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Are Masks Useful After All? Not Likely.
Until a week or two ago, all I’d heard in a long time about masks indicated they were doing more harm than good. Sure, it made sense when we thought we might have a child-killer spreading through coughing. But then, even back in 2020, we starting hearing that Covid doesn’t hurt kids much. We also learned that the virus doesn’t spread much by coughing. It’s aerosolized; it spreads through infected people just breathing it out, and when they do it’s small enough to go both through and around cloth masks and regular surgical masks. And then Omicron came., replicating in the outer airways 70 times as fast as Delta, which was already a much faster-spreading virus than the original Covid.
There’s no stopping this thing with masks, which are not harmless in any case, and little to no slowing of it. Don’t trust me, of course. I’m a dang philosopher. Trust reliable sources on the internet–if you can find any. But does that count the New England Journal of Medicine? Some authors there say masks can at least prevent the spread of the virus.
Some Problems with the NEJM Article
Now there are any other problems with the article’s reasoning. It doesn’t stick to medical science, and spins its own supposed discoveries as a great way of fighting structural racism. It ignores the harm done by masks–the unhealthiness of breathing through sweaty face diapers, the developmental delays in small children who can’t see adults’ mouths when they’re trying to learn how to talk, the cruelty to asthmatics. It ignores the relative harmlessness of Omicron–generally ranging from mild cold to bad flu, and that’s only for the people who actually have symptoms. It ignores the fact that probably somewhere between 75 and 95 percent of us have had some kind of Covid by now anyway.
Basically, as it seems to me, there’s no awareness of the need to do any cost-benefit analysis. Nor of the superior abilities of people, who know their own situation better than centralized bureaucrats, to do their own analysis for their own dang selves.
Still, if there really is some actual evidence here that masks really do have the benefit of preventing some Covid infections, I would like to know that. My early-2020 optimism about masks has since given way to a deep pessimism about masks. Was I wrong then, or am I wrong now?
The Article’s Main Argument
So let’s look at the NEJM article’s argument for that conclusion. From what I can understand, these guys are comparing Boston schools without mask requirements and Boston schools with mask requirements and finding that during the April-June Omicron spike there were more positive Covid cases in the schools that lifted mask requirements.
Something like . . . 45/1,000 more people getting Covid over a space of 15 weeks.
This is illustrated in the article’s Figure 1, which shows higher Covid rates for the schools that dropped the mask mandates.
They conclude from this that the lack of masks is likely the reason these schools had more Omicron cases.
Ok. Seems to make sense. And, to their credit, they make some effort to rule out other possible causes–e.g., the schools that kept the mask mandates and had less Covid were also the ones that had worse “ventilation or filtration systems,” so when some schools had higher Covid rates it wasn’t because they had worse air systems.
But I’m kind of interested in something else: Figure 2. If I’m reading it properly, the same schools with the higher Covid rates after dropping mask requirements also had higher Covid rates during the December-January spike.
So this raises a darn big question: How are we supposed to know whether these schools were not just more prone to getting Covid for some reason not considered in the article? (There are plenty of possible explanations I can think of–something about their location, schoolkids’ parents’ jobs, or what a few clusters of first-graders sometimes do on the weekend–and many more I can’t even think of.) The reason they got even more Covid during the next Omicron spike is simply that the next version of Omicron was spreading even faster.
That was my initial, provisional concern with the article.
Other Problems with the Article
Apparent Dr. Vinay Prasad had some objections as well. Dr. Prasad says this study is not a randomized control trial; it’s just an observational study. But a randomized control trial is what we need. This would not be difficult, but Fauci is against it, and won’t fund it, and instead we’re funding these “observational studies that fit a certain narrative.”
That’s an important objection! Do you remember why they were saying back in 2020 that chloroquine didn’t have good science in its favor? It was because it didn’t have any randomized controlled studies–you know, the kind we still apparently don’t have for masks either.
Sheesh.
Dr. Prasad recommends reading this piece on Substack by Dr. Tracy Beth Høeg. It’s a nice, detailed look at many things wrong with the NEJM piece. I don’t notice Høeg looking over my particular concern, but I am pleased that she, Dr. Prasad, and I are all worried about other causes of a difference in Covid rates that the article does not sufficiently rule out.
And golly–Dr. Høeg did a great job critiquing the NEJM article! Her article has some of the same concerns as Dr. Prasad. It also has this insight: The NEJM study assumes that Covid spread outside of school is caused by Covid spread inside school, and not vice versa. That’s a heckuvan assumption there. And Høeg links to some other studies that indicate little to no benefit of masks.
“Let Us Hear the Conclusion of the Whole Matter”
Not that I find all this easy to understand. But if I’m provisionally trusting someone, whom am I going to trust–the freethinker on Substack or the establishmentarians jabbering about structural racism and calling it medical science?
In short, the NEJM article notwithstanding, it is still perfectly reasonable to think that masks are not useful against Covid–that they are doing more harm than good. As far as I can tell, the available evidence still points to that conclusion.
Published in General
Yes. Theory has a lot of valid uses. For example, asking what does virus laden condensate building up in and permeating the mask really stop? Viruses from being expelled out the front? Viruses working their way through the material and being inhaled? These are important things to consider.
There’s simple diffusion, capillary action, condensation, evaporation and recondensation. Then there’s agitation, which includes the mask flexing during breathing and movement during speaking or compressing the mask when you grasp it, all in addition to things like capillary action.
Even if the outer (or inner) 20% of the thickness of the mask “catches droplets” either being breathed in or out, that increases the mask’s “viral load”. Viral load is at least partly indicative transmissibility, and the viral load of a mask makes each breath either inhaled or exhaled more infectious (if any virus is present at all).
But besides this, when I’m in my optometrist’s office and he is wearing a mask that falls down from his nose with every syllable he speaks, and he cursorily uses his thumb and forefinger every third word to reposition his mask, and then he handles his tools and puts them into contact with my face, theory takes a back seat to simple clean technique.
So what does it matter if his breath is being filtered or not? Or if his nose is continually outside the mask, if he’s not able to do his job using simple cleanliness? (And frankly, he can’t.) I don’t care about fomites or virus’ survivability on certain surfaces if he’s in effect touching his nose and immediately touching my eye ball.
If anything his mask wearing is worse than farcically ineffectual, in reality it’s actually increasing the potential for transmission. That is, if he has any virus in his system anyway, and if my immune system is not capable of dealing with minor viral loads and of preventing infection.
Just saw this on the new Twitter. https://twitter.com/Kerry_Berry12/status/1597357885503295488/photo/1
Why do young people have such flawless skin?
A combination of feeling good from virtue signaling and lots of makeup is my guess.
That the eye docs haven’t been shut down is evidence of the fallacy. If masks were effective when used correctly, but aren’t in these settings, everyone would get Covid from the doc and they’d shut it down as a superspreader location.
Nope. Because it isn’t. It’s largely theatre for low-risk humans.
Barely any good.
I have seen articles that support masks and those that say they say they aren’t that effective if at all. Neither strike me as totally honest. Only the n-95 mask is worth the effort. But then they must fit properly and not be reused. Fiddling with them just increases your chance of infecting yourself. However, it can filter about 95% (n-95) of particles .3 nm or larger. Covid is smaller, .1 nm, but might be attached to larger particles. The nature of the mask’s filtration system allows it to catch some smaller particles.
All those blue disposable masks and cloth masks are of little to no use. Their boxes say as much in the fine print. Masking children in school was child abuse.
N/KN-95 masks are single use and cost $1-$2 each. People reused them, rendering their effectiveness almost useless.
Masks are a pain. Even the cloth mask I used deprived me of oxygen. I was always pulling it down to get my breath back. I would sit in bathroom stalls so I could take it off and breathe for a few minutes. I was fighting little chest coughs when I had to wear them.
Covid – 19 is endemic. I must either wear a minimally effective mask the rest of my life even though Covid will find me sooner or later or I can toss the mask, deal with covid when I get it, and live life normally. I chose the latter.
I lived normally for most of covid, caught it in July, and kicked it off quickly. Now I have natural immunity. Almost all my masks are packed away. I keep token ones in my purse in case a medical office requires one. If I am sick, I stay home.
The article’s headline (ie BeckerNews) is wrong on the meaning of the study and a case of poor journalism. The second line in the article: “The results from the RCT study deal a major blow to advocates of N95 and surgical masks as effective means to “stop Covid.”-is clearly an incorrect interpretation of the study. The study in Annals, itself, doesn’t show masks don’t work-it just shows that surgical masks are not inferior to N95 masks. The study only compared surgical masks to N95, it had no group of unmasked controls. If you try to claim the data shows X, you need to be sure that is what the data evaluated. We have too much scientific hubris as it is, we do not need to add extrapolating far beyond the science (that is what the left did when it said we need to keep lock downs).
In any event, COVID is now endemic & we need to learn to live with it.
Ok, surgical masks are not inferior to N95s, so N95s are not superior to surgical masks, and we already knew surgical masks are not worth the trouble they cause, so N95s are also not worth the trouble they cause.
Yes.
And not wear masks.
There is more to it than mask pore size and virus size. The respiratory system is vulnerable to only certain range of particle sizes. Things too small are breathed in and out without sticking. Things too big are filtered by nose and throat. But particles of the right size go in and stick. Particles about 1 micron are optimal. That is why asthma inhalers make particles that size.
This article has more than you want to know about the fluid dynamics of coughing and sneezing. It has some great high speed photography of coughs and sneezes. The chart below shows that most droplets are too big to an issue. However smaller droplets will degrade and may linger in the air. My advice is avoid being the same room/same air as someone that is symptomatic.
The webpage keeps crashing when I try to access it on my iPad. Do you recall where these numbers fall within the parameters of a “viral load ” for covid?
I prefer to mostly go without a mask. If I have a cold, I will stay home but wear a mask if I must go out. I keep 15 cloth masks and a box of cheap disposables. I like single use then wash, if I must, which means don’t put mask back on if I have coughed or sneezed into it. This means either leave on or use a new one every time I put on a mask. This gets to expensive with n-95s, and too grungy, so I know others are probably reusing masks and might be more of a risk to me than the unmasked.
I accept Covid is here to stay and want my body to develop gas much natural immunity to it before I turn 75 in a few years. I have had covid once and don’t fear it as anything more then a nuisance now that I know my body can throw it off.
The article did not cover viral load. It was all mechanics: particle size, distances, distribution vectors.
My solution was to find a mask so thin that you can breathe normally. I could find no such thing on Amazon – clearly their policy was to not allow such a thing. But I got this on Etsy:
https://www.etsy.com/ca/listing/905828163/single-layer-active-sports-face-mask
Works perfectly – you don’t even notice you’re wearing it. The marketing picture shows that you can see through it to the model’s face, but in practice it is black enough and others do not see through it.
Of course it is completely useless for stopping the spread of an aerosol virus, but so is every single mask everyone else is wearing.
Since I was making my own cloth marks, I considered doing that
I wish you lived in my town. Neither my wife nor I have doctors right now because I refuse to go to someone who is incapable of engaging in (or who lacks the humility to engage in) the sort of reasoning you’ve just described.
I simply refused to wear one at all. Pretending to do so, in my mind was just as bad as actually doing it. I can think of fewer more outright totalitarian and unjustifiable policies than forcing masks on people, and we should have taken up arms to fight it. Of course we didn’t, but I want going to play along, either. Got kicked out of a few businesses, but other than that it was just fine.
My advice is to let your immune system handle it. Because that’s why you have one.
Science denier!