Are Face Masks Effective? The Evidence.

Originally published in July, updated December 15, 2020. Think science matters? It doesn’t.

An overview of the current evidence regarding the effectiveness of face masks.

1. Studies on the effectiveness of face masks

So far, most studies found little to no evidence for the effectiveness of cloth face masks in the general population, neither as personal protective equipment nor as a source control.

Go to the link – 10 studies are listed including one from the University of Illinois.

Development of cases after mask mandates

In many states, coronavirus infections strongly increased after mask mandates had been introduced. The following charts show the typical examples of Austria, Belgium, France, Germany, Ireland, Italy, Spain, the UK, California, Hawaii and Texas. See more examples.

Go to the link is see the charts.

Additional aspects

1. There is increasing evidence that the SARS-2 coronavirus is transmitted, at least in indoor settings, not only by droplets but also by smaller aerosols. However, due to their large pore size and poor fit, cloth masks cannot filter out aerosols (see video analysis below): over 90% of aerosols penetrate or bypass the mask and fill a medium-sized room within minutes.
2. The WHO admitted to the BBC that its June 2020 mask policy update was due not to new evidence but “political lobbying”: “We had been told by various sources WHO committee reviewing the evidence had not backed masks but they recommended them due to political lobbying. This point was put to WHO who did not deny.” (D. Cohen, BBC Medical Corresponent).
3. To date, the only randomized controlled trial (RCT) on face masks against SARS-CoV-2 infection in a community setting found no statistically significant benefit (see above). However, three major journals refused to publish this study, delaying its publication by several months.

Go to the link to see more.

2. Studies claiming face masks are effective

Some recent studies argued that cloth face masks are indeed effective against the new coronavirus and could at least prevent the infection of other people. However, most of these studies suffer from poor methodology and sometimes show the opposite of what they claim.

Typically, these studies ignore the effect of other measures, the natural development of infection numbers, changes in test activity, or they compare countries with very different conditions.

An overview:

1. A meta-study in the journal Lancet, commissioned by the WHO, claimed that masks “could” lead to a reduction in the risk of infection, but the studies considered mainly N95 respirators in a hospital setting, not cloth masks in a community setting, the strength of the evidence was reported as “low”, and experts found numerous flaws in the study. Professor Peter Jueni, epidemiologist at the University of Toronto, called the WHO study “essentially useless”.
2. A study in the journal PNAS claimed that masks had led to a decrease in infections in three global hotspots (including New York City), but the study did not take into account the natural decrease in infections and other simultaneous measures. The study was so flawed that over 40 scientists recommended that the study be withdrawn.
3. A US study claimed that US counties with mask mandates had lower Covid infection and hospitalization rates, but the authors had to withdraw their study as infections and hospitalizations increased in many of these counties shortly after the study was published.
4. A German study claimed that the introduction of mandatory face masks in German cities had led to a decrease in infections. But the data does not support this claim: in some cities there was no change, in others a decrease, in others an increase in infections (see graph below). The city of Jena was an ‘exception’ only because it simultaneously introduced the strictest quarantine rules in Germany, but the study did not mention this.
5. A Canadian study claimed that countries with mandatory masks had fewer deaths than countries without mandatory masks. But the study compared African, Latin American, Asian and Eastern European countries with very different infection rates and population structures.
6. A small review by the University of Oxford claimed that face masks are effective, but it was based on studies about SARS-1 and in health care settings, not in community settings.

Click the link to read more.

3. Risks associated with face masks

Wearing masks for a prolonged period of time is not harmless, as the following evidence shows:

1. The WHO warns of various “side effects” such as difficulty breathing and skin rashes.
2. Tests conducted by the University Hospital of Leipzig in Germany have shown that face masks significantly reduce the resilience and performance of healthy adults.
3. A German psychological study with about 1000 participants found “severe psychosocial consequences” due to the introduction of mandatory face masks in Germany.
4. The Hamburg Environmental Institute warned of the inhalation of chlorine compounds in polyester masks as well as problems in connection with face mask disposal.
5. The European rapid alert system RAPEX has already recalled 70 mask models because they did not meet EU quality standards and could lead to “serious risks”.
6. In Germany, two 13-year-old children died suddenly while wearing a mask for a prolonged period of time; autopsies couldn’t exclude CO2 intoxication or a sudden cardiac arrest.
7. In China, several children who had to wear a mask during sports classes fainted and died; the autopsies found a sudden cardiac arrest as the probable cause of death.

Conclusion

Cloth face masks in the general population might be effective, at least in some circumstances, but there is currently little to no evidence supporting this proposition. If the SARS-2 virus is indeed transmitted via indoor aerosols, cloth masks are unlikely to be protective. Health authorities should therefore not assume or suggest that cloth face masks will reduce the rate or risk of infection.