Thread by @kevinnbass

A review published by @CellCellPress shows mask-wearing may contribute to stillbirths, irreversible cognitive deficits in children, testicular dysfunction, and much more.

This suggests the ethical principle "first, do no harm" was violated by mask mandates.

Thread.🧵

Before beginning, I want to point out that during the pandemic, I dismissed others' concerns about the topic and insisted on masking. I masked my children in public and I regret doing so. Anti-maskers made me angry. I was wrong. I am sorry.

Now, the thread:

- "She is breath of fresh air!"

- "Would you like to go outside and get some fresh air?"

In the English language, there are many phrases and idioms that hint at the beneficial effects of the outside air well-being, equating fresh air with relief.

What if these turns of phrase actually reflect an underlying biological reality?

What if our common expressions reflect important facts about human health?

There is a large body of literature suggesting just that.

This article from @TheAtlantic, published just months before mask mandates would become the rage among America's elites, examined the question with respect to cognition thoroughly and came to disturbing conclusions.

At its essence, it cites a number of papers to show, roughly, what this systematic review showed:

Elevated CO2 levels, up to 0.5% (5000 ppm; normal atmospheric CO2 is 350 ppm, or 0.035%), impair cognition, mainly of the higher forms of decision-making.

pubmed.ncbi.nlm.nih.gov/32557862/

One notable study was this one from investigators from Harvard and Syracuse (ref: dash.harvard.edu/bitstream/hand…). In it, investigators a strong dose-response relationship between CO2 levels and multiple cognitive domains in the research subjects, illustrated below:

Note that the "high CO2 condition" was only 1500 ppm, or 0.15% CO2.

This will become relevant in a moment.

This brings us to masking.

Masking has long been insisted to provide benefits to reducing Covid transmission, without downsides.

"What's the harm?" It was demanded.

The harm has to do with CO2, the levels of which can become very high and cause serious health problems.

This was the subject of this explosive new paper published in @CellCellPress and the subject of this thread.

cell.com/heliyon/fullte…

This paper starts by noting that the 8-hour threshold limit for safe CO2 concentrations by the National Institute for Occupational Safety and Health (NIOSH) is 0.5%.

The 15-minute threshold limit is 3%.

The concentration at which death occurs is about 10%.

The paper reviewed studies examining CO2 concentrations under or near masks and found that they far exceeded even the 15-minute safety threshold set by NIOSH:

0.42-0.94%
2.8-3.2%
0.22-0.29%
2.8%
1.41-1.7%
2.4-2.6%
2.8-3.2%
1.28-3.52%

Here's the table:

Note that one study did find concentrations of only 0.22-0.29%. This was the only study that measured CO2 at the bridge of the mask, which may have artificially reduced the CO2 levels and not reflected those that are inhaled.

Otherwise, virtually all studies exceeded the 8-hour CO2 exposure safety threshold of 0.5% set by NIOSH.

Most even exceeded the 15-minute CO2 exposure safety threshold.

These are the same masks that were mandated for everyone to wear publicly during the pandemic, and which many people wore all day long.

(As an aside, this increase in inhaled CO2 occurs because masks provide breathing resistance and create a dead space that traps CO2.)

Now compare these values to the highest values in ppm from the Harvard/Syracuse study that showed strong effects on cognition: 1500 ppm, or 0.15%.

These studies show up to 3.52% inhaled CO2, which translates to 35200ppm.

This is 23 times higher than the highest CO2 concentrations (1500 ppm) from the Harvard/Syracuse study at which cognitive impairment was found in a dose-response manner.

This is a disturbing finding.

Next, the study authors asked whether the current research literature shows that these masked CO2 concentrations actually produce increases in blood CO2 levels.

After all, maybe the CO2 measured under the mask might be high, but this might not translate to elevated blood CO2.

The studies reviewed showed a very robust increase in blood CO2 levels.

Table below:

But do these elevations in blood CO2 levels correspond to the very high CO2 concentrations seen in inhaled CO2 in the first table we showed?

The answer is yes.

To see this, here's the abstract from a 1967 study conducted by the U.S. military where they put human subjects in 3% CO2. It shows a virtually identical 3-4 mmHg increase in arterial CO2 as many of the mask studies shown in the table immediately above.

In fact, many of the mask studies report a significantly higher elevation in arterial CO2 than 3-4 mmHg, suggesting the possibility that the inhaled CO2 is even higher than the 3-3.5% measured by most of the studies we have seen before.

Finally, the authors reviewed studies conducted on animals that investigated asked at what CO2 levels animals show adverse health effects.

It found:

😷0.48% CO2 for 10 minutes per day for 20 days in pregnant guinea pigs caused stillbirth and birth defects in 68% of the pups.

I have screenshotted these remarkable and disturbing findings, provided in the image below.

Reference: ntrl.ntis.gov/NTRL/dashboard…

😷3% CO2 (equivalent 0.8% for humans) chronically in pregnant rats caused stillbirth and birth defects

Reference: apps.dtic.mil/sti/pdfs/ADA58…

😷0.3% CO2 (chronically, pregnant rats): Brain damage, increased anxiety, impaired memory and learning in rat pups born to mothers chronically exposed to 0.3% CO2 during pregnancy

Reference: tandfonline.com/doi/full/10.31…

😷0.3% CO2 (chronically, young mice): Brain damage, increased anxiety, impaired memory and learning in young mice chronically exposed to 0.3% CO2 during development to adulthood

Reference: tandfonline.com/doi/full/10.31…

😷2.5% (0.5% for humans) (4 hours, male mice): Destruction of testicular cells and sperm in adult male mice exposed to 2.5% CO2 for just 4 hours.

Reference: rep.bioscientifica.com/view/journals/…

Table below:

The authors noted that some animal research resulted in a recommendation by the U.S. Navy to keep CO2 concentrations on submarines below 0.8%.

This research found at 3% CO2, rat mothers miscarried and gave birth to pups with deformities.

This makes inhaled CO2 a teratogen.

Therefore the Navy set the limit at 0.8% to account for species differences and protect female Navy sailors.

0.8%!

Recall that most masking studies saw concentrations of inhaled CO2 far above 0.8%.

See, again, below.

What are the implications for pregnant women?

Here are a few studies.

First, here is a study conducted in pregnant women using N95s, looking at exhaled O2 and CO2. It clearly shows an impact of the N95s on these exhaled gases.

Reference: aricjournal.biomedcentral.com/articles/10.11…

Second, confirming this effect is this remarkable paper, showing an increase in red blood cells in women during the period of heavy mask use in Israel.

Reference: obgyn.onlinelibrary.wiley.com/doi/full/10.10…

This study is a confirmation of the above data because it demonstrates a robust physiological compensation to low blood oxygen.

However, we do not have any good evidence in pregnant women (or, in the parlance of the present age: pregnant people who can become pregnant) of the long-term effects of mask-wearing and therefore no evidence that these effects occur in women.

All we have are animal studies and a clear indication that changes in CO2 concentrations do occur in mask-wearing women.

It therefore seems reasonable to say, given this evidence gap, that benefits to mask-wearing should be clearly demonstrated to justify mandates.

We will return to this.

Let's loop back to the beginning. We mentioned that cognitive impairment occurred at just 0.15% CO2 in a substantial body of human research

Yet as we have seen in the masking studies, inhaled CO2 can exceed 3%.

Is there any evidence that masking can impair cognition?

This recent study suggests that there is. It showed that chess players wearing masks made significantly worse decisions.

This is consistent with evidence showing that high CO2 concentrations impair decision-making processes.

pnas.org/doi/10.1073/pn…

This finding is confirmed in this abstract, showing that prolonged masking modestly impaired cognition.

Other, more short-term studies found no significant effect, which may be due to the duration of mask-wearing and its impact on oxygenation.

See, e.g., ncbi.nlm.nih.gov/pmc/articles/P…

Surveys confirm these findings among healthcare workers. In one survey of 343 nurses during the Covid pandemic, more than 90% reported adverse effects after wearing an N95 respirator on shift.

pdfs.semanticscholar.org/bdea/3aef30775…

Headache was by far the most common adverse effect reported, which is believed to be caused by dilation of the brain's blood vessels in response to elevated CO2--the same mechanism by which caffeine withdrawal causes headache.

Reference: link.springer.com/article/10.216…

Skin breakdown was also remarkably common among these nurses. pdfs.semanticscholar.org/bdea/3aef30775…

As was acne.

Yet a full quarter of nurses also reported noticeably impaired cognition, consistent with what we saw reported above.

Another study among healthcare workers showed similarly high rates of adverse effects among operating room workers, with these increasing over time. By 4 hours, the majority of workers (70%) had some adverse effects.

ncbi.nlm.nih.gov/pmc/articles/P…

This brings us to a recent meta-analysis published on the topic. Most "debunkings" on this platform focused on the SpO2 reading changes, but the other outcomes were more important since they actually affected the experience of subjects.

https://twitter.com/kevinnbass/status/1645825293779865600

The findings in the above meta-analysis are consistent across a wide variety of research publications and are not really disputable. The methodology of the meta-analysis might have been poor, but that doesn't change the fact that the substance of the findings is largely correct.

As a side note, the modest impact of surgical masking on SpO2 and the irrelevance thereabout could be gleaned by just a passing familiarity with the masking literature. scielo.isciii.es/pdf/neuro/v19n…

This brings us to the final and most important point.

Only two of sixteen randomized controlled trials on masks for infection prevention have shown modest benefits.

Meta-analysis, furthermore, does not show any benefit of mask-wearing for this purpose.

https://twitter.com/VPrasadMDMPH/status/1647039134744317953?s=20

Why therefore, given the above documented and potential harms of masking, were mandates thought to be justified?

Here Rochelle Walensky from CDC lies and says that there was no equipoise, meaning there was no debate that mask benefits exceeded harms.

https://twitter.com/kevinnbass/status/1641205922671513602

However, as we have seen, harms of masking are clearly substantial and even potentially serious, while benefits are unestablished.

Why therefore were mask mandates implemented?

In short, we can speculate that this was done because pandemic policy was woke: so overwhelmed by emotional considerations, critical thinking about risks and benefits was bulldozed:

https://twitter.com/kevinnbass/status/1643505225276293121

This kind of mass psychosis, thankfully, occurred only in the context of a mild pandemic and not during some other more serious event. We must take it seriously so that we do not find ourselves in a much more serious situation in the future--and behave the same irrational way.

ADDENDUM: It is important to note that many masking symptoms also overlap with those of Long COVID and may contribute to some of the psychogenic aspects of long COVID syndrome. @VPrasadMDMPH talks about the lack of link between COVID and long COVID here

https://twitter.com/VPrasadMDMPH/status/1641932655259426816

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