On November 18, 2022, I sent the following letter to the editor of The New England Journal of Medicine about the Boston Face Mask study that I wrote about yesterday.
editorial@nejm.org, letter@nejm.org
Dr. Rubin:
The paper “Lifting Universal Masking in Schools — Covid-19 Incidence among Students and Staff” from Tori L. Cowger, Ph.D., M.P.H., Eleanor J. Murray, Sc.D., M.P.H., Jaylen Clarke, M.Sc., Mary T. Bassett, M.D., M.P.H., Bisola O. Ojikutu, M.D., M.P.H., Sarimer M. Sanchez, M.D., M.P.H., Natalia Linos, Sc.D., and Kathryn T. Hall, Ph.D., M.P.H comes to meaningful conclusions that dropping face mask mandates in schools results in a higher number of Covid-19 cases.
Authors write “the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time.”
This is contrary to the data produced by the 14 randomized controlled trials reviewed by Xiao et al. in the paper “Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures” published in the CDC’s peer-reviewed Emerging Infectious Diseases in May 2020.
As the data from Cowger et al. contradicts all gold standard laboratory confirmed RCT studies to date, it is with keen interest that I read this research.
The data in this study appears to be so poorly sourced, however, that I am surprised to see such data used. Authors write, “Throughout the study period, DESE [Massachusetts Department of Elementary and Secondary Education] required standardized weekly reporting of all positive tests for Covid-19 among students and staff, regardless of symptoms, testing type or program (e.g., testing of symptomatic persons or pooled polymerase-chain-reaction testing), and testing location (community setting or school setting).”
The sensitivity analyses conducted by study authors is useful in proper scenarios, but is unable to make up for poorly sourced data. As such, it has here been misused.
Furthermore, the Massachusetts standardized policy to commingle data on non-symptomatic children with data on symptomatic children belies medical practice and calls into the question the usefulness of the test being administered. Such approaches may have been a stop-gap measure, resorted to in a difficult environment, but there is little reason that such a stop-gap be used as a foundation of science moving forward. At best, this collection of data was an early warning sign that could have been useful when there was uncertainty around ideas such as community spread and asymptotic spread. That uncertainty is no longer indicated. Polymerase-chain-reaction testing is a poor diagnostic tool on its own. Patient symptoms are the foundation of disease diagnosis.
The conclusions of this paper and its Boston Face Mask study are significant, but are not defended by the quality of the data that is the foundation of this work. As such, I write requesting that you rescind this paper unless authors are able to produce a more trustworthy data source defending their claims that removing mandatory masks led to an additional 44.9 in 1,000 Covid cases.
Respectfully,
Allan Stevo
Author, Face Masks Hurt Kids
When you recognize lies spoken in the world around you, it is incumbent upon you to speak out against those lies, to not let them stay in the air untouched. You must do that when the world puts a lie in front of you. Does doing that change the world overnight? That seems unlikely, but it may change the world as you know it.
A great illness in the world is silence in the face of evil. The silent majority is part of the problem. With some dishonesty, the silent majority refuses to speak up. They hide what they really feel and as a result of their silence, they allow the proliferation of that which they know to be evil.
I ask you this day, and every day hereafter, to not permit lies to be spoken in your presence without speaking up to the best of your ability in calling those lies out.
I really thank you for imploring the silent majority, myself included, to speak up. You answered my question to the world as the only “hesitation” I’ve had in all things Covid, is to do just that - speak to the elephant in the room. I really hate conflict. A 41 year old fit and healthy friend of mine just died suddenly of a heart attack, and I know it was from the vaxx. I need to speak up for him. Many thanks for all you do, Steve.
NEJM is notorious now for publishing obfuscation, sleight of hand and outright misinformation. From the initial Pfizer m-RNA vaccine trial press releases, to the Shimabukuro pregnancy registry distortion, to this clumsy mask study, the NEJM like JAMA and Lancet are unreliable at vetting politically charged research.