Cato's bizarre take on cloth face masks.

in cato •  3 years ago 

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https://www.cato.org/regulation/winter-2021/2022/how-effective-are-cloth-face-masks

Quite a bizarre article but here's my attempt to pick it apart.

Argues that aerosols are likely important with the coronavirus and not necessarily close droplet spread. Then goes on to show mask studies support that masks reduce viral spread.

The paper selection was quite odd too. Used a lot of old meta analyses pre pandemic for non coronavirus viruses in hospital and household settings where risk of transmission and duration of contact are highest. They argue these (old) meta analyses argue there is a lack of sufficient quality data (because they are old!).

Then of the actual coronavirus studies they handwave away the non RCT data by talking about all the limitations. Again which show reduction in viral spread.

Of the two coronavirus RCTs, one was underpowered, had poor adherence, was self report, and as they noted unable to answer the relevant questions in regards to source control (the main benefit of masking). The other RCT which showed a benefit they handwave away as not generalizable and speculate on possible non mask reasons for the observed benefit. Ignoring also the things that understated the true benefit like how mask wearing was not high in the treatment group. Also ignoring the subgroup analysis in the study that showed higher benefit for certain at risk groups.

No selection criteria for the review is listed in this. They left out some mask studies for coronavirus that showed a benefit particularly in non household and non hospital settings.

This sort of reminds me of the IVMMETA site for Ivermectin. A lot of combining of different studies with differing endpoints and completely different viruses, settings, masks, and protocols, into a mish mash.

Their conclusions seem at odds with even what they conclude within the analyses. They note aerosol spread. They note mask filtration is high. They note N95 > surgical > cloth and that double masking can improve fit. They cite studies that show reduced viral expulsion. And of the highest quality evidence on coronavirus masking they handwave away its benefit.

And for the negative cost column they use a lot of low quality data that they don't interrogate. And again muddle. As though skin irritation is on the level of breathing restriction.

It is an overstated conclusion that ignores all the conflicting data.

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