Senator Rand Paul is a fierce opponent of mandatory face masking to prevent the spread of COVID-19. So is Representative Marjorie Taylor Greene. Paul says “Most of the masks you get over the counter don’t work. They don’t prevent infection.” Greene says both vaccines and masks do not reduce the spread of the virus.

In light of these statements, YouTube suspended Paul’s account and Twitter did the same for Greene.

Was this an overreaction? In researching reliable answers to this question, I was overwhelmed by a staggering amount of endorsements of masking by the scientific community. Most of these were based on compelling observational studies that include:

— In a high exposure event, two hairdressers, who were symptomatic and later proven to have COVID, interacted with 139 clients over a period of
at least 15 minutes. The stylists and clients all wore masks, and none of the 67 clients who were able to be tracked developed infection.

— In a study from Thailand, investigators followed 1,000 persons who were
at risk for infection from a high exposure event. Those who wore masks
experienced a 70% reduced risk of acquiring infection compared to
their maskless colleagues.

— In an outbreak of COVID infections on the USS Roosevelt, those wearing face coverings had a 70% reduced risk of getting infected
compared to those who used no facial coverings.

And it goes on and on. Anti-maskers, however, have pointed out, accurately, that these observational studies lacked the power of the gold standard in clinical research–the randomized controlled trial (RCT)*. This is no longer true.

In a recently published study from Stanford University, researchers randomized 350,000 (!) citizens of Bangladesh to a group that used masking without any special urging and a group that received frequent reminders to wear masks. The intervention group had triple the amount of mask usage compared to the other group (42% to 13%), and had a 9% reduction in symptomatic cases (those wearing cloth masks, rather than surgical masks, had a 5% reduction).

This may seem like a modest advantage, but researchers point out that, because they only looked at symptomatic cases (rather than those who were infected but had no symptoms), the reduction of infections in the group receiving reminders to wear masks was significantly understated.

But even using this modest figure, universal masking in the United States could have prevented almost 10% of the COVID infections (currently at about 46,400,000) and thousands of COVID related deaths. Senator Paul is a physician–an ophthalmologist. When it comes to wearing face masks to prevent infection, he seems to be quite myopic.

*In an RCT, a large number of people (the larger the better) agree to be randomly assigned to one of two groups: the group that is receiving an intervention in question and the control group. The latter group receives “usual care,” that is, nothing is added to whatever they were doing prior to the study.

POSTSCRIPT: Face masks have a role in preventing COVID infections, but they pale in comparison to vaccines for prevention of the spread of COVID. Regardless of how you view masking, GET VACCINATED!