Unmasked: The Global Failure of COVID Mask Mandates
By Ian Miller
Post Hill Press, New York, 2022
Unmasked is an easy-to-read graph-filled book that makes a very strong case that masks, also known as face coverings, have little or no effect on infection, transmission, hospitalization or death due to COVID-19 and may even be somewhat harmful. Although the book does not quantify what “little” might mean, one of several weaknesses of the book, it likely means at most a few percent reduction. After nearly two years of COVID-19 and masking, this should be pretty obvious and non-controversial, but it remains a highly contentious topic with the United States CDC continuing to produce and promote dubious mask studies claiming or implying high levels of mask effectiveness. Conservative commentator Dan Bongino was recently deplatformed by YouTube (Google/Alphabet) ostensibly for asserting that masks don’t work (or cloth masks don’t work according to some accounts).
The book discusses how the “settled science” before the end of March 2020 was that masks had little or no benefit as shown by many prior studies. Masks had in fact clearly failed during the infamous 1918 influenza epidemic. This was reflected in now infamous public statements by Anthony Fauci, US Surgeon General Jerome Adams, and other “experts.” The “settled science” reversed one-hundred and eighty degrees at the beginning of April 2020 with Fauci subsequently claiming his original statements were a lie, now usually described as a “noble lie” to save N95 masks for health care workers.
The book devotes several short readable chapters to masks and the flu (meaning the influenza virus), the CDC pro-mask studies, the US states California and Florida arguably representing the two extremes on mask policy, Sweden which largely eschewed masks, and international comparisons.
The climax of the book is a long, dense chapter going alphabetically through all US states and Washington DC, with a graph of daily new cases per million population for each jurisdiction during the pandemic, graphs annotated with start and stop dates of mask mandates, a few measurements of mask compliance rates, and notable news articles either extolling the mask policy in the state shortly before cases skyrocketed or predicting disaster following removal of a mask mandate, followed by continuing sharp drops in the daily new cases.
The chapter closes with a bar chart showing age adjusted death rates for all US states (no Washington D.C.) sourced in tiny almost unreadable type to the US CDC, from the highest age adjusted death rate (New Jersey with about 140 COVID deaths per one-hundred thousand residents) to the lowest (Vermont with about 15 deaths per one-hundred thousand). States without mask mandates or minimal mask mandates are highlighted, spanning nearly the entire range with South Dakota as 3rd worst state just behind Number 2 New York and Alaska at 46. High profile Florida falls at forty in the graph with about 55 deaths per one-hundred thousand. This is for the twelve month period thru the fourth quarter (Q4) of 2020.
The plots and other data in the book make a strong case that masks at best only have a small positive effect that must nearly always be swamped out by other factors which the book largely does not discuss.
Several Weaknesses
The book appears to be largely aimed at conservative, libertarian, pro-Trump or anti-(anti-Trump) audiences. By anti-(anti-Trump) is meant the many people who fall somewhere between unenthused about Trump to quite concerned but view the “get Trump at any cost” reaction to Trump as a dangerous, irrational overreaction. The anti-(anti-Trumpers) span the conventional political spectrum and arguably include such prominent figures as Glenn Greenwald, former Rolling Stone writer Matt Taibbi, and podcaster Joe Rogan. The book features advanced praise quotes from libertarian author Tom Woods, conservative commentator Ann Coulter, and similar figures on its first page.
While the book does have references, these are all or nearly all popular news articles and not scholarly peer reviewed scientific journal articles of which their are many, pre-prints, or similar non-peer reviewed content (e.g. “working papers”). The numerous plots do have a reference in tiny print at the bottom, almost unreadable. These references are often secondary sources such as Worldometer or the New York Times COVID dashboards etc. This is better than Scot Atlas’s A Plague Upon Our House, also from Post Hill Press, which has no references despite the author emphasizing the importance of scientific references in critiquing Anthony Fauci and others. However, the book should have scholarly references and links to primary data sources such as the CDC web site.
The plots are quite small. The printed book is about 5 1/2 inches wide by 8 1/4 inches high with nearly all plots about 4 inches wide by 2 1/2 inches high with small to very tiny type, undoubtedly hard for many readers. It probably would have been better to devote an entire page to each plot for clarity.
The book should devote more space to the issue of mask compliance. Quite clearly the mask mandates failed, but the fallback argument is that the people, especially knuckle dragging Trump supporters, failed to follow the mask mandates. The book does cite several studies of mask compliance — actual mask wearing — contradicting this explanation. Living in the San Francisco Bay Area, I am personally sure mask compliance was high in the SF Bay Area and likely other urban centers such as LA and San Diego. But even in California, the failure could be blamed on rural Californians. In fact, COVID-19 deaths soared in urban Santa Clara County during the winter of 2020-2021 despite the heavy use of masks.
The weakest part of the book is the fourth chapter on the CDC’s handful of highly promoted studies claiming or implying dramatic benefits from mask wearing. These are of course highly contradicted by the mountain of data in the final chapter as well as other chapters. Nonetheless some of the arguments seemed rather weak relying on typical assertions made during scientific and political controversies. Accusations of “poor scientific or statistical methodology” are common and need to be specifically backed up.
The book would be stronger with a chapter on why masks might fail. The likely explanation is that there is practically significant aerosol transmission of COVID-19, meaning the virus floats in the air like fine dust or smoke. The viral particles are tiny, too small to be seen by an optical microscope, about 1/500th the width of a human hair. They can easily flow through the mesh of cloth or surgical masks. The N95 masks claim to stop 95 percent of particles 0.3 microns (300 nm) in diameter. The coronavirus is about 0.14 micron (140 nm) in diameter. The N95 masks probably stop less than 95 percent of such small particles. In theory even one viable viral particle can infect and kill a person.
The book would also benefit from a chapter on the downsides of masks which reduce air intake, trap carbon dioxide, interfere with communication, and have other negative effects. Masks are not advised for persons with asthma and various other respiratory problems. How well can we determine who can safely wear a mask and for how long. OSHA has strict limits on mask use in work settings that would preclude the use of masks to try to control COVID-19.
The book would be stronger by quantifying the bounds on the effectiveness of masks and discussing under what conditions these quantitative bounds apply. This is likely to be a range from negative a few percent (makes things worse) to positive a few percent (weak benefit).
Some articles that review the primary scientific literature in more and better detail than Unmasked are:
“Do Masks Work?” by Jeffrey H. Anderson, City Journal, August 11, 2021
More than 150 Comparative Studies and Articles on Mask Ineffectiveness and Harms by Paul Elias Alexander, (libertarian) Brownstone Institute, December 20, 2021
“Masks don’t work” by Denis Rancourt
“Mask studies reach a new scientific low point,” by Vinay Prasad, Brownstone Institute, Feb. 6, 2022
All have some weaknesses and suffer from the politicization of the mask issue in various ways, but overall complement the weaknesses of Unmasked.
At this point, with huge numbers of fully vaccinated, mask wearing persons contracting the Omicron variant or at least getting sick and getting test results interpreted as Omicron, it should be clear that masks are largely ineffective, just as was the case during the 1918 influenza epidemic. Rather than beating a dead horse, public discussion and efforts to mitigate the COVID-19 pandemic should focus on more promising options such as UV lighting in ducts and ventilation systems, installation of air purifiers with UV sub-systems to kill viral particles in the air, as well as other possibilities which avoid the enormous social and psychological costs, not to mention physical health risks of prolonged mask wearing.
(C) 2022 by John F. McGowan, Ph.D.
About Me
John F. McGowan, Ph.D. solves problems using mathematics and mathematical software, including developing gesture recognition for touch devices, video compression and speech recognition technologies. He has extensive experience developing software in C, C++, MATLAB, Python, Visual Basic and many other programming languages. He has been a Visiting Scholar at HP Labs developing computer vision algorithms and software for mobile devices. He has worked as a contractor at NASA Ames Research Center involved in the research and development of image and video processing algorithms and technology. He has published articles on the origin and evolution of life, the exploration of Mars (anticipating the discovery of methane on Mars), and cheap access to space. He has a Ph.D. in physics from the University of Illinois at Urbana-Champaign and a B.S. in physics from the California Institute of Technology (Caltech).