Remember how state governments around the world, including state governments in the US, threw out decades of research into pandemic response and instead resorted to extreme authoritarian measures that had no scientific basis, and how they ridiculously did so in the name of “following the science”?
One of those interventions effectively served as little more than a symbol of subservience to the state: mandatory mask usage by members of the general public in the community setting.
There was never any scientific evidence supporting these executive orders by clueless governors. The CDC and others later produced studies trying to provide ex post facto justification for them, claiming they work, but the CDC’s attempts in particular were excoriated even in the mainstream media.
A CDC study published on September 24, 2021, claimed to have found an association between school mask policies and COVID-19 outbreaks. The CDC produced this graphic to dramatically highlight the study findings:
The CDC announced the study on Twitter by saying that it found that schools in two Arizona counties without a mask mandate “were 3.5 times more likely to have a #COVID19 outbreak than schools requiring masks from the start of the school year. CDC recommends universal masking for K–12 schools.”
CDC Director Rochelle Walensky amplified that tweet by suggesting that schools couldn’t be safely opened without a mandatory masking policy.
On CBS’s Face the Nation on September 26, Walensky claimed that “places that had no masks in place were three and a half times more likely to have outbreaks than places that did have masks in place. So we know how to keep them safe.”
Note, first, as a simple thought experiment, that were an observational study to have found an association between mask mandates and increased COVID‑19 cases, and were opponents of mandatory mask policies to claim that the study showed that the mask use caused the increase, the media’s faux “fact checkers” would all over it reminding us that an association found with this type of study design does not prove a causal relationship. But when the CDC director proclaims that a CDC proved that mask use was the cause of the reduced risk of outbreaks, the media’s “fact check” organizations are nowhere to be found.
That’s not to say that nobody in the mainstream media fact-checked the CDC’s claim. Author David Zweig did the public the service of doing a little investigating and reporting his conclusion in The Atlantic on December 16, 2021, that the claim was “based on very shaky science.”
Noting that the CDC had “taken an especially aggressive stance” that was contrary to the policy of the World Health Organization (WHO), which mildly recommended against mask use for children under age 6 (since they were unlikely to be worn properly), and the European Centre for Disease Prevention and Control, which recommended against the use of masks for any children in primary school, Zweig observed how Walensky had repeatedly touted the claim in the media.
But experts whom Zweig spoke with told him that the study was useless. A public-health economist at Arizona State University told him, “You can’t learn anything about the effects of school mask mandates from this study.” A scientist and co-author of a systematic review of COVID-19 mitigation policies described the CDC study as “so unreliable that it probably should not have been entered into the public discourse.” In Zweig’s own words, the CDC’s claim was “profoundly misleading.”
Zweig pointed out that the study examined the period of July 15 to August 31, but whereas some schools opened at various points in the second half of July, others didn’t begin classes until the second week of August. This introduced a selection bias whereby schools that opened earlier had greater time at risk of a COVID-19 outbreak. While the experts he spoke to disagreed about whether this could explain the study findings, one arguing that it was insignificant acknowledged that the schools without mask mandates were generally open longer.
The CDC had also defined an “outbreak” as two or more cases among students or staff members, but just because two or more people in a school get COVID-19 does not mean that the transmission occurred in the school.
Additionally, in one of the counties, local guidelines defined only unmasked students as “close contacts” of an infected student, which introduced another selection bias whereby students in schools without mask mandates may have been more likely to get tested following a known exposure.
One scientists whom Zweig spoke with called the CDC study “ridiculous” for failing to control for the vaccination status of staff or students. While the Atlantic article didn’t mention it, for that matter, the study failed to control for immune status more broadly to include whether students had already acquired natural immunity.
Zweig also found discrepancies in the CDC’s data, such as the study authors stating that 782 public schools in one of the counties were included when in fact there were “at most roughly 740” that could have been included, the rest being virtual learning academies, preschools, or vocational programs associated with otherwise-listed schools. When he asked the CDC for their list of included schools, the CDC refused to provide that data.
In sum, it was a poorly designed study that essentially told us nothing about the effect of mask mandates on outbreaks of COVID-19 in schools, yet there was the CDC director touting it as proof that mask use reduced the risk of a school outbreak by three-and-a-half times.
This was known at the time as “following the science” (or “The Science™”, as the appropriate mockery goes).
In May 2022, a Lancet preprint study (not yet peer-reviewed) by researchers from the University of Toronto was published at SSRN that further excoriated the CDC’s evidentiary basis for its policy recommendation. The authors began by pointing out how the CDC’s own findings were contradicted by other studies “finding no significant effect of school mask mandates on pediatric cases.” The CDC’s studies were “inconsistent with more rigorously designed observation studies”.
Commenting on the Arizona study, they remarked that the findings “were likely confounded by crucial differences, such as the number of instructional days or contact tracing policy differences, rather than being driven by the effects of masks themselves.”
The CDC had also published another study on October 1, 2021, by Samantha Budzyn et al., similarly claiming to have found an association between counties with school mask mandates and a reduction in COVID‑19 cases among children compared to counties without such mandates. The authors of the Lancet preprint study set out to replicate this CDC study but with more data, utilizing a larger sample of districts and over a longer time interval.
They were indeed able to replicate the CDC’s results when they confined their analysis to the CDC’s more limited dataset, but “incorporating a larger sample and longer period showed no significant relationship between mask mandates and case rates.” As they commented (emphasis added):
We successfully replicated the main result of the original study by Budzyn et al. However, our extension shows that the results do not hold in a larger sample of school districts, or even in the original sample of districts when extended to a longer time interval. Specifically, when we extend the sample to districts that began later in the Fall, which encompasses a much larger portion of the country, we find no association between mask requirements and pediatric cases. Even in the set of districts studied by Budzyn et al, the initial association between mask requirements and reduced case rates disappeared when we extended the analysis to a longer time interval.
The researchers further noted how the CDC had ended its analysis on September 4, thus excluding counties with a median school start date later than August 14, which “heavily over-samples regions that open schools by mid-August”, with southern states being more likely to have early start dates.
One might be tempted to conclude from this observation that the CDC had found a trick that worked and so stuck with it for multiple studies.
As the researchers diplomatically put it, their re-analysis of the CDC’s data demonstrated “that observational studies of interventions with small to moderate effect sizes are prone to bias caused by selection and omitted variables.”
In other words, the CDC appears to have simply cherry-picked the data that produced the desired result.
Additionally, the reanalysis found that “removing redundant socioeconomic data from the regression analysis actually resulted in a significant positive association between school mask mandates and COVID-19 cases.” (Emphasis added.) The authors remarked, “No causality can be inferred with the increased cases, but this demonstrates how controlling multiple times for similar variables can alter results and . . . may have strengthened the negative association identified by Budzyn et al.”
One might be further tempted from this to conclude that the CDC researchers were massaging the data with the aim of producing a desired result.
Further illustrating the CDC’s own bias, the university researchers sought to have their reanalysis published in the CDC’s journal Morbidity and Mortality Weekly Report (MMWR), where the CDC’s own study had been published, but their paper was “not accepted for publication by MMWR despite using the same methods, but with an expanded population and time frame.”
This is indicative of “publication bias”, they remarked, which “can lead to the published ‘science’ being a self-fulfilling prophecy rather than an unbiased pursuit of truth.” They concluded by remarking how their own findings “demonstrate how observational studies can be misleading when used to guide public health policy.”
To put it another way, the CDC’s “science” followed its policy rather than its policy following the science.
Other studies have found mask mandates to be associated not merely with no effect but with worsened outcomes.
A study published in the Southern Medical Journal in September 2021 pointed out the dearth of scientific evidence supporting executive orders requiring mask use in the community setting, so the authors sought to assess “the effects of a county-wide mask order on per-population mortality, intensive care unit (ICU) utilization, and ventilator utilization in Bexar County, Texas.” They found no decrease in hospital resource consumption, which was the primary reason for the mandate. On the contrary, they found that “the caseload for all of the measured outcomes increased after the mask orders went into place.” (Emphasis added.)
While the authors offer no remark about it, data presented in Table 2 of the study showed that before the mask order, the rate of new COVID-19 deaths was 0.06 per 100,000 population, whereas after the implementation of the mandate, it rose to 0.58 per 100,000.
A study by a German doctor named Zacharias Fögen that was published in the journal Medicine compared the case fatality rates (CFRs) between groups with and without mask mandates in Kansas, which had “issued a mask mandate, but it allowed its 105 counties to either opt out or issue their own mask mandate”. As the author remarked:
The most important finding from this study is that contrary to the accepted thought that fewer people are dying because infection rates are reduced by masks, this was not the case. Results from this study strongly suggest that mask mandates actually caused about 1.5 times the number of deaths or ~50% more deaths compared to no mask mandates.
While no firm conclusion about causality can be drawn from this observational study, the author proposed a hypothesis to explain the finding of mask mandates being associated with greater mortality. It was likely that “virions that enter or those coughed out in droplets are retained in the facemask tissue, and after quick evaporation of the droplets, hypercondensed droplets or pure virions (virions not inside a droplet) are re-inhaled from a very short distance during inspiration.”
The author named this after himself as “the ‘Foegen effect’ because a review of the literature did not yield any results on this effect, which has not been described earlier.”
Additionally, virions from aerosolized particles, as opposed to larger droplets, were more likely to be inhaled deeper into the respiratory tract. The author further hypothesized:
Moreover, the “Foegen effect” could increase the overall viral load because virions that should have been removed from the respiratory tract are returned. Viral reproduction in vivo, including the reproduction of the re-inhaled virions, is exponential compared with the mask-induced linear droplet reduction. Therefore, the number of exhaled or coughed out virions that pass through the facemask might, at some point, exceed the number of virions shed without facemasks. Furthermore, the hypercondensed droplets and pure virions in the mask might be blown outwards during expiration, resulting in aerosol transmission instead of droplet transmission. . . .
The use of “better” masks . . . with a higher droplet-filtering capacity probably should cause an even stronger “Foegen effect” because the number of virions that are potentially re-inhaled increases in the same way that outward shedding is reduced.
This hypothesis is supported by a study of golden Syrian hamsters that found “a significant increase in viral load in the lungs of masked hamsters compared with non-masked hamsters”. Further studies to test the hypothesis “should be a priority to public health scientists”, the author opined.
Regardless of how plausible one considers the hypothesis that mask use results in increased viral loads for the wearer and thus increases the risk of severe disease, what is indisputable is that the claimed benefits of mask mandates never manifested in the data. These government interventions remain today, as when they were first implemented, unsupported by scientific evidence.
Perhaps if so-called “public health” authorities would stop just talking about following the science and start actually doing it, their policy recommendations wouldn’t be so, at best, useless.
Source: Those Killer Mask Mandates: How CDC ‘Science’ Follows Policy