Objection 1: It seems that masks are efficacious in preventing this illness, as they are worn by surgeons to prevent illness.

Objection 2: Countries which have required masks, like South Korea, have outperformed countries which have not, like Italy. Likewise, states which have required masks, like California, have outperformed states which have not, like Texas.

Objection 3: Masks may not be universally efficacious, but in a closed environment like a church building, they seem to be.

Objection 4: Even if masks had no effect on the spread of the illness, they are, at worst, harmless pieces of cloth, and can be worn with no negative effects.

Objection 5: Studies confirm the efficacy of masks. For example, there was a study that showed a 75% reduction in spread using them[1].

On the contrary, Dr. Anthony Fauci said “There’s no reason to be walking around with a mask. While masks may block some droplets, they do not provide the level of protection people think they do. Wearing a mask may also have unintended consequences: People who wear masks tend to touch their face more often to adjust them, which can spread germs from their hands.”[2]

I answer that there is a dearth of evidence in support of the efficacy of masks, but considerable research prior to the politicization of COVID-19 that demonstrates that masks are generally ineffective. In considering the evidence, I readily admit to rejecting research done very recently (April 2020 or later). I have already seen good research removed on the subject because of politicization[3].

First, the orders to wear masks came long after the virus declined in their absence. See Figure 1.

Figure 1. Daily Michigan Coronavirus Deaths thru 2020-07-0

It may be tempting the decline to the lockdown, but mobility rankings reveal that we had a long period of time with no effective lockdown during which the outbreak declined. The first order to wear masks was limited but began on May 29, 2020[4]. It was preceded by a full month of increased travel with no effects on new cases or deaths. See Figure 2.

Masks were a late request, coming long after mobility data began to return to normal. Cases and deaths dropped considerably, despite this.

Figure 2. Social Distancing Scoreboard for Michigan (<https://www.unacast.com/covid19/social-distancing-scoreboard?view=state&fips=26>)

Face coverings have been around for most of human history. It is interesting to note that in the Old Testament, which has many scientifically sound practices that were far ahead of time (evidencing, I think, God’s authorship), including quarantines keeping the sick outside of camp[5], quarantines for suspected illness[6], destroying contaminated possessions[7], cleaning human waste[8], and more, that there is no mention of masks or face coverings.

There was some anticipation during the Spanish Flu of the early 20th century that masks might help prevent the spread of that virus. However, W. H. Kellogg, M.D., infectious disease expert and, at the time, executive officer of the California State Board of Health, said in 1920 that “The masks, contrary to expectation, were worn cheerfully and universally, and also, contrary to expectation of what should follow under such circumstances, no effect on the epidemic curve was to be seen. Something was plainly wrong with our hypotheses.”. While the Spanish Flu was a different virus than COVID-19, both are upper respiratory infections and the viruses themselves spread in similar ways.

A study in “Nature Medicine” showed[9] that properly fitted surgical face masks (not cloth masks) might reduce non-COVID-19 cold-causing coronaviruses. However, the researchers discovered that the majority of participants with the influenza virus did not shed detectable virus in respiratory droplets or aerosols. Importantly, “prolonged close contact would be required for transmission to occur, even if transmission was primarily via aerosols, as has been described for rhinovirus [i.e., common] colds.” This sort of prolonged close contact is the kind that occurs in homes or in hospital settings, but not businesses or churches.

A meta-analysis of ten randomized, controlled trials estimated that mask effectiveness in lowering confirmed cases of influenza.[10] They concluded that “Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza. We similarly found limited evidence on the effectiveness of improved hygiene and environmental cleaning.”

They continue: “Disposable medical masks (also known as surgical masks) are loose-fitting devices that were designed to be worn by medical personnel to protect accidental contamination of patient wounds, and to protect the wearer against splashes or sprays of bodily fluids. There is limited evidence for their effectiveness in preventing influenza virus transmission either when worn by the infected person for source control or when worn by uninfected persons to reduce exposure. Our systematic review found no significant effect of face masks on transmission of laboratory-confirmed influenza.

Another article from the New England Journal of Medicine suggested “scant evidence” that mask-wearing “does anything to reduce transmission of COVID-19”[11]. They say “We know that wearing a mask outside health care facilities offers little, if any, protection from infection.”

Public health authorities have been clear on their definition of “significant exposure” to COVID-19, saying it involves face-to-face contact within six feet with a symptomatic patient for up to half an hour or more. This is not the sort of interaction that occurs at church or in the general public. There is a reason that hospital workers are decked from head to toe in personal protective gear.

There have been many other studies that have shown the inadequacy of masks. A small collection is available at <https://www.rcreader.com/commentary/masks-dont-work-covid-a-review-of-science-relevant-to-covide-19-social-policy>.

Response to Objection 1: It actually appears that this behavior is not rooted in science, but tradition. As Oral Health put it[12], “Covering the nose and mouth for infection control started in the early 1900s when the German physician Carl Flugge discovered that exhaled droplets could transmit tuberculosis. The science regarding the aerosol transmission of infectious diseases has, for years, been based on what is now appreciated to be “very outmoded research and an overly simplistic interpretation of the data.” Modern studies are employing sensitive instruments and interpretative techniques to better understand the size and distribution of potentially infectious aerosol particles.Such knowledge is paramount to appreciating the limitations of face masks. Nevertheless, it is the historical understanding of droplet and airborne transmission that has driven the longstanding and continuing tradition of mask wearing among health professionals. In 2014, the nursing profession was implored to “stop using practice interventions that are based on tradition” but instead adopt protocols that are based on critical evaluations of the available evidence.”

They go on to discuss all the failures of the theory that have come from testing in the past century.

Response to Objection 2: There is some correlation between carefully selected countries and states, but on the whole, there is no real correlation in the data. Because causal connections require a correlation, we can infer that there is no causal connection. One strong example of this is China, where it is an offence not to wear a mask in public. China originated COVID-19 and it spread uncontrollably.

There are many countries not convinced of the efficacy, including Denmark, Sweden, Norway, and Finland.

Response to Objection 3: As the New England Journal of Medicine points out12, there is little evidence of mask-wearing offering any protection outside of hospital settings, and in those cases, fitted, hospital-grade masks are required to cause an effect. As well, the study in “Nature Medicine”10 indicates that a prolonged period of face-to-face contact with a symptomatic person is the situation we should avoid. Church settings do not fit this description.

Response to Objection 4: There have been warnings since March that wearing masks can provide a false sense of safety[13]. They may even lead to more infections[14]. There are also the considerations related to fear I will address in later sections.

Response to Objection 5: The study in question was performed on hamsters using fans to blow air past sick hamsters onto health ones. Hamsters do not behave like humans, do not have human immune systems, don’t live in conditions human live, and the experiment didn’t represent anything that really happens in human life.

Even far-left Slate wrote an article condemning the study and saying “Hayes, the CNBC story, and Yuen reflect a belief that masks meaningfully—actually, dramatically—lower the transmission rates of the novel coronavirus among civilians. This belief is so deeply held that we take hospital-grade gear for ourselves and shame people who go without masks even while maintaining social distancing in the outdoors. I am intentionally calling it a belief because the science on how much masks help is still fuzzy.”[15].

[1] Study: Surgical masks can reduce spread of COVID-19 virus by up to 75% <https://www.sfgate.com/science/article/Study-Surgical-masks-reduce-spread-hamster-hong-ko-15281491.php>

[2] From an interview of Dr. Fauci on 60 Minutes <https://www.cbsnews.com/news/coronavirus-containment-dr-jon-lapook-60-minutes-2020-03-08/>.

[3] “Why Face Masks Don’t Work: A Revealing Review” was “updated” to remove the entire study due to “the current climate” <https://www.oralhealthgroup.com/features/face-masks-dont-work-revealing-review/ >

[4] Executive Order 2020-109 (May 29, 2020) < https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-530541–,00.html>

[5] Lev. 13:46.

[6] Lev. 13:26,33.

[7] Lev. 13:55.

[8] Deut. 23:12-13.

[9] “Respiratory virus shedding in exhaled breath and efficacy of face masks” <https://www.nature.com/articles/s41591-020-0843-2?ContensisTextOnly=true>

[10] “Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures – Volume 26, Number 5—May 2020 – Emerging Infectious Diseases journal – CDC” <https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article>

[11] “Universal Masking in Hospitals in the Covid-19 Era” <https://www.nejm.org/doi/full/10.1056/NEJMp2006372>

[12] “Why Face Masks Don’t Work: A Revealing Review” <https://web.archive.org/web/20200605090916/https://www.oralhealthgroup.com/features/face-masks-dont-work-revealing-review/>

[13] “Commentary: Masks-for-all for COVID-19 not based on sound data” < https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data>

[14] From the Independent: “Coronavirus: Face masks could increase risk of infection, medical chief warns” < https://www.independent.co.uk/news/health/coronavirus-news-face-masks-increase-risk-infection-doctor-jenny-harries-a9396811.html?__twitter_impression=true>

[15] From Slate, “That viral Mask Study Was Done on Hamsters” <https://www.sfgate.com/science/article/Study-Surgical-masks-reduce-spread-hamster-hong-ko-15281491.php>