Cochrane Settles the Mask Debate
Masks go down in flames
Cochrane has now settled a debate that, for most of the pandemic, we were not even allowed to have. In those dark days, any whiff of anti-mask talk was meant with derision and cries of “rat-licker”. Fast forward to the present day and Cochrane confirm that what was true before Covid (that masks don’t work) and which magically became untrue for two years during Covid has now become true once again. If you’ve had a hard time keeping up, I suspect that was rather the point. In the absence of evidence, confusion is a useful tool.
So, who are Cochrane? I’ll be brief. Wikipedia state that they are:
“a British international charitable organisation formed to organise medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers.”
Essentially, Cochrane perform incredibly thorough and systematic reviews of medical interventions and publish the results so the medical community can make informed, evidence-based decisions about which measures are worth pursuing and which ones are best avoided. It means you or your doctor do not have to read every single study about, say, masks (as I did) to decide whether or not to use one. You can just read the Cochrane review as they’ve done it already and have summarised the findings.
As the Guardian reported in 2016:
"Cochrane summarizes the findings so people making important decisions – you, your doctor, the people who write medical guidelines – can use unbiased information to make difficult choices without having to first read every study out there..."
And their reviews are generally good. In 2004, in a paper discussing the value of Cochrane, the Canadian Medical Association Journal stated that their reviews are “of comparable or better quality and are updated more often than reviews published in print journals.” They concluded their piece by saying “Cochrane Library is the best single resource for methodologic research and for developing the science of meta-epidemiology.”
So, while no one is above reproach, we should probably take what Cochrane say seriously. And what do they say about masks? Well, their latest update to ‘Physical interventions to interrupt or reduce the spread of respiratory viruses’ is a characteristically robust review covering 78 randomised control trials and 610,872 participants. It is clear and unequivocal and speaks for itself so I’ll let it do just that.
Medical/surgical masks compared to no masks
“Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks.”
“Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks.”
Conclusion: “The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks.”
N95/P2 respirators compared to medical/surgical masks
“We are very uncertain on the effects of N95/P2 respirators compared with medical/surgical masks on the outcome of clinical respiratory illness.”
“N95/P2 respirators compared with medical/surgical masks may be effective for ILI (RR 0.82, 95% CI 0.66 to 1.03; 5 trials, 8407 participants; low‐certainty evidence). The use of a N95/P2 respirators compared to medical/surgical masks probably makes little or no difference for the objective and more precise outcome of laboratory‐confirmed influenza infection.”
Conclusion: “There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection.”
There’s really nothing more to say at this point. This is as thorough a review of the evidence for masking that you are going to get. It is completely up to date with the latest studies specifically focusing on SARS-CoV-II transmission. And it shows masks don’t work. Even your fancy N95s are useless. Case Closed. Move on. Let’s not talk about it anymore, okay?
A better topic of conversation would be why on earth institutions like the World Health Organisation (WHO) suddenly started recommending them during Covid. The Cochrane review is, after all, an update to one published in November 2020 which contained the exact same negative conclusions about masking. Furthermore, it perfectly tied in with the WHO’s own pre-Covid review of mask studies which concluded that “there was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza.” In other words, we always knew masks didn’t work so what were the WHO up to in 2020 when they suddenly changed their advice? Was it political, as BBC Medical Correspondent, Deborah Cohen, said at the time?
“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.”
Of course, they couldn’t back them. How could anyone looking at the evidence back them? But, they recommended them anyway (a different thing altogether), apparently due to “political lobbying”. Yes, we told you to wear them but we never said they would work!
That recommendation led to the enforcement of a measure known to be ineffective for the best part of two years. It led to people losing their jobs and some ridiculous countries arresting OAPs and putting them in jail for not wearing a mask in the supermarket. It led to children being made to wear them all day long in school. It still has doctors, nurses, and patients continuing the charade in hospitals around the world right now. The Government ministers who signed the laws and mandates, along with the advisors and committee members who made the recommendations, all probably very much hope we can just forget it and move on but some of us have long memories and we’re not going to let it go.
