"The Cochrane Review on Masks is Damning"
Vinay Prasad
Feb 1, 2023
I want to highlight what just came out: the Cochrane review on masking. It shows that community mask recommendations have no firm data to support it. The authors write:
“There is a need for large, well-designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, as well as the impact of adherence on effectiveness, especially in those most at risk”
Now, who does that sound like?
Let me be clear: The science did not change. Public health experts started lying. We never had good data that mask mandates help, or that mask advice (a softer policy) improves outcomes. Yet it was widely pushed— most likely to distract from true federal failures.
After vaccination, not only do we not have evidence. It is irrational to mask. At best you marginally delay the inevitable, and unlike pre-vax, there is no milestone you are waiting for. Let’s take a closer look.
Here is the big summary finding. With 276,000 participants in RCTs or cluster RCTs, masking does nothing. No reduction in influenza like or Covid like illness and no reduction in confirmed flu or COVID. That’s stone cold negative. See those effect sizes and confidence intervals.
This is why Fauci said what he said initially on 60 minutes. He wasn’t lying. The best evidence showed no benefit. That was before we saw a concerted campaign to promote cloth masking— a bizarre way to treat anxiety. People routinely wore cloth masks outside— something that was less 21st century and more 3rd century, akin to animal sacrifice, and dancing to make the rains come.
The section on N95 masks was also devastating. Read this
https://vinayprasadmdmph.substack.com/p/the-cochrane-review-on-masks-is-damning?utm_source=direct&utm_campaign=post&utm_medium=webObviously, unlike the types of studies that the CDC likes— hairdresser anecdotes— randomized trials are the best way to separate an intervention from the habits of someone who embraces them. Comparing Pima and Maricopa counties is a pointless way to study masks—because the people are fundamentally different— apart from masking. They have different rates of vaccination and different levels of caution. But randomization balances outcome distributions and the effect (if a statistically persuasive one is seen) can only be due to the intervention.
Cochrane is run by smart people. I have met Tom Jefferson, and I know he understands evidence. He was the driving force behind the Tamiflu reanalysis for BMJ. These researchers know that not all evidence is the same. RCTs are imperative for recommendations that span years, or longer.
Who should we be angry with? Obviously there is a class of twitter expert that doesn’t understand how to read evidence. Some of them have even been promoted to be deans for public health schools. So much for public health. But the real failure is NIAID and CDC. It is Tony Fauci.
Fauci controlled NIAID budget. He could have run 10 RCTs of masking— different masks, different ages, different settings. He chose to run zero. Instead he went on TV, 1000 times and lied about effectiveness of cloth masks. The first time on 60 mins he told the truth, the rest were lies.
CDC & AAP are also steeped in failure. These agency forced 2 year olds to masks. Against the advice of the World Health Organization and UNICEF. The Cochrane review fails to identify any data that pertains to 2 year olds. The CDC should be ashamed of themselves. Tens of thousands of people working from home, and no one inside the organization with the ability to stop this policy.
Those are just some small highlights. But the whole review is worth your time."
The study from the Cochrane Library:
"Physical interventions to interrupt or reduce the spread of respiratory viruses
Tom Jefferson, Liz Dooley, Eliana Ferroni, Lubna A Al-Ansary, Mieke L van Driel, Ghada A Bawazeer, Mark A Jones, Tammy C Hoffmann, Justin Clark, Elaine M Beller, Paul P Glasziou, John M Conly
Authors' declarations of interestVersion published: 30 January 2023
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full
