There have been some crackles in recent days on twitter, as the Bangladeshi mask trial caught light again. The crackling started with the publication of a ‘short note‘ that provided a ‘simple analysis’ of the recently released raw data from the Bangladeshi trial that claimed that, given the new ‘simple analysis’, the trial failed to show any covid protection benefit from mask wearing. Not content with blowing holes in masks, the authors of the ‘simple note’ also report that they did nonetheless find some other highly significant differences between the intervention and control groups, including one that could introduce more than enough bias to explain the original trial report’s marginal benefit from wearing surgical masks. In the limp language of academic writing, the authors suggest their findings ‘urge caution’ (sic) in interpretation of small differences, and that ‘bias-susceptible endpoints…should be used with care’. Translating into plain English, the masks don’t work, and the mandates should go.
You might be forgiven for thinking the new discipline of maskonomics was created by government to facilitate to masking of awkward and tiresome economic results. In fact, it is a close cousin of economics, the field of study that makes astrology look rigorous, and its purpose is to mask, or silence, mask dissenters by providing a barrage of argument in favour of wearing face masks, or coverings, in public to reduce covid–19 spread. Its high priestess in England is none other than the utterly formidable Prof Trisha Greenhalgh, a medical OBE whose gaze alone is sufficient to curdle fresh milk at twenty paces. Lesser prelates include Dr Venki Ramakrishnan, a more benign but no less mask committed Nobel Prize winning structural biologist who is for the time being Chief Pongo at the Royal Society, where he has found applying structural social engineering to promote mask wearing very much to his liking.
The biggest fact about face masks and covid–19 is there are no facts. This should not surprise us one bit. Covid–19 is a new disease, and research takes time to conduct. Furthermore, the sort of research that would give us a definitive answer, a randomised controlled trial, is burdened with almost — but not totally — insurmountable difficulties, from ethical concerns to procedural obstacles. One solution, attempted by the three authors of the Royal Society report covered by Dr No in his last post, is not to let the best be the enemy of the good, a pragmatic wheeze that says that the absence of the great (RCT evidence) doesn’t mean we should ignore the good (lower quality but, one hopes, tolerable evidence). The danger is that following Voltaire can all to easily turn into ‘no need to bother with that sort of nonsense round here’, where ‘that sort of nonsense’ is good quality evidence. This is what the Royal Society report authors did. Having found no reliable clinical evidence, they turned instead to an in vitro, laboratory based physics experiment, and came to a clinical conclusion. Dr No regrets to say that simply won’t wash. But then again, you hire demographers, you get pyramids.