Quick Take
A viral video misrepresents scientific papers and the reasons for wearing face masks to claim that they are ineffective in mitigating transmission of COVID-19. The Centers for Disease Control and Prevention has said that masks may help prevent the spread of the disease.
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A video pushing misinformation about face masks racked up hundreds of thousands of views on Facebook and YouTube, before the latter removed it for violating the platform’s community standards.
It begins with a promise to answer these questions:
“In our highly politicized climate, it seems like everybody has to be on some kind of team… If we set aside feelings and we just look at facts, what do facts say about wearing a face mask? What does science say about face masks and whether or not they prevent the spread of viruses like COVID-19?”
But it doesn’t report either facts or science.
Right from the start, in that introduction, the video gets it wrong — COVID-19 isn’t a virus. Rather, it’s the disease that is caused by the novel coronavirus, or SARS-CoV-2.
More importantly, contrary to its claim that it would cut through the politics of wearing masks, the video actually goes on to misrepresent several scientific papers in an effort to support the claim that wearing a face mask is useless, or worse, that its use is harmful to the wearer.
The Centers for Disease Control and Prevention has explained that face coverings are meant to help prevent the spread of the novel coronavirus by containing respiratory droplets created when people cough, sneeze or talk. That’s called source control. The CDC has also noted that masks shouldn’t be worn if they are likely to cause harm, and it has said not everyone will be able to wear one.
That’s been the recommendation of the CDC since early April, when the agency changed its original position on the use of face masks during the COVID-19 pandemic, citing new studies on the transmission of the novel coronavirus.
We’ve written numerous stories explaining the guidance and correcting misinformation on the issue.
Despite all that, misinformation about masks persists. This video is a particularly polished example since it is produced to look like a television news segment. It’s presented by Ben Swann, a television journalist who won regional Emmy Awards in 2005 and 2009. But Swann has more recently been featured as the co-host of a show called Boom Bust on the Russia-based, government-funded TV network RT, formerly Russia Today, and he has made videos pushing conspiracy theories. The video was produced by Swann’s website, called Truth In Media.
Papers Focused on Health Care Workers
In this video, Swann starts off by citing seven scientific papers. He incorrectly refers to them all as “studies,” but only two of them are studies, while the rest are reviews. Reviews are often more comprehensive than individual studies since they provide an overview of a scientific issue by analyzing relevant studies, although they don’t provide new facts or findings of their own.
After listing the papers, Swann says: “All of these are RTCs, randomized controlled tests, that are essentially set up to determine whether or not these N95 respirator masks help to prevent the spread of viruses in this setting, and all of these studies found that they do not.”
Not only is it wrong to say they are all RTCs, or randomized clinical trials — as we said, five of them are reviews of those types of studies — it’s also wrong to characterize their findings that way.
One of the studies and two of the reviews he cites looked at how N95 masks compared to surgical masks in protecting health care workers from getting sick, and the rest of them, similarly, mostly examined how masks generally performed in protecting health care workers from disease.
It’s important to note that nearly all of the studies covered in the reviews were dealing with the use of masks by health care workers, who have more exposure to infected patients than the general public. They also focused on protection from infection, not source control.
Swann then claimed: “In the 2019 study, there was no significant difference by wearing N95 respirator masks. Happened again in 2020.”
But the 2019 study looked at the effect of N95 respirators compared to surgical masks to prevent health care workers from getting the flu and “other viral respiratory infections in geographically diverse, high-exposure, outpatient settings.” It did not examine the use of masks as source control for containing the spread of a virus in the general population. It also didn’t include a group of study subjects who didn’t wear masks at all, so the outcomes of those who wore surgical masks or N95 respirators can’t be compared to outcomes for non-mask wearers.
The 2020 “study” is actually a review that includes the 2019 study along with five other similar studies, looking largely at the effect of masks in protecting health care workers from getting sick.
That review included only one study that wasn’t focused on health care workers. Published in 2009, that study looked at the use of masks in households with a sick child and found that if masks aren’t used regularly and correctly, they won’t be effective in controlling the spread of seasonal viruses. “However,” the study found, “during a severe pandemic when use of face masks might be greater, pandemic transmission in households could be reduced.”
As we’ve written before, there have been relatively few studies looking at the efficacy of face masks on the public, and the ones that have been done are inconsistent or have not observed large effects.
Swann goes on to claim (emphasis added): “There’s another study that was also done in 2020. It was done by a group of researchers in Hong Kong. The study was conducted just before COVID-19 hysteria took over and the results of it were released just a few weeks ago and, once again, those researchers found the very same thing: that there was, in fact, no statistical reason to believe that face masks will protect you, but improper use of a face mask actually puts you at greater risk of contamination.”
Again, this was a review of previously completed studies, not a new study, and it looked largely at how effective various methods — including wearing a mask, hand hygiene, covering coughs and sneezes, and cleaning surfaces — would be in responding to an influenza pandemic. The review did include studies of face masks used for source control, but found that “[m]ost studies were underpowered because of limited sample size, and some studies also reported suboptimal adherence in the face mask group.”
The researchers also said, “We did not find evidence that surgical-type face masks are effective in reducing laboratory-confirmed influenza transmission, either when worn by infected persons (source control) or by persons in the general community to reduce their susceptibility. However, as with hand hygiene, face masks might be able to reduce the transmission of other infections and therefore have value in an influenza pandemic when healthcare resources are stretched.”
Swann released a follow-up video about a week after the original and relied heavily on this paper, claiming that it “proves that face masks do not prevent the spread of a virus.”
But one of the researchers who worked on the paper, Benjamin Cowling, told us by email, “It is wrong to say that our review said there was no effectiveness of face masks. We could only rule out very large effects.”
Cowling, an epidemiologist at the University of Hong Kong, explained that, “while we said there was not a significant effect, we could not exclude the possibility that masks reduce transmission by 10% or 20%. Those would be useful effect sizes.”
He also noted on Twitter that he and his colleagues worked with the World Health Organization in 2019 to come up with guidelines for mitigating pandemic influenza. Those guidelines recommend wearing a mask in “severe epidemics or pandemics.”
As for the claim that using a mask improperly could “put you at greater risk of contamination,” that possibility is mentioned in one sentence in the paper, which cites interim guidance from the WHO to address the H1N1 pandemic in 2009. That two-page WHO paper doesn’t explain what that caution is based on, but it does lay out best practices for wearing masks in the general public, saying:
If masks are worn, proper use and disposal is essential to ensure they are potentially effective and to avoid any increase in risk of transmission associated with the incorrect use of masks. The following information on correct use of masks derives from the practices in health-care settings:
- place mask carefully to cover mouth and nose and tie securely to minimise any gaps between the face and the mask
- while in use, avoid touching the mask − whenever you touch a used mask, for example when removing or washing, clean hands by washing with soap and water or using an alcohol-based handrub
- replace masks with a new clean, dry mask as soon as they become damp/humid
- do not re-use single-use masks − discard single-use masks after each use and dispose of them immediately upon removing.
Swann next builds on his claim about contamination, saying (emphasis added): “What we’ve been told, over and over, is that if you just wear a cloth mask over your face, it’s better than nothing, so you should do that. And, so, because of that, we have tens of millions of people walking around with cloth masks on their face. Now, get this, in 2015, there was actually a study done taking a look at medical masks versus just a cloth mask and whether or not wearing a cloth mask would protect against the spread of a virus and what that study found in 2015 should alarm you. Not only does wearing a cloth mask not prevent the spread of a virus, it can actually put you at greater risk for catching the virus.”
Again, this study did not look at the effect of masks as source control in slowing the spread of a virus, which is the reason the CDC recommends wearing them. Like most of the other papers cited in this video, it looked at how effective masks were in keeping health care workers from getting sick. And, like the 2019 study, it didn’t include a group who wore no masks, so it couldn’t say whether or not cloth masks might provide more protection than no mask at all.
The study did find that “[m]oisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection.” But it said that “[f]urther research is needed to inform the widespread use of cloth masks globally.”
Also, the authors of that study released a statement this year to clarify questions about their 2015 findings in relation to COVID-19. They noted the shortage of personal protective equipment and explained that, in their study conducted in Vietnam, the cloth masks may not have been washed well enough and that the effectiveness of a mask could change depending on the material and the number of layers used.
On top of that, Raina MacIntyre, who was lead researcher on that study, clarified to FactCheck.org in an email, “The findings of the study are not translatable to the community, or to all cloth masks.”
MacIntyre, who heads the biosecurity program at the University of New South Wales’ Kirby Institute, went on to say, “There is also the matter of source control, which is preventing outward transmission from an infected person. A face covering provides a physical barrier.” She stressed that reusable masks have to be cleaned after every use.
The Myth of Rebreathing the Virus
Swann next made this sweeping claim: “Wearing a face mask on a regular basis is unhealthy for you and there are multiple studies that show that.”
That’s based entirely on an article written by Dr. Russell Blaylock, who has pitched several dubious claims over the years and writes an alternative medicine newsletter. Swann focused on the section of the Blaylock article that said health care workers have reported getting headaches with prolonged use of personal protective equipment, which is backed up by two studies cited in Blaylock’s article. Those studies looked at health care workers who wore N95 masks for hours at a time, not shoppers wearing a cloth face covering to go to the grocery store.
Swann also read from another section of Blaylock’s article, paraphrasing it this way: “There’s another danger to wearing these masks on a daily basis, especially if you’re wearing it for several hours. When a person is infected with a respiratory virus, they will expel some of that virus with each breath. But if you’re wearing a mask, especially an N95 mask, you’re breathing back in the virus every time you attempt to expel it.”
Swann doesn’t explain what he means, but it sounds like a claim we debunked when it was made in the viral video called “Plandemic” that filled social media feeds in May. In that video, Judy Mikovits, a former chronic fatigue researcher, claimed: “Wearing the mask literally activates your own virus. You’re getting sick from your own reactivated coronavirus expressions and if it happens to be SARS-CoV-2, then you’ve got a big problem.”
Experts we talked to at the time said her claim didn’t hold up. Linsey Marr, a professor of civil and environmental engineering at Virginia Tech who studies airborne disease transmission, told us then, “If you’re shedding (breathing out) virus, then you’re already infected. Even without a mask, infected people who are shedding virus probably rebreathe some of their own viruses, but there are already billions times more viruses in your body. Hopefully, the mask is protecting other people from your exhalations.”
Also, the fact-checking organization Science Feedback addressed the same Blaylock article that Swann cited, debunking the claim that wearing a mask concentrates “exhaled viruses” in the nose, which sends them to the brain. Science Feedback called it “unsupported and illogical.” They wrote: “If someone is exhaling the virus, then they are already infected. The spread of the infection would be largely determined by how well the person’s immune system fights off the infection, not by whether they inhaled virus particles that they previously exhaled.”
Misrepresenting Dr. Fauci
Swann wrapped up the video with a misrepresentation aimed at Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“Even the biggest doctor of them all in this country, Dr. Anthony Fauci, who keeps talking about this issue, referred to wearing a face mask as mostly symbolic. Listen to his words — he called it, ‘mostly symbolic,'” Swann said.
Here’s what Fauci actually said on CNN’s “Newsroom”: “I wear it for the reason that I believe it is effective. It’s not 100% effective. I mean, it’s sort of, respect for another person and have that person respect you — you wear a mask, they wear a mask, you protect each other. I mean I do it when I’m in the public for the reasons, A) I want to protect myself and protect others and also I want to make it be a symbol for people to see that that’s the kind of thing you should be doing.”
Regardless of Fauci’s real message, Swann used his twisted version of it to draw the conclusion that the recommendation to wear face masks is not about public health, but about the “submission of the public.” Looking at the camera, Swann asked, “Are we being forced to submit merely because politicians want us to?”
Like his bogus claims based on misrepresentations of scientific papers, that claim is based on a misrepresentation of Fauci’s statement. Swann offered no further support for it.
Editor’s note: FactCheck.org is one of several organizations working with Facebook to debunk misinformation shared on social media. Our previous stories can be found here.
Sources
Centers for Disease Control and Prevention. “About Cloth Face Coverings.” Updated 28 Jun 2020.
Centers for Disease Control and Prevention. “Considerations for Wearing Cloth Face Coverings — Help Slow the Spread of COVID-19.” Updated 16 Jun 2020.
McDonald, Jessica. FactCheck.org. “COVID-19 Face Mask Advice, Explained.” 6 Apr 2020.
Collins, Ben. Daily Beast. “Meet Ben Swann, the Republican Pizzagate Truther Hosting Atlanta’s CBS Nightly News.” 11 Apr 2017.
Jacobs, Joshua, et al. “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. 12 Feb 2009.
Radonovich, Lewis Jr., et al. “N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel — A Randomized Clinical Trial.” JAMA. 3 Sep 2019.
Long, Youlin, et al. “Effectiveness of N95 respirators versus surgical masks against influenza: A systematic review and meta‐analysis.” Journal of Evidence-Based Medicine. 13 Mar 2020.
Offeddu, Vittoria, et al. “Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis.” Oxford University Press for the Infectious Diseases Society of America. 7 Aug 2017.
Smith, Jeffrey, et al. “Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis.” CMAJ. 17 May 2016.
Cowling, B.J., et al. “Face masks to prevent transmission of influenza virus: a systematic review.” Cambridge University Press. 22 Jan 2010.
Bin‐Reza, Faisal, et al. “The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence.” Influenza Journal. 21 Dec 2011.
MacIntyre, C Raina, et al. “Face mask use and control of respiratory virus transmission in households.” Emerging Infectious Diseases. Feb 2009.
Xiao, Jingyi, et al. “Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures.” Emerging Infectious Diseases. May 2020.
World Health Organization. “Advice on the use of masks in the community setting in Influenza A (H1N1) outbreaks — Interim guidance.” 3 May 2009.
MacIntyre, C Raina, et al. “A cluster randomised trial of cloth masks compared with medical masks in healthcare workers.” BMJ Open. 2015.
MacIntyre, C Raina, et al. “COVID-19, shortages of masks and the use of cloth masks as a last resort.” BMJ Open. 30 Mar 2020.
Blaylock, Russell. “Dr. Russell Blaylock: Face Masks Pose Serious Risks To The Healthy.” Accessed 20 Jul 2020.
Fichera, Angelo, et al. FactCheck.org. “The Falsehoods of the ‘Plandemic’ Video.” 8 May 2020.
Science Feedback. “No evidence that using a face mask helps coronavirus enter the brain, contrary to claim by Russell Blaylock.” 19 May 2020.
Stracqualursi, Veronica. CNN. “Fauci says he wears a mask to be a symbol of what ‘you should be doing.’” 27 May 2020.
MacIntyre, Raina. Head of the biosecurity program at the University of New South Wales’ Kirby Institute. Email exchange. 22 Jul 2020.
Cowling, Benjamin. Epidemiologist, University of Hong Kong. Email exchange 23 Jul 2020.
World Health Organization. “Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza.” 2019.