Wearing Masks to Prevent Infection Is Not Evidence-Based Medicine: Experts

Israeli child Liam Lev Tov, 6, in the arms of his mother, receives a Pfizer-BioNTech COVID-19 vaccine from medical staff at Clalit Health services in Tel Aviv, Israel, on Nov. 23, 2021. Oded Balilty/AP

There’s no scientific and medical basis for mandating that people wear masks in the general public and medical facilities to prevent infection from COVID-19 or other respiratory viruses, experts said in a letter sent to the Israel Medical Association Journal (IMAJ).

The letter, published in the December 2022 issue of the monthly journal, was written by Yoav Yehezkelli and Amnon Lahad. Yehezkelli is a specialist in internal medicine and medical management, a lieutenant colonel in the Israel Defense Forces, and one of the founders of the Epidemic Management Team and Evaluation Programs for Extreme Biological Incidents—a professional body that advises the director general of the Israel Ministry of Health (MOH). Lahad is chairman of the National Council for the Health of the Community and head of the Department of Family Medicine at the Hebrew University of Jerusalem’s School of Medicine.

The letter, titled “Masks for Prevention of Respiratory Infections—Is It Evidence-Based Medicine?” addresses mask mandates, which remain mandatory in medical facilities in Israel.

Both authors are members of the Public Emergency Council for the COVID-19 Crisis (PECC), an independent organization made up of Israeli physicians, researchers, and social welfare professionals.

Lack of Evidence-Based Medicine

Before the COVID-19 pandemic, the existing available data about respiratory viruses including influenza and various types of coronaviruses showed that there’s no basis for wearing masks to prevent the spread and infection of a respiratory virus, Yehezkelli told The Epoch Times.

“All the studies done in the world until 2020 showed that there is no justification for this,” he said.

The guidelines of the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) also showed that there’s no need for wearing masks in the general public, Yehezkelli said.

The practice of wearing masks in Eastern countries had no professional justification, he said.

In 2020, the recommendation in Israel and around the world for wearing masks suddenly changed “without having any new professional support to confirm that it does indeed have effectiveness against respiratory infection,” according to Yehezkelli.

The authors of the letter wrote that “most of the studies on the subject during the epidemic suffer from low quality and many biases.”

Since the start of the COVID-19 pandemic, only two high-quality controlled studies were done, Yehezkelli said. One was done in Denmark and the other one was done in Bangladesh.

The study in Bangladesh found some marginal benefit for people older than the age of 50, but overall, both studies show “that there is no benefit in wearing masks to prevent infection with the coronavirus,” he said.

“That’s actually what I wrote in this review, that it doesn’t actually have a professional justification,” Yehezkelli said.

To the contrary, he noted, there are some studies that show that wearing masks might do some harm.

Wearing a Mask Might Harm Health

In the letter, the authors pointed to several observational studies that show that wearing masks can cause some harm, including headaches, concentration difficulties, shortness of breath, a decrease in blood oxygen levels, an increase in the level of carbon dioxide, bacterial contamination from the mask itself, and the existence of substances suspected of being carcinogenic as a result of a lack of regulations in the production of masks.

According to Yehezkelli, the accumulation of carbon dioxide—at levels that sometimes exceed the permitted standard—might cause tiredness, blurriness, sleepiness, and deficiency in judgment and thinking.

It might also cause communication problems for people with impaired hearing who need to lip-read, as well as for children. It’s important for children to see a face for their language development, he said. Some studies show the negative effects of wearing masks on communication and children’s development.

According to a position paper (pdf) published in March 2021 by the PECC, after an in-depth review of medical literature, the council recommended against the wearing of masks for children for extended periods “due to concerns for actual harm to their health and development.”

Medical Facilities

There’s a particular situation in which wearing masks is justified, according to Yehezkelli, who’s also a former lecturer at the Department of Emergency and Disaster Management at Tel Aviv University.

In the context of medical treatment, when a patient with respiratory disease is closely examined by medical staff, and certainly in the case of COVID-19, “there is justification for wearing masks by both the therapist and the patient,” he said.

As a doctor who has practiced in family medicine, Yehezkelli said, “When a patient comes to me with leg pain, there is no reason for him or me to wear a mask. If a patient comes in with anemia, there is no reason, either.”

In the medical encounter, the relationship that exists between the doctor and the patient has great significance, and masks interfere with that relationship and the empathy that should exist between them, he said.

Currently, there’s still a directive for wearing masks in medical, health, and welfare facilities in Israel, which “actually has no justification,” Yehezkelli said.

MoH Mask Recommendation

According to an existing webpage on the MOH’s website, the science behind wearing masks is settled.

“Although some try to make others doubt the effectiveness of masks, the scientific information concerning their effectiveness in preventing transmission of COVID-19 to others is well-founded and well-established!” the webpage reads.

“Many studies have shown that wearing masks in public settings significantly reduces the community spread of COVID-19, too.”

But Yehezkelli said the MOH recommendation is “incorrect information.”

“I will not hesitate to call it disinformation,” he said.

Most of the studies that the MOH are relying on are observational studies.

“In medicine, we try to rely on controlled studies, which are of higher quality than observational studies,” Yehezkelli said.

Some observational studies show that the wearing of masks is beneficial and some show that it isn’t. But the controlled studies show that there’s no benefit.

“I think this is an example of the trending, misleading information provided both by the Israeli Ministry of Health and by health authorities around the world ... which was provided both to the public and to the professional public, including to us doctors,” he said.

“When you read these studies in depth and you read their methods, you realize that there is no justification and no effectiveness, in fact.”

The information given by the authorities about other measures taken to prevent the spread of COVID-19, such as lockdowns, closing schools, quarantines, and vaccines—including information about their effectiveness and safety—is also “very inaccurate information to say the least,” according to Yehezkelli.

The MOH didn’t respond by press time to a request by The Epoch Times for comment.

Yehezkelli said he would expect the scientific and medical communities to follow evidence-based medicine rather than beliefs when deciding upon these measures or at least change these measures “over time and as more data have accumulated.”

Maybe these strict measures were initially taken by the authorities “to go a little on the safe side,” he said. But the data that soon became available showed that these strict measures had no professional justification, were ineffective, and ended up causing more harm than good.

“The wrong policy in response to COVID-19 caused, in my understanding, a disaster on a global scale,” Yehezkelli said.

Examples of this disaster include the loss of school years for children; anxiety and depression in the population as a result of the isolation and lockdowns, mainly among youth who are still affected by it; an increase in cases of eating disorders; unemployment; and economic damage.

“I think we are still absorbing the shockwaves of the policy, not of the virus,” he said.

‘Educate the Public’

“The Ministry of Health’s outreach strategy throughout the epidemic was a strategy of intimidation,” which damaged the public’s trust, Yehezkelli said. In managing emergencies, the right strategy is to “give transparent, reliable information and recommendations for action.”

At the beginning of the pandemic, the epidemic management team in Israel concluded in its discussions that there’s no benefit to wearing masks, he said.

It’s noted in the team’s discussions that “the purpose of the masks is to educate the public,” according to Yehezkelli.

“I don’t think it is appropriate for some government body to educate the public in this way,” he said.

Following a freedom of information (FOI) application submitted by attorney Gadi Shiloh, a member of the PECC, the protocols of the discussions of the epidemic management team were released, dated March 30, 2020, and April 1, 2020.

“Wearing masks has an educational message as part of maintaining hygiene and social distancing,” and it has “a psychological effect,” the epidemic management team stated in its protocols.

It noted that “in the absence of professional or factual basis,” the team would have a hard time issuing a recommendation to wear masks.

“There is no established scientific proof that masks lower morbidity,” it stated.

“There is doubt about the effectiveness of using a mask to prevent infection.”

Yet one suggestion considered by the team was for the public to wear masks as a means to ease the lockdown policy. They noted that if this recommendation was to be made, it must be done together with “an explanation why this recommendation was made and that the public will be aware that there is no proof that it prevents infection.”

“It is important to make sure that wearing masks will not cause harm, and the harm may be greater than the benefit,” the team noted.

On April 7, 2020, the MOH decided to mandate that citizens wear a mask in public, an emergency order that came into effect five days later.

Medical Journals

The authors sent the letter to the IMAJ in response to another letter that had been published in the journal’s July 2022 edition, which advocated the effectiveness of wearing masks.

The authors sent their letter to IMAJ in July 2022, and within a day, Yehezkelli received a message that it was approved for publication, he said.

Yet the letter was only published in the December 2022 edition, six months after it was sent.

When they tried to find out why the letter hadn’t been published in subsequent editions, they were told that it would take time. Later, they were told that the letter needed some language editing.

In the end, “the letter was published as-is,” Yehezkelli said.

Not a single word had been changed.

Although the letter was eventually published, the delay may be an example “of some reluctance” in the medical press to publish articles “that advocate a different approach than the approach of the health authorities regarding the coronavirus,” he said.

The IMAJ told The Epoch Times in an email, “As usual, the letter went through a review process, and yes, the editorial work takes time.”

Yehezkelli, who’s also a consultant for a medical research institute called KI Institute, said that “this is a very noticeable phenomenon” and that it’s difficult to publish studies in magazines around the world that “challenge the existing approach.”

According to Yehezkelli, “most leading medical press in the world, unfortunately, sinned during the COVID-19 period, and still sin” with the publishing of studies that support the institutional stance of health authorities and a reluctance to publish articles that show the opposite.

This noticeable trend is problematic because the medical profession relies on articles published in high-quality journals. In the past three years, “the bias in publications is very significant in medicine,” he said.

“I’m afraid the doctors are going through a kind of brainwashing by the medical establishment,” receiving inaccurate and misleading information, so the doctors themselves don’t know what’s right and what’s not, Yehezkelli said.

“The medical establishment has fallen into some kind of foolishness” in which there’s no longer any need to stop and examine things and draw lessons moving forward, “which is ultimately what’s important, that next time we will behave in a more rational way and based on facts and research,” he said.

“And perhaps most important of all,” the letter’s authors wrote, “the continued refusal to have an open professional discussion, and the disdain for different positions backed by research and data, are not consistent with norms in medicine and science, and this has long-term negative consequences for the medical profession—consequences that every doctor should be concerned about.”