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A very long and well constructed discussion of the science surrounding the effectiveness, or lack thereof, of wearing a mask to stop the spread of a viral contagion.
Orofecal transmission?
Where do we begin on masks? How about infection fatality rate/IFR?
How did we get here?
Article continues much more at the link.
The question on whether to wear a face mask or not during the Covid-19 pandemic remains emotional and contentious. Why? This question about the utility of face coverings (which has taken on a talisman-like life) is now overwrought with steep politicization regardless of political affiliation (e.g. republican or liberal/democrat).
Importantly, the evidence just is and was not there to support mask use for asymptomatic people to stop viral spread during a pandemic. While the evidence may seem conflicted, the evidence (including the peer-reviewed evidence) actually does not support its use and leans heavily toward masks having no significant impact in stopping spread of the Covid virus.
In fact, it is not unreasonable at this time to conclude that surgical and cloth masks, used as they currently are, have absolutely no impact on controlling the transmission of Covid-19 virus, and current evidence implies that face masks can be actually harmful. All this to say and as so comprehensively documented by Dr. Roger W. Koops in a recent American Institute of Economic Research (AIER) publication, there is no clear scientific evidence that masks (surgical or cloth) work to mitigate risk to the wearer or to those coming into contact with the wearer, as they are currently worn in everyday life and specifically as we refer to Covid-19.
We present the evidence in full below. We also state that should adequate evidence emerge that supports the effectiveness of surgical and cloth masks in this Covid pandemic (or any similar type masks), then we will change our position and conclude otherwise. Our focus is on face masks for Covid but we will touch gently on the issue of school closures and lockdowns, as these three issues remain the key public health policy catastrophes we have faced as global societies.
Back in August 2020, a survey by Pew indicated that 85% of Americans wore masks when in public all or most of the time. So, the public has been using masks extensively.
Importantly, the evidence just is and was not there to support mask use for asymptomatic people to stop viral spread during a pandemic. While the evidence may seem conflicted, the evidence (including the peer-reviewed evidence) actually does not support its use and leans heavily toward masks having no significant impact in stopping spread of the Covid virus.
In fact, it is not unreasonable at this time to conclude that surgical and cloth masks, used as they currently are, have absolutely no impact on controlling the transmission of Covid-19 virus, and current evidence implies that face masks can be actually harmful. All this to say and as so comprehensively documented by Dr. Roger W. Koops in a recent American Institute of Economic Research (AIER) publication, there is no clear scientific evidence that masks (surgical or cloth) work to mitigate risk to the wearer or to those coming into contact with the wearer, as they are currently worn in everyday life and specifically as we refer to Covid-19.
We present the evidence in full below. We also state that should adequate evidence emerge that supports the effectiveness of surgical and cloth masks in this Covid pandemic (or any similar type masks), then we will change our position and conclude otherwise. Our focus is on face masks for Covid but we will touch gently on the issue of school closures and lockdowns, as these three issues remain the key public health policy catastrophes we have faced as global societies.
Back in August 2020, a survey by Pew indicated that 85% of Americans wore masks when in public all or most of the time. So, the public has been using masks extensively.
Understanding the transmission of this respiratory SARS-CoV-2 pathogen is also evolving given evidence of orofecal spread as having a potentially larger contributor role in non-respiratory transmission of Covid. As an example, a recent open-evidence review brief by Oxford researchers (Jefferson, Brassey, Heneghan) and its publication in CEBM, reveals the growing recognition that SARS-CoV-2 can infect and be shed from the gastrointestinal (GI) tract of humans. Orofecal spread demands urgent study and if orofecal spread is shown to be definitive and more consequential in Covid transmission, then this could impact mitigation strategies beyond those for respiratory transmission.
So why would we continue this way with these unsound and very punitive restrictive policies and for so long once the factual characteristics of this virus became evident and as alluded to above, we finally realized that its infection fatality rate (IFR) which is a more accurate and realistic reflection of mortality than CFR, was really no worse than annual influenza?
How did we arrive at the confusion and misinformation surrounding mask use which is our focus, yet by extension, the crushing societal lockdowns and harmful school closures? There are serious harms and downsides due to these crushing restrictive policies and we understand that one would think reflexively if there is a pathogen, we should just lock and shut everything down and away. We understand this initial instinct.
However, there are benefits and risks to any action and the harms of these lockdowns and school closures far outweighed the benefits based on what has transpired. We even knew this soon after implementing lockdowns yet we continued catastrophic policies and are still continuing. How did we get here societally? How have our government bureaucratic leaders failed so disastrously?
However, there are benefits and risks to any action and the harms of these lockdowns and school closures far outweighed the benefits based on what has transpired. We even knew this soon after implementing lockdowns yet we continued catastrophic policies and are still continuing. How did we get here societally? How have our government bureaucratic leaders failed so disastrously?
Perhaps one of the most seminal and rigorous studies (along with the Danish study published in the Annals of Internal Medicine) emerged from a United States Marine Corps study performed in an isolated location; Parris Island. As reported in a recent NEJM publication (CHARM study), researchers studied SARS-CoV-2 transmission among Marine recruits during quarantine. Marine recruits at Parris Island (n=1,848 of 3,143 eligible recruits) who volunteered underwent a 2-week quarantine at home that was followed by a 2nd 2-week quarantine in a closed college campus setting.
As part of the study, participants wore masks and socially distanced while symptoms were monitored with daily checks of temperature. RT-PCR testing was used to assess the effectiveness of these strategies insofar as the presence or absence of SARS CoV-2 mRNA was concerned. Samples were obtained by the use of nasal swabs which were collected between arrival and the 2nd day of supervised quarantine and on days 7 and 14 (the 2nd quarantine used to mitigate infection among recruits). All recruits were required to have a negative RT-PCR result prior to entering Parris Island. It was found that within 2 days following arrival on the closed campus, 16 participants now tested positive for SARS-CoV-2 mRNA (15 being asymptomatic) and 35 more tested positive on day 7 or on day 14 (n=51 in total).
More specifically, of the 1,801 recruits who tested negative with PCR at study enrollment, 24 (1.3%) tested positive on day 7. On day 14, a total of 11 of 1,760 (0.6%) of the previously PCR-test negative participants tested positive; none of these participants were seropositive on day 0. As such, 35 participants who had had negative PCR test results within the first 2 days post arrival at the campus then became positive during the strict supervised quarantine. Of the 51 total participants who had at least one positive PCR test, 22 had positive tests on more than 1 day. Phylogenetic analysis was conducted whereby 6 independent monophyletic transmission clusters (independent viral strains) indicative of local transmission were uncovered during the supervised quarantine. The majority of clusters principally included members of the same platoon, and numerous infected recruits had an infected roommate.
The authors reported that about 2% who had earlier negative tests for SARS-CoV-2 at the beginning of strict supervised quarantine (we ask the reader to think; military grade supervision), and less than 2% of recruits who had unknown prior status, tested positive by day 14. Positive volunteers were mainly asymptomatic and transmission clusters occurred within platoons. The predominant finding was that despite the very strict and enforced quarantine (including 2 full weeks of supervised confinement and then forced social distancing and masking protocols), the rate of transmission was not reduced and in fact seemed to be higher than expected! Hence, we point out that not only was masking ineffective in preventing the spread of disease, but even made things worse. Despite quarantines, social distancing, and masking, in this cohort of mainly young male recruits, roughly 2% still went on to become infected and tested positive for SARS-CoV-2. Sharing of rooms and platoon membership were reported risk factors for viral transmission.
As with the Danish investigation this study of Marine recruits who were kept under stringent military level supervision raises serious questions about the utility of quarantines, as it appears that not only do masks appear to be ineffective in preventing communal disease spread but also that quarantines do not work even when supervised for 2 weeks in a closed college. As we have stated elsewhere, it seems that quarantines are ineffective and that would also seem to include enforced social distancing!
As part of the study, participants wore masks and socially distanced while symptoms were monitored with daily checks of temperature. RT-PCR testing was used to assess the effectiveness of these strategies insofar as the presence or absence of SARS CoV-2 mRNA was concerned. Samples were obtained by the use of nasal swabs which were collected between arrival and the 2nd day of supervised quarantine and on days 7 and 14 (the 2nd quarantine used to mitigate infection among recruits). All recruits were required to have a negative RT-PCR result prior to entering Parris Island. It was found that within 2 days following arrival on the closed campus, 16 participants now tested positive for SARS-CoV-2 mRNA (15 being asymptomatic) and 35 more tested positive on day 7 or on day 14 (n=51 in total).
More specifically, of the 1,801 recruits who tested negative with PCR at study enrollment, 24 (1.3%) tested positive on day 7. On day 14, a total of 11 of 1,760 (0.6%) of the previously PCR-test negative participants tested positive; none of these participants were seropositive on day 0. As such, 35 participants who had had negative PCR test results within the first 2 days post arrival at the campus then became positive during the strict supervised quarantine. Of the 51 total participants who had at least one positive PCR test, 22 had positive tests on more than 1 day. Phylogenetic analysis was conducted whereby 6 independent monophyletic transmission clusters (independent viral strains) indicative of local transmission were uncovered during the supervised quarantine. The majority of clusters principally included members of the same platoon, and numerous infected recruits had an infected roommate.
The authors reported that about 2% who had earlier negative tests for SARS-CoV-2 at the beginning of strict supervised quarantine (we ask the reader to think; military grade supervision), and less than 2% of recruits who had unknown prior status, tested positive by day 14. Positive volunteers were mainly asymptomatic and transmission clusters occurred within platoons. The predominant finding was that despite the very strict and enforced quarantine (including 2 full weeks of supervised confinement and then forced social distancing and masking protocols), the rate of transmission was not reduced and in fact seemed to be higher than expected! Hence, we point out that not only was masking ineffective in preventing the spread of disease, but even made things worse. Despite quarantines, social distancing, and masking, in this cohort of mainly young male recruits, roughly 2% still went on to become infected and tested positive for SARS-CoV-2. Sharing of rooms and platoon membership were reported risk factors for viral transmission.
As with the Danish investigation this study of Marine recruits who were kept under stringent military level supervision raises serious questions about the utility of quarantines, as it appears that not only do masks appear to be ineffective in preventing communal disease spread but also that quarantines do not work even when supervised for 2 weeks in a closed college. As we have stated elsewhere, it seems that quarantines are ineffective and that would also seem to include enforced social distancing!
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