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November 17, 2020
by Jeff Brown, Editor, The Bleeding Edge
I’m excited to share the results of some very interesting research on COVID-19 published last week in the New England Journal of Medicine.
I’m actually surprised that it was published at all.
The purpose of the study was to determine the efficacy of public health measures for COVID-19. This includes things like masks, hand sanitizer, and social distancing.
Researchers used U.S. Marine recruits on Parris Island, South Carolina, to conduct the study. This was a great decision. The authors could essentially ensure 100% compliance with the personal health measures in order to get the highest quality results from the study.
Every Marine recruit quarantined for two weeks prior to moving to Parris Island to ensure that they weren’t infectious. The study started with a clean slate.
1,848 recruits participated in the study and adhered to the study’s public health measures:
All recruits wore double-layered cloth masks at all times indoors and outdoors.
They stayed at a distance of at least six feet.
No one was allowed to leave the campus.
No one had access to personal electronic devices or anything else that might be a surface for spreading transmission.
They practiced routine washing of hands.
Recruits cleaned their rooms daily (of course).
They sanitized their bathrooms with bleach wipes with each use.
They ate pre-plated meals in a dining hall that was cleaned with bleach after each platoon ate.
I think we’ll agree that these are very strict measures taken in the hopes of stopping the spread of COVID-19. The high compliance and repeated cleanings after each use make this study unique.There were also 1,554 nonparticipants who did not take these measures. Over a 14-day period, all of the recruits were tested for COVID-19.
We would expect the infection rates to be higher in those who did not participate in the strict personal health measures.
But that’s not at all what happened.
By day 14, 51 of the 1,848 participants had tested positive for COVID-19. Only 26 out of the 1,554 nonparticipants tested positive.
In other words:
Those who wore masks, used bleach, and stayed strictly distanced tested positive at a rate of 2.8% within the first two weeks.
Those who didn’t and went about a normal life tested positive at a 1.7% rate over the same time period.
I believe the journal agreed to publish the study because the authors drew no conclusions. They didn’t explore why the personal health measures were unsuccessful in stopping the spread of COVID-19 and produced worse results.They also didn’t explore why the infection rate was lower for those who didn’t participate.
This is one of the very best studies that I’ve seen to date on COVID-19. And these insights should be used in public policy making for how we go about our lives.
Note the masks used in Danish study were higher in qualitiy than N-95 masks.
Landmark Danish study finds no significant effect for mask wearers
Do face masks work?
Yesterday marked the publication of a long-delayed trial in Denmark which hopes to answer that very question. The ‘Danmask-19 trial’ was conducted in the spring with over 6,000 participants, when the public were not being told to wear masks but other public health measures were in place. Unlike other studies looking at masks, the Danmask study was a randomised controlled trial – making it the highest quality scientific evidence.
Around half of those in the trial received 50 disposable surgical face masks, which they were told to change after eight hours of use. After one month, the trial participants were tested using both PCR, antibody and lateral flow tests and compared with the trial participants who did not wear a mask.
In the end, there was no statistically significant difference between those who wore masks and those who did not when it came to being infected by Covid-19. 1.8 per cent of those wearing masks caught Covid, compared to 2.1 per cent of the control group. As a result, it seems that any effect masks have on preventing the spread of the disease in the community is small.
When it comes to masks, it appears there is still little good evidence they prevent the spread of airborne diseases. The results of the Danmask-19 trial mirror other reviews into influenza-like illnesses. Nine other trials looking at the efficacy of masks (two looking at healthcare workers and seven at community transmission) have found that masks make little or no difference to whether you get influenza or not.
But overall, there is a troubling lack of robust evidence on face masks and Covid-19. There have only been three community trials during the current pandemic comparing the use of masks with various alternatives – one in Guinea-Bissau, one in India and this latest trial in Denmark. The low number of studies into the effect different interventions have on the spread of Covid-19 – a subject of global importance – suggests there is a total lack of interest from governments in pursuing evidence-based medicine. And this starkly contrasts with the huge sums they have spent on ‘boutique relations’ consultants advising the government.
This is why large, randomised trials like this most recent Danish study are so important if we want to understand the impact of measures like face masks. Many people have argued that it is too difficult to wait for randomised trials – but Danmask-19 has shown that these kind of studies are more than feasible.
And now that we have properly rigorous scientific research we can rely on, the evidence shows that wearing masks in the community does not significantly reduce the rates of infection.
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