What is it about conservative COVID deniers and masks?
For some reason, mask mandates have been the target of more overheated carping by right-wingers about anti-COVID measures than almost anything else, vaccines aside.
They've physically attacked retail staffers for trying to enforce mask rules, marched performatively around public spaces with their mugs proudly bared, carried on endlessly about how mask mandates infringe on their individual liberties.
Joseph Ladapo, Florida's crackpot surgeon-general, refused to wear a mask at a meeting with a state legislator even after she told him she was a breast cancer patient with an elevated susceptibility to infection. Ladapo, a physician, was ejected from the office.
The mask critics are now touting what they seem to think is evidence for their claim that mask mandates don't work. It's a meta-study — that is, a compilation — of studies on physical interventions against the spread of respiratory viruses. That includes chiefly masks of various types and hand-washing.
The anti-maskers jumped right on the study soon after its publication on Jan. 30 by the usually trusted Cochrane Library, asserting that it proved that masking didn't work against COVID-19. Leading the triumphal parade was Bret Stephens, a New York Times columnist and certified member of the "don't confuse me with the facts" crowd.
Stephens surfaced the other day with a column purportedly based on the Cochrane study and headlined, "The Mask Mandates Did Nothing. Will Any Lessons Be Learned?"
He wrote, "Those skeptics who were furiously mocked as cranks and occasionally censored as 'misinformers' for opposing mandates were right. The mainstream experts and pundits who supported mandates were wrong."
A few things about this.
First, one lesson about Stephens that many people learned long ago was that he doesn't do his homework.
Assuming he bothered to read the study all the way through, he seems to have missed this important admonition in the text: "The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions." (Emphasis mine.)
Something else he missed is that the two studies in the meta-analysis that actually measured the effect of mask mandates in the COVID-19 pandemic, from Bangladesh and Denmark, showed that mask mandates did reduce infections and the spread of the virus — quite the opposite of a conclusion that they "did nothing."
Stephens also relied on an interview given by Thomas Jefferson, the British epidemiologist he identifies as the "lead author" of the Cochrane paper, in which Jefferson asserted that "There is just no evidence that [masks] make any difference. Full stop."
It's tempting to rely on the statements of a study's "lead author" as gospel. It's also slothful. Jefferson is the first-named of the 12 authors on the paper, but it appears from the text that he had relatively little to do with it. His name comes last or doesn't appear at all in the paper's rundown of every author's specific contributions to the final product.
In any event, Jefferson is something of a shaky reed on which to hang judgments about the paper's conclusions.
As Kelsey Piper of Vox points out, he has "a number of eccentric and flatly nonsensical opinions about Covid-19," including that it circulated in Europe for years before its outbreak in China in December 2019.
He also has claimed that "catching covid [offers] protection against future infection and severe disease" and is "the way out of the pandemic," which is misleading at best: The level of natural immunity has been found to be related to the severity of the original infection and therefore less predictable than vaccine-delivered protection — which doesn't require getting sick to attain. Jefferson has been a critic of vaccine mandates, among other anti-pandemic approaches, which he criticized for their "ridiculousness."
The biggest problem with Jefferson's statement about masks is that it's profoundly at odds with the data in the very paper carrying his name.
Let's take a look.
To begin with, of the 78 studies compiled in the Cochrane paper, only six concerned the COVID pandemic and only two of those studied COVID and mask mandates. Those didn't actually examine mask-wearing, but only whether mask mandates were in place.
Nevertheless, they found that mask mandates helped suppress COVID. In one, a massive study of more than 340,000 residents of rural Bangladesh, the study found that mask programs that promoted but didn't mandate masks "increased mask usage and reduced symptomatic SARS-CoV-2 [that is, COVID] infections, demonstrating that promoting community mask-wearing can improve public health." Masking trebled among the test group.
The second study, involving about 6,000 Danes, found a modest difference between mask-wearers and non-wearers. But the study was small and underpowered in statistical terms — it was designed to test for a 50% reduction in infection rates, and took place in a setting where COVID infection rates were already very low.
A Centers for Disease Control and Prevention compilation of studies of mask efficacy shows that most have found appreciable gains from masking.
Among them are a study of an outbreak aboard the USS Theodore Roosevelt, where sailors lived and worked in close quarters, which found that masks produced a 70% reduced risk of infection.
Another study of 33,000 pupils in eight school districts in Massachusetts found an infection rate of 11.7% for unmasked and 1.7% for masked children.
During the 2021 outbreak of the Delta strain of COVID, outbreaks were 3½ times more likely in schools without masking rules compared with those with the mandates.
Stephens tries to dodge the weight of empirical evidence by suggesting that politics inevitably made mask mandates in the U.S. "a bust."
He writes that "there was never a chance that mask mandates in the United States would get anywhere close to 100 percent compliance" — never mind that even compliance at far, far lower rates would help reduce the spread of the virus.
He blames "American habits and culture," "constitutional limits on government power," "competing social and economic necessities" and "the evolution of the virus itself."
This is all abject twaddle. Nothing about American habits would have interfered with more masking, if conservative politicians didn't declare that it was a violation of American values. Nothing in the Constitution obstructs mask mandates any more than it obstructs selt-belt laws or, indeed, the Affordable Care Act's insurance mandates (the Supreme Court has said so).
What "competing social and economic necessities" or "the evolution of the virus" have to do with mask mandates, Stephens doesn't say. We can take that as a sign that he doesn't know.
Anyway, he should look in the mirror: The attack on sensible anti-pandemic policies by conservative pundits like him had more to do with turning those policies into political footballs than anything he mentioned.
Stephens writes that "the Cochrane report ought to be the final nail in this particular coffin." He should read the report again, or perhaps read it for the first time. Because it doesn't say anything like what he thinks it does.
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