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Danish mask study author: effect may be small, but worthwhile

November 20, 2020 - 11:53am

The Danish ‘randomised control trial’ study into the protective effects of facemasks caused the predictable furore when it was published this week. Comparing a sample of 3,000 people who were wearing masks and 3,000 people who were not, 42 of the mask-wearers became infected with Covid-19 and 53 of the non-mask-wearers: a small, non-statistically-significant difference.

The self-appointed Defenders of Science were quick to move into attack mode. Oxford’s Trish Greenhalgh said it was not necessarily “high quality science” and made some technical objections to the study; science-activists like Vincent Rajkumar, Editor-in-Chief of the Blood Cancer Journal, announced: “Ignore the Danish study. Masks work. Wear a mask… Speaking as someone who has led 10 RCTs and knows when to ignore one”; a former CDC director lambasted the study in the same journal that published it.

To make it worse, there were rumours that the study had been squashed or censored, rejected by medical journals on political grounds.

But in a sign of how rash this debate has become, none of the critics seems to have taken the time to talk to the study’s authors. We spoke to the lead investigator, Professor Henning Bundgaard of the University of Copenhagen, and found him to be the most inoffensive, on-message, pro-mask advocate you could find. It turns out that the scientist they were attacking was one of their own. His view, it turns out, is that:

  • Even though the protective effect is small, masks should be worn diligently wherever recommended.
  • The main benefit of masks is the ‘source control’ effect, where other people are protected from you, which the study does not cover.
  • The usefulness of the result is that it shows that you cannot be complacent even if wearing a mask — it must be seen as one tool among many, including social distancing, hand hygiene etc.
  • There was no conspiracy to censor his results: even though the study was rejected from the New England Journal of Medicine, JAMA and the Lancet, he does not believe it was for political reasons, more likely simply that it was a neutral conclusion.
  • He fully stands by his results and maintains that the study was carried out as scientifically as it is possible to do.
I think the message should be that wearing a mask, in the correct way of course, would to some extent — not a large extent but some extent — protect you. But it’s your contribution to protect others, that we should take care of each other. All of us would hate the idea that I had a dangerous disease now I passed it on to you because I was not wearing a mask. So we have good reasons to recommend masks, I guess.
- Professor Henning Bundgaard, University of Copenhagen

Not exactly someone worthy of the heavy-handed cancellation treatment.

Thanks to Professor Bundgaard for taking the time to talk to us, and clarifying his views.


is the Editor-in-Chief & CEO of UnHerd. He was previously Editor-in-Chief of YouGov, and founder of PoliticsHome.

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Paul Melzer
Paul Melzer
3 years ago

So, with a .3 difference between wearing masks and not wearing mask, that’s three more out of a thousand catching the bug! With a CFR of .5, that makes 15 dying out of a million who catch CV19.

Also, there’s been ZERO evidence presented that asymptomatic “cases” are spreaders. Caring for others means limiting public movement when one is not feeling well, and this should be encouraged more, but the whole idea of everyone wearing a mask just because we’re told, or just in case you could kill someone, is (or should be) offensive to all.

david bewick
DB
david bewick
3 years ago
Reply to  Paul Melzer

I’ve reposted your last sentence, I hope you don’t mind. Makes a lot of sense and I hope drawing attention to it will help. Thanks.

Michael Dawson
Michael Dawson
3 years ago
Reply to  Paul Melzer

I don’t think you’ve got this right at all. Surely the correct way to look at the problem is like this, assuming the sample results can be applied to the whole population (which is clearly questionable, as the sample ended up being very small and the difference is therefore not statistically significant). 42 of the mask-wearers became infected with Covid-19 and 53 of the non-mask-wearers. You are therefore roughly 25% more likely to catch the virus if not wearing a mask, compared with wearing a mask. Assuming masks don’t reduce the viral load that the wearer breathes in, which might be well a wrong assumption, one would expect a corresponding reduction in deaths if everyone wore masks, compared with nobody wearing masks. Maybe I’ve got this wrong – please tell me if I have.

The Danish study obviously could not measure how much masks reduce transmission BY the person wearing them, as opposed to the wearer themselves being protected. All the literature suggests this effect is likely to be greater.

I can’t say I like wearing masks and I don’t think they make a huge difference, but I do agree with the author of the Danish study that they are overall worth persevering with, certainly in enclosed public places.

jeff2
jeff2
3 years ago
Reply to  Michael Dawson

can you explain your arithmetic that got 25% more likely to catch the virus

Michael Dawson
MD
Michael Dawson
3 years ago
Reply to  jeff2

53 – 42 divided by 42. See my other posts – I completely accept the point about a small sample and the 25% difference potentially being completely illusory.

Fran Martinez
Fran Martinez
3 years ago
Reply to  Michael Dawson

Michael, when the differences are so small and the numbers so small, there is a chance (measured by the p values) that what you saw is purely random. That is, if you make the study again, it could be 50 – 40 the other way around, etc. So this situdy only proves that at best the masks do not work.

Michael Dawson
MD
Michael Dawson
3 years ago
Reply to  Fran Martinez

I said in my post that my assumption that the results could be applied to the population “is clearly questionable, as the sample ended up being very small and the difference is therefore not statistically significant”. So, absolutely, the results could be random. But being unable to show a positive relationship is not the same as proving that there is no relationship. It just means that on current evidence, we don’t know, based on this trial. As the authors noted and I repeated, the study was only looking at masks from one perspective, which is do they offer any protection to the wearer. The study did not look at whether a person wearing a mask offers some degree of protection to other people.

Jane Jones
Jane Jones
3 years ago
Reply to  Michael Dawson

“But being unable to show a positive relationship is not the same as proving that there is no relationship.”

So what is the point of the study, again?

Michael: Proves nothing, but that is no proof that there is not something to prove . . .

Haha. You are funny.

Adrian
A
Adrian
3 years ago
Reply to  Jane Jones

The point of the study was to find out. However Covid refused to rage in Denmark, so there were too few infections to find out. It was a worthwhile endeavour nonetheless.

Chris Clark
Chris Clark
3 years ago
Reply to  Michael Dawson

You don’t understand statistical analysis if you think there was a 25% difference between the masked and unmasked groups’ chances of catching Covid-19. Using the absolute numbers is not how the comparison can be measured. The percentage difference was 0.3%. This means there was no significant difference between the 2 groups. None. That’s what the p value of 0.38 tells us. And when a 95% CI for difference the crosses 0 (95% Confidence Interval is −1.2 to +0.4), it means there is just nothing to say. By all means wear a mask if it makes you feel better. But as of yet, there is still no evidence that a mask will make any impact at all on whether you do or don’t contract Covid 19.

Michael Dawson
Michael Dawson
3 years ago
Reply to  Chris Clark

I don’t agree. I think the problem in this case is that the sample of those actually infected was very small, relative to the difference between the two groups, so we really don’t know if there no relationship. Imagine if the same ratio of % infected wearing masks to % infected infected not wearing masks – the c25% I mentioned – was retained, but we multiplied both sides by 10. So the numbers would be 420 and 530. I’ve not done the calculation, but the p value would certainly be higher, and at some point, if you kept increasing the overall number of infections, would pass 0.9, then 0.95 etc.

I’m not saying the 25% reduction from wearing a mask would remain with a larger sample. It could well disappear. I was simply disagreeing with the earlier poster that the study emphatically shows masks don’t protect the wearer. I would also caveat your final statement: there is still no evidence [from this study] that a mask will make any impact at all on whether you do or don’t contract Covid 19 [when wearing a mask yourself, although the study did not look at the possible benefits for other people from you wearing a mask].

I am not here as an evangelist for masks. Personally, I think they probably do have some marginal benefit for the wearer, on average, and probably a bit more of one for other people nearby.

Randall Clawson
Randall Clawson
3 years ago
Reply to  Michael Dawson

Yes, this study did not address if mask wearing prevents spread to others. But no randomized controlled study addresses that and therefore, scientifically speaking, there is “no evidence” that masks prevent spread. There is no need to make a caveat.

Mike Orman
MO
Mike Orman
3 years ago
Reply to  Chris Clark

“By all means wear a mask if it makes you feel better.”
I think that reason for wearing a mask is not a good one. It is likely to reduce compliance with social distancing, which is one measure that might actually have a worthwhile effect. Although probably not enough of an effect to justify its economic and other health consequences.

Paul Melzer
PM
Paul Melzer
3 years ago
Reply to  Michael Dawson

Let’s take Professor Bundgaard’s own words: “300 people should wear a mask for roughly a month in order to protect one from getting an infection.” Not fatality”infection.

Even if the case fatality rate is as high as .1% (one out of a thousand), how many millions of otherwise healthy humans must mask their faces in order to protect life?

We must not see masking as without costs”in physical and mental health. And I hope that the study results might at least tilt the discussion away from governments requiring them, and towards simpler wise counseling of good hygiene and smart public interactions.

Shalal Sadullah
Shalal Sadullah
3 years ago
Reply to  Paul Melzer

One other cost is the actual cost of masks! I think there was a study from UCL that if everyone in Lincolnshire wore masks it would be £150 million a year in one county alone.If they were being provided free of charge by the NHS (like medicines)it would have led to a technology appraisal by NICE!!

Mike Orman
Mike Orman
3 years ago

Then there are all the environmental effects of production, distribution & disposal, plus all the work time taken up in fitting and removing, and removing glasses to wipe off the steam, plus the accidents due to impaired vision……..I’m sure we could all think of a few more.

kennethhawkins2
kennethhawkins2
3 years ago
Reply to  Paul Melzer

And, as we all know, let the truly fearful stay at home or mask anywhere and everywhere, let the elderly and people with underlying conditions stay home. These actions would also tilt the discussion even more away from restrictions on the vast majority of people who have a 99.99 chance of survival even if they are symptomatic.

Adrian
A
Adrian
3 years ago
Reply to  Michael Dawson

Good on you. The pro and anti maskers desperately want certainty.
How is it that people can’t work with a ‘maybe’? I’ve flip-flopped on the best interpretation of the science for 9 months now, and I’m proud to do so.

On the other hand, given that ‘face coverings’ (not masks) have been shown to increase particle transmission in some cases, and given that this trial on surgical masks is a weak maybe in favour of masks, we desperately need more studies.

If we could get mink to wear a mask we might be able to get a definitive answer as to whether they reduce transmission or not. I suspect we may never know, but if masks keep the superstitious happy, maybe that’s good enough.

Bruno Noble
Bruno Noble
3 years ago
Reply to  Paul Melzer

Sorry but where’s the offence? I may consider someone asking me to wear a mask in the belief that my not doing so could kill them to be mistaken, but in what way is it offensive?

C Arros
C Arros
3 years ago
Reply to  Bruno Noble

You might want to read again the whole sentence: ‘the whole idea of everyone wearing a mask just because we’re told, or just in case you could kill someone…’, I would as well take offence in being told like a child or a person who has no judgement of his/her own to do so just because we’re told to do so. And how would you feel, assuming you lived in the same city as me, if I asked you to stop driving your car because you could kill my children?

kennethhawkins2
kennethhawkins2
3 years ago
Reply to  C Arros

Love the analogy, stop driving your car because you might kill my children

Jane Jones
Jane Jones
3 years ago

How about stop being a couch potato and eating trans fats and becoming obese so that you don’t negatively impact the demographics and the price of my health insurance premiums?

How about not speeding so you do not crash into me? How about stopping abusing alcohol and drugs so that I don’t have to chip in from my taxes to fund programs to get you up and running?

This is a fun game, and it could go on for quite a while, and it really should, until people finally grasp the basic idea that I am not more responsible for another’s health than that person is for mine, and it is for ME to decide what I consider to be risky behavior that I must steer clear of. Unfortunately so much unhealthy behavior is not only allowed but actively encouraged or made actually unavoidable in our society that it has become in practice impossible to protect oneself from the poor choices of others.

And now, suddenly, I have to go along with a ridiculous mask demand to protect someone whose health profile may well be a far greater hazard to me than mine to his or hers. yet no one is demanding that these human hazards must, say, get a stomach staple to protect themselves and me or get a stop mechanism on their cars so that they cannot speed. It is bonkers.

James N
James N
3 years ago
Reply to  Bruno Noble

Voltaire said something like “He who can make me believe absurdities can make me commit atrocities.”

Shalal Sadullah
Shalal Sadullah
3 years ago
Reply to  Paul Melzer

And thats such an important question. Are asymptomatic carriers/cases capable of spreading? From the Track and trace experience of other countries it seems highly unlikely. it appears that this virus is now endemic so unless we answer that question we will end up locking
and muzzling our entire population for a considerable period of time-vaccine or no vaccine

lilybordbar
LB
lilybordbar
3 years ago
Reply to  Paul Melzer

Masks have given them a false sense of protection. We would discard a tissue if we sneezed or coughed into it, but most people coughing and sneezing into their masks for hours and I find it negligent and gross if they think the masks is protecting anyone and not causing damage by breathing recycled air through their soaked mask!

Mike Orman
MO
Mike Orman
3 years ago
Reply to  lilybordbar

On top of which, if the wearer has a lightweight infection (low viral load breathed in initially) he possibly gets to breathe back in a little more of what he would have breathed back in had he not worn the mask, thus giving the particles a second chance to settle on any of the surfaces in his respiratory system.

Shalal Sadullah
SS
Shalal Sadullah
3 years ago

When masks became mandatory the arguement was that there was neither evidence of its usefulness nor was there concrete evidence that they are not useful. So whats to lose as there were no randomised trials. Then we have a randomised trial. The trial i presume was not meant to give a verdict on its use in symptomatic patients who are coughing and sneezing; thats a bit of a no brainer. It was about randomly assigning masks to two groups to show the difference. And the difference is clinically insignificant. So where is the controversy.
There is no point having an RCT if we are only going to believe the result we want it to be

david bewick
DB
david bewick
3 years ago

Hi, I’ve reposted your last sentence, I hope you don’t mind. Makes a lot of sense and I hope drawing attention to it will help. Thanks.

Adrian Smith
Adrian Smith
3 years ago

It is just another example of the precautionary principle leading to bad policy decisions, which don’t get changed for political reasons even when clearer evidence does become available. I have felt from the outset that vulnerable people were more at risk by wearing masks than not. It is entirely possible, though we will never know for sure, that this flawed policy has cost more lives.

hctkbt822
hctkbt822
3 years ago

Clinically and statistically insignificant results. When there are basically no reliable studies confirming mask effectiveness one way or the other and so many have been done, you know that the intervention is either totally ineffective or at best, mostly ineffective. And based on the data he reports, I’d say it’s the former!

klymenko.t
TK
klymenko.t
3 years ago

It is good Freddie Sayers spoke to the author and they were able to sound their opinion. Nice chat, which does not change two facts: 1) the source protection idea (benefit to others) was not tested in this study and no data exist to set it one way or another; 2) the conclusion of the paper is that there is no statistically significant benefit to the wearer of the mask. I am curious why the study did not look at any adverse effects of the mask wearing. Is it because those are so well established that no further research is needed? It is surprising that Freddie Sayers did not ask a single question about it. He usually does more in-depth interviews.

Jane Jones
Jane Jones
3 years ago
Reply to  klymenko.t

” I am curious why the study did not look at any adverse effects of the
mask wearing. Is it because those are so well established that no
further research is needed? It is surprising that Freddie Sayers did not
ask a single question about it.”

Agree absolutely. Thanks for sparing me the need to bring this up. When the doc mentioned the virus etc. found on the inside of masks his conclusion was stated as obvous: that this person has not infected others Unmentioned is that the mask wearer is probably not only courting hypoxia by wearing a mask that on top of this he/she is probably concentrating his/her viral load because cannot access the natural breathing function of expelling nasty stuff that should be expelled.

So, the fact that a study geared toward self-protection yields the same old same old conclusion of Wear A Mask to Protect Others and Not Kill Granny is quite disappointing. But the twisted logic is obvious so I guess that is a good thing, since the inescapable inference is that the twisting results from a political consideration.

The doc does at least state that this is for people to decide on their own, and mask policing or shaming is not supported by the results of the study. Just virtue signaling and willingness to self-harm is the end result . . .

Adrian
A
Adrian
3 years ago
Reply to  klymenko.t

The guys who released this study are pretty brave, and under attack from the superstitious people left right and center. I don’t blame them for not wanting to answer certain questions, given the propensity of people to deliberateley misquote these days.

Mike Orman
Mike Orman
3 years ago
Reply to  klymenko.t

I think a study needs to narrow down its focus to answer a single question. Trying to answer two at once would make the whole thing too complicated and muddy the conclusion(s).
To study adverse effects of mask wearing would be a very difficult subject as you would have to think of all the possible effects there might be and try and cover them all, perhaps by a long-running study, or more likely several studies, of regular wearers such as hospital staff or shorter term studies but with a huge number of participants. Even then, the likelihood of finding significant evidence could be small.

It is possible that there will be other ways the data gathered in this study can be analysed in future to provide more insights into other questions.

Clach Viaggi
CV
Clach Viaggi
3 years ago

I don’t understand the purpose of the study. It has been said from the beginning that the introduction of masks was not to protect the wearer, but to protect the others to spread infection.
This study confirm the first part (it offers no protection), but didn’t give any contribution to the second, to which there is no any serious study that prove it.
We are still to the point that the Lancet metastudy used to introduce mandatory masks has been quickly retracted, because full of methodological mistakes, and the Who admitting to BBC that changed its policy (from not recommending it’s widespread use to the opposite) just because of political pressures and no to new evidences.
On the other hand the datas around the world in the last year show a correlation of increasing of cases whenever there was an introduction of mandatory masks.
SWPRS has the best review of the masks studies I have found on the web

gumballsamurai
GS
gumballsamurai
3 years ago
Reply to  Clach Viaggi

If droplet theory as primary infection route is true, 6 feet of separation and wearing masks should be effective. There should be at least some improvements consider masks stop droplets. If the virus is airborne the 6 feet rule does not apply and masks don’t work because the particles are too small. The mainstream quietly admitted there is at least some airborne spread in October but reassuring the masses it is mostly droplet spread and the masks work. https://www.thelancet.com/j

gumballsamurai
gumballsamurai
3 years ago
Reply to  Clach Viaggi

https://www.wired.com/story

Oh yes… much controversy.

Asadi’s research group, led by Bill Ristenpart, has spent the better part of the last decade building a model to understand how things like temperature, humidity, and other factors influence how respiratory viruses transmit through the air. There’s been much controversy over whether or not SARS-CoV-2 is actually “airborne””meaning that it can remain aloft on respiratory particles smaller than 5 microns, as the measles virus does. Asadi and Ristenpart are among a growing number of researchers who suspect the coronavirus can in fact be harbored in these very fine particles, termed “aerosols,” as they wrote in a recent editorial in Aerosol Science and Technology. This would mean the coronavirus could be spread not just by an uncovered cough or sneeze but also just by regular breathing and talking. It would also complicate the current standard 6-foot rule for social distancing that the CDC and OSHA have recommended meat processors implement for their workers.

gumballsamurai
gumballsamurai
3 years ago
Reply to  Clach Viaggi

8 meter distancing!!!!
https://papers.ssrn.com/sol

carrotwax
MS
carrotwax
3 years ago

It may be worthwhile for some people to wear a mask, but the level of possible benefit (which isn’t statistically significant) does not warrant a mandate and punishment for not wearing a mask. Society is falling apart because masks are a wedge issue. It should be publicized far and wide that masks have a small benefit, so don’t shame anyone for not wearing it.

Elizabeth W
Elizabeth W
3 years ago
Reply to  carrotwax

The masks are just a precursor to a mandatory vaccine, in my opinion.

Mike Orman
Mike Orman
3 years ago
Reply to  Elizabeth W

Sadly, the pharmaceutical industry has spent untold millions, billions? on producing vaccines now and governments are reliant on them working, or at least appearing to work – whether or not they do. It would be bankruptcies all round if that pyramid were to collapse for any reason. So we can expect coercion at the least.

Adrian Smith
Adrian Smith
3 years ago

So a trial that aimed to prove the effectiveness of wearing mask failed to do so. And this was with proper quality masks being used properly and changed far more regularly than anyone in the general public ever would. Good that he explained the additional dangers of wearing masks incorrectly to the mask wearer.

Surely this is all the evidence needed to conclude that the mask policy being enforced is a total waste of time and indeed is actually counter productive. What might make a little bit of sense would be free fresh proper quality masks provided at the entrance point to public transport with a proper bin to dispose of the mask worn at the end of the journey. However on the strength of this study it would be hard to justify the cost of such a programme.

Mike Orman
MO
Mike Orman
3 years ago
Reply to  Adrian Smith

The bus would quickly become a hotspot for virus transmission due to every passenger passing the overflowing used mask bin on the way out! The driver would probably be the first casualty.

(Replying to: “What might make a little bit of sense would be free fresh proper quality masks provided at the entrance point to public transport with a proper bin to dispose of the mask worn at the end of the journey.”)

Adrian Smith
AS
Adrian Smith
3 years ago
Reply to  Mike Orman

Proper bins that get emptied and the contents disposed of properly.

Mike Orman
Mike Orman
3 years ago
Reply to  Adrian Smith

Yeah, sorry I was thinking about the UK. lol
Anyway, what about the environmental damage from production and disposal of all those extra masks (1 per passenger journey) and still more importantly, the salary of the bin change and disposal specialist and his line manager, which has an effect on the bus fares (someone has to pay) and hence workers need pay increases etc. etc. …..

Alan Thorpe
AT
Alan Thorpe
3 years ago

What is the point of a RCT if opinion rather than facts from the study determine policy? There seems to be a flaw in the work compared to drug trials when all the people on the trial will have a specific illness and some will be on the drug and others on a placebo. In the case of masks we don’t even know how many came into contact with the virus and if so, for how long. It was also for one specific type of mask. It did not cover preventing masks preventing the spread of the virus so this comment is just opinion. My understand is that they might prevent the spread if people are coughing, but these people should not be out anyway.

david bewick
david bewick
3 years ago
Reply to  Alan Thorpe

I’ve reposted your first sentence, I hope you don’t mind. Makes a lot of sense and I hope drawing attention to it will help. Thanks.

Andrew Boyle
Andrew Boyle
3 years ago

I some of his comments bizarre. The study finds the effect of masks statistically insignificant which is exactly the case with all mask RCT’s over the last 15/20 years. There is literally no evidence from RCT’s that they work.

Adrian
A
Adrian
3 years ago
Reply to  Andrew Boyle

Galileo could not get the Pope to look through the telescope.

Most scientists understand this. Sometimes you just have to publish and start ducking the bullets. People are stupid and people are hateful, why should he have to suffer for their stupidity?

david bewick
david bewick
3 years ago

Three excellent points from three different comments and I thought I’d list them here:
” the whole idea of everyone wearing a mask just because we’re told, or just in case you could kill someone, is (or should be) offensive to all.”
“There is no point having an RCT if we are only going to believe the result we want it to be”
“What is the point of a RCT if opinion rather than facts from the study determine policy?”

Seems to make sense to me.

Bruno Noble
BN
Bruno Noble
3 years ago
Reply to  david bewick

I don’t disagree with your points 2 and 3. But re point 1, where’s the offence? I may consider someone asking me to wear a mask in the belief that my not doing so could kill them to be mistaken, but in what way is it offensive?

David Hartlin
DH
David Hartlin
3 years ago
Reply to  Bruno Noble

We are not being asked,we are being told and the order inforced with the threat of punishment ,that’s offensive.

david bewick
DB
david bewick
3 years ago
Reply to  Bruno Noble

Someone has already replied before me. He’s correct.

7882 fremic
7882 fremic
3 years ago
Reply to  Bruno Noble

Your irrational fear does not deny me my rights.Demonstrate a mask, and also what mask, prevents the virus first. This study used 1.7 masks per day per subject, 98% masks, the very best kind! Not a bandana worn for weeks.

Mike Orman
MO
Mike Orman
3 years ago
Reply to  Bruno Noble

We are adults with education and life experience, able to think for ourselves.
We’re being herded like sheep or schoolchildren.That’s what I find offensive.

Chauncey Gardiner
CG
Chauncey Gardiner
3 years ago

The point estimate is 0.3% lower rate of infection among people who wore masks. The effect is small, AND it is not statistically significant. The effect may very well have been 0.0%. Or -0.3%

So, there is no statistically-distinguishable evidence here that masks protected users. And, yet, we’re asked to tout the (small) point estimate as evidence that “masks work”. What nonsense.

Bengt Hansson
BH
Bengt Hansson
3 years ago

Well done Professor Bundgaard and that you take your time with interviews. As a Swede I find it hard to believe that the findings are controversial. From start source control have been the argument, and personal protection down-played in the debate re. mask use.

Mavka Rusalka
Mavka Rusalka
3 years ago
Reply to  Bengt Hansson

Just one week after the CDC said masks protect the wearer. So, not really.

Frederik van Beek
Frederik van Beek
3 years ago

I just had a glance at the interview but I heard not a word about aerosols (which by now everyone knows are dominant in the spreading of this disease), is the good man aware of their existence and the fact that they go through face masks like a mosquito through a fence? Or did he mention aerosols and did I miss that? Quite a big deal if you state that face masks are there to protect the other….

ru si
RS
ru si
3 years ago

Since the statistical difference of any benefit is so small as a result of mask use, have any studies been done to show the detrimental effects of wearing masks? I’m sure such a study would demonstrate that the cons far outweigh the pros.

James N
JN
James N
3 years ago

Having worked in hazmat, wearing custom-fitted PPE and supplied air, I find it embarrasing that I belong to a race of animals that thinks scraps of cloth, purchased on Etsy, loosely draped across their faces is going to stave off mortality. An old sock would provide more protection.

Political polarization makes it impossible for mask proponents to concede any weakness in the theory. As such, they’re telling at-risk people that they’re safe when they’re not.

Paul Melzer
PM
Paul Melzer
3 years ago

What about the things that were left out? Were these removed from the final paper?

(from El Gato Malo: https://twitter.com/boriqua

“The protocol had a significant number of measures for adverse events:
bacteria, psychological, full healthcare, sick leave, infection in the household, other hospital diagnostics, etc.

NONE are included in the study.”

Matt S
MS
Matt S
3 years ago

There’s very little to discuss here: it’s incredibly simple risk management.

Taleb explains the case far better than I could ever hope to from a statistical perspective:

https://medium.com/incerto/

James Moss
JM
James Moss
3 years ago

And just in case Unherd wants to allow it, here it is.
https://gidmk.medium.com/wh

James Moss
JM
James Moss
3 years ago

A good explanation of what the Danmask-19 paper shows and does not show can be found by searching (Gideon Health Nerd Medium Masks). I’d have preferred to give a link but Unherd doesn’t seem to like them.

One point I will draw out from this non-link, since a misunderstanding recurs in the comments so far. When the Danmask-19 study refers to “statistically significant difference”, this is not referring to whether the masks had any statistically significant effect, but whether such effect was greater than 50%.

Randall Clawson
RC
Randall Clawson
3 years ago
Reply to  James Moss

I love how they conclude by saying “And don’t believe the hype.
The new mask study really didn’t tell us much at all.”

Um, yeah that’s the point. Even with this new randomized controlled trial, we still have basically no science that proves masks provide any benefit for protection or source control. Somehow though, the author manages to keep saying that masks work, just as the author of the DANMASK study being interviewed in this post. How on earth do they know this? They don’t and can’t possibly know because they are relying on intuition and anecdotes, not hard science.

It really is shocking how zealous mask enthusiasts remain, and how they blame others for “denying” science, when they continue to provide no good evidence for their claims.

Shalal Sadullah
SS
Shalal Sadullah
3 years ago

Exactly. And Vincent Rajkumars statement that masks work- keep wearing them and the study is flawed typifies that. He is an expert in myeloma- since when did he become such a key opinion in infection control?!

Randall Clawson
RC
Randall Clawson
3 years ago

The mask debate really brings new meaning to “cherry picking”. There are very few serious people discussing the topic.

James Moss
JM
James Moss
3 years ago

It’s something of an exaggeration to say “we still have basically no science”. What we don’t have are statistically significant trials which prove the hypothesis.

Given the practicality of designing a trial to measure the benefit to others from mask wearing which also is deemed ethical to conduct, this is a pretty tall order. Maybe in time someone will do some really elegant experiment with ferrets wearing little masks.

In the meantime (i) there is some evidence, though not conclusive, that masks are a benefit; (ii) it’s no big deal to wear one; (iii) it’s not as if we have a surfeit of other measures proven to work.

For some reason though, the issue has been politicised.

Randall Clawson
RC
Randall Clawson
3 years ago
Reply to  James Moss

Yeah, James, here is the issue: it’s always hilarious to me when people say, OK we have no published good science but we have a ton of evidence otherwise…

1) Um, no WE DO NOT. Where is this evidence?

2) Yes it is a big deal to some people, myself included, to both wear a compulsory mask or live in a society obsessed with them, and

3) Yeah, dude, none of us are against actual ideas that work, like avoid large gatherings indoors, and stay home if you’re sick – you know, all the things the CDC and WHO recommended for the general population for forty years right up until nine months ago?

It’s SHOCKING this issue of forced mask mandates from people like you is so political. Imagine that.

James Moss
James Moss
3 years ago

!. Easy to find if you are really interested to look. Just as one example, there is an article in the 6th October edition of Nature.
2. Get some perspective.
3. Actually it appears that a lot of the people opposed to the very idea that wearing masks is a harmless yet potentially helpful NPI are opposed to these things too. Maybe you’re not and if so, good on you.

Shalal Sadullah
SS
Shalal Sadullah
3 years ago
Reply to  James Moss

I have no problems with people who cling to a belief and follow it. But to suggest that this is scientifically proven because you have a superstition is simply misinformation. The wearing of masks in the Uk where i reside is not a matter of personal belief! It is mandated by law. You face a fine if you dont comply! That on the evidence that exists about its usefulness to me atleast is perplexing if not ridiculous. People do many things which are not evidence based but its a matter of choice. There is an industry around multi vitamins and minerals that people take without any evidence of its use if you have a balanced diet. I have no problems with it. Their belief; their money.I however would have a problem if i were to get fined for not visiting a health shop weekly!
As for it being no big deal! Nothing is a big deal if it is known to work- and everything is if based on a whim and forced on you

James Moss
JM
James Moss
3 years ago

I never said it was scientifically proven – I made clear at the beginning that obtaining robust scientific proof in either direction is extremely problematic.

However, there is no firm proof it does no good and there is some evidence that it does some good (you could also argue that there is no firm proof that it is absolutely does some good and that there is some evidence that it might not).

This is thus not superstition, but a question of weighing up rationally what evidence is available. Hence I gave as an example of evidential support a refernce to an article in Nature, not one in the Christian Science Monitor.

I too live in the UK and am aware that mask wearing is mandated by law, but only in certain circumstances. Moreover, anyone with a health reason for not wearing one is excluded.

I voluntarily use, under different circumstances, such safety equipment as a cycle helmet, a ski helmet, a life jacket and a safety helmet. None of these has ever been the subject of a statistically significant randomised double blind placebo trial. The same is true of a parachute. All these items are far more cumbersome – a face mask in a shop or on a bus really is no big deal.

Barry Sharp
Barry Sharp
3 years ago

I’m curious. If another person chooses to wear a mask why would they be concerned about me not wearing a mask or is there some suggestion that doubling up the mask barrier improves things?

Aaron Kevali
AK
Aaron Kevali
3 years ago

Professor Henning Bundgaardis may be affable and honest, but now he is covering his ass for the inevitable backlash for telling the truth.

MASKS. DON’T. WORK.
And they never did.

Gitry Heydebrand
GH
Gitry Heydebrand
3 years ago

Freddie, please investigate the study by Dr. Genevieve Briand at Johns Hopkins about the statistical errors that have been made about “excess deaths” due to COVID. It is appalling to me that the study has been taken down by the university but it is still archived, and is referenced by other sites such as the American Institute for Economic Research.

Paul Wright
Paul Wright
3 years ago

This seems to be an underpowered study which didn’t show anything very much, and the authors seem pretty reasonable about that. It’s a shame it’s been taken up by the “Wake up sheeple! PCR can’t melt steel beams!” crowd as evidence that the lizard people are muzzling us for their own nefarious ends.

If you’re anti-lockdown, you should be pro-anything else which might suppress the virus, especially something as trivial as mask wearing. It’s odd then that the anti-lockdown and anti-mask attitudes go together in so many people. I think they’re basically tribal identifiers/virtue signalling at this point.

Elizabeth W
E
Elizabeth W
3 years ago
Reply to  Paul Wright

Oh Paul, you need to just open your eyes to the nonsense spewing, unless your mask is covering them too. I know this sounds insulting and I don’t want to be t*t or tat with your unsound post above but just look around and really ask yourself, “What is this really about?”

Katy Randle
KR
Katy Randle
3 years ago
Reply to  Paul Wright

You might regard the wearing of masks as a trivial matter. Others might have a different opinion. Personally, while I wear them in indoor situations where it is impossible to keep a social distance, I would protest to the rooftops about their further imposition.

For those living alone and without an established local social network, they are massively dehumanising, increasing the risk of depression and even suicide.

So please reconsider your casual categorisation of the matter. Thank you.

Randall Clawson
Randall Clawson
3 years ago
Reply to  Paul Wright

I am so exhausted by people acting like universal, no-end-in-sight mask wearing has no serious side-effects, both emotionally and physically. It is deeply unimaginative and casually dismissive of the millions of mental health sufferers we already ignore.

The reason anti-lockdown and anti-mask enthusiasm trends so nicely together is that they’re both drastic, compulsory expectations that show little evidence of even working at all. There’s even some evidence they do the exact opposite of their intended purpose.

And your last statement is beyond bizarre. It is so obvious to any casual observer that the mask wearers are the ones virtue chasing. The entire rationale of masks is that you get to protect others.

Paul Wright
PW
Paul Wright
3 years ago

I speak of the kind of mask wearing which is compulsory in this country (the UK), namely, indoors in most public places. Unmasked people can still meet outdoors, subject to the the lockdown-type restrictions. (I think this is right: the evidence suggests outdoor spread of the virus is hard, given we did not see any outbreaks from hordes of unmasked people crowding onto beaches on the south coast this past summer, annoying though they were for other reasons).

This is bad for people who rely on lip reading, or, as I read, PSTD sufferers who associate having their mouth covered with being assaulted (but here they are exempt, and can get lanyards saying so, I believe). For the rest of us, it is nothing like the trauma of a lockdown, and the amount of drama that people create about masks suggests the drama is mainly political signalling, especially if they’re also supposedly anti-lockdown, as I say.

> It is so obvious to any casual observer that the mask wearers are the ones virtue chasing.

The virtue being signalled here is a contrarian independence from the sheeple and their so-called experts, instead adhering to their own ingroup’s expertise from diet gurus with Engineers’ Disease, Profs who’ve “gone a bit Emeritus”, and talk show hosts.

Randall Clawson
RC
Randall Clawson
3 years ago
Reply to  Paul Wright

This just further proves my point that you are completely unimaginative. Indeterminate universal masking affects everyone to some extent, and if you’re an introvert, socially isolated, depressed, disabled, in mourning, etc etc etc, you are likely to experience significant trauma. We literally know this is the case.

And this idea that we must endure masks if lockdowns are to end is absolutely childish. If an idea is bad and doesn’t work, then it’s a bad idea that doesn’t work. We don’t need to negotiate for a less bad idea.

And sure there are some bad actors and agents that hold this opinion, but your rush to categorize them doesn’t exactly make you seem like someone worth engaging.

Paul Wright
PW
Paul Wright
3 years ago

> We literally know this is the case.

Do we? With what evidence?

Paul Wright
Paul Wright
3 years ago

> Indeterminate universal masking affects everyone to some extent

It’s not indeterminate, since it’ll be over by the end of next year I expect, now we have several affective vaccines. Neither is it universal, since various people are exempt as I said above.

> We literally know this is the case.

No we don’t. I’m an introvert. It doesn’t affect me, I just get on with it. If you want to argue that the effects are terrible, present your evidence rather than using your vaunted imagination.

> And this idea that we must endure masks if lockdowns are to end is absolutely childish. If an idea is bad and doesn’t work, then it’s a bad idea that doesn’t work. We don’t need to negotiate for a less bad idea.

I agree that if masks do not work, we should not use them. But most people who are against both are not against them because they don’t work (because they do, and the study we’re talking about in this article is not evidence that masks don’t), but because they are horrified that anything, however trivial, would be imposed upon them in order to benefit others.

Randall Clawson
Randall Clawson
3 years ago
Reply to  Paul Wright

1. It indeed is indeterminate because you can’t actually guarantee a time when it will end. Your best guess is not reassuring at all because the standard for mask mandates is so low. Flu already killed 50-80k in the U.S. alone each year – are we truly to return to being heartless bastards after coronavirus wanes? Additionally the entire basis for mask mandates is based on positive tests. If the virus remains endemic (which it likely will since not everyone will take the vaccine) then we will continue to see positive tests and deaths for eternity.

2. In many locales there are no such exceptions for mental health sufferers using critical services like grocery stores. This exists purely in your head.

3. It is laughable that you are applying an evidential standard to me that you feel no obligation towards, but you’ve got a point. Here is a highly reputable german study showing that there are severe psychological issues with mask wearing in the general population: https://www.pnas.org/conten…. You can see more evidence of negative consequences of mask wearing in section #3 here: https://swprs.org/face-mask…. In fact that article in its entirety should explain well how inconclusive mask wearing is.

4. “Because they do…” You keep saying this as if it has some magical power. Sure, this study doesn’t confirm that but neither do any population-level studies, so I’m not sure what you’re so confident about. You’re absolutely correct that some people won’t be told what to do regardless of its benefit. At the same time bundling us good-faith truth seekers with them is absolutely childish and self-serving.

Randall Clawson
RC
Randall Clawson
3 years ago
Reply to  Paul Wright

1. It indeed is indeterminate because you can’t actually guarantee a time when it will end. Your best guess is not reassuring at all because the standard for mask mandates is so low. Flu already killed 50-80k in the U.S. alone each year – are we truly to return to being heartless bastards after coronavirus wanes? Additionally the entire basis for mask mandates is based on positive tests. If the virus remains endemic (which it likely will since not everyone will take the vaccine) then we will continue to see positive tests and deaths for eternity.

2. In many locales there are no such exceptions for mental health sufferers using critical services like grocery stores. This exists purely in your head.

3. It is laughable that you are applying an evidential standard to me that you feel no obligation towards, but you’ve got a point. Here is a highly reputable german study showing that there are severe psychological issues with mask wearing in the general population: (Unherd bocks URLs) PNAS dot org slash content/117/36/21851. You can see more evidence of negative consequences of mask wearing in section #3 here: SWPRS dot org slash face-masks-evidence. In fact that article in its entirety should explain well how inconclusive mask wearing is.

4. “Because they do…” You keep saying this as if it has some magical power. Sure, this study doesn’t confirm that but neither do any population-level studies, so I’m not sure what you’re so confident about. You’re absolutely correct that some people won’t be told what to do regardless of its benefit. At the same time bundling us good-faith truth seekers with them is absolutely childish and self-serving.

Paul Wright
PW
Paul Wright
3 years ago

Flu already killed 50-80k in the U.S. alone each year – are we truly to return to being heartless bastards after coronavirus wanes?

I hope not, they wear masks in Asia because it’s seen as a pro-social thing to do if you’re symptomatic. No harm in that norm spreading here.

If the virus remains endemic (which it likely will since not everyone will take the vaccine) then we will continue to see positive tests and deaths for eternity

I’d support mandates (rather than norms) only if there was a threat of the virus getting out of control. With a vaccine and other treatments coming, I expect that threat to be removed by the end of 2021.

Here is a highly reputable german study showing that there are severe psychological issues with mask wearing in the general population

You haven’t read the study, you just copied it from the very suspect SWPRS site, which used to be for anti-NATO conspiracies (who’s funding that, I wonder?) but has recently got into the COVID denialism biz (and changed its name). The study nowhere uses the phrase “severe psychological consequences” (which you also copied from SWPRS), and does not say what you claim it says, rather, it’s about how people view mask wearing (or not wearing) by others, especially if those people are vulnerable to COVID19. Unsurprisingly, the non-mask wearers are seen as anti-social.

Sure, this study doesn’t confirm that but neither do any population-level studies

Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US seems to be what you’re looking for.

Frederik van Beek
Frederik van Beek
3 years ago

Aerosol, remember that word when you’re ‘protecting’ humanity with your mask

shinybeast1
C
shinybeast1
3 years ago
Reply to  Paul Wright

Mask wearing is so passive aggressive

Jay Bird
JB
Jay Bird
3 years ago

To whom it may concern…When I wear my mask in situations indoors where I cannot maintain social distance and there is limited ventilation, my altruistic action significantly reduces the likelihood I will infect you. By doing the same you do the same for me. Win Win. Also my mask may give me a little protection against antisocial people who refuse to do the right thing for all our sakes. In my reading, the study and its author support that view. If you are too bloody minded or uncaring to do your bit please stay at home. Thankyou. 😊

Alex Lekas
Alex Lekas
3 years ago
Reply to  Jay Bird

You have every right to wear a mask if you so desire; you have no right to insist that I do likewise. This mask-as-talisman play is becoming tedious. It’s not meant to stop the spread of infection; it’s meant to ensure that people remain panicked by ensuring that herd immunity is put off as long as possible.

Elizabeth W
E
Elizabeth W
3 years ago
Reply to  Alex Lekas

Exactly my thoughts Alex!!

C Arros
CA
C Arros
3 years ago
Reply to  Jay Bird

Your language makes me feel that I’d like to socially distance myself from you whether you wear or whether you don’t wear mask…, so you can consider yourself safe from me, who incidentally considers it a big mistake to assume that masks provide much protection at all or that they are going to make a big dent in the number of transmissions of a virus.

Derek M
DM
Derek M
3 years ago
Reply to  Jay Bird

“my altruistic action significantly reduces the likelihood I will infect you” – How do you know that?

7882 fremic
7882 fremic
3 years ago
Reply to  Jay Bird

Do not wear the mask for me, Jay Bird. I refuse to accept the onus you lay on me for you having to wear a mask. I do not feel there is a social contract on such a belief based act.

Kerensa Sandham
Kerensa Sandham
3 years ago
Reply to  7882 fremic

Ditto!

Adrian
A
Adrian
3 years ago
Reply to  7882 fremic

fremic, you talk a lot of nonsense at times, but I think you have hit the nail on the head with this particular comment.

Kerensa Sandham
L
Kerensa Sandham
3 years ago
Reply to  Jay Bird

Sorry but the self importance in your comment makes my stomach churn!

Shalal Sadullah
Shalal Sadullah
3 years ago
Reply to  Jay Bird

Actually this entire thread is based on a trial which suggests that you are no more likely to infect me without a mask as you are with one.so its not really altruistic is it? Just misinformation!

Graham Thorpe
Graham Thorpe
3 years ago
Reply to  Jay Bird

Did you read the report? Or the report of the report? Or the comments here?

Adrian
A
Adrian
3 years ago
Reply to  Jay Bird

But I’m not sure your altruistic action is helping me at all. It’s merely helping you feel better about yourself. Why should I stay at home because I refuse to engage in superstition?

People like you want life to be simple. If you can demonstrate that you are unselfish, then I won’t be catching your germs, and maybe you won’t be catching mine.

But I’ve seen people walk to the shops in their mask, just to demonstrate their goodness, despite the fact that they are preloading their mask with virus by doing so. They aren’t even wearing a mask. They are wearing a cloth face covering which spills virus soaked cotton fibers into the air where they remain for hours.

I know they wish me well, but the mask wearers are actively doing me harm. I’ve read the scientific papers, and in every one it’s clear that the masks are semi-useless, and face-coverings are possibly harmful. Luckily I’ve had the virus eight months ago so I’m just wearing a mask to avoid a fine.

Randall Clawson
RC
Randall Clawson
3 years ago
Reply to  Jay Bird

LMAO this must be a troll comment.