Before the rebuttals, it might be worth learning about the network of the Brownstone Institute. The names of the connections are not surprising at all. They are the big minimizers, liars, and grifters. In addition, a number of their articles about masks don’t include any studies and are nothing more than unfounded opinion pieces. Their sources of funding are also very telling.
Universal Masking In Health Care Settings Is Unnecessary ⋆ Brownstone Institute
The author of this piece is the founder of an organization called Rational Ground. When I tried to go to the site, it no longer exists, even though this piece was posted on 4/25/23. I searched using one of the internet archive sites, and what I found wasn’t surprising. It’s all right-wing talking points about COVID and is pretty telling about their lack of science to back claims.
He goes on to write about one article, not a study, in the Archives of Internal Medicine, that is nothing more than an opinion piece. His link at the bottom to where he had originally published it in Rational Ground though goes to nothing more than a substack, so Rational Ground was really never an organization, but just a lot of his opinion, which shows he really doesn’t have a good grasp of COVID or science.
Further, he was also the plaintiff in a lawsuit related to the lies he spread. “Plaintiff Justin Hart, a California resident, is suing Defendants Facebook Inc., Twitter Inc., President Joseph Biden, Surgeon General Vivek Murthy, the Department of Health and Human Services (HHS), and the Office of Management and Budget (OMB). See Compl. (dkt. 1). Hart alleges that, between late 2020 and mid-2021, Facebook and Twitter flagged his posts as misinformation about COVID-19 and suspended or locked his accounts.” The US District Court found for the plaintiffs, “For the foregoing reasons, the Court GRANTS the motions to dismiss without leave to amend, but without prejudice to Hart bringing his state claims in state corut [sic]. The Court does not reach the motions to strike.”
His bio on Regenery says about everything else one needs to know about him. “Justin Hart…worked with everyone from Florida Governor Ron DeSantis to Dr. Scott Atlas to Dr. Jay Bhattacharya. Previously, Hart directed special projects on the Mitt Romney campaign. He’s appeared on Fox News, OAN, and Newsmax.” He’s not a good source of COVID info by any means.
Long Covid Could be Mask Induced Exhaustion Syndrome (MIES) ⋆ Brownstone Institute
In the third paragraph, Daniel Horowitz begins with “To this day, three years into this immoral, illogical, and inhumane policy, health care settings in red states are still forcing workers and often patients in distress to wear the pagan burka.” That’s rather an odd position to take when masks have been required in certain healthcare settings for decades.
He then links to an article in the Daily Mail, as opposed to an actual study to start his piece, which is not a good source.
The big question was if this was even a published study. It wasn’t, meaning that no data or analysis could be reviewed. It looks to have been a presentation at a conference, and the media attention on it was due to a press release. Legitimate science is published, but there wasn’t even anything to find on a preprint server.
He then goes on to claim “Those of us with critical thinking skills knew from day one, as well as our government, based on 10 randomized controlled trials of the flu, knew that masks never worked. But this one clearly demonstrates that the holy grail of masking in hospitals is a farce.” Most people won’t actually go to look at the study he is referring to, which used studies going back as far as 1946, and all of the studies cited in were on mask use, not respirator use. In addition, the methodology was not consistent among them. One of the biggest gaps among them though is likely that mask use wouldn’t have been consistent, suggesting that subjects may have been exposed to influenza in other environments. In addition, we know during the pandemic that self-reported mask use versus observed mask use is very different, such as this example from New York shows, which suggests that masks do not get used anywhere near the frequency as self-reported use might imply.
For his next piece of evidence, he states “Another study measuring a broad array of symptoms from masking found a massive statistically significant increase in side effects from long-term masking – the sort of symptoms you would not want to induce upon acutely ill patients. German researchers published a meta-analysis of 2,168 studies on adverse medical mask effects – the largest in its kind – and the findings across a diverse array of studies and surveys are appalling but predictable.”
He doesn’t bother to mention that the study was retracted. “The journal retracts the 5 April 2023 article cited above. Following publication, concerns were raised regarding the scientific validity of the article. An investigation was conducted in accordance with Frontiers’ policies. It was found that the complaints were valid and that the article does not meet the standards of editorial and scientific soundness for Frontiers in Public Health; therefore, the article has been retracted. This retraction was approved by the Chief Editors of Frontiers in Public Health and the Chief Executive Editor of Frontiers. The authors did not agree to this retraction.”
He continues and makes some claims against N-95 masks referring to three studies but does not provide citations.
He then links to a preprint, even though it was eventually published on 9/15/22, even though his article is from 4/14/23, which is more evidence of sloppy journalism, although calling this journalism is a stretch. The study looked at CO2 concentration using capnography without a mask, with a surgical mask, and with a respirator. The authors found “With surgical masks, the mean CO2 concentration was 7091 ± 2491 ppm in children, 4835 ± 869 in adults, and 4379 ± 978 in the elderly. With FFP2 respirators, this concentration was 13 665 ± 3655 in children, 8502 ± 1859 in adults, and 9027 ± 1882 in the elderly. The proportion showing a CO2 concentration higher than the 5000 ppm (8-hour average) acceptable threshold for workers was 41.1% with surgical masks, and 99.3% with FFP2 respirators.”
The authors of the study are correct about the 8-hour average threshold of 5000 ppm, but it’s very unlikely that anyone wears one for eight hours straight. In addition, the short-term exposure limit (STEL) provided by the government is 30,000 ppm averaged over 15 minutes, which is obviously not happening. It’s also worth noting that even at 10,000 ppm (1.0%), there are typically no effects, other than possible drowsiness.
One other interesting piece related to that study is that the authors didn’t discuss pulse oximetry readings, which should be 95-100% for most people. They had collected this data, which was available in the supplementary material. I searched for any readings below 95%, and only found this in two study participants.
I suspect that somehow Column H was reversed for these two, since it makes no sense that an O2 sat would increase with a mask on (row 141). It is also telling that O2 sats stayed consistent across no mask, surgical mask, or respirator for most participants, indicating that there was no impact on oxygenation.
This means that a relative risk assessment is really crucial when it comes to mask or respirator use. The risk of COVID FAR EXCEEDS the risk of any mask use.
This article was also a reprint from Conservative Review, so clearly has a strong bias against actual science.
How Zeynep Tufekci and Jeremy Howard Masked America ⋆ Brownstone Institute
It should be noted that the author is very anti-China, which tarnishes much of what he writes. His own bio states he “is an attorney and author of Snake Oil: How Xi Jinping Shut Down the World. He has been researching the influence of the Chinese Communist Party on the world’s response to COVID-19 since March 2020 and previously authored China’s Global Lockdown Propaganda Campaign and The Masked Ball of Cowardice in Tablet Magazine.”
The author starts out stating “an authoritative study has finally confirmed what humanity gained from all those mask advisories during COVID: approximately Zero. His use of the Cochrane Review to make a claim against masks is a deceptive narrative.
Instead of actually writing anything about the science of masking, he goes on to make ad hominem attacks against Zeynep Tufeckci and Jeremy Howard because they used data from China to help guide masking recommendations. This is really pretty ethnocentric thinking on his part. I used work from the China CDC at the start of the pandemic to create an impact calculator on 3/16/20 that has been used all over the country. I later added some of the modeling work done by the Imprerial College of London who also used the China CDC publication in their work.
The tool I built combined the China CDC data with US census data to project cases, general hospitalizations, ICU needs, and deaths, stratified by age group. Further, it would allow the selection of an expected attack rate and choosing any set of counties in the country to assess the impact in that area. This would allow hospitals to plan for the areas that they drew patients from.
Worse though, than his anti-mask rhetoric, is that his political views are dangerous to Asian Americans.
Here are another person’s thoughts on Justin Hart.
Eye Protection Wasn’t Misdirection
This starts as a hit piece on Dr. Anthony Fauci, based on one statement, “If you have goggles or an eye shield, you should use it,” made on July 30th, 2020, before we had more information on the mode of transmission.
Mansell then continues to describe the anatomy of the lacrimal ducts. No dispute there. However, the risks of airborne eye exposure are obviously less than respiratory exposure because of the large volume of aerosolized virus that would be inspired, versus landing on someone’s eye. Yes, ocular exposure is a risk, but even the CDC Isolation Precautions guidelines state “Use PPE to protect the mucous membranes of the eyes, nose and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions and excretions.” Further, this is categorized as a IB/IC recommendation.
Mansell continues to conflate masks with respirators, in what appears to be an attempt to confuse people. Part of the reason that a regular mask helps is that is captures some of the respiratory droplet. Obviously all would be better, but her thinking would be akin to saying there should be no speed limits since accidents happen anyway or that we shouldn’t use seatbelts or airbags because they sometimes don’t protect the driver or passenger.
Oddly enough, she continues with the use of some language and text that actually make a very STRONG case for the use of a respirator.
She continues to use four citations, three of which are from pay to publish sources, which are generally not great references, and the other likely is given that it’s open access, but it’s Brazilian, so I was unable to find a payment structure.
What is most interesting though is that her final paragraph makes an excellent case for respirator use, even though she tries to paint them as not being beneficial.
“TLDR: Ocular transmission is a viable method of transmission for SARS-CoV-2. Masks are not source control. Even N95s aren’t going to fix this. And all child masks are unregulated, untested, unethical, and unsafe, with zero efficacy, fit, term of wear, or medical clearance standards, and with ocular transmission being a proven route of transmission for RSV, masks aren’t going to fix that issue, either.”
Her bio on Brownstone states she “has a background in hazardous environs PPE applications.” That strikes me as the language of someone who maybe has done some fit testing, but perhaps not much more, trying to oversell herself.
It’s also very telling that she hides her Tweets. I wondered if I had been blocked by her in the past so I used another account that I don’t Tweet on to check. Same result. She only wants to be heard in her little bubble. Of course there is money to be made here too by selling her book. It must not be selling well. The Kindle price is only $2.99.
“I decided to do some more searching on her and found this. “Today, PPE expert Megan Mansell joins me to answer your questions on why masks don’t work. Not only do they not work to filter out or keep in the virus particles, it turns out that they actually help aerosolize larger droplets that would otherwise fall to the ground. Also, they cause so many other harms, especially among children. Megan explains why the recommendation, much less mandate, of mask-wearing under these circumstances would never pass an ethics investigation in normal times.”I decided to do some more searching on her and found this. “Today, PPE expert Megan Mansell joins me to answer your questions on why masks don’t work. Not only do they not work to filter out or keep in the virus particles, it turns out that they actually help aerosolize larger droplets that would otherwise fall to the ground. Also, they cause so many other harms, especially among children. Megan explains why the recommendation, much less mandate, of mask-wearing under these circumstances would never pass an ethics investigation in normal times.”
Self-proclaimed PPE expert, sure. Actual expert, definitely not.
Tomás Pueyo Returns: The MBA Who Shut Down Europe on Masks and the Cochrane Review
There’s no science to respond to here, but it is amusing because of the irony. Michael Senger makes a point that “Others questioned how someone with no experience or previous interest in epidemiology was suddenly one of the most influential voices in a public health emergency.” This is from an attorney who within his linked bio states “is an attorney and author of Snake Oil: How Xi Jinping Shut Down the World. He has been researching the influence of the Chinese Communist Party on the world’s response to COVID-19 since March 2020 and previously authored China’s Global Lockdown Propaganda Campaign and The Masked Ball of Cowardice in Tablet Magazine.” Tell me how he can write books on these topics with “no experience or previous interest in epidemiology.” Talk about snake oil.
He did mention a story in the New York Times discussing a study done by the National Bureau of Economic Research about excess deaths from non-COVID causes. The authors of the study itself state in the conclusion “Critics will likely suggest that the public policy choices did not lead to the large number of non-Covid excess deaths, that these excess deaths were a consequence of personal choices, driven by fear or boredom. We do not disagree that this may be a key driver of excess non-Covid deaths.”
Senger claims “that the response to COVID had led to over 170,000 excess deaths among young Americans,” which is a blatant lie. The authors only use this figure once, and it is in the conclusion of the study. It states, “Summing our estimates across causes and age groups, we estimate 171,000 excess non-Covid deaths through the end of 2021 plus 72,000 unmeasured Covid deaths.” It’s also worth noting that the study did not account for future deaths due to the sequelae of COVID.
Mask Mandates in Healthcare Facilities are the Evilest of them All
This is one of the most laughable pieces I’ve read. The bio of Aaron Hertzberg states he “is a writer on all aspects of the pandemic response.” I did some searching and I can’t find any academic credentials at all. His website, Resisting the Intellectual Illiteratti, really looks like he is a conspiracy theorist crackpot. It’s amazing that The Brownstone Institute provides a platform to people like this. It’s a reflection of their lack of credibility.
Hertzberg states “Mask requirements in healthcare facilities are the most indefensible and unconscionable of them all. It is hard to find a practice more corrosive to patient welfare and the provision of medical care than mask mandates.” He seems to think that this is something new. This has been in place since before I got into the field 20+ years ago, and is codified in CFR 1910.134.
Further, the CDC guidelines for laboratories working with COVID call for BSL-3 level precautions. “Cultures of SARS-CoV-2 should be handled in a Biosafety Level 3 (BSL-3) laboratory using BSL-3 practices, and inoculation of animals with infectious wild-type SARS-CoV-2 should be conducted in an Animal Biosafety Level 3 (ABSL-3) facility using ABSL-3 practices and respiratory protection.”
What is a BSL-3 lab? This is a screenshot of how HHS defines them.
I could obviously go on a long rabbit trail about why we are allowing the public to be exposed to a pathogen like this without mitigation measures, but I will stick to his article. Hertberg says “Forcibly masking patients imposes medical harm; causes patients physical and emotional distress; poisons the doctor-patient relationship; pits the patient against the medical staff now doubling as mask police; and, worst of all, dethrones individual patient welfare as the overarching priority in favor of the welfare of a nebulously characterized ‘everyone else,'” without providing any evidence of his claims.
He continues with more crackpot nonsense. “Masking patients is inherently a savagely violent desecration of ‘primum non nocere’ – first, do no harm. Masking patients amounts to medical molestation, a depraved abuse of patients already suffering from medical maladies, one that also substantially interferes with and cripples patient care. Contrast mask requirements to vaccine mandates – as evil and deadly as those are – that at least in the abstract can be theoretically justified with [false] insinuations about the necessity and efficacy of a vaccine,” again with no evidence for any of those claims.
It’s not even worth writing anything further. He’s a nut who seems not to have any science education. If he did, he would at least make an attempt to provide evidence for his claims.
The Freedom Not to Wear a Mask
John Tamny is an economist with no apparent science background. His bio on his website is particularly funny. Here’s a screenshot.
I had to look elsewhere to find his qualifications. He has a BA in political science and a MBA. Not exactly a person to rely on for good science. He just rehashes the very biased Cochrane review which I’ve rebutted.
Robert Blumen is a software engineer. It’s amazing that people listen to people like this with absolutely no education or expertise in this field.
He makes a claim that there are only two strategies to dealt with the pandemic, herd immunity and zero COVID. That’s simply false and doesn’t show any understanding of the nuances of different approaches.
Different strategies can work together to improve the outcomes for an entire population. I’ll show how that works.
One problem with a pandemic is that it can overwhelm healthcare capacity. To offset this, hospitals increase their surge capacity. That’s simply planning on altered utilization of space to make more patient care areas available. In this illustration, it’s easy to see how raising that capacity can help the population get care. The black line represents the maximum capacity of hospitals shown against an epidemic curve. Those above that line don’t get care. When the surge capacity is increased, fewer people suffer.
Another strategy is the use of nonpharmaceutical interventions, such as respirators, social distancing, air filtration, and increased air changes per hour in an enclosed space. These effectively both flatten the curve and push it later in time, as this illustration shows.
Another means is vaccination, which effectively lowers the disease and death burden after implementation. The results of this from COVID vaccination are very clear. This illustration shows how it trims off the tail of the epidemic curve.
The big benefit comes from combining different strategies. This animation combines the three above. One can easily see how the number of people who are at risk of not receiving care is significantly decreased.
Blumen goes on to make a ridiculous claim, “The vaccine was supposed to end the epidemic once everyone was vaccinated. The vaccine arrived but did not work as planned, everyone got covid.” First, it’s not an epidemic, it’s a pandemic, it was never promoted as the sole means to end the pandemic, And not everyone has been infected by COVID.
He then states “It is now understood by almost everyone outside of the performing arts that herd immunity is inevitable.” That’s blatantly false. Manaus, Brazil should have been the nail in the coffin of that argument. Both The Lancet and BMJ discussed this, and there is a technical model of why this occured in PNAS.
In the next paragraph, he continues with what he calls a thought experiment. “Suppose that we were still trying zero covid. If that was ever going to work, it would have required all of society to buy in. It would not be enough to stop the spread in stores or schools and let it spread elsewhere. It would have to be stopped everywhere. Today, when zero covid is in the rear view, what is the point of trying to stop the spread during classical music performances? If you limit infection in the concert hall, people walk out of the performance and walk right into a bar, a restaurant, a hotel lobby, or get in a cab. Even if you could ensure that no one gets infected during a performance, but they get it before or after – what good is that? Have you accomplished anything?” What he fails to grasp is the exponential nature of growth. Simply put, preventing disease in one person prevents many cases of disease further generations of transmission later.
He then proceeds to masks, starting with outright lies. “The arguments against masks are they do not work, and they are harmful.” His first piece of “evidence” refers to the DANMASK-19 study, but he doesn’t link to the study itself, but to an article in The Spectator, which suggests he didn’t even bother to read the study itself. The authors of the DANMASK-19 study stated their limitations were “Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others.” The final paragraph of the study also states “Thus, these findings do not provide data on the effectiveness of widespread mask wearing in the community in reducing SARS-CoV-2 infections. They do, however, offer evidence about the degree of protection mask wearers can anticipate in a setting where others are not wearing masks and where other public health measures, including social distancing, are in effect.” It’s also worth reading many of the comments on the study website.
The next citation by Guerra he tries to claim as evidence was only a preprint and was never published and never will be. It’s so lacking in data and so poorly designed that I’m surprised that the authors haven’t pulled it down out of embarrassment.
He then points to what he claims is a systematic review but is merely a policy discussion in EID, which I already addressed above. Of course then he uses the Cochrane Review to make another claim, and then quotes Vinay Prasad’s take on it, who is a known minimizer. It seems like these people don’t have any independent thoughts, but keep rehashing the same nonsense.
He then makes the amateur mistake of using a bunch of graphs to claim that they don’t make a difference. In fact, without them case and hospitalization numbers would have been higher.
Another paragraph is worth a screenshot because of how devoid of science his thinking is.
I’m willing to bet that he doesn’t grasp that the virus is within a respiratory droplet, nor does he know what Brownian motion or electrostatic charges are which make respirators effective. This is an illustration of how they work.
He then claims that “Even public health officials have begun to admit in the last year that masks do not slow or stop viruses,” and uses a picture of Dr. Scott Gottlieb, who is not and never has been a public health official. In addition, he’s been a moderate minimizer as well. It totally misses the difference between masks and respirators.
Next, he uses “evidence” from “Jim Meehan, MD, in An Evidence Based Scientific Analysis of Why Masks are Ineffective, Unnecessary, and Harmful.” Meehan is an ophthalmologist who makes really big claims about his expertise. “
“Jim Meehan, MD is an ophthalmologist and preventive medicine specialist with over 20 years of experience and advanced training in immunology, inflammation, and infectious disease. He has performed well over 10,000 surgical procedures. His research experience includes investigating associations between military vaccinations and Gulf War Syndrome. Dr. Meehan is also trained in internal medicine, addiction medicine, endocrinology, integrative medicine, functional medicine, and nutrition.” Opthalmologist, yes, expertise in infectious diseases and epidemiology, clearly not. I’m not the only one who saw through him. Judge Thomas G. Moukawsher did as well.
Blumen is just another Brownstone Institute author who is really out of his league.
