CORONA---The Masquerade

          On July 1, Pennsylvania’s Rachel Levine published an “Order of the Secretary of the Pennsylvania Department of Health Requiring Universal Face Coverings.”  This is merely the latest, of course.  For ninety days, everyone inside a building presenting a prescription or getting an oil change or purchasing a banana had to wear a mask, as well as the people who filled the prescription or changed the oil or sold the banana.  But that wasn’t enough.  Now if there’s some chance you might come closer than six feet from somebody outside, on a running track or at a farmers market or pushing your child on a swing, you are required to wear a mask as well.

          Why?  Well, there’s not a lot of explanation for that.  We’re all just supposed to know it because it is pounded home to us on every newscast and in every newspaper.  “Wear your mask!  It’s the smart thing to do!  We’re all in this together!”  Etc.

 

          Ms. Levine, however, in her thousand-word ukase, offers us this: “See https://www.//www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html#recent-studies.  When used in public settings, face coverings will work to reduce the spread of COVID-19 in the Commonwealth.”  At this CDC site, there are nineteen academic, medical-journal type studies listed.  This is the proof that Rachel Levine’s Order is based on something.  You know--- the science.

          So I went there, and first of all, it was not easy.  The address of the CDC site is not hyperlinked in the Order, and since it was published as a PDF file, I also couldn’t figure out how to copy and paste the address.  (My browser?  My ineptitude?)  What I had to do was manually type the more than 100 characters of the address into my search engine, and of course, I made a couple of mistakes before I got it right.  Now, I am not claiming this is part of some grand conspiracy among Rachel Levine, Anthony Fauci and the Illuminati, but the point is that one is never encouraged to look behind the curtain, to assess the “science” on your own.

          At the website, some of the nineteen studies have links embedded, and others do not.  It is possible, however, to track down the studies and read them.  I did so, though I only had to go beyond the abstracts on a couple of them.  One must assume that neither Rachel Levine nor Governor Wolf ever read the damn things, because if they had, they would be embarrassed to claim they offer any support for her statement that, “When used in public settings, face coverings will work to reduce the spread of COVID-19 in the Commonwealth.”

          A dozen do not even mention masking.  They deal with two issues that were much discussed early on in the pandemic but which nobody argues about today.  First was the question whether direct human-to-human transmission was even possible.  This was only an issue because the Chinese authorities initially lied about it and said there was no direct transmission.  The second question was whether asymptomatic or minimally-symptomatic people can transmit the ‘rona; there is no longer much question that this is possible.

          The other studies on the CDC site at least mention masking in some context.  A few deal with the efficacy of surgical masks worn by professional care workers in hospitals (e.g, “Effectiveness of selected surgical masks in arresting vegetative cells and endospores when worn by simulated contagious patients” by Green, Davidson, Panlilio et al., 2012).  Others speculate on what materials (cotton, silk, etc.) might be most effective in masks worn by the general public.  (e.g, “Testing the efficacy of homemade masks: would they protect in an influenza pandemic?” by Davies, Giri, Kafatos, Walker, Bennett, 2013).

          But literally none of these studies offer any support for Rachel Levine’s claim that “When used in public settings, face coverings will work to reduce the spread of COVID-19 in the Commonwealth.”

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          But there was one recent study of public mask-wearing that has gotten considerable attention for its conclusion that face covering is effective in preventing infection.  It was not on Levine’s (or the CDC’s) list.  This is the much-discussed “Identifying airborne transmission as the dominant route for the spread of COVID-19” that was presented in the Proceedings of the National Academy of Sciences on May 16.

          I read it.  I’m not an epidemiologist (but neither are the authors---they’re chemists and climate scientists), and I can't say it was easy, and maybe I even misunderstood some of it, but I do have some observations about the methodology and the geographical areas the researchers decided to study.

 

          So let's start with the areas chosen for study---Italy, NY and Wuhan.  I will grant you that every place that has taken a serious hit from COVID has had a different experience from every other place that has been hit hard, but is it possible to come up with three places LESS typical of the pandemic experience than Italy, NY and Wuhan?  Italy has the oldest population in Europe (second oldest in the world), and a dreadful national health service, and as a result, had a very unpleasant experience with the virus.  New York is unique for its lunatic Governor who ordered the state's nursing homes to take in COVID patients discharged from hospitals but still infectious, so they could infect thousands of otherwise healthy (though vulnerable) elderly people.  Then he sneakily undercounted the nursing home deaths.  Then he blamed Trump for it all.  In general, if you remove the 14,000 or 15,000 Cuomo-inflicted nursing home deaths from New York's numbers, the state did not have an unusually lethal experience.  Also, of course, mask-wearing had exactly nothing to do with Cuomo’s nursing home holocaust.

          Finally, there's Wuhan, where the researchers dutifully report the official Chinese government numbers of 4600 deaths, and then conclude that the swift imposition of mask protocols in China, along with the general acceptance of mask-wearing among the Chinese, was responsible for the extremely low numbers of Wuhan fatalities.

          Question.  Have you read any other study of the COVID experience that accepts Chinese government case numbers and fatalities and uses them to draw rational, scientific conclusions?  No?  Well, I haven't either.  Maybe you remember the stories about the numbers of urns delivered to funeral homes in Wuhan, or the various accounts of health-care workers (some of whom were never heard from again).  Guo Wengui, the exiled Chinese businessman and whistle-blower, estimated the death toll in Wuhan was 50,000, based on his information from crematoriums.  Other estimates from those on the scene are of a similar magnitude.

          Italy, NY and Wuhan.  Are these the places you would have chosen if you were seeking to draw some general conclusions about what typical governments or the health-care establishment did effectively?

          Another troubling issue was related to their methodology, specifically the (unstated, undiscussed) assumption that the only factors in the spread of the virus and the number of cases were the government edicts regarding masks, distancing, etc.   In other words, they assume the nature of the virus itself had no role in the matter.  Nowhere do they even acknowledge the number of studies (probably in double-digits by now), reporting on the pattern of infections and cases that was common from country to country.  With minor variations, there's six weeks of build-up to a peak that lasts about two weeks, and then the number of cases declines rather sharply.  This has happened everywhere, and it is not possible that these researchers are unaware of the studies, yet they ignored them.  To them, the only thing that mattered was when mask-wearing rules were imposed, regardless of where in the ten-week pattern the rules were issued.

          In terms of the number of cases to be expected in coming weeks, nothing is more important than how far along a state or country is in this ten-week pattern.  If a mask edict is imposed in Week 2, cases will continue to spike for another six weeks and the mask edict will appear to have no effect.  If the edict is promulgated in Week 8, however, mask-wearing will appear to have “broken” the pandemic because the number of new cases is about to fall precipitously.  In either case, the masks would have nothing to do with it.  In Week 8 of the ten-week pattern, if an Order were issued demanding that people wear underwear on their heads, it would appear to have a miraculous effect because the number of cases is about to fall anyway.  Underwear on the head?  Who knew??

          This type of selective “science,” ignoring important and well-known factors in the spread of cases in the interest of reaching a desired conclusion, is indefensible.  Maybe masks have an effect.  Maybe distancing does, and other restrictions.  I can accept that if it's true.  But the failure of these researchers to even acknowledge the epidemiological playing field on which they are working is hard to forgive.

          Next, the climate scientists here base their conclusions on an assumption that mask orders are black-and-white matters, so they measure infections and deaths before and after critical dates like NY's imposition of mask-wearing on April 17 or Italy's on April 6.  But the distinction between NY on April 17 and Pennsylvania on April 17 (or Sweden on April 17) is anything but a bright line.  In Pennsylvania, EVERYONE in a store, or engaged in a food-related transaction, has been required to wear a mask since March 16.  Is that so different from Italy or NY, or even China?  People in Sweden wear masks though they may not be required to.  Yet, for these researchers, the measuring begins and ends on the dates of certain particular government edicts even though the edicts really cannot logically be used to differentiate one place from another.

          So based on all their assumptions, the authors conclude (spoiler alert!), that wearing masks is the reason Wuhan and NY had such an easy and carefree COVID experience.  No kidding.  They really think New York and Wuhan did a great job, and they assert that the mask edicts were a central aspect of the success of those two governments.  I do not share their conclusions.  In fact, I LOL’ed when I got to that part of the study, and that’s something I rarely do when I read a peer-reviewed medical article in an academic journal.

          The response of actual epidemiologists to this paper has not been kind, and there have been demands that the PNAS withdraw it from their prestigious publication.  For one thing, nobody takes China's official numbers seriously.  In addition, nobody except propagandists views China's behavior during the pandemic to be especially admirable.  Finally, there is another reason to withdraw the study, though no one will mention it.  The first four authors of this study praising China’s brilliant response to the pandemic are Renyi Chang, Yixin Li, Annie L. Zhang, and Yuan Wang.

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          I could perform this same sort of comic autopsy on any number of recent academic articles on mask-wearing that rely on unsupportable assumptions and often appear to grow more out of political beliefs than an honest desire to answer a scientific question.  Another that has gotten some attention is “The Case for Universal Cloth Mask Policies to Increase the Supply of Medical Masks for Health Workers,” published April 6 by Abaluck, Christaki, Forman, and a bunch of other Yalies.  They simply assume the effectiveness of masks worn by the general public, citing a number of studies as proof, but which prove no such thing.  Their contribution to the debate is apparently their ability to monetize the benefits, concluding that each John Q. Public who routinely wears a mask while filling his tank or shopping at Costco translates to a societal boon of $3,000 to $6,000 (a “conservative” figure, they assure us).

          There’s just not much there.  There is speculation that masks prevent infection, and there is plenty of scolding, particularly from those who are deeply invested politically in forcing the public to wear masks.  But “science?”  There’s nothing really.  A fair summary would be that there seems little reason to think wearing masks does any great harm, though there is also some disagreement about that.  Some believe that wearing a mask for an extended period and rebreathing one’s own exhaled air is unhealthy, though there are no studies supporting that either.  Also, Surgeon General Jerome Adams said on March 2, 2020 that the public should not wear masks because some people would wear them incorrectly and increase the spread of the infection.  (A reminder: as recently as March, the WHO, the CDC and the U.S. Surgeon General each recommended that the general public not wear masks.  All recently changed their official positions.)

          Which leaves us, finally, with the argument we increasingly hear from our bureaucrats and politicians and cable-news geniuses:  "Wear a mask! Why not? It’s not going to kill you, and maybe it will help.  We’re all in this together!”

          We might just as well pass a law saying everyone has to wear garlic around their necks because, well, that’s not going to hurt us either, right?  The point is that we are either a society that is governed by logic and reason and science or we’re not, and if we are not, why not?  I’m still kind of fond of the Enlightenment.  I’m committed to reason.  I thought we all were, or at least were supposed to be.

          Besides, I’m not trying to order anyone NOT to wear masks.  Wear them everywhere.  Enjoy yourself.  Wear them until they develop that vaccine you’ve been praying for.  However, “it can’t hurt much” is hardly a justification for a universal, significant intrusion of indefinite duration upon my personal space and the rights I am guaranteed under American law.  For that, you need a bit more.  You need something, anyway, especially when the authorities issuing these orders have been so consistently wrong in their public health pronouncements.  So why don’t you decide what’s best for you, and I’ll decide what’s best for me.  That way, we can both be right.

Copyright2020MichaelKubacki