Planned Parenthood’s Racism Is Showing. It’s Time We Stopped Enabling Them

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The Charlie Kirk Show – The Biblical Defense for the Defenseless

Planned Parenthood, America’s largest abortion provider, likes to bill itself as concerned with racial equality, despite its origins in racist eugenics. But the recent firing of their Pennsylvania Chapter Executive Director over racial discrimination suggests that racism is alive and well within Planned Parenthood.

On a closer look, it becomes clear that despite the image Planned Parenthood strives to project, racism, ethical issues, and downright illegal activities have been endemic in the organization since its founding. More and more disturbing evidence shows how Planned Parenthood has for years covered up the illegal sale of baby parts, facilitated medical fraud, and neglected to report abuse of minors — sometimes multiple instances of abuse which led to underage girls receiving abortion services.

And Planned Parenthood’s recent debacle with racism in the Pennsylvania Chapter is only one in a series of controversies relating to discrimination. In another recent controversy, Lauren McQuade, the head of Planned Parenthood Great Plains — a Planned Parenthood affiliate group — parted ways with the company after she “created a culture of fear and intimidation,” and limited “upward mobility for Black staff”.

But the bottom line is that this racist, unethical, and illegal behavior is easily hushed up by throwing money at the problem. While Planned Parenthood certainly does whatever it can to extort taxpayer funding, much of their $1.5 billion budget comes from corporate donors. It’s unconscionable that companies who claim to work for the public good would pour so much money into an organization which promotes the murder of babies, covers up sex abuse, and has such close ties with racism. If corporations want to keep their reputation untarnished, if they want us to continue giving them our 2ndVote dollars, they must withdraw their funding from Planned Parenthood and give it to organizations which value every life, no matter the stage or skin color.

EDITORS NOTE: This 2ndVote column is republished with permission. ©All rights reserved.

The U.S. Army Adopted the Sig Sauer P320. Can This Gun Protect Your Home?

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The Sig Sauer P320 Compact is a modular-framed, striker-fired pistol designed for versatility and customization. It’s got a lot of interesting features and supports the Sig Sauer reputation for reliable and quality firearms. But is it worth buying? Keep reading to find out.

Accuracy

This gun is very accurate. Right out of the box, the P320 averages 1.5-inch groupings at anywhere from 7 to 25 yards, slow-fire. There is very little recoil, which is surprising considering it can feel a little top-heavy until you get used to it. You may have to allow yourself some time to adjust to the 6’oclock hold as well, especially if you are used to shooting with a more angled grip, like with a Glock. The photoluminescent sights provide an accurate sight picture and allow for precise shooting in low-light situations. The RX model also comes with a great red dot optic, Sig’s Romeo 1. Speaking of romeo, you can upgrade your Ruger 10/22 with this optic.

Reliability

The Sig P320 is amazingly reliable. After over 500 rounds and a wide variety of ammo — including Hornady TAP, Winchester White Box, and Blazer Brass FMJ — there were no misfires or jams. Testing out all the frames with hollow and plink ammo has proven you can count on this gun to fire consistently and without issue.

Handling

I really like how the P320 handles. It’s lightweight, if a little top-heavy, and is easy to maneuver between targets. The RX Carry model is great for concealed carry, and the potential for customization on this pistol means it can be customized for almost every shooter’s needs. The P320 is a technically a chassis gun with a series of interchangeable grip frames or a Sig X-change kit. You can change out the caliber, barrel, grip, and slide for the entire series — excluding the .45 ACP — to fit your needs and specifications. So, if you don’t like the grip, or decide you want a to try out another caliber, the P320 provides an alternative to buying a completely different gun.

Even with all the customizations available, the P320 remains fairly simple in its design. The magazine release is reversible, the slide lock and disassembly lever are easy to use and there isn’t an external safety.

Trigger

The trigger seems to be the only point of contention for the Sig P320. As far as I’m concerned, it’s just going to come down to preference. The trigger on the P320 is a wide, single-action trigger that breaks cleanly at around 5.5 pounds with a smooth reset. There’s no stacking and some overtravel that could affect accuracy, so you may have to make some adjustments if the trigger isn’t a fit for you.

Magazine & Reloading

Sig Sauer packages these guns with two 15-round for the compact model and 17-round mags for the carry. These steel mags are easy to load and smoothly drop free when released. Another great thing about the P320 is that its magazines are exchangeable with the P250.

Length & Weight

The P320 is only 7.2-inches in overall length, 5.3 inches tall, and 28 oz when loaded. It’s small, compact, and has a sleek design. No matter your application, this gun won’t weigh you down.

Recoil Management

The high, vertical grip, high bore axis, and undercut trigger guard all contribute to excellent recoil management in the P320. With the custom grip models available, there’s no reason you should have trouble keeping an accurate sight picture between shots or have the gun jerk out of your grip.

Price

The P320 runs for about $500 retail, depending on the model. The X-Change kits sell from Sig Sauer for around $450 and the grip frames for about $45.

My Verdict?

The Sig Sauer P320 Compact is a great gun for anything from concealed carry to competition shooting. It’s accurate, reliable, and primed for customization. If you are looking for a unique and dependable handgun, you can’t go wrong with the P320.

RELATED VIDEO: The Army’s New Handgun | SIG SAUER P320 | Tactical Rifleman

©Richard Douglas. All rights reserved.

Gallup Poll: Americans’ Mental Health Hits 20-Year Low Ahead of Renewed Lockdowns

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Any retrospective analysis of lockdown policies—the effectiveness which is seriously disputed—must be weighed against the loss of life and human suffering they caused.

In California and other parts of the country, Americans are headed back to lockdown or otherwise facing renewed restrictions on their day-to-day lives amid another spike of COVID-19. Yet a new Gallup poll shows these lockdowns come as people are already struggling with their mental health.

“Americans’ latest assessment of their mental health is worse than it has been at any point in the last two decades,” Gallup reports.

The new polling found that 34 percent of respondents said their mental health was “excellent,” which is 9 points down from 2019. Similarly, 85 percent of Americans had rated their mental health as “good or excellent” in 2019. Just 76 percent did this year. [VIEW CHART HERE]

This poll only further documents an ongoing trend.

As Jon Miltimore previously explained for FEE.org, the Centers for Disease Control found that 1 in 4 young Americans considered suicide this past summer amid life under lockdown and unprecedented levels of social isolation. In one anecdote that painfully demonstrates this broader trend, a California hospital doctor told local news in May that during lockdown he witnessed “a year’s worth of suicide attempts in the last four weeks.”

Much of the decline in mental health over the last 9 months can reasonably be attributed to pandemic lockdowns rather than COVID-19 itself.

Why? Well, consider that for the aforementioned suicidal young adults, the actual mortality risk of COVID-19 is close to zero. It’s the shuttering of their schools, closures of their offices, and isolation from family, friends, and community that has affected them so drastically.

And the negative health effects, both physical and mental, of social isolation are well-documented. Consider this report from the New York Times:

A wave of new research suggests social separation is bad for us. Individuals with less social connection have disrupted sleep patterns, altered immune systems, more inflammation and higher levels of stress hormones. One recent study found that isolation increases the risk of heart disease by 29 percent and stroke by 32 percent.

Another analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 percent higher risk of dying in the next seven years, and that this effect was largest in middle age.

Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions. These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors. All told, loneliness is as important a risk factor for early death as obesity and smoking.

It’s certainly true that we can’t solely attribute the burgeoning mental health crisis to the lockdowns. But there’s no denying the intuitive and demonstrable fact that confining people to their homes and stripping away their livelihoods has driven the spikes in suicide and depression.

How could it not?

Ample research shows how stripping people of their agency and leaving them feeling powerless contributes to mental health decline.

“Having a high sense of control is related to proactive behavior and positive psychological outcomes,” health researchers point out. “Control is linked to an ability to take preventative action and to feel healthy. An impairment of control is associated with depression, stress, and anxiety-related disorders.”

So, such drastic government lockdowns seizing control of the minutiae of American life were always going to have severe mental health consequences. Unintended consequences plague all top-down government efforts to control or manage society.

“Every human action has both intended and unintended consequences,” Antony Davies and James Harrigan explain for FEE. “Human beings react to every rule, regulation, and order governments impose, and their reactions result in outcomes that can be quite different than the outcomes lawmakers intended.”

Replacing individual decision-making of hundreds of millions’ of peoples’ everyday lives with centralized government mandates intended to slow the spread of COVID-19 inevitably causes enormous ripple effects. Our retrospective analysis of lockdown policies—the effectiveness which is seriously disputed—must be weighed against the loss of life and human suffering they caused in their own right.

COLUMN BY

Brad Polumbo

Brad Polumbo (@Brad_Polumbo) is a libertarian-conservative journalist and Opinion Editor at the Foundation for Economic Education.

EDITORS NOTE: This FEE column is republished with permission. ©All rights reserved.

VIDEO: COVID-19 Bounty? Is Pandemic Death Count Skewed by Medicare Reimbursement Bonus?

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Government-mandated pandemic shutdowns may force cash-starved hospitals to attribute patient deaths to COVID-19, even if another comorbidity or accident, caused the death. What role might a Medicare COVID-19 ‘bounty’ play in the growing trends, as cases and deaths from the novel coronavirus spike to new records? And what to make of the stat that 89% of those who die from the pandemic had an advanced directive ‘Do Not Resuscitate’ order (DNR)?

Listen to the Audio Version

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Dr. Fauci (Basically) Admits Rand Paul Was Right 6 Months Ago on Schools and COVID-19

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Top White House COVID-19 Advisor Dr. Anthony Fauci recently changed his prior position and recommended that we keep schools open (while also advising the nation to close bars back down).

“Obviously, you don’t have one size fits all, but as I said in the past and as you accurately quoted me, the default position should be to try as best as possible within reason to keep the children in school or to keep them back at school,” Fauci said. “The best way to ensure the safety of our children in school is to get the community level of spread low.”

In the same interview, Fauci noted that the spread of the disease among school children has remained incredibly low throughout the pandemic.

“If you look at the data, the spread among children and from children is not very big at all,” Fauci added. “Not like one would have suspected.”

Fauci is correct. Schools have certainly not proven to be the hotbeds for the virus that many warned of this summer.

Two international studies have found no relationship between in-person K-12 learning and the spread of COVID-19. And another study, this one from the United States, found that childcare workers have experienced no greater risk of infection either.

These data, coupled with anecdotal evidence gathered from more than 2,000 schools across the nation, have led many health experts and pediatricians to warn of the risks of keeping schools closed, expressing concerns that the unintended consequences may be outweighing the threat of the virus.

The American Academy of Pediatrics said in a statement that:

“All policy considerations for the coming school year should start with a goal of having students physically present in school…. Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation.”

When families are able to homeschool their children or choose the private or public school that’s right for them, they thrive. However, when you take those options away and force all families into remote distance learning, the many kids for whom this isn’t the right fit suffer. Since the vast majority of districts have not passed school choice programs, most families have been left in a bind this year—paying for public schools they often cannot use or whose new models do not work for their children. The consequences include the risks of mental health problems, hunger, missing routine exercise, lack of medical care, child abuse in the home, and the loss of education.

Other research shows that kids are indeed beginning to fall significantly behind in math scores and modestly behind in some other proficiencies such as reading. This is especially troubling news as American children already lag in international proficiency scoring.

Additionally, the Centers for Disease Control and Prevention recently released a report suggesting that the social isolation caused by COVID-19 and ongoing government lockdowns is taking a toll on children’s mental health.

All of that to say, Fauci’s new recommendations will come as welcomed news to millions of people who have been negatively impacted by private and public school closures, while being left with few or no alternatives.

Parents have been unable to work a regular schedule. Women have been disproportionately impacted by the pandemic as a whole, but especially by school shutdowns as the brunt of childcare falls to them. In September alone, 865,000 women dropped out of the workforce, a number four times higher than that of men.

Businesses have struggled to provide flexible work schedules for impacted parents. And childcare providers have been met with uncertainty and a constantly changing landscape of regulations as they work to tailor curriculum to virtual environments, keep children physically distanced, and implement other new policies, like mask-wearing, for their pupils.

But while Fauci is currently correct in his findings and recommendations, he is incorrect when he asserts that this has been his consistent position. In reality, his newfound mentality is at least six months behind the curve, and there were many others who told him as much as far back as this summer. Notably, Senator Rand Paul, a doctor himself, took the correct position many months ago.

Fauci and Paul sparred over the question of whether schools should reopen back in May of this year, leading to countless online attacks against Senator Paul by many prominent progressives.

What did Paul do to deserve such visceral attacks? He merely pointed out the same science Fauci is now hanging his hat on.

“There’s a great deal of evidence that’s actually good—good evidence—that kids aren’t transmitting this—it’s rare—and that kids are staying healthy, and that yes we can open our schools,” Paul stated during a committee hearing.

While Fauci has maintained all along that the goal should be for children to return to schools, he previously issued much more cautious recommendations. He suggested some schools remain closed and pushed for a heavier handed approach from the federal government when it came to deciding protocols for reopening schools. At that time, he also indicated that children could spread the disease as easily as adults.

Fauci’s change in position has led many, including right-wing Twitter commentator Jack Posobiec, to call for apologies to Rand Paul, which wouldn’t be the first time the senator has been owed one by the establishment.

As per usual, Paul is right. Dr. Fauci does owe an apology to the American people. But his mistake is one of arrogance, not malice—and it’s one we see repeated over and over again by the adherents of central planning.

F.A. Hayek once famously said, “The more the state ‘plans’ the more difficult planning becomes for the individual.”

Central planning fails and wreaks havoc on the individuals in a country because of the knowledge problem. The knowledge problem refers to a concept developed by Hayek in his work “The Use of Knowledge in Society.” It’s actually a pretty simple economic concept that holds that central planners cannot possibly possess all of the information they need to successfully direct the lives of others—especially given the need for rapid adaptation in response to changing circumstances.

Such has been the case with Fauci and many others in our government as they seek to combat the coronavirus. They overestimate their abilities, presume they know more than they do, and seek to tell others from afar how to best respond to their rapidly changing environment. It hasn’t worked, and it never will, and the reasons for this trace their way back to the knowledge problem.

Dr. Fauci, and many of our other political leaders, have issued incorrect information, overstepped their constitutional boundaries, and often amplified the negative impacts of the coronavirus. Instead of recognizing their own limitations in the face of a virus, they’ve instead doubled down on their authority and continued to try and control the minute details of people’s lives. This has caused chaos, often needlessly, and it has placed undue hardships on individual Americans who are attempting to do the right things and rebuild their lives.

Fauci’s new recommendations ought to come with a dose of humility and a recognition that the government, and even very smart scientists working within it, cannot centrally plan their way out of an unprecedented pandemic and crisis. Instead, Americans should be given the best, most up-to-date information available and allowed to decide for themselves what the best path forward is for their family and their community.

COLUMN BY

Hannah Cox

Hannah Cox is a libertarian-conservative writer, commentator, and activist. She’s a Newsmax Insider and a Contributor to The Washington Examiner.

EDITORS NOTE: This FEE column is republished with permission. All rights reserved.

The Left’s Gender Theories Are Anti-Scientific Nonsense, but They’re Gaining Ground

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On Nov. 22, 2020, New York Times columnist Charles Blow unleashed one of the most bizarre tweets in recent memory.

“Stop doing gender reveals,” he stated. “They’re not cute; they’re violent. All we know before a child is born is their anatomy. They will reveal their gender. It may match your expectations of that anatomy, and it may not. If you love the child you will be patience, attentive and open.”

 

This is patently insane for a variety of reasons.

The left is actively working to undermine the integrity of our elections. Read the plan to stop them now. Learn more now >>

First, the characterization of gender reveal parties—parties during which parents celebrate finding out whether their unborn children are boys or girls—as “violent” is, in and of itself, radically nuts. Parents are excited to learn whether their children will be boys or girls. That is absolutely unobjectionable.

But for an ardent fan of abortion-on-demand such as Blow to characterize a gender reveal party celebrating the sex of an unborn baby as “violent” while characterizing the in utero dismemberment of that same unborn baby as “choice” is so morally benighted as to boggle the mind.

Blow’s tweet goes further. The implication that parents are doing violence against their own children if they connect sex and gender is utterly anti-evidentiary. Sex and gender are interconnected. For nearly every human being born, biological sex will correspond with genital development in the womb.

And gender, contrary to the idiotic, pseudoscientific paganism of the gender theory set, is not some free-floating set of biases we bring to the table. Males and females have different qualities in a variety of functions, attitudes, desires, and capabilities.

In every human culture—indeed, in every mammalian species—meaningful distinctions between male and female remain. To reduce children to genderless unicorns simply awaiting hormonal guidance from within piles absurdity upon absurdity.

And, of course, Blow’s take on “patience” is not limitless. Presumably, should your daughter announce that she is a boy at the tender age of 5, all measures will immediately be taken to ensure that she is treated as a boy by those such as Blow. There will be no call for watchful waiting; to do so would be yet another act of “violence.”

Why does any of this matter? Because Blow’s perspective has become mainstream on the left. In October, Healthline, a supposed medical resource, ran an article reviewed by a licensed marriage and family therapist titled “‘Do Vulva Owners Like Sex?’ Is the Wrong Question—Here’s What You Should Ask Instead.”

Whether “vulva owners” like sex is indeed the wrong question. The right question, to begin, might be what makes “vulva owners” distinct from women; as a follow-up, we might ask how one would go about leasing or renting a vulva if ownership seems like too much of a burden.

But the madness gains ground. CNN reported in July that the American Cancer Society had changed its recommendations on the proper age for cervical cancer screenings for women, only CNN termed women “individuals with a cervix.” Which seems rather degrading to women, come to think of it.

Lest we believe that this is merely some lunatic fringe, it is worth noting that Blow, Healthline, and CNN are merely saying out loud what those who place gender pronouns in their Twitter bios, such as Vice President-elect Kamala Harris, imply: that gender and sex are completely severable, and that biology has nothing to do with the former.

President-elect Joe Biden has openly stated that an 8-year-old can decide on his transgenderism; Sen. Elizabeth Warren, D-Mass., infamously stated that she would have a 9-year-old transgender child screen her secretary of education nominee. Male and female are arbitrary categories to which anyone can claim membership.

Unless, of course, the left wishes to treat sex as an important characteristic. Then the logic changes. Thus, it is historic that Biden has nominated an all-female communications team, and it is deeply moving that Harris is a woman.

It’s almost as though the definitions of words have no meaning, according to the left. All that matters is fealty to whatever narrative the chosen moral caste dictates on a daily basis. And if you cross it, you’re doing violence.

COMMENTARY BY

Ben Shapiro

Ben Shapiro is host of “The Ben Shapiro Show” and editor-in-chief of DailyWire.com. He is The New York Times best-selling author of “Bullies.” He is a graduate of UCLA and Harvard Law School, and lives with his wife and two children in Los Angeles. Twitter:

RELATED ARTICLE: UK High Court Rules Children Under 16 ‘Unlikely to Be Able to Give Informed Consent’ to Puberty Blockers

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How To Beat Homelessness: Sarasota, Florida vs. Los Angeles, California

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It seems like a strange matchup, a midsize community against one of the world’s great cities — or once great cities. Other than being in the United States and never seeing snow, there are not a lot of similarities between Los Angeles and Sarasota, Florida.

Except about 10 years ago, they both, like most American cities, were facing an increasing homeless problem. The warmth of southern cities, particularly Florida cities, is a major attraction for everyone, and as it turns out there are homeless snowbirds, of a sort.

But Sarasota and L.A. took two opposite paths in dealing with the problem. L.A., like many progressive cities, turned to a mix of homelessness or housing as a human right and pursued a “housing first” concept. Any program that got keys into the hands of the homeless quickly under “rapid housing” was pursued with gushers of taxpayer money — without regard to what had caused people to become homeless in the first place.

At the same time, those progressive cities — San Francisco, Portland and Seattle stand out with L.A. but there are many others — hamstrung attempts by law enforcement and business owners to remove the homeless from badgering patrons and threatening people or just urinating or defecating at their front door. “Homelessness is not a crime!” they cried emotionally. But what they meant was that the homeless committing crimes was not a crime.

We’ve all seen the results of these policies. Massive tent cities in L.A. where the homeless population is estimated to be 80,000 strong and is one of many factors contributing to people fleeing the once City of Angels. They have swelled into the suburbs, too, leaving fewer people feeling safe if they don’t live behind walled mansions with armed guards, such as the Hollywood elite who, bubbled away from impact on themselves, self-righteously push for the destructive progressive policies.

Sarasota took a different approach, one advocated by Robert Marbut, a consultant at the time he was hired by Sarasota in 2013, and who was later tapped by President Donald Trump to be the executive director of the U.S. Interagency Council on Homelessness — the homelessness czar.

Sarasota officials — and importantly, private institutions and organizations — followed many, not all, of Marbut’s advice to target the root cause of the homeless, seeing the homelessness as a symptom of a deep underlying problem with the individuals that normally falls into the categories of drug and alcohol addiction and mental health issues. This is undeniably true.

Statistics are notoriously tricky on the homeless for obvious reasons. But numerous studies have found that somewhere between 20 and 40 percent of all homeless people have a severe mental illness, while another 15 to 40 percent suffer from chronic substance abuse. Large percentages also have spent significant time in prison and many have a disability. Despite these ranges, it’s easy to see that the vast majority of homeless people are not those who were “down on their luck” but otherwise fine, they lost their job and were evicted.

That’s why attacking those foundational causes of homeless is the only realistic and compassionate long-term solution.

So the Sarasota community, both the city and county working together, got rid of the homeless camps that had sprouted up, pursued treatment programs and ensured interagency cooperation that is often lacking, making sure the homeless received help with their underlying problems, their root causes, and then got help getting back on their feet with training and housing.

The Gulf Coast Community Foundation and other nonprofits in the Sarasota region work closely with the Sarasota County School District to make sure young people and their families get connected with social services and housed quickly while often requiring treatment of the underlying problems. Marbut calls this work the “most innovative youth programming in America.”

The result is that the Sarasota area’s “unsheltered homeless” population — those who do not have a permanent residence but are in shelters or other facilities — has fallen almost in half in the past four years.

It shows on the streets. Downtown Sarasota, considered one of the most thriving mid-sized downtowns in the country, was dealing with constant homeless problems a decade ago. It was the top story and the biggest issue for downtown business establishments. But it rarely makes any news now.

Like everywhere, Sarasota still has to deal with groups that the media likes to call “homeless advocates,” but which actually end up advocating for people being homeless through their poorly thought-out solutions. But the public sees the results. It is hard to argue with success. Treat the underlying causes of homelessness, not the symptom, through cooperative programs linking public and private agencies, schools and law enforcement. Common sense again offers up the best solution.

“Twice in the last week, when asked where is the best program in the country, I said Sarasota, Florida,” Marbut said recently.

EDITORS NOTE: This Revolutionary Act column is republished with permission. ©All rights reserved. Like Rod’s new Youtube channel. Follow Rod on Parler.

Me, Über Alles: The Maddening Reason Politicians Break Their Own Lockdown Rules

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There’s hypocrisy, damned hypocrisy, and the actions of statist politicians.

Most of us have seen the pictures or heard the stories. Governor Gavin Newsom, Rep. Nancy Pelosi, Sen. Diane Feinstein and other leftists have been caught blithely breaking the very COVID-1984 restrictions they self-righteously visit on the citizenry. In the case of Denver mayor Michael Hancock, he recently flew to Mississippi not an hour after warning city residents to “avoid travel, if you can.” I guess he couldn’t.

This has left a lot Americans wondering if these posturing pols actually believe their own coronavirus rhetoric. Many no doubt don’t, at least not completely. Also, whatever they believe, they quite surely lack the discipline (not a big word among leftists) to adhere to any program. What would we expect, after all, from people whose only consistent credo is “If it feels good, do it” other than convenience-driven behavior? Yet there’s another, mostly unknown reason for these statists’ hypocrisy.

Studies have shown that leaders, no matter the time or place, tend to be worse than the people they lead. A major reason for this is that politics attracts power-mongers (along with the narcissists and sociopaths).

Power lust is alien to most people. Oh, they can understand lusting after sex or food or money, as virtually all of us have related urges (just hopefully not to a disordered degree). Though it’s a rarer defect, however, people can lust after power in just the way a robber baron may crave money; a nymphomaniac, sex; and a glutton, food. But most people can’t relate to this problem — and generally don’t even consider its existence — because they’re not saddled with it; instinctively projecting one’s own mindset and priorities onto others is a common error.

(If only this weren’t so, people might be more on guard against the power-driven, known as “megalomaniacs.”)

Now, megalomaniacs are overrepresented in politics because, of course, that’s the realm in which you can most directly exercise control and power. These people love it, “need” it and live for it. At risk of seeming frivolous, I think the following nine-second Star Wars clip well epitomizes their mindset.

[Please insert: https://www.youtube.com/watch?v=Sg14jNbBb-8]

(If Gavin Newsom actually had the above ability, he could at least make himself useful and remedy his state’s rolling blackouts.)

So how does this relate to COVID hypocrisy? Well, one way to enhance your sense of power is by flouting rules everyone else must follow.

It’s even more of a rush if you imposed those rules on them in the first place.

It can make you feel special, above it all, like an elite, master of all you survey. Rules are “for the little people,” as the supercilious suppose, so you can feel like a big person if you’re beyond rules, beyond limits, beyond constraints.

These politicians are beyond reason and rectitude, though, tragically. A truly great leader knows he should share the sacrifices he asks of his people, but our power-mongers will have none of that. The point, however, is that they’re not necessarily just weak and willing to violate their own rules. Often, they revel in doing so.

Leaders’ increasing exhibition of blatant hypocrisy is also a sign of a declining republic. In a healthy one, this is less possible because politicians are held accountable. But to whatever degree a pseudo-elite establishment places itself beyond voter discipline (e.g., via rigged elections), it can in the same proportion place itself beyond the voters’ government-imposed burdens.

Megalomaniacs will never stop exercising irrational control over you because control is the goal, an end unto itself. They inflict their torments not just with the approval of their own consciences, but at the urging of their most animalistic desires.

Contact Selwyn Duke, follow him on Gab or Parler (preferably) or Twitter, or log on to SelwynDuke.com.

COVID: How Democrats are Slowly, but Surely, Forcing Americans to ‘Submit’

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“In a country where the sole employer is the State, opposition means death by slow starvation. The old principle: who does not work shall not eat, has been replaced by a new one: who does not obey shall not eat.” ― Leon Trotsky

QUESTION: Are the policies of Democrats slowly starving Americans to death?

This question may seem absurd at first but while I was doing research on how many counties each presidential candidate won in 2016 and 2020 I now believe this is a valid question. The Trump administration is all about creating jobs. But are Democrats all about using Covid to kill jobs? As William Shakespeare wrote,

“To be, or not to be: that is the question

Do Democrats want those who voted for and continue to support President Donald J. Trump to be, or not to be.

Should Americans do what Shakespeare suggested:

Whether ’tis nobler in the mind to suffer the slings and arrows of outrageous fortune, or to take arms against a sea of troubles, and by opposing end them?

Outrageous Fortune

If you live in a state controlled by Democrats you may be suffering from outrageous fortune. Or even worse, losing your life, liberty and pursuit of happiness.

Here is what I found and it was was both shocking and revealing. During the 2020 election Democrats won the votes in 6.41% (or 477) of the 3,061 counties in America. Donald Trump won the vote in 2,497 counties. But the issue is that 70% of the wealth, and therefore the economic power in America, is concentrated in this 6.41%.

I found a Brookings Institute column by Mark Muro, Eli Byerly Duke, Yang You, and Robert Maxim titled Biden-voting counties equal 70% of America’s economy. What does this mean for the nation’s political-economic divide?

Here’s the Brooking Institute chart contained in the column:

TABLE 1. CANDIDATES’ COUNTIES WON AND SHARE OF GDP IN 2016 AND 2020

Year Candidate Counties won Total votes Aggregate share of US GDP
2016 Hillary Clinton 472 65,853,625 64%
Donald Trump 2,584 62,985,106 36%
2020 Joe Biden 477 75,602,458 70%
Donald Trump 2,497 71,216,709 29%

Note: 2020 figures reflect unofficial results from 96% of counties

As Mark Muro, Eli Byerly Duke, Yang You, and Robert Maxim from the Brookings Institute note:

Biden’s winning base in 477 counties encompasses fully 70% of America’s economic activity, while Trump’s losing base of 2,497 counties represents just 29% of the economy. [See the Brookings chart here]

The State’s Take Over of American Jobs under Democrat Rule

The Democrats have said that their goal is to take over large portions of the American economy. The Affordable Care Act (a.k.a. Obamacare) was an initial effort to control not only the health insurance of millions of Americans, but also designed to take total control of the insurance industry, and thereby control how medicine is practiced by doctors.

Fast forward to today and the real possibility of programs like the Green New Deal would become a reality. In September, 2019 the 98 member Democratic Congressional Progressive Caucus (which includes the four members of The Squad) sent out an email titled, “Read what Alexandria Ocasio-Cortez and Pramila Jayapal just said.” Here is the content of the email:

Scientists estimate that we only have 12 YEARS until the effects of climate change become IRREVERSIBLE. We have to act, now!

That’s why Progressive Caucus members like Alexandria Ocasio-Cortez and Pramila Jayapal are speaking out:

We must pass bold initiatives, like a Green New Deal, if we want to stop climate change in its tracks.

But we can’t do that unless we elect a wave of pro-environment Progressives who will fight to keep our planet habitable for future generations.

Should the Green New Deal become law then all aspects of the U.S. economy would be controlled by the state.

Why do Democrats support lockdowns?

Today we now understand why Biden and the Democrats are pushing lockdowns, even from people celebrating Thanksgiving. The intent is to punish small business owners and the working class who have supported President Trump. Covid has become the Democrats weapon of choice used to destroy the working class! Lockdowns harm most of all those who work in “traditional” industries like hospitality (hotels, motels) restaurants, SalonSpaBoutiques,  small family owned businesses, construction, services companies (e.g. plumbing HI-VAC, electrical, etc.) and manufacturing and factories.

Who benefits from lockdowns? Who benefits from small businesses shutting down and going bankrupt? Why big corporations and the rich companies like Apple, Amazon, Walmart, Target, Big Tech and, of course, Communist China. When small businesses close and factories move off shore China wins!

Conclusion.

As Leon Trotsky warned when the state becomes the sole employer you must obey. Today, lockdowns are being used across America by Democrat politicians to decide which employees can or can’t work. Working Americans are finding it hard to keep their jobs. Family owned small businesses are struggling to keep their doors open. People are forced into wearing face masks, even though study after study says that face masks do no stop Covid.

Control the jobs and you control the people. Making American people wear face masks even in their own homes, under penalty of law, and you control how they fundamentally live. The Democrats are constantly sending out emails asking if there should be a “national mask mandate.” What they are really asking is you to voluntarily “submit to the state.”

Using their weapon of choice, Covid, the Democrats, in states like New York, Michigan and California, have taken total control of their citizens and their jobs. Trotsky would be proud to see that in certain parts of America there are those who if they do not obey will not eat. And if they do not obey and wear a face mask they will not work. Literally.

SUBMIT! Or else!

Or, should Americans “take arms against a sea of troubles, and by opposing end them?”

RELATED TWEET:

©Dr. Rich Swier. All rights reserved.

Lockdowns Not Linked With Lower COVID Death Rates, New Study Finds

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Many US states and countries around the world are imposing another round of economic lockdowns in an effort to combat the coronavirus.

The actions are certain to come with a series of devastating unintended consequences—economic destruction, surging poverty, and mental health deterioration among them—but a new study suggests the lockdowns may not do what they are designed to do: save lives.

A new study published by Frontiers in Public Health concluded that neither lockdowns nor lockdown stringency were correlated with lower death rates.

Researchers analyzed data from 160 countries over the first 8 months of the pandemic, testing several factors—including demographics, public health, economy, politics, and environment—to determine how they are correlated with COVID-19 mortality.

“Stringency of the measures settled to fight pandemia, including lockdown, did not appear to be linked with death rate,” the researchers said.

The researchers found that the criteria most associated with a high death rate was life expectancy, though higher COVID death rates were also observed in certain geographic regions.

“Inherent factors have predetermined the COVID mortality: understanding them may improve prevention strategies by increasing population resilience through better physical fitness and immunity,” the authors said.

On one hand, the findings are astonishing. After all, the lockdowns have resulted in mass collateral damage: a global recession, millions of businesses ravaged, tens of millions of jobs lost, widespread mental health deterioration, a resurgence in global poverty, and surges in suicide.

To look at the destruction lockdowns have wrought only to learn they have failed to effectively slow the spread of the virus is maddening and, frankly, nauseating.

On the other hand, the findings shouldn’t be terribly surprising. Months ago researchers had compiled enough empirical evidence to determine how effective lockdowns were in taming COVID-19.

“…there’s little correlation between the severity of a nation’s restrictions and whether it managed to curb excess fatalities — a measure that looks at the overall number of deaths compared with normal trends,” Bloomberg’s data columnist Elaine He noted back in May.

Since then the evidence has only grown stronger. Sweden, for example, which opted to not lockdown in March, has seen its mortality ranking steadily fall throughout 2020.

In September, as it passed the US, Sweden saw its COVID mortality rate fall to 11th highest in the world. Its rate of 577 COVID deaths per million people was far better than many of its European neighbors who implemented strict lockdowns, such as the United Kingdom, Spain, Belgium, and Italy. Since then, Sweden has fallen further down the list, currently standing at 23rd in the world.

While critics of Sweden’s “lighter touch” strategy point out that its mortality rate is well above that of its Nordic counterparts Norway and Finland, many fail to realize that Norway and Finland have had less restrictive government policies than Sweden for the majority of the pandemic.

The reality is that lockdowns come with incredible collateral damage but appear to do little if anything to actually slow down the coronavirus. This is precisely why the World Health Organization reversed course in October and began advising nations to refrain from using them.

“Lockdowns just have one consequence that you must never ever belittle, and that is making poor people an awful lot poorer,” Dr. David Nabarro, the WHO’s Special Envoy on COVID-19, observed.

Dr. Michael Ryan, Director of the WHO’s Health Emergencies Programme, offered a similar sentiment.

“What we want to try to avoid … is these massive lockdowns that are so punishing to communities, to society and to everything else,” Ryan said at a briefing in Geneva in October, adding that sometimes they are “unavoidable.”

Despite mounting evidence that lockdowns don’t work and are incredibly harmful, government officials around the world continue to push them. Why? Because lockdowns are designed to save lives and experts are unwilling to admit they are powerless to control the virus.

In doing so, they’re falling victim to a dangerous deception: the good intentions fallacy.

“One of the great mistakes is to judge policies and programs by their intentions rather than their results,” the famed economist Milton Friedman once warned.

It’s time for the intellectual class to admit a basic reality about lockdowns.

They aren’t just horribly destructive and an affront to liberty. They’re actually failing to save lives.

COLUMN BY

Jon Miltimore

Jonathan Miltimore is the Managing Editor of FEE.org. His writing/reporting has been the subject of articles in TIME magazine, The Wall Street Journal, CNN, Forbes, Fox News, and the Star Tribune. Bylines: Newsweek, The Washington Times, MSN.com, The Washington Examiner, The Daily Caller, The Federalist, the Epoch Times.

5 Charts That Show Sweden’s Strategy Worked. The Lockdowns Failed

WHO Reverses Course, Now Advises Against Use of ‘Punishing’ Lockdowns

4 Life-Threatening Unintended Consequences of the Lockdowns

Lockdown Despotism and the “Control Panel” Delusion

Harvard Researchers: Nearly Half of Young Adults Showing Signs of Depression Amid Pandemic

Why Sweden Succeeded in “Flattening the Curve” and New York Failed

EDITORS NOTE: This FEE column is republished with permission. ©All rights reserved.

Waffle House’s Stand Against Lockdowns Is Exactly What America Needs—Almost

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Waffle House CEO Walt Ehmer’s stance against lockdowns is courageous, but ultimately bolder action may be required to save businesses from the pernicious effects of lockdowns.

Walt Ehmer, the CEO of Waffle House, didn’t mince words when he explained his biggest problem with economic lockdowns stemming from the COVID-19 pandemic.

“None of the people who make the decisions to shut down businesses and impact people’s livelihoods ever have their own livelihood impacted,” Ehmer recently told Business Insider.

There’s clearly some hyperbole in the statement. After all, everyone is impacted to some degree by the lockdowns. But Ehmer’s larger point is correct: the people shutting down the economy are not being affected by lockdowns to the same extent others are.

When the coronavirus swept across America earlier this spring, Waffle House, which has locations in 25 states, was forced to shut down some 700 restaurants across the country. This put roughly 28,000 hourly Waffle House employees out of work, who became part of the 26.5 million Americans who filed for unemployment that month.

The story of these workers underscores an overlooked reality of the pandemic: lower-income Americans are being harmed the most by lockdowns.

Pew Research studies show that Hispanic women, immigrants, young people, and individuals with less education have been the most likely to lose jobs and the least likely to save income during the pandemic. They’ve also been by far the most likely to say they’ve struggled to pay rent or bills.

Ehmer says many people don’t seem to realize the harm that’s being done to the people who can least afford it.

“A lockdown is going to put a lot of people out of work,” Ehmer added in his interview. “It’s really not about the business — it’s about the people. These people have jobs, they have livelihoods, they need to take care of their families.”

It’s safe to say the politicians ordering these lockdowns have not suffered the same way. For starters, they still have their jobs. But it’s also more than that.

The reality is that many politicians have probably seen their wealth increase. The lockdowns have been hell on Main Street but great for Wall Street. The Dow Jones Industrial Average hit an all-time high this week, in large part because so many corporations have seen their competition sidelined, increasing their market share.

But the inequities of the pandemic go beyond wealth. Time and again, the pandemic has shown that politicians have not been subjected to the rules and regulations they pass in the same way every day Americans have.

They can make a quick phone call to buy jewelry at stores that are officially closed, as New Mexico Gov. Michelle Lujan Grisham did back in April. They can arrange an appointment with a stylist while salons are closed because these businesses are “not essential” (unless you appear on TV, in which case they are very essential), as House Speaker Nancy Pelosi and Chicago Mayor Lori Lightfoot did. Or, like Philadelphia mayor Jim Kenney, they can ban indoor dining for others while sneaking out for a bite to eat on the sly.

These actions might earn lawmakers some bad press, but that pales in comparison to what restaurants have endured during the pandemic. Eateries like Waffle House have been among the industries hardest hit by the lockdowns. Many do not see eating out as an “essential” activity (until a close friend’s birthday comes up, that is) and research has shown that eating out, like gyms, poses a greater risk of spreading the virus than other activities.

It’s certainly true that some activities are going to pose greater risks than others, but the reality is that only individuals can determine how much risk is worth taking to engage in a given activity. (See Milton Friedman explain this idea to a student in the video below.) This is a truth lawmakers too often ignore.

When Gavin Newsom broke his own COVID-19 dining restrictions to enjoy dinner with friends, he knew there was a risk he might contract the virus. But he determined that the risk was worth the value of a night out. When Bill de Blasio went to the gym to work out while other New Yorkers were forbidden to do so, he knew there was risk—but he similarly determined the risk was worth the rewards of exercise.

To be clear, I’m not saying Newsom and de Blasio should not do these things because they come with risks. I’m saying everyone should be able to determine how much risk they’re willing to take to engage in a given activity.

This is how Ehmer is approaching his work at Waffle House. He’s not denying that there are risks to dining out or going to work. He’s saying these risks need to be balanced against the damage being done from lockdowns.

“The people making the decisions are not paying the same price that the workers in this country are paying,” Ehmer added. “I’m not going to work in an unsafe environment and I’m not going to let our folks work in an unsafe environment.”

When he says he works “side by side” with folks, Ehmer isn’t being metaphorical. When Business Insider interviewed the Waffle House CEO, he was in the back of one of the chain’s Memphis locations, wearing a polo uniform like the workers. He doesn’t sit on Zoom calls all day talking to managers at locations, but visits four to seven restaurants every day to work shoulder-to-shoulder with the employees who are delivering a service to customers.

“The true way to solve a crisis is to go stand in the middle of it, and figure out how to take care of people and figure out how to help put things back together,” Ehmer said. “That does not change regardless of what the crisis is.”

This might sound reckless to some people, but it’s a clear sign of leadership. It also reveals a basic economic reality that many of today’s decision makers often forget.

“Everyone does not have the ability to work from home,” Njeri Boss, Waffle’s House’s public relations manager, told Business Insider back in April.

Unlike many of us, restaurant workers and owners don’t have the luxury of working from home.

These jobs and eateries may matter little to the decision makers, but the National Restaurant Association points out that countless livelihoods are at stake because of the aggressive measures lawmakers are taking to slow the spread of the virus.

“Tens of thousands of additional restaurant bankruptcies — and millions of lost jobs — are now more likely, while the science remains inconclusive on whether any health benefits will accrue,” the NRA said in a letter sent to the National Governors Association on Tuesday.

For this reason, Ehmer says Waffle House restaurants will remain open unless they are forced to shut down by lawmakers.

“We’re trying to provide reliable careers and jobs for people,” Ehmer said.”We work side by side with folks.”

Ehmer’s stance against lockdowns is courageous, but ultimately bolder action may be required to save businesses from the pernicious effects of lockdowns.

Adhering to government orders that force businesses to close their doors may seem like the only sensible action to take, but there is another way— as Elon Musk has shown. In May, the Tesla founder simply refused to adhere to a government order forcing Tesla’s car plant in Fremont, California to remain closed.

“Tesla is restarting production today against Alameda County rules. I will be on the line with everyone else,” Musk tweeted. “If anyone is arrested, I ask that it only be me.”

Many would view Musk’s action as radical, but as FEE’s Dan Sanchez pointed out, it was the embodiment of civil disobedience, a form of peaceful protest that is perhaps the most effective tool for fighting injustice in modern history.

[Musk] is not seizing government buildings. He is just asserting his right to open Tesla’s private property to willing employees, and to pay them to produce cars to sell to willing buyers. And he expressly offered himself up for arrest should the government decide to invade private property and cage him for it. It may seem sacrilegious to include an eccentric billionaire in the same tradition as such heroic figures as King and Gandhi. But I would argue that economic freedom is as worthy a cause as any. Our very lives, livelihoods, and living standards depend on production and commerce. If civil disobedience is ever justified, surely it is for the sake of providing for ourselves and our children.​

Musk’s act of civil disobedience paid off. Government officials caved and allowed Tesla to reopen. Musk’s peaceful defiance would have made Henry David Thoreau proud.

“Disobedience is the true foundation of liberty,” the author wrote in his seminal work Civil Disobedience. “The obedient must be slaves.”

Ehmer’s opposition to lockdowns should be applauded, but eventually it may require more than words to break the lockdown spell. It may require peaceful but assertive action.

COLUMN BY

Jon Miltimore

Jonathan Miltimore is the Managing Editor of FEE.org. His writing/reporting has been the subject of articles in TIME magazine, The Wall Street Journal, CNN, Forbes, Fox News, and the Star Tribune. Bylines: Newsweek, The Washington Times, MSN.com, The Washington Examiner, The Daily Caller, The Federalist, the Epoch Times.

Hilariously Truthful Defense of Waffle House Goes Viral

WHO Reverses Course, Now Advises Against Use of ‘Punishing’ Lockdowns

4 Life-Threatening Unintended Consequences of the Lockdowns

Lockdown Despotism and the “Control Panel” Delusion

Harvard Researchers: Nearly Half of Young Adults Showing Signs of Depression Amid Pandemic

EDITORS NOTE: This FEE column is republished with permission. ©All rights reserved.

VIDEO: Resist the Great Reset!

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You have likely been hearing a lot about the international globalist/commie/UN plan called the “Great Reset”. Our friend Leo Hohmann told you about how the Chinese virus ‘crisis’ is being used to control us and to put the “Great Reset” in motion here.

I was surprised to see Tucker report on it last night.  (Tucker Carlson is now the only show I watch at Fox News and I am very much enjoying Newsmax’s coverage of election fraud.)

If you missed it, you can watch Tucker’s whole opening monologue below.  BTW, Carlson put rumors to rest that he was leaving Fox.  He said in the same show that he was staying and that somehow Fox was going to expand his type of reporting.  LOL! Finally Fox has competition and daytime viewers are leaving in droves.

Imagine what Trump TV could do!

I have a dream and that is if the President is replaced via a stolen election with the help of gutless Republicans that he will put together a media empire and hire real investigative reporters to expose the deep state (including Republican deep staters), election fraud, the Biden family enrichment scheme and more.

Frankly, as a ‘fire in the belly’ leader of an America First! movement, he would be more powerful outside of government than in it.

Tucker gets around 5 million viewers, give or take a million. Other cable ‘luminaires’ are lucky to reach into the upper 1 million mark.

President Donald Trump would be starting with 73 million viewers!

Update!  Looks like the little creeps at Youtube took it down.  You should be able to see his opening monologue here:

Tucker Carlson: The elites want COVID-19 lockdowns to usher in a ‘Great Reset’ and that should terrify you.

RELATED VIDEO: The COVID pandemic empowered mediocre politicians

EDITORS NOTE: This Frauds, Crooks and Criminals column is republished with permission. ©All rights reserved.

Harvard Researchers: Young Adults Showing Signs of Depression in Pandemic

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Mounting evidence shows that pandemic-related lockdowns and restrictions have inflicted much more harm on younger people than the coronavirus itself. A new report reveals that nearly half of 18 to 24 year-olds are “showing at least moderate depressive symptoms,” and for many the depression is severe.

Researchers at Harvard, Northeastern, Rutgers, and Northwestern universities conducted eight large survey rounds across all US states from April through October, finding that young adults are increasingly having suicidal thoughts. In the US adult population as a whole, the incidence of suicidal ideation typically hovers around 3.4 percent. But this new study reveals that in October, 36.9 percent of young adults had suicidal thoughts, compared to 32.2 percent in May in the wake of the first round of government lockdowns.

These new figures reinforce similarly dismal data released by the Centers for Disease Control and Prevention (CDC) in August. The CDC found that one-quarter of young people ages 18-24 contemplated suicide in the previous month, in large part due to the pandemic and lockdowns.

‘In effect, what we’ve been doing is requiring young people to bear the burden of controlling a disease from which they face little to no risk,’ said Dr. Jay Bhattacharya.

According to the new study, lockdowns and other pandemic policies have drastically upended the lives of most young adults. Only 20 percent of study participants said that they experienced little change since the pandemic began. Instead, just over half of the participants said that their school or university had closed, while 41 percent had to adapt to working from home, 28 percent experienced a pay cut, and 26 percent were laid off.

“The next [presidential] administration will lead a country where unprecedented numbers of younger individuals are experiencing depression, anxiety, and, for some, thoughts of suicide,” the report’s authors conclude. “These symptoms are not concentrated among any particular subgroup or region in our survey; they are elevated in every group we examined.”

Dr. Jay Bhattacharya, a professor of medicine at Stanford University and one of the authors of the Great Barrington Declaration advocating against lockdowns, explains that the negative impact of government lockdowns on young people’s health and well-being is much more severe than the impact of the virus on this cohort.

In a debate last week with pro-lockdown Harvard epidemiologist, Marc Lipsitch, Dr. Bhattacharya acknowledged that COVID-19 “is an absolutely deadly disease for people who are older and for people who have certain chronic conditions.” He explained that there is a 95 percent COVID-19 survival rate for people 70 and older, while for people who are under 70, there is currently a 99.95 percent survival rate.

“For children,” said Dr. Bhattacharya in the debate, “the flu is worse. We’ve had more flu deaths of children this year than Covid deaths.”

Given the disproportionate impact of COVID-19 on older people and those with certain chronic conditions, Dr. Bhattacharya and his Great Barrington Declaration co-authors argue for a “Focused Protection” approach that would shield the most vulnerable in society while allowing younger, healthy people to go about their lives and help to build population immunity.

“Lockdowns have absolutely catastrophic effects on physical and mental health of populations both domestically and internationally,” Dr. Bhattacharya said during the debate. “For people who are under 60 or 50 the lockdown harms—again mentally and physically—are worse than COVID.”

With more US states and countries now imposing new lockdowns in response to rising COVID-19 cases, the mental health of young people is likely to further deteriorate. Already disconnected from many of their peers with work, school, and college shutdowns, these young people must now contend with new 10:00 pm curfews and 10-person gathering limits in some areas, closed restaurants and bars, travel restrictions, and socially distanced holidays.

Relying on government lockdowns to save some lives while ignoring the ways in which these lockdowns do harm to other lives is unhelpful and damaging.

Meanwhile, college students are being shamed by administrators for celebrating their football team’s win or snitched on by peers for socializing. It’s not surprising that young adults are feeling increasingly anxious and depressed.

As Dr. Bhattacharya said in remarks last month: “In effect, what we’ve been doing is requiring young people to bear the burden of controlling a disease from which they face little to no risk. This is entirely backward from the right approach.”

Many of those advocating an end to lockdowns recognize their unintended consequences and the harm they cause to individuals and groups that may match or exceed the harm caused by the virus itself. Declining mental health due to lockdowns, isolation, and economic displacement is one unintended consequence of these policies, but there are others as well.

For example, the World Bank reported in October that 150 million people are expected to be thrust into extreme poverty by 2021 as a result of the pandemic response, which would be the first rise in global poverty in more than 20 years.

There are no easy answers to managing a pandemic, just manifold subtle answers that only free societies, and not top-down planners, can discover. Relying on government lockdowns to save some lives while ignoring the ways in which these lockdowns do harm to other lives is unhelpful and damaging.

As professors Antony Davies and James Harrigan write:

“The uncomfortable truth is that no policy can save lives; it can only trade lives. Good policies result in a net positive tradeoff. But we have no idea whether the tradeoff is a net positive until we take a sober look at the cost of saving lives. And we can’t do that until we stop with the ‘if it saves just one life’ nonsense.”

As the pandemic continues, the severe costs of lockdowns on young adults and others are becoming distressingly clear.

This article was originally published on FEE.org. Read the original article.

COLUMN BY

Kerry McDonald

Kerry McDonald is a Senior Education Fellow at FEE and author of Unschooled: Raising Curious, Well-Educated Children Outside the Conventional Classroom (Chicago Review Press, 2019). She is also an adjunct… 

EDITORS NOTE: This MercatorNet column is republished with permission. ©All rights reserved.

Massive Danish Mask Study Finds MASKS INEFFECTIVE

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https://twitter.com/seanmdav/status/1329068654349185025?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1329068654349185025%7Ctwgr%5E&ref_url=https%3A%2F%2Fgellerreport.com%2F2020%2F11%2Fmassive-danish-mask-study-finds-masks-ineffective.html%2F

Abstract

Background:

Observational evidence suggests that mask wearing mitigates transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is uncertain if this observed association arises through protection of uninfected wearers (protective effect), via reduced transmission from infected mask wearers (source control), or both.

Objective:

To assess whether recommending surgical mask use outside the home reduces wearers’ risk for SARS-CoV-2 infection in a setting where masks were uncommon and not among recommended public health measures.

Design:

Randomized controlled trial (DANMASK-19 [Danish Study to Assess Face Masks for the Protection Against COVID-19 Infection]). (ClinicalTrials.gov: NCT04337541)

Setting:

Denmark, April and May 2020.

Participants:

Adults spending more than 3 hours per day outside the home without occupational mask use.

Intervention:

Encouragement to follow social distancing measures for coronavirus disease 2019, plus either no mask recommendation or a recommendation to wear a mask when outside the home among other persons together with a supply of 50 surgical masks and instructions for proper use.

Measurements:

The primary outcome was SARS-CoV-2 infection in the mask wearer at 1 month by antibody testing, polymerase chain reaction (PCR), or hospital diagnosis. The secondary outcome was PCR positivity for other respiratory viruses.

Results:

A total of 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%). The between-group difference was −0.3 percentage point (95% CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio, 0.82 [CI, 0.54 to 1.23]; P = 0.33). Multiple imputation accounting for loss to follow-up yielded similar results. Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.

Limitation:

Inconclusive results, missing data, variable adherence, patient-reported findings on home tests, no blinding, and no assessment of whether masks could decrease disease transmission from mask wearers to others.

Conclusion:

The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.

Primary Funding Source:

The Salling Foundations.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has infected more than 54 million persons (1, 2). Measures to impede transmission in health care and community settings are essential (3). The virus is transmitted person-to-person, primarily through the mouth, nose, or eyes via respiratory droplets, aerosols, or fomites (4, 5). It can survive on surfaces for up to 72 hours (6), and touching a contaminated surface followed by face touching is another possible route of transmission (7). Face masks are a plausible means to reduce transmission of respiratory viruses by minimizing the risk that respiratory droplets will reach wearers’ nasal or oral mucosa. Face masks are also hypothesized to reduce face touching (8, 9), but frequent face and mask touching has been reported among health care personnel (10). Observational evidence supports the efficacy of face masks in health care settings (11, 12) and as source control in patients infected with SARS-CoV-2 or other coronaviruses (13).

An increasing number of localities recommend masks in community settings on the basis of this observational evidence, but recommendations vary and controversy exists (14). The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (15) strongly recommend that persons with symptoms or known infection wear masks to prevent transmission of SARS-CoV-2 to others (source control) (16). However, WHO acknowledges that we lack evidence that wearing a mask protects healthy persons from SARS-CoV-2 (prevention) (17). A systematic review of observational studies reported that mask use reduced risk for SARS, Middle East respiratory syndrome, and COVID-19 by 66% overall, 70% in health care workers, and 44% in the community (12). However, surgical and cloth masks were grouped in preventive studies, and none of the 3 included non–health care studies related directly to COVID-19. Another systematic review (18) and American College of Physicians recommendations (19) concluded that evidence on mask effectiveness for respiratory infection prevention is stronger in health care than community settings.

Observational evidence suggests that mask wearing mitigates SARS-CoV-2 transmission, but whether this observed association arises because masks protect uninfected wearers (protective effect) or because transmission is reduced from infected mask wearers (source control) is uncertain. Here, we report a randomized controlled trial (20) that assessed whether a recommendation to wear a surgical mask when outside the home among others reduced wearers’ risk for SARS-CoV-2 infection in a setting where public health measures were in effect but community mask wearing was uncommon and not recommended.

Methods

Trial Design and Oversight

DANMASK-19 (Danish Study to Assess Face Masks for the Protection Against COVID-19 Infection) was an investigator-initiated, nationwide, unblinded, randomized controlled trial (ClinicalTrials.gov: NCT04337541). The trial protocol was registered with the Danish Data Protection Agency (P-2020-311) (Part 10 of the Supplement) and published (21). The researchers presented the protocol to the independent regional scientific ethics committee of the Capital Region of Denmark, which did not require ethics approval (H-20023709) in accordance with Danish legislation (Parts 11 and 12 of the Supplement). The trial was done in accordance with the principles of the Declaration of Helsinki.

Participants and Study Period

During the study period (3 April to 2 June 2020), Danish authorities did not recommend use of masks in the community and mask use was uncommon (<5%) outside hospitals (22). Recommended public health measures included quarantining persons with SARS-CoV-2 infection, social distancing (including in shops and public transportation, which remained open), limiting the number of persons seen, frequent hand hygiene and cleaning, and limiting visitors to hospitals and nursing homes (23, 24). Cafés and restaurants were closed during the study until 18 May 2020.

Eligible persons were community-dwelling adults aged 18 years or older without current or prior symptoms or diagnosis of COVID-19 who reported being outside the home among others for at least 3 hours per day and who did not wear masks during their daily work. Recruitment involved media advertisements and contacting private companies and public organizations. Interested citizens had internet access to detailed study information and to research staff for questions (Part 3 of the Supplement). At baseline, participants completed a demographic survey and provided consent for researchers to access their national registry data (Parts 4 and 5 of the Supplement). Recruitment occurred from 3 through 24 April 2020. Half of participants were randomly assigned to a group on 12 April and half on 24 April.

Intervention

Participants were enrolled and data registered using Research Electronic Data Capture (REDCap) software (25). Eligible participants were randomly assigned 1:1 to the mask or control group using a computer algorithm and were stratified by the 5 regions of Denmark (Supplement Table 1). Participants were notified of allocation by e-mail, and study packages were sent by courier (Part 7 of the Supplement). Participants in the mask group were instructed to wear a mask when outside the home during the next month. They received 50 three-layer, disposable, surgical face masks with ear loops (TYPE II EN 14683 [Abena]; filtration rate, 98%; made in China). Participants in both groups received materials and instructions for antibody testing on receipt and at 1 month. They also received materials and instructions for collecting an oropharyngeal/nasal swab sample for polymerase chain reaction (PCR) testing at 1 month and whenever symptoms compatible with COVID-19 occurred during follow-up. If symptomatic, participants were strongly encouraged to seek medical care. They registered symptoms and results of the antibody test in the online REDCap system. Participants returned the test material by prepaid express courier.

Written instructions and instructional videos guided antibody testing, oropharyngeal/nasal swabbing, and proper use of masks (Part 8 of the Supplement), and a help line was available to participants. In accordance with WHO recommendations for health care settings at that time, participants were instructed to change the mask if outside the home for more than 8 hours. At baseline and in weekly follow-up e-mails, participants in both groups were encouraged to follow current COVID-19 recommendations from the Danish authorities.

Antibody and Viral PCR Testing

Participants tested for SARS-CoV-2 IgM and IgG antibodies in whole blood using a point-of-care test (Lateral Flow test [Zhuhai Livzon Diagnostics]) according to the manufacturer’s recommendations and as previously described (26). After puncturing a fingertip with a lancet, they withdrew blood into a capillary tube and placed 1 drop of blood followed by 2 drops of saline in the test chamber in each of the 2 test plates (IgM and IgG). Participants reported IgM and IgG results separately as “1 line present” (negative), “2 lines present” (positive), or “I am not sure, or I could not perform the test” (treated as a negative result). Participants were categorized as seropositive if they had developed IgM, IgG, or both. The manufacturer reported that sensitivity was 90.2% and specificity 99.2%. A previously reported internal validation using 651 samples from blood donors before November 2019 and 155 patients with PCR-confirmed SARS-CoV-2 infection estimated a sensitivity of 82.5% (95% CI, 75.3% to 88.4%) and specificity of 99.5% (CI, 98.7% to 99.9%) (26). We (27) and others (28) have reported that oropharyngeal/nasal swab sampling for SARS-CoV-2 by participants, as opposed to health care workers, is clinically useful. Descriptions of RNA extraction, primer and probe used, reverse transcription, preamplification, and microfluidic quantitative PCR are detailed in Part 6 of the Supplement.

Data Collection

Participants received 4 follow-up surveys (Parts 4 and 5 of the Supplement) by e-mail to collect information on antibody test results, adherence to recommendations on time spent outside the home among others, development of symptoms, COVID-19 diagnosis based on PCR testing done in public hospitals, and known COVID-19 exposures.

Outcomes

The primary outcome was SARS-CoV-2 infection, defined as a positive result on an oropharyngeal/nasal swab test for SARS-CoV-2, development of a positive SARS-CoV-2 antibody test result (IgM or IgG) during the study period, or a hospital-based diagnosis of SARS-CoV-2 infection or COVID-19. Secondary end points included PCR evidence of infection with other respiratory viruses (Supplement Table 2).

Sample Size Calculations

The sample size was determined to provide adequate power for assessment of the combined composite primary outcome in the intention-to-treat analysis. Authorities estimated an incidence of SARS-CoV-2 infection of at least 2% during the study period. Assuming that wearing a face mask halves risk for infection, we estimated that a sample of 4636 participants would provide the trial with 80% power at a significance level of 5% (2-sided α level). Anticipating 20% loss to follow-up in this community-based study, we aimed to assign at least 6000 participants.

Statistical Analysis

Participants with a positive result on an antibody test at baseline were excluded from the analyses. We calculated CIs of proportions assuming binomial distribution (Clopper–Pearson).

The primary composite outcome (intention-to-treat) was compared between groups using the χ2 test. Odds ratios and confidence limits were calculated using logistic regression. We did a per protocol analysis that included only participants reporting complete or predominant use of face masks as instructed. A conservative sensitivity analysis assumed that participants with a positive result on an antibody test at the end of the study who had not provided antibody test results at study entrance had had a positive result at entrance. To further examine the uncertainty of loss to follow-up, we did (post hoc) 200 imputations using the R package smcfcs, version 1.4.1 (29), to impute missing values of outcome. We included sex, age, type of work, time out of home, and outcome in this calculation.

Prespecified subgroups were compared by logistic regression analysis. In a post hoc analysis, we explored whether there was a subgroup defined by a constellation of participant characteristics for which a recommendation to wear masks seemed to be effective. We included sex, age, type of work, time out of home, and outcome in this calculation.

Two-sided P values less than 0.05 were considered statistically significant. Analyses were done using R, version 3.6.1 (R Foundation).

Role of the Funding Source

An unrestricted grant from the Salling Foundations supported the study, and the BESTSELLER Foundation donated the Livzon tests. The funders did not influence study design, conduct, or reporting.

Results

Participants

A total of 17 258 Danish citizens responded to recruitment, and 6024 completed the baseline survey and fulfilled eligibility criteria. The first participants (group 1; n = 2995) were randomly assigned on 12 April 2020 and were followed from 14 to 16 April through 15 May 2020. Remaining participants (group 2; n = 3029) were randomly assigned on 24 April 2020 and were followed from 2 to 4 May through 2 June 2020. A total of 3030 participants were randomly assigned to the recommendation to wear face masks, and 2994 were assigned not to wear face masks (Figure); 4862 participants (80.7%) completed the study. Table 1 shows baseline characteristics, which were well balanced between groups. Participants reported having spent a median of 4.5 hours per day outside the home.

Figure. Study flow diagram. Inclusion and exclusion criteria are described in the Methods section, and criteria for completion of the study are given in the Supplement. SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.

Table 1. Characteristics of Participants Completing the Study

Based on the lowest adherence reported in the mask group during follow-up, 46% of participants wore the mask as recommended, 47% predominantly as recommended, and 7% not as recommended.

Primary Outcome

The primary outcome occurred in 42 participants (1.8%) in the mask group and 53 (2.1%) in the control group. In an intention-to-treat analysis, the between-group difference was −0.3 percentage point (CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio [OR], 0.82 [CI, 0.54 to 1.23]; P = 0.33) in favor of the mask group (Supplement Figure 1). When this analysis was repeated with multiple imputation for missing data due to loss to follow-up, it yielded similar results (OR, 0.81 [CI, 0.53 to 1.23]; P = 0.32). Table 2 provides data on the components of the primary end point, which were similar between groups.

Table 2. Distribution of the Components of the Composite Primary Outcome

In a per protocol analysis that excluded participants in the mask group who reported nonadherence (7%), SARS-CoV-2 infection occurred in 40 participants (1.8%) in the mask group and 53 (2.1%) in the control group (between-group difference, −0.4 percentage point [CI, −1.2 to 0.5 percentage point]; P = 0.40) (OR, 0.84 [CI, 0.55 to 1.26]; P = 0.40). Supplement Figure 2 provides results of the prespecified subgroup analyses of the primary composite end point. No statistically significant interactions were identified.

In the preplanned sensitivity analysis, those who had a positive result on an antibody test at 1 month but had not provided antibody results at baseline were considered to have had positive results at baseline (n = 18)—that is, they were excluded from the analysis. In this analysis, the primary outcome occurred in 33 participants (1.4%) in the face mask group and 44 (1.8%) in the control group (between-group difference, −0.4 percentage point [CI, −1.1 to 0.4 percentage point]; P = 0.22) (OR, 0.77 [CI, 0.49 to 1.22]; P = 0.26).

Three post hoc (not preplanned) analyses were done. In the first, which included only participants reporting wearing face masks “exactly as instructed,” infection (the primary outcome) occurred in 22 participants (2.0%) in the face mask group and 53 (2.1%) in the control group (between-group difference, −0.2 percentage point [CI, −1.3 to 0.9 percentage point]; P = 0.82) (OR, 0.93 [CI, 0.56 to 1.54]; P = 0.78). The second post hoc analysis excluded participants who did not provide antibody test results at baseline; infection occurred in 33 participants (1.7%) in the face mask group and 44 (2.1%) in the control group (between-group difference, −0.4 percentage point [CI, −1.4 to 0.4 percentage point]; P = 0.33) (OR, 0.80 [CI, 0.51 to 1.27]; P = 0.35). In the third post hoc analysis, which investigated constellations of patient characteristics, we did not find a subgroup where face masks were effective at conventional levels of statistical significance (data not shown).

A total of 52 participants in the mask group and 39 control participants reported COVID-19 in their household. Of these, 2 participants in the face mask group and 1 in the control group developed SARS-CoV-2 infection, suggesting that the source of most observed infections was outside the home. Reported symptoms did not differ between groups during the study period (Supplement Table 3).

Secondary Outcomes

In the mask group, 9 participants (0.5%) were positive for 1 or more of the 11 respiratory viruses other than SARS-CoV-2, compared with 11 participants (0.6%) in the control group (between-group difference, −0.1 percentage point [CI, −0.6 to 0.4 percentage point]; P = 0.87) (OR, 0.84 [CI, 0.35 to 2.04]; P = 0.71). Positivity for any virus, including SARS-CoV-2, occurred in 9 mask participants (0.5%) versus 16 control participants (0.8%) (between-group difference, −0.3 percentage point [CI, −0.9 to 0.2 percentage point]; P = 0.26) (OR, 0.58 [CI, 0.25 to 1.31]; P = 0.19).

Discussion

In this community-based, randomized controlled trial conducted in a setting where mask wearing was uncommon and was not among other recommended public health measures related to COVID-19, a recommendation to wear a surgical mask when outside the home among others did not reduce, at conventional levels of statistical significance, incident SARS-CoV-2 infection compared with no mask recommendation. We designed the study to detect a reduction in infection rate from 2% to 1%. Although no statistically significant difference in SARS-CoV-2 incidence was observed, the 95% CIs are compatible with a possible 46% reduction to 23% increase in infection among mask wearers. These findings do offer evidence about the degree of protection mask wearers can anticipate in a setting where others are not wearing masks and where other public health measures, including social distancing, are in effect. The findings, however, should not be used to conclude that a recommendation for everyone to wear masks in the community would not be effective in reducing SARS-CoV-2 infections, because the trial did not test the role of masks in source control of SARS-CoV-2 infection. During the study period, authorities did not recommend face mask use outside hospital settings and mask use was rare in community settings (22). This means that study participants’ exposure was overwhelmingly to persons not wearing masks.

The observed infection rate was similar to that reported in other large Danish studies during the study period (26, 30). Of note, the observed incidence of SARS-CoV-2 infection was higher than we had estimated when planning a sample size that would ensure more than 80% power to detect a 50% decrease in infection. The intervention lasted only 1 month and was carried out during a period when Danish authorities recommended quarantine of diagnosed patients, physical distancing, and hand hygiene as general protective means against SARS-CoV-2 transmission (23). Cafés and restaurants were closed through 18 May, but follow-up of the second randomized group continued through 2 June.

The first randomized group was followed while the Danish society was under lockdown. Reopening occurred (18 May 2020) during follow-up of the second group of participants, but it was not reflected in the outcome because infection rates were similar between groups (Supplement Figure 2). The relative infection rate between mask wearers and those not wearing masks would most likely be affected by changes in applied protective means or in the virulence of SARS-CoV-2, whereas the rate difference between the 2 groups would probably not be affected solely by a higher—or lower—number of infected citizens.

Although we saw no statistically significant difference in presence of other respiratory viruses, the study was not sufficiently powered to draw definite conclusions about the protective effect of masks for other viral infections. Likewise, the study had limited power for any of the subgroup analyses.

The primary outcome was mainly defined by antibodies against SARS-CoV-2. This definition was chosen because the viral load of infected patients may be only transiently detectable (31, 32) and because approximately half of persons infected with SARS-CoV-2 are asymptomatic (33, 26). Masks have been hypothesized to reduce inoculum size (34) and could increase the likelihood that infected mask users are asymptomatic, but this hypothesis has been challenged (35). For these reasons, we did not rely solely on identification of SARS-CoV-2 in oropharyngeal/nasal swab samples. As mentioned in the Methods section, an internal validation study estimated that the point-of-care test has 82.5% sensitivity and 99.5% specificity (26).

The observed rate of incident SARS-CoV-2 infection was similar to what was estimated during trial design. These rates were based on thorough screening of all participants using antibody measurements combined with PCR, whereas the observed official infection rates relied solely on PCR test–based estimates during the period. In addition, authorities tested only a small subset of primarily symptomatic citizens of the entire population, yielding low incidence rates. On this basis, the infection rates we report here are not comparable with the official SARS-CoV-2 infection rates in the Danish population. The eligibility requirement of at least 3 hours of exposure to other persons outside the home would add to this difference. Between 6 April and 9 May 2020, we found a similar seroprevalence of SARS-CoV-2 of 1.9% (CI, 0.8% to 2.3%) in Danish blood donors using the Livzon point-of-care test and assessed by laboratory technicians (36). Testing at the end of follow-up, however, may not have captured any infections contracted during the last part of the study period, but this would have been true in both the mask and control groups and was not expected to influence the overall findings.

The face masks provided to participants were high-quality surgical masks with a filtration rate of 98% (37). A published meta-analysis found no statistically significant difference in preventing influenza in health care workers between respirators (N95 [American standard] or FFP2 [European standard]) and surgical face masks (38). Adherence to mask use may be higher than observed in this study in settings where mask use is common. Some mask group participants (14%) reported adverse reactions from other citizens (Supplement Table 4). Although adherence may influence the protective effect of masks, sensitivity analyses had similar results across reported adherence.

How SARS-CoV-2 is transmitted—via respiratory droplets, aerosols, or (to a lesser extent) fomites—is not firmly established. Droplets are larger and rapidly fall to the ground, whereas aerosols are smaller (≤5 μm) and may evaporate and remain in the air for hours (39). Transmission of SARS-CoV-2 may take place through multiple routes. It has been argued that for the primary route of SARS-CoV-2 spread—that is, via droplets—face masks would be considered effective, whereas masks would not be effective against spread via aerosols, which might penetrate or circumnavigate a face mask (37, 39). Thus, spread of SARS-CoV-2 via aerosols would at least partially explain the present findings. Lack of eye protection may also have been of importance, and use of face shields also covering the eyes (rather than face masks only) has been advocated to halt the conjunctival route of transmission (40, 41). We observed no statistically significant interaction between wearers and nonwearers of eyeglasses (Supplement Figure 2). Recent reports indicate that transmission of SARS-CoV-2 via fomites is unusual (42), but masks may alter behavior and potentially affect fomite transmission.

The present findings are compatible with the findings of a review of randomized controlled trials of the efficacy of face masks for prevention (as personal protective equipment) against influenza virus (18). A recent meta-analysis that suggested a protective effect of face masks in the non–health care setting was based on 3 observational studies that included a total of 725 participants and focused on transmission of SARS-CoV-1 rather than SARS-CoV-2 (12). Of 725 participants, 138 (19%) were infected, so the transmission rate seems to be higher than for SARS-CoV-2. Further, these studies focused on prevention of infection in healthy mask wearers from patients with a known, diagnosed infection rather than prevention of transmission from persons in their surroundings in general. In addition, identified comparators (control participants) not wearing masks may also have missed other protective means. Recent observational studies that indicate a protective association between mandated mask use in the community and SARS-CoV-2 transmission are limited by study design and simultaneous introduction of other public health interventions (14, 43).

Several challenges regarding wearing disposable face masks in the community exist. These include practical aspects, such as potential incorrect wearing, reduced adherence, reduced durability of the mask depending on type of mask and occupation, and weather. Such circumstances may necessitate the use of multiple face masks during the day. In our study, participants used a mean of 1.7 masks per weekday and 1.3 per weekend day (Supplement Table 4). Wearing a face mask may be physically unpleasant, and psychological barriers and other side effects have been described (44). “Face mask policing” between citizens might reinforce use of masks but may be challenging. In addition, the wearer of a face mask may change to a less cautious behavior because of a false sense of security, as pointed out by WHO (17); accordingly, our face mask group seemed less worried (Supplement Table 4), which may explain their increased willingness to wear face masks in the future (Supplement Table 5). These challenges, including costs and availability, may reduce the efficacy of face masks to prevent SARS-CoV-2 infection.

The potential benefits of a community-wide recommendation to wear masks include combined prevention and source control for symptomatic and asymptomatic persons, improved attention, and reduced potential stigmatization of persons wearing masks to prevent infection of others (17). Although masks may also have served as source control in SARS-CoV-2–infected participants, the study was not designed to determine the effectiveness of source control.

The most important limitation is that the findings are inconclusive, with CIs compatible with a 46% decrease to a 23% increase in infection. Other limitations include the following. Participants may have been more cautious and focused on hygiene than the general population; however, the observed infection rate was similar to findings of other studies in Denmark (26, 30). Loss to follow-up was 19%, but results of multiple imputation accounting for missing data were similar to the main results. In addition, we relied on patient-reported findings on home antibody tests, and blinding to the intervention was not possible. Finally, a randomized controlled trial provides high-level evidence for treatment effects but can be prone to reduced external validity.

Our results suggest that the recommendation to wear a surgical mask when outside the home among others did not reduce, at conventional levels of statistical significance, the incidence of SARS-CoV-2 infection in mask wearers in a setting where social distancing and other public health measures were in effect, mask recommendations were not among those measures, and community use of masks was uncommon. Yet, the findings were inconclusive and cannot definitively exclude a 46% reduction to a 23% increase in infection of mask wearers in such a setting. It is important to emphasize that this trial did not address the effects of masks as source control or as protection in settings where social distancing and other public health measures are not in effect.

Reduction in release of virus from infected persons into the environment may be the mechanism for mitigation of transmission in communities where mask use is common or mandated, as noted in observational studies. Thus, these findings do not provide data on the effectiveness of widespread mask wearing in the community in reducing SARS-CoV-2 infections. They do, however, offer evidence about the degree of protection mask wearers can anticipate in a setting where others are not wearing masks and where other public health measures, including social distancing, are in effect. The findings also suggest that persons should not abandon other COVID-19 safety measures regardless of the use of masks. While we await additional data to inform mask recommendations, communities must balance the seriousness of COVID-19, uncertainty about the degree of source control and protective effect, and the absence of data suggesting serious adverse effects of masks (45).

This article was published at Annals.org on 18 November 2020

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