Think again

The 88.6 percent all masked up at the Black Lives Matter protest in Seattle this summer/Wikimedia Commons

If you believe a covering over your face or anyone else’s is offering you all that much protection from the sometimes deadly SARS-CoV-2 virus, you might want to think again.

A research letter published last week at JAMA (formerly the Journal of the American Medical Association) would indicate masking isn’t doing much to slow infections rates in the U.S. The letter is not an argument to avoid masks, but a warning that adherence to other, so-called nonpharmaceutical interventions (NPIs) are equally or more important.

Americans have done a very good job of adapting to masks since April, but as a result they appear to be ignoring the other NPIs.

“Reported wearing of a mask or other face covering showed a significant increase among participants (going from) 39.2 percent to 88.6 percent” through November 24, said the report authored by researchers associated with the John Hopkins, Yale and Southern California universities. The survey was reported to have a margin of error of 4 to 6 percent.

It comes against the backdrop of a SARS-CoV-2 infection rate soaring in the U.S. since the start of October, and a warning from the Alaska Department of Health and Social Services that a new, more contagious strain of the virus first identified in the United Kingdom has arrived in the 49th state.

The World Health Organization (WHO) dashboard shows that both infections and deaths from COVID-19, the disease caused by SARS-CoV-2, began rising noticeably as fall approached in the U.S. with the weekly number of confirmed cases almost tripling from 328,000 on Oct. 5 to 1.25 million by November 30.

Deaths lagged behind infections given that it takes the infection time to kill people, but they almost tripled as well, the dashboard shows.

Correlation is not causation, but there are strong reasons to believe there is a connection between masking and rising infection rates given the results of the JAMA survey.

In the early April to late November time period, the survey reported that as the country embraced masks, there were significant drops in overall adherence to other NPIs known to reduce the spread of SARS-CoV-2.

Overall, the survey reported:

  •  The number of people staying home except for essential activities or exercise fell by almost half, dropping from 79.6 percent to 41.1 percent.
  • The number of people who allowed visitors into their homes more than doubled, growing from 19.7 percent to 42.4 percent.
  • And the number of people visiting restaurants almost tripled, increasing from 12.7 percent to 34.2 percent.

Danger zones

A U.S. Centers for Disease Control and Prevention (CDC) analysis of infections back in September concluded that bars, restaurants and coffee shops appear to represent environments in which people are most likely to encounter the SARS-CoV-2 virus.

“Restricting the analysis to participants without known close contact with a person with confirmed COVID-19, case patients were more likely to report dining at a restaurant (2.8 times more likely) or going to a bar/coffee shop (3.9 times more likely) than were control-participants,” the study said. “Exposures and activities where mask use and social distancing are difficult to maintain, including going to places that offer on-site eating or drinking, might be important risk factors for acquiring COVID-19.”

Given all of this, the latest JAMA study would suggest people should think of a face mask as much like a seatbelt. Seatbelts have been shown to reduce the odds of death in an accident by 45 percent for front-seat passengers and seriously reduce the odds of serious injury, according to the National Highway Traffic Safety Administration.

But they don’t help much if you drive around with your eyes closed.  The absolute best way to avoid serious injury or death in a motor-vehicle accident is to stay alert and avoid crashes.

The protective value of face masks remains unclear, but it appears to be less than that of seatbelts, making other NPIs even  more important in trying to avoid infection with SARS-CoV-2.

That people appear to be straying from those NPIs the authors of the JAMA study attributed to what they labeled “pandemic fatigue.” Fatigue is driving “an increasing attitude of apathy or resistance toward adherence to NPIs” other than masks, they concluded.

Overall the researchers reported, “all U.S. census regions experienced decreases in the overall NPI adherence index from early April to late November” with the rates falling from:

  • 70.0 to 60.5 percent in the South
  • 71.5 to 62.2 percent in the West
  • 70.8 to 62.4 in the Northeast.
  • And 70.3 to 54.4 in the Midwest

The authors were, however, happy about the uptick in the use of face coverings.

“The increase in reported mask wearing aligns with other national surveys of self-reported mask use,” they wrote, “and may reflect improved public health messaging.”

To “combat pandemic fatigue” as regards other NPIs, they suggested further “government mandates and consistent communication from authorities” may be in order, although they added that new research to quantify “the differential effect of NPIs in reducing COVID-19 transmission” is clearly needed.

 Limited research

An international team of researchers who studied a broad range of NPIs in 41 countries between January and the end of May reported in October that their “results cast doubt on reports that mask wearing is the main determinant shaping a country’s epidemic, (but) the policy still seems promising given all available evidence, due to its comparatively low economic and social costs.”

The authors led by Dr. Jan M. Brauner at the University of Oxford in England said their metanalysis of previous studies on masks found a negative 1 percent change linked to masks in a range of a minus 13 percent to a positive 8 percent between various examinations. The latter number is what suggested promise for masks.

The non-peer reviewed study also found other NPIs far more effective. It was posted at MedRxiv along with a link to a calculator governments could use to determine the best mix of NPIs to reduce infections, but it received little public attention.

The study concluded the most effective, government-ordered NPIs were closing schools and universities, limiting gatherings to 10 people or less, and closing most non-essential businesses.

All of those actions limit potential contacts between infected and uninfected individuals. It is possible for individuals to gain much the same protections on their own by themselves staying away from others, avoiding all but non-essentials business, and spending as little time as necessary in the latter when they must buy food and supplies.

The Brauner-led study of NPIs was followed by a peer-reviewed, random-controlled trail (RCT) of masks in Denmark that reported finding no difference in infection rates between the masked and the unmasked, but cautioned that “the findings…should not be used to conclude that a recommendation for everyone to wear masks in the community would not be effective in reducing SARS-CoV-2 infections because the trial did not test the role of masks in source control of SARS-CoV-2 infection.”

RCTs are considered the gold standard of medical research.

Other studies, largely limited to hospitals, have concluded that when a full range of personal protective equipment (PPE) is employed and used properly, it can reduce the risk of infection.

For those at greatest risk of death from SARS-CoV-2, the acquisition of full PPE and training would appear a sensible idea. More than 90 percent of those dead from COVID-19 in the U.S. appear to have been suffering from serious, pre-existing medical conditions or what are now commonly being called “comorbidities.”

The CDC at the end of December updated its list of conditions putting people at the greatest risk of serious illness or death from COVID-19. On its list of dangerous comorbidities are:


The CDC also provided a second list of chronic diseases that might increase the risk of serious illness from SARS-CoV-2. Those were:

The updated CDC report also advised that the best way to avoid infection is to limit contacts with other people. The new JAMA analysis underlines that conclusion.

Other than living in a cabin in the middle of the Alaska wilderness with food supplies enabling you to stay there for a year without human contact, the CDC noted, “there is no way to ensure you have zero risk of infection. So it is important to understand the risks and know how to be as safe as possible if or when you do resume some activities, run errands, or attend events and gatherings.

“People at increased risk of severe illness from COVID-19, and those who live with them, should consider their level of risk before deciding to go out and ensure they are taking steps to protect themselves. Consider avoiding activities where taking protective measures may be difficult, such as activities where social distancing can’t be maintained.”














13 replies »

  1. We are getting to the point where we know more about some of the long term affects of covid, and it isn’t a pretty picture. Most people who’ve had covid have at least one symptom six months after having contracted the virus. Some are dying from long term issues that covid caused. The good news is the virus is mutating and who knows where we will be six months or a year from now!

    • Steve o , im getting to point where I know the long term effects of old age and it isn’t a pretty picture. Most people have at least one old age symptom that follows them to the death bed . In fact people are dying every where of sll kinds of diseases related and un related to age and personal choice. The good news is covid isn’t at the top of the list and it is primarily a fear tactic to push in more government control to help justify a police state . Who knows where we be in six months from now . Its not looking good and covid doesn’t even register as a concern.

  2. Just saw an ADN story “double down” on two masks in 2021… WTF?

    We are living in a dangerous situation and the seasonal cold is not my main concern.

    People need to get outside and organize face to face before it is too late.

    Internet communications does not solve the communist dilemma at our door.

    • Steve stine , well said . I don’t really think the fake communists are the biggest danger though. I think its the lying corrupt politicians who pretend to be public servants but are really just power hungry creeps. For sale to highest bidder and voters be darned . Twisting words into a convoluted jumble to demonize half the citizens and turn us all against each other, using words in ways that don’t parallel any reasonable definition. Domestic terrorists my hind end. Tulsi gabbard says it right. The people like Brennan schiff and polosi are the incitement instigators. They are trying to destabilize and destroy America from inside out. Tulsi says the democrats want to turn America into a police state . She should know. Brennan and the democratic party heads are the true domestic terrorists. The are just bushwackers for hire to whom ever has the bucks. Ethics and loyalty are foreign to these traitors. A prison should be their home . Traitors to our nation and heritage. Criminals. You wanna talk conspiracy to defraud Americans of their rights. Brennan leads the charge. 33 executive orders? We do not live in a free country. Join together. Don’t be divided. Forget your minuscule differences . Fight as one people to preserve and further liberty for all future humans. Do not be fooled by these dividers. Rat on your fellow man ? How disgusting!

  3. Since “touching” your eyes can give you covid, then airborne covid can also stick to your eyes. I would venture eyes are a very vlunerable portal of transmission………….

  4. It would be interesting to know how much of an increase in the suicide rate has occurred since last March. Also just how many deaths have been truly caused by Covid 19. When a person suffers a heart attack and dies and it is discovered they have the virus what exactly is the cause of death. If a person commits suicide and then found to have the virus is that counted as death from Covid?
    The politics and money seem to dictate finding as many deaths caused by Covid as possible. The more deaths attributable to Covid the more the Govt is able to control the population and make it dependent on the Govt. the more the Govt hands out $ to the people the less incentive there is to work. Especially when the amounts given are close or even exceed what people were making working for the money. It’s almost Marxist. Giving money according to their needs and taking money from those that have earned it.
    We are heading down a slippery slope!

  5. You finally got it nearly right when you stated that “at least 90% of deaths from COVID” (you should have said with COVID, not from COVID) “had several serious comorbities”.

    So, we are at what, 400,000+ deaths with COVID in the U.S. now after nearly a year? If 90%+ had serious comorbidities, that means 10% or less died from COVID only.

    Let’s just go with 10% for easy math. 400,000 reported deaths multiplied by 10% (COVID-only deaths)= 40,000 deaths from only COVID. That is about the average annual death rate from the flu.

    The rest have serious comorbidities.

    And for perspective, it must be stated that about 2.4 MILLION to 2.8 MILLION people die in the U.S. every year.

    The media is not reporting the number of deaths that occur every year from all causes of death. So this causes a complete lack of perspective in the general public’s minds.

    Meanwhile the CDC website as of just a few days ago reported only less than 1,200 infections in the U.S. from the regular flu. There are only two types of common flu totaling about 1,200 on the CDC website. Please look it up, Craig. We need you to report this.

    The CDC puts this oddly low number of flu deaths off as due to the testing methods that hospitals are using to handle the COVID situation. So, hospitals are clearly testing and reporting deaths incorrectly, by a significant percentage.

    The CDC and the WHO are painting themselves into a statistics corner that they can’t get out of. They will blather on about other numbers, like you did in this article, but what is stated here in this comment, seems to be the key facts.

    That, and the fact that the WHO’s recommendations of how many times these COVID tests are to be cycled, which is 35 cycles or less to avoid high numbers of false positive test results, is less than the CDC’s recommended number of cycles of as much as 40 cycles until just recently. So the CDC has been telling hospitals to use a highly flawed testing process causing massive amounts of false positives for the entirety of 2020.

    The only people that should take extra precautions are the seriously ill and their caregivers.

    The rest of society should be back to normal. We are not responsible for the 2.4 MILLION deaths that occur in this country every year, nor are we responsible for the deaths of people with serious comorbidities and COVID which are about 400,000+ of the 2.4 MILLION deaths that occur every single year.

    But the marketing term to cause this finger-pointing paradigm shift is “SUPER SPREADER”. That is all it is, a marketing term for the mass consumption of the public.

    All us normally healthy people that don’t believe all this COVID BS are SUPER SPREADERS. We are evil! Narc on your neighbors for having Thanksgiving. Miss Mayor, please keep sending agents out around the city to check businesses for mask compliance like NAZI brown shirts.

    The new marketing term to keep this fiasco going is VARIANT. That is all you will hear about now. VARIANT strains of this “deadly” virus.

    • You make excellent talking points on a great Medred article that is reporting on a solid scientific study. It is a crying shame that all three get drowned-out by a crushing amount of media/gov’t slanted-information.

    • Larry your math is a bit fuzzy with regards to the flu.And while i cant find a document that clearly makes the distinction between actual flu deaths vs flu plus co morbidity.
      Its quite often mentioned that it many times brings on bacterial infection in the lungs.
      That would be the big green lungers,and the feeling of never enough O2.
      If left untreated,your talking pneumonia,now we got problems.
      But that is no longer “flu”
      Just sayin

  6. Mr. Medred , Really good article. It seems the mental health aspect of lockdowns and risk of isolating self from others physically and to some degree emotionally isn’t getting the press or recognition it should. Especially for elderly and the young. I see monk is following your articles and must be interested to desire “pressure checks”/ proofs . Perhaps knowledge can make inroads on even the most biased people. Btw good job monk on considering the angles and possibilities.

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