All within the space of two weeks, governments and health authorities across the world are preparing the public to reintroduce their beloved covid measures. From France to India the message is the same: “wear masks.”
We’ve been here before. We know the evidence is not on their side.
In the week before Christmas, French Prime Minister Élisabeth Borne urged the public to once again wear masks in confined spaces. Two days later, the Indian Medical Association called for covid appropriate behaviour with immediate effect including face masks and social distancing. Two days after that, Ireland’s Chief Medical Officer “strongly advised” people to wear masks on public transport.
Two weeks after France, Professor Susan Hopkins, chief medical advisor to the UK Health Security Agency (“UKHSA”), said unwell adults should stay at home and wear a mask if they have to go outside.
Mid Devon Advertiser reported that patients and visitors to hospitals in south Devon from yesterday are required to wear masks following a surge in covid and flu cases. So, before the covid era, during every flu season over our entire lives we never wore face masks. Now flu, which has made a reappearance two years after its miraculous disappearance, apparently requires we wear face masks. We can only assume Covidians are hoping to make covid measures and restrictions the “new normal.” This was confirmed by the Scottish Government’s National Clinical Director, Jason Leitch, who said face coverings could be a positive legacy of covid restrictions as he urged Scots to wear facemasks to “help” the NHS.
Yesterday the Daily Mail reported that UK ministers are said to be considering issuing fresh guidance to wear masks on public transport, work from home and socially distance if the health service “is at risk of collapse.” We have been here before, it is a replay of early 2020.
Swiss Policy Research began compiling research in July 2020 from a variety of sources including real-world evidence and mask-related risks. But a study published in February 2022 is particularly relevant as it relates to their use in schools and covid-style restrictions are being planned just as schools are re-opening after their holiday break. The study found there was no evidence that face coverings, two metre social distancing or stopping children from mixing lowered the covid or cold infection rates in schools. And, in fact, face covering was associated with nearly 3 times higher odds of school covid cases.
Apart from the negative physical and mental health impacts, we’ve all witnessed what the daily use of face masks practically means. As Nina Murden noted, masks are often dirty and unwashed, slung under noses, hanging from ears, dropped and picked up from pavements, taken off when sneezing, stuffed in and out of pockets, crumpled up in work vans. They litter the streets and green spaces, clog drains, and choke turtles on far-flung beaches.
In 2020 alone, it was estimated that the oceans were littered with 1.56 billion face masks – an additional 4,680 to 6,240 metric tonnes of marine plastic pollution. These masks will take as long as 450 years to break down, slowly turning into microplastics, all the while negatively impacting marine wildlife and ecosystems.
On Tuesday, A day after UKHSA issued its warning, two leading professors, Paul Hunter and Professor Hugh Pennington, spoke out and insisted the UK doesn’t need to return to mandatory mask-wearing. Also on Tuesday, Trust the Evidence spoke out insisting, as they have before, that there is no evidence to support that masks work – from low influenza-like illness to pandemics clinical trials have failed to show any effect.
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Those who thought they had seen the last mask mandates were badly mistaken.
It starts with the message on masking, and let’s see how the public reacts. It won’t be long before governments resort to reintroducing compulsory mask use to address the “winter crisis”. They say masks will decrease the number of respiratory infections that are the major cause of the recurring winter crisis.
Readers will recall that in early December, we challenged the evidence base cited by Lord Markham as proof that masks work. We wrote: ‘According to the UKHSA, the official scientific rationale for mask mandates in the community is based on a review last updated in the summer of 2021 of 28 studies, two of which are trials and the rest studies of abysmal quality. The review, identified through a Parliamentary Question, is in two parts: the main body and supplementary tables reporting the data. The problem is that the review is full of errors: the two parts do not match and appear to have been written separately and not even proofread.’
Most of the studies in the review are observational, making claims such as an 80 per cent reduction in cases after mask introduction – making masks use a miracle, not a human intervention. If that were the case, SARS-CoV-2 had been sent packing years ago, and with it, all the other respiratory viruses.
We also cited the co-author of Mr Hancock’s pandemic memoir, revealing that Johnson, Whitty and Hancock knew from the start that masks do not do the job, and yet they went ahead and coerced Britons to wear them.
The reality is different. Clinical trials in various settings – across vastly different ranges of circulation rates – from low influenza-like illness to pandemics have failed to show any effect. Which tallies with everyone’s personal experience of mask “protection.” So, why the sudden reintroduction?
Something odd is happening. We live in a world with more information and reactive media that fails to grasp the reality of the problem. Managing the message becomes more important than fixing the problem, particularly when you know you won’t be in your job much longer. Masks are a distraction.
The reality is a merry-go-round as new ministers, advisors, and experts pop up. They look to a simple solution to gloss over rather than fixing the long-term structural problems in the NHS.
We learnt this painful lesson with Tamiflu in the Swine flu Pandemic. Ministers reiterated, as did public health officials, that what mattered is they needed to be seen to be doing something. Whether it was evidence-based or not was immaterial. A complex problem requires a simple fix – a highly visible one: masking fits the bill perfectly.
Part of the problem is officials go unchallenged, no one asks for the evidence, and if they do, they feel intimidated – as an anonymous BBC reporter disclosed. You can virtually state anything in this modern era. By tomorrow the media will have moved on.
However, for now, let’s follow the jungle cry: do something! What? It does not matter; we have to be seen to be doing something!!!!
About the Author
Trust the Evidence is a Substack page for the writings of Tom Jefferson and Carl Heneghan. Carl Heneghan is a professor of Evidence-based Medicine at the University of Oxford, Director of the Centre for Evidence-Based Medicine (“CEBM”) and NHS Urgent Care general practitioner (“GP”) who regularly appears in the media. Tom Jefferson is a clinical epidemiologist and a Senior Associate Tutor at the University of Oxford.
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