And So We Finally Learn Just How Effective Mask Mandates Really Are

Spoiler alert: not very.  That is the conclusion of one of the most recent studies, that found--surprise!--no robust correlation between COVID case growth rates and either mask mandates or even mask usage rates across the USA.  This dovetails rather nicely with that iconoclastic Danish study from last year, plus literally decades worth of research as well.  Look, you can cherry-pick the data all you like to get the results you want, as some previous studies have, but dare to include just enough inconvenient data and the whole house of cards collapses faster than you can say, "A-HA!  So THAT'S why Americans universally stopped wearing these things in the spring of 1919, returned to normal, and didn't look back for over 100 years!"

And people will probably keep debating the mask question 100 years from now as well, given how it is one of the oldest debates in public health history.  Granted, we do not discount that masks, at least higher quality ones, may very well be at least marginally effective in selected instances.  But for the general population across the board, in the realest of real-world settings?  Well, if you really believe that, we've got a nice bridge we'd like to sell you.

(And an even bigger bridge to sell those who believe masks were what caused the flu to practically disappear for over a year now.  Hey, try to explain how it also practically disappeared in Florida, Georgia, South Dakota, and Sweden then. Go on.)

It's essentially a classic macro-micro problem, where just because something may work at the micro level, it does NOT follow that it will also work at the macro level.  The same goes for quarantines, the macro level equivalent of which being indiscriminate, population-wide lockdowns (instead of just the sick).  Some things simply don't scale very well at all!

Voluntary mask wearing may simply be a classic placebo, where the wearers may simply be more cautious in general, while forced/coerced mask wearing may lead the wearers to be less cautious in general than they otherwise would, a phenomenon that has also been observed with mandatory seatbelt laws.  (To be fair, unlike mask mandates, seatbelt laws do still seem to have a net lifesaving effect regardless, albeit to the chagrin of pedestrians and cyclists.)

Honestly, if they did work at the macro level, then in any place with a broad mask mandate like most states and localities had (or at least mask usage rates above 80%, like practically all of the USA eventually was for a while), the pandemic would have been over within two weeks, three weeks tops.  And then masks would have thus made themselves obsolete.  Yes, some otherwise highly intelligent and knowledgeable mask advocates actually predicted (over a year ago, no less) that would happen, which in turn influenced even the TSAP's own formerly pro-mask mandate position as an alternative to lockdowns at the time (a position which we now deeply regret).  Yet alas, that clearly did NOT happen--for obvious reasons.  

And so, once the proper statistical controls (timing, seasonality, previous exposure, etc.) are employed, the statistical mirage of spurious correlation is thus debunked, deboned, sliced, diced, julienned, and its remains have been completely laid waste.

Game. Set. Match.

The TSAP actually supported mask mandates (albeit with nuance) from April/May up until about August 2020, half-supported them until December, and since then we have generally opposed them and currently we support repealing them in their entirety, as was done in 1919 nationwide and has already been done in most states (including those who never had such mandates at all) as of late May 2021.  That includes schools too, by the way, especially for students, as even the CDC now subtly admits that school mask mandates for students did NOT show any statistically significant benefit no matter how much they tried to torture the data.  (Apparently, the only thing that robustly and reliably works in schools is to ventilate, ventilate, ventilate, which actually makes sense for what we know now is in fact a predominantly airborne virus.)  Nor do we support discrimination against anyone by vaccination status either.

Look, if YOU personally want to keep wearing a mask, fine, more power to you.  Ditto if you want to avoid people who don't wear them, fine, keep your distance then.  Problem solved.  But currently we see no valid or compelling reason to continue to force people to wear them, in public or private.  Since when did this become such a controversial position to take?

From the looks of it at face value, Fauci may have indeed been largely right the first time when he initially pooh-poohed masks and actually told us not to touch our faces, and we're certainly old enough to remember that.  And it's not like mask mandates have actually led to faster reopenings or averted lockdowns either.  So whatever merits there are to individual mask wearing in whatever circumstances, there is no valid reason for any government to force them on anyone (outside of a healthcare setting), period, and it should be left to individuals and businesses to decide for themselves. 

By the same token, it looks like the WHO was also right the first time in that regard as well.  Even as recently as July 2020, believe it or not.

Kinda like when they let it slip in June 2020 that truly asymptomatic spread, while possible, is a lot rarer than most people think, a mere 0.7% even in that very closest and riskiest setting of all, within households.  Only to be forced to walk it back the very next day, of course.  And outdoor spread?  A vanishingly low 0.1% of cases.  And fomites (surfaces)?  An even lower still < 0.01%, and probably even less than that if people wash their hands and don't touch their faces or keep fiddling with their masks!  All for a disease with an infection fatality rate within the ballpark of a nasty flu season for most people, and that we know now how to treat effectively.  This is what the actual science says.  And it utterly demolishes the need for lockdowns, closures, mask mandates, or any other New Abnormal restrictions at this juncture, period.

See also here as well for a good explanation of the crucial difference between large droplets (that masks do seem to work for) and much smaller aerosols (which basically go right through and/or around essentially ALL masks other than properly fit-tested N95s).  It is the latter that seem to be a bigger driver of transmission, unfortunately, and worse, since they tend to penetrate deeper into the lungs, they also tend to make you sicker too.  Thus, we should not be at all surprised by the null effects of universal community masking at the macro level.  In fact, even the "variolation" theory is basically turned on its head as well--larger droplets would probably provide better "variolation" than aerosols would, ironically.

As for children, see here for a good and thorough debunking of the notion that forcing them to wear masks in school and elsewhere is somehow necessary, effective, or benign.  Even the WHO says that children under 5 years of age should not wear masks at all, children ages 6-11 should only wear them in certain circumstances, and children of any age with various kinds of disabilities or health conditions should not be required to wear them at all.  The CDC, on the other hand, apparently prefers to steamroll over anything even remotely resembling nuance in that regard.

See also here as well for an excellent article about how continued universal masking may even be harmful in the long run for all ages.  All the more reason NOT to make this practice permanent in any sense, and to phase it out completely in nearly all circumstances. We ignore actual science at our peril.

UPDATE:  The American Academy of Pediatrics (AAP) announced that they recommend that children ages 2-11 (!) continue to wear masks and socially distance until they are fully vaccinated (despite the fact that no COVID vaccine has been authorized yet for children under the age of 12, and even if there were, safety concerns would still remain due to the relative lack of clinical trial data for that age group).  All for a disease that is less deadly than the flu for kids, and about as deadly as chickenpox (the reader may even be old enough to remember chickenpox parties for kids up until the early 1990s before that vaccine came out), and furthermore that they rarely transmit to adults (a majority of whom are anyway either fully vaccinated or very soon to be).  Seriously?  Talk about some grade-A gaslighting and triangulation there, that would make even the most malignant narcissistic abuser blush!  We will all one day look back on this dark time in history with utter horror and disbelief, and alas today's youngest generation may never fully recover.  To the AAP, we have one question for you:  how does it feel to be on the wrong side of history?  Because we really wouldn't know anything about that.

And the CDC's much-hyped, supposed "increase" in teen hospitalizations is based on outdated data, and many of those are likely incidental positives when hospitalized for non-COVID reasons, particularly psychiatric admissions that have increased due to the lockdown-induced mental health crisis that is has been hitting young people particularly hard.

And finally, the Earth will thank us as well when we finally do belatedy ditch these (mostly plastic) masks for good, but alas, the damage to the oceans is done.

JUNE UPDATE:  One nuance that gets glossed over by both pro-mask and anti-mask folks is the issue of presymptomatic transmission, as the Swiss Doctor notes.  While truly asymptomatic transmission is indeed quite rare, presymptomatic transmission may actually be quite common, as is the case with influenza (albeit with COVID having a more gradual onset of symptoms than influenza).  It is a brief window of usually 1-2 days, though sometimes up to 4 days between peak viral load and (known) symptom onset.  Regardless though, masks still don't work for aerosol transmission, which would be especially predominant in such instances given the lack of large sneezing and coughing droplets.  The only thing that really works for aerosols is good ventilation, as well as perhaps air filters and UV light.  Masks are to aerosol viruses as chain-link fences are to mosquitoes.

And lest you still credit masks with the apparently success of East Asian countries in keeping death rates so low, a better explanation would be the near-absence of obesity in these countries, along with perhaps previous exposure to other related coronaviruses.  Especially judging from these countries' performance during past flu seasons, during which masks seemed to make no difference. 

People keep citing a North Carolina school study as "proof" that "masks work!", but since that study lacked a mask-optional school control group for comparison (i.e. all schools in the study mandated masks for everyone ages 5 and older), it says literally NOTHING about the effectiveness of masks.

And another school study looking at Florida, New York, and Massachusetts found no correlation between school mask mandates and COVID case rates for students OR staff after adjusting for confounders.  Not only that, but greater in-person student density was actually associated with fewer COVID cases, not more.  This dovetails with the cross-sectional CDC study that looked at Georgia schools between November 16, 2020 and December 11, 2020 and found no statistically significant effect of student mask mandates.  And it also strongly implies that the latter study's apparent correlation between staff mask mandates and fewer cases was most likely spurious and driven by selection bias, endogeneity, and/or confounding from community case rates, especially since the former study looked a much longer time period than the latter one, and also controlled for community case rates.  Thus, this new study should really be the final nail in the coffin in terms of mask mandates, particularly for schools.  Game. Set. Match.

And see here and here as well.

AUGUST UPDATE:  Looks like there is even more evidence that masks are basically useless and little more than window dressing overall.  That is true even for adults, let alone for children to whom it applies a fortiori to.  The pro-mask side of what passes for "debate" really can't rely honestly on science anymore, so they increasingly resort to censorship and ad hominem attacks instead.  Ten years from now, if not much sooner, we guarantee that they will regret their stance just like they did not long after 1918.

SEPTEMBER UPDATE:  About that poorly-designed Bangladesh study that the pro-maskers are claiming "proves" once and for all that "masks work!", well, it clearly doesn't prove that at all.  It also says nothing at all about children, schools, or mandates, since neither of these were studied at all by this study.  The best it possibly says is that voluntary use of surgical masks when combined with distancing MIGHT work modestly at the margin in VERY selected instances (even if only a placebo effect as a universal symbol for "keep your distance!"), while cloth masks (i.e. the most commonly used kind) are basically completely useless, and it only goes downhill from there.