The Man in the Porous Mask

Emergency

On Monday, January 30th, President Biden announced an ending of the national emergency and public health emergency declarations. The emergency declarations will be expiring on May 11th. The measures were of course put in place in response to the COVID-19 pandemic that rocked our homes, communities, and the entire globe. President Biden’s announcement nearly lined up with the release of the largest comprehensive study on the effects of some of the COVID measures that were put in place over the course of the last couple of years.

While the great bulk of COVID policies are no longer in place, I find it important to consult scientific evidence that can teach us where we went right and where we went wrong so that we can appropriately plan for the future. The study performed by the Cochrane group looked at different measures such as surgical masks, N95 masks, cloth masks, social distancing, handwashing, surface disinfection, and other measures to test their effectiveness during the pandemic.

Cochrane

According to Wikipedia, Cochrane is a “British international charitable organisation formed to organise medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients, and policy makers. It includes 53 review groups that are based at research institutions worldwide. Cochrane has approximately 30,000 volunteer experts from around the world.” Founded in 1903, the group “Conducts systematic reviews of health-care interventions and diagnostic tests and publishes them in the Cochrane Library.”

In an editorial from The Canadian Medical Association, they noted, “Cochrane reviews appear to be more up to date and of better quality than other reviews” describing them as “The single best resource for methodologic research and for developing the science of meta-epidemiology.” The organization has been credited with leading to methodological improvements in the medical literature.

The purpose of credentialing this organization of researchers from around the world is so that the data that I am going present from their recent study isn’t perceived to be obtained from Alex Jones’ “My First Science Kit.”

Respiratory Viruses

Before getting into the study, first, we must have a baseline understanding of respiratory viruses and how they spread. “Respiratory viruses are viruses that infect the cells in your airways: nose, throat, and lungs. These infections can cause serious problems and affect normal breathing. They can cause flu (influenza), severe acute respiratory syndrome (SARS), and COVID-19. People infected with a respiratory virus spread virus particles into the air when they cough or sneeze. Other people become infected if they come into contact with these virus particles in the air or on surfaces on which they land. Respiratory viruses can spread quickly through a community, through populations and countries (causing epidemics), and around the world (causing pandemics).”

The Study

Physical interventions to interrupt or reduce the spread of respiratory viruses.

What did we want to find out?

“We wanted to find out whether physical measures stop or slow the spread of respiratory viruses from well-controlled studies in which one intervention is compared to another, known as randomised controlled trials.”

What did we do?

“We searched for randomised controlled studies that looked at physical measures to stop people acquiring a respiratory virus infection. We were interested in how many people in the studies caught a respiratory virus infection, and whether the physical measures had any unwanted effects We identified 78 relevant studies. They took place in low-, middle-, and high-income countries worldwide: in hospitals, schools, homes, offices, childcare centres, and communities during non-epidemic influenza periods, the global H1N1 influenza pandemic in 2009, epidemic influenza seasons up to 2016, and during the COVID-19 pandemic. We identified five ongoing, unpublished studies; two of them evaluate masks in COVID-19. Five trials were funded by government and pharmaceutical companies, and nine trials were funded by pharmaceutical companies. No studies looked at face shields, gowns and gloves, or screening people when they entered a country.”

Background: “Viral epidemics or pandemics of acute respiratory infections (ARIs) post a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID-19) caused by SARS-COV-2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID-19 pandemic.”

Objective: “To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses.”
Selection Criteria: “We included randomised controlled trials (RCTs), and cluster RCTs investigating physical interventions (screening at entry portals, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission.”

Main Results

“We included 11 new RCTs and cluster RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID-19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID-19 pandemic.”

Medical or surgical masks 

Ten studies took place in the community, and two studies in healthcare workers. Compared with wearing no mask in the community studies only, wearing a mask may make little to no difference in how many people caught a flu-like illness/COVID-like illness (9 studies; 276,917 people); and probably makes little or no difference in how many people have flu/COVID confirmed by a laboratory test (6 studies; 13,919 people). Unwanted effects were rarely reported; discomfort was mentioned. 

N95/P2 respirators

Four studies were in healthcare workers, and one small study was in the community. Compared with wearing medical or surgical masks, wearing N95/P2 respirators probably makes little to no difference in how many people have confirmed flu (5 studies; 8407 people); and may make little to no difference in how many people catch a flu‐like illness (5 studies; 8407 people), or respiratory illness (3 studies; 7799 people). Unwanted effects were not well‐reported; discomfort was mentioned.

Surface/Object disinfection compared to control

Two studies tested multi component interventions and observed no significant difference in ARI (acute respiratory infection) outcomes.

Cloth Masks

In one trial cloth masks were associated with a significantly higher risk of both ILI nad laboratory-confirmed respiratory virus in healthcare workers. In addition, filtration capacity of the two-ply cotton cloth masks was found to be only 3% and markedly less than with medical/surgical masks based on standardised particle testing. The authors suggested moisture retention, poor filtration, and penetration of the virus through the mask as plausible explanations for the increased risk of infection.

Hand Hygiene

Following a hand hygiene programme may reduce the number of people who catch a respiratory or flu‐like illness, or have confirmed flu, compared with people not following such a programme (19 studies; 71,210 people), although this effect was not confirmed as statistically significant reduction when ILI (influenza-like infection) and laboratory‐confirmed ILI were analysed separately. Few studies measured unwanted effects; skin irritation in people using hand sanitiser was mentioned.

Physical distancing/quarantine compared to control

We identified one trial that evaluated the effect of quarantine and found a reduction in influenza transmission to co‐workers when those with infected household members stayed home from work (Miyaki 2011),. However, staying home increased their risk of being infected two‐fold. Two studies conducted during the COVID‐19 pandemic on SARS‐cov‐2 transmission showed (1) non‐inferiority of daily contact testing of school‐based contacts (intervention) compared to self‐isolation (control) (Young 2021); and (2) access to fitness centres with physical distancing and low population prevalence of SARS‐CoV‐2 infection did not increase risk of SARS‐cov‐2 infection (Helsingen 2021).

Copyright © 2023 The Authors. Cochrane Database of Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The Cochrane Collaboration.

THE (political) SCIENCE

Many of the covid measures taken on federal, state, and individual levels proved to be disastrous. Under the guise of “Safety” and “Compassion for your community,” we were fear-mongered into going along with measures that were tangibly ineffective and in fact harmed the community, country, and broader world. A trend that only becomes exacerbated by social media incentivization is the need to virtue to the world one’s self-perceived superior sense of moral virtue. Although often coming from a well-intentioned place, good intentions such as “We need to shut down schools and society” can turn out to have disastrous net-negative effects.

The purpose of putting this together is not an attempt to shame anyone or for some sort of perverse, “I told you so.” Any error on the side of the public I do not attribute to a lack of intelligence or malicious intent, I consider it a product of having too much implicit trust in our institutions that led to fear-induced panic and psychological groupthink. I do not intend to return the “Mask-shaming” and I have no issue at all with people who choose to wear masks, I am simply wanting to show that science-based evidence that runs counter to the one “Approved narrative” does not equate to being a conspiracy theory. Natural immunity, for example, was demonized and made out to be some sort of a pseudo-conspiracy theory despite it being common knowledge that natural immunity is by far the most effective means of immunity. I cannot help but wonder if this was somehow related to Pfizer’s record revenue total of $100 billion in 2022 alone. The same Pfizer that pays our politicians and media institutions hundreds of millions of dollars.

An issue that I do have with the public, regardless of where it comes from or what it’s about, is the forcing of a thought process onto a group of people of a different perspective. Whatever the issue may be, it is important that we seek to look from the perspectives of others and listen to them, perhaps we can learn something that we did not know.

Science is more than a body of knowledge, it is a way of thinking. A way of skeptically interrogating the universe with a fine understanding of human fallibility. If we are not able to ask skeptical questions, to interrogate those who tell us that something is true, to be skeptical of those in authority, then we’re up for grabs for the next charlatan, political or religious who comes ambling along. It’s a thing Jefferson laid great stress on. It wasn’t enough, he said, to enshrine some rights in the constitution or bill of rights, the people had to be educated and they had to practice their skepticism and their education. Otherwise, we don’t run the government, the government runs us.”

Carl Sagan

The typical mask you buy in the drug store is not really effective in keeping out virus, which is small enough to pass through the material. It might, however, provide some slight benefit in [keeping] out gross droplets if someone coughs or sneezes on you.”

Anthony Fauci