The mask was the first push down a very slippery slope
Why not wearing a mask is pro public health
Just under a year ago I wrote a post about why it caused me “severe distress” to wear a mask (rather face covering). Since the UK made it mandatory to wear one, starting in shops, in June 2020, I have only donned a mask twice: both times to accompany why wife for pre-natal appointments at a hospital.
As someone who has been incredibly fortunate to benefit from a first class science education and career in financial markets, I find myself hardwired to take a sceptical mindset when tackling most problems. But at the same time I am deeply aware of the hubris that can set in and the dogma that can accompany important decision making— indeed I have just finished reading Think Again by Adam Grant and count Black Box Thinking by Matthew Syed as one of the books to have influenced me most (along with Range, Rebel Ideas and Drive). I have therefore regularly challenged myself with my controversial stance…am I just doing this because I don't want to admit defeat? am I just being stubborn? what have I got wrong?
Two glaring issues: effectiveness and harm
The first problem that I encounter in the debate is that face coverings “obviously” work. At a singular level for one human they clearly prevent the odd bit of spittle coming out of your mouth and travelling a distance when talking, laughing, coughing or sneezing. Fine. I have always conceded there is perfect logic in that assertion. The issue is that from there this does not mean that they prevent the spread of an airborne pathogen on a system-wide level. All the studies I have read that purport to show a benefit of mask wearing are generally based on modelled assumptions or hypothetical simulations. Those based on real world data are not controlled trials because so many other factors are influencing transmission, hospitalisation or eventual death rates. Once you introduce the chaos of human existence-
- the fact so many wear a mask not covering their nose
- the fact so many pull their mask down to talk closely to one another
- the fact those with symptoms will feel more comfortable travelling about
- the fact most transmission takes place in the very place they are not worn
this adds up to the reality of very little convincing empirical evidence that masks make any difference to infection rates at all. Below is a chart, from a recent study in Kansas that regularly appears on Twitter from mask advocates, based on the 15 counties that adopted mask mandates vs the 68 counties that didn’t.
Granted there are lower case counts in the counties that adopted mask mandates but it is a much smaller sample size and the researchers themselves go on to say “This study was limited because it did not control for daily testing rates by county in the state of Kansas, which were not available”. Furthermore. there is no dramatic difference in the shape of the curves. If one’s hypothesis was that masks make so much difference to transmission rates you would expect an almost exponential explosion that were far greater than what is seen, which is a mirrored progression. Comparing case rates across Arizona, Nevada and California, the former two reopening and abandoning mask mandates, makes this point, cases didn't suddenly spike and they are now all seeing cases rise at equal rates. Or you can look at case rates across various European countries which have all gone through different mask mandates, with some having outdoor wearing mandatory, apart from Sweden which remained voluntary. In the second wave the rise and falls of peaks was broadly random with similar trajectories in all.
The second problem I struggle with is that so many say “its harmless, so why don’t you comply, it makes others feel safer”. This is probably the area of contention where I most struggle to keep my cool. I have written a more recent post titled “the corrosive fear of asymptomatic transmission” which details my push back on this more thoroughly, but needless to say:
- when the CDC, a respected US organisation, start promoting that you should mask any child over 2 years old,
- when the oceans get filled with 1.6bln face masks,
- when 1/6 people with hearing loss continue to struggle,
- when people start wrongly assuming face coverings protect THEMSELVES,
Any debate should not ignore that there are severe negative consequences to mandatory mask wearing. I also believe there is evidence that focusing so heavily on masks as a key part of the way to combat COVID transmission has meant that the one single intervention that is likely to have the most significant impact on reducing transmission has regularly been overlooked or bypassed— staying at home if you are unwell. Survey data of over 50,000 people in the UK from this study in the BMJ showed that only half of people WITH SYMPTOMS actually isolated. Protected by the anonymity of hiding behind a mask, and misunderstood protection, they instead went out and about…
“A reliable way to make people believe in falsehoods is frequent repetition, because familiarity is not easily distinguished from truth. Authoritarian institutions and marketers have always known this fact.”
Daniel Kahneman, Nobel Prize winner.
But they do work…in a very sinister way
Despite all this I realise I got the whole mask debate entirely wrong. It was never about the effectiveness of a mask at stopping transmission directly. It was purely a measure of control and a subconscious reminder for the public to stay “alert” or “safe” and in this way masks have been incredibly effective. Something Graham Brady, a Conservative MP in the UK, unexpectedly opined on in the Daily Mail recently.
To illuminate this realisation take Formula 1; a global business that travels from country to country and is broadcast to 100s of millions of people. Despite outdoor transmission being an undisputed irrelevance (c0.1% of cases), all mechanics, management, drivers and TV pundits wear masks at all times in mainly outdoor settings. There is no rationale or scientific reason for this other than the fact F1 is broadcast around the world and clearly the higher powers have mandated this as a necessity. This was made to look especially ridiculous at the recent British Grand Prix where all spectators (140k of them) were maskless vs the rigorously tested drivers, media etc who all wore masks.
What this means is that even if you live in, say, Sweden, where general mask adoption is low and not mandatory; unless you are cut-off from Twitter, Instagram, Facebook or global news you are still exposed to exactly the same amount of underlying “reminders” about the inherent background “risks” of COVID-19. All those lovely famous people that have profile pictures of themselves wearing a mask, like Sadiq Kahn, have indelibly left their mark.
With this in mind it better explains why the curves of infection spread tend to be so similar regardless of mask mandates. There is NO counter-factual; even those that think they are maskless are still impacted by the subliminal messaging and so underlying behaviours are different.
What is sinister about that?
Does this mean I have changed my mind and acquiesce that they are a good thing and are savings lives? I’m afraid not.
What seems to be rarely acknowledged by the pro-mask masses is the longer lasting negative consequences. Indeed the basis for justification seems to be the pre-cautionary principle, that if it helps, even a little bit, even subliminally, then it is worth it. I don’t want to get too drawn on this topic but the advancement of our entire race, especially in the last two thousand years, didn’t come about under the “pre-cautionary principle”. Back in F1 how hypocritical that they adopt the precautionary principle while drivers race around a track for 2 hours at 200mph putting their lives and health at risk?
For the specific instance of mask wearing what sort of trade-offs are required for any tiny, immeasurable benefit? To me the way that masks made it through the legal system when there was, and continues to be, so much scientific debate as to their effectiveness sets a very worrying precedent that you can see playing out wherever you look. Slippery slopes are everywhere.
Start with the mask rules on wearing them when outside in beer gardens, or the hypocrisy of waiting staff wearing them but customers not. Then take clear plastic face shields — these are known to do nothing and even the UK Government website said that they were insufficient (before Freedom Day) yet you would still see (and perhaps will still see) armies of waiting staff wearing them. While those being waited on supposedly “feel safer”. Or there is hygiene theatre — again it is known that surface transmission is a miniscule factor in combatting transmission. Even the CDC pared back its guidance on cleaning. However many restaurants and schools still spray down tables and equipment ad infinitum and a recent Tesco advert post Freedom Day talks about “staying safe” and leads off with sanitisation…
More worrying than just misunderstandings is the gross misallocations of capital that could have been used for more honourable causes. Take an example: in my local woods in early May, a new 2m wide plastic banner appeared, hammered into the forest floor, urging people to stay apart. Yet this was AFTER a host of restrictions on outdoor activity had been lifted, not to mention the fact I can confidently state no-one has caught COVID from a walk in the woods. But start thinking about the manufacture of 100s of these signs, the labour required to install them, the needless plastic used too and you probably roll into £100ks for just one local council. That could have been spent in any manner of more beneficial ways -rather than scaring more unsuspecting walkers, just wanting some fresh air and getting some exercise. To paraphrase a whole industry of vested interests has sprung up around COVID (and its testing) and many don't want that to go away.
Then there is the total breakdown in balanced reporting across the BBC and other mainstream media outlets. Every news organisation will be driven by an agenda but the BBC, as a public funded body, should be devoid of obvious government interference. Fearing for its future in the face of #defundthebbc the BBC has aggressively spread fear mongering and misreported; whether that meant splashing its front pages with the few deaths of children from Covid early on in the pandemic (of course tragic but incredibly rare) to more recent incidents of completely misstating the true scale of Freedom marches across the UK and France or wrongly paraphrasing historical research to ramp up the fear for the young.
All this has led to a dangerous erosion of common sense, scientific judgment and a terrifying uninformed negative feedback loop. A populous, scared of its own shadow, answers doctored surveys preferring to be locked in homes and barred from pubs or holidays, reinforcing the government, with a mind on future elections, that it is doing the right thing. Gone is leadership and the realisation of the true LONG TERM cost to society, mental health and, most critically, global financial stability…and the mandatory mask order was the first push down that slide.
Not wearing a mask has become an incredibly important act
Indeed in my first blog a year ago I made the following comment:
The problem I envisage is that the shrug, in some cases gleeful, with which most have accepted mandatory mask wearing, without due debate and parliamentary action, could lead to other more draconian and less pleasant measures taken which equally lack scientific backing or more thoughtful (and constitutional) debate as to long term consequences.
With vaccine passports on the horizon, led by a Prime Minister who deplored ID cards for years, and Emmanuel Macron effectively making vaccination, via drugs that are still in phase 3 trials, mandatory for everyone in France, over the age of 12, this is clearly happening.
Gone is the rationale around prior immunity from infection being more complete or the fact that the risk/reward trade off for many fit and healthy young people should mean they have a choice in whether to get vaccinated, which is not devoid of risks…
Instead we are sleepwalking into a position where rules are laid down by the Twitterati, genuine debate and opposition is stifled. Take the hypocrisy of local cafés and pubs now deciding public health policy regarding masks, despite serving unlimited cake and beer to the overweight masses. Obesity being a critical predictor of COVID hospitalisation btw.
So I think now more than ever, when there is no longer a systemic risk posed by Covid, not wearing a mask has become essential. It has become a stand against all the much more sinister things that have come about since the beginning of the pandemic — censorship, financial instability, declines in mental health, an obsessional focus on Covid at the expense of all else. Given these now pose a far greater risk to the stability of our society, even if masks provided a small benefit, that sacrifice is worth foregoing.
P.S.
TO clarify I am not a denier that COVID can be a very harrowing disease for the elderly or those with co-morbidities and clearly can be easily transmitted. I am acutely aware of that. I am also pro many common sense interventions like reducing the congestion in London on crammed public transport via home working and having a policy that allows people to stay at home while infectious, and be supported financially to do that properly. In fact I think one of the positive aspects of the last 18 months has been a shattering the “soldier on” mentality at work places, which would have been a huge contributor to transmission of respiratory diseases in the past (I speak with experience). What most of this article is about is the lack of education around what matters and the way unjust rules and laws are unhelpfully dividing society, while doing little to actually prevent Covid transmission.
