"Masks don't work" is also a concession

The argument against masks is that they are wretched, and enable de facto totalitarianism.

The reason I skipped commenting on the recent update to ye old Chochrane maske reviewe,

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is the same reason pro-maskers have rebuffed all the gleeful dancing on the alleged corpse of mask efficacy that erupted in the wake of the same — there is not in fact a corpse there. Reality is not adjudicated by randomized control trials nor “reviews” of the same; this is merely a conventionally accepted (and not particularly impressive) process for evaluating drugs and care protocols. Masks are not drugs, and public masking is not a healthcare protocol — it is perverted, antisocial insanity — so the Cochrane review was never relevant. It fails to determine anything precisely for this reason.

Now we must confront the reality that even the source has denounced its own review as meaningless. Utterly misleading headline incoming:

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source: The New York Times. Image credit as shown; fair use asserted for reproduction: Illustrates the publication’s own presentation of masking.

Let’s dovetail to a spoiler reveal regarding Tufekci’s headline: Nothing at all in her essay makes it “clear” that masks work. Nor is there anything particularly “the Science™” about the evidence she is evaluating. It’s just a meager heap of pencil-pushing dressing up our eternal human ignorance.

Consider the Sabrina Santiago photograph used as the cover image, itself, for evidence that the headline’s assertion is problematic:

A trollish ploy on my part, to be sure; but literally nothing Tufekci offers is remotely convincing of this woman’s choice inviting or ensuring a negative outcome, vs. the idiotic and humiliating behavior of the other two subjects. Nothing “clear” can be offered, because nothing “clear” exists to offer.

The Disavowal

With the headline briefly rebuked, we move on to the more substantial element of her essay, the reporting of Cochrane’s disavowal [emphasis added]:

“Many commentators have claimed that a recently updated Cochrane review shows that ‘masks don’t work,’ which is an inaccurate and misleading interpretation,” Karla Soares-Weiser, the editor in chief of the Cochrane Library, said in a statement.

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“The review examined whether interventions to promote mask wearing help to slow the spread of respiratory viruses,” Soares-Weiser said [this is actually deceptive, but it does apply to the two masking studies added in the current update], adding, “Given the limitations in the primary evidence, the review is not able to address the question of whether mask wearing itself reduces people’s risk of contracting or spreading respiratory viruses.” […]

Michael D. Brown, a doctor and academic who serves on the Cochrane editorial board and made the final decision on the review, told me the review couldn’t arrive at a firm conclusion because there weren’t enough high-quality randomized trials with high rates of mask adherence.

In other words, the Cochrane review was a pointless sham; a farce. To repeat an analogy I have used previously, we could imagine that Cochrane issued a review of randomized control trials of basketball plays, finding “there is no evidence that slam dunks work.”

It would be ridiculous for anyone to crow over such a result, because the result would only reflect that no trials have been conducted. Randomized control trials and “science” in general aren’t how humans figure out “what works” when it comes to almost the entirety of practical activity. As with basketball, we just imitate and innovate wildly from day to day until a tiger eats us. There’s no magic rule-book called “science” that can actually solve reality.

Consider the Cochrane network itself. A philanthropic endeavor to provide high-quality scorecards for every medical intervention under the sun, it was founded in 1993, and has 7,500 topics under review.

Has healthcare improved very much in the last three decades?

Has human understanding of medicine become less confused?

Or is the Cochrane network a symptom, rather than the remedy, of the stalling of medical “progress”?

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And given that it is arguably the former, what meaning is there to the statement that Cochrane is the “gold standard” of anything? What actual authority does Cochrane possess on any subject, including the efficacy of masks? If fifty million Frenchmen can be wrong, so can fifty million doctors and healthcare wonks. Citing a Cochrane review, in other words, is not compelling. They aren't even doing the studies.

In the case of masks, the basketball analogy is imperfect. There have been randomized control trials for masks (or promotion of the same), but they are exactly as farcical as trials would be for basketball plays. They produce meaningless results, because you can neither randomize nor control human behavior.

Importantly when it comes to SARS-CoV-2, the masks (and other physical interventions) review has been underway since 2006, and the current update primarily adds two works concerning (promotion of) masks and this virus. One of these claims (spuriously) to show positive effects. But neither are sufficient to overcome the built-in flaws of the endeavor — randomized control trials can’t answer the question being asked. Jefferson, et al. was not updated because a conclusion had been reached regarding masks; it was updated because Cochrane runs living reviews that update from time to time, regardless of having any conclusion. And so Tufekci further rhetorizes competently but deceptively:

While the review assessed 78 studies, only 10 of those focused on what happens when people wear masks versus when they don’t, and a further five looked at how effective different types of masks were at blocking transmission, usually for health care workers. The remainder involved other measures aimed at lowering transmission, like hand washing or disinfection, while a few studies also considered masks in combination with other measures. Of those 10 studies that looked at masking, the two done since the start of the Covid pandemic both found that masks helped.

This is a true-but-false statement. Despite being right about the limits of the review ("it can’t answer the question of whether masks work"), the pro-maskers can’t help dipping their hand into this particular cookie jar ("but also, it totally shows they work"). The studies in question are presumably Abaluck, et al.

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(the infamous Bangladesh study) and Bundgaard, et al.

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What Tufekci is eliding is the same thing she had reported only moments before: These studies regarded mask recommendations, not “masks.”

In particular (and it’s not often enough pointed out), Abaluck, et al. appears to have been designed strictly as a sociological and policy investigation, with the question of how to measure “infections” improvised sometime in the course of the project — there are no clear baseline seropositivity measurements to make inference of infections during the intervention period possible. And while Bundgaard, et al. measured test-reported infections, the difference in rates was minimal and didn’t impress the formulas for statistical significance. Hence why Jefferson, et al. (the mask review)’s conclusion that “Harms were rarely measured and poorly reported (very low‐certainty evidence),” which is essentially the same text as the previous version before this year’s update, is entirely accurate for the two new studies.

The tactics of “masking science”

One could counter that the Cochrane update forced the pro-maskers to reveal that claims that masks work were “Lucy-footballs” all along. Once “the Science™,” per its own terms, returned from deliberation to announce a verdict, a mistrial was declared and the football snatched away.

I have no problem with such an interpretation. But I would ask, what next? The “experts” who subvert our modern political disputes by deeming what is “safe” and “effective” do not actually depend on scientific proof of their declarations. Everyday people will (often) still trust what the experts think, on the basis that doing so generically ensures conformity, reduces friction, and seems not to result in being eaten by tigers.

The fact is that “masking science” is a Lucy football — we will never have any kind of “proof” of whether they work or not. If you doubt otherwise, show me the proof that bicycle helmets work (I don’t wear them). The debate could be moved to a theoretical stage — based on engineering or evolutionary grounds (i.e., if breathing through fabric were beneficial, we would have evolved with flaps) — but this won’t achieve proof of anything either. Whether slam dunks work cannot be demonstrated in a lab experiment.

Whereas the practical domain of masking (and locking down) lends itself to an interpretation that, in fact, these atrocities do “work.” Places that masked and locked down a lot, despite often recording the most cases (because of the aggressive testing that justifies mask mandates and lockdowns), preserved viral virginity for frankly mind-blowing lengths of time. Consider the People’s Republic of Canada:

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Zinszer, K. et al. with values for US kids from Clarke, KEN. et al.

Generally, the people who wanted to avoid the virus both followed the advice of experts and avoided the virus. It may be impossible to know whether masking helped or not (or if it did help, whether this was merely an indirect effect related to how masking affects other behaviors). But these people will never be convinced that masks didn’t work, because in their practical experience, they did.

For this reason, I feel and have long argued that a strictly political argument against masking is the only tactic with any chance of avoiding “defeat by indifference.” Arguing that masks “don’t work” is conceding that it means something if they do. The first and most important stage of reframing the argument is to establish that:

Masks are not politicized, they are political

When pro-maskers and “public health” propagandists lament that masks have become politicized, this is a tactic to deny counter-arguments against a political position. Both public masking and mask-mandates are intrinsically and obviously political:

Political - relating to the government or the public affairs of a country. (Oxford Languages)

By doing so, the pro-maskers issue themselves a writ for their own political position to be immune from debate or the requirement to achieve consensus in the public forum. They achieve a dictatorship over anything that they can successfully insinuate into their sphere of “apolitical” medical interventions; again, arguing that masks “don’t work” only affirms this dictatorship, by simply insisting that here the wrong thing has been dictated.

Not only are masks intrinsically political, but they are scarcely the first time in human history that extreme disputes have centered on apparel in general or the public obscuration of the face specifically, with hijabs being banned reflexively in many polities as soon as they start to be worn (except where they are instead mandated). Affixing an additional valence to public masking — health and infection — does not remove the political valence. Public masking is a public affair. Your mask pisses me off (fact). Your mask is a minor nuisance, and any protestations on your part to the contrary are invalid (a lie). Your mask warps the emotions of children (a plausible belief). Your mask protects me (a practically plausible short-term fact with no long-term benefit). Your mask makes you look like a retarded duck (opinion).

What humans should do about masking is not litigated by the binary issue of whether they inconvenience viruses. Like any public affair, it is a battlefield for conflicting values and preferences that may spill over to legal dictates (mandates or bans) within the limits of local constitutional proscriptions (as interpreted ad hoc). The weaponry of this battle is all-encompassing of human experience — it includes, inter alia, values of physical comfort, social traditions, crime control, aesthetics, the pleasure of human beauty, and sure — practical notions of “safety,” respect for the vulnerable, etc. (Everything in those latter categories can be attacked on grounds of futility; though interventionists and conservatives will usually just be preaching to their own choirs at that point.)

When pro-maskers dismiss non-“scientific” arguments against masks as immature, superfluous, or entitled, these claims whether valid or not (which depends on subjective consensus) are not substantive to the question of masking as a public affair. Values have a place on the political battlefield regardless of their alleged superfluity. But to gain agreement, those values still must first be voiced.

I hate masks. They look stupid, and they signify terror of life itself (of which illness and death are integral, sacred elements), as well as the reification of totalitarian state power which allows for further assaults and degradations of myself and my fellow citizens. They should be shunned in public, and may be banned as communities see fit, akin to any other vulgar affront.

Give us respiratory liberty, or give us death.

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1. Jefferson, T. et al. “Physical interventions to interrupt or reduce the spread of respiratory viruses. [version 6]” Cochrane Database Syst Rev. 2023; 2023(1): CD006207.

2. Tufekci, Zeynep. “Here’s Why the Science Is Clear That Masks Work.” (2023, March 10.) The New York Times.

3. Soares-Weiser, Karla. “Statement on 'Physical interventions to interrupt or reduce the spread of respiratory viruses' review.” (2023, March 10.)

4. Where progress has not stalled is in the medicalization of human life, of course.

5. Abaluck, J. et al. “Impact of community masking on COVID-19: A cluster-randomized trial in Bangladesh.” Science. 2022 Jan 14; 375(6577): eabi9069.

6. Bundgaard, et al. “Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial.” Ann Intern Med. 2021 Mar;174(3):335-343

7. Zinszer, K. et al. “Seroprevalence, seroconversion, and seroreversion of infection-induced SARS-CoV-2 antibodies among a cohort of children and adolescents in Montreal, Canada.” medrxiv.org

Values for US kids from:

Clarke, KEN. et al. “Seroprevalence of Infection-Induced SARS-CoV-2 Antibodies — United States, September 2021–February 2022.” MMWR Morb Mortal Wkly Rep. 2022 Apr 29;71(17):606-608.