In a crowded restaurant recently I spoke to a man who was not wearing a face mask. “I’m from Texas,” he said, “and I guess I’m just a free spirit. I don’t like being told what to do.”
Anyway, he said, he’d heard about a report that showed that face masks provided little or no protection against Covid. I’d read the report he was talking about; it was from the Cochrane Library, an independent medical body that meta-analyzes vast databases to provide comprehensive interpretations of reports from around the world. This particular report, published on January 30, found that places where mask mandates had been imposed had not experienced significantly fewer Covid cases than places where mandates had not been imposed. What it appeared to be saying, according to certain anti-mask factions and right-wing media, was that masks didn’t work.
For example, Matthew Bauer, a physician and medical health officer in the Toronto, Ontario, region, writing in the National Post, cited the report and adverted that “doctors owe the public a genuine mea culpa for missteps made amidst a sea of unknowns.” Health authorities, he claimed, had rushed into mask mandates without scientific evidence warranting such drastic interventions. And now, he wrote, there was clear evidence that masks didn’t work. He quoted the Cochrane Library to the effect that “wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness.”
Not true. What the Cochrane Library actually said was that, because the evidence came from such a small database (only five studies), “our confidence in these results is generally low to moderate for the subjective outcomes related to respiratory illness,” and that its conclusions “might change when further evidence becomes available.” The Review admitted that mask mandates had been generally ineffective, not because masks didn’t work, but because “relatively low numbers of people followed the guidance about wearing them.” If a city imposed a mask mandate and 40 percent of its citizens refused to wear one, then obviously the mandate would be ineffective. That did not mean that mask wearing was ineffective.
Bauer went on to quote Dr. Michael Osterholm, a highly respected virologist and member of Biden’s Covid-19 Advisory Board, saying that masks have “a very minor role to play in preventing person-to-person transmission” of an infectious disease.
Again, what Dr. Osterholm actually said, in a PBS interview aired on March 8, 2021, was that cloth masks didn’t work: “I have had concerns when you actually look at face cloth coverings,” he said. Cloth masks, he said, “actually have very little impact in reducing the amount of virus that you inhale in or exhale out.” If you’re in a room with someone who has Covid, said Osterholm, a cloth mask might give you five minutes of protection. “On the other hand,” he went on, “if you use the N95 respirator and fit it tight to your face, you can actually spend 25 hours in that same room and still be protected.”
An N95 mask, as the name implies, filters about 95 percent of airborne globules from the air. Surgical masks – those light-blue, flimsy paper face coverings that health-care workers are issued – are designed to protect the wearer from splatter (think about what happens in an operating room). The two types of mask are designed to do different things . A surgical mask doesn’t need to fit tightly to the face. But the Cochrane Library report did not distinguish between the types of mask, and in any case, a week later the Library apologized for the ambiguous wording of its original report, stressing that face masks worked.
Despite what you might read in the media, there has been no scientific confusion about the benefits of mask-wearing. Early on in the pandemic, N95 masks were in short supply and thus were reserved for front-line workers. Health-care officials recommended cloth masks, or no masks at all, unless a person was exhibiting Covid symptoms. When it was found that Covid was also spread by people who were not exhibiting symptoms, health officials suggested we wear masks whenever we were in crowded situations. For the past three years, the science has been clear: wearing face masks, either N95s or surgical masks, if they were fitted properly, is an effective way of preventing the spread of Covid.
So it comes down to not liking being told what to do. The free-spirited Texan I spoke to in the restaurant wasn’t following the science.
“What side of the highway do you drive on?” I asked him.
“What? The right side, of course.”
“Do you stop at red lights?”
“Yeah, of course.”
“Why do you do that? Because the government tells you to?”
“Well, yes and no. Because I don’t want to be T-boned by a truck.”
I nodded. He looked at me as though he thought my mind had come untethered from its hitching post. But I felt I had made my point.
Thanks, Mark. I wonder if mask mandates will come back, now that new subvariants are making the rounds. And then I wonder if anyone will follow them. I recall the phrase from the 1980s, "environmental fatigue," people just getting tired of worrying about Armageddon. The same thing is happening with Covid: pandemic fatigue. We're like mice after being toyed with by a cat for too long: "Do with us what you will." As for me, I keep a stack of N95s handy, and am signing up for my sixth booster. Thanks for your comment; not too long at all.
That Cochrane Library study was reported here in New Zealand, too. And, as in Canada, it was (mis)quoted by those who were anti-mask (and anti-vax, in many cases). Although the quick, long initial lockdown here certainly helped reduce the number of cases and deaths (which have remained low), it was was definitely a game of two halves. The much less effective blue surgical masks were promoted over N95 respirators long after supplies ceased to be an issue. I resorted to watching mask reviews posted on YouTube by The Mask Nerd (Aaron Collins) and ordered his top picks (N94s and N95s). Like elsewhere, all mandates have since been dropped in New Zealand, and there is no mention of masks at all, despite a significant number of vulnerable people. "All for one and one for all" just isn't a thing, it seems.
I realise this is a bit wordy for a comment. Logs should never be longer than the truck that caries them. Thanks for your thoughtful and informative posts.