BY @HOLD2LLC (MIT ANTI-MASKER NETWORK CHARTER MEMBER)
This summary reviews information published between October 2019 and December 2020.
The purpose is to see what was known and believed before and after discovery of SARS-CoV-2 (COV2).
WHO NPIs for Influenza (Oct 2019)
We’ll start with research on epidemic/pandemic influenza (flu) from the World Health Organization (WHO) in October of 2019.
Aerosols vs. Droplets
Do we really know how COV2 spreads? Is it via aerosols or respiratory droplets? If this is still not fully understood for flu, do we even know how COV2 is transmitted?
Is seasonality a known phenomenon recognized by the WHO? Why don’t we hear it mentioned when predicting and explaining the waves that keep occurring according to seasonality?
The text below is on page 2 of the Introduction in the WHO Global Influenza Programme document titled “Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza.”
Dr. Edgar Hope-Simpson tracked global influenza patterns from 1965 to 1974 and published those findings in The Transmission of Epidemic Influenza. This image shows the monthly likelihood for a flu outbreak across latitude ranges that cover the United States: North Temperate and North Tropical.
We re-visualized that data and lined up the months with the United States outbreak, which became detectable March of 2020. The charts below show N. Temperate and N. Tropical separately and then overlaid.
Intended impact of NPIs
Does the image below look familiar? This was published in October of 2019 by WHO but was previously referenced in CDC and ECDC publications in 2017 and 2018.
Why does this “flatten the curve” image always go to 0 with no resurgence and have no values on either axis?
Let’s look at NY and FL for fun.
Note that this 2019 WHO document is the first update since the 2009-2010 H1N1 pandemic and consists of “an updated review of all available evidence on the effectiveness of NPIs in mitigating the risk and impact of influenza epidemics and pandemics, and will contribute to preparations for the next pandemic.” As we know, the COV2 pandemic had probably already started by the time this was published.
Evaluation of the evidence
Order of quality (best to worst) for the evidence provided in the WHO Oct 2019 guidance:
Randomized Controlled Trials (RCTs)
How many RCTs on masks have been done since the discovery of COV2? None besides DANMASK, which attempted to measure the self-protection efficacy of community masking but not whether masks serve as source control.
How about the CDC review in this document of 14 RCTs covering NPIs in the community? Yes, this was for flu (and hand hygiene) but coming into COV2, it was the official summary of the available information. The highlighted text will be a theme as we move forward, specifically “although mechanistic studies support the potential effect…”
Summary of Recommendations
For asymptomatic people:
Conditionally recommended “although there is no evidence that this is effective in reducing transmission”
For symptomatic people:
Recommended always despite no evidence
Why? Mechanistic plausibility.
Surface and object cleaning
Recommended at all times “although there is no evidence this is effective in reducing transmission.”
Why? Mechanistic plausibility.
Recommended at all times but very low quality of evidence
“no obvious rationale for this measure”
School measures and closures
Conditionally recommended with very low quality of evidence
Should only be for a limited period of time with all adverse effects fully considered first
Personal Protective Measures
Apparently, RCTs with moderate overall quality of evidence have found hand hygiene not to be effective against flu in community settings. I did not know this. Did you?
This is only known to work theoretically and experimentally against flu, so again the recommendation is based only on mechanistic plausibility.
From a meta-analysis of 10 RCTs, “there was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza.”
Why then does this same entity conditionally recommend wearing of masks by asymptomatic people?
“[M]echanistic plausibility” again.
What is the definition of conditionally recommended?
“The group believes that the balance between benefits and harms is uncertain, and some conditions should apply when implementing the recommendation.”
So what are the harms of masks according to this document?
That seems odd. How can they say there are no major adverse effects? There is no reference given to any studies showing this. Did they perhaps not consider what would happen if entire countries forced children to wear masks all day in their classrooms or when playing sports? Or if employees were forced to wear them all day at work regardless of climate or exertion?
The 2020 WHO documents contain a long list of potential harms, which we will see later.
Now, notice the mention of “important gaps in our knowledge” for person-to-person transmission as it pertains to droplets and aerosols.
Even with all this lack of evidence from RCTs and knowledge gaps around transmission mechanisms, the WHO still recommended mask-wearing by asymptomatic people in this 2019 document.
Most people would be surprised at this assertion in the abstract:
“evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza”
“We similarly found limited evidence on the effectiveness of improved hygiene and environmental cleaning”
and yet again a mention of the same knowledge gap from the WHO document:
“We identified several major knowledge gaps requiring further research, most fundamentally an improved characterization of the modes of person-to-person transmission.”
In reality, these should not be surprising when they all match the WHO conclusions from October 2019.
What changed for COV2?
March 8, 2020: Why did Fauci say masks should not be worn?
“There’s no reason to be walking around with a mask. When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face.”
May 27, 2020: Fauci then says he wears a mask as source control, for self-protection, and as a symbol:
“I want to protect myself and protect others, and also because I want to make it be a symbol for people to see that that’s the kind of thing you should be doing,”
March 28, 2021: Fauci now says the children of vaccinated parents still must continue to wear masks:
“When the children go out into the community, you want them to continue to wear masks when they’re interacting with groups from multiple households.”
All of this except his initial statement defied all known science up to that point except for “mechanistic plausibility.” No new evidence has been discovered regarding the efficacy of community masking of healthy people to prevent spread of COV2.
Correlation as Causation?
Did public health officials mistake correlation for causation while ignoring seasonality and forgetting the WHO statement from 2019?
Who made that mistake?
Vanity Fair, The New York Times, and TIME (see the call-outs on the chart for headlines at specific points in the pandemic):
By now, masks had gone from obscurity to being mandated for the general public in many countries.
The WHO acknowledged many countries had recommended use of masks for the general public, though the recommendations had become mandates on an increasing scale.
The WHO also acknowledges in the same paragraph that “the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence…”
However, the WHO still recommended masks due to “a growing compendium of observational evidence…,” which essentially means they took correlation as causation during a time of natural seasonal decline from March to May of 2020.
A perfect example of this is the Czech Republic. Notice the author states, “there is no question.” Yes, there were certainly questions, but most of the world – including the WHO and CDC – seemed willing to accept simple correlation from a mechanism that had never been shown to work before: masking of healthy people to prevent viral transmission.
What direct evidence is there for “the effectiveness of universal masking of healthy people in the community to prevent infection with respiratory viruses”?
This is where the mask recommendations become dubious.
Of all the “potential benefits/advantages” listed, only one has anything to do with viral transmission, and that bullet only mentions “reduced potential exposure risk.”.
The other bullets indicate psychological and financial reasons:
Virtue (playing a role)
Source of income
The list of potential harms is much longer, more specific, and more scientific:
Self-contamination due to touching mask and face/eyes
Self-contamination due to improper use, amplifying microorganism growth
Headaches / breathing difficulties
Communication, especially children, deaf, and developmentally challenged
False sense of security
Poor compliance, especially among young children
Waste management, disposal, environmental hazard
Difficulty of wearing for many subgroups
No big deal, right? In the earlier WHO guidance, remember the nearly empty “harms” section stating, “there are no major adverse effects of face mask use,” which was factored into the cost-benefit analysis. Can we assume the “harms” input variable was near zero?
Where are the studies showing no adverse effects to children being forced to wear masks all day during school/aftercare? The effects could include increased infections, not only with COV2 but with other viral and bacterial infections, including skin and eye infections. It could, of course, include impediments to learning and social development, among many other negatives. Why weren’t those studied and verified before instituting mass-scale mask mandates with no direct evidence of efficacy?
No new supporting evidence, but the language was changed from:
“there is no direct evidence”
“there is only limited and inconsistent scientific evidence”
Basically… there is no evidence, but they keep recommending mask usage anyway. Yes, still, as of December 2020, there is no evidence to support what Fauci and the CDC are telling us.
As a bonus, the European CDC (ECDC) meekly admits the same.
The “reduced potential exposure risk” bullet was replaced with “reduced spread of respiratory droplets containing infectious viral particles.” Notice the explicit reference to “droplets” without mentioning aerosols despite the earlier admissions by both the CDC and WHO to a “knowledge gap” regarding modes of transmission relevant to droplet size, including aerosols.
They still have stigmatization and virtue listed.
They retained the compliance bullet but removed the word “compliant” and replaced “reminding people” with “encouraging.” This bullet is about using masks to remind people COV2 exists.
They removed the bullet regarding financial benefits of “individual enterprise” through creating custom masks and replaced it with a bullet claiming the masking of healthy people prevents TB and flu. The reference given does not provide evidence.
1 major change (2 bullets removed):
Both of the “self-contamination” bullets were removed
They went from first on the list to non-existent. Why? These are crucial and should have been studied in-depth before any mask mandates were imposed.
Why would those self-contamination concerns no longer exist? They were the top concern and would be the most likely explanations for why community masking of healthy people does not prevent viral spread and could possibly be a reason for increased spread.
How do we know community masking of healthy people does not lead to increased infections? Is anyone studying this?
In the end, “despite the limited evidence of protective efficacy of mask wearing in community settings,” the WHO still advises mask-wearing.
Is this enough to force children to wear masks for many hours each day while sitting in class and playing sports? When there is no evidence of efficacy and no time spent studying the harms of instituting such measures?
Is the evidence for mask-wearing and NPIs shown in this article enough to scare people into not only wearing masks wherever they go but even wearing two?
We must stop. Don’t be fooled. Don’t let yourself be coerced into compliance. #ForgetYourMask everywhere you go. Do it with a smile, do it politely, and be willing to leave if asked. If our Public Health authorities won’t do the right thing, then we must do it ourselves.