Hiltzik: mask mandates and the right End-shutdown

What do conservative COVID deniers and masks have?

For whatever reason, mask mandates have been the subject of more heated criticism from right-wingers over anti-COVID measures than almost anything else aside from vaccinations.

They have physically attacked retail store clerks for trying to enforce mask rules, theatrically marched through public spaces with their mugs proudly uncovered, talked endlessly about how mask mandates infringe on their individual liberties.

Increased use of masks…reduction in symptomatic SARS-CoV-2 infections, demonstrating that promoting mask use in the community can improve public health.

—Abaluck et. al, on the results of a blinding study in Bangladesh

Joseph Ladapo, Florida’s wacky surgeon general, refused to wear a mask in 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 doctor, was thrown out of office.

Mask critics are now touting what they seem to think is evidence for their claim that mask mandates don’t work. Is a meta-study —that is, a compilation—of studies on physical interventions against the spread of respiratory viruses. That mainly includes masks of various kinds and hand washing.

Anti-masks jumped right into the study shortly after its January 30 publication by the usually trusted Cochrane Library, claiming it proved masking did not work against COVID-19. Leading the triumphant parade was Bret Stephens, a New York Times columnist and certified member of the “don’t confuse me with the facts” group.

Stephens showed up the other day with a column supposedly based on the Cochrane study and titled, “Mask Mandates Did Nothing. Will any lessons be learned?

He wrote: “Those skeptics furiously mocked as cranks and occasionally censured as ‘whistleblowers’ by opposing mandates were right. The leading pundits and pundits who supported the mandates were wrong.”

A few things about this.

First, a lesson about Stephens that many people learned a long time ago was that he didn’t do his homework.

Assuming you bothered to read the full study, you seem to have missed this important caveat in the text: “The high risk of bias in trials, the variation in outcome measurement, and the relatively low adherence to interventions across studies Difficulties in drawing firm conclusions.” (Emphasis mine).

Something else that was missed is that the two studies in the meta-analysis that actually measured the effect of mask mandates on the COVID-19 pandemic, from Bangladesh and Denmark, showed that mask mandates reduced infections and the spread of the virus. virus, quite the opposite of the conclusion that they “did nothing.”

Stephens also relied on an interview given by Thomas Jefferson, the British epidemiologist he identified as the “lead author” of the Cochrane article, in which Jefferson said that “there is simply no evidence that [masks] make any difference. final point.”

It is tempting to trust the claims of the “lead author” of a study as gospel. He’s so lazy. Jefferson is the first of 12 authors on the article, but it appears from the text that he had relatively little to do with it. His name appears last or not at all in the article abstract of each author’s specific contributions to the final product.

In any case, Jefferson is something of a trembling reed on which to hang judgments about the conclusions of the article.

ace Vox’s Kelsey Piper points outhas “a number of eccentric and flatly nonsensical views on COVID-19”, including that it circulated in Europe for years before its outbreak in China in December 2019.

He has also stated that “catching covid [offers] protection against future infections 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 is therefore less predictable than the protection delivered by the vaccine, which does not require getting sick to achieve it. Jefferson has been a critic of vaccination mandates, among other approaches to the pandemic, which he blasted as “ridiculous.”

The biggest problem with Jefferson’s statement on the masks is that it is deeply at odds with data from the very newspaper that bears his name.

We’ll see.

For starters, of the 78 studies compiled in the Cochrane article, only six concerned the COVID-19 pandemic, and only two of them looked at COVID and mask mandates. Those didn’t actually examine mask use, but only whether mask mandates were in effect.

However, they found that mask mandates helped suppress COVID. In one, a massive study of more than 340,000 residents of rural Bangladeshthe study found that mask programs that promoted but did not mandate mask use “increased mask use and reduced SARS-CoV-2 symptoms [that is, COVID] infections, demonstrating that promoting community use of masks can improve public health.” Blinding was tripled among the test group.

The second study, involving around 6,000 Danes, found a modest difference between mask wearers and non-mask wearers. But the study was small and statistically underpowered: it was designed to test a 50% reduction in infection rates and was conducted in a setting where COVID infection rates were already very low.

A federal center for disease control and prevention compilation of mask efficacy studies shows that most have found appreciable gains from masking.

Among them is a study of an outbreak aboard the US aircraft carrier Theodore Roosevelt, where sailors lived and worked indoors, which found that masks produced a 70% lower risk of infection.

Another study of 33,000 students in eight Massachusetts school districts found an infection rate of 11.7% for children without masks and 1.7% for children with masks.

During the 2021 outbreak of the Delta strain of COVID, outbreaks were 3½ times more likely in schools without masking rules compared to those with mandates.

Stephens tries to sidestep the weight of empirical evidence by suggesting that politics inevitably made US mask mandates “a failure.”

He writes that “there was never a chance that mask mandates in the United States would get anywhere near 100 percent compliance,” never mind that even compliance at much lower rates would help reduce the spread of the coronavirus.

He blames “American mores and culture”, “constitutional limits on government power”, “competing social and economic needs” and “the evolution of the virus itself”. Along the way, Stephens also takes an ignorant and completely unwarranted jab at the CDC, which he calls “nonsense.”

All of this is abject nonsense. Nothing about American habits would have interfered with more masking, if conservative politicians hadn’t declared it a violation of American values. Nothing in the Constitution obstructs mask mandates any more than it obstructs belt laws or, indeed, the insurance mandates of the Affordable Care Act (The Supreme Court has said).

Stephens does not say what “competing social and economic needs” or “the evolution of the virus” have to do with mask mandates. We can take that as a sign that he doesn’t know. As for the CDC, who should you go to for professional public health advice: Stephens or the CDC? Given Stephens’ record of dispensing unsubstantiated nonsense, detailed above, asking the question is answering it.

Still, Stephens should look in the mirror: The attack on pandemic-sensitive policies by conservative pundits like him had more to do with turning those policies into political footballs than anything he’s mentioned.

Stephens writes that “the Cochrane report should be the final nail in this particular coffin.” He should read the report again, or maybe read it for the first time. Because he doesn’t say anything like what he thinks he says.

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