Do Masks Save Lives?  Part II

The word “science” has frequently been used during the Covid pandemic implying “science” numbers are correct and those numbers are what we should believe and follow.  However, that is far from the truth.

In scientific research, the number of variables affecting data collection will change the “science” numbers, and have to be considered when formulating a hypothesis. Once a hypothesis is formulated addressing these variables, it can then be proven or not in a randomized controlled clinical trial.

When researching each of the 23 variables (Wed, Oct 7) affecting the efficacy of wearing masks to decrease spread of disease, one begins to realize there may be no definitive answer for the effectiveness of masks on Covid 19 transmission at this time.

The “science” numbers vary widely even when researching the effects of individual variables, making it nearly impossible to come to a reasonable conclusion as to what is truth and what is not, much less to find a randomized controlled clinical trial incorporating those 23 variables.  Since the original list of variables, I added two more variables: 1. Compliance wearing a mask,  2. Reuse of dirty masks.

Hence, to date, what you have been told about masks is someone’s opinion based on observations of a model.  You can argue for the use of masks or against the use of masks using the same “scientific numbers” presented as observational studies.  This is not new in medicine and/or research, but rather the norm as a hypothesis is generated by observations.  The clinical trial needs to prove the hypothesis.  One needs to be aware of what kind of study to which people are referring.

Surprisingly, after 2 weeks of research I could find no randomized controlled studies to prove wearing cloth masks protects us from Covid 19.  There are multiple studies with arms using masks and hand washing or hand sanitizer combined, but few mask alone studies.  All studies followed transmission of influenza and not Covid 19 which is more contagious than influenza.  A 2012 study having a mask alone arm stated in their discussion,

“Masks alone did not provide a benefit, suggesting that single personal protective interventions do not protect against incidence of influenza like illness or influenza”.*

The CDC as late as October 2020 stated, ”To our knowledge, only 1 randomized controlled trial has been conducted to determine the efficacy of cloth masks.”  **

The study I found and to which the CDC was referring, was one of the better studies.  It was done in Australia in 2015 following1607 healthcare workers in a hospital during the flu season.  “Workers were randomized to those who wore N 95 medical masks, cloth masks, or control group who wears a mask routinely (probably surgical but not stated). 

Cloth masks had the highest rate of infection compared to N95 masks and surgical masks. Penetration of cloth masks by particles was 97% and N95 masks 44%. “Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection”. 

The control arm was ‘standard practice’, which comprised mask use in a high proportion of participants.  As such (without a no-mask control), the finding of a much higher rate of infection in the cloth mask arm could be interpreted as harm caused by cloth masks, efficacy of medical masks, or most likely a combination of both.”*** 

Since the majority of people are wearing cloth masks, I feel it imperative to share this study to raise awareness that people who are wearing cloth masks may be putting themselves and others at a higher risk of infection.

Next week will examine major variables affecting the efficacy of masks in decreasing transmission of airborne diseases and to answer, “Do mask decrease deaths?”

Have a blessed and awesome day!  Dr. D

• • https://pubmed.ncbi.nlm.nih.gov/22188875/
  • https://wwwnc.cdc.gov/eid/article/26/10/20-0948_article Effectiveness of Cloth Masks For Covid 19
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/ april 2015Australian new Zealand clinical trial This study is large, a prospective randomised clinical trial (RCT) and the first RCT ever conducted of cloth