Open Letter to Politifact and Other Fact-Checking Organizations

Hi,

Thank you for extending the conversation with the Politifact article inspired by my post. The article said that I was contacted for a further comment, however I can’t seem to find any contact attempt. And I’d like to clarify some points in hopes that a true point of accuracy is reached.

Please note, I’m a research scientist, clinician, author of one international bestselling book and one USA Today National bestselling book. My books are in libraries and doctor’s offices all over the world, largely on the weight of them being well-referenced, evidence-based, and practical. I’ve lectured at, consulted with, or worked alongside colleagues everywhere from NYU to Harvard to the Cleveland Clinic and countless other educational institutions and patient care facilities. I’ve been in this field for nearly 20 years obsessively working in research, education, and training. I’m not just some guy on the internet. I take this work very seriously.

That said, the analysis done on the data I shared was remarkably rudimentary and deflected from huge pieces of data that could be helpful and even lifesaving for people. I’m not sharing this data to be controversial. I want face masks to be an effective protective measure. I’m sharing the data because it exists and it is routinely ignored or cherry-picked with a clear politicized-type slant. That’s not science and it’s not ethical. If you’re coming into it with your mind made up and an immovable cognitive bias, you’re going to miss the data right in front of you time and time again. If the goal is to be truly ethical and helpful, then I invite you to review these peer-reviewed studies and include them in clear language in the article.

1) An overwhelming amount of randomized controlled trials exist demonstrating that masks are ineffective in reducing the spread of viral infections. For example, this one published in the prestigious peer-reviewed journal the BMJ titled “A CLUSTER RANDOMIZED TRIAL OF CLOTH MASKS COMPARED WITH MEDICAL MASKS IN HEALTHCARE WORKERS” included 14 healthcare settings. The participants were randomized into three different groups: One group wore medical masks at all times on their work shift; a second group wore cloth masks at all times on their shift; a third group (the control group) were allowed general practice which included intermittent mask-wearing, instances of no mask-wearing, and significantly lower time worn when you analyze the rate of compliance.

The study found that the use of medical masks were not statistically significant at reducing rates of viral infection versus the control group (but there was a small potential benefit noted, which any scientist would be ok with noting–though the emphasis should be that it’s not statistically significant). But what’s most useful about this study, and what could be helpful to the public and our healthcare workers, is that healthcare workers wearing cloth masks were upwards of 13 times more likely to experience a viral-type infection than those wearing medical masks. The researchers cautioned against wearing cloth masks due to moisture retention and poor filtration, yet, our citizens, including children, are now advised to wear them for hours a day. And when Politifacts could be stepping up to protect them by AT LEAST cautioning them against cloth masks and using surgical masks instead, the data is ignored and focused on cherry-picking from the work of good scientists.

Another peer-reviewed study, a meta-analysis of 19 RANDOMIZED CONTROLLED TRIALS published in The International Journal of Nursing Studies examined the effectiveness of masks in reducing infections in 8 community settings, 6 healthcare settings, and 5 as source control. The study results found that in healthcare settings “Medical masks were not effective, and cloth masks even less effective.” Very clear language. And, though there “appeared” to be possible benefit in the community setting, if you actually read the references that the evidence is pulled from (which takes time and the ability to actually process the fullness of the research) you’ll see repeated references like this one from Aiello et al. published in PLoS One titled “FACEMASKS, HAND HYGIENE, AND INFLUENZA AMONG YOUNG ADULTS: A RANDOMIZED INTERVENTION TRIAL” finding that although they “observed a substantial reduction in the incidence of influenza infection in the face mask and hand hygiene group compared to the control, this estimate was not statistically significant. There were no substantial reductions in influenza-like illness or laboratory-confirmed influenza in the face mask only group compared to the control.” 

Again, when I say there are no randomized controlled trials proving the effectiveness of masks in the real world, it’s not to be controversial. If you have the ability to actually understand the data then you’d know this to be true. And, if there happened to be small evidence found in RCTs demonstrating mask effectiveness, why then would you ignore the bulk of the data demonstrating that they’re not effective and, in the case of cloth masks, potentially increasing the risk of infections? Just because it’s inconvenient and doesn’t fit into your preconceived narrative, it does not mean that the data doesn’t exist. It exists. And I would hope that you’d have the honor and integrity to acknowledge that.

2) Addressing the studies on mask effectiveness in specific relationship to COVID-19. The article you did on the evidence I shared conveniently left out the CDCs randomized controlled trial that included patients with confirmed cases of SARS-CoV-2 revealing that over 70% of them reported strictly adhering to mask mandates and always wore their mask, while only 4% of confirmed cases were found in people who reported never wearing a mask. And (despite the relatively small percentage of them overall going out to eat and removing their mask) the control group, who did NOT go out to eat as often, still contracted illnesses even with their high mask compliance. Almost 75% of the people who got sick in this group reported always wearing their mask, while just 3% reported that they never wore a mask.

Of course, there are many variables that can sway this data in different directions. But the results of the study exist. Not only that, it’s reported by the CDC, the very source of evidence that so much of the news is pointing to. Yes, you can “fact check” and point out the variables that can sway the results of the study. But why not do that same thing for the cookie-cutter studies you use as affirmative evidence in your fact checking efforts? Like the study published in The Science of The Total Environment which is a COMPARATIVE STUDY that simply calls out a perceived pattern in mask wearing in different states. Finding patterns and making connections like that, WITHOUT evidence of what the actual intervention that helped was (like increased distancing, handwashing, lower rates of preexisting diseases, etc), is called a post hoc fallacy. These types of studies, that your organization is glorifying, are open to massive biases. And to knowingly post them to discredit real world randomized controlled trials, that use a SPECIFIC intervention to measure a SPECIFIC OUTCOME from that intervention, is unethical and not remotely close to efficacious science.

Saying masks reduced the spread of infections in that comparative study ignores countless other factors that could influence the outcome. And what about the two (versus seven) states with mask mandates that DIDN’T see a decrease in cases during the study period? Can you just explain that away? You can assume that the people wearing masks in the states that saw success were wearing their mask correctly and being honest, but when it comes to the other states and the real world RANDOMIZED CONTROLLED TRIALS demonstrating that masks are ineffective, you can quickly pivot to the deflection point that these people weren’t wearing their mask correctly or not being honest in their reporting. At least be consistent in your deflection tactics.

The same thing holds true for the Danish Study which, again, demonstrates that masks are ineffective in reducing the spread of viral infections to a significant degree. The data that I shared (being able to decipher more poignant aspects of the evidence than someone less educated and experienced who may be “fact checking”) highlighted that participants who were reported to wear their masks “EXACTLY AS INSTRUCTED” at all times contracted SARS-CoV-2 infections 2.0% of the time versus the control group WHO DID NOT WEAR MASKS contracting SARS-CoV-2  infections 2.1% of the time. The infection rate, contrary to the popular narrative, is almost exactly the same. In fact, the researchers who did the work of orchestrating a RANDOMIZED CONTROLLED TRIAL that you claim to be “scant” and hard to find, in a population where masks were not normalized and added as a measurable intervention, concluded that, “after analyzing a variety of different patient characteristics, we did not find a subgroup where face masks were effective at levels of statistical significance,” and “In this community-based, randomized controlled trial, a recommendation to wear a surgical mask when outside the home among others did not reduce, at levels of statistical significance, the incidence of SARS-CoV-2 infections compared with no mask recommendation.” The evidence exists. At least have the integrity to honor that. You can talk about the controversial variables in a study whenever it’s convenient, but not use that same level of scrutiny on the truly “scant” data that exists demonstrating that masks are effective.

For instance, there’s the ragtag compilation of OBSERVATIONAL STUDIES published in The Lancet that has become one of the de facto references for people who don’t actually understand scientific evidence. How hard is it to understand these are mainly OBSERVATIONAL STUDIES and COMPARABLE STUDIES? If you’re going to be a fact-checker, at least understand the difference and continuously note the fact that these types of studies are open to massive biases on a tremendous number of variables. And, if you truly have the integrity, you can actually READ THE REFERENCES of the studies you’re purporting as fact. Again and again, you’ll see that the evidence in these studies directly contradict each other and (often) disprove the assumption taken by non-educated readers.

For example, reference 5 in the Lancet study, published in Infection Control and Hospital Epidemiology found that of 413 healthcare workers caring for the confirmed cases of COVID-19, 11 had unprotected exposure, yet NONE of them contracted the infection. And reference 31 from MedRxiv – BMJ/Yale finding that, “Compared to (not wearing) masks there was no reduction of influenza-like illness (ILI) cases or influenza (by wearing) masks in the general population, nor in healthcare workers. There was also no difference between surgical masks and N95 respirators for ILI or influenza.” And reference 60 from Emerging Infectious Disease detailing how a series of unmasked healthcare workers and household members were in close contact with an infected patient and didn’t get infected concluded, “This investigation documents that, under certain circumstances, SARS-CoV is not readily transmitted to close contacts, despite ample unprotected exposures.” Not to mention reference 7 from Science of The Total Environment stating, “Our results concur with a recent published in the Journal of the American Medical Association which indicated SARS-CoV-2 could not be transmitted by an airborne route, suggesting that airborne transmission is not driving the pandemic.” I could go on and on. To keep referencing this Lancet study, as if it’s remotely credible, is a clear indication of how inexperienced in understanding data the authors of your “fact checking” articles are.

Additionally, ignoring the data from the randomized controlled trials done in the REAL WORLD demonstrating that masks are ineffective, in favor of deflecting to observational studies NOT BASED IN THE REAL WORLD, where test subjects are putting masks on and off and coughing into an apparatus, is just as ignorant. Just like the study used to “debunk” the validity of the RCTs I’ve repeatedly shared, this study from Nature Medicine assumes the effectiveness of masks by having participants breathe/cough into a collection apparatus. This time it was a G-II bioaerosol collecting device. To repeat, this on and off duration of mask use and direct collection of particles neglects how viruses travel in the real world, how aerosols and droplets travel above, below, through, and out the sides of a mask, and how the duration of mask usage makes them exceedingly less effective. This study, again, is incredibly shortsighted and does NOT demonstrate how effective masks are in the real world. Which, for the final time, you can find an abundance of well-constructed, randomized controlled trials, conducted in REAL WORLD SETTINGS, demonstrating that masks are ineffective at reducing the spread of viral infections if you care to look. And if you’re truly dedicated to sharing the facts about what’s happening in our world to really help our citizens thrive, you’ll do it. Because the thing that has not been expressed is the THOUSANDS of peer-reviewed studies demonstrating how we can reduce the spread of viral infections, decrease susceptibility, and decrease the severity of symptoms by optimizing sleep quality, having some regular movement practices, improving nutrition, and reducing excessive stress.

For example, have you reviewed the study cited in the European Journal of Physiology detailing how sleep deprivation suppresses the production and performance of our immune cells leading to immunodeficiency? Did you know that the very immune cells that defend our bodies against SARS-CoV-2 infected cells are made from the food, water, and oxygen you consume? You’d think these three things would receive more attention. Especially with nearly 80 percent of hospitalized COVID-19 patients being clinically overweight or obese. But that’s science being real science. That’s science being solutions-oriented. That’s science addressing the real underlying causes and susceptibility to an illness.

3) The final thing that was left out of the data I shared regarding mask effectiveness was the overwhelming amount of evidence showing how haphazard mask wearing can be hazardous to human health. Like this controlled clinical study published in the journal Antimicrobial Resistance & Infection Control finding that within 15 minutes of wearing an N95 mask, healthcare workers experienced a reduction in volume of air displaced between inhalation and exhalation by 23%, it reduced the volume of gas inhaled or exhaled specifically from their lungs each minute by 25.8%, it reduced their volume of overall oxygen consumption by 13.8%, and their ability to expire carbon dioxide was reduced by 17.7%. How about you fact check that and tell the world about it? Really do something to help educate and protect people. Especially our healthcare workers.

You can also tell them about this study published in the journal Ergonomics finding that, even at low work rates, wearing a mask contributed to significantly higher levels of CO2 rebreathing… with notable side effects such as fatigue, dizziness, headaches, and muscular weakness. You do understand these symptoms are indicative of restricted breathing and the onset of harmful biological dysfunction? Just focusing on ONE of these warning signs being headaches, when encouraged to wear masks, this study published in Occupational and Environmental Medicine found that nearly 52 percent of healthcare workers developed mask-related de novo headaches.

Again, I can go on and on. Every study that actually LOOKS to find negative side effects from wearing a mask finds it. It’s just a matter of whether you care enough to look. Then, using a simple cost-benefit analysis, we can determine how much of this is ethical based on the plethora of randomized controlled trials in the real world demonstrating the ineffectiveness of masks in reducing the spread of viral infections, coupled with the potential dangerous side effects of wearing a mask for extended amounts of time. Combine that data with the millions of people now required to wear masks for hours a day to be able to make an income to support their family, and children all over the country being required to wear a mask for hours a day to be able to go to school and get an education. Ask yourself if this is ok. Ask yourself if this makes logical sense based on real world facts and not assumptions. And ask yourself where you’ll stand on the side of history when all of this comes to light.

All best,

Shawn Stevenson