Thursday, February 2, 2023

Physical interventions to interrupt or reduce the spread of respiratory viruses - Cochrane Library

The Cochrane Review on Masks is Damning

The Cochrane Library

Cochrane Library has existed for 35 years. I was a young physician when it came into existence. Its publication was based on real clinical results. I its infancy few physicians even knew about it rarely referring to it for treatment recommendations. The gold standard was the New England Journal of Medicine and the National Library of Medicine, or specialty journals and reviews.

Now it ranks up there with those bastions of information. Cochrane is for anyone interested in using high-quality information to make health decisions. Whether you are a clinician, patient or carer, researcher, or policy-maker, Cochrane evidence provides a powerful tool to enhance your healthcare knowledge and decision-making.

Cochrane's members and supporters come from more than 190 countries, worldwide. We are researchers, health professionals, patients, carers, and people passionate about improving health outcomes for everyone, everywhere. Our global independent network gathers and summarizes the best evidence from research to help you make informed choices about treatment and we have been doing this for 30 years.

We do not accept commercial or conflicted funding. This is vital for us to generate authoritative and reliable information, working freely, unconstrained by commercial and financial interests.

Unfortunately, Cochrane is rarely quoted or referred to as a source of reliable information by the national media, social media, or even google. It does not appear on page one in my google searches for medical information, or treatment plans. Cochrane has become sensitized to this lack of visibility and initiated an RCT (Randomized Clinical Trial)) to evaluate what the impact of using Twitter to disseminate Cochrane Reviews as a source of information.

I want to highlight what just came out: the Cochrane review on masking. It shows that community mask recommendations have no firm data to support them. The authors write:

“There is a need for large, well-designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, as well as the impact of adherence on effectiveness, especially in those most at risk”

Let me be clear: The science did not change. Public health experts started lying. We never had good data that mask mandates help, or that mask advice (a softer policy) improves outcomes. Yet it was widely pushed— most likely to distract from true federal failures.

After vaccination, not only do we not have evidence. It is irrational to mask. At best you marginally delay the inevitable, and unlike pre-vax, there is no milestone you are waiting for. Let’s take a closer look.

Here is the big summary finding. With 276,000 participants in RCTs or cluster RCTs, masking does nothing. No reduction in influenza-like or Covid like illness and no reduction in confirmed flu or COVID. That’s stone-cold negative. See those effect sizes and confidence intervals.