To Mask or Not to Mask, is that the Question?

We are now 3 years into the COVID-19 Pandemic. We have lived through unprecedented times where millions of people have become infected with the SARS-CoV-2 virus and, sadly, over 1.1 million people in the USA, and 6.86 million in the world, have died from this infection.  We have found that some of the initial recommendations for prevention of COVID-19 acquisition and transmission have changed. This has fostered some distrust and skepticism in the general public. In my opinion, Public Health experts have been building this COVID-19 prevention plane as they were flying it. In other words, we all have been learning as we go.

On a number of occasions, I have heard physicians (e.g., gynecologist, pathologist, and cardiologist) casting doubts on vaccines and the need to quarantine or use masks. In each case, where I saw or heard about an educated healthcare professional giving information that did not coincide with known experts in the field of infectious disease or public health, I researched who these people were. It was interesting to me to see that in the 3 physicians I researched, all three were said to be quacks and were discredited by their peers.

Recently an article appeared in the City Journal, a publication of the Manhattan Institute for Policy Research, a leading free-market think tank. The article published on February 17, 2023 was written by John Tierney. He wrote “we now have the most authoritative estimate of the value provided by wearing masks during the pandemic: approximately zero.” It was his opinion that experts including those from the CDC and the rest of the public health establishment have chosen to ignore the science. Then Mr. Tierney goes on to reference his source, and he goes so far as to say “the gold standard of medical evidence is the randomized clinical trial (RCT) and the gold standard for analyzing the evidence is Cochrane (formerly the Cochrane Collection).”

Here is where Tierney loses me. I did my own research and looked up the Cochrane review on this topic of masking. (Jefferson T., Dooley, L., Ferroni, E., et al. Physical Interventions to interrupt or reduce the spread of respiratory viruses, published January 30, 2023.)  Imagine my surprise when I read the review of the studies that included 11 new RCTs bringing the total number of RCTs to 78. Only 6 of the trials were conducted during the COVID-19 pandemic.  The review stated that adherence with interventions was low in many of these studies.  Additionally, the review stated the risk of bias for the RCTs was mostly high or unclear. So now I asked myself, did Tierney even read the source he referenced?

The Cochrane review concluded that drawing firm conclusions under the circumstances (high risk of bias, low adherence to interventions) were hampered. It also stated that the effect estimate is limited and that the true effect may be different from the observed effect. Again, I wondered if Tierney actually read his reference or understood the conclusions.

Another article appeared in the Opinion Section of the New York Times, February 21, 2023  by Brett Stephens with a similar disregard for the use of masks. At this time, the public is COVID-19 exhausted and these articles that are being published have potential for harming people as they cast doubts on the effectiveness of masking.  The public will latch onto these ideas and run with them because it is convenient and they are tired of masking.

In my opinion, this is not rocket science and you don’t have to be a genius to conclude that having a mask, whether surgical or N95 respirator, gives the wearer more protection from acquisition and transmission of any of the respiratory pathogens than without.  Any additional protection is better than none.

Long-Term Care institutions are uniquely affected by masking mandates in that they have very vulnerable and immune compromised residents that are being cared for, and until specific data is released with strong evidence to support otherwise, the CDC guidelines should be followed.  My hope is that people will do their own due diligence when reading something like this. If you hear something that sounds out-of-the box or outrageous, do your own research! 


Jefferson T., Dooley, L., Ferroni, E., et al. Physical Interventions to interrupt or reduce the spread of respiratory viruses. January 30, 2023. Retrieved from

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Comments on "To Mask or Not to Mask, is that the Question?"

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Pete Patterson - Sunday, March 19, 2023

Nice work Dolly. I too read Brett Stephens' Op Ed (his blah-blah opinion). It's typical of pseudoscientific claptrap from not-actually experts. /Dr. P

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