Cloth masks don't work: The CNN admission
And yet that's the only one mandated in US community & for kids as young as 2
If you haven’t seen this video clip, check it out, it is a startling admission on cable TV of something that has been true this entire pandemic
The clip is accurate. Cloth masks do not slow sars-cov-2 spread. That answer was evident in the pre-existing body of literature on community masking. And that was made clearer with Bangladesh cluster RCT which failed to find any impact of cloth masking on community spread on the primary endpoint. Note: we reviewed al data on community masking in a 25,000 word article here, which supports this sober interpretation. This is also why all leading health organizations did not advise cloth masking in early March 2020.
Prior to widespread adult vaccine availability in the USA, slowing the spread of the virus had some rationale. If a simple intervention could accomplish it, it would be reasonable to promote it, and especially over other draconian options (closures).
Yet, every single community mask intervention in the USA advised cloth masking. (only Germany reached for community surgical masking). As such, our policy did nothing to change the pandemic trajectory, but led to a huge cultural divide, and incessant arguments.
Of course, the fiercest battles were over whether children in school or on airplanes should be compelled to wear them, and if so, how young. Remember, we were fighting about a mask that does not work when tested in adult populations. The idea that it would work among 6 year olds was odd, but the USA pursued a more delusional policy.
The American Academy of Pediatrics and CDC advised routine cloth masking for kids as young as 2. There was no evidence that this would slow spread in these ages, where compliance may be most dubious. This policy was also in defiance of the World Health Organization and UNICEF, which advised against masking less than 6.
Finally, many day care centers that mandated cloth masking (2-4 year olds) also had children nap together in a room for hours on end without wearing masks (suffocation risk). What benefit could a cloth mask have when worn for just a portion of indoor airtime together?
After widespread availability of vaccination, it was debatable whether the goal of slowing spread is desirable. Some argue that exposure before antibodies wane may be ideal and strengthen immunity. Eventually exposure is inevitable in all, as the virus is endemic. Thus, even if cloth masks worked, one might question their value post vaccine availability.
But, the situation is worse: there is no relevant data support cloth masks post vaccination. If they didn’t work in an immune naive, adult population in Bangaldesh pre-vax, how could they work in a highly vaccinated population in the USA post vax?
In the setting of a new, highly infectious, but milder variant that can pierce vaccination & boosters, what is the likelihood a mask that has only failed will confer benefit? And, if it does, what would be the point?
Some suggest that the physical properties of masks can prove that cloth masks do work. This is a flawed understanding of science. Understanding the molecular mechanism of a drug or medical intervention does not ensure that it works. You must test it directly. Similarly the size of filtration does not predict that cloth masks will work. The intervention is a human and behavioral one. You must test it directly, which was done, and negative. (Note: but if an intervention cannot work mechanistically — i.e. cannot have a biological rationale, it might not be worth testing).
One observation from Bangladesh is that mask use waned drastically after the study ended. The truth is it has already waned in America. Compliance is deteriorating by the minute outside of select urban enclaves and twitter.
Finally, our leaders have shifted standards (isolation to 5 days) acknowledging trade-offs, yet we persist with this obsession for the youngest kids?
The whole episode is more a commentary on adult anxieties & political tribalism than evidence based policy.