Resource Roundup: Masks Are Not Effective Against Covid-19
Below is a compilation of resources that provide evidence that masks are not effective protection (to the wearer or to others) against Covid-19 in a community setting. Note that this is not a “fair and balanced” roundup, due to the fact that you can find ample arguments in support of masking in any mainstream media outlet. The purpose of this Substack is to balance the scales and give equal “air time” to the opposing viewpoint.
Rather than create new posts every time I find a new, relevant article, I’ll simply continue to update this one post, so be sure to check back occasionally.
Wondering what you can do in place of masks? Check out my separate post on Mitigating Exposure to the Covid-19 Virus.
Originally Published: December 3, 2022
Last update: April 26, 2023
My opinion: Not only are masks ineffective, but they are detrimental to physical and mental health and impair social connectedness.
Summary of Findings
It is now known (and acknowledged by the CDC) that the SARS-CoV-2 virus is aerosolized and spreads via very tiny particles (0.1-0.3 micron), similar to the common cold and influenza.
The science around masks is extremely robust. We have decades of research on their use in both medical and industrial applications. Not once, prior to the pandemic, did any health agency recommend masking to prevent community spread of respiratory viruses. This is because the science was clear: masks don’t stop aerosolized viruses from spreading. This article regarding masking in JAMA from March 4, 2020 is a good example of previous thinking on mask wearing.
There isn’t a single reputable study supporting the use of cloth masks or surgical masks to reduce virus transmission in a community setting (see links below).
There is evidence that properly fitted N95 masks on trained personnel in healthcare settings may provide some personal protection from infection. However, Austria implemented a nationwide N95 mask mandate in January 2021 and by November 2021 their daily cases had skyrocketed, so the effectiveness of N95 masks in a community setting remains highly questionable.
When you wear a cloth or surgical mask, the majority of your breath, both inhaling and exhaling, escapes around the edges of your mask (see this video). Try a quick experiment for yourself: put your mask on and attempt to seal the edges around the mask with your hands. Then observe how different it feels to breathe or speak when you have to actually breathe through the material.
Real-world results comparing states or countries with mask mandates to neighboring states or countries without mandates show that the unmasked areas had equal or better outcomes (see the Postscript August 2021 on this page). Notice I state “neighboring,” as only similar populations with similar climate should be compared.
The detrimental effect masks have on childhood development and social cohesion should not be underestimated. Public health initiatives should always weigh all costs, instead of just focusing on one potential benefit.
Resources
Possible Toxicity of Chronic Carbon Dioxide Exposure Associated
with Face Mask Use, Particularly in Pregnant Women, Children and
Adolescents – A Scoping Review (Heliyon - March 2023) This report reviewed 43 studies on carbon dioxide and mask wearing and concluded “Circumstantial evidence exists that extended mask use may be related to current observations of stillbirths and to reduced verbal motor and overall cognitive performance in children born during the pandemic. A need exists to reconsider mask mandates.” This means mask wearing by pregnant women may have caused still births, as well as brain damage to their unborn children.
Physio-metabolic and Clinical Consequences of Wearing Face Masks—Systematic Review with Meta-analysis and Comprehensive Evaluation (Frontiers for Public Health - April 5, 2023) This systemic review looked at 2,168 studies and “revealed ample evidence for multiple adverse physio-metabolic and clinical outcomes of medical face masks, with worse outcomes in the case of N95 masks. This can have long-term clinical consequences, especially for vulnerable groups e.g., children, pregnant, older adult, and the ill.”
The Mask Mandates Did Nothing. Will Any Lessons Be Learned? (New York Times - February 21, 2023) This is an opinion piece, but it does a good job recapping what was found in the Cochrane Review (linked below).
Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses (Cochrane Database of Systemic Reviews - updated January 30, 2023) Cochrane reviews are considered the “gold standard” of medical research. They found the following: “Compared with wearing no mask in the community studies only, wearing a [medical or surgical] mask may make little to no difference in how many people caught a flu‐like illness/COVID‐like illness; and probably makes little or no difference in how many people have flu/COVID confirmed by a laboratory test.” They also found “Compared with wearing medical or surgical masks, wearing N95/P2 respirators probably makes little to no difference in how many people have confirmed flu; and may make little to no difference in how many people catch a flu‐like illness, or respiratory illness.” [emphasis mine]
Medical Masks Versus N95 Respirators for Preventing COVID-19 Among Health Care Workers (Annals of Internal Medicine - November 29, 2022) led by researchers at Canada's McMaster University, the study found no statistically significant difference in protection between surgical and N95 masks in healthcare facilities in Canada, Israel, Pakistan and Egypt.
It’s Time to End Mandatory Masks in Schools (Time Magazine - February 5, 2022) A well-reasoned editorial from a physician and mother of four about why the science no longer supports masking in schools.
After 2 Years, Growing Calls to Take Masks Off Children in School (NPR - January 28, 2022) This article from NPR goes into detail on concerns experts have that masks can impair children’s brain development, contribute to speech impediments and delays, and inhibit social interactions.
The Case Against Masks at School (The Atlantic - January 26, 2022) Another editorial looking at the science specifically applying to masks in schools.
Are Face Masks Effective? The Evidence (Swiss Policy Research - July 2022) A comprehensive overview of studies related to masking. In particular, check out Section G which reviews studies that have shown mask benefits, and the August 2021 Postscript, which shows charts from Ian Miller comparing outcomes of states and countries with mask mandates and without.
More than 150 Comparative Studies and Articles on Mask Ineffectiveness and Harms (Brownstone Institute - December 2021) Another thorough review of the studies on masks, this one divided up into: mask ineffectiveness, mask mandates, and mask harms.
Experimental Investigation of Indoor Aerosol Dispersion and Accumulation in the Context of COVID-19: Effects of Masks and Ventilation (Physics of Fluids - July 21, 2021) The results show that standard surgical and three-ply cloth masks, which see current widespread use, filter at apparent efficiencies of only 12.4% and 9.8%, respectively. Apparent efficiencies of 46.3% and 60.2% are found for KN95 and R95 masks, respectively, which are still notably lower than the verified 95% rated ideal efficiencies. Furthermore, a one-way valve on a KN95 mask reduces the mask's apparent efficiency by more than half (down to 20.3%), while a loose-fitting KN95 provides a negligible apparent filtration efficiency (3.4%).
Scientific Brief: SARS-CoV-2 Transmission (U.S. CDC - May 7, 2021) The CDC finally admitted the virus was aerosolized in this updated document which reads in part: “Infectious exposures to respiratory fluids carrying SARS-CoV-2 occur in three principal ways (not mutually exclusive): 1. Inhalation of air carrying very small fine droplets and aerosol particles that contain infectious virus….”
The 60-Year-Old Scientific Screwup That Helped Covid Kill (Wired - May 13, 2021) An excellent article on how the CDC and WHO clung to outdated theories on virus size and particle spread, which led to incorrect assumptions regarding masking.
Your Mask Protects Me: And Other Socio-Ethical Inversions (Bad Cattitude - April 21, 2021) A well-supported post on why masks can’t work against an aerosolized virus. And why our government kept pushing them anyway. “Masking was a low-energy pathway for politicians. Mandates would enable them to look like they had done something and to demand and enforce social virtue with highly visible in-group/out-group markers.”
Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers (Annals of Internal Medicine - March 2021) This randomized controlled trial with 6,000 participants, found no statistically significant effect of face masks against SARS-CoV-2 infection in a community setting.
Asymptomatic Covid Spread: This "Invisible Dragon" Is Mostly a Mythical Beast (Bad Cattitude - March 31, 2021) This post by El Gato Malo tackles asymptomatic spread, which was used extensively to justify masking. He examines a meta-analysis (see link below) which finds “Symptomatic carriers had an SAR (secondary attack rate) of 18%. Asymptomatic carriers had an SAR of 0.7%. Not only is that a nearly 26X variance, but it shows that the likelihood of an asymptomatic carrier spreading disease to you is less than 1% overall even in what looks to be one of the highest risk cases around: living together.”
Household Transmission of SARS-CoV-2: A Systematic Review and Meta-analysis (JAMA Network Open - December 14, 2020) This is the meta-analysis that El Gato examines in the link above. You have to carefully read the “Results” section of the study, as the numbers on asymptomatic transmission were not mentioned in the findings or conclusion.
Facemask Against Viral Respiratory Infections Among Hajj Pilgrims: A Challenging Cluster-Randomized Trial (PLOS One - October 13, 2020) A large randomized controlled trial with close to 8,000 participants found that masks “did not seem to be effective against laboratory-confirmed viral respiratory infections nor against clinical respiratory infection.”
Mask Facts (Association of American Physicians and Surgeons - September 26, 2020) An excellent overview of the existing literature on masking. They concluded that “Wearing masks (other than N95) will not be effective at preventing SARS-CoV-2 transmission, whether worn as source control or as PPE.”
Non-pharmaceutical Public Health Measures for Mitigating the Risk and Impact of Epidemic and Pandemic Influenza (WHO - September 19, 2019) This report done by the WHO in 2019 reviewed ten randomized controlled trials and found that none of the trials showed a statistically significant benefit to masks.
Postoperative Wound Infections and Surgical Face Masks: A Controlled Study (World Journal of Surgery - May 1991) This controlled study looked at the post-surgery infection rates based on whether or not surgeons wore surgical masks. The results? 4.7% infection rate when the surgeons wore masks, and 3.5% infection rate when they did not. Wearing a mask increased infection rates by 34%.
Better Options for Mitigating Virus Exposure
So if masks don’t work, what can you do? Check out my separate post on Mitigating Exposure to the Covid-19 Virus.