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For those who don’t know, the Cochrane Collaboration is named after Archie Cochrane, a British epidemiologist who beat the drum loudly for evidence-based medical thinking. Not just doing what had been done forever, but doing what the best medical evidence available recommends. The Cochrane Collaboration is a prestigious and highly respected international medical research organization founded in 1993 to conduct systematic reviews of all the pertinent medical literature and extract the best recommendations based on the most current research on any given disease or intervention.
Since the Cochrane Collaboration is free from pharmaceutical or other industry funding, and since it involves the collaboration of many, many experts on a given subject, its results are considered the gold standard of current evidence.
The only real blemish on the record of the Cochrane Collaboration was when an internal dispute ended up with the group basically kicking out one of the founding members, Dr. Peter Gøtzsche. Dr. Gøtzsche is a Danish physician, who accused members of Cochrane of basically selling out where psychotropic drugs are concerned. Many of you have probably heard of Dr. Gøtzsche due to his many books, the most famous of which is Deadly Medicines and Organized Crime.
I know Dr. Gøtzsche. I have heard him speak numerous times, and have spent time with him. He’s an irascible guy, so I can see how he would get under the skin of anyone who disagreed with him. I suspect the folks at Cochrane were glad to see the back of him and vice versa.
The medical profession—at least those who keep up—pretty much relies on the findings of the Cochrane Collaboration to define what is the current best evidence for treatment. That doesn’t mean it will be the very best treatment, just that it’s deemed the best based on the currently available studies.
Having provided all this prologue, I’m happy to report that the Cochrane Collaboration has released its latest report advising that masking with medical/ surgical masks provides no protection against Covid, influenza, or other aerosol viral diseases.
I know, I know, you’re saying to yourselves, yea, but what about N95 masks. Those do work.
Well, not so fast. Here’s what the folks at Cochrane discovered about those:
The authors of this report summarize as follows:
I wonder how the we’re-all-going-to-die-if-we-don’t-wear-masks brigade is going to respond to this?''
For those who don’t know, the Cochrane Collaboration is named after Archie Cochrane, a British epidemiologist who beat the drum loudly for evidence-based medical thinking. Not just doing what had been done forever, but doing what the best medical evidence available recommends. The Cochrane Collaboration is a prestigious and highly respected international medical research organization founded in 1993 to conduct systematic reviews of all the pertinent medical literature and extract the best recommendations based on the most current research on any given disease or intervention.
Since the Cochrane Collaboration is free from pharmaceutical or other industry funding, and since it involves the collaboration of many, many experts on a given subject, its results are considered the gold standard of current evidence.
The only real blemish on the record of the Cochrane Collaboration was when an internal dispute ended up with the group basically kicking out one of the founding members, Dr. Peter Gøtzsche. Dr. Gøtzsche is a Danish physician, who accused members of Cochrane of basically selling out where psychotropic drugs are concerned. Many of you have probably heard of Dr. Gøtzsche due to his many books, the most famous of which is Deadly Medicines and Organized Crime.
I know Dr. Gøtzsche. I have heard him speak numerous times, and have spent time with him. He’s an irascible guy, so I can see how he would get under the skin of anyone who disagreed with him. I suspect the folks at Cochrane were glad to see the back of him and vice versa.
The medical profession—at least those who keep up—pretty much relies on the findings of the Cochrane Collaboration to define what is the current best evidence for treatment. That doesn’t mean it will be the very best treatment, just that it’s deemed the best based on the currently available studies.
Having provided all this prologue, I’m happy to report that the Cochrane Collaboration has released its latest report advising that masking with medical/ surgical masks provides no protection against Covid, influenza, or other aerosol viral diseases.
I’ve removed all the statistical numbers and separated the sentences for easier reading. You can see the original here.We included 12 trials (10 cluster‐RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks… 9 trials, 276,917 participants; moderate‐certainty evidence.
Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks… trials, 13,919 participants; moderate‐certainty evidence.
Harms were rarely measured and poorly reported (very low‐certainty evidence).
I know, I know, you’re saying to yourselves, yea, but what about N95 masks. Those do work.
Well, not so fast. Here’s what the folks at Cochrane discovered about those:
Again, I removed the statistical figures and separated some of the sentences for easier reading. All the numbers are in the original.We pooled trials comparing N95/P2 respirators with medical/surgical masks (four in healthcare settings and one in a household setting). We are very uncertain on the effects of N95/P2 respirators compared with medical/surgical masks on the outcome of clinical respiratory illness… 3 trials, 7779 participants; very low‐certainty evidence.
N95/P2 respirators compared with medical/surgical masks may be effective for ILI… 8407 participants; low‐certainty evidence. Evidence is limited by imprecision and heterogeneity for these subjective outcomes.
The use of a N95/P2 respirators compared to medical/surgical masks probably makes little or no difference for the objective and more precise outcome of laboratory‐confirmed influenza infection…; 5 trials, 8407 participants; (moderate‐certainty evidence). Restricting pooling to healthcare workers made no difference to the overall findings.
Harms were poorly measured and reported, but discomfort wearing medical/surgical masks or N95/P2 respirators was mentioned in several studies (very low‐certainty evidence).
One previously reported ongoing RCT has now been published and observed that medical/surgical masks were non‐inferior to N95 respirators in a large study of 1009 healthcare workers in four countries providing direct care to COVID‐19 patients.
The authors of this report summarize as follows:
It’s hard to be clearer than that. “No clear reduction…” and “no clear differences…” are pretty firm statements that masks don’t work. Especially coming from Cochrane.The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection.
I wonder how the we’re-all-going-to-die-if-we-don’t-wear-masks brigade is going to respond to this?''