Yet Another European Study Contradicts CDC Doctrine

Mirroring other results, a new study from Finland found that masking young kids in schools did nothing. Why has the CDC insisted otherwise?

In a recent interview, Anthony Fauci said that “at the population level, masks work at the margins—maybe 10 percent.”

The hedged specificity of “maybe 10 percent” was based on discredited results from a study in Bangladesh. But the more important part of the quote is his somewhat remarkable admission that masks at a population level—meaning when mandated or recommended for the community or schools, for example—only “work at the margins.” In other words, at best, there is a meager effect.

This public confession directly contradicts repeated statements made by Rochelle Walensky throughout her tenure as the head of the CDC. It also contradicts the findings of very questionable studies published by the CDC, and some studies in scientific journals that purported to show large benefits of school masking, which were championed by the American public health establishment (and often reported on unquestioningly in the media).

Fauci’s somewhat heretical admission comes on the heels of a new study from Finland, which found school mask mandates for younger children did nothing. Intriguingly, acknowledging that there is, at best, a marginal benefit places Fauci now far closer to the ethos of European pediatric masking guidelines and to the findings of numerous studies in Europe.

The question worth considering is why did the CDC and much of the general narrative in the US part so dramatically from Europe on this topic? And what is the sensible course of action when there is conflicting evidence?

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First, to the Finnish study.

In the fall of 2021, Finnish authorities recommended face masks for all people age 12 and above. Two cities—Helsinki and Tampere—followed this guidance and mandated masks in schools for everyone age 12 and older. Another city—Turku—went a step further, mandating masks in schools down to age 10. All three cities had a similar baseline incidence of Covid in August and September 2021. The study, published this month in the peer-reviewed journal “BMC Public Health,” compared the outcomes from the three cities.

Turku—the city with school mask mandates for kids down to age 10 (versus age 12 in the other cities)—had a higher incidence of Covid cases. The authors also looked specifically at case rates among 10 to 12 year olds, and found no overall benefit of the mask mandate for that age group in Turku. In conclusion, the authors write, “face mask recommendations in schools did not reduce COVID-19 incidence among 10–12-year-olds in Finland.”

Is this study the final word on the effect—or lack thereof—of school mask mandates? Of course not. Like all observational studies it has limitations.

Yet its limitations are no more—and in many instances, far less—invalidating than those in studies that found a benefit of mask mandates.

During the pandemic, the most trumpeted school masking studies that purported to show a benefit—with one by the CDC outlandishly claiming that schools without mandates were 3.5 times more likely to have outbreaks—were rife with methodological flaws and errors, or, in one instance, their findings were wiped out in a more robust re-analysis that simply added more participants and a longer time period. 

Moreover, as I’ve written about previously, systematic reviews of randomized trials of community masking for other respiratory viruses prior to the pandemic found no clear evidence of benefit.

Matching the Finnish results, a study in Catalonia, Spain, that included nearly 600,000 children, where those aged 6 and older were required to wear masks in school, and those aged 5 and below were not, found no significant difference in transmission between the two age groups. The graph below—with the helpful vertical dotted line indicating the age cutoff between no mask mandate and masks mandated—shows, in a fairly stunning fashion, everything you need to know. The requirement—just as the Finish study found—made no difference.

If mask mandates had any meaningful effect whatsoever you would see a dramatic dip where the blue line begins. Instead, the trajectory of the diagonal line, moving from green to blue, depicts a slow and steady rise in transmission as children get older, with the intervention of masks clearly shown to be irrelevant.

Why has the CDC director, and so many public health professionals in the US, spoken with such certitude about the benefit of school mask mandates, when, at best, the evidence is mixed? Why did the US recommend masks for children all the way down to two year olds, while the ECDC (the European CDC) did not recommend masks at all for kids in primary school? How can both the “science” and the guidance from two continents be so different?

To be generous, even if we were to grant that the evidence from the American studies was just as robust and valid as the European studies and the systematic reviews that didn’t find a benefit of mask mandates, medical and public health ethics traditionally dictate that an intervention must show a clear benefit for it to be approved, let alone imposed on people. Yet, at best, the requirement of this intervention has led to very conflicting results.

To my mind, perhaps the worst mistake in the US during the pandemic was the hubris of the health authorities and professionals who made unwavering pronouncements about the supposed beneficial effect of certain interventions. This hubris was brazenly on display when Walensky testified before Congress in February and—astonishingly—said the CDC didn’t conduct randomized trials on masks because there was no equipoise (meaning, according to her, there was no ambiguity about the evidence that community masking “worked”). Either Walensky was flat out lying, or she is wildly ignorant of the evidence from Europe and even in the US that found no clear benefit—both the former and the latter disqualify her to run the CDC.

Had health authorities spoken with more humility, and expressed the uncertainty of the evidence, they would have garnered far more confidence from the public. Hopefully systems will be put into place to reduce the chances of this type of error moving forward. One norm that should change is much of the media’s default to simply repeating what Walensky or a chosen health professional says, rather than asking for proof behind their claims.

I’ve written critically of health institutions not because I inherently don’t want them to exist. On the contrary, it is through criticism that I hope for them to be improved so they can gain the trust of the public.