New Mask Study
Medical Masks Versus N95 Respirators for Preventing COVID-19 Among Health Care Workers. https://doi.org/10.7326/M22-1966
Professor Carl Heneghan of the Centre for Evidence Based Medicine at Oxford University has just tweeted the results of a sizeable multicentre randomised trial into mask effectiveness (29 centres, 1009 subjects). I noted that they'd done something sensible and that is to compare performance of ear loop masks (a.k.a. surgical masks) with full-on N95 respirators (proper-job PPE), so I grabbed my morning lemon tea and smacked the link in eager anticipation.
I should not have bothered for here's the rather thin conclusion:
It is uncertain if medical masks offer similar protection against COVID-19 compared with N95 respirators.
What they’re doing their best at avoiding is telling you that the primary outcome (incidence of COVID by mask type) yielded a hazard ratio (HR) of 1.14, [95%CI = 0.77 to 1.69]. When you see a hazard ratio confidence interval straddle zero like this it means one thing… the difference observed is statistically insignificant!
In plain English, a fragile and loosely worn medical mask designed for blocking big stuff like hair, skin, dandruff, spit, blood, aftershave and bone fragments is no better and no worse than a tight-fitting mask designed to filter the air to a level of 95% airborne particulate purity. We may infer from this that neither mask serves a useful purpose when it comes to viral transmission. This will not come as a surprise for anybody bothering to read the disclaimer on a box of either mask type.
Exposure
Although outcome measures were rigorous (nasal swab & serum, RT-PCR assay with Ct value (hurrah!), EUROIMMUN assay, symptom record, absenteeism, self-report, care history, adherence to mask protocol audits, social interaction etc etc) a rather frail attempt was made to account for background risk of infection and levels of environmental exposure.
Yes, they looked at contact with with declared COVID cases both at home and in the hospital setting but that relies on a reliable memory and other people openly declaring their health status without error. What about undeclared cases and folk who haven't figured that their snivel is, in fact, mild COVID? How about all those folk with nothing more than a sore throat who think they've got COVID as a result of a false positive test result? How do you assess the infection status of the twenty people queuing up for a kebab with you?
Thus, we find that the most important covariate of all is distinctly lacking in value and robustness. Neither was an attempt made to compensate for disease prevalence which would have varied over time and differed between centres.
This is a great shame and a golden opportunity to settle the mask matter has been lost. Then again, I can't honestly think of a decent, cheap and easy way in which we can properly and accurately adjust for personal exposure to virions, and therein lies the weakness of all mask studies. It’s also a darn shame that an unmasked control group could not be included (presumably on grounds of safety/ethics)1.
Ask An Expert
One of the problems with mask studies is failure to fully consult with PPE experts. I’ve seen doctors claim they are PPE experts by virtue of their medical degree, and I’ve seen surgeons demand people listen to them because they’ve gone and got another set of qualifications that enable them to cut, suck, burn, slice and stitch. I’ve also seen nurses of all grades claim PPE expertise. Wearing a mask as part of your job in healthcare isn’t any measure of PPE expertise (and, yes, I’ve been gowned and masked for the purpose of conducting clinical audits but that doesn’t mean I’m an expert either). Neither should we view academics as PPE experts.
There are indeed PPE experts who are truly expert in PPE, this being a specialism in its own right that involves study, certification and professional insurance. If you ever get the chance to talk to a well-qualified and experienced technician you’ll soon see just how much tripe is being peddled by experts claiming to be expert, including those who conduct clinical trials. I had the good fortune of working alongside our PPE technicians for a while when a viral outbreak got out of control in our busy teaching hospital, and we had to rapidly assess infection control methods. To be blunt not a lot works against a determined virus, so it’s largely an issue of damage limitation and mopping up.
Fortunately, there is a cracking 15min presentation by an experienced PPE professional on use of ear loop masks that was given before the New Hampshire Senate for Health and Human Services on 30th March 2022. This sure opens the eyes, and I recommend grabbing a coffee and watching it here.
Kettle On!
This gives me a wacko idea for running a similar study for 1,009 folk who don’t work in the healthcare sector, enabling zero mask controls.
There’s a video I watch a while ago now of a ventilation, mask expert. It was in America, not sure which state but he had over 25yrs experience and his knowledge showed up the masks mandates for the shambles, they were and still are.
He’s on the record stating how the masks are tested for efficiency by sticking them down to a board, which is not only not realistic it’s actually conning the public about the performance benefit.
His expertise prior to covid had been used in schools, hospitals, offices, any building you could think of, he said good working ventilation was paramount in buildings with people mixing, working together, air quality made sure people didn’t get ill and he stood by this same principle when he was asked about stopping covid spreading.
What I’d like to know is how they know covid strands are extremely minute to the point that up too a hundred million strands can fit on the size of a pin head. With this knowledge how exactly could they promote the facade that anything other than a full suited mask with oxygen tank attached could stop infection or spread of anything that is as contagious as the public were led to believe.
From my own personal experience I believe the masks caused problems and infections that wouldn’t have happened otherwise. As we didn’t know what we were dealing with at the start, I was the lifeline for my mum who was late 70’s and my sister and nephew who is immune suppressed for their shopping.
I lasted two weeks wearing a mask until I decided there was no way I was wearing one anymore, I came to the conclusion that there’s no way they’re good for your health. I say this as someone who had pneumonia 15yrs ago, I wasn’t treated correctly early enough, amoxicillin didn’t and still doesn’t work on me and I ended up in hospital on a drip on two kinds of industrial antibiotics, which caused kinds of havoc and was minutes away from being sent to the icu due to blood pressure being 85 over 47 and going into organ failure. Within hours my body fought back and turned me from the bright yellow banana colour I’d become back to my pale and interesting. The lesson I learnt was the body is the most truly complex healing machine given the chance.
Months later after my follow up X-rays the doctor told me they didn’t expect me to live never mind recover and the X-rays in front of him were a miracle. I was 37years old when this happened to me with a one and a two year old that I was determined I wasn’t leaving and I’ve had no repeat and can count on one hand how many times I’ve needed or seen my gp, it was actually a joke last year that I hadn’t seen one of them for six years.
Fast forward to 2020 to the unknown and full on promoted hysteria and all of a sudden I have a pain in my right lung that I’m familiar with but haven’t felt in over a decade, all whilst wearing a mask.
Twice I’m out shopping and twice I have this pain that I do not have when I’m not wearing one so I ditched the masks.
While the masks may have been fine for some, I’ve no doubt they caused problems and damage in others.
What I’ve found horrifying from this whole experience is witnessing treatment being denied where early treatment is crucial for recovery as survival, this is more so in the elderly of our population.
It makes me so angry that hospitals were stood empty while people suffered, we’ve had countless deaths that could have been prevented and it’s about time we the public had answers and those who made and enforced them were held accountable.
The gaslighting of the public has been no less than criminal and I will never stop calling out how people died of neglect and lack of treatment which at any other time would have not have happened universally.
Covid is unavoidable. The primary mask study outcomes should have always been infection severity, given infection. In my opinion. Masks could reduce the initial viral dose, and hence severity. And they humidify the lungs, which could fight infection also. On the other hand, masks could make infection more severe according to the "Foegen effect":
https://journals.lww.com/md-journal/fulltext/2022/02180/the_foegen_effect__a_mechanism_by_which_facemasks.60.aspx
Could be whole other question looking at date of mask mandates and correlating with IFR.