A reply to healthfeedback.org

This is a reply to this article by Iria Carballo-Carbajal.

Okay, let’s start over with the claim you literally put into my mouth by putting my picture next to it, and listing me as the first source. Oh, by the way, do you have permission to use my photo on your website?

“Countries with high levels of mask compliance did not perform better than those with low mask usage”; “Mask Mandates [are] Associated With Increased Covid Death Rate“

So, first of all, the first quote is from Beny Spira, not from me. And the second quote is also not from me, because it is just plain wrong. My study finds that mask mandates are associated with increased case fatality rate, not death rate.

I mean what further can I say about your review if you cannot differentiate between both? Your limited understanding of my study is further demonstrated by the following quote

While Foegen claimed to account for infection rate, his methods for doing so are unclear. The same applies to the counties’ inclusion and exclusion criteria.

I mean, if you don’t understand something you can approach me and ask me. I am a kind person I will explain it to you. But just stating that you don’t understand it so it must be wrong, what the hell?

Then you write the following

But he offered no evidence demonstrating the existence or even the plausibility of this mechanism. Indeed, Foegen conceded that such an effect has never been demonstrated in the scientific literature for any disease.

Did you actually read my study? There is an entire chapter called „Supporting Literature“ which you ignore here, especially the „helmet study“ by Patel et. al. which is a very profound peer-reviewed study showing that the mask in front of the face of respiratory ill patients worsens their course of disease.

Next, you critizise my study by claiming that you can’t infer from mask mandates to mask usage, which is fair, however that was already done by Van Dyke et. al. from the CDC, which I refer to multiple times, because they basically do what I do just without case fatality rate, and which you even write about as a good example for a study:

One study published in 2020 evaluated the effect of maks mandates in Kansas counties between June and August 2020^[3]. Counties that ultimately implemented mask mandates had higher initial infection rates compared to counties that didn’t. To control for this potential bias, the authors used trends rather than infection rates as an outcome measure. They found that mask mandates mitigated SARS-CoV-2 transmission in counties that implemented them and reversed the increasing trend in infections, whereas counties that didn’t issue mask mandates continued to experience daily increases in COVID-19 cases.

Then you talk about ecological fellacy.

The failure to recognize this limitation is known as the ecological fallacy.

First, you seem not to know what you’re writing about, as there are actually four statistical evological fallacies which you could have found out on wikipedia.

Second, I did not argue like this. Just read the abstract! I found a correlation between mask mandates and case fatality rate, and then I went on to write a hypothesis why the mask might influence the individual under mask mandate.

Then you bring about the study by Ginther et al. which also uses Kansas‘ Data but does not calculate CFR. Because of this does not control for underlying frailty of the population (old age and illness), which is a mistake as demonstrated in my study („The assessement showed that, after step 1, the crDR of the noMMC group was 1012.6 deaths per 100,000, while the MMC group had an crDR of 782.5 deaths per 100,000, clearly indicating a bias of noMMC group being a more vulnerable population, counterintuitively“.)

You then go on to argue in length that face masks limit the release of infectious respiratory particles from infected individuals – that is actually the problem in the foegen effect, the virions that should leave your body coming back at you. So, are you taking my side here?

Then you go totally off topic by writing about a reduced infection rate, which is best seen in your conclusion:

In contrast, large and robust studies conducted over the past two years demonstrate that face masks effectively reduce the spread of respiratory viruses like SARS-CoV-2 in community settings.

Again, it is not about infection rate but case fatality rate.

And that’s already all your arguments…