As you might imagine, there are a lot of things I would like to write about, but time runs short. One of these, as school approaches, is to try to summarize for people all the arguments they can make for why their children shouldn’t be abused by forcible masking. I will try to get that done, but in the meantime, read the Wall Street Journal column from this morning on the subject. (WSJ Article) Written by two physicians, but I am sure Twitter will find a way to censor them. The arguments they make should be common sense to anyone by now, but we are a nation of “believers” not a people who care about actual data and facts. And by God, if I believe masks work, what more do you need. The authors point out the usual statistics that very, very few children have incurred a serious illness from CV-19, that any adult who is worried should get vaccinated and that there are harms associated with masks. They tiptoe around the fact that they just don’t work to slow transmission.
I have posted this study before, but it is always good to have pre-epidemic research to look at, before everything became political, especially masks. The study was published in September 2019, when CV-19 was likely just beginning to surface. (JAMA Article) It tested N-95 respirators versus surgical ones for protecting health care workers against influenza, using a randomized controlled trial design across many centers. (By the way, masks have apparently worked amazingly well to stop the spread of flu in the last year or so. Or maybe there is a more logical explanation since they have done nothing in regard to CV-19.). The really amazing result is that neither one worked all that well. Over four years, there was basically no difference between the two, which is surprising since the N-95s are supposed to stop everything, but apparently aren’t that effective against the very small aerosols on which many viruses travel. And around 8% of each group got the flu and a much higher number got some respiratory infection. Wonder how many were coronavirus? It says some were, but no numbers or percents. Now where the subjects got infected is unclear, but at least some was almost certainly in the workplace. But again, the really key lesson is that even among health care workers, who presumably know how to wear them, neither masks nor respirators stopped infection from occurring.
Now here is a study that has attracted some attention, because as I mentioned this weekend, it is fascinating how little we actually understand about the act of transmission and the relative role of droplets versus aerosols, is there any surface transmission, etc. This study from Singapore is relevant to masks, because as I have said 100 times, there are good physical reasons why they are very unlikely to stop the virus from being inhaled or exhaled, and consequently do little to nothing to prevent spread in the community. (JID Article) The authors examined the size of emitted particles during breathing, talking and singing and looked for the presence of our good friend CV-19. They had CV-19 patients do this for 30 minutes of breathing and 15 minutes each of talking and singing. (I just want to note that this was a racist study, as the talking involved reading a Dr. Seuss book. Those Singaporeans must not be as wokely enlightened as we are here and I can’t believe they subjected these patients to this racist bilge.) Now that is a useful design and useful data. 13 out of 22 patients emitted measurable viral RNA, including 2 who were asymptomatic and one who was presymptomatic.
So stop there for a minute, a significant fraction of infected people exhaled no virus. Viral loads varied wildly. Two patients accounted for 52% of the viral load, supporting the superspreader notion. 94% of virus was emitted during talking and singing and talking accounted for more than singing. Small aerosols contained 85% of the virus. Uh-oh, that’s not good, those go right through everything. These small aerosols are more likely to go right to the lungs as well. But here is what is really interesting, none of the virus samples that were captured could be cultured, indicating an absence of viable virus, but that may be due to the relatively low levels of virus, especially compared to swabbing. But it was an interesting contrast to the cycle numbers from the swabbed sample which tested positive, which was often quite low, indicating a high viral load.
Finally, on this topic, the former director of the CDC, Robert Redfield, will be next to be roasted by the priests of the mask religion, as he acknowledged that there is no data to support the CDC’s recommendation that children be masked in school. This from the man who once said that masks were the new vaccine, and better than a vaccine. Now I am hoping that the latter statement does not turn out to be ironically true.