We must resist the normalisation of masks

Their adoption by zerocovid supporters as a kind of talisman is no substitute for rigorous research

The divide in the House of Commons was striking last week. Nearly all members of the Opposition were wearing masks while only a handful could be seen on the Government benches. I do not know whether this was an organised political statement, a natural result of personal choice, or a difference in the implications drawn from the scientific evidence. But whatever the explanation, political posturing over face coverings matters.

For a year or more, many commentators have been suggesting that the Government’s responses to the pandemic owe more to politics and polls than science. We must resist the creeping normalisation of masks and resist the way in which they have been adopted as a talisman by the campaign for the impossible state of zero Covid.

Does it matter that half of the MPS were not wearing a mask in a large enclosed space? The Office for National Statistics estimates that more than 90 per cent of adults have antibodies anyway. The WHO advice prior to 2020 was that cloth face coverings and surgical masks were not effective in preventing transmission of viruses. Prof Chris Whitty has stated that the evidence for using masks was weak. It does not appear that any new evidence has emerged in the last 18 months to overturn that consensus.

According to the scientific method, it is not for those claiming the veracity of an effect to expect others to disprove their claim. The onus is on those asserting that masks work to devise a suitable experiment to prove it.

The best evidence would be from randomised control trials (RCT), but too few have been done. One Danish RCT showed no statistically significant difference in the infection rate between those who used masks in the community and those who did not. It was not a perfect study: participants had to self-report how well they used masks once they had been shown how to use them properly. But compliance will likely have been better than the average we see around us.

In the absence of compelling RCTS, we need to examine indirect evidence. Looking at different countries, there is little or no correlation between changes in the infection rate and the dates of implementation of mask mandates. If the number of infections was increasing when the mandate was imposed, it carried on increasing at the same rate. If the number of infections was falling or stable, they continued on that line. This statistic tells us nothing about individual behaviour, but should inform governments which have to make decisions at the population level.

Also, the UK pilot study for largescale indoor and outdoor events found no worrisome spikes in infection.

The real world has many variables and picking apart these effects using statistical methods is hard. That makes it easier for the mask proponents to argue that if mask-wearing saves just one life and a few infections it is worth it. But that is a value statement, which takes no account of possible harms.

There are many downsides to using masks. They stoke fear and anxiety, reminding us that we are living in a state of emergency. They are a hindrance to communication, and can have a significant impact on child development, particularly in relation to social interaction.

If the real-world effect of mask-use on reducing transmission was strong, there would likely have been a signal in the infection data. Overall, it seems that the best we can say about masks is that any effect on transmission they might have is obscured by the effects of other interventions, perhaps lost in the noise below any readily observable level.

Responses to pandemics should account for all factors that make for a well-functioning society. The rules and advice need to balance health, economic, and human and social factors. If face coverings do become a political battleground in the UK, as they have done in the US and elsewhere, politicians will not be solely responsible. The wider scientific advice system and its relatively narrow base of expertise must shoulder some blame for failing to commission systematic trials and transparent, balanced risk-benefit analyses.

If the results of such research are open to all, we can end those remaining mask mandates and let the public make up their own minds.