Roald Dahl Is Another Target of Woke Censorship Absurdity: The Importance of Freedom of Expression

Another day, another battle in the culture wars. This time, the topic is Roald Dahl. Roald Dahl was a British novelist, short-story writer, and screenwriter. He wrote such wonderful children's books as Matilda, James and the Giant Peach, and Charlie and the Chocolate Factory. The publisher Puffin hired sensitivity readers from Inclusive Minds to bowdlerize Dahl's works. To bowdlerize is to remove or modify content thought to be vulgar or otherwise objectionable. The term bowdlerize comes from the Bowdler siblings who infamously expurgated (edited) William Shakespeare's works to make them more appropriate for women and children. You would think we have that reached a point in history where we did not have to cave into the most prudish and puritanical members of society, yet this is 2023. Why would I expect anything less?

So what exactly transpired? Per the Associated Press, "some passages relating to weight, mental health, gender, and race were altered." In defense of its edits, the publisher Puffin said "it's not unusual to review the language alongside updating other details...any changes have been small and carefully considered." An argument for "a sensitive consideration of whether the word-choice matches current sensitivities" was made in The Sydney Morning Herald by children's author Andy Griffiths. Griffiths opines that "children's books are not sacred texts; they are living breathing collaborations between the writer's words and the active imagination of the reader. Words that might reasonably be predicted to upset or offend sections of the audience are, in most cases, better off being replaced."

"Reasonably be predicted." Let's see what is so offensive that it would be considered reasonable to edit. Augustus Gloop from Charlie and the Chocolate Factory is called enormously fat, and the editors changed it to enormous. His "great flabby folds of fat" were similarly bowdlerized. The famed Oompa Loompas went from being "small men" to "small people." This is one of the multiple linguistic shifts towards gender-neutral language to not offend transgender or non-binary individuals. Mrs. Twit from The Twits is no longer called "ugly." The words "mental" and "crazy" have been replaced to not insult those with mental health issues. In The Big Friendly Giant, the giant doesn't wear a black jacket, and the characters do not turn "white with fear." Let me get into why I, along with greats such as Salman Rushdie, take issue with these edits.

One of the issues of bowdlerizing the text is that it distorts works of literature and introducing ideas that were not in the original text. One such example is Augustus Gloop. Dahl was not making a statement about obesity in his text per se. Gloop was overweight because of his gluttony for food. It was his greed that got him stuck in a factory pipe and presumedly made into fudge. Dahl used Gloop's fatness as a metaphor for what happens when we have excess consume our lives. 

Diluting the language means diluting the power of the story. Literature is a part of culture and history; it is meant to be a reflection of the times in which it was written. You can add a forward or introduction to contextualize Roald Dahl's writing style and word usage. If you want something more in alignment with your values, buy an author's book that is reflective of those values. If Dahl's work is truly that offensive, his work will fade in the background and will be forgotten. There is no need to bowdlerize. 

I find the call to bowdlerize to be hypocritical given that the side of the political aisle that is for these revisions is also clamoring for critical race theory (CRT). Forget for a moment that CRT is a dangerous bait-and-switch that only serves to erode race relations and K-12 education. CRT proponents advocate for CRT because we should not whitewash history. That much they are right about: we need to teach the good, bad, and ugly of history. But here is where it goes awry. The woke Left want us to understand racial injustice in spite of alleged "white fragility," but describing the physical appearance a fictional character as "fat" or "ugly" is too triggering? The people on the woke Left cannot acknowledge their own fragility, but I will digress from the woke Left's intellectual inconsistency.

What exactly are we teaching children when we take out certain words because they are too offensive? Children are bound to meet people who think and act differently than they do. This sort of behavior encourages children to complain and strong-arm when they do not get their way, i.e., act like children instead of adults. Instead, we should be encouraging future generations to be more emotionally resilient. Similar to comedy, literature is meant to be surprising and provocative. If you remove the content that could be offensive, you remove its potency.

Plus, the idea that children cannot understand a book simply because it was written in the past is insulting. Especially as they get older, children learn to understand the difference between literal and figurative language. People are capable of reading a text from the past without judging it by modern standards. We should not talk down to or patronize children because they will not learn better. 

Dahl's style includes dark humor and unexpected twists, which has been part of his appeal enough to sell over 250 million copies of his books. As Ben Shapiro astutely points out, Roald Dahl's books teach a lesson about the world: "Life is a rough place where people are mean to you and social expectations are set for you." Life is not sugar-coated, certainly not the way Augustus Gloop would have liked. The beauty of Dahl’s works is that the protagonists develop resilience and find creative ways to navigate brutal realities. To reiterate, trying to shield children from life's brutishness or unfairness does not do any favors to prepare them for living in the real world. 

Forget that Roald Dahl did not want anyone to change his texts. It is not the job of publishers to remove discomfort from its readers because life is not one big safe space. Nor is it a practical endeavor to bowdlerize. A similar censorship debacle happened a couple of years ago with Dr. Seuss. As I asked then, "who determines what is too offensive?" Is it a worry about offending everyone or a select few? The CEO at PEN America, an organization dedicated to free expression, rightly stated that "the problem with taking license to re-edit classic works is that there is no limiting principle." I brought this up with political correctness: the list of potential triggers is subjective and never-ending. If we take this need to not offend to its logical conclusion, it would mean banning fiction all together. This leads to the crux of why I take issue with this latest attempt in censorship. To quote PEN America CEO Suzanne Nossel:

Rewriting novels, like efforts to rewrite history, has origins in authoritarian playbooks. While editors and publishers might be tempted to try to excise ideas or words from he past that offend us today...we can't go about ridding regrettable ideas and words from the past without potentially diluting the original text and the story itself. We need to learn from the perspective of the past, not eliminate viewpoints we no longer accept. Much of literature could be construed as offensive to someone, based on race, gender, religion, age, economic or other status or myriad other factors...[If we bowdlerize], we risk distorting the work of great authors and clouding the essential lens that literature offers on society.

Fortunately, there was pushback as I was writing this piece. It was not only other publishers throughout Europe that decided they were not going ahead with this bowdlerizing nonsense. Even better, this pushback resulted in Puffin announcing a Roald Dahl Classic Collection to keep the author's original text in print. I am happy to see this take place, but it is also a partial victory. Why? Because they are still going to sell the bowdlerized version alongside the original version. 

As a writer at Forbes pointed out, it very well could have been Puffin's plan all along to stir up controversy and create both versions to boost sales. On some level, I suppose it gives greater consumer choice, which helps maximize Puffin's bottom line. Maybe Puffin really was making a business decision to take advantage of the current culture war we are in. 

As much as I would rather not be in the midst of a culture war, c'est la vie. Roald Dahl and his children's books ended up being another battleground. In George Orwell's Animal Farm, freedom was abolished not through violence, but by changing meaning of words and the record of the past. Sadly, Orwell's dystopian fiction is becoming more real by the day. 

As I pointed out last month, the woke Left is on the warpath to control language. They will not stop at Roald Dahl. They will continue with the attempts to bowdlerize texts and cancel anything that does not agree with their worldview. The fight is for much more than a book.   

As comedian John Cleese points out, this level of wokeness and political correctness sets the bar according to those who are the most touchy and most emotionally unstable. If we do not take a stand or draw a line, they will continue to let their unfounded sense of moral indignation continue to erode literature and indeed all forms of artistic expression.

What gives me hope from the latest Roald Dahl controversy is that there are plenty of people who do not care for the bowdlerizing and fought back. Yes, advocates of freedom of expression can claim a victory with Roald Dahl's work. But the fight is hardly over. If anything, it is only beginning. If we want to emerge victorious from the woke Left's relentless crusade to sanitize art and speech, we will need to push back and we will need to push back hard. Anything less will result in the loss our freedom of expression in a way that would turn the Orwell's fictitious 1984 to reality.

CBO Report Shows Government Spending Is Creating a Fiscal Crisis

The Congressional Budget Office (CBO), which is the agency responsible for federal budgetary and legislative analysis, released its annual Budget and Economic Outlook. Normally, this would be a normal update to a seemingly uninteresting report. What made the report intriguing is not simply updating for such economic realities as high inflation and tighter monetary policy. This report accounted for the fact that we are at the end of an unprecedentedly high amount of so-called "emergency" pandemic spending, i.e., expansionary fiscal policy. Given how critical I have been of the Federal Reserve and Congress, particularly when it came to contributing to inflation, I am not surprised that the fiscal state is not going well. However, I did not expect things to get this atrocious this quickly. The big picture is that federal debt is projected to climb to 195 percent of GDP by 2053. 

What is the reason for this major increase? Those who were critical of Trump thought it would be because of the tax reform in the Tax Cuts and Jobs Act. There was a slight dip in corporate taxes in 2018, but there was otherwise an increase in tax revenue (p. 3).

According to the CBO, it is "mainly because of increasing interest costs and the growth of spending on major health care programs and Social Security (p. 2)." Social Security and major federal health care programs account for about 60 percent of the projected growth between 2023 and 2033.

The CBO recognizes that government spending since spring 2022 exacerbated inflation (p. 39). The sad truth is that it was not simply unprecedented stimulus spending during the pandemic that made our economic situation worse. GDP growth is expected to stagnate, averaging 2.4 percent from 2024 to 2027 and 1.8 percent from 2028 to 2033 (p. 3). Unemployment and labor force participation rate do not look better (p. 44).

This does not bode well for the United States. Much of economic literature finds that by the debt-to-GDP ratio reaches 78 percent, a country starts to run into issues. We are clearly past that point. By 2028, it will reach 106 percent, which is higher than the previous record for debt-to-GDP ratio that was set during World War II. As I explained in December 2020, a high debt-to-GDP ratio matters for many reasons, including slower economic growth, more tax dollars paying interest payments, and lower investment. 

As we can see above, tax increases alone cannot cover the ballooning spending. Federal spending is out of control and will only get worse as interest rates get higher. Trying to balance a $20 trillion budgetary shortfall suddenly is going to be too much for politicians to stomach. The debt limit should be a leverage point. If we want the United States to avoid financial ruin, Congress needs a credible fiscal stabilization plan. Only with true fiscal reform that entails discipline in government spending can the United States avoid going off a fiscal cliff.

CDC Director's February 2023 Testimony Reminds Us Why We Shouldn't Trust the CDC

A couple of weeks ago, various leaders from the Department of Health and Human Services (HHS) testified in front of Congress about the government's response to COVID. One of those leaders was the Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky. A Congresswoman asked Walensky how evidence is processed to determine if the CDC updates, modifies, or withdraws current guidance. You can see Walkensy's response below. Ultimately, she says that "our masking guidance doesn't change with time." What can possibly be wrong with that statement?

When asked if the CDC will revise its guidance to mandate masks in schools in light of the Cochrane review showing masks do not curb COVID, CDC Director Walensky tells Congress its advice on child masking will never change. “Our masking guidance doesn’t really change with time.” pic.twitter.com/TwjZpN3jEl

— Michael P Senger (@MichaelPSenger) February 14, 2023

If you noticed, she made her comment in reference to the Cochrane systematic review. I covered the topic of the Cochrane systematic review a couple of weeks ago. The findings of this systematic review were that face masks do not work, and that included the lauded N95 masks. While she did acknowledge the Cochrane review, she also diminished it in whatever way she could. 

For one, she said that the review only included randomized control trials (RCT). The RCT is considered the gold standard for public health interventions, so I am baffled as to why she would ignore that important detail. She complained that some of the RCTs were not for COVID. At the same time, there were 11 RCTs related to COVID. It is not as if the RCTs related to influenza-like illness were completely irrelevant. Then she says there were not enough studies in the meta-study or they were not robust enough. Who doesn't wish for more studies in a meta-study? She pointed out methodological flaws, as if all studies do not point out their methodological limits as a standard disclaimer. But as we shall see shortly, the Cochrane review is much less problematic than studies that the CDC has lauded as evidence.

And where does she get the chutzpah to complain there were not enough studies? She said in her testimony that the CDC did not conduct clinical trials because "there was not equipoise to the question." This is a fancy way of saying "it is so obvious that masks work that we did not bother conducting the studies." You cannot both shirk your responsibility to conduct clinical trials to see if the masks work and complain that there are not enough studies. 

In May 2020, the CDC hailed "the latest science" from a single case study from a hair salon in Missouri. Amazing how the CDC was able to draw such a sweeping conclusion from such a small observational study. The CDC then jumped on another case study of schools in Arizona that was so methodologically flawed that the Left-leaning Atlantic called out the CDC on its usage of shaky science. One or two case studies are much lower on the hierarchy of public health evidence. Systematic reviews and meta-analyses of RTCs are the gold standard for public health research. The CDC has jumped on much weaker evidence to advocate for masks, which implies that the CDC cares more about staying face than it does what the Cochrane study had to say.   

Walensky and other critics of the Cochrane review argue that the clinical trials conducted so far are not extensive enough to draw conclusions. While there is a theoretical possibility that further studies could show that masks could do some good, that is not where we are at right now. The argument they are making is trying to shift burden of proof onto the mask skeptics, not mask lovers. Change “face mask efficacy” with “Bigfoot.” The argument would sound like “we don’t have evidence of Bigfoot, but that doesn’t mean Bigfoot doesn’t exist.” Most people don’t use that logic to justify a position that Bigfoot exists, so why do mask lovers think they can get away with such flawed logic? The same argument would apply for Ivermectin and COVID. The issue is not absence of evidence, but rather evidence of absence. 

The reality is that three years of a pandemic, the best available evidence, whether in the form of RCTs or observational studies, shows that face masks are ineffective at curtailing COVID transmission. If an intervention is not proven to work vis-à-vis RTCs, it has been common practice in the medical world to abandon it. We should advise the public on health practices based on the best evidence, not on the fantastical whims of the most risk-averse, fearful members of society. 

If Walensky cared about scientific evidence or rigor, she would not base the CDC's recommendations off of some vague possibility that masks might work. She would follow the conclusions from the gold standard organization that conducted the systematic review of studies that are considered the gold standard of public health research. As the head author of the Cochrane review emphatically stated, "there is just no evidence that they [the face masks] make any difference. Full stop." 

When Walensky said "our masking guidance really doesn't change with time," what Walensky is effectively saying is that she does not care what the best available scientific evidence has to say. She does not care whether public health advice is supposed to be made based on strong evidence. The CDC's job is to be "the nation's leading science-based, data-driven, service organization that protects the public health." If she is going to do her job, she should follow the most science-based solutions instead of her wishful thinking. 

This is hardly Walensky's first faux pas as it relates to COVID. In November 2021, Walensky could not explain why the CDC did not conduct any clinical studies on natural immunity from COVID. Walensky greatly exaggerated the risk of transmitting COVID outdoors, as well as the threat of breakthrough cases. She recommended double masking by only using simulated data gathered in a laboratory instead of clinical data. She also said in July 2021 that there would not be a federal vaccine mandate, only for there to be one two months later. Not only did Walensky sign the John Snow Memorandum that advocated for the discredited lockdowns, but she lauded China's zero-COVID policy. That one aged really well! 

In short, the CDC is not committed to the most readily available data or anything remotely related to the scientific method. Much like former NIAID Director Anthony Fauci, Walensky has shown that she is not interested in following best scientific practice. Walensky would rather cling onto public health practices that are not shown to be effective. Ladies and gentlemen, my advice in May 2021 rings as true as it did back then: we should ignore the CDC and simply enjoy our lives because the CDC is incapable of providing best evidence when it comes to public health.

Pandemic Unemployment Insurance Fraud Ran Rampant and the Government Has Not Learned Its Lesson

This pandemic wreaked a lot of havoc, but the government response to the pandemic brought a lot of so-called "joys" to our world: harmful lockdowns, ineffective face masks, school closures that caused delays in education, travel bans, mixed messaging that eroded the people's trust in government providing health advice, inflation. The government gave us another "joy" during the pandemic: expanded unemployment insurance (UI) benefits. 

When the pandemic hit, various jurisdictions decided to lock down large swathes of the economy. This left millions without a job during the lockdowns. In response, Congress enacted the Coronavirus Aid, Relief, and Economic Security [CARES] Act. Part of the CARES Act included an additional $600 per week in UI benefits, federal funding for state UI funds up to 39 weeks, and additional federal funding for up to 13 weeks if the state funds were depleted. 

The premise of this UI expansion was to provide households with economic stability while people stayed at home to wait until COVID blew over. Clearly COVID still exists, but at least higher rates of unemployment were one result of lavish unemployment benefits. What else did the taxpayers get as a result of the unprecedentedly excessive unemployment benefits? A report released nearly a month ago from a government watchdog, the Government Accountability Office, gives us an answer. The UI benefits expansion came with high rates of abuse and fraud. 

Between April 2020 and September 2022, the expanded UI programs that were created as a result of the CARES Act and subsequent legislation allocated $878 billion. In total, the GAO estimated that $60 billion out of the $878 billion were allocated for fraudulent payment (GAO, p. 17). This high fraud rate is on top of an earlier GAO report showing that improper payment rate for UI benefits was 18.9 percent. For reference, fraud is a type of improper payment, along with overpayments, underpayments, or payments not made in strict adherence with the given statute. 

However, there is reason to think that the UI fraud rate is higher than the GAO's estimated 6.8 percent. The Department of Labor (DOL) released a paper called "OIG Oversight of the Unemployment Insurance Program." The DOL points out that pre-pandemic fraud rates were 10 percent. These rates were likely higher during the pandemic. Why, aside from the fact we saw a similar phenomenon with the Paycheck Protection Program? 

In addition to the increased amount in benefits, the Pandemic Unemployment Assistance (PUA) reliance on self-certification incentivized criminals to attack and defraud (GAO, p. 10). The PUA certification did not require documentation to confirm self-employment or prior employment (GAO, p. 11). The expanded coverage also made it more difficult for states to determine initial and continued program eligibility (ibid.). 

You might think that the UI program is something of the past and this is merely an academic exercise. This is not simply because between 2005 and 2021, the GDP grew 79 percent, federal government programs grew 228 percent, and improper payments shot up by 522 percent. That argument is problematic because many economists are anticipating a recession this year. An increasingly common government response to recession is more UI benefits. The other disturbing part of the recent GAO report is that Department of Labor did not implement any measures of the antifraud strategy that the GAO recommended back in October 2021 to manage the UI fraud risks (GAO, p. 32). To quote the report, "Without an antifraud strategy, DOL is not able to ensure that it is addressing the most significant fraud risks facing the UI system in alignment with the Fraud Risk Framework." 

This goes beyond not being able to estimate the full extent of fraud committed (GAO, p. 29). If we have another major economic downturn, especially if it happens this year, the government is not ready to withstand another onslaught of fraudulent payments. The GAO makes recommendations to improve government operations and bureaucrats are not responsive to make changes that would save taxpayers billions. To quote Nobel Laureate Gary Becker, "on the whole, government failure is far more pervasive, damaging, and less self-correcting than is market failure." In case I did not have enough reminders of that reality, the GAO's report on unemployment insurance fraud adds enough reasons to my long list. 

Questions the U.S. Government Should Answer to Learn From Its Botched COVID Response

To say that the U.S. government's response to the pandemic failed on multiple levels is an understatement. Government policy obstructed an intelligible, initial pandemic response and it only went downhill from there. Seven states notwithstanding, governors implemented harmful lockdowns. States implemented mask mandates that did very little to nothing to slow transmission, as well as travel bans and a federal mask mandate on airplanes and public transit. School closures did a number on the mental health and educational attainment of children.  

While COVID-19 brought disease and COVID-related death, the government chose fear and panic over following the science. As a result, the collateral damage left by the government's unsound public health practices will leave its mark on the American people for years to come. This is where the Norfolk Group comes in. 

The Norfolk Group is a cohort of eight infectious disease experts, two of whom were co-authors of the Great Barrington Declaration. The Great Barrington Declaration got flak from such organizations as the World Health Organization and the British Academy of Medical Sciences. However, as I have commented on since the beginning of the pandemic, more and more evidence is showing that the Great Barrington Declaration's approach of avoiding strict public health measures was largely correct. 

The Norfolk Group is pushing for a bipartisan Congressional hearing to address and investigate the government's public health interventions during the pandemic. Last week, the Norfolk Group released a white paper with questions they would ask in the event of such a hearing. There were a number of great questions that this group of infectious disease experts asked. You can read the full report here, but here were a few of my favorite questions:

1. Why was there an almost exclusive focus on COVID-19 to the detriment of recognizing and mitigating collateral damage on other aspects of public health, including but not limited to cancer screening and treatment, diabetes, cardiovascular disease, childhood vaccinations, and mental health? 
2. Protective services such as rehabilitation and physical therapy were severely restricted or discontinued, as were visits from family and friends, even post vaccination. Such activities would have helped older people maintain physical and mental health and reduced dementia due to isolation. Were the effects of severe isolation and lack of services take into consideration in this population, particularly post-vaccination? 
3. Why did the CDC downplay infection-acquired immunity, despite robust evidence for it?
4. Why did hospital and nursing homes not pursue such focused protection of the most vulnerable? Why did they not try to hire staff with infection-acquired immunity? Why was this not recommended by the CDC?
5. After firing many unvaccinated nurses and physicians, some hospitals experienced severe staff shortages in late 2021 and into 2022, many of which persist today. How did this affect the quality of healthcare? How many patients did not receive healthcare because of this? What did governors and state health departments do to avoid these self-imposed problems? 
6. On August 7, 2020, the CDC published an MMWR study based on COVID-Net data from March 1, 2020 through July 25, 2020, which clearly established the low risk to American children. In this analysis, children comprised less than 0.01% of hospitalizations and 0.0005% of associated COVID-19 mortality. Why did the CDC not use these data to reassure concerned parents that in-person schools were safe for children? 
7. How many people had cancer diagnosis delayed during the pandemic? What did the CDC and state health departments do to avoid this problem? What have they done to ensure catch-ups with cancer screenings? What will be the toll on future cancer mortality due to delated cancer diagnoses? 
8. Why were many gyms closed by local and state governments? Why were sports programs for children terminated? 
9. Did lockdown-induced rise in unemployment increase mortality in 2020 and 2021? Does this explain some of the excess mortality seen among Americans below the age of 65? 
10. Women disproportionately provided the necessary childcare at home. How has this affected the short- and long-term economic situation for working mothers and their families? How has it affected the mental and social health of women? How has this affected women's career advancement and salary trajectories? 
11. To accurately estimate an infection fatality rate (IFR), it is necessary to have accurate cause-of-death data but the CDC reports included deaths with an incidental COVID-19 infection. Why did the CDC consistently provide inaccurate IFR estimates? 
12. Why was public perception of hospitalization and mortality risk due to COIVD-19 so different from the actual risk? What actions, if any, did CDC take to help the public better and more accurately understand COVID-19 risk? 
13. CDC information guidance provided to healthcare workers continued to contradict recommendations for the general public, for example stating that "face masks protect the wearer from splashes and sprays," while "respirators, which filter inspired air, offer respiratory protection." Why did the CDC recommend surgical and cloth face masks for the general public while at the same time informing healthcare workers that facemarks do little to filter inspired air or offer protection from respiratory viral infection? 
14. Why did Drs. Fauci and Walensky recommend double masking based only on simulated rather than real-world data?
15. Why were masks mandated on public transportation such as buses, trains, and airplanes without any scientific studies showing their efficacy in such settings? 
16. Before the pandemic, there was not much evidence that cloth masks were effective against respiratory viruses...Despite [the lack of] such evidence, why were cloth masks encouraged rather than discouraged as protection against COVID-19? 
17. Why did the US decline to use the validated European [COVID] test when it became available or to use the WHO test?  How many lives of nursing home residents and other elderly high risk could have been saved by more rapid deployment/use/creation of tests during the 6 weeks that the US lagged the rest of the developed world? 
18. Why did the CDC require testing for international air travel, but not for domestic? 
19. In 2015, the CDC evaluated effectiveness of border entry screening during the SARS1 and H1N1 influenza outbreaks, and concluded that both were heavily resource-intensive, unlikely to be successful in preventing entry of disease, and should not be used. Why did the CDC not follow its 2015 conclusions? 
20. Why did many organizations continue with mandates through the summer and fall of 2021, despite data demonstrating both waning efficacy of symptomatic inflection and reduce long-term ability to curb viral spread? 

N95 Masks Are Not Shown to Be Effective At Preventing COVID Transmission, Either

The coronavirus disease of 2019, colloquially known as COVID-19, has been with us for over three years now. Since the discovery of COVID-19 in December 2019, we went through harmful lockdowns in 2020 and various restrictions since then. About 7 million people are in the official COVID death count, although the actual death count very well could be higher. At the same time, there has been progress. We have improved COVID-19 treatment, nothing to say of the creation and dissemination of a vaccine. On top of that, we have greater herd immunity. Researchers at Harvard University estimate that 94 percent of Americans had COVID-19 as of November 2022 (Klaasen et al., 2022). Many countries and jurisdictions have lifted COVID restrictions, which is a welcome move in the right direction. 

I remember I wrote a two-part entry almost a year ago on why mask mandates need to go (see here and here). I thought back then that it would be the last time I would ever have to write about masks. I thought we would have moved past it by now because it's 2023, yet here I am writing about masks. Why the argument about masks still matters will be made clear by the end of this piece. But first, I want to cover the evidence on face masks generally and N95 masks specifically.

There is at least intuition to face mask efficiency, which is that covering up the face could mitigate the spread of COVID. There was a strong enough of a mechanistic plausibility argument where I made a libertarian case for a temporary face mask mandate in May 2020, even in spite of the weak evidence base. As I saw the evidence come in, I realized that a) cloth or surgical masks did not have a statistically significant impact, and b) mask mandates did not have additional impact on transmission rates. Let's think why that would be the case:

• COVID particles are small. COVID particles range from 0.15 to 5.0 micrometers. The size of a typical COVID particle is 20 times smaller than a typical bacterium. The small size makes it easier for particles to pass through masks. 
• COVID is primarily airborne. Both aerosols and droplets can be generated during sneezing, coughing, talking or exhaling. However, droplets settle quickly, whereas aerosols can potentially travel in air currents for hours. If COVID were primarily transmitted by droplets, masks would have been more effective, but it is primarily airborne.
• COVID is very contagious. On top of being airborne, COVID had a high rate of transmission (e.g., Mahmood et al., 2021). The high reproduction rate and rate of transmission made it easier to infect others and more difficult to contain the virus.

For those who are for masking, they might concede that the cloth masks or the surgical masks are not effective. But what about N95 masks? After all, N95 masks have better filtration efficiency because they can pick up particles more easily. Plus, the N95 fits better over the face, which means less face piece leakage. Intuitively, it would make more sense for an N95 mask to work, or at least work better than a cloth face mask or surgical face mask. Yet the emerging research on the topic has found otherwise.   

In December 2022, the Annals of Internal Medicine released a randomized control trial (the gold standard of health research) across 29 health care facilities in Canada, Israel, Pakistan, and Egypt (Loeb et al., 2022). This study compared medical masks versus N95 masks. This study is also significant since healthcare workers are most likely to wear the masks correctly. Even with universal masking policies and tracking potential exposure points, the study showed no real difference. Although it was a randomized control trial, there were nevertheless methodological flaws.

To cover my bases, I bring to your attention this meta-analysis that Cochrane released last week (Jefferson et al., 2023). For context, Cochrane is the gold standard for systematic review of health research, much like the Congressional Budget Office is the gold standard for federal legislative analysis. Cochrane's meta-analysis on physical interventions for respiratory diseases dates back to 2006. It is not some short-term project, but a long-term meta-analysis from one of the foremost health research institutions in the world. The latest 2023 version includes the COVID-specific RCTs. What are the findings from Cochrane? 

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 routing care to reduce respiratory viral infection...Harms associated with physical interventions were under-investigated.

A large group of international researchers looking through dozens of randomized control trials of physical interventions against respiratory diseases. With 276,000 participants in RCTs or cluster RCTs, the researchers at Cochrane cannot even conclude a "modest effect" on infection or illness rates. This finding was not only for cloth masks or surgical masks, but also failing to show that N95 masks work. The pandemic was the best time to collect this sort of data given the high level of mask wearing. If the efficacy of masks were that blatantly obvious, it would have shown up by now in epidemiological data, especially with transmission rates. Yet the most comprehensive research on the topic we have does not show that face masks are effective to fight against COVID-like illness or influenza-like illness. 

I can provide two additional explanations as to why N95 masks plausibly do not work. One is that the COVID particles are too small. The second is theory versus practice. If one were to perfectly and consistently wear an N95 mask, it could theoretically work. The problem is the incapability of having oneself masked like that 24/7. It matters much more how they fare in the real world than they do in mechanistic studies taking place in a laboratory. The implausibility of adhering to that rigid standard of mask wearing, whether it is healthcare workers or not, sheds some light onto why the current evidence shows face masks or mask mandates are ineffective.

You might be wondering why this still matters in 2023. This is more than an academic debate looking at past policy. It is not only about how the masking proponents used overblown fear without scientific backing in 2020, equated masking with "love thy neighbor," or how they accused you of being a self-serving libertine or of committing criminal negligence if you did not wear a mask. 

Biden's mask mandate was overturned on April 18, 2022. It has been the better part of a year since the overturning and we have seen the number of COVID cases, hospitalizations, and deaths remain relatively low, especially when comparing to previous years. 

Yet the Biden administration is still in court trying to appeal. Also, there are also school districts in such states as Pennsylvania, California, and Massachusetts reinstating mask mandates. To quote University of California-San Francisco professor of epidemiology and biostatistics Vinay Prasad and his response to the Cochrane study:

The proponents of masking had a burden. The burden was on their shoulders. You either show it works or you shut up and you take it away. Three years is far too long to continue a practice with no evidence. Not only should it not be mandated, but you do not have evidence to advise the community to do it. 

The CDC still recommends masking if you live in a "high transmission" area...in 2023! The government continues to keep us scared with its current recommendations. If "following the science" means "updating one's priors when new evidence becomes available," then the CDC should have already updated their recommendation based on this comprehensive research from Cochrane. But I wager that you will see the same doubling-down and cling to studies with small sample sizes and few controls. Is it really any wonder why I do not trust the CDC with public health advice?

This nation has not healed from the trauma inflicted by the pandemic itself, as well as the fear mongering of the government and the press. Data from market research firm Ipsos shows that as of early December, 60 percent of Americans are wearing masks occasionally. Ten percent wear the masks all the time. It is not only face masks. Research at the National Bureau of Economic Research found that 10 percent will social distance after the pandemic, with an additional 45 percent doing limited social distancing (Barrero et al., 2022). 

It was 16 months ago when I wrote that this pandemic would end when we as a society could accept risk again. It is clear that the pandemic and subsequent response to it has left its mark on an entire generation. As much as the United States and other countries have scaled back or removed various COVID restrictions, we are still reeling from the shock of the pandemic. It does not surprise me that we have remnants of COVID restrictions lingering into 2023, but it does dismay me. 

I want to end by saying this. If you personally want to wear a mask, that is your right and a matter of your personal autonomy. But no one can seriously lecture me or anyone about "following the science" on face masks when the world's foremost health research organization when it comes to systematic reviews found that face masks do not stop or slow the spread of COVID-19.

Parsha Beshalach: Bitter Waters and How Perspective Is Key

Water is essential to life.  It is an intrinsic part of life, as we see in this week's Torah portion. The Sea of Reeds opened and the Israelites crossed it. They sang and danced to celebrate (Exodus 15:20-21). But all things come to an end, including miracles and their celebration. They pressed onward into the wilderness of Shur. The Israelites wandered for three days without finding water. This is typically the amount of time a human being can last without water, so it is understandable that the Israelites would get nervous. The Torah then has this to say:

ויבאו מרתה. ולא יכלו לשתת מים ממרה, כי מרים הם. על כן קרא שמה מרה.

And when they came to Marah, they could not drink the waters of Marah because they were bitter. Therefore, the name of it was called Marah. -Exodus 15:23

The simple meaning refers to the waters being bitter. That is how many have translated the verse.  The Hebrew word for water (מים) is in the plural, which means the "They were bitter" can refer to the water. At the same time, there is a grammatical ambiguity because (הם) "they" can also refer to the Israelites. This is an interpretation provided in the Midrash (Exodus Rabbah 50:3). The Israelites were so busy complaining that they could not notice the drinkable water. 

This is not the first time that this has happened in the Torah. Abraham expelled Hagar and Ishmael. Once they consumed what water they had, she was beside herself because they were stranded in the desert and she did not believe they would survive (Genesis 21:-15-17). She did not want to see the death of her child. Ultimately, G-d opened her eyes and she perceived the well of water (Genesis 21:19). As Artscroll  brings up on its commentary on Genesis 21:19 (Chumash):

The Torah does not say that a well was created miraculously; the verse implies that her eyes were opened and she saw a well that had been there all along. This teaches that G-d always provides what we need, but we must be ready to open our eyes and see it (Midrash).

According to this Midrashic interpretation, the Israelites had drinkable water. They just chose not to see it. This is not the last time the Israelites incorrectly perceive a situation. Later when they were wandering in the desert, they were accusing G-d and Moses off bringing them in the wilderness to die because there was no food or water (Numbers 21:5). What is interesting is that immediately after saying there was no bread, they were disgusted by "the rotten bread (ibid.)." This is even more intriguing because the Talmud (Yoma 75a) states that manna taste whatever the eater wants it to taste like. Think about that for a moment. Manna can taste whatever the eater would like and yet the Israelites chose rottenness, a choice that resulted in G-d sending fiery snakes to poison many of the Israelites (Numbers 21:6).

The Israelites were guilty of kvetching, which is the Yiddish meaning "to complain excessively." When people make too much of a fuss, they are incapable of seeing the good. It was such an incapability that brought much personal suffering to the Israelites. It is a mentality that has not gone away since Biblical times and still brings suffering in our time. 

Negativity bias is a cognitive bias that events or things of a more negative nature have greater emotional weight than positive or neutral events. Perhaps it is a survival mechanism that was engrained into human DNA centuries ago, but it takes three positive events to neutralize a negative event. It makes sense that kvetching became a part of Yiddish because it is also a human tendency. The irony of kvetching becoming such a part of Yiddish culture is that it is anathema to Jewish ethics. How so?

One of the words for a Jew is יהודי. The word יהודי comes from the Hebrew verb "to thank" (להודות). It is a Jewish namesake not to kvetch, but to be grateful. In Judaism, the Hebrew term for gratitude is , which literally means "to recognize the good." This does not mean we ignore the bad or look at the world through rose-colored glasses. It means being able to see what the Israelites at Marah could not: goodness in the world. It would explain why Judaism has a practice of saying 100 blessings a day. Whether meant to be taken literally or not, it helps us examine just how much good this world has to offer. 

On the one hand, there is some space for negative thinking. We cannot be happy all the time. As I wrote for Tisha B'Av in 2020, there is a place in our lives to diminish happiness where it can paradoxically increase happiness. On the other hand, happiness has a major perspective component to it. Catastrophizing that the Israelites partook in leads to more suffering (Petrini and Arendt-Nielsen, 2020). Those who have a more hopeful view on life tend to be happier than those who are negative all the time much like the Israelites at Marah were. R. Jonathan Sacks, z"tl, taught that optimism is a viewpoint that the world was getting better, whereas hope is the belief that we can make the world better. Optimism is more passive; it does not require action, only belief. Hope is a more active concept. We work towards it. We have confidence that we can make things better, whether in our individual lives or for others. 

That was where the Israelites messed up. They saw bitterness when there was fresh water in front of them. They ignored the manna's existence, only to complain about it shortly thereafter. The excessively negative lens through which the Israelites viewed the world made it hard to appreciate life. It also made it difficult to find solutions because as we see in these texts, the bitterness makes it impossible to see what is in front of you. This would explain why the first blessing we say in the morning is to ask us to distinguish between night and day (אשר נתן לשכוי בינה להבחין בין יום ובין לילה), so that we can discern between such concepts as right and wrong, and good and bad, or helpful and harmful. 

Rather than take in the bitterness from the Israelites, I think we can learn to be optimistic realists. We cannot ignore the harsh realities of life, but we cannot ignore the beauty, wonder, and joy that life has to offer. Judaism teaches us to focus on the positive because we are prone to the negative. It is a work in progress, but we need to be in a mindset of abundance, gratitude, and overall optimism if we are to make life better. To quote filmmaker George Lucas, "Your focus determines your reality." What sort of reality would you like to have: one where bitterness is all around you or one where you can learn to appreciate what life has to offer?