RALEIGH, N.C. (WNCN) — It’s been nearly two full years since North Carolina had a COVID-19 mask mandate.
Since then, one question has lingered: Did it work?
A total of 39 states, including North Carolina, put mask mandates of some type into place early in the pandemic.
In a column that drew plenty of outcry this week on social media, an opinion writer at one of the nation’s largest newspapers of record argues they didn’t work, and points to new scientific research into masking as proof of that.
But an authority on masks from the University of North Carolina’s medical school says that not only does the study lacks context, the columnist is reading it the wrong way.
THE CLAIM: An opinion piece in The New York Times headlined “The Mask Mandates Did Nothing. Will Any Lessons Be Learned?” argues that mask mandates were “a bust” and “a fool’s errand from the start,” and calls the Centers for Disease Control and Prevention’s adherence to masking recommendations “mindless.”
THE FACTS: Dr. Emily Sickbert-Bennett, who has conducted extensive research on masks and their effectiveness, said she was “surprised to see such a strong statement … considering how strong I think the data are in many ways.”
Columnist Bret Stephens bases his argument on a study with a conclusion that seems to undermine his position.
He quotes author Tom Jefferson, an Oxford epidemiologist, as telling journalist Maryanne Demasi that “there is just no evidence that they (masks) make any difference.”
Demasi’s earlier work included an accusation that the Food and Drug Administration is misleading doctors about COVID vaccines, and an interview with a doctor who is calling for the vaccines to be suspended.
And there are plenty of issues with the study Stephens cited.
Even the first sentence of its conclusion seems to serve as a warning to readers, pointing out several factors that it says “hampers drawing firm conclusions.”
Published last month by UK-based nonprofit Cochrane, it looks at multiple studies of several groups of people across different time frames in what’s called a meta-analysis — or, a “study of many studies,” Sickbert-Bennett said.
But that creates some apples-to-oranges comparisons. For example, it combines trials where masks or respirators were worn some of the time with those when they were worn all the time.
And Sickbert-Bennett, the director of infection prevention at the UNC School of Medicine, pointed out another comparison that doesn’t square.
The authors specifically say it doesn’t apply to healthcare settings — such as crowded hospitals where sick patients could be breathing out viral particles, making transmission much riskier.
In fact, the largest study of the project — and the only one conducted during the COVID pandemic — showed what Sickbert-Bennett called a “clinically meaningful and statistical improvement:” A 13 percent relative reduction that increased to 35 percent when looking at the highest-risk population of those 60 and older.
“We don’t really want to take one summary of summaries across multiple time points without really understanding the context of it all,” Sickbert-Bennett said.
Another problem: Most of those trials only looked at part of the issue — whether the mask-wearer was protected.
But it didn’t address the other half — whether masks kept an infected person from infecting others. That was part of the allure of the masking movement: Your mask protects me, my mask protects you.
Also, COVID-19 makes up only a fraction of the viruses involved in the studies. Others include the H1N1 flu pandemic in 2009, non-epidemic flu seasons and epidemic flu seasons up to 2016.
That means most of those don’t take into account what makes COVID unique — namely, that it’s twice as infectious as the flu, and masking wasn’t nearly as widespread in a pre-COVID world.
“It wasn’t that important of a strategy when we were just seeing these more localized influenza outbreaks,” Sickbert-Bennett said.
There’s also a difference between arguing that masks didn’t work and that mask mandates didn’t work.
“They work when people choose to wear them at times when they have exposure, and so compliance matters a lot,” Sickbert-Bennett said. “And the actual circumstances of when they’re wearing it matters. And whether mask mandates are effective at getting compliance, and whether mask mandates are issued at the times when … the exposure is happening the most is kind of another circumstantial piece to consider with masking mandates.”