By Jeffrey H. Anderson
Many Americans have been taught to believe that masks work—at least a little—and that wearing them comes at a minimal cost. Nearly the opposite is true.
The best scientific evidence invites a far less rosy assessment of masks’ effectiveness than is broadcast by public health officials. In its worldwide impact, the COVID-19 pandemic has been the worst in a century. As a threat to Americans’ health, however, it is closer to the 1968 Hong Kong flu or the 1957 Asian flu—neither of which noticeably altered Americans’ everyday lives—than to the 1918 Spanish flu.
In a head-to-head comparison, COVID-19 makes the Spanish flu look like the Black Death of medieval Europe. According to the best available figures from the Centers for Disease Control and Prevention (CDC) and elsewhere, the typical American under the age of 40 in 1918 was more than 100 times as likely to die of the Spanish flu than the typical American under the age of 40 in 2020 was to die of COVID-19.
Whereas COVID-19 sadly shortened the lives of many older people already in poor health, the Spanish flu took people in the prime of life and left orphans in its wake.
The Spread of Public Health Officials
Americans’ reaction to COVID-19, however, has been radically different from their behavior in 1968, 1957, or even 1918. Writing in the Wall Street Journal, the Hoover Institution’s Niall Ferguson recalls that President Dwight Eisenhower asked Congress for $2.5 million in additional funding for the Public Health Service during the Asian flu. Overall, Congress has authorized about 2 million times that much for COVID-19.
In 1957, there were no widespread school closures, travel bans, or mask mandates. Ferguson quotes one person’s recollection of those days: “For those who grew up in the 1930s and 1940s, there was nothing unusual about finding yourself threatened by contagious disease. Mumps, measles, chickenpox, and German measles swept through entire schools and towns; I had all four…. We took the Asian flu in stride.”
One major difference between then and now is the increased role of public health officials. Long before their ascension, Socrates made clear in Plato’s Republic that he did not want doctors to rule. Philosophers or even poets would be better governors of society because they at least attempt to understand political and social life in its entirety and minister to the human soul.
Doctors, by contrast, tend to disregard the soul: it is the nature of their art to focus on the body in lieu of higher concerns. Moreover, Greek philosophers and poets alike celebrated courage in the face of death—Plato’s Socrates and Homer’s Achilles were undeterred from their noble missions by fear of the grave. But rule by public health officials, under which we increasingly live today, encourages excessive risk-aversion and almost transforms cowardice into a virtue.
Wear the Mask, Neanderthal
Surgical masks were designed to protect patients’ wounds from becoming infected by medical personnel, not to prevent the spread of viruses. When COVID-19 hit our shores, the CDC initially recommended that most Americans not wear masks.
On April 3, 2020, the CDC abruptly reversed this position. Surgeon General Jerome Adams explained that “new evidence” had revealed that “a significant portion of individuals with coronavirus lack symptoms” and “can transmit the virus to others before they show symptoms” (emphasis added).
As a rationale for wearing masks, this did not entirely make sense. According to the World Health Organization (WHO), “potentially pre-symptomatic transmission…is a major driver of transmission for influenza.”
Yet the CDC does not (yet) recommend that seemingly healthy people wear masks during flu season. It seems likely that the CDC panicked in April and wanted to be seen as doing something. Plus, public health officials are naturally enthusiastic about public health interventions.
The day after the CDC endorsed nationwide mask-wearing, President Trump announced, “I won’t be doing it personally.” From that instant, the mask quickly became a symbol of civic virtue—a sort of Black Lives Matter flag that could be hung from one’s face. For many it conveyed a trio of virtues: I’m unselfish; I’m pro-science; I’m anti-Trump.
What it also conveyed, incidentally, was a rejection of longstanding Western norms, unhealthy risk-aversion, credulous willingness to embrace unsupported health claims and a pallid view of human interaction.
Masking the Science
The most reliable science on whether masks are effective in stopping the transmission of viruses comes from randomized control trials (RCTs), almost all of which were conducted before COVID-19 began.
Randomized control trials have found little to no evidence that masks work to prevent viral transmission—either from the wearer to others or vice versa. In fact, some significant evidence from RCTs indicates that masks increase transmission.
A 2020 study by Professor Henning Bundgaard and his team in Denmark is the only RCT that has tested the effectiveness of mask-wearing against COVID-19. It found that 1.8 percent of those participants in the group wearing masks, and 2.1percent of those in the unmasked control group, became infected with COVID-19 within a month. This difference was not statistically significant. The study must have had difficulty getting published since it appeared months after it was conducted.
In attempting to justify its mask guidance on its website, the CDC has relied almost entirely on observational studies while studiously disregarding RCTs.
Anyone who thinks the CDC is an impartial, politically neutral agency, dedicated solely to the pursuit of scientific truth, should perhaps consider the recent e-mail evidence that the teachers union and Joe Biden’s White House effectively rewrote sections of the agency’s return-to-school guidance.
Like so many unelected leaders, CDC officials consider themselves more accountable to “stakeholders” than to the American people. Legislatures have largely been AWOL during the coronavirus period, while public health officials and executive branch leaders have reveled in their newfound powers.
Jeffrey H. Anderson served as director of the Bureau of Justice Statistics at the U.S. Department of Justice from 2017-2021. An extended version of this article appeared in the Claremont Review of Books, Summer 2021. Reprinted with permission.