Does my heart good to see the Fauch lies exposed so all can see. Thanks Newsmax for this great article.
https://youtu.be/soMUg_y3sqw
Fauci Emails and Covid Lab Leak Theory
By Nick Koutsobinas
The New Civil Liberties Alliance (NCLA) has released six video depositions taken in a federal lawsuit that sheds light on what role government actors, including Dr. Anthony Fauci, played in censoring or, as revealed in the Twitter Files, the offshoring of government requests to private social media companies or foreign actors to censor speech around COVID-19.
In his deposition for State of Missouri v. Joseph R. Biden Jr., as NCLA outlines, Fauci “testified ‘I do not recall’ 174 times, and ‘I don’t remember,’ at least 212 times.” According to NCLA, evidence from “his own emails and past statements” indicate the former head of the National Institute of Allergy and Infectious Disease (NIAID) “cast substantial doubt” on his claim to a “failing memory.”
According to U.S. Right to Know, Fauci requested Wellcome Trust Director Jeremy Farrar organize a secret teleconference on Feb. 1, 2020, onstensibly to shift concerns from a lab leak to one of natural origin.
Furthermore, NCLA says, “his deposition testimony — that he genuinely believed COVID had natural origins — conflicts with emails he exchanged with scientists in early 2020, indicating that he believed the lab leak hypothesis could be accurate.”
The recent ruling by Judge Terry A. Doughty of the U.S. District Court for the Western District of Louisiana denying the government defendants’ motion to dismiss has paved the way for the case to continue. The judge was unpersuaded by the defendants’ arguments.
Elvis Chan, who has been named in the Twitter Files, said in his deposition that the FBI played a prominent role in working with Big Tech to sway public opinion. In regard to the wider scope of what’s been termed the “censorship industrial complex,” Chan, on the eve of the New York Post’s Hunter Biden laptop story, sent Twitter’s then-head of site integrity, Yoel Roth, 10 documents. “Within hours,” journalist Michael Shellenberger writes, “Twitter and other social media companies” began censoring the story.
Nonetheless, the recently filed Supplemental Preliminary Injunction Brief as well as the Proposed Findings of Fact reveal a damning effort by the Biden administration and federal officials’ in employing “illicit tactics” to silence voices on social media that presented views on COVID-19 that were otherwise deemed inconvenient or disfavored.
Jenin Younes, litigation counsel for NCLA, said, “These depositions further confirm what other discovery in the case has already demonstrated: Dozens of members of the federal government, including unelected bureaucrats like Dr. Fauci, orchestrated a campaign to shut down debate about COVID-19 related subjects; and they deceived the American public on issues ranging from the lab leak theory to efficacy of masks to the protection offered by naturally acquired immunity to whether the vaccines could prevent disease transmission.”
There’s a number of anonymous Twitter accounts that are doing the best investigative work on the COVID vaccines — and one of the best is called Jikkyleaks. (I’ve mentioned this researcher’s work previously on Substack.) Back in January, this anonymous researcher discovered some very troubling information hiding out in an obscure medical study.
The article’s title: Circulating Spike Protein Detected in Post–COVID-19 mRNA Vaccine Myocarditis.
This article highlighted by JikkyLeaks should be sent to every parent who gave one of the COVID “vaccines” to their child — it’s a matter of life and death.
Here’s the problem: parents were told that the spike proteins would disappear from the body after a few weeks — only the antibodies would remain.
The medical study proves that these claims were clearly false.
Here’s the main point that you need to understand from this study: there were 436 billion copies of the spike protein found in the plasma of kids one month after they got the jab.
436 billion copies of the spike protein.
That’s much too much.
The study also showed that the experimental COVID “vaccines” were causing myocarditisin children — which is fatal in 50% of all patients over a 5-year period.
This heart damage was revealed in troponin tests.
JikkyLeaks adds:
It’s a problem because the study authors should have raised an alarm after the first two or three cases. You see, that was their duty. It was a duty as medical officers and as research officers. But to our knowledge they said nothing and kept recruiting.
But it didn’t matter that young people were getting myocarditis (with a known 5-year mortality of up to 50%). What mattered is finishing the study so they could publish.
Santa Clara County, California, imposed some of the harshest Covid restrictions in America. A church and its members defied them — and became the targets of an unprecedented surveillance operation
Calvary Chapel San Jose, in Santa Clara County, CA. Pastor Mike McClure, center.
Long famous as the core of Silicon Valley, Santa Clara County, California, also earned the distinction in the last three years as perhaps the most aggressive and punitive enforcer of pandemic restrictions in the country. On March 16, 2020, Santa Clara, along with a half-dozen other Bay Area counties, was the first in the nation to announce a shelter in place order, commanding all citizens to remain at home other than for specific activities that the county deemed essential, such as food shopping or medical care. It wasn’t until mid-October — seven months after the initial order — that Sara Cody, the head of the county’s public health department, began allowing indoor gatherings at churches, provided they were no more than 100 people or 25 percent of a facility’s capacity, whichever was fewer. At these limited gatherings face coverings and social distancing were required, and singing was banned.
San Jose’s Calvary Chapel, led by its pastor, Mike McClure, brazenly defied these orders. On May 24, 2020, McClure stated publicly that he would reopen the church the following week, regardless of the health department’s orders, and that he would never close the church again. After two months of isolation, many congregants were teetering toward despair. They were suffering greatly from loneliness, depression, and crippling anxiety — the church was their community, and returning to the normalcy of its rituals and in-person fellowship was vital for their mental, spiritual, and physical well-being.
True to McClure’s word, at the end of May Calvary began holding indoor gatherings, often with hundreds of worshipers, a large portion of whom were without masks, in breach of distancing rules, and singing. This set off a collision between the openly defiant church and the county that culminated in two lawsuits. One, in federal court, in June 2020, by the church against the county, claiming the restrictions violated a list of constitutional rights, and the other, in state court, in October 2020, by the county against the church, for “flagrantly and repeatedly” violating public health orders and nonpayment of fines.
Both cases are still in litigation, but extensive legal documents, totaling more than a thousand pages, reveal a county, and its health department, that went to extraordinary, and potentially unlawful, lengths to enforce its decrees. These efforts include levying more than $2 million in fines against Calvary, and a multi-faceted surveillance program of the church and its members, breathtaking in scope and reminiscent of totalitarian regimes, rather than an American county health department — the spy operation included stakeouts, forced in-person monitoring of prayer groups and other intimate activities, and tracking the cellular mobility data of churchgoers.
The county’s public health orders, which were applied incongruently to different entities, and its enforcement mechanisms raise important legal and ethical issues about government infringements on citizens’ rights related to privacy, assembly, and religion that run well beyond the context of the pandemic and have potential implications for Americans regardless of their religious or political affiliation.
* * *
AN AGGRESSIVE COUNTY, AND ARBITRARY RULES
From the outset, Santa Clara had an unusual fervor for enforcing its health orders, and for punishing those who didn’t comply. By one analysis, as of March 2021, the county had issued an astonishing $4.9 million in fines to nearly 400 businesses and entities for pandemic rules infractions. By comparison, six other Bay Area counties combined had collected just $82,000.
Santa Clara’s aggressive stance can be traced back to August 11, 2020, when the county established a “civil enforcement program” for its public health orders. As part of the program, a Business Compliance Unit was created, composed of as many as ten or more enforcement officers, tasked with investigating potential violations of the health department’s orders. In public communications, the county asked residents to report on people and entities not in compliance with the health orders through a special hotline and website. To encourage citizens to rat out offenders, an explicit part of the enforcement system, detailed in the county’s Urgency Ordinance, was granting confidentiality to those who filed complaints.
On August 21, 2020, in response to one such complaint, Calvary was served with a cease-and-desist letter for holding indoor gatherings, for failing to ensure everyone wore masks, for failing to ensure social distancing, and for failure to ensure there was no singing. Two days later, enforcement officers arrived at the church and reported observing at least 100 unmasked people gathered inside, not distancing, and with some of them singing.
So began a series of issuances of fines for violations every single day, beginning in August, and running through the spring of 2021. The fines began at $1,000 each. Per the terms of the public health order, there was no grace period, and the amounts doubled each day that the violations were not corrected until a maximum of $5,000 per day was reached. By October 27, 2020, the county had already fined Calvary $350,000.
As I read the legal filings and reviewed the various public health decrees issued by Santa Clara authorities, something struck me as very odd. The church was accruing fines like John Bender racking up detentions in the Breakfast Club for breaching various orders; yet other aspects of society during that same time had very different restrictions.
In September, Santa Clara churches were still prohibited from any indoor gatherings, yet, by contrast, shopping malls could operate at fifty-percent capacity. By October 14, when county churches were then allowed the lesser of 100 people or twenty-five percent capacity, museums could run at fifty percent, and stores had no capacity limits placed on them at all.
Much of Santa Clara’s restrictions early on were tied to state requirements, which were harsher on churches than stores. But Santa Clara expanded the chasm between houses of worship and retail establishments beyond what the state prescribed. (Through multiple exchanges with a county communications officer, asking why malls had looser conditions than churches, I was not given an explanation.)
The seeming illogic and unfairness aside, the county was determined to steadfastly enforce its orders on Calvary and impose financial penalties with terms that would shame a loanshark. To achieve these goals the Compliance Unit sought to document — with exceeding care, and through multiple forms of surveillance — the infractions of the outlaw chapel.
* * *
STAKEOUTS, AND ON-SITE SURVEILLANCE
On August 23, enforcement officers from the county’s Business Compliance Unit began regular surveillance of the church. On the first visit they entered the premises, observed the congregants, and then left to write up a Notice of Violation for masking, gathering, singing, and distancing violations. When the officers returned shortly after to deliver the Notice they were denied entry and told to get off the property. From then forward, each Sunday the enforcement officers were locked out of Calvary. But this did not stop them.
Barred from the premises, the Unit struck an agreement with the law-abiding church next door to Calvary for the officers to set up camp there for their operations. Enforcement officers, often working in pairs, conducted dozens of stakeouts, spying on Calvary staff and members by peering at them through a chainlink fence from the adjacent property.
Among the hundreds of court documents filed in the state case are extensive declarations from multiple county enforcement officers. It is in these declarations where they describe in granular, mundane detail the illegal goings on at Calvary Chapel. Masking and distancing infractions of church greeters and of attendees being welcomed into the building were documented over and over again. The officers also surveyed the church’s several parking lots each week, counting the number of cars to estimate how many people were inside.
Note was even made of traffic directors, who obviously were working outdoors, for not wearing masks. And hugging — presumably a distancing violation — was also documented.
This scenario played out every week, each instance described with the same particulars in a Groundhog Day type cycle. Yet all this meticulous documentation seems strangely superfluous since Calvary recorded its services and made them available online, providing all the evidence the enforcement officers needed.
Every Sunday, for months, the officers went through the same drill. The chainlink fence, the tallying of cars, the watching the livestream of maskless churchgoers singing, congregating. It is hard to believe this was an actual law enforcement operation that went on for months on end. The sheer absurdity of it all — the hyper specificity, the repetition, the mundanity. Instead of envelopes of cash being handed off and tucked into suit jacket pockets or shots taken with a telephoto lens of steel briefcases containing contraband, the reports consisted of people hugging or not wearing a mask while directing traffic in a parking lot. The declarations recounting the surveillance read like stakeout scenes from a screenplay of a police comedy — earnestness played as farce, with the officers as the classic straight man.
Things took a turn in November, when a judge issued a temporary restraining order, which empowered the enforcement officers to enter the property, which they did on numerous occasions purposefully timed with scheduled church events.
It is here where the details of the declarations take on a more creepy quality. Often intimate activities, with people sometimes at their most vulnerable — mothers in small prayer groups; children in daycare — were subject to observation. Officers described being escorted to an event called Manna for Moms.
The officers said they did not want to disturb the gathering, and favored observing through a window. But they were there, surveilling a private event: 17 women, one infant, and two children were in the room where the gathering was held. Most maintained six feet of distance, but some were not wearing masks, and one person was singing.
Pastor McClure offered the officers a tape measure, but this was declined. (He also tried to gift them his wife’s book at one point, which was also “politely declined.”) Officers noted that “a gentleman who identified himself as ‘Chris’ recorded us with his mobile phone. Chris also was not wearing a face covering.”
The officers returned repeatedly, often specifically on days and at times they knew there would be gatherings, such as bible study classes, youth events, and on Sundays for services. The cataloging of church members, their actions, and violations continues in the declarations ad infinitum. Women drinking coffee in a hallway. In the church cafe 11 young adults gathered, not wearing masks or distancing. Another youth gathering was noted for having chairs “arranged in a manner that did not allow for social distancing.” The officers observed baptisms, describing McClure touching the faces of baptismal candidates and pinching their noses as he submerged them in water (presumably this was marked down as a double violation of not masking and not distancing).
I am generally unacquainted with court declarations, and found much of the tone and content to be of such awkward literalness about such pedestrian circumstances, that it achieved a sort of high art of dry humor. And yet, these were often personal, intimate moments that were being monitored by force. I ultimately found myself increasingly uncomfortable reading the declarations, thinking about government officers intruding, over and over, on these private ceremonies and gatherings.
* * *
THE MEMBERS
Anthony, a 29-year-old county social worker, was one of the many people being observed at Calvary. [Some names have been changed to protect members’ identities.] Why was he there, knowing that it was against the rules?
“I was having some really dark moments,” he told me. Around the time the pandemic started he had gone through a breakup, which devastated him. And then the restrictions kicked in and his depression began to spiral downward. Thoughts of suicide entered his mind.
The pandemic in the spring was “a scary time for everyone,” he said. “We were getting swamped with cases in May and June. People were hurting.” While he tried to help others, he desperately needed help himself. “It was hard for me to regulate my emotions,” he said. Going to church, an activity that had centered him for his whole life, spending time with the other congregants, conversing face to face with the pastors, was the one thing he had to keep himself from doing something truly awful. “Those two hours I spent there were the best two hours of the week. It brought comfort. Despite everything that was going on.”
While he recognized that Covid presented risks to himself and society, he didn’t understand why people could go to a liquor store but not church. He tested himself every other day, used hand sanitizer, and, at least initially, wore a mask. In part because most everything was closed, he generally kept his distance from people. He didn’t see how he was endangering anyone. And everyone at church chose to be there. As a healthy young man Covid posed a real but extremely small risk to him, he said. Whereas without the church he was in serious trouble.
In the spring of 2020, Bryan Wells, aged 37, lost his job selling motorcycles up in Marin County, where he lived, because the dealership closed when the economy shut down. “I was in a big motorcycle community, but even that ended,” he said. “No one wanted to go anywhere. My sister and brother in law didn’t want to meet in person.” Wells struggles with addiction and relies on his faith to keep himself from swaying. “Christ turns off the taste for the things you want to do but that are bad for you,” he said.
Wells got a new job at a dealership in San Jose (businesses related to transportation were allowed to stay open), and began commuting close to two hours each way before eventually moving to San Jose. Several customers told him about this church that was open, and he began to attend. For him, more than the isolation that the new norms created, was that everyone around seemed to be living in constant fear. For Wells, fear is toxic. Going to Calvary, being with people unafraid, gave him the strength he needed to stay off drugs and alcohol.
For Katie Truman, going to Calvary didn’t save her, but she believes without it her son, Jonathan, 21 at the time, would be dead. When the restrictions hit he lost his job as a plumber’s apprentice. He had an alcohol problem before this happened, but after “his drinking got so bad, we worried for his life,” she said. Katie and her husband didn’t know what to do or how to help him. They were alone, at home, and weren’t talking with anyone, and didn’t know how to find resources.
I asked her why she couldn’t have just called the pastor for advice. She seemed surprised at or confused by my question. The topic wasn’t something she and her husband could even conjure up to discuss. It was only after being in the church, in person, having fellowship, that she shared with others what was happening with her son. “When you have no hope for your child who you love so much, to know where to go for that hope when almost everything is shut down, it was . . .” she drifted off.
One of the pastors then told Katie about a program for her son. She gave Jonathan an ultimatum and he agreed to go. She believes the program saved his life. He stayed in it for a year, and is now living in the Northeast and got married.
* * *
TRACKING MOBILITY DATA OF CHURCHGOERS
For their work monitoring and documenting the crimes of Katie and her husband, Bryan Wells, Anthony, and hundreds of others, each enforcement officer was paid $219 per hour. Between November 25, 2020 and January 3, 2021, alone, there were 51 hours of on-site surveillance.
But the county did not stop there. As if the outside surveillance from the stakeouts, the on-site visits, and the freely available video evidence of services wasn’t enough, the county also had another, far more sophisticated tool at its disposal.
The Santa Clara County health department used cellular mobility data to track how many people were attending Calvary Chapel on any given day. I found this information in a remarkable declaration amid the legal documents, from a professor at Stanford Law School named Daniel Ho. A research team, led by Ho, was hired to analyze the data for Santa Clara county health officers.
Ho, who has an expertise in statistical inference and quantitative data analysis on public health, explained in his declaration how the process worked. The county paid to acquire the data from a firm called SafeGraph, a company that “aggregates information from 47 million mobile devices across the United States.” SafeGraph aggregates these data on points of interest (POIs), including daily visit counts.
A geofence — a virtual geographic boundary — was set up around Calvary Chapel’s property.
Aerial image of Calvary Chapel and geofence
SafeGraph matches Global Positioning System (GPS) data to individual POIs by using “geographic shapefiles” — the red boundary runs the perimeter “shape” of the Calvary property, and the yellow boundaries indicate individual building shapes within the property. The data was so granular that Ho’s team differentiated daily visits to both the overall parcel of land, and to specific structures within the Calvary building complex. Once a device was in the geofenced area for four minutes it was counted as a visit.
Of the 47 million devices tracked by SafeGraph, approximately 65,000 during the study period were in Santa Clara County. Since this only represents a portion of all mobile devices, Ho’s team used statistical modeling to extrapolate the actual number of people coming to Calvary. Ho estimated that before the pandemic Calvary maxed out at 670 people visiting in one day. In early 2021 that number had exploded to a 1,700 person daily peak.
Should the lawsuit ever get to trial, the county plans to use Ho’s analysis of the SafeGraph data to show that Calvary was an outlier among POIs in general, and specifically among religious organizations, for daily visits. But it’s hard to imagine how this information bolsters their case beyond what was already known from the declarations recounting what was observed on the innumerable stakeouts and on-site visits. Moreover, the church has never disputed that it held services and other events. On the contrary, it has been overtly public about it.
The SafeGraph data ostensibly does not provide personal information on individuals. Yet I spoke with a scientist who utilizes similar data in their work who said it would, of course, be easy to identify an individual user. You can track the location at one POI, in this case the church, and then follow the device back to its home address. This isn’t to suggest that Ho or Santa Clara did this or had access to the movement data. But the point is an entity could easily figure out individuals’ identities if SafeGraph gave them the data.
Santa Clara was using SafeGraph data as early as November 2020 for general purposes as part of its pandemic initiatives. According to a member of the County Board of Supervisors, the Health Department wanted to track people coming in and out of the county to try to predict the impact of Thanksgiving. In a December 2020 meeting, where the data were reviewed, the member expressed concern about the data showing many Santa Clara residents traveling for the holiday to Southern California, where Covid rates were higher than in the Bay Area.
(It is not clear to me what was actionable about learning this, since the review was after the fact. And one can only conjecture about what the authorities could do with this information. Presumably the Health Department, under Cody’s direction, for example, was not considering an attempt at closing the County’s borders. Perhaps if they saw too many residents going somewhere they felt was dangerous, like LA, and then returning to the county, they would consider imposing harsher lockdown measures.)
Unsurprisingly, the top six POIs on the day after Thanksgiving were shopping centers and malls. It is worth noting that during that time churches were barred from any indoor gatherings.
For any readers who may think all of this data tracking is fine, especially so of the churchgoers, since they were breaking the law, you may want to take a breath here. Because surveillance is never limited to the people you disagree with.
According to a Vice exposé, SafeGraph also sold mobility data of people visiting abortion clinics, including more than 600 Planned Parenthood locations. The data showed “where groups of people visiting the locations came from, how long they stayed there, and where they then went afterwards.”
The CDC, along with a number of municipalities and researchers also track mobility data for epidemiological and other purposes. How these data are being used in every instance is unknown. The Santa Clara lawsuit, however, gives a rare window into a particularly egregious example of an American municipal government monitoring the whereabouts of its own people without their knowledge.
* * *
TO WHAT END?
Daniel Ho’s analysis of the SafeGraph data — for which the county paid him $800 per hour — appears to be correct. When I spoke with Pastor Mike McClure he confirmed that Calvary’s attendance exploded during the pandemic, roughly matching the numbers from Ho’s report. At a certain point Calvary began holding two Sunday services, with close to a thousand attendees in each. McClure also said that prior to 2020, he performed fifty to 100 baptisms a year. During the pandemic, and continuing now, he has averaged 1,000 each year. The church wasn’t just attended by its own members, but also by hundreds of people, like Bryan Wells, who weren’t members but came because it was the only spiritual place open.
The Calvary attendees I spoke with were not firebrands and provocateurs. They were not demanding on March 17, 2020 that barbershops be allowed to give haircuts. McClure told me the church membership runs the gamut from blue collar workers, to doctors and lawyers, construction contractors, and grocery store cashiers. These are everyday people who, after months of being denied what they felt they needed to thrive — and for some, to survive — were pushed to act, even though it was against the rules decreed by a county official.
None of the people I interviewed thought Covid was a hoax, or that the vaccine was a conspiracy by Bill Gates, or any other nonsense that has so often been ascribed to anyone who didn’t want to follow every Covid rule without questions. They just had a different risk benefit calculation than those made by the authorities, and after some time they felt backed into a corner to the point where they could no longer comply.
“We are law-abiding people,” Katie Truman told me. “And it was hard to think that people would think we didn’t care about them and that we were being defiant and disrespectful of them.” She said she couldn’t understand how banning the indoor gathering at the church made sense when casinos were open.
Each of the congregants I spoke with mentioned that while they were not dismissive of the harms of Covid, they were in church week after week, with hundreds, or more than a thousand other people, and there was nothing noticeable happening. In Calvary’s declarations they point out that there is no evidence that church attendees had a higher rate of Covid infections than the community at large.
In 2006, D.A. Henderson, a doctor who led the program to eradicate smallpox, and who was considered, before his death in 2016, perhaps the world’s most celebrated epidemiologist, wrote the following: “Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted.”
Ironically, the SafeGraph data confirms the failure of Santa Clara’s public health orders. Government-imposed interventions only work to the extent that people are willing to follow them. One must question whether official rules are effective or reasonable when they compel a large number of good people to become criminals. The authorities said it would be two weeks, and didn’t adequately check in with the public to ask, “Hey, is it cool if we continue with this?”
In February 2021, the US Supreme Court struck down California’s ban on gathering in churches. As a result, Santa Clara has dropped its complaint against Calvary for gathering violations, and instead is only suing for masking violations. As is well-accepted now by nearly all public health officials, there is no evidence that cloth masks — the only kind that were mandated — have any meaningful benefit at the population level. Currently, the county is seeking $2.78 million, and a decision is expected this spring.
* * *
Producing an investigative feature of this depth and complexity requires extensive research, cultivating sources, interviews, writing, editing, and fact checking. I made this piece free for anyone to read because I believe it’s important for it to reach the widest audience possible. You’re not going to find this reporting in legacy media outlets.
WASHINGTON, DC – MARCH 9: CDC Director Rochelle Walensky speaks during a news conference at HHS headquarters March 9, 2023 in Washington, DC. Secretary of the Department of Health and Human Services Xavier Becerra and other agency heads discussed President Joe Biden’s fiscal year 2024 budget request for the Department of Health and Human Services. (Photo by Drew Angerer/Getty Images)
Now they’re claiming we can’t trust the Vaers database they themselves set up.
U.S. health authorities have responded to the warning from Florida’s surgeon general about a spike in reports of adverse events following COVID-19 vaccination.
Drs. Rochelle Walensky and Robert Califf claimed in the response that Dr. Joseph Ladapo, the surgeon general, was misleading the public by focusing on the increase in adverse events reported to the Vaccine Adverse Event Reporting System (VAERS).
“The claim that the increase of VAERS reports of life-threatening conditions reported from Florida and elsewhere represents an increase of risk caused by the COVID-19 vaccines is incorrect, misleading, and could be harmful to the American public,” Walensky and Califf said in the missive.
The COVID-19 vaccines were given emergency authorization in late 2020. Under the emergency authorizations, vaccine companies and healthcare workers are required to report certain adverse events through VAERS, “so more reports should be expected,” Walensky and Califf said.
“Most reports do not represent adverse events caused by the vaccine and instead represent a preexisting condition that preceded vaccination or an underlying medical condition that precipitated the event,” they said.
They did not cite any studies or other research to support the claim.
While anyone can lodge reports with the system, authorities request medical records and other documentation in an effort to verify reports of certain events. Out of 1,826 reports of heart inflammation after Pfizer or Moderna vaccination in adults through May 26, 2022, for instance, the CDC verified 72 percent.
The CDC also identified hundreds of safety signals for the Moderna and Pfizer COVID-19 vaccines through analyzing VAERS data in 2022, according to records obtained by The Epoch Times. A safety signal is a possible sign of a side effect. Only a handful of adverse events are definitely caused by the vaccines, according to the CDC, including myocarditis, or heart inflammation, and severe allergic shock.
Ladapo said in February that in Florida, the number of reports to VAERS after the COVID-19 vaccines were authorized spiked by 1,700 percent, while the increase in vaccine administration rose by just 400 percent.
“We have never seen this type of response following previous mass vaccination efforts pushed by the federal government,” Ladapo said in a letter to Walensky and Califf.
“These findings are unlikely to be related to changes in reporting given their magnitude, and more likely reflect a pattern of increased risk from mRNA COVID-19 vaccines,” he added, calling for “unbiased research … to better understand these vaccines’ short- and long-term effects.” The Pfizer and Moderna vaccines both use messenger RNA (mRNA) technology.
Florida officials pointed to a study that found in the original clinical trials that the vaccinated were more at risk of serious adverse events, as well as otherpapers that found an increased risk of adverse events after COVID-19 vaccination.
Florida currently recommends against COVID-19 vaccination for young, healthy males who have been shown to be at the highest risk of myocarditis. Vaccinating the population “doesn’t make any sense” from a risk-benefit standpoint, Ladapo, appointed by Republican Florida Gov. Ron DeSantis, told The Epoch Times. The heart inflammation causes serious problems and can even lead to death in some cases.
Food and Drug Administration (FDA) Commissioner Robert Califf testifies during a Senate Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Subcommittee hearing on Capitol Hill in Washington on April 28, 2022. (Kevin Dietsch/Getty Images)
Officials Differ
Walensky and Califf, both appointed by Democrat President Joe Biden, told Ladapo that their reference information supports vaccinating virtually all people aged 6 months and older with not only a primary series of the COVID-19 vaccine, but boosters.
“Based on available information for the COVID-19 vaccines that are authorized or approved in the United States, the known and potential benefits of these vaccines clearly outweigh their known and potential risks,” they said. “Multiple well conducted, peer-reviewed, published studies and demonstrate that the risk of death, serious illness and hospitalization is higher for unvaccinated individuals for every age group.”
The officials cited studies from the CDC, including papers published by the agency’s quasi journal. According to the CDC, some papers published by the journal aren’t peer reviewed. All of the studies are shaped by agency officials to align with its messaging, which during the pandemic has been aggressively pro-vaccination, even as awareness of confirmed and possible side effects has grown.
The messaging was on display in the letter.
“As the leading public health official in state, you are likely aware that seniors in Florida are under-vaccinated, with just 29% of seniors having received an updated bivalent vaccine, compared to the national average of 41% coverage in seniors,” Walensky and Califf said. “It is the job of public health officials around the country to protect the lives of the populations they serve, particularly the vulnerable. Fueling vaccine hesitancy undermines this effort.”
The officials said that they “stand firmly behind the safety and effectiveness of the mRNA COVID-19 vaccines, which are fully supported by the available scientific data.”
“Staying up to date on vaccination is the best way to reduce the risks of death and serious illness or hospitalization from COVID-19. Misleading people by overstating the risks, or emphasizing the risks without acknowledging the overwhelming benefits, unnecessarily causes vaccine hesitation and puts people at risk of death or serious illness that could have been prevented by timely vaccination,” the officials continued.
The letter came after the CDC’s recent risk-benefit assessment of the new, updated boosters was criticized by independent medical professionals for downplaying risks and exaggerating benefits.
Florida Surgeon General Dr. Joseph Ladapo. (York Du/The Epoch Times)
Reaction
Walensky’s and Califf’s response to Ladapo featured citations to flawed studies, Dr. Harvey Risch, professor emeritus of epidemiology at the Yale School of Public Health, told The Epoch Times via email, “The CDC routinely conducts cross-sectional studies and inappropriately analyzes them as if they were case-control studies, which substantially overestimates their reported vaccine efficacy measures.
“In this letter, these doctors cherry pick studies and ignore, for example, reliable Public Health UK data showing the exact opposite of what they claim,” Risch said.
“As much as they claim that the VAERS data are not quantitatively useful, these data indeed show a major COVID-19 vaccine rollout-period mortality signal that cannot be ignored or handwaved away by the lack of a population reference. These agencies continuously proclaim their data monitoring of several other information sources, yet they have not been transparent with these data,” he added.
Risch noted that insurance data shows a jump in COVID-19 deaths after the vaccines were authorized and that, according to a recent survey, many Americans know of at least one person who has suffered an adverse event after vaccination.
“FDA and CDC have lost credibility with much of the American public, and accusing Dr. Ladapo of misinformation when they themselves are the official purveyor of misinformation is unconscionable,” Risch said.
Nikki Whiting, a spokeswoman for Ladapo, said that the surgeon general would be sending a response letter to the officials.
“The response from the federal government is just another redundant display of the same apathetic talking point of ‘safe and effective.’ Googling their fact sheets would have achieved the same result,” she told The Epoch Times in an email.
“While the Feds gaslight the American public, Florida pushes for the truth. Three inquiries remain unanswered: 1. Access to raw patient-level data to allow for unbiased research. 2. Adequate attention surrounding the risks detected by numerous researchers around the world. 3. Public transparency from the CDC, FDA, and Big Pharma.”
Mandatory Face mask law and by-law for wearing masks and facial coverings as a regulation for public safety as a medical or hospital legal issues with 3D illustration elements.
Dishonesty from the nation’s leading public health agency.
It’s no secret by now that the CDC is not a particularly trustworthy or competent organization.
Their documented failures on virtually every aspect of pandemic policy have been consistent and discrediting.
Recently the current director, Rochelle Walensky, once again misled the public on the efficacy of masking, completely disregarding a gold standard evidence review that concluded that they don’t work.
Unmasked
CDC Director Rochelle Walensky Misleads on Masks Yet Again
The position of CDC director continues to be one of the most dangerously misleading in the field of public health. Robert Redfield became notorious for his nonsensical over-reliance on masking early on in the pandemic. He first claimed that the pandemic could essentially be ended in just a matter of weeks if everyone wore masks…
The CDC has continually published low quality studies throughout the pandemic, providing cover for media outlets and politicians to continue mandating or promoting masks.
Unmasked
The CDC’s Latest Study on Masks is Purposeful Misinformation
“Misinformation” is one of the most overused terms in our modern world. Instead of referring to information that is purposefully misleading, it’s now become an easy shorthand term for major media outlets when referring to information they don’t like…
Read more
It is simply inexcusable that they would deliberately mislead the public on safety signals, yet according to newly released emails, that seems to be exactly what they did.
Post-vaccination myocarditis has become a well-known concern for adolescents, especially young men. But in the early days of mass vaccination, as the CDC increasingly recommended younger and younger age groups get vaccinated, they were pushing forward without fully acknowledging the risks.
Yep, they’ve done it again. Who, you ask? You know…THEY…high impact medical journals, compromised researchers, Big Pharma, Big Tech, the alphabet health agencies. They are the THEY of why so many people throughout the world died needlessly from COVID-19.
THEY wanted money. THEY wanted power. THEY wanted control. So THEY put in the fix—on YOUR health and YOUR medical freedom.
The latest installment in this feculent, unseemly true crime series comes from JAMA—the once venerated Journal of the American Medical Association. Take a look at the ivermectin study they just dropped. In it, the “authors” conclude that, “These findings do not support the use of ivermectin among outpatients with COVID-19.”
While we have grown sufficient scar tissue to fortify us against repeated shock from these all-to-frequent assaults on science, we are not so acclimatized as to ignore that which threatens the lives of every person on the planet. The molestation and the resultant annihilation of scientific integrity dooms the health of one and all.
Here’s the bottom line on JAMA’s latest “research blitzkrieg” from our Dr. Kory:
“Suddenly in the middle of the trial they changed the protocol. They moved the outcome from the difference [in symptoms] on Day 14 to Day 28. Why? Well, it begins with the Posterior “P”, a statistical term that means results are significant if they are above .95. During the course of this study, ivermectin was showing statistical significance at Day 7 (.97), and at Day 14 (.98). You had to go out to Day 28 for there to be NO statistical significance. And that’s what the investigators did. They moved the endpoint to Day 28. Four weeks after symptoms first showed up.
“The trial was also purportedly studying mild-to-moderate COVID-19 patients. Literally 60% of patients had no symptoms or mild symptoms. By ‘pure randomized chance’, more of the severe patients landed in the ivermectin arm. So, as Dr. Paul Marik observed, those in the placebo arm must have been “severely asymptomatic.”
So now, we have pages and pages of Google search results trumpeting to the world that ivermectin is not effective for COVID-19—when in fact, the exact opposite is true. Rigorous science, conducted with the utmost integrity proves such…in nearly 100 randomized controlled trials. THOSE trials do NOT show up in Google searches. That’s because Google is in a big comfy bed with the rest of the THEY.
THIS IS THE LIFE-LIMITING EFFECT OF SEVERELY COMPROMISED RESEARCH. IT BECOMES WIDELY SHARED AROUND THE WORLD WITH NO REGARD FOR THE INTEGRITY (OR LACK THEREOF) OF THE “STUDY.” THIS BLINDS THE PUBLIC TO THE WAYS PEOPLE CAN SAVE THEMSELVES, AND INSTEAD CONDITIONS THEM TO BELIEVE THAT “THEY” KNOW WHAT’S BEST. THEY DO NOT. REAL, UNCOMPROMISED, RIGOROUS SCIENCE DOES.
By the way, you can watch Dr. Kory’s breakdown of JAMA’s latest entry into the “research blitzkrieg sweepstakes” in the opening segment of our FLCCC Weekly Webinar HERE.
EDITOR’S NOTE: I wonder how on earth THEY can sleep at night. You see, I know (and you probably do too) that the physicians of the FLCCC—led by Drs. Marik and Kory—are arguably among the world’s most brilliant and accomplished medical scholars. There is robust evidence of the hundreds of thousands (likely millions) of lives they have saved since March, 2020—all while they were made to walk through a relentless, punishing storm so merciless that it has no name fit to describe its madness.
Long ago, many of us — myself included — had to stop trying to tell family and friends what we know about how they can save themselves when armed with pristine science. They don’t want to hear it—yet. They remain deeply hypnotized in a way—frozen in the trance of the official narrative. But we sense a change in wind direction—it is now breezing at our back as more and more evidence is revealed about the unspeakable crimes the “THEY” committed against science and humanity.
I look forward to writing the following headline in a future edition of the FLCCC Weekly News Capsule: “FLCCC Physicians Awarded the Nobel Prize in Medicine for Developing the Most Efficacious Protocols Against COVID-19 Using Repurposed Drugs, Saving Untold Lives.” May it come to pass. — JK
On Wednesday’s FLCCC Weekly Webinar, host Betsy Ashton was joined by our Drs. Paul Marik and Pierre Kory for a review of their recent travels. Dr. Kory traveled to Sweden and Australia for a whirlwind speaking tour while Dr. Marik was in Florida and Connecticut. The doctors also highlighted the brilliant work of other warriors they encountered in the fight for scientific integrity and medical freedom. A not-to-be-missed episode!
Our Substack columnist Jenna McCarthy has taken to her computer keyboard once again. This time, she’s created a list of questions for us to consider should…uh…the unthinkable happen again. (Like another pandemic! Yeesh!)
Some of us — you might know us as anti-vaxxers, conspiracy theorists, science deniers, or granny killers — found the whole setup sketchy from the get-go. But as injuries and unanswered questions mount, our ranks are growing by the day, thanks in part to folks like surf legend Kelly Slater and Congresswoman Nancy Mace speaking out about their personal experiences with vaccine injuries and loss.
Since COVID won’t be our last pandemic (Bill Gates said so!), here are a few questions we all might want to ponder before the next wave hits…”
We love every question she’s proposed. But our favorite has to be this one:
“Are people being threatened, coerced, or bribed with everything from pizza to pot (You missed the Joints for Jabs campaign?) to sign up for a supposedly safe, life-saving treatment?”
You go, girl!
“Berberine and Pancreatic Beta Cells” is the third in the series of lectures on this magical herb from our own Dr. Been. “Berberine has many important mechanisms, explains Dr. Been. “In the current series of talks we are presenting the mechanisms related to the management of Type 2 diabetes mellitus. In the current talk we look at the high level mechanism of how berberine helps increase the insulin secretion.”
This entire series provides you with a deep dive on one of the most effective natural remedies that we’ve added to our protocols!
NOTE: After listening to a talk at the Brownstone Institute over the weekend by our own Dr. Paul Marik who was discussing repurposed drugs — including berberine — Dr. Robert Malone wrote an in-depth Substack about this incredible Chinese herb!
When COVID hit in Oct 2021, this gentleman was so thankful the FLCCC advice was out there for thinking minds who want to discern information and form practical conclusions. Watch his story now.
💊 This week, the Federalist published an article on the lawsuit brought by three physicians (including our Dr. Paul Marik) against the FDA for prohibiting the use of ivermectin for COVID-19. Our Dr. Pierre Kory was interviewed for the piece:
“Repurposed drugs are the Achilles heel of the entire business model of the pharmaceutical industry,” Kory said. “And when you see our health agencies literally working in the service of the pharmaceutical industry by destroying the credibility of repurposed drugs, it’s terrifying. They’re not working according to the interests of patients or physicians but the pharmaceutical companies.”
💊 Our own Dr. Paul Marik recently gave an exclusive interview to The Ohio Press Network. Read “Are Turbo-Charged Cancers Being Driven by COVID-19 Shots and Boosters?” HERE.
From the article:
Cancer as a side effect of COVID-19 shots “has not been well studied,” says Marik because “the powers that be” don’t recognize the cancer-COVID-19 shot connection, and major medical institutions therefore refuse to study it. The increased incidence of cancer could be related to increased levels of IgG4 induced by multiple shots, he says, but adds that it may also involve a change in gene expression; certain tumor-suppressor genes, when expressed properly, keep cancer in check. One example is the tumor-suppressor gene known as P53, which some scientists speculate might be turned off by injected mRNA.
💊 A Parent’s Guide to Prevention and Early COVID Treatment for Children
Most children with COVID-19 handle the virus well and recover fully. Despite a lot of fear-mongering, COVID is not a deadly disease for most children. In fact, data show that the death rate is extremely low in patients under 17 years old. The FLCCC has developed a guide which aims to help you understand the real risks and know how to respond. The best thing you can do is focus on making sure your child is healthy overall and that their immune system is strong and robust.
According to Ohio Advocates for Medical Freedom (OAMF), the bill received 1,500 proponent testimonies supporting the bill and a fairly insignificant number of letters opposing the legislation. No similar legislation anywhere else in the United States has ever been as successful in the legislative process as HB248.
Always check with your healthcare provider before taking medications and supplements! Enjoy!
Nearly three years after the Covid-19 pandemic shut down much of the world, we still don’t know how it started.
But the Department of Energy is ready to submit its best guess. In a new report based on fresh intelligence, the agency has concluded that Covid-19 most likely spread to humans as a result of a mistake at a Chinese laboratory (aka the “lab leak” theory), the WSJ reports.
Important note: In making this determination, the Energy Dept. is about as self-assured as any Michael Cera character—it reportedly has “low confidence” that this theory is correct.
Also, why would the Energy Dept. have information about a pandemic’s origins? Little-known fact: The Energy Dept. oversees a network of 17 national laboratories, and some of those labs do advanced bioresearch. The agency frequently leverages this lab network to gather information, rather than relying on typical intelligence operations, according to the NYT.
But there’s still no consensus
In endorsing the lab leak theory, the Energy Dept. joins the FBI, which has concluded with “moderate confidence” that Covid originated accidentally from a Chinese lab: the Wuhan Institute of Virology. The two agencies reportedly arrived at this conclusion via different methods.
However, four other US agencies and the National Intelligence Council have concluded that Covid originated through natural transmission from an infected animal. But they, too, have low confidence their conclusions are correct.
One piece of evidence that’s missing from the natural transmission theory? The animal that hypothetically did the infecting hasn’t been identified. Given all this uncertainty, two other US agencies haven’t reached a conclusion on Covid’s beginnings yet.
So, if you’re doing the math at home: Four US agencies believe it was natural transmission, two say lab leak, and two are undecided.
Zoom out: Scientists say it’s important to make every effort to learn how Covid-19, a pandemic that’s caused nearly 7 million deaths globally, began, so we can better prevent the next one.
But with the Chinese government (Joe and Hunter’s best buds) thwarting investigations by global authorities, there may only be so much information the US can gather. And it might never be able to confidently answer the question: How did Covid begin? Edited.
I’ve decided to post the entire interview from Dr. Demasi’s substack Also our lurker loons seem to be confused about what’s a fact and what’s Progressive gobly gook. Before I forget, the Study Doctor Jefferson’s group of doctors and scientists did was peer reviewed. Recently one of the lurker posted what it called a fact. A assistant worker at a hospital as a rebuttal to the report. One low level person. Well again this loon went after the report.
It’s source was Michael Hiltzik. What doctor or scientist is Mr. Hiltzik? He’s not one. I’ve been in contact with him since 2004. He’s a business writer for the LA Times. Yes a business writer. And a very good one at that. Not a medical writer. So if you wish to read his articles, you’ll find him in the business section not medical.
Tom Jefferson, senior associate tutor at the University of Oxford, is the lead author of a recent Cochrane review that has ‘gone viral’ on social media and re-ignited one of the most divisive debates during the pandemic – face masks.
The updated review titled “Physical interventions to interrupt or reduce the spread of acute respiratory viruses” found that wearing masks in the community probably makes little or no difference to influenza-like or covid-19-like illness transmission.
This comes off the back of three years of governments mandating the use of face masks in the community, schools and hospital settings. Just last month, the WHO upgraded its guidelines advising “anyone in a crowded, enclosed, or poorly ventilated space” to wear a mask.
Jefferson and his colleagues also looked at the evidence for social distancing, hand washing, and sanitising/sterilising surfaces — in total, 78 randomised trials with over 610,000 participants.
Jefferson doesn’t grant many interviews with journalists — he doesn’t trust the media. But since we worked together at Cochrane a few years ago, he decided to let his guard down with me.
During our conversation, Jefferson didn’t hold back. He condemned the pandemic’s “overnight experts”, he criticised the multitude of scientifically baseless health policies, and even opened up about his disappointment in Cochrane’s handling of the review.
The Interview
DEMASI: This Cochrane review has caused quite a stir on social media and inflamed the great mask debate. What are your thoughts?
JEFFERSON: Well, it’s an update from our November 2020 review and the evidence really didn’t change from 2020 to 2023. There’s still no evidence that masks are effective during a pandemic.
DEMASI: And yet, most governments around the world implemented mask mandates during the pandemic…
JEFFERSON: Yes, well, governments completely failed to do the right thing and demand better evidence. At the beginning of the pandemic, there were some voices who said masks did not work and then suddenly the narrative changed.
DEMASI: That is true, Fauci went on 60 minutes and said that masks are not necessary and then weeks later he changed his tune.
JEFFERSON: Same with New Zealand’s Chief Medical Officer. One minute he is saying masks don’t work, and the next minute, he flipped.
DEMASI: Why do you think that happened?
JEFFERSON: Governments had bad advisors from the very beginning… They were convinced by non-randomised studies, flawed observational studies. A lot of it had to do with appearing as if they were “doing something.”
In early 2020, when the pandemic was ramping up, we had just updated our Cochrane review ready to publish…but Cochrane held it up for 7 months before it was finally published in November 2020.
Those 7 months were crucial. During that time, it was when policy about masks was being formed. Our review was important, and it should have been out there.
DEMASI: What was the delay?
JEFFERSON: For some unknown reason, Cochrane decided it needed an “extra” peer-review. And then they forced us to insert unnecessary text phrases in the review like “this review doesn’t contain any covid-19 trials,” when it was obvious to anyone reading the study that the cut-off date was January 2020.
DEMASI: Do you think Cochrane intentionally delayed that 2020 review?
JEFFERSON: During those 7 months, other researchers at Cochrane produced some unacceptable pieces of work, using unacceptable studies, that gave the “right answer”.
DEMASI: What do you mean by “the right answer”? Are you suggesting that Cochrane was pro-mask, and that your review contradicted the narrative. Is that your intuition?
JEFFERSON: Yes, I think that is what was going on. After the 7-month delay, Cochrane then published an editorial to accompany our review. The main message of that editorial was that you can’t sit on your hands, you’ve got to do something, you can’t wait for good evidence…. it’s a complete subversion of the ‘precautionary principle’ which states that you should do nothing unless you have reasonable evidence that benefits outweigh the harms.
DEMASI: Why would Cochrane do that?
JEFFERSON: I think the purpose of the editorial was to undermine our work.
DEMASI:Do you think Cochrane was playing a political game?
JEFFERSON: That I cannot say, but it was 7 months that just happened to coincide with the time when all the craziness began, when academics and politicians started jumping up and down about masks. We call them “strident campaigners”. They are activists, not scientists.
DEMASI: That’s interesting.
JEFFERSON: Well, no. It’s depressing.
DEMASI: So, the 2023 updated review now includes a couple of new covid-19 studies….the Danish mask study….and the Bangladesh study. In fact, there was a lot of discussion about the Bangladesh mask study which claimed to show some benefit….
JEFFERSON: That was not a very good study because it was not a study about whether masks worked, it was a study about increasing compliance for wearing a mask.
DEMASI: Right, I remember there was a reanalysis of the Bangladesh study showing it had significant bias….you’ve worked in this area for decades, you’re an expert…
JEFFERSON [interjects]… please do not call me an expert. I’m a guy who has worked in the field for some time. That has to be the message. I don’t work with models, I don’t make predictions. I don’t hassle people or chase them on social media. I don’t call them names… I’m a scientist. I work with data.
David Sackett, the founder of Evidence Based Medicine, once wrote a very famous article for The BMJ saying that ‘experts’ are part of the problem. You just have to look at the so-called ‘experts’ that have been advising government.
DEMASI: There were so many silly mask policies. They expected 2yr olds to wear masks, and you had to wear a mask to walk into a restaurant, but you could take it off as soon as you sat down.
JEFFERSON: Yes, also the 2- meter rule. Based on what? Nothing.
DEMASI: Did you wear a mask?
JEFFERSON: I follow the law. If the law says I need to wear one, then I wear one because I have to. I do not break the law. I obey the law of the country.
DEMASI: Yeah, same. What would you say to people who still want to wear a mask?
JEFFERSON: I think it’s fair to say that if you want to wear a mask then you should have a choice, okay. But in the absence of evidence, you shouldn’t be forcing anybody to do so.
DEMASI: But people say, I’m not wearing a mask for me, I’m wearing it for you.
JEFFERSON: I have never understood that difference. Have you?
DEMASI: They say it’s not to protect themselves, but to protect others, an act of altruism.
JEFFERSON: Ah yes. Wonderful. They get the Albert Schweitzer prize for Humanitarianism. Here’s what I think. Your overnight experts know nothing.
DEMASI (laughs)
JEFFERSON: There is just no evidence that they make any difference. Full stop. My job, our job as a review team, was to look at the evidence, we have done that. Not just for masks. We looked at hand washing, sterilisation, goggles etcetera…
DEMASI: What’s the best evidence for avoiding infection?
JEFFERSON: I think your best shot is sanitation/sterilisation with antiseptic products. We’ve known for about 40 to 50 years that the inside of toilets, handles, seats for example, you recover a very high concentration of replication competent virus, it doesn’t matter what viruses they are. This argues for a contact / fomite mode of transmission.
Also, hand washing shows some benefit, especially in small children. The problem with that is, unless you make the population completely psychotic, they will not comply.
DEMASI: May I just ask a finer point on masks… it’s not that masks don’t work, it’s just that there is no evidence they do work…is that right?
JEFFERSON: There’s no evidence that they do work, that’s right. It’s possible they could work in some settings….we’d know if we’d done trials. All you needed was for Tedros [from WHO] to declare it’s a pandemic and they could have randomised half of the United Kingdom, or half of Italy, to masks and the other half to no masks. But they didn’t. Instead, they ran around like headless chickens.
DEMASI: I’ve worked as a political advisor, so I know that Governments don’t like to appear “uncertain,” they like to act as if they are in control of the situation….
JEFFERSON: Well, there’s always uncertainty. Masking became a “visible” political gesture, which is a point we make over and over again now. Washing hands and sanitation and vaccination are not overtly visible, but wearing a mask is.
DEMASI: Your review also showed that n95 masks for healthcare workers did not make much difference.
JEFFERSON: That’s right, it makes no difference – none of it.
DEMASI: Intuitively it makes sense to people though…. you put a barrier between you and the other person, and it helps reduce your risk?
JEFFERSON: Ahhhh the Swiss cheese argument…..
DEMASI: Well, the ‘Swiss cheese’ model was one of the most influential explanations for why people should layer their protection. Another barrier, another layer of protection? You don’t like the Swiss cheese model?
JEFFERSON: I like Swiss cheese to eat — the model not so much …It’s predicated on us knowing exactly how these respiratory viruses transmit, and that, I can tell you, we don’t know. There isn’t a single mode of transmission, it is probably mixed.
The idea that the covid virus is transmitted via aerosols has been repeated over and over as if its “truth” but the evidence is as thin as air. It’s complex and all journalists want 40 years of experience condensed into two sentences. You can quote the Swiss cheese model, but there’s no evidence that many of these things make any difference.
DEMASI: Why? How can that be?
JEFFERSON: It’s probably related to the way that people behave, it could be the way viruses are transmitted or their port of entry, people don’t wear masks correctly….no-one really knows for sure. I keep saying it repeatedly, it needs to be looked at by doing a huge, randomised study – masks haven’t been given a proper trial. They should have been done, but they were not done. Instead, we have overnight experts perpetuating a ‘fear-demic.’
DEMASI: I’ve heard people say it would be unethical to do a study and randomise half of a group to masks and the other half to no masks….do you agree?
JEFFERSON: No, because we don’t know what effect masks will have. If we don’t know what impact they have, how can it be unethical? Strident fanatics have managed to poison this whole discussion and try and make it into a black and white thing…and rely on terribly flawed studies.
DEMASI: Thanks for the chat with me today.
JEFFERSON: You’re welcome, Maryanne.
Note: This interview was edited for clarity and brevity. Jefferson is co-author of Trust The Evidence
Side effects include a multitude of things the shot should NOT be doing.
Hits: 20
When a COVID infection wave hit the most and least vaccinated states in 2022, the most vaccinated state had the higher COVID case rates and the higher relative death peaks.
So just for fun, I thought I’d see how these states fared when there was a huge COVID infection outbreak at the start of 2022 that affected both these states.
It turned out that the least vaccinated state had the lower rise in all-cause mortality (1.25 vs. 1.42) vs. avg mortality for the year.
In other words, vaccination appeared to increase all-cause mortality when COVID hit.
However, it might be the case that Rhode Island simply was “hit harder” by the COVID wave with twice as many COVID infections per capita. Or was Rhode Island hit harder because more people were vaccinated and thus more susceptible to infection which is what the Cleveland Clinic study showed very clearly?
By looking at a younger age group, we see a 3X disparity between the two states. The least vaccinated state came out on top.
We have further, and more conclusive, confirmation from an extensive study done by Josh Stirling. There is simply no way for anyone to explain those results which looked at every county in the US.
34% increase in Covid deaths in most vaxxed states vs least vaxxed. In yet ANOTHER study. How many reports have to be published before the truth can no longer be shouted down?
The bottom line: higher vaccination —> higher deaths for all age groups. That’s why 15-year-olds with heart attacks are now the new normal when they were non-existent before the vaccines rolled out.
Methodology
COVID waves are when the CDC would expect the most vaccinated states to do the best compared to the average death rate for the year. So we’d expect a smaller rise in deaths during a COVID infection wave compared to the deaths over the year.
The biggest COVID death peak is at the start of 2022.
So the method is pretty simple: compare the worst four weeks at the start of 2022 with the average death rate for the year in that state. The winner should have the lowest ratio.
Let’s try the next age group down which is 45-64 over the same “deadly” period.
Weeks 1-4 avg for Wyoming=(24+23+22+16)/4=21.25 Average for 2022=19.25 Ratio: 21.25/19.25= 1.1
Weeks 1-4 avg for Rhode Island: (50+46+44+31)/4=42.75 Avg for 2022=32.6 Ratio: 42.75/32.6=1.31
Again, Wyoming had the smaller spike among that age group.
A possible explanation for the discrepancy
The only way for a pro-vaxxer to attack this result is to claim that Rhode Island had a COVID infection wave in January 2022, but Wyoming missed the wave.
Let’s check that out…
These are the COVID cases for Rhode Island:
Here are the COVID cases for Wyoming:
Isn’t this interesting? The pre-vax peak is relatively close to the post-vax peak.
So it was a fair test. Both states had their largest COVID peaks in January. So that was fair.
However, you could also argue that Rhode Island was “harder hit” by the COVID wave than Wyoming and that accounts for the greater all-cause mortality.
Let’s see if that is true.
The population is 1.1M in Rhode Island vs 578K in Wyoming, so Rhode Island is 1.9X larger, but they had 4X as many cases!
So for the 65-74-year-old age group, the most vaccinated state did slightly better since it was hit harder than the ratios could account for! But see the next section…
However, when we look at the 45-64 year age group, we have a spike that is 3X higher in Rhode Island. That’s hard to explain since there is only a 2X per capita increase in cases.
Did Rhode Island have more cases because it is more vaccinated?
For some insights into this, look at the ratio between the pre-vax peak in Wyoming vs. the peak around Jan 2022… it’s only about 50% higher. But the pre-vax vs. post-vax peak in Rhode Island is more than 4X higher!!!Did Rhode Island simply get unlucky and have an 8-fold increase (=4/.5) in the relative sizes of the COVID infection peaks?
I looked at the next two states on the list: Alabama (least vaccinated) and Vermont (most vaccinated). I compared the pre-vax and post-vax peaks and found the same ratio! The higher vaxxed state had a greater infection ratio pre- vs. post-vax (2564/248=10.3X) than the less vaxxed state (17106/4221=4.05).
Isn’t that interesting? In short, it appears the more vaccinated the state, the greater the COVID infection rate on a per capita basis.
What’s the right answer here?
Josh Stirling looked at how cities in the US did in 2022 vs. 2021. He did a longitudinal study where you compare the city with itself one year ago. This is the best way to see what is going on… did your mortality increase or decrease?
Check this out: cities with higher vaccination had larger all-cause mortality increases than cities with lower vaccination rates. In other words, the line goes the “wrong way.”
The line goes the “wrong way.”
This is devastating for the narrative, but of course consistent with what the death reports are saying.
The R2 doesn’t need to be .9 for this to be convincing. They are correlated and it’s the slope of the line that is significant. The slope goes the wrong way. That’s the point.
Could someone argue that this could be caused by other factors? Sure.
But this result is consistent with other analyses, such as the Devil’s Advocate global analysis by Martin Neil and Norman Fenton showing a similar effect (though not longitudinal).
And how is anyone going to explain why we can’t seem to find any nursing home where the death rates went DOWN after the vaccine program was rolled out?
For example, I know one nursing home in Melbourne, Australia with around 90 people who had close to 30 deaths within 12 months after the vaccines rolled out. So we know it wasn’t COVID that killed people in such huge numbers since they were all vaccinated. So I wonder how they died? I have a video of their death announcements.
Finally, a large geriatric practice (around 1,000 patients, 75% over 65, had just 4 COVID deaths (vaccinated) and 1 COVID death (unvaxxed). Population was 85% vaxxed. More important was that in 2022, instead of the normal 11 deaths, they had 39 deaths. They attributed the excess to the vaccine. So it would be difficult for anyone to explain that data. But I’m open to hearing it!
[Several charts shown in a previous article have been omitted for space reasons. The original article is HERE:]
Summary
If the vaccine really worked, the state with the lowest vaccination rate should have the highest spike in all-cause mortality during a COVID wave. That wasn’t the case for the 45-64 age group and it’s arguably not true for the 65-74 age group if you believe that the higher cases are due to higher vaccination rates.
Josh Stirling’s analysis of all cities in the US makes it clear that it’s more likely than not that the vaccines have resulted in a net increase in deaths and thus were a very dumb intervention.
Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread. This is an update of a Cochrane Review last published in 2020. We include results from studies from the current COVID‐19 pandemic.
Objectives
To assess the effectiveness of physical interventions to interrupt or reduce the spread of acute respiratory viruses.
Search methods
We searched CENTRAL, PubMed, Embase, CINAHL, and two trials registers in October 2022, with backwards and forwards citation analysis on the new studies.
Selection criteria
We included randomised controlled trials (RCTs) and cluster‐RCTs investigating physical interventions (screening at entry ports, isolation, quarantine, physical distancing, personal protection, hand hygiene, face masks, glasses, and gargling) to prevent respiratory virus transmission.
Data collection and analysis
We used standard Cochrane methodological procedures.
Main results
We included 11 new RCTs and cluster‐RCTs (610,872 participants) in this update, bringing the total number of RCTs to 78. Six of the new trials were conducted during the COVID‐19 pandemic; two from Mexico, and one each from Denmark, Bangladesh, England, and Norway. We identified four ongoing studies, of which one is completed, but unreported, evaluating masks concurrent with the COVID‐19 pandemic.
Many studies were conducted during non‐epidemic influenza periods. Several were conducted during the 2009 H1N1 influenza pandemic, and others in epidemic influenza seasons up to 2016. Therefore, many studies were conducted in the context of lower respiratory viral circulation and transmission compared to COVID‐19. The included studies were conducted in heterogeneous settings, ranging from suburban schools to hospital wards in high‐income countries; crowded inner city settings in low‐income countries; and an immigrant neighbourhood in a high‐income country. Adherence with interventions was low in many studies.
The risk of bias for the RCTs and cluster‐RCTs was mostly high or unclear.
Medical/surgical masks compared to no masks
We included 12 trials (10 cluster‐RCTs) comparing medical/surgical masks versus no masks to prevent the spread of viral respiratory illness (two trials with healthcare workers and 10 in the community). Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate‐certainty evidence. Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks (RR 1.01, 95% CI 0.72 to 1.42; 6 trials, 13,919 participants; moderate‐certainty evidence). Harms were rarely measured and poorly reported (very low‐certainty evidence).
N95/P2 respirators compared to medical/surgical masks
We pooled trials comparing N95/P2 respirators with medical/surgical masks (four in healthcare settings and one in a household setting). We are very uncertain on the effects of N95/P2 respirators compared with medical/surgical masks on the outcome of clinical respiratory illness (RR 0.70, 95% CI 0.45 to 1.10; 3 trials, 7779 participants; very low‐certainty evidence). N95/P2 respirators compared with medical/surgical masks may be effective for ILI (RR 0.82, 95% CI 0.66 to 1.03; 5 trials, 8407 participants; low‐certainty evidence). Evidence is limited by imprecision and heterogeneity for these subjective outcomes. The use of a N95/P2 respirators compared to medical/surgical masks probably makes little or no difference for the objective and more precise outcome of laboratory‐confirmed influenza infection (RR 1.10, 95% CI 0.90 to 1.34; 5 trials, 8407 participants; moderate‐certainty evidence). Restricting pooling to healthcare workers made no difference to the overall findings. Harms were poorly measured and reported, but discomfort wearing medical/surgical masks or N95/P2 respirators was mentioned in several studies (very low‐certainty evidence).
One previously reported ongoing RCT has now been published and observed that medical/surgical masks were non‐inferior to N95 respirators in a large study of 1009 healthcare workers in four countries providing direct care to COVID‐19 patients.
Hand hygiene compared to control
Nineteen trials compared hand hygiene interventions with controls with sufficient data to include in meta‐analyses. Settings included schools, childcare centres and homes. Comparing hand hygiene interventions with controls (i.e. no intervention), there was a 14% relative reduction in the number of people with ARIs in the hand hygiene group (RR 0.86, 95% CI 0.81 to 0.90; 9 trials, 52,105 participants; moderate‐certainty evidence), suggesting a probable benefit. In absolute terms this benefit would result in a reduction from 380 events per 1000 people to 327 per 1000 people (95% CI 308 to 342). When considering the more strictly defined outcomes of ILI and laboratory‐confirmed influenza, the estimates of effect for ILI (RR 0.94, 95% CI 0.81 to 1.09; 11 trials, 34,503 participants; low‐certainty evidence), and laboratory‐confirmed influenza (RR 0.91, 95% CI 0.63 to 1.30; 8 trials, 8332 participants; low‐certainty evidence), suggest the intervention made little or no difference. We pooled 19 trials (71, 210 participants) for the composite outcome of ARI or ILI or influenza, with each study only contributing once and the most comprehensive outcome reported. Pooled data showed that hand hygiene may be beneficial with an 11% relative reduction of respiratory illness (RR 0.89, 95% CI 0.83 to 0.94; low‐certainty evidence), but with high heterogeneity. In absolute terms this benefit would result in a reduction from 200 events per 1000 people to 178 per 1000 people (95% CI 166 to 188). Few trials measured and reported harms (very low‐certainty evidence).
We found no RCTs on gowns and gloves, face shields, or screening at entry ports.
Authors’ conclusions
The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions. There were additional RCTs during the pandemic related to physical interventions but a relative paucity given the importance of the question of masking and its relative effectiveness and the concomitant measures of mask adherence which would be highly relevant to the measurement of effectiveness, especially in the elderly and in young children.
There is uncertainty about the effects of face masks. The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness, and although this effect was also present when ILI and laboratory‐confirmed influenza were analysed separately, it was not found to be a significant difference for the latter two outcomes. Harms associated with physical interventions were under‐investigated.
There is a need for large, well‐designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, as well as the impact of adherence on effectiveness, especially in those most at risk of ARIs.
The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.
Do physical measures such as hand‐washing or wearing masks stop or slow down the spread of respiratory viruses?
Key messages We are uncertain whether wearing masks or N95/P2 respirators helps to slow the spread of respiratory viruses based on the studies we assessed.
Hand hygiene programmes may help to slow the spread of respiratory viruses.
How do respiratory viruses spread? Respiratory viruses are viruses that infect the cells in your airways: nose, throat, and lungs. These infections can cause serious problems and affect normal breathing. They can cause flu (influenza), severe acute respiratory syndrome (SARS), and COVID‐19.
People infected with a respiratory virus spread virus particles into the air when they cough or sneeze. Other people become infected if they come into contact with these virus particles in the air or on surfaces on which they land. Respiratory viruses can spread quickly through a community, through populations and countries (causing epidemics), and around the world (causing pandemics).
Physical measures to try to prevent respiratory viruses spreading between people include:
· washing hands often;
· not touching your eyes, nose, or mouth;
· sneezing or coughing into your elbow;
· wiping surfaces with disinfectant;
· wearing masks, eye protection, gloves, and protective gowns;
· avoiding contact with other people (isolation or quarantine);
· keeping a certain distance away from other people (distancing); and
· examining people entering a country for signs of infection (screening).
What did we want to find out? We wanted to find out whether physical measures stop or slow the spread of respiratory viruses from well‐controlled studies in which one intervention is compared to another, known as randomised controlled trials.
What did we do? We searched for randomised controlled studies that looked at physical measures to stop people acquiring a respiratory virus infection.
We were interested in how many people in the studies caught a respiratory virus infection, and whether the physical measures had any unwanted effects.
What did we find? We identified 78 relevant studies. They took place in low‐, middle‐, and high‐income countries worldwide: in hospitals, schools, homes, offices, childcare centres, and communities during non‐epidemic influenza periods, the global H1N1 influenza pandemic in 2009, epidemic influenza seasons up to 2016, and during the COVID‐19 pandemic. We identified five ongoing, unpublished studies; two of them evaluate masks in COVID‐19. Five trials were funded by government and pharmaceutical companies, and nine trials were funded by pharmaceutical companies.
No studies looked at face shields, gowns and gloves, or screening people when they entered a country.
We assessed the effects of:
· medical or surgical masks;
· N95/P2 respirators (close‐fitting masks that filter the air breathed in, more commonly used by healthcare workers than the general public); and
· hand hygiene (hand‐washing and using hand sanitiser).
We obtained the following results:
Medical or surgical masks
Ten studies took place in the community, and two studies in healthcare workers. Compared with wearing no mask in the community studies only, wearing a mask may make little to no difference in how many people caught a flu‐like illness/COVID‐like illness (9 studies; 276,917 people); and probably makes little or no difference in how many people have flu/COVID confirmed by a laboratory test (6 studies; 13,919 people). Unwanted effects were rarely reported; discomfort was mentioned.
N95/P2 respirators
Four studies were in healthcare workers, and one small study was in the community. Compared with wearing medical or surgical masks, wearing N95/P2 respirators probably makes little to no difference in how many people have confirmed flu (5 studies; 8407 people); and may make little to no difference in how many people catch a flu‐like illness (5 studies; 8407 people), or respiratory illness (3 studies; 7799 people). Unwanted effects were not well‐reported; discomfort was mentioned.
Hand hygiene
Following a hand hygiene programme may reduce the number of people who catch a respiratory or flu‐like illness, or have confirmed flu, compared with people not following such a programme (19 studies; 71,210 people), although this effect was not confirmed as statistically significant reduction when ILI and laboratory‐confirmed ILI were analysed separately. Few studies measured unwanted effects; skin irritation in people using hand sanitiser was mentioned.
What are the limitations of the evidence? Our confidence in these results is generally low to moderate for the subjective outcomes related to respiratory illness, but moderate for the more precisely defined laboratory‐confirmed respiratory virus infection, related to masks and N95/P2 respirators. The results might change when further evidence becomes available. Relatively low numbers of people followed the guidance about wearing masks or about hand hygiene, which may have affected the results of the studies.
How up to date is this evidence? We included evidence published up to October 2022.
Authors’ conclusions
Implications for practice
The evidence summarised in this review on the use of masks is largely based on studies conducted during traditional peak respiratory virus infection seasons up until 2016. Two relevant randomised trials conducted during the COVID‐19 pandemic have been published, but their addition had minimal impact on the overall pooled estimate of effect. The observed lack of effect of mask wearing in interrupting the spread of influenza‐like illness (ILI) or influenza/COVID‐19 in our review has many potential reasons, including: poor study design; insufficiently powered studies arising from low viral circulation in some studies; lower adherence with mask wearing, especially amongst children; quality of the masks used; self‐contamination of the mask by hands; lack of protection from eye exposure from respiratory droplets (allowing a route of entry of respiratory viruses into the nose via the lacrimal duct); saturation of masks with saliva from extended use (promoting virus survival in proteinaceous material); and possible risk compensation behaviour leading to an exaggerated sense of security (Ammann 2022; Brosseau 2020; Byambasuren 2021; Canini 2010; Cassell 2006; Coroiu 2021; MacIntyre 2015; Rengasamy 2010; Zamora 2006).Our findings show that hand hygiene has a modest effect as a physical intervention to interrupt the spread of respiratory viruses, but several questions remain. First, the high heterogeneity between studies may suggest that there are differences in the effect of different interventions. The poor reporting limited our ability to extract the information needed to assess any ‘dose response’ relationship, and there are few head‐to‐head trials comparing hand hygiene materials (such as alcohol‐based sanitiser or soap and water). Second, the sustainability of hand hygiene is unclear where participants in some studies achieved 5 to 10 hand‐washings per day, but adherence may have diminished with time as motivation decreased, or due to adverse effects from frequent hand‐washing. Third, there is little evidence about the effectiveness of combinations of hand hygiene with other interventions, and how those are best introduced and sustained. Finally, some interventions were intensively implemented within small organisations, and involved education or training as a component, and the ability to scale these up to broader interventions is unclear.
Our findings with respect to hand hygiene should be considered generally relevant to all viral respiratory infections, given the diverse populations where transmission of viral respiratory infections occurs. The participants were adults, children and families, and multiple congregation settings including schools, childcare centres, homes, and offices. Most respiratory viruses, including the pandemic SARS‐CoV‐2, are considered to be predominantly spread via respiratory particles of varying size or contact routes, or both (WHO 2020c). Data from studies of SARS‐CoV‐2 contamination of the environment based on the presence of viral ribonucleic acid and infectious virus suggest significant fomite contamination (Lin 2022; Onakpoya 2022b; Ong 2020; Wu 2020). Hand hygiene would be expected to be beneficial in reducing the spread of SARS‐CoV‐2 similar to other beta coronaviruses (SARS‐CoV‐1, Middle East respiratory syndrome (MERS), and human coronaviruses), which are very susceptible to the concentrations of alcohol commonly found in most hand‐sanitiser preparations (Rabenau 2005; WHO 2020c). Support for this effect is the finding that poor hand hygiene, despite the use of full personal protective equipment (PPE), was independently associated with an increased risk of SARS‐CoV‐2 transmission to healthcare workers in a retrospective cohort study in Wuhan, China in both a high‐risk and low‐risk clinical unit for patients infected with COVID‐19 (Ran 2020). The practice of hand hygiene appears to have a consistent effect in all settings, and should be an essential component of other interventions.
The highest‐quality cluster‐RCTs indicate that the most effect on preventing respiratory virus spread from hygienic measures occurs in younger children. This may be because younger children are least capable of hygienic behaviour themselves (Roberts 2000), and have longer‐lived infections and greater social contact, thereby acting as portals of infection into the household (Monto 1969). Additional benefit from reduced transmission from them to other members of the household is broadly supported by the results of other study designs where the potential for confounding is greater.
Routine long‐term implementation of some of the interventions covered in this review may be problematic, particularly maintaining strict hygiene and barrier routines for long periods of time. This would probably only be feasible in highly motivated environments, such as hospitals. Many of the trial authors commented on the major logistical burdens that barrier routines imposed at the community level. However, the threat of a looming epidemic may provide stimulus for their inception.
Implications for research
Public health measures and physical interventions can be highly effective to interrupt the spread of respiratory viral infections, especially when they are part of a structured and co‐ordinated programme that includes instruction and education, and when they are delivered together and with high adherence. Our review has provided important insights into research gaps that need to be addressed with respect to these physical interventions and their implementation and have been brought into a sharper focus as a result of the COVID‐19 pandemic. The 2014 WHO document ‘Infection prevention and control of epidemic ‐ and pandemic‐prone acute respiratory infections in health care’ identified several research gaps as part of their GRADE assessment of their infection prevention and control recommendations, which remain very relevant (WHO 2014). Research gaps identified during the course of our review and the WHO 2014 document may be considered from the perspective of both general and specific themes.A general theme identified was the need to provide outcomes with explicitly defined clinical criteria for acute respiratory infections (ARIs) and discrete laboratory‐confirmed outcomes of viral ARIs using molecular diagnostic tools which are now widely available. Our review found large disparities between studies with respect to the clinical outcome events, which were imprecisely defined in several studies, and there were differences in the extent to which laboratory‐confirmed viruses were included in the studies that assessed them. Another general theme identified was the lack of consideration of sociocultural factors that might affect adherence with the interventions, especially those employed in the community setting. A prime example of this latter point was illustrated by the observations of the use of masks versus mask mandates during the COVID‐19 pandemic. In addition, the cost and resource implications of the physical interventions employed in different settings would have important relevance for low‐ to middle‐income countries. Resources have been a major issue with the COVID‐19 pandemic, with global shortages of several components of PPE. Several specific research gaps related to physical interventions were identified within the WHO 2014 document and are congruent with many of the findings of this 2022 update, including the following: transmission dynamics of respiratory viruses from patients to healthcare workers during aerosol‐generating procedures; a continued lack of precision with regards to defining aerosol‐generating procedures; the safety of cohorting of patients with the same suspected but unconfirmed diagnosis in a common unit or ward with patients infected with the same known pathogen in healthcare settings; the optimal duration of the use of physical interruptions to prevent spread of ARI viruses; use of spatial separation or physical distancing (in healthcare and community settings, respectively) alone versus spatial separation or physical distancing with the use of other added physical interventions coupled with examining discrete distance parameters (e.g. one metre, two metres, or > two metres); the effectiveness of respiratory etiquette (i.e. coughing/sneezing into tissues or a sleeved bent elbow); the effectiveness of triage and early identification of infected individuals with an ARI in both hospital and community settings; the utility of entrance screening to healthcare facilities; use of frequent disinfection techniques appropriate to the setting (high‐touch surfaces in the environment, gargling with oral disinfectants, and virucidal tissues or clothing) alone or in combination with facial masks and hand hygiene; the use of visors, goggles or other eyewear; the use of ultraviolet light germicidal irradiation for disinfection of air in healthcare and selected community settings; the use of air scrubbers and /or high‐efficiency particulate absorbing filters and the use of widespread adherence with effective vaccination strategies.
There is a clear requirement to conduct large, pragmatic trials to evaluate the best combinations in the community and in healthcare settings with multiple respiratory viruses and in different sociocultural settings. Randomised controlled trials (RCTs) with a pragmatic design, similar to the Luby 2005 trial or the Bundgaard 2020 trial, should be conducted whenever possible. Similar to what has been observed in pharmaceutical interventions where multiple RCTs were rapidly and successfully completed during the COVID‐19 pandemic, proving they can be accomplished, there should be a deliberate emphasis and directed funding opportunities provided to conduct well‐designed RCTs to address the effectiveness of many of the physical interventions in multiple settings and populations, especially in those most at risk, and in very specific well‐defined populations with monitoring of the adherence to the interventions.
Several specific research gaps deserve expedited attention and may be highlighted within the context of the COVID‐19 pandemic. The use of face masks in the community setting represents one of the most pressing needs to address, given the polarised opinions around the world, and the increasing concerns over widespread microplastic pollution from the discarding of masks (Shen 2021). Both broad‐based ecological studies, adjusting for confounding and high quality RCTs, may be necessary to determine if there is an independent contribution to their use as a physical intervention, and how they may best be deployed to optimise their contribution. The type of fabric and weave used in the face mask is an equally pressing concern, given that surgical masks with their cotton‐polypropylene fabric appear to be effective in the healthcare setting, but there are questions about the effectiveness of simple cotton masks. In addition, any masking intervention studies should focus on measuring not only benefits but also adherence, harms, and risk compensation if the latter may lead to a lower protective effect. In addition, although the use of medical/surgical masks versus N95 respirators demonstrates no differences in clinical effectiveness to date, their use needs to be further studied within the context of a well‐designed RCT in the setting of COVID‐19, and with concomitant measurement of harms, which to date have been poorly studied. The recently published Loeb RCT conducted over a prolonged course in the current pandemic has provided the only evidence to date in this area (Loeb 2022).
Physical distancing represents another major research gap which needs to be addressed expediently, especially within the context of the COVID‐19 pandemic setting as well as in future epidemic settings. The use of quarantine and screening at entry ports needs to be investigated in well‐designed, high‐quality RCTs given the controversies related to airports and travel restrictions which emerged during the COVID‐19 pandemic. We found only one RCT investigating quarantine, and no trials of screening at entry ports or physical distancing. Given that these and other physical interventions are some of the primary strategies applied globally in the face of the COVID‐19 pandemic, future trials of high quality should be a major global priority to be conducted within the context of this pandemic, as well as in future epidemics with other respiratory viruses of less virulence.
The variable quality and small scale of some studies is known from descriptive studies (Aiello 2002; Fung 2006; WHO 2006b), and systematic reviews of selected interventions (Meadows 2004). In summary, more high‐quality RCTs are needed to evaluate the most effective strategies to implement successful physical interventions in practice, both on a small scale and at a population level. It is very unfortunate that more rigorous planning, effort and funding was not provided during the current COVID‐19 pandemic towards high‐quality RCTs of the basic public health measures. Finally, we emphasise that more attention should be paid to describing and quantifying the harms of the interventions assessed in this review, and their relationship with adherence.
