Nearly three years after the start of COVID-19 in early 2020, people are still showing up in my clinic wearing single and double masks, with tremendous fear of getting an infection with COVID-19 or Influenza. As of the end of 2022, some “so called” experts started telling people in the public to wear masks again, and patients in droves are showing up masked to their medical appointments in the last four weeks.
Before the COVID-19 pandemic, the existing available data about respiratory viruses including influenza and various types of coronavirus showed no evidence or justification for wearing masks to prevent the spread of infection of a respiratory virus. The legitimate reason for use of a mask is during surgery to lend protection from blood and body fluid splatter between patient and providers or with specific types of filtration masks designed to specifically protect from certain types of bacterial infections.
Review of the Medical Literature:
Here are key anchor points to the extensive scientific literature that establishes that wearing surgical masks and respirators (e.g., “N95”) does not reduce the risk of contracting a verified illness:
Jacobs, J. L. et al. (2009) “Use of surgical face masks to reduce the incidence of the common cold among health care workers in Japan: A randomized controlled trial,” American Journal of Infection Control, Volume 37, Issue 5, 417 – 419. https://www.ncbi.nlm.nih.gov/pubmed/19216002. N95-masked health-care workers (HCW) were significantly more likely to experience headaches. Face mask use in HCW was not demonstrated to provide benefit in terms of cold symptoms or getting colds.
bin-Reza et al. (2012) “The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence,” Influenza and Other Respiratory Viruses 6(4), 257–267. https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1750-2659.2011.00307.x “There were 17 eligible studies. … None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.”
Smith, J.D. et al. (2016) “Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis,” CMAJ Mar 2016 https://www.cmaj.ca/content/188/8/567 “We identified six clinical studies . . . In the meta-analysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection, (b) influenza-like illness, or (c) reported work-place absenteeism.”
Offeddu, V. et al. (2017) “Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis,” Clinical Infectious Diseases, Volume 65, Issue 11, 1 December 2017, Pages 1934–1942, https://academic.oup.com/cid/article/65/11/1934/4068747 “Self-reported assessment of clinical outcomes was prone to bias. Evidence of a protective effect of masks or respirators against verified respiratory infection (VRI) was not statistically significant.”
Radonovich, L.J. et al. (2019) “N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial,” JAMA. 2019; 322(9): 824–833. https://jamanetwork.com/journals/jama/fullarticle/2749214 “Among 2862 randomized participants, 2371 completed the study and accounted for 5180 HCW-seasons. … Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.”
Long, Y. et al. (2020) “Effectiveness of N95 respirators versus surgical masks against influenza: A systematic review and meta-analysis,” J Evid Based Med. 2020; 1- 9. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12381 “A total of six RCTs involving 9,171 participants were included. There were no statistically significant differences in preventing laboratory-confirmed influenza, laboratory-confirmed respiratory viral infections, laboratory-confirmed respiratory infection, and influenza-like illness using N95 respirators and surgical masks. Meta-analysis indicated a protective effect of N95 respirators against laboratory-confirmed bacterial colonization (RR = 0.58, 95% CI 0.43-0.78). The use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory-confirmed influenza.”
Conclusion: Masks Do Not Work
No randomized controlled (RCT) study with verified outcome shows a benefit for health care workers or community members in households to wearing a mask or respirator. There is no such study in existence.
Likewise, no study exists that shows a benefit from a broad policy to wear masks in public.
If there were any benefit to wearing a mask, because of the blocking power against droplets and aerosol particles, then there should be more benefit from wearing a respirator (N95) compared to a surgical mask, yet several large meta-analyses, and all the RCT, prove that there is no such relative benefit.
No Evidence or Justification for Mask Wearing
Despite the news media with all their hype, all of the scientific studies done in the world up until 2020 demonstrated that there was absolutely no justification for mask wearing to prevent spread of respiratory illness including influenza and corona-viruses. The guidelines of the World Health Organization (WHO) and the US Center for Disease Control and Prevention (CDC) also showed that there was no need for wearing masks in the general public. The practice of wearing masks did not, and to this day, have any professional justification.
In 2020, the recommendation around the world for wearing masks suddenly changed without any new professional support to confirm their effectiveness against respiratory infection. The vast majority of studies during the pandemic suffered from very low quality and many biases.
Only Two High Quality Mask Studies Exist
Since the start of the pandemic only two high-quality studies have been completed, one looking at a population of over 3000 people in Denmark, and the other with over 342,000 adults completed in Bangladesh. The study in Bangladesh found some marginal benefit for people over age 50 years old, but overall both studies show that there is no significant benefit for wearing masks to prevent infection with influenza or the corona-virus specifically.
In fact, the results of both of these studies demonstrate that the wearing of masks actually may do more harm than good. In addition to these studies, several observational studies demonstrated that wearing a mask can cause headaches, concentration difficulty, shortness of breath, decrease in blood oxygen levels, increase in the level of carbon dioxide, bacterial contamination from the mask itself and the existence of substances suspected being carcinogenic as result of lack of regulations and the production of masks.
Wearing a mask for a prolonged period of time can become problematic because of the accumulation of carbon dioxide levels that may exceed permitted standards, might cause tiredness, blurriness, sleepiness and deficiency in judgment, as well as thinking.
Masks Adversely Affect Social, Mental and Emotional Health
An additional issue I personally found to be a problem in my office, masks create communication difficulty with people who have impaired hearing and need to read lips is a major factor. Additional studies demonstrated the negative effect of wearing masks on communication and especially with children’s mental and emotional development.
There are a few particular situations in which wearing masks is justified. In the context of medical treatment when a patient with a respiratory disease is closely examined by medical staff who will be spending prolonged periods of time with that patient, and certainly in the cases of active infectious COVID-19 there is justification for wearing a mask by both the therapist and the patient. However, research still demonstrates the spread to be very low if the contact is less than three hours in length.
As a physician who has practiced medicine for over 20 years, when the patient comes to me with leg pain there is no reason for him or for me to wear a mask. If a patient comes in with anemia, there is also no reason to wear a mask. In the medical encounter, the relationship that exist between the doctor and the patient has great significance. Masks interfere with that relationship and the empathy that should exist between them. Mask wearing when none is justified creates a subconscious barrier and changes the social and emotional dynamics between the patient and doctor. Currently, there is a directive for mask-wearing in medical, health and welfare facilities around the world in a number of countries and in a number of hospitals which actually has no scientific justification.
Untrustworthy Medical Journals and Bias
The medical profession and providers within this profession rely heavily on articles published in high-quality journals to provide evidence based guidance and direction for our decisions and actions. However, in the last three years, bias in these publications has been very significant and misleading in these leading journals. It has essentially made them untrustworthy.
Because of this, doctors have passed through a kind of brainwashing by the medical establishment. They have been receiving inaccurate, misleading and contradictory information from previously trusted sources now swayed by bias, political, governmental and monetary influence, so doctors themselves struggle to know what is right and what is not.
Perhaps most worrisome is the continued refusal to have open professional discussion, and the disdain for different positions backed by poor quality research and data not consistent with the norms of medicine and science. This has had long-term negative consequences for the medical profession and consequences that every doctor in the world should be concerned about.
As I mentioned above, no study exists that shows a benefit from any broad policy to wear masks in public. There is good reason for this. It would be impossible to obtain unambiguous and bias-free results because:
Any benefit from mask-wearing has only a very small effect, since undetected in controlled experiments, which would be swamped by the larger effects, notably the large effect from changing atmospheric humidity.
Mask compliance and mask adjustment habits would be unknown and impossible to account for.
Mask-wearing is associated (correlated) with several other health behaviors; see Wada (2012).
The results would not be transferable, because of differing cultural habits.
Compliance is achieved by fear, and individuals can habituate to fear-based propaganda, and can have fundamentally different basic responses.
Monitoring and compliance measurement are near-impossible, and subject to large errors.
Self-reporting (such as in surveys) is notoriously biased, because individuals have the self-interested belief that their efforts are useful.
Progression of the epidemic is not verified with reliable tests on large population samples, and generally relies on non-representative hospital visits or admissions.
Several different viruses and strains of viruses causing respiratory illness generally act together, in the same population and/or in individuals, and are not resolved, while having different epidemiological characteristics.
Unless you’re going in to perform surgery, please, for your health and mine, stop wearing a mask.
After graduation from medical residency, I served for four years as my AirForce Reserve unit’s biological/chemical weapons expert & physician. My job was to understand the risks of all the known biologic and chemical weapons that could be used on a human being, including severe viral and bacterial diseases that could pose a threat. My training was specifically focused on how to prevent and treat the effects of these illnesses in those under my care, military or otherwise.
I spent four years reading and researching where and when various types of masks, respirators and protective equipment would and should be used. Never once was a surgical or cloth mask ever found to be effective. Even N95 masks failed the rigors of these encounters.
This week our fearless Dr. Fauci says it’s “common sense” to wear two masks. So, my question to him and all of the other emperors of medicine is, what about three masks?
Even better yet, 10 masks makes even more “common sense!!” Where does this stop? (I stop at 11, because, my ears flop over at 12 masks.)
I’m thinking that 100 masks is 100% effective right?
I guess those filtered gas masks really aren’t essential then?!
One surgical mask decreases risk by 1-2% (yes, that’s the benefit of a mask that we’ve been required to wear). You’re more likely to have a 40% COVID risk reduction by throwing salt over your shoulder when you leave the house . . . (that’s the actual placebo effect).
The whole reason for mask wearing is to decrease “asymptomatic” transmission of COVID-19. That means, masks are supposed to decrease your risk of spreading or inhaling this virus when you or the person near you have no symptoms. Initially, we recommended wearing masks, because we did not know how infective the COVID-19 virus was to humans. We also knew that there was limited access to the N95 masks used in the hospital setting.
However, in the last 12 months, we’ve learned a great deal and we have a tremendous amount of data about treating this virus in the outpatient setting. You can follow Dr. Nally’s COVID-19 treatment protocol here.
How Contagious is COVID-19?
What’s the actual risk of spreading the virus when you have no symptoms? It’s about 0.06% if you have prolonged contact (3 hours continuous face-to-face) with a person within six hours of that person having onset of symptoms (i.e. – fever, sore throat, fatigue, headache, loss of taste or smell, or runny nose). It is very rare to be infected at all with COVID-19 asymptomatically if you contact a person 6-9 hours before they have symptoms.
In fact, a recent study revealed there were no positive tests (or asymptomatic spread) among 1,174 close contacts of asymptomatic cases. So, why are we still wearing masks? Because it is politically convenient, increases fear, and increases your likelihood of getting a vaccine.
Are There Unintended Consequences of Mask Wearing?
Is wearing a mask to decrease a minimal risk by 1% more worth the risk? Increased bacterial and fungal infections that are on the rise as a consequence of chronic and continued daily mask wearing.
I’m seeing patients with increased frequency of facial rashes, fungal infections, non COVID-19 induced bacterial infections. Reports are coming from my colleagues, all over the world, that suggest bacterial pneumonias are on the rise.
Why? Because we are wearing and re-wearing of dirty masks. Untrained members of the public are wearing medical masks, repeatedly… in a non-sterile fashion… They’re becoming contaminated. They’re pulling them off of their car seat, off the rearview mirror, out of their pocket, from their countertop, and they’re reapplying a mask that should be worn fresh and sterile every single time. And, there is no way around this when 330 million people are required to wear a mask to go to Wal-Mart or Costco.
In a recent report in Emerging Infectious Diseases, the U.S. Centers for Disease Control and Prevention (CDC) suggests what experts have stated all along: There is no conclusive evidence that cloth masks protects users from coronavirus, especially since most people do not use them correctly and do not keep them clean.
The report actually says, “To our knowledge, only 1 randomized controlled trial has been conducted to examine the efficacy of cloth masks in healthcare settings, and the results do not favor use of cloth masks. More randomized controlled trials should be conducted in community settings to test the efficacy of cloth masks against respiratory infections.”
A commentator and pastor recently noted that we a have reached a mark where two seemingly contradictory ideology’s define our society.
There is a denunciation of all claims of absolute truth.
There is powerful fanaticism in which one position or group is absolutely right, nothing at all ambiguous, and any divergent view should be expunged, removed or destroyed.
Interestingly, the second ideology will always attempt to fill the void created by the absence of the first. This contradiction of ideologies held within the same human mind is the definition of “double-mindedness” found biblically. It is also one of the signs of the times.
It is and always has been, that in the absence of absolute truth, “my truth” progresses down the road of authoritarian power to become “kneel before Zod!” It is the direction that corrupts the soul drawing one, in the words of Emperor Palpatine, to seek for “Power, unlimited power!”
In the absence of absolute truth, the Beatitudes are replaced with fanaticisms. These are ever-changing, non-eternal, and often entirely arbitrary relating to one’s ability to hold or grab power. Humility and healing are thrown out with the bathwater and half-truths are elevated to the level of ultimate individual justice.
The latest fanaticism is our wearing of masks. We’ve progressed miles past science in this personal truth and we now sit squarely in the realm of voodoo. Yet, this voodoo gets louder and stronger and more obnoxious the more it is proven to be a complete and utter fraud.
In Arizona, we’ve had a mask mandate for almost 150 days, Ohio for 112 days, Maryland for 106 days, New York for 128 days. Yet all of these states are currently threatening more shutdowns of schools, business, and gatherings because of a new “surge” in coronavirus.
Absolutely nowhere upon the earth have masks been scientifically shown to slow COVID-19 in real time after almost 6 months of trying. Not a state, not a country, . . . nowhere has this mandate been effective. The science published by the CDC itself even said masks would be ineffective for control of respiratory bacterial and viral infections prior to COVID-19 rearing it’s ugly head.
Yet, today through the necromancy of media, mask wearing has become the sign of worthiness for worship at the alter of Baal. It’s become the symbol of false righteousness many times over. The witch doctor atop the CDC has incredulously taught us through a daily camera dance, much like the rain dance of old, that masks are better than a vaccine.
Masks are a vaccine, of sorts, not meant to kill the virus, but to kill hope, liberty and civility within the human soul. The more they don’t work, the more we continue to and agree to wear them. Action is our communication with Providence that our fear is our greatest certainty and the flatness of the earth actually brings us comfort.
It’s no wonder we’ve attempted to elected one of our elders with dementia. He is the mask personified. The twice failed presidential candidate with a 49 year track record of public “service” never once improving humanity, government or the human condition. Let’s just try using him harder this time. It has to work. What could go wrong?
This failure has literally become sacramentalized. Fundamentalization of failure into the religion of the mask becomes a personal truth, when the increasingly preposterous becomes our governing idol.
This is the exact opposite of creation. It is the only religion that can exist in the absence of absolute truth. God’s grace steps into the void and compels the creation of good and holy. In opposition to this, the religion of the mask is the fanaticism that propels the abuse of everything so that one might worship the oppressed and then celebrate the anointing of nothing at all. Power over the abyss is the destination of those that govern.
It is the greatest swindle of all time. It is working on you, and it is working on me . . . so sayeth the mask.
The Danish Study on Masks was finally published today. It is the largest and the ONLY randomized control trial (RCT) on 6000 people wearing masks and the results . . .
Masks DON’T protect you!!!
Authors state, to the chagrin of the CDC, that the results were NOT statistically significant, but Reuters and NY Times is going to spin this to say they protect you from others . . . that statement is, again, NOT statistically significant.
The CDC, prior to changing its position on universal mask-wearing, had previously cited 10 randomized controlled trials that showed “no significant reduction in influenza transmission with the use of face masks.” Now, the CDC and other elite institutions would have us believe that coronavirus is somehow different. The Danes were the first to actually study the effect of large-scale universal mask-wearing specifically against the spread of COVID-19.
Remember in science class when you found out that the placebo effect was up to 40%? The FDA will NOT approve ANY drug or medical treatment unless is passes 40% effectiveness (placebo) for effect.
Masks ARE NOT, and never have been, any more effective than placebo. . . Period. Hard stop. End of story. And, the ONLY RCT trial ever done now proves it. I can give you a Skittle and you’re probably less likely to get COVID-19 then you are wearing a mask. . . the reason is placebo, up to 40% reduction if I tell you that “it’s a powerfully protective Skittle.”
Interestingly, this study was completed in October, but three medical journals refused to publish it because it “wasn’t politically correct.”
Over the last few months, our fearless infectious disease leader, Dr. Anthony Fauci, and the Ivory Tower of medical journals, the New England Journal of Medicine, have clearly informed us that mask wearing by the healthy is little more than symbolic ‘Virtue Signaling.’
For those Karen’s and Felicia’s who have tried to shout me down like a Tourette’s tick with ‘Social Media Science,’ in Wal-Mart, in the big box stores, at the gas station and at the burger shop, lets look closely at what the New England Journal of Medicine said on May 21, 2020.
We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to COVID-19 as face-to-face contact within 6 feet with a patient with symptomatic COVID-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching COVID-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.
So, why have we been ordered to wear are masks everywhere by mayors and governors and city officials across the country? Symbolism. Pure and simple symbolism. From that same NEJM article:
It is also clear that masks serve symbolic roles. Masks are not only tools, they also serve as a talisman [an object that acts as a charm to avert evil and bring good fortune] that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals.
The Surgeon General was widely mocked and ridiculed for suggesting in March that masks might even increase the spread of the virus. Yet, here, in the “journal of all medical journals,” the NEJM provides the same warning to mask-wearers:
What is clear, however, is that universal masking alone is not a panacea. A mask will not protect providers caring for a patient with active COVID-19 if it’s not accompanied by meticulous hand hygiene, eye protection, gloves, and a gown. A mask alone will not prevent health care workers with early COVID-19 from contaminating their hands and spreading the virus to patients and colleagues. Focusing on universal masking alone may, paradoxically, lead to more transmission of COVID-19 if it diverts attention from implementing more fundamental infection-control measures.
However, suddenly on June 17th, 2020, Dr. Fauci suddenly changed his tune, and contrary to all the scientific evidence and over 50 years of medical literature on the subject, said wearing a mask is “better than nothing.” Within weeks, executive orders for mask wearing were signed across the nation.
The argument should have been over. Anyone advocating for universal mask wearing by the healthy, according to all the mask wearing literature, is merely engaging in virtue signaling, not actual public health.
Cities and states across the nation have mandated mask wearing (some even advocate using bananas). I’m not telling you to break the law. I am saying that the mask mandate has done nothing to “slow the spread” as so many people have now bought into. Research demonstrates that homemade masks do little to stop the spread of viral infections. It also demonstrates that properly fitted surgical masks worn correctly decrease this risk of viral spread in a highly controlled setting at the very best by only 2-5%.
In the most recent comprehensive review of the mask wearing literature, the authors stated, “The evidence is not sufficiently strong to support widespread use of face-masks as a protective measure against COVID-19. However, there is enough evidence to support the use of face-masks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.”
What is effective is washing your hands regularly with soap and water, avoiding those who are actually sick or have fevers over 101 degrees, eating a healthy diet that prevents diabetes risk and getting adequate sleep. Those at high risk for infection can and should be vigilant about avoiding exposure to those who are sick.
For the rest of us, it’s time to unmask. I, myself, struggle daily to maintain enough virtue in my bones for myself, let alone signal others about it all day long.
Isn’t it interesting, back in April and May, 2020, those of us closely watching the data stated that this virus would look much like the influenza pandemic of 1918. Look closely at the numbers of deaths in St Louis (who participated in the 1918 quarantine – red line) and Arizona, who has done much the same in our approach (in the 2nd graphic below).
The death count curves are nearly identical. Interestingly, the numbers of those that died St Louis are almost identical to Arizona’s graph below, directly from the Arizona Department of Health Website. We know that the rates of infection differ between the two viruses and a number of things including domicile proximity, health of the city or state, transportation methods, sanitary condition, etc. play a significant role in the infection rates. My point is not to compare the two viruses, but to point out that the effect of quarantine did exactly what we expected it to do.
We expected the resurgence of the virus. Let’s say that again. We expected it. However, the media and many health professionals that I interact with seem horrified that it occurred.
We predicted this pattern months ago.
I am surprised at the number of health professionals that are just beside themselves about this virus. I recognize that, in its most severe form, this virus can be deadly. And, so is the flu, RSV and other RNA viruses. Do these professionals not read history? Do they not read the actual scientific literature? Do they not see the patterns that diet and control of hyperinsulinemia have on this virus?
Instead, these medical professionals have remained quiet, and in some cases cheered, as our government over-reach and personal liberty infringement took place. We’ve lost our ability to travel, participate in group gatherings and church services. Quarantine, mask wearing and social distancing has essentially done nothing for our community in the last 3 months.
Our initial reasoning for quarantine was to take the peak off of hospitalizations. That was done. Yet continued suppression of personal liberties has done nothing for the overall health of our society. The second wave of infection was going to occur no matter what we did.
Instead, the media fear mongering, social distancing and force wearing of masks has lead to increased risk of suicide, overdose and drug addiction. Estimates are as high as 150,000 deaths due to the effects of quarantine and social distancing mandates. In fact, much of the anxiety and PTSD that is expected will not be seen until 4-6 month after the quarantine occurs.
According to a recent JAMA report, “It is possible that the 24/7 news coverage of these unprecedented events could serve as an additional stressor, especially for individuals with preexisting mental health problems.” Our routines have been completely upended and even things like wearing a mask or waiting in lines at the grocery store can make you feel tense.
Some common signs of pandemic-induced stress are:
Fear and worry about your own health and the health of your loved ones
Changes in sleep or eating patterns
Difficulty sleeping or concentrating
Worsening of chronic health problems
Worsening of mental health conditions
Increased use of alcohol, tobacco, or other drugs
What we know from research after the SARS outbreak is that post-traumatic stress (PTSD) is possible, especially in front line healthcare workers. In one particular study, about 10 percent of the hospital employees had had high SARS-related PTSD symptoms post-outbreak. And about half of them still had symptoms three years later. Other studies have shown that when a person’s PTSD symptoms persist for more than 6 months after an event, they are very likely to continue to persist over the long term.
A significant part of the problem in both the lay public and among health care workers is confusion about actual risk of disease, what can be done to prevent/treat the disease, and how to access treatment. I see this confusion today in many physicians and nurses I interact with in my community.
If you are having symptoms of anxiety, stress or depression, don’t be afraid to reach out for help. Knowledge is power. The more you know, the less fear and anxiety you will have.
Wear your mask if you want. Initially, when we didn’t know how invective this virus was, I was all for using any protection available. But, since the end of April, the data has changed my mind. Wearing a mask isn’t doing anyone any good.
Some cities and states have mandated mask wearing. I’m not telling you to break the law. I am saying that the mask mandate has done nothing to “slow the spread” as so many people have now bought into. Research demonstrates that homemade masks to little to stop the spread of viral infections and surgical mask that have been properly fitted and worn correctly decrease this risk of viral spread by only 2-5%. In the most recent review of the mask wearing literature, the authors stated, “The evidence is not sufficiently strong to support widespread use of face-masks as a protective measure against COVID-19. However, there is enough evidence to support the use of face-masks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.”
What is effective is washing your hands regularly with soap and water, avoiding those who are actually sick or have fevers over 101 degrees, eating a healthy diet that prevents diabetes risk and getting adequate sleep. Those at high risk for infection can and should be vigilant about avoiding exposure.
(Note: Author Updated this article on January 31, 2021)
I’ve been accused of writing this article because of my personal political motivation. That is not the case. I write this article because my patient’s expect me to treat them based on the actual science that exists, not the interpretative politics and non-evidence based health mandates that so many have recently cowered under, or used as a virtue signaling security blanket. A number of my patients, and potential patients, have notified me since I first published this article that I upset or angered them, because I haven’t conformed to “everyone else’s opinions.” My intent in writing this is not to anger anyone, agree with your opinion or to put forth a political agenda. Just because the media, politicians or city bureaucrats repeat something over and over doesn’t make it true. I share with you the actual science that has been recently made available so that you and I can make an educated judgement on how to act. Without an understanding of the actual evidence how are you and I to respond when there are so many voices sharing so many differing opinions? If you can’t trust your doctor to follow updated scientific evidence, then who can you trust?
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After graduation from medical residency, I served for four years as my AirForce Reserve unit’s biological/chemical weapons expert & physician. My job was to understand the risks of all the known biologic and chemical weapons that could be used on a human being, including severe viral and bacterial diseases that could pose a threat. My training was specifically focused on how to prevent and treat the effects of these illnesses in those under my care, military or otherwise.
I spent four years reading and researching where and when various types of masks, respirators and protective equipment would and should be used. Never once was a surgical or cloth mask ever found to be effective. Even N95 masks failed the rigors of these encounters.
This week our fearless Dr. Fauci says it’s “common sense” to wear two masks. So, my question to him and all of the other emperors of medicine is, what about three masks?
Even better yet, 10 masks makes even more “common sense!!” Where does this stop? (‘Cause my ears flop over at 11 masks.)
I’m thinking that 100 masks is 100% effective right?
I guess those filtered gas masks really aren’t essential then?!
One surgical mask decreases risk by 1-2% (yes, that’s the benefit of a mask that we’ve been required to wear). You’re more likely to have a 40% COVID risk reduction by throwing salt over your shoulder when you leave the house . . . (that’s the actual placebo effect).
The whole reason for mask wearing is to decrease “asymptomatic” transmission of COVID-19. That means, masks are supposed to decrease your risk of spreading or inhaling this virus when you or the person near you have no symptoms. Initially, we recommended wearing masks, because we did not know how infective the COVID-19 virus was to humans. We also knew that there was limited access to the N95 masks used in the hospital setting.
However, in the last 12 months, we’ve learned a great deal and we have a tremendous amount of data about treating this virus in the outpatient setting.
How Contagious is COVID-19?
What’s the actual risk of spreading the virus when you have no symptoms? It’s about 0.06% if you have prolonged contact (3 hours continuous face-to-face) with a person within six hours of that person having onset of symptoms (i.e. – fever, sore throat, fatigue, headache, loss of taste or smell, or runny nose). It is very rare to be infected at all with COVID-19 asymptomatically if you contact a person 6-9 hours before they have symptoms.
In fact, a recent study revealed there were no positive tests (or asymptomatic spread) among 1,174 close contacts of asymptomatic cases. So, why are we still wearing masks? Because it is politically convenient, increases fear, and increases your likelihood of getting a vaccine.
Are There Unintended Consequences of Mask Wearing?
Is wearing a mask to decrease a minimal risk by 1% more worth the risk? Increased bacterial and fungal infections that are on the rise as a consequence of chronic and continued daily mask wearing.
I’m seeing patients with increased frequency of facial rashes, fungal infections, non COVID-19 induced bacterial infections. Reports are coming from my colleagues, all over the world, that suggest bacterial pneumonias are on the rise.
Why? Because we are wearing and re-wearing of dirty masks. Untrained members of the public are wearing medical masks, repeatedly… in a non-sterile fashion… They’re becoming contaminated. They’re pulling them off of their car seat, off the rearview mirror, out of their pocket, from their countertop, and they’re reapplying a mask that should be worn fresh and sterile every single time. And, there is no way around this when 330 million people are required to wear a mask to go to Wal-Mart or Costco.
In a recent report in Emerging Infectious Diseases, the U.S. Centers for Disease Control and Prevention (CDC) suggests what experts have stated all along: There is no conclusive evidence that cloth masks protects users from coronavirus, especially since most people do not use them correctly and do not keep them clean.
The report actually says, “To our knowledge, only 1 randomized controlled trial has been conducted to examine the efficacy of cloth masks in healthcare settings, and the results do not favor use of cloth masks. More randomized controlled trials should be conducted in community settings to test the efficacy of cloth masks against respiratory infections.”
So, why, again, are we wearing these masks?
Should We Still Be Hiding In Our Homes?
Six months after the the largest variant of the five coronavirus sub-types appeared with it’s ugly little glycoprotein envelope and infective RNA fusion peptide coating, many states and countries are still in a quarantine or lock-down. Initially, because of the rapid infection rate that was seen in Italy and China, health experts recommended quarantine of the general population in order to keep hospital systems and medical providers from being overwhelmed. However, the “overwhelm” has been quite underwhelming. This begs answer to four very important questions:
Should we still be quarantined?
Should we still be wearing a mask when in public?
Should businesses still be shut down?
Should we wait for a vaccine?
This is the first time in history that large scale quarantine of the healthy across the country was ever used. The sole purpose was to control the number of severe cases requiring intensive care and ventilator use. Multiple mathematical models predicted that hundreds of thousands would die based upon statistics seen in Italy and China.
In early February, 2020, we were concerned that risk of death as high as 5.5% in our initial data from Italy and China. Limited N95 masks and protective equipment was available. In agreement with the CDC and WHO, I recommended everyone wear a mask, take drastic infection precautions and quarantine to prevent risk of transmission (Davies A, et al., Aug 2013).
Because viruses like COVID-19 and influenza are so small, a single layer cloth mask and or surgical mask has only been shown to decrease your risk of viral infection or transmission to others by 1-2%. Triple layer cloth masks with central interfacing layer give 3% – 20% reduction of infection risk based on the studies we have in the medical literature (Disaster Med Public Health Preparedness. 2013;7:413-418). At the time we learned about this virus, our understanding was that any protection was better than no protection.
Underwhelming
Yet, as this virus crossed our shores, traveled over the amber waves of grain and ascended the majestic purple mountains of majesty, the overwhelming number of patients hitting the hospital in droves isn’t what we saw. A few areas like New York and Washington State were hit hard, but not nearly as predicted. The large numbers of deaths seen in these states is because of their decision to send thousands of recovering COVID-19 patients into nursing homes, exposing those over 65 at greatest risk for death, to this virus.
The ONLY reason to quarantine an entire population was to decrease the load on hospitals and medical providers. Since the corona-virus entered the US, only 2% of those who actually get infected have required hospitalization. Our fears never came to fruition. The hospitalization load never even reached full capacity in 99% of hospital facilities across the country and many facilities began furloughing employees in April 2020. In fact, this weeks estimate by the CDC is that the fatality ratio for COVID-19 is 0.004. That means if you get the infection, you have a 0.4% chance of dying from coronavirus. Remember, influenza has a fatality ratio that fluctuates between 0.002-0.005 depending on the year (0.2%-0.5% fatality risk). In layman’s terms, your risk of death from a coronavirus infection is no greater than the flu.
The population with the greatest risk for death with any infection is that group over 65 years old. Your overall risk of getting this infection in the United States and dying, if you are over 65 years old, is 0.04% based on our current population and fatality rates. Your overall risk of getting the flu and dying, if you are over 65 years old, is between 0.03%-0.05% depending on the severity of the year.
Arizona Department of Health Services COVID-19 Dashboard – June 18,2020
As of June 18th, eight weeks from the time we began opening up businesses, elective surgeries and letting people go back to work, the death count from COVID-19 continued to fall. If social distancing and mask wearing was really effective, significant rise in infections and COVID-19 deaths should have escalated in mid-May (5-6 days after exposure). Yet, in states like Arizona COVID-19 death counts continued to fall.
Quarantine of the Healthy
In all of history, we have never seen any benefit to quarantining the healthy. In fact, quarantine of the healthy has been demonstrated to be unhealthy for a “well population” (Brooks SK, et al., Lancet, Feb 2020). Based on scientific evidences we have today, despite what our politicians say, there is no reason to quarantine those that are not ill. Seeing all this data over the last two weeks dramatically changed my perspective on this virus.
Asymptomatic Transmission
“Oh no, Dr. Nally! You can’t say that, because this virus can be transmitted when you’re not symptomatic!” Yes. I’ve heard that argument for the last three months. And it is unfounded.
The main reason for quarantine was the fear of asymptomatic transmission. Early editorial reports (these were not actually controlled studies, they were opinion reports based on a case review) showed that the virus “may” be spread prior to a person showing symptoms via respiratory secretions. Initial data in seven very small presumptive editorial case reports out of China, Singapore and Germany postulated that this could occur in 40-50% of those infected (1,2,3,4,5,6,7). Yet all of these articles were case reports of 1-10 people and the exact mechanism of transmission was observational only and is still unknown.
The CDC made its recommendations on wearing masks based on these seven presumptive editorial cases between January and May, 2020. Recent nursing home case report data from April and May looked at 76 people in two nursing homes, 50% of those with positive infections were asymptomatic for the first 5-6 days. The report implies that those with COVID-19 must have had the potential to spread the disease 3-4 days before onset of symptoms. All of our social distancing and mask wearing has been based on upon these seven very small presumptive case reports and/or medical editorials. Never in medical history has sweeping health recommendations or mandates been made on editorial reports alone.
It is very important to note a recent larger population study of 455 patients was performed looking at infected members of families and those living in close quarters over 2-4 weeks. The researchers findings were opposite that of the seven small case reports above and concluded that the likely hood of asymptomatic SARS-CoV-2 transmission was “weak.”
The assumption that viral infections can be transmitted in the asymptomatic state comes from the Ghandi study, and others, that 30-50% of asymptomatic influenza patients can spread the flu a full 3-4 days prior to showing any symptoms, and in some cases up to 7 days prior to symptom onset. We’ve assumed that is the case with COVID-19, but that isn’t what the larger study demonstrated.
Have we or do we currently quarantine the healthy or institute social distance because of asymptomatic influenza spreading risk? No.
Do we quarantine the healthy or social distance because of the highly contagious croup or whooping cough (that is still prevalent on our southern border)? No.
But, these are the same editors and journals that have been telling us for the last 50 years that eating fat makes us fat. So, we must trust them, right? Wait, didn’t the New England Journal of Medicine and the Lancet both just retract “ground breaking” articles on COVID-19 because of falsified data that was never peer reviewed?
The fear of asymptomatic spread is therefore a mute point, as it is roughly identical to the flu. And it has infectious similarities to other infectious diseases like whooping cough (pertussis) and the croup (para-influenza virus). If the only actual large study of COVID-19 demonstrates that asymptomatic droplet based spread is weak, then why have we created fear and economic collapse for a virus that is less likely to spread in the asymptomatic person than the flu, croup, or whooping cough?
Risk Factor for Disease Severity
These three maladies (hypertension, diabetes & coronary artery disease) are the three most common medical problems that I see in my clinic, and they affect 85% of the people in my practice. All three are caused and driven by hyperinsulinemia.
Hyperinsulinemia is defined as an elevated insulin production (2-30 times normal) when ingesting any form of carbohydrate or starch. It starts 15-20 years before the onset of diabetes and is the cause of hypoglycemia, elevated fasting blood sugar, pre-diabetes, metabolic syndrome, chronic kidney disease, idiopathic neuropathy, hypertension and coronary artery disease.
Elevated insulin, even small elevations, puts a load on the immune system. The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes and heart disease. We found that those with elevated insulin levels and those over 45 years old with stressed immune systems are the most susceptible to severe COVID-19 infection.
We know that those who do get severely ill are those over 45 with immune system compromise and/or hyperinsulinemia. A very interesting fact was published in The Lancet. The authors found that the highest rates of death occurred in those with current hypertension, diabetes and/or coronary artery disease (heart disease or atherosclerosis of the arteries).
Interestingly, Italy, Spain and Portugal have the highest incidence of metabolic syndrome (hyperinsulinemia) across all of Europe. It stands to reason that they have also been hit the hardest with a virus that is focused on this form of immune-compromise.
Corona-Virus is Quite Common
The corona-virus, traditionally, causes a simple common cold. In fact, 2% of the population are asymptomatic carriers of the six corona-virus strains that are known to infect humans. And this class of virus is responsible for 10% of respiratory infections yearly around the world (Cascella M, et al. 2020 Apr 6. In: StatPearls.).
Should We Still Be In Quarantine?
Should we still be in quarantine? The answer is therefore “no.”
What we should be focused on is limiting exposure to those with the greatest risk like those in nursing homes, care centers, populations of elderly (over 65 years old), and those with known risk for suppressed immunity. Our focus, efforts and funds should be spend keeping these populations from exposure to COVID-19.
Should we still be wearing masks in public?
As noted above, cloth masks provide only very minimal (20-40%) protection from bacteria and almost no protection (1-2.3%) from viral infections. The two studies that do exist about effectiveness of mask wearing during viral infections to prevent spread demonstrate that adherence is very difficult and that transmission of viral infections is not statistically different between those wearing masks and those not wearing masks (MacIntyre CR et al., Cowling BJ et al.). Because we now know that this virus is similar to influenza in risk for death, general healthy populations should have no need to wear masks. Wearing of a mask actually increases the likely-hood of infection by increased frequency of touching your face. It also perpetuates a climate of risk and fear. It, also, implies that if required, mask should be a covered cost of medical provision at the State and Federal levels. As you can see, even the NIH director over NIAID, Anthony Fauci, MD, the one person in the country with the most experience in pandemic infectious disease, has trouble wearing a mask in public.
Second, there are a number of other medical problems including exacerbation of headache and migraines that occurs with chronic use of both surgical and N95 masks. For those who have COPD, mask wearing can exacerbate hypercapnia (increased carbon dioxide levels causing slowed respiration, confusion and fatigue). Mask wearing can also cause chronic hypoxia (reduced oxygenation) which has been shown to increase risk of cancer growth. In cases where patients with pulmonary fibrosis or impaired lung function wear masks for prolonged periods, syncope or loss of consciousness has been documented.
Therefore, wearing a mask for prolonged periods of time when it is not medically justified is not recommended and in many cases dangerous to your health.
Despite this, and the fact that there is significant doubt as to asymptomatic transmission of this virus, mandates to wear face masks in public were decreed across Arizona today.
Should businesses be shut down?
If our ultimate goal was to “flatten the curve,” and protect hospitals from being overwhelmed, then we were successful at doing that in mid-April. Some communities rightfully extended that quarantine to the end of April. However, there has been no justifiable evidence to suggest that healthy people cannot go back to work, feed their families, pay their mortgages and provide for themselves. In fact, multiple states including Wisconsin, Kansas, & Michigan have had Federal courts overturn draconian quarantine measures enacted by over-reaching emergency gubernatorial orders.
How accurate are the tests anyway?
The accuracy and predictive values of SARS-CoV-2 tests have not been systematically evaluated, and the sensitivity of testing likely depends on the precise RT-PCR assay, the type of specimen obtained, the quality of the specimen, and duration of illness at the time of testing.
In a study of 51 hospitalized patients in China with positive SARS-CoV-2 RT-PCR test (mainly on throat swabs), 15 patients (29 percent) had a negative initial test and only were diagnosed by serial testing [Fang Y, et al., Radiology 2020]. In a similar study of 70 patients in Singapore, initial nasopharyngeal testing was negative in 8 patients (11 percent) [Lee TH, et al. Clin Inf Dis 2020]. In both studies, rare patients were repeatedly negative and only tested positive after four or more tests.
Seven additional studies (including two unpublished reports) that evaluated RT-PCR performance, the estimated rates of false-negative results were 100 percent on the day of exposure, 38 percent on day 5 (estimated as the first day of symptoms), 20 percent at day 8, and 66 percent at day 21 [Kucirka LM, et al., Ann Int Med 2020].
And even though manufacturers are pushing the new antibody testing, antibody testing with IgG and/or IgM tests are frequently falsely positive [Guo L, et al., Clin Infect Dis 2020] and have been shown to be erroneous 20-30% of the time. The accuracy and time to antibody detection vary with the particular test used. Studies evaluating the specificity of serologic tests in a broad population are lacking; in particular, the rate of cross-reactivity with other coronaviruses is a potential concern, and IgM tests are prone to false-positive results.
In the first week since symptom onset, fewer than 40 percent had detectable antibodies; by day 15, IgM and IgG were detectable in 94 and 80 percent, respectively.
In the United States, several serologic tests have been granted emergency use authorization by the FDA for use by laboratories certified to perform moderate- and high-complexity tests [FDA.gov]. The FDA highlights that serologic tests should not be used as the sole test to diagnose or exclude active SARS-CoV-2 infection. The sensitivity and specificity of many of these serologic tests are uncertain.
Should We Wait For A Vaccine?
As a preface to this section, please be aware that I am a very strong proponent of safe and effective vaccine use. Because the RNA vaccines are so new, long-term efficacy, safety and adverse reaction studies are essential before these vaccines can be recommended across the board. It takes at least 4-5 years to 1) bring a vaccine to market and 2) complete adequate safety studies.
Let’s start by looking at the effectiveness of current RNA viral vaccines. The most common RNA vaccine currently in use is the influenza vaccine, quadravalent (four flu strains) and high dose (five flu strains) versions. Over the last 20 years, the percentage of seniors getting flu shots increased sharply from 15% to 65%. It stands to reason that flu deaths among the elderly should have taken a dramatic dip due to increased flu vaccination each year.
Instead, as you can see above, influenza deaths among the elderly continued to climb. It was hard to believe, so researchers at the National Institutes of Health set out to do a study adjusting for all kinds of factors that could be masking the true benefits of the shots. But no matter how they crunched the numbers, they got the same disappointing result: flu shots had not reduced deaths among the elderly.
It’s not what health officials hoped to find. I was shocked when I read these studies. Two studies, here and here, demonstrate that yearly flu vaccine for those over age 65 does nothing to decrease influenza related death. These studies funded by the government in 2005 and 2006 were suppressed and I never heard about them. Yet the CDC still emphasizes to the elderly, “Get your flu shot.”
One reason these vaccines are ineffective is that viruses like influenza and corona-viruses are highly antigenic. That means that there are hundreds of strains and the virus is changing rapidly. Influenza has over 600 strains. Our current high dose vaccine only covers five of these strains.
SARs-CoV-2 (COVID-19) is known to have over 160 strains. “There are too many rapid mutations to neatly trace a COVID-19 family tree.” Said Peter Forster, geneticist at the University of Cambridge. “We used a mathematical network algorithm to visualize all the plausible trees simultaneously.” (Proceedings of the National Academy of Sciences, 2020). Dr. Forster’s research identifies 160 genomes within the hundreds of additional variants of the three central COVID-19 strain variants.
The other very fascinating concern found when making RNA virus vaccines is the potential to increase susceptibility to other viruses. In a Department of Defense study, looking at 6000 military personal vaccinated in the 2017-2018 season, those who got the influenza vaccine demonstrated an increases susceptibility to corona-viruses by 36%. Those who were vaccinated with the flu vaccine had additional increased susceptibility to non-influenza viruses by 15%, and increased susceptibility to human metapneumovirus by 59%.
A second influenza study demonstrated an increased risk of para-influenza virus in adults (increased by 4.6% of vaccinated adults and only 2.6% of unvaccinated adults.) Though the researchers dismissed it as calculation error, the p value reflects that the vaccine played some roll (P=0.04) in the increased susceptibility.
Herd Immunity? Maybe in 200 Years
Do the math on a vaccine that covers only four out of 600+ strains like the quadravalent influenza vaccine. For a vaccine to create “herd immunity,” currently being touted across the airwaves as the way to return to normal, it would require the average human to be vaccinated every year for 100 years, and would take 200-400 years to create any semblance of herd immunity. And, that’s after 4-5 years studying the safety of a vaccine in large populations.
Influenza and HPV, the two most widely used RNA vaccines, still have a number of post-market adverse reactions including: Guillain-Barré syndrome (GBS), convulsions, febrile convulsions, myelitis (including encephalomyelitis and transverse myelitis), facial palsy (Bell’s palsy), optic neuritis/neuropathy, brachial neuritis, syncope (shortly after vaccination), dizziness, and paresthesia (tingling of the extremities) (Package-Insert—Gardasil.pdf; Package-Insert—Fluzone High Dose.pdf). Though these adverse events occur more rarely, it is essential you and I understand the risks of these newer RNA vaccines.
Conclusion
In summary, our focus should be shifting to protecting our elderly and immune-compromised. The evidence does not support quarantine of the healthy. Evidence does not support general public mask wearing. And there is no evidence that continued business closure is beneficial.
What can you and I do?
Reduce your risk of hyperinsulinemia. Follow a carbohydrate restricted diet, exercise, control blood sugar, blood pressure, cholesterol and limit risk factors that suppress your immune system. Quit smoking, vaping, etc.
Actively engage your congressman or congresswoman. What are they are doing to assist/protect the seniors, nursing home patients, and shut-in’s in your area?
Let your governor or mayor hear your voice. What damage has quarantine has done to your livelihood and those of your family?
Get educated about your civil liberties and do not let anyone take them under the guise of an emergency.
Ensure your loved ones, especially the elderly and immune suppressed, understand the truth about their risk of infection.
Don’t be afraid to go outside and be a human being again.
Should you and your family members be wearing a mask to slow the spread of coronavirus (COVID-19)? This is a hotly debated topic and one that may not soon be agreed upon by everyone. Over the last few weeks, a number of voices are saying “Yes.”
I am, also, one of those proponents of dawning a mask. And, that’s no April Fool’s joke.
Dr. Nally in the office
The head of the Chinese Center for Disease Control and Prevention, Dr. George Gao, is also one who has been very vocal about using a mask. “The big mistake in the US and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role — you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth.” Gao said in his interview in Science.
Because coronavirus is a droplet based infection, and not an aerosolized infection, wearing a face mask can more effectively prevent the droplets that carry the virus from escaping and infecting other people. However, I don’t recommend using the medical grade masks. Save those for those that must have face to face contact with COVID-19 positive patients and persons with direct exposures. For the lay person in the grocery store who must get essentials and may have brief contact, I recommend using a specially designed homemade mask.
Masks Actually Help
Recent research shows that some people infected with the COVID-19 virus who don’t have any acute symptoms can still spread the virus. This means that the person in line with you to buy toilet paper, might just be infected and not know it. Research also shows that even wearing a proper homemade mask can reduce silent transmissions of bacteria and viruses in these situations.
In fact, this has been the recent topic of discussion at the CDC, and the use of homemade masks were reviewed in great detail in yesterday’s Washington Post article here.
Homemade Masks Make a Dent in Viral Spread
Wearing a homemade mask has become the norm in Czechia. The government of Czechia mandated the wearing of masks on March 18th, 2020. Jeremy Howard of #Masks4all has collected and summarized 40 published scientific research papers that show wearing masks actually does work. One 2011 meta-analysis shows, when coupled with strict hand washing, masks have the greatest impact on reducing virus spread.
Mr. Howard states that this action of the Czechian government has flattened the curve of the pandemic in his country. You can read the article in Prague Morning.
What Kind of Mask Should I Wear?
So, what kind of mask should I wear? The what, where and how of homemade masks that I am recommending to my patients can by found in my youtube video below.
How can you avoid contaminating the mask and yourself?
The main objection of the mask naysayers is that the mask itself becomes contaminated. Carelessly using the mask and not cleaning it can become of source of viral transmission. The benefit of a homemade mask is that it is cheap, washable and re-usable.
Here are some steps to follow to ensure that you and your family remain healthy while using a homemade mask:
Wash with soap and water, or sanitize your hands well, before making any mask.
Wash and sanitize your hands before putting the mask on.
When removing the mask, do not touch the front of the mask with your hands; take it off by the ties or elastics. Then wash your hands.
Immediately after use, do not put the mask on any surface. Put the mask into the washing machine or a sink of hot soapy water and clean well. Some data shows that you can also bake fabric masks. However, the temperature must reach 180F° (82C°) for 20 minutes to cleans it.
If you have made a disposable mask out of paper towels or coffee filters, throw it out into a plastic-lined waste bin with a lid.
After discarding, or sanitizing the mask, sanitize your hands again.
Any time you are wearing a mask, do not touch the mask, your face or rub your eyes.
Wearing any mask over the next 3-4 weeks will help protect you from passing the virus on to others at greater risk. It may also decrease your risk of someone else passing the virus on to you.
This will help reduce the number of infected people from overwhelming our healthcare system, first responders, and healthcare workers.
