Since I learned in April 2020 that transmission of covid was mainly via extremely small aerosols, I have regarded face masks as a placebo: they are to aerosols what garden gates are to mosquitoes. Yet, placebos have a role so I wasn’t too against them and willing to have my assessment overturned by new insights. After all, face masks might not stop aerosols, but they made many people feel better and might unexpectedly work in some other way against covid, such as by changing behaviour or changing the way the air flows into noses, or whatever. 16 months later, I am more against them because a multi-billion dollar industry has arisen that thrives on creating a mask-waste mountain and is thus heavily invested in their continued use, just as the industry of hand sanitizers, tests, and others. I personally found masks a nuisance to wear and an overt sign of submission. I have a like-minded friend in Sydney going around Sydney shops with a guy fawkes mask as a quiet symbol of defiance against compulsory masks.

I want to share two external reviews on masks of two different groups I have been following. One is a group of largely retired UK doctors who assembled in 2020: the HART group that looks at all the medical science around covid. The people involved in that group write on personal title, so one knows who the advice is from, which is a big plus. The second is a pre-existing’ Swiss policy research’ group formed in 2016. It is a bit like the research version of wikileaks and seems to have found its origin largely in concerns for press freedom and suspicion of the CIA, which is why its contributors are anonymous (which I understand, but dont like, particularly not as a sole source of information). SWPR took it upon itself early on to wade through the science of covid so as to come to its own assessment.

I have found the combination of them useful. SWPR is not so good in understanding the models or being consistent about what explains covid-outcomes, but is good at classic medical stuff (treatments, trials) and media manipulation. The HART group is good on covid measurement issues, medical organizational matters, and has better modelers on their team, but it largely stays away from political economy and is less prepared to venture guesses about origins and such. Yet, both have taken reasonable lines on things for which there is little doubt. Both those sources for instance say vaccines reduce covid severity. These sources have not always agreed the last 18 months and I have noted technical issues in areas I have particular expertise where they didn’t quite understand what some sophisticated empirical studies were saying, but I have learned to lean on them for useful summary takes. I haven’t detected an obvious bias. Here is what the HART people say about masks (https://www.hartgroup.org/masks/):

Contrary to the Government message that it ‘follows the science’, the sudden change in advice by the WHO was not based on any new, high-quality scientific studies. By summer 2020, there was substantial evidence that non-medical masks for the general public did not reduce the transmission of respiratory viruses. A review of 14 controlled studies had concluded that masks did not significantly lessen the spread of seasonal ‘flu in the community.[] A Norwegian Institute for Public Health review found that non-medical masks achieve no benefit for healthy individuals, particularly when viral prevalence is low.[] From a common sense angle, scientists had argued that cloth masks contain perforations that are far too big to act as a viral barrier and therefore ‘offer zero protection against COVID-19’.[]

Inevitably, the public often wear masks incorrectly, or improperly handle them when putting them on, or removing them, constituting an additional infection hazard. There has been recognition of this contamination risk in the scientific literature[] and other researchers have cautioned against the use of cloth face coverings.[] Potential harms to the wearer include exhaustion, headaches, fatigue and dehydration.[] Some doctors have suggested an increased risk of pneumonia.[] Furthermore, the widely varying physical characteristics of the face coverings used by people in the community, that are not standardised for material, fit, length of wearing, changes after washing and drying, and disposal, means that laboratory research on mask efficacy cannot be generalised to real-world situations.

With particular reference to COVID-19, the only large randomised controlled trial exploring the benefits of adopting face coverings in the community found that masks (even the surgical variety) did not result in a significant reduction in infection risk for the wearer.[] A detailed analysis[] of all research investigations, including those purported to suggest that masks might achieve some benefits, led to the view that there is ‘little to no evidence’ that cloth masks in the general population are effective.

Masks impair verbal communication, render lip-reading impossible for the deaf, and stymie emotional expression, the latter effect potentially constituting a gross impediment to children’s social development. Acting as a crude, highly visible reminder that danger is all around, face coverings are fuelling widespread, irrational fear.

Wearing a mask will heighten the distress of many people with existing mental health problems and may trigger ‘flashbacks’ for those historically traumatised by physical and/or sexual abuse. Sadly, going without a mask (even as a means of avoiding psychological distress) can often attract harassment and further victimisation. In response to this, ‘exemption lanyards’ have been developed, which further stigmatise those who cannot wear face coverings due to health conditions or previous trauma.

Note that this is their summary conclusion, which did not go over the more positive studies that one would like to see discussed. Continue reading →