masking the downside

covering for the failure of masks to stop covid by ascribing "no cost" to wearing them fails in the face of the evidence

masks have been one of the big covid hot buttons. the evidence that they work has never been present. in 2019, everyone from doctors to the WHO knew that masks do not mitigate respiratory viruses. they they ALL changed their tune based on no new evidence. this has been well documented as has the consistent failure of masks to work on covid and the consistent garbage and fraud promulgated by folks like the CDC to pretend that they did.

and no, N95’s do not work any better as a covid NPI.

but masks simply would not go away. as a performative symbol of social signaling, they are extremely powerful and as a wubbie for the anxious they were seized and clung to and became “talismanic” just as many medical professionals, right from the start, claimed they would.

and this rapidly evolved.

“your mask protects me” was a wonderful soundbite to shift responsibility for my superstitious anxiety to you. but it never had ANY basis in fact.

your mask protects me

it was invented from whole cloth and spread like wildfire because it was a wonderfully coercive meme and despite having been the norm for all our lives, suddenly your desires for facial freedom was cast as anti-social and selfish.

even as efficacy claims fell to pieces, the masqueraders fell back to this position:

“it’s really not a big deal. do it for me. even if it works a little or makes people feel better, where is the harm? why not try?”

but even this has fallen to pieces. masks wrecked schools and learning. they also impeded the social and verbal development of infants and toddlers.

many have ascribed this to having lost the facial cues that make up so much of human communication. i suspect there is likely some truth to this. but what if there is another force at work here as well?

what if masks really were making everyone quite a lot worse off and unable to concentrate because they were getting too much CO2?

because it’s sure starting to look like they did. frequent sounding board and gatopal™ andrew bostom (professor at brown university med school and a rare beacon of principled reason at the gato alma mater) explains here:

Andrew Bostom, MD, MS @andrewbostom

Gold-standard CO2 monitoring study: Short-term surgical mask usage→inhaled CO2 levels ≥5000ppm in 90% of 10-18yos= UNACCEPTABLE/FORBIDDEN level for workers due to its freq assoc w/ "headache, nausea, drowsiness, rhinitis, & ↓ed COGNITIVE PERFORMANCE" medrxiv.org/content/10.110…

THIS STUDY appears well performed and the result are quite striking.

they use 5,000ppm as a cut off for risk buckets because this is the OSHA occupational limit but keep in mind that even approaching that will have noticeable effects.

this has been long known and regulated.

but like so many other things covid, all this past knowledge was not only ignored but inverted, especially with regard to children who have been subjected to masking rules no workplace would have been permitted to implement before 2020.

and based on this data, they really bore the brunt of it.

(an FFP2 respirator is extremely similar to an N of KN 95 and one would expect about the same performance/issues)

the data here are striking in several regards.

1. children clearly got much higher CO2 levels than adults and exceeded 5,000ppm in both mask categories

2. adults and elderly were under 5k for surgical masks (though 37.5% and 25% of each respectively exceeded it) but not by much

3. FFP2’s caused much higher CO2 than surgical masks and severely exceeded 5k in all age groups.

4. all masks in all ages resulted in at least a 10X rise in CO2 rate from ambient and some were nearly 30X.

i plotted it here:

these are deeply worrying outcomes, especially for children where 90% were over 5k in surgical masks and 100% in FFP2’s.

perhaps we’re starting to see why concentrating in school posed such challenges. this is well over the line into drowsiness and reduced cognitive performance which makes it doubly bizarre that kids in schools seem to be one of the last groups still being forced to mask.

it’s clearly doing them harm.

it’s also clearly doing them no good whatsoever in terms of mitigating covid.

certain internet felines published this from the emily oster data back in may of last year:

so, we have a set of clear costs and a very high likelihood of zero or even negative benefits. this would seem to be one of the most clear cut cost/benefit choices around and medicine is everywhere and always a cost benefit decision.

children should not be masked in school or anywhere else for that matter. it’s just plain harm imposed in service of the fears and pseudoscientific proclivities of the folks who were supposed to be the adults around here.

interestingly, this CO2 study may provide the answer to another of the interesting issues of masking and infection: surgeons who wear them during surgery wind up with higher rates of post op infection in their patients.

(you can see this and more in the “your mask protects me” piece linked above)

i had had a number of hypotheses on what might drive this and it always seemed a bit implausible that the masks, worn by trained pros who do not touch them with hands were actually concentrating pathogens and pushing them at patients.

but if they simply upped CO2 levels and impeded cognitive function and concentration somewhat, perhaps that explains the variance. it’s not the mask affecting infection, it’s the mask affecting surgical performance quality.

a fascinating check on this might be to assess other surgical outcomes such as success, heal time, time to complete, complication rates, etc in a similar study.

i wonder if unmasked surgeons simply perform better surgery.

but, however one looks at this, it seems to me that 2 things appear clear:

1. there is not nor ever was any compelling reason to believe that masks work to stop covid spread, protect the wearer, or function as source control and lots of high quality evidence showing that they do not

2. ideas that masks are “no or low cost” to the wearer are similarly fraught and the evidence now shows many clear harms on many dimensions, especially for children who have been among the most consistently and persistently targeted by this mitigation.

these masks have no place in the anti-covid armamentarium. they are cosplay and performance art masquerading as public health and fail utterly on any remotely evenhanded cost/benefit analysis.

we have normalized the abnormal and placed superstitious signaling above science for far too long already.

reaching for this grubby wubbie again because we heard a bump in the night will not serve us well.

it will only pile more harm on top of that already accumulated.

it’s time this was acknowledged and that we moved on.