By Paul Elias Alexander, MSc, Ph.D., Liesel-Marie Alexander, MBA
Note: This is Part 1 of a two-part series.
The question on whether to wear a face mask or not during the COVID-19 pandemic remains vexing, emotional and highly contentious. This question about the utility of a face covering (which has taken on a talisman-like life) is now fraught with steep politicization regardless of political affiliation (e.g., Republican or liberal/Democrat).
Importantly, the evidence was never there to support mask use for asymptomatic people to stop viral spread during a pandemic. While the evidence may seem conflicted, the research (including the peer-reviewed studies) actually does not support their use and leans heavily toward masks having no significant impact in stopping spread of the COVID virus. That’s right, the blue surgical face masks and the white cloth masks are utterly useless!
In fact, it is not unreasonable at this time to conclude that surgical and cloth masks, used as they currently are, have absolutely no impact on controlling the transmission of the COVID-19 virus, and current evidence implies that face masks actually can be harmful – especially as currently used and without other PPE type equipment. This conclusion is comprehensively documented by Dr. Roger W. Koops in a recent American Institute of Economic Research (AIER) publication. He state that there is no clear scientific evidence that masks (surgical or cloth) work to mitigate risk to the wearer or to those coming into contact with the wearer, as they are currently worn in everyday life and specifically as we refer to COVID-19.
Just look at the devastation, the complete disaster visited upon the Canadian population, the U.S. population, the British, the Australian, the Caribbean, the European populations and others by the specious, unsound, and reckless lockdowns policies. The band of COVID advisers employed by government are highly stupid and inept people. A “clown car,” if you will. What absurdities and junk statements have been made for 18 months now by each of these advisers, each being more inane and vacuous than the other. Pure nonsense, lacking of any substance or underpinning evidence! It quickly became clear that most of these “expert advisers” were invited there, and their role was not based on any merit. A strong grade 11 biology student could run rings around these lockdown lunatics!
We now present evidence below, making the argument that all the evidence and our conclusions also apply to the current delta variant. The “experts” and their media are relentless in trying to scare you into vaccinating with a vaccine largely untested for safety. They are coming, led by irrational and incompetent Anthony Fauci, after your children. We fail to find one statement on COVID over 18 months by Fauci that has any real scientific or evidence underpinning. Once you read or listen carefully, you realize that it is complete garbage pseudo-science he spews, non-stop.
Do children spread the virus thus warranting masks?
This brings us to the actual evidence. Do we have any on risk of transmission? Is there any on risk to children and COVID spread in schools, to adults, to the home? Well, it turns out we have tons of evidence, and while limited here by space, we will provide just a sample using roughly 50 studies/reports (actual reports, systematic reviews and research studies) to help support our core thesis that schools must be reopened immediately and remain open. Closing schools was a devastating policy failure and harmed our children. The school remains the safest place for children and teachers in this emergency.
No, the evidence is clear that children do not readily transmit COVID virus. We have evidence from Switzerland, Canada, the Netherlands, France, Iceland,the U.K., Australia, Germany, Singapore, Greece and Ireland that the infection rate in children is very low, that spread from child to child is uncommon, that spread from child to adult/parent is uncommon, that cases in children typically comes from a household transmission/cluster by droplet spread, and if infected, children have no to mild symptoms with the risk for hospitalization, severe illness, or death being very low.
For example, Heavey out of Ireland looked at secondary transmission of COVID in children (March 2020). Researchers looked at children and adults in a school setting and identified 6 cases (3 children, 3 adults of which 2 were teachers) and their 1,155 contacts (924 child contacts and 101 adult contacts identified). Researchers reported no evidence of secondary transmission in the school environment. Specifically, they stated there is “no case of onward transmission to other children or adults within the school. … In the case of children, no onward transmission was detected at all. Furthermore, no onward transmission from the three identified adult cases to children was identified.”
Additionally, The Atlantic’s Thompson on Jan. 28, 2021, pointed to a study out of Singapore involving three COVID-19 clusters, finding that “children are not the primary drivers” of COVID outbreaks and that “the risk of SARS-CoV-2 transmission among children in schools, especially preschools, is likely to be low.”
A Norwegian study looked at 200 primary-school children aged 5 to 13 who had COVID-19 (testing all contacts twice within their quarantine), and found that there were no instances of secondary spread, further dispelling the notion that children play a primary role in spreading within the school setting.
A very comprehensive systematic review by Ludvigsson published in Acta Pediatrica, studied 47 full-texts and reported, “Children accounted for a small fraction of COVID-19 cases. … Children may have lower levels than adults, partly because they often have fewer symptoms, and this should decrease the transmission risk. … Household transmission studies showed that children were rarely the index case and case studies suggested that children with COVID-19 seldom caused outbreaks. … Children are unlikely to be the main drivers of the pandemic.”
Duke University researchers (CIDRAP) examined 35 North Carolina school districts with in-person teaching and found that there were no instances of child-to-adult spread in schools.
A recent CDC report on transmission of SARS-CoV-2 in K-12 schools found that, “Based on the data available, in-person learning in schools has not been associated with substantial community transmission.”
Based on a high-quality McMaster University (Brighter World) review, researchers found that in children under 10 years of age, “Transmission was traced back to community and home settings or adults, rather than among children within day cares or schools, even in jurisdictions where schools remained open or have since reopened. … The bottom line thus far is that children under 10 years of age are unlikely to drive outbreaks of COVID-19 in day cares and schools and that, to date, adults were much more likely to be the transmitter of infection than children.”
A BMJ scoping review study evaluated the role of children in the transmission of COVID-19 virus and included 14 studies. It was found that children are not transmitters to a greater extent than adults. Nonetheless it does appear that in this study it was concluded that children can spread disease. We do not argue with this, but point the reader to the rarity of this type of spread.
The British Columbia Center for Disease Control (BCCDC) issued a full report in September 2020 on the impact of school closures on children and found that 1) children comprise a small proportion of diagnosed COVID-19 cases, have less severe illness, and mortality is rare, 2) children do not appear to be a major source of SARS-CoV-2 transmission in households or schools, a finding which has been consistent globally, 3) there are important differences between how influenza and SARS-CoV-2 are transmitted, 4) school closures can have severe and unintended consequences for children and youth, 5) school closures contributes to greater family stress, especially for female caregivers, while families balance child care and home learning with employment demands, and 6) family violence may be on the rise during the COVID pandemic, while the closure of schools and child care centers may create a gap in the safety net for children who are at risk of abuse and neglect.
Additionally, a high-quality robust study in the French Alps examined the spread of COVID-19 virus via a cluster. They followed one infected child who visited three different schools and interacted with other children, teachers and various adults. They reported no instance of secondary transmission despite close interactions. These data have been available to the CDC and other health experts for over a year.
We could go on and on about the very low risk of children spreading the virus or its variants – so why the move to mask in August 2021? Is there new data we do not know about? We would be remiss if we did not accentuate that for many children, especially less advantaged children, the school setting presents as their principal route out of crushing poverty, and for many it is the only daily safety from the dangers of a chaotic, disordered, and at times threatening home life. School closure and shift to online learning has been a catastrophic mess and a real threat. In a February 2021 BMJ publication, Lewis et al. cogently outlined how closing schools is not evidence-based and harms children, and this is supported by a very recent systematic review which shows that when the lowest risk of bias studies are examined, school closures have no obvious or distinct effect on SARS-CoV-2 transmission.
Any evidence on effectiveness of masks?
No, we find none, zero! Neutral in some instances but clearly ineffective in most. Where is the evidence by these scientific experts that masks work and for our children – especially when children do not spread the virus or get ill? Where is this evidence? We say they have none, and this delta variant (and others to come) are and will be used to continue the baseless fear mongering within the society, and mainly now to drive persons to vaccinate (especially our children) with an untested vaccine that remains investigational and experimental. We are being asked to submit our children to this risk, where there is no opportunity for benefit but only opportunity for harm. No one, not one prior Trump administration official nor current Biden administration official, can point to any evidence that warrants children being subjected to these vaccines. None. And this is frightening given children may be set up for a lifetime of possible disability and ill effect given we do not know the long-term effects of the vaccines because the vaccine developers did not study this. This last sentence is an incredible one if you ponder it carefully! That we would put out a vaccine that was not safety tested!
We argue that the messaging by the media and medical experts initially suggested that all persons are of equal risk of severe illness from COVID infection. This is where it all went wrong and where societies were greatly deceived. We were never “all” at equal risk. This was deeply flawed and has crippled the U.S. and global nations since day 1 of this pandemic.
This messaging continues today with the push to scare the population into vaccinating. This was and remains a flat-out falsehood, and it has driven irrational fear by the public. This clearly erroneous intimation has stuck in the minds of the public and severely impacted their perception of their risk and how they would move forward. This falsehood, along with the falsehood on the prominence of asymptomatic spread as a driver of the infection and re-current infection, is extensive. These are very rare occurrences if any, yet if you listened to the television medical experts, you would take your teddy bear and go hide under your mother’s bed for the next 25 years. They have subverted science by their unscientific messages. This caused irrational fear and hysteria, and it has held on. This type of deception and the resulting unfounded fear has been driven by the media despite “a thousandfold difference in risk between old and young.”
The use of face masks is our focus in this column. What is the current best evidence (comparative effectiveness research and any type of higher-quality reporting), and what does it tell us about face masks, especially for our children, in terms of harms? There are potentially catastrophic harms due to mask use (references 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33). A recent study report published in JAMA indicated that wearing a mask can expose children to very dangerous levels of carbon dioxide in just three minutes. We are seeking clarification, for this study may have been retracted due to the current political and biased research publication era we are operating in. We will update as needed.
The sum total of the mask evidence, even if we torture it and say it is “neutral,” states conclusively that masks do not work in this COVID emergency and will not work for the delta variant etc. – at least based on how they have been used and the type of masks that have been used. Certainly, this does not apply to a properly fitted seal-tested N95 mask in the proper environment and with other protective equipment. Masks based on the evidence are ineffective and a waste of time in stopping transmission or curbing deaths. We thus provide the ineffectiveness of masks based on references 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42. We also know of the failure of mask mandates (references 1, 2, 3, 4, 5, 6, 7, 8). While the recent report by Blazemedia shreds the delta variant narrative of it being lethal etc., it actually showcases that masks do not work given India has among the highest mask use globally yet is/was ineffective against the delta variant. These masks do not work, and something other than science is at play in terms of the prior catastrophically failed lockdowns, school closures and masking! The World Health Organization (WHO) has stated, “In general, children aged 5 years and under should not be required to wear masks.”
Let us unpack a few of these more pivotal COVID mask studies and a particularly important seminal research study by the CDC published in Emerging Infectious Diseases (EID) in May 2020 and looking at nonpharmaceutical measures for pandemic influenza in non-healthcare settings (personal protective and environmental measures using 10 RCTs), found that use of masks did not reduce the rate of laboratory-proven infections with the respiratory influenza virus. “In pooled analysis, we found no significant reduction in influenza transmission with the use of face masks.”
Similarly, a strong argument against the use of masks in the current pandemic gained traction when a recent CDC case-control study reported that well over 80% of cases always or often wore masks. This CDC study further called into question the utility of masks in the COVID-19 emergency. This CDC study showed that the majority of persons infected wore face masks, and still got infected.
Look no further than the study out of Sweden by Ludvigsson on COVID transmission with no lockdowns or mask mandates in children. In terms of masking children, Ludvigsson powerfully evidenced the low risk in children by publishing this seminal paper in the New England Journal of Medicine among children 1 to 16 years of age and their teachers in Sweden. From the nearly 2 million children that were followed in school in Sweden, it was reported that with no mask mandates, there were zero deaths from COVID and a few instances of transmission and minimal hospitalization.
Then there is the high-quality randomized controlled trial Danish Study published in the Annals of Internal Medicine that sought to assess whether recommending surgical mask utilization outside of the home would help reduce the wearer’s risks of acquiring SARS-CoV-2 infection in a setting where masks were uncommon and not among recommended public health measures. This can be regarded as the highest-quality study on the effectiveness of COVID masks. The sample included a total of 3,030 participants who were assigned randomly to wear masks, and 2,994 who were told to not wear masks (i.e. the control arm). The authors concluded that there was no statistically or clinically significant impact of mask use in regard to the rate of infection with SARS CoV-2.
Perhaps one of the most seminal and rigorous studies emerged from a United States Marine Corps study performed in an isolated location: Parris Island. As reported in a recent NEJM publication (CHARM study), researchers studied SARS-CoV-2 transmission among Marine recruits during quarantine. Marine recruits at Parris Island (n=1,848 of 3,143 eligible recruits) who volunteered underwent a two-week quarantine at home that was followed by a second two-week quarantine in a closed college campus setting.
As part of the study, participants wore masks and socially distanced while symptoms were monitored with daily checks of temperature. RT-PCR testing was used to assess the effectiveness of these strategies insofar as the presence or absence of SARS CoV-2 mRNA was concerned. Samples were obtained by the use of nasal swabs, which were collected between arrival and the second day of supervised quarantine and on days 7 and 14 (the second quarantine used to mitigate infection among recruits). All recruits were required to have a negative RT-PCR result prior to entering Parris Island. It was found that within two days following arrival on the closed campus, 16 participants now tested positive for SARS-CoV-2 mRNA (15 being asymptomatic), and 35 more tested positive on day 7 or on day 14 (n=51 in total).
More specifically, of the 1,801 recruits who tested negative with PCR at study enrollment, 24 (1.3%) tested positive on day 7. On day 14, a total of 11 of 1,760 (0.6%) of the previously PCR-test negative participants tested positive; none of these participants were seropositive on day 0. As such, 35 participants who had had negative PCR test results within the first two days post arrival at the campus then became positive during the strict supervised quarantine. Of the 51 total participants who had at least one positive PCR test, 22 had positive tests on more than one day.
The authors reported that about 2% who had earlier negative tests for SARS-CoV-2 at the beginning of strict supervised quarantine (we ask the reader to think; military grade supervision), and less than 2% of recruits who had unknown prior status, tested positive by day 14. Positive volunteers were mainly asymptomatic and transmission clusters occurred within platoons.
The predominant finding was that despite the very strict and enforced quarantine (including two full weeks of supervised confinement and then forced social distancing and masking protocols), the rate of transmission was not reduced and in fact seemed to be higher than expected! Hence, we point out that not only was masking ineffective in preventing the spread of disease, but even made things worse. Despite quarantines, social distancing and masking, in this cohort of mainly young male recruits, roughly 2% still went on to become infected and tested positive for SARS-CoV-2. Sharing of rooms and platoon membership were reported risk factors for viral transmission.
As with the Danish investigation, this study of Marine recruits who were kept under stringent military level supervision raises serious questions about the utility of quarantines, as it appears that not only do masks appear to be ineffective in preventing communal disease spread, but also that quarantines do not work even when supervised for two weeks in a closed college. As we have stated elsewhere, it seems that quarantines are ineffective, and that would also seem to include enforced social distancing! At the risk of repeating ourselves, all this is to say that in this study where compliance was monitored and enforced, and the conditions are favorable enough to support a rigorous study, so called “mitigation” strategies just do not work and cannot work amongst the general population. This study stands as one of the higher-quality and more robust studies on the question of masking.
In August 2020, a review by a German professor in virology, epidemiology and hygiene reported that there is no evidence for the effectiveness of face masks and that if used improperly, then it may in fact lead to an increase in infections.
We even argue that the recent escalation of infections in India (delta) that was followed by the use of early treatment anti-virals such as ivermectin and hydroxychloroquine that crushed the wave and brought things under control as to infections, hospitalization, or deaths, really showed that masks do not work. Why? India was one of the most masked nation on earthy, near 99%.
Again, even if we tried to tease out “minimal help” and say that “they may help a little,” these COVID-19 masks are largely ineffective. As an example, a very recent publication stated that typical face masks become non-consequential and do not function after 20 minutes due to saturation. “Those masks are only effective so long as they are dry,” said professor Yvonne Cossart of the Department of Infectious Diseases at the University of Sydney. “As soon as they become saturated with the moisture in your breath, they stop doing their job and pass on the droplets.” In a similar light, there are indications that wearing a mask that has already been used, which is very common as we tend to reuse our masks, is riskier than if one wore no mask at all.
Tomorrow: Are masks actually harmful to our children?
Paul Elias Alexander, PhD, an expert in epidemiology, evidence-based medicine and research methodology, is an independent academic scientist and consultant. He has been a professor at McMaster University in evidence-based medicine, COVID pandemic adviser to WHO-PAHO in Washington, D.C., and senior adviser on COVID pandemic policy at the Department of Health and Human Services. He did graduate studies at the University of Oxford in England, the University of Toronto in Canada, McMaster University in Canada, and York University in Canada.
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