By Jeffrey Schweers, Capital Bureau USA TODAY NETWORK, Dec 3, 2021.
When he was first introduced by Gov. Ron DeSantis as his nominee to be the next state Surgeon General, Dr. Joseph Ladapo promised that the Department of Health would draw a distinction between science and opinion.
“People have been taking the science and misrepresenting it,” he said, hinting at mainstream public health officials who have been setting policy for the nation. “You will know when we are talking about data and opinion,” Ladapo added. “Never lose sight that public health is not just one thing. It is not just about the amount of Covid at a single location.”
The next day he signed an emergency order that strengthened bans on school mask mandates and stripped schools of the authority to quarantine students who had come in contact with the Covid-19 virus for up to four days, leaving that decision to parents.
More recently, after DeSantis signed into law restrictions on vaccine mandates, including exemptions for people who have recovered from Covid and who are pregnant or planning to be pregnant, he thanked DeSantis for his “leadership in making practical and informed decisions based on science.”
So where’s the science?
Asked for the scientific basis for Ladapo’s statements, Christina Pushaw, DeSantis’ press secretary, offered three studies to back up his claims about vaccines and masks.
While selected parts of the studies do back up the claims that vaccines are losing their effectiveness or that masks aren’t a panacea, other data in those studies contradict their assertions.
While the state health department has consistently touted getting vaccinated as the best and most effective tool to protect against Covid-19 and prevent its spread, Ladapo personally has cast doubt over the effectiveness and safety of the vaccine. Public health experts say such public statements contribute to vaccine hesitancy, the reluctance to get immunized against Covid-19.
“Remember when people were telling you that these vaccines would stop transmission and the rate of protection was greater than 90%? Ten months later, we’re finding that the rate of protection is less than 40% than some of them,” he has said.
Pushaw cited two news links — one from CNBC and one from Forbes — to a study reported by the Israel Health Ministry that showed a full course of the Pfizer/ BioNTech vaccine was only 39% effective against the Delta variant in Israel, where high levels of the delta variant led to a resurgence in outbreaks of Covid-19.
The Forbes article was more specific — the vaccine was only 39% effective at preventing infections and 41% effective at preventing symptomatic infections caused by the variant. Both articles noted that was down from 64% two weeks earlier.
Pushaw, however, didn’t mention that the study was based on “an unspecified number of people between June 20 and July 17,” according to Forbes, and that it conflicted with data from the United Kingdom that found a full course of the vaccine was 88% effective against “symptomatic disease caused by the variant.”
She also omitted that the health ministry said the vaccine still provided high levels of protection against hospitalization (92%) and severe illness (91%) caused by the delta variant.
Diminished strength over time
Pushaw provided another article on a study on vaccine effectiveness and death in the Veterans Health Administration over time. The report, cited in Science, said efficacy dropped from 87.9% to 48.1% from February to October, confirming what many scientists thought could happen with the vaccine as the months passed.
But the report also said the vaccine continued to protect against death in people who became infected during the Delta surge.
The report also said that the Pfizer and Moderna vaccines “have effectively prevented clinically significant disease caused by severe acute respiratory syndrome coronavirus” since they became available last December.
And while initial reports showed sustained protection, three reports of the Centers for Disease Control and Prevention in August showed protection waning as the delta variant became the dominant strain by mid-summer. But protection against hospitalizations and deaths remained high.
The article also mentioned that, after Israel saw a decline in the vaccine’s effectiveness after several months, it authorized booster shots for adults 60 and older in July and extended that authorization to people 50 and older in August.
“Rates of infection and severe illness subsequently declined in those who received a booster,” the Science report said.
One of the main reasons critics of mask mandates have cited as a reason not to support mandatory mask wearing is the lack of a randomized controlled trial (RCT). Scientists and policymakers have had to rely on observation and lab studies to justify mask mandates.
Until recently. Considered to be the gold standard of scientific research, RCTs are carefully constructed and monitored trials where participants are assigned at random to either a control group or intervention group.
“Inspired by the growing body of scientific evidence that face masks can slow the spread of the disease and save lives,” a group led by scientists from Stanford and Yale universities conducted a randomized trial of nearly 350,000 people in 600 small villages in Bangladesh, the authors said in the introduction of their report.
Pushaw offered it as evidence that wearing masks don’t work, but the study’s authors said they found the opposite to be true.
“This really should be the end of the debate,” Ashley Styczynski, an infectious-disease researcher at Stanford University in California and a co-author of the report, told Nature. The study’s findings, released Sept. 1, found that “the number of symptomatic cases was lower in treatment villages than in control villages,” the Nature article reported.
“It’s notable that even though fewer than 50% of the people in the intervention villages wore masks in public places, we still saw a significant risk reduction in symptomatic Covid-19 in these communities, particularly in elderly, more vulnerable people,” Styczynski said in a Stanford Medicine article.
People in villages that were given several interventions promoting the use of surgical masks were 11% less likely to develop COVID-19 than people in villages that didn’t receive such interventions, the report said. That protection increased to 35% among people 60 and over.
Researchers said the true risk reduction is likely greater because they didn’t test people without symptoms or whose symptoms did not meet the World Health Organization definition of Covid-19.
Pushaw noted that the study “didn’t control for other behavioral differences in this age group.” She also said the study found that “mask mandates make no statistically significant difference in terms of Covid spread for people under age 50.”
School children and masks
Because there were no randomized clinical trials conducted in the U.S. on masking and Covid, “we only have observational data from the last ~20 months, when different cities and states enacted different masking policies,” Pushaw said in an email.
The data showed no correlation between mask mandates and reduced Covid infection rates, she said, yet said that in Florida, “we observed that pediatric Covid infections fell at the same rate in school districts with and without mask mandates since school started in August.”
Pushaw also said that forcing school children to wear masks is not the scientific consensus and is not data-driven.
Not so, said Julie Swann, a department head and professor at North Carolina State University, who leads a Covid-19 forecasting team funded by the Centers for Disease Control and Prevention.
“The results about masks and children are overall very positive,” Swann said. “There are empirical studies that have been published from 2021 showing very few infections in schools when (and) where masks were worn.”
One such study done in the spring among 1 million students in 100 school districts and 14 charter schools in North Carolina found that mask mandates helped keep transmission rates of Covid-19 to under 1% in schools last fall and spring.
“The science clearly shows us that masking is an effective strategy to prevent within-school transmission when Covid-19 is circulating and when vaccination is not yet available for all children,” Dr. Kanecia Zimmerman, co-chair of the ABC Science Collaborative that conducted the study, said in a report published by NPR.
Contact Jeffrey Schweers at [email protected] and follow him on Twitter @jeffschweers.
“Rates of infection and severe illness subsequently declined in those who received a booster.”
Image Credits: Lawrence Mower