Thread by @johndefeo

Why do mask mandates fail? Even with strict compliance and N95s? The video below (and the continuation in the next tweet) explain why.

The rest of this🧵summarizes why I believe those pushing for mask mandates are dishonest &/or willfully ignorant &/or mentally unwell.

1/31

If an N95-style respirator isn't perfectly sealed, it isn't capable of filtering an aerosolized respiratory pathogen.

The video below shows how "fit-testing" works.

Masks cannot filter aerosolized particles (see above) and an unsealed N95 respirator is merely a mask.

2/31

Exaggerating the capabilities of masks (or even N95 respirators) provides a *false sense of security*. Below, a certified industrial hygienist testifies about real-world limitations.

His claims are backed by controlled studies. E.g. - academic.oup.com/jid/advance-ar…

3/31

In the video clips below, spanning 2009 to 2020, infectious disease experts laugh at the idea of mask mandates or mask-wearing to prevent illness (alluding to crime, ineffectiveness, loss of dignity and annoyance).

Did "the science" change in April 2020? It did not.

4/31

The NEJM suggested that universal masking may not have a scientific nor logical basis, yet cited masks as "talismans" that may increase a "sense of safety, well-being, and trust." (A prelude to further arguments conflating perception with reality.)

nejm.org/doi/full/10.10…

5/31

Textile masks were often mocked as a superstitious relic of the past. On Apr. 2, 2020, The Washington Post dismissed them as "useless."

washingtonpost.com/history/2020/0…

Ironically, on the next day, Apr. 3, the Trump administration recommended them:

cnn.com/2020/04/03/pol…

6/31

If the filtration capability of an N95 is compromised by a gap the size of a human hair, then what of cloth masks?

A 2015 cluster randomized trial found that workers who wore cloth masks presented more illness than those who wore no mask at all:

ncbi.nlm.nih.gov/pmc/articles/P…

7/31

Masks pose a risk of self-contamination after extended clinical use (> 6 hours), calling into question the wisdom of reusable masks. Furthermore, workers reported discomfort, headache, and breathing/communication issues during extended mask wearing: bmcinfectdis.biomedcentral.com/articles/10.11…

8/31

The use of face masks resulted in "no significant reduction in influenza transmission" outside of a healthcare setting, according to the findings of a May 2020 CDC-published analysis of 10 randomized controlled trials that spanned 1946-2018.

wwwnc.cdc.gov/eid/article/26…

9/31

A widely-cited June 2020 paper claiming that face masks were critical to prevent transmission of SARS-CoV-2 was met with calls for retraction from scientists who called the paper "dangerously misleading," and lacking "any basis in evidence."

metrics.stanford.edu/PNAS%20retract…

10/31

The trend of using anecdotes and observations to tout the ability of face masks to prevent the transmission of SARS-CoV-2 had continued throughout Summer 2020.

E.g. The hair salon story, published in CDC's non-peer reviewed MMWR.

11/31

A more rigorous study of mask efficacy was published in July 2021. It alluded to the failure of masks in the real-world, while giving credence to filtering efficacy in a lab setting. (Self-contamination and user discomfort/risk were not addressed).

ncbi.nlm.nih.gov/pmc/articles/P…

12/31

By 2021, the CDC's non-peer reviewed MMWR was used to retroactively justify the agency's own recommendations by publishing studies that lacked controls or statistically-significant results. The CDC kept kids in masks; yet, data didn't support it.

nymag.com/intelligencer/…

13/31

What followed in Sept. 2021 may be the most widely-cited study of the pandemic: "The Bangladesh mask study." I believe it was conducted in good faith.

The media rewrote the press release, yet seemingly-neutral academics questioned the study's risk reduction claim (~11%).

14/31

Later in Sept. 2021, CDC Director Rochelle Walensky broadcast that schools without mask mandates were 250% more likely to have a Covid-19 outbreak.

She cited a study that failed to account for which schools were open or closed for summer break.

theatlantic.com/science/archiv…

15/31

A re-analysis of the CDC's Sept. 2021 MMWR failed to find a relationship between school-masking and pediatric Covid-19 cases. Additionally, a skeptical observer might infer that the original paper's conclusion was based on cherry-picked data.

papers.ssrn.com/sol3/papers.cf…

16/31

By Feb. 2022, "experts" now claimed real-world mask efficacy that was greater than what was achieved under ideal lab conditions, citing a CDC self-reported phone survey that was "subject to at least eight limitations" with results that were "not statistically significant."

17/31

In Mar. 2022, an NIH-funded study claimed that schools with mandatory masking had approximately 72% fewer cases of school-based transmission of SARS-CoV-2 during the Delta surge.

This study may be the most poorly designed (or intellectually dishonest) that I've ever seen.

18/31

Meanwhile in Europe (where many kids were never forced to mask), a large scale, apples-to-apples study found no benefit from school mask mandates. The U.S. press neglected to report on it, opting to promote the flawed Duke study (see above).

english.elpais.com/society/2022-0…

19/31

On an individual basis, the odds of successful respirator use are slim, yet possible. This fact is evidenced by the data above. However, the failure of mask mandates, domestically and worldwide, is irrefutable.

E.g. Mask mandates failed on a statewide level.

20/31

E.g. Mask mandates failed at a university level.

Cornell's Covid-19 outbreak was not contained despite strict masking rules plus additional measures, including: vaccination, boosting, routine PCR testing, isolation orders, contact tracing, etc.

pubmed.ncbi.nlm.nih.gov/35583871/

21/31

E.g. Mask mandates failed in Asian countries where surveys claiming +95% compliance could be viewed with less skepticism (considering the cultural normalcy of mask wearing, deference, and obedience to authority).

22/31

E.g. Mask mandates failed despite N95 requirements (see Germany). Mask mandates failed in one of the most sparsely-populated countries in the world, where resistance was met with violent force (see Australia).

23/31

E.g. Mask mandates, coupled with vaccine passports and other travel restrictions, failed to prevent one of the most catastrophic surges in Covid-19 deaths worldwide (see Hong Kong).

Masking everyone, all the time, doesn't spare the high-risk elderly who are unvaccinated.

24/31

In additional to being empirically and demonstrably ineffective, mask mandates often violate all four pillars of medical ethics. Autonomy and consent are revoked, beneficence is statistically improbable and maleficence (harms) are all-too real, especially in children.

25/31

Forcibly masking a child in diapers is a cruel and indefensible public policy that is unique to the U.S. (and one that was rigorously enforced in New York City). There are no benefits to this abuse, yet the physical/psychological/developmental harms are myriad.

26/31

Closing Thoughts #1

Political- and public-health leaders have been dishonest about masks and mandates since 2020. E.g. G7 attendees posing for a photo with N95 masks, then promptly removing them. A physician ordering masks only for a press conference. "Noble lies," etc.

27/31

Closing Thoughts #2

Some of the most tireless public-health voices in favor masking children and mandating masks forever also tirelessly promote misleading studies (see above), reject the idea of controlled studies, minimize or ignore collateral harms, block critics, etc.

28/31

Closing Thoughts #3

Mandates are correlated with violence. To force a person to wear a mask can be as psychologically traumatic as forcing a person to remove a mask.

Yet, those who wish to impose masks on others often appear to suffer from persecutory delusion.

29/31

Closing Thoughts #4

America is facing an unprecedented surge in addiction, depression, and suicidal thinking. Additionally, less obvious forms of mental illness exist and are "contagious" by way of the press, social media and public policy. Beware institutionalized abuse.

30/31

Closing Thoughts #5

Mandates are ineffective, medically unethical, and thus, unjustifiable. I believe that those who continue to advocate for mandates are undeserving of power, let alone extraordinary emergency powers, and are unfit for public service.

31/31

P.S. Published with thanks to @davidzweig @ianmSC @ifihadastick @VPrasadMDMPH @TracyBethHoeg @MarkChangizi @angrybklynmom @beenwrekt @justin_hart @shvetaraju @TheEliKlein @AJKayWriter @metrolawyering @daniela127 @Jusrangers @DrJBhattacharya @MartinKulldorff and many others.