabetes, studies show. A separate post-viral syndrome called long Covid can cause a range of debilitating symptoms from cognitive dysfunction to extreme fatigue, according to federal estimates.”
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“This is why many public health experts say the Biden administration’s focus on preventing hospitalizations over infections is a poor strategy, one that ignores the potential of millions of newly sick or disabled Americans further straining the health care system and potentially worsening the labor shortage.”
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“Some public health experts agree with the administration’s approach, noting that for most people, vaccines provide strong protection against severe illness and death, and individuals should manage their own risk.
The country is averaging more than 37,000 infections per day, up about 45 percent over the last two weeks, according to the Centers for Disease Control and Prevention. Those figures are likely undercounted given the prevalence of rapid tests, which aren’t often reported to health departments.”
“That is saying a lot, because the scientific justification for the TSA’s rule has always been weak, given that the conditions on airplanes are not conducive to COVID-19 transmission. The ventilation systems on commercial aircraft, which mix outdoor air with air recycled through HEPA filters and limit airflow between rows, help explain why there were few outbreaks associated with commercial flights even before vaccines were available.
“The risk of contracting COVID-19 during air travel is low,” an October 2020 article in The Journal of the American Medical Association noted. “Despite substantial numbers of travelers, the number of suspected and confirmed cases of in-flight COVID-19 transmission between passengers around the world appears small.”
Sebastian Hoehl, a researcher at the Institute for Medical Virology at Goethe University Frankfurt in Germany, concurred in an interview with Scientific American the following month. “An airplane cabin is probably one of the most secure conditions you can be in,” he observed.”
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“On February 25, the Centers for Disease Control and Prevention (CDC) stopped recommending general indoor masking in parts of the country it rates as “low” or “medium” risk, which as of last week covered more than 98 percent of the U.S. population. According to the CDC, then, it is safe to dispense with masks in stores, churches, schools, bars, and restaurants—environments where the risk of virus transmission is much higher than it is on airplanes.
Yet the TSA said it extended its mask rule “at CDC’s recommendation” so the agency could develop “a revised policy framework” based on “the latest science.” Mask rules for transportation are complicated, said Jen Psaki, the White House press secretary, because people are “moving from one zone to another”—an explanation that makes little sense when virtually the entire country is in the same “zone” as far as the CDC’s mask advice goes.”
“for millions of Americans, many of whom have chronic conditions or disabilities that make them especially vulnerable to Covid-19, the pandemic is far from over.”
“Late last year, Laura Wing-Kamoosi visited her 79-year-old father at the hospital in northern Michigan. To her surprise, a worker asked her to remove her N95 and replace it with a surgical mask. She declined, layering the surgical mask atop her N95 instead.
She saw no staff wear N95s, among the best respiratory protection available, while they treated her father for a tear in his aorta and other medical issues, she told POLITICO. One doctor wore his surgical mask under his nose, she said. Her father, who was hospitalized for about a month, contracted Covid-19 during his stay, and while he survived, the virus slowed his recovery.
The hospital, Munson Healthcare, said it requests visitors wear the surgical masks it provides to ensure people are using quality masks and that it allows visitors to layer one over their own. The hospital is following guidance from the Centers for Disease Control and Prevention — and for many public health advocates, that’s exactly the problem.
They fear that surgical masks put the most vulnerable people at higher risk of catching Covid-19. N95s, which seal tighter to the face, offer better protection against the airborne virus, studies show. For more than a year, many have called on the Biden administration to change its guidance to offer more protection inside hospitals, even as mitigation measures have been dialed back and case counts decline.
And yet, patients across the country say they are often told to replace their N95s with surgical masks as they enter hospitals.”
“Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. But as Flam notes, “the benefits of universal masking have been difficult to quantify” in the real world, where cloth models predominate and masks may not be clean, well-fitted, or worn properly.
The strongest real-world evidence in favor of general masking comes from a randomized trial in Bangladesh, which found that the use of surgical masks reduced symptomatic infections by 11 percent. That’s not nothing, but it’s a pretty modest effect, and it was achieved with surgical masks worn by adults in conditions that encouraged proper and consistent use. The same study found that cloth masks did not have a statistically significant effect.”
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“Given the situation during the omicron surge, there are additional reasons to doubt that mask mandates, even with perfect compliance, had much of an impact. While mandates required shoppers to don masks before entering supermarkets, for example, the risk of transmission in such settings is low, given the amount of time customers usually spend in them, the size of the air space, and typically wide distances between patrons. Conditions in bars and restaurants are more conducive to virus transmission, since customers spend more time there in closer proximity to each other, often while talking. But since people were allowed to remove their masks while eating and drinking, requiring them to cover their faces upon entry was more a symbolic gesture than a serious safeguard.
Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. Even if masking works, that does not necessarily mean mandates do.
An Annals of Epidemiology study published last May found that mask mandates in the United States were associated with lower transmission rates from June through September 2020. “The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening,” the researchers reported. But the study did not take into account other policies or voluntary safeguards that may have differed between jurisdictions with and without mask mandates. Nor did it look at actual mask wearing, as opposed to legal requirements.
Based on data from various countries and U.S. states from May to September 2020, a preprint study published last June found that general mask wearing was associated with a reduction in virus transmission. But the researchers found no clear relationship between mask mandates and mask use. “We do not find evidence that mandating mask-wearing reduces transmission,” the authors reported. “Our results suggest that mask-wearing is strongly affected by factors other than mandates.”
An August 2021 systematic review of 21 observational studies found that all of them “reported SARS-CoV-2 benefits” from mask mandates “in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes.” But “few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing.”
Like the debate about lockdowns, the debate about mask mandates will continue. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. But it seems clear that anyone who takes it for granted that mask mandates have played a crucial role in controlling the spread of COVID-19 is making a series of assumptions that are not justified by the evidence.”
“pediatric hospitalizations are occurring almost exclusively among kids who are not vaccinated. Most school-age children are eligible to have been vaccinated, but most school-age children have not yet been vaccinated. Depending on what numbers you look at, only around 50 to 60 percent of kids ages 12 to 17 have been fully vaccinated, and only around 25 percent of kids ages 5 to 11.”
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“today is not the day to remove mask mandates in schools. Rather, you want to wait until case rates are much lower than they are today. Not simply for the sake of kids, but also so that children aren’t bringing the disease home. But governors are up against political pressures.
The important thing to highlight here is that many of the governors who have lifted mask mandates in the last couple of days have said that the mandates will be lifted for schools three or four weeks in the future, not today. And three or four weeks in the future, chances are that case rates will be lower, so by then it actually will be much safer to remove the mask mandates without putting kids and communities at high risk, just because there won’t be a lot of circulating COVID.”
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“There are a number of observational studies showing that communities and schools that have universal masking have lower rates of COVID-19 among kids in the school, and a couple of studies suggesting higher rates of transmission within schools that forego masking. And of course, there are many more studies in adults and kids in general — really, the preponderance of evidence supports that masks work, and they work for kids as well as for adults.”