The most rigorous and comprehensive
analysis of scientific studies conducted on the efficacy of masks for reducing
the spread of respiratory illnesses — including COVID-19 — was published late
January. Its conclusions, said Tom Jefferson, the Oxford public health
researcher who is its lead author, were unambiguous.
اضافة اعلان
“There is just no evidence that they” —
masks — “make any difference,” he told journalist Maryanne Demasi. “Full stop.”
But wait, hold on. What about N95 masks, as
opposed to lower-quality surgical or cloth masks?
“Makes no difference — none of it,” said
Jefferson.
What about the studies that initially
persuaded policymakers to impose mask mandates?
“They were convinced by non-randomized
studies, flawed observational studies.”
What about the utility of masks in
conjunction with other preventive measures, such as hand hygiene, physical
distancing, or air filtration?
“There’s no evidence that many of these
things make any difference.”
Thousands of participants, multiple
countriesThese observations do not come from just
anywhere. Jefferson and 11 colleagues conducted the study for Cochrane, a
British nonprofit that is widely considered the gold standard for its reviews
of health care data.
“There is just no evidence that they” — masks — “make any difference… Full stop.”
The conclusions were based on 78 randomized
controlled trials, six of them during the COVID pandemic, with a total of
610,872 participants in multiple countries. And they track what has been widely
observed in the US: States with mask mandates fared no better against COVID
than those without.
No study — or study of studies — is ever
perfect. Science is never absolutely settled. What is more, the analysis does
not prove that proper masks, properly worn, had no benefit at an individual
level. People may have good personal reasons to wear masks, and they may have
the discipline to wear them consistently. Their choices are their own.
But when it comes to the population-level
benefits of masking, the verdict is in: Mask mandates were a bust. Those
skeptics who were furiously mocked as cranks and occasionally censored as
“misinformers” for opposing mandates were right. The mainstream experts and
pundits who supported mandates were wrong.
Humble, transparent science?In a better world, it would behoove the
latter group to acknowledge their error, along with its considerable physical,
psychological, pedagogical, and political costs.
When it comes to the population-level benefits of masking, the verdict is in: Mask mandates were a bust.
Do not count on it. In congressional
testimony this month, Rochelle Walensky, director of the US Centers for Disease
Control and Prevention, called into question the Cochrane analysis’s reliance
on a small number of COVID-specific randomized controlled trials and insisted
that her agency’s guidance on masking in schools would not change. If she ever
wonders why respect for the CDC keeps falling, she could look to herself,
resign, and leave it to someone else to reorganize her agency.
That, too, probably will not happen: We no
longer live in a culture in which resignation is seen as the honorable course
for public officials who fail in their jobs.
But the costs go deeper. When people say
they “trust the science”, what they presumably mean is that science is
rational, empirical, rigorous, receptive to new information, sensitive to
competing concerns and risks. Also: humble, transparent, open to criticism,
honest about what it does not know, willing to admit error.
The CDC’s increasingly mindless adherence
to its masking guidance is none of those things. It is not merely undermining
the trust it requires to operate as an effective public institution. It is
turning itself into an unwitting accomplice to the genuine enemies of reason
and science — conspiracy theorists and quack-cure peddlers — by so badly
representing the values and practices that science is supposed to exemplify.
It also betrays the technocratic mindset
that has the unpleasant habit of assuming that nothing is ever wrong with the
bureaucracy’s well-laid plans — provided nobody gets in its way, nobody has a
dissenting point of view, everyone does exactly what it asks and for as long as
officialdom demands. This is the mentality that once believed that China
provided a highly successful model for pandemic response.
Never a real solutionYet there was never a chance that mask
mandates in the US would get anywhere close to 100 percent compliance or that
people would or could wear masks in a way that would meaningfully reduce
transmission. Part of the reason is specific to American habits and culture,
part of it to constitutional limits on government power, part of it to human nature,
part of it to competing social and economic necessities, and part of it to the
evolution of the virus itself.
The last justification for masks is that… they seemed like a relatively low-cost, intuitively effective way of doing something against the virus in the early days of the pandemic. But “do something” is not science, and it should not have been public policy.
But whatever the reason, mask mandates were
a fool’s errand from the start. They may have created a false sense of safety —
and thus permission to resume semi-normal life. They did almost nothing to
advance safety itself. The Cochrane report ought to be the final nail in this
particular coffin.
There is a final lesson. The last
justification for masks is that, even if they proved to be ineffective, they
seemed like a relatively low-cost, intuitively effective way of doing something
against the virus in the early days of the pandemic. But “do something” is not
science, and it should not have been public policy. And the people who had the
courage to say as much deserved to be listened to, not treated with contempt.
They may not ever get the apology they deserve, but vindication ought to be
enough.
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