“A growing number of studies show face masks reduce the spread of the coronavirus,” CNN reported on June 17, “especially because many people are contagious before they have symptoms and because this virus can spread by just talking or breathing.”
This is an enlightening example of how the media are misinforming the public about what science tells us about the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The message being communicated to the public is that a major driver of community spread is people who have no symptoms but infect others through airborne transmission. This narrative has been used to justify and manufacture consent for extreme lockdown measures, including executive orders for universal mask use in community settings.
The truth is that it remains uncertain whether asymptomatic carriers are a significant source of community spread, and it remains uncertain whether virus-laden aerosols are a significant mode of transmission. Instructively, this truth is revealed simply by examining the primary sources cited by CNN to support the narrative.
- Is the WHO Wrong about Asymptomatic Transmission?
- Fact-Checking CNN’s “Fact Check” (and Anthony Fauci)
- If the Numbers Aren’t Conducive for Fearmongering, They’re No Good!
- Reporting Reassuring Data as Cause for Alarm
- But What About Masks?!
In this case, CNN cites two prior CNN articles. The first was an article on June 10 titled “Fauci says the WHO’s comment on asymptomatic spread is wrong. Here’s the difference between asymptomatic and pre-symptomatic spread”.
We’ll come back to that second article, but let’s start with the first. It discusses a statement by an official from the World Health Organization (WHO) who said that, from the data available, asymptomatic transmission “appears to be rare”.
CNN does not clarify, but the transcript of the WHO press briefing shows that the official, Dr. Maria Van Kerkhove, was referring to people who are “truly asymptomatic”, meaning that they never developed any symptoms, as opposed to people who had mild symptoms or “presymptomatic” individuals who later did develop symptoms. Cases with documented transmission from truly asymptomatic individuals, she stated, are “very rare”.
This is a curious omission since the article begins with an explanation of the difference between “asymptomatic” and “presymptomatic” and then goes on to cast doubt on Van Kerkhove’s statement by discussing viral transmission by both asymptomatic and presymptomatic individuals—as though she had not distinguished between the two.
First, CNN asserts that Van Kerkhove’s statement prompted “widespread confusion” because “doctors and scientists have been saying the opposite for months.”
Next, CNN tries to cast doubt on her statement by citing Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID) under the National Institutes of Health (NIH).
CNN paraphrases Fauci as saying that 25 percent to 45 percent of people may not have symptoms. “And we know from epidemiological studies they can transmit to someone who is uninfected even when they’re without symptoms,” he is then quoted as saying. “So to make a statement that’s a rare event was not correct.”
But what CNN fails to point out for readers is that Fauci’s reasoning here is a non sequitur fallacy. His conclusion that asymptomatic transmission is common does not follow from the premise that it can occur. The question remains as to what extent asymptomatic individuals contribute to community transmission.
Ironically, CNN then goes on to reinforce the WHO official’s statement by citing Babak Javid, a researcher from Tsinghua University School of Medicine in Beijing, China. “Detailed contact tracing from Taiwan as well as the first European transmission chain in Germany suggested that true asymptomatics rarely transmit,” CNN quotes Javid as saying.
Javid goes on to say that studies have found that people with “extremely mild symptoms” can transmit the virus, and that “transmission often appeared to occur before or on the day symptoms first appeared.” He says this was shown “in particular” by a study documenting “the first European transmission chain in Germany”.
CNN does not link to or provide any other information about the studies Javid was referencing. Presumably, though, he was referring to an early paper by German researchers that has been widely cited to support claims of asymptomatic transmission, which we’ll come to.
Under the subheading, “How many people get infected by someone without symptoms?”, CNN goes on to say, “The US Centers for Disease Control and Prevention estimates 40% of coronavirus transmission happens before people feel sick.
“In one study, about 4 in 5 people with confirmed coronavirus in China were likely infected by people who didn’t know they had it, according to research published in the journal ‘Science.’”
Further, CNN cites experts from Harvard Medical School who wrote that, “We know that a person with COVID-19 may be contagious 48 to 72 hours before starting to experience symptoms. Emerging research suggests that people may actually be most likely to spread the virus to others during the 48 hours before they start to experience symptoms.”
Finally, the article quotes CNN’s own Chief Medical Correspondent Dr. Sanjay Gupta saying, “People tend to be the most contagious before they develop symptoms, if they’re going to develop symptoms”.
Returning to CNN’s claim that “doctors and scientists have been saying” that asymptomatic transmission, contrary to the WHO official’s statement, is common, the source provided is yet another CNN article, which was published on April 2 and is titled “Fact check: Georgia governor says we only just learned people without symptoms could spread coronavirus. Experts have been saying that for months”.
That article quotes the director of the Centers for Disease Control and Prevention (CDC), Robert Redfield, from a CNN interview on February 13 as saying that “asymptomatic transmission” had been “confirmed”. “What we don’t know though”, Redfield added, “is how much of the asymptomatic cases are driving transmission.”
In the interview, Redfield cited his source as the Chinese Center for Disease Control and Prevention but did not reference any published documents, and CNN does not provide any links to any reports from the China CDC to support the claim.
The “Fact Check” article goes on to refer to the aforementioned paper by German researchers by recalling how, in late January, Fauci had told CNN, “There’s no doubt after reading this paper that asymptomatic transmission is occurring.”
That paper was published in the New England Journal of Medicine on January 30. It reported that a Chinese woman who had travelled to Germany to meet with a business partner transmitted the virus to him. Three others at the company were subsequently also infected, including two who’d only had contact with her partner and not the Chinese woman. The researchers claimed that during her stay in Germany, “she had been well with no signs or symptoms of infection but had become ill on her flight back to China”.
However, that statement is false. The German researchers had not spoken with the woman before publishing their claim, and when researchers from Germany’s public health agency, the Robert Koch Institute, did so, she informed them that she did have symptoms while in Germany, which included fatigue and muscle pain that had prompted her to take the fever-reducing drug paracetamol.
“Yet the latest update to the CDC site”, CNN adds to make its case, “also cites several studies from February and March documenting coronavirus in asymptomatic patients. The CDC guidance clarifies that ‘although transmission of SARS-CoV-2 from asymptomatic or pre-symptomatic persons has been reported, risk of transmission is thought to be greatest when patients are symptomatic.’”
The CDC webpage contained the quoted statement at the time CNN published its “Fact Check” article, but it has since been changed to further distinguish between asymptomatic and presymptomatic transmission in terms of supporting evidence. Presently, the CDC webpage states that presymptomatic transmission has been documented in several studies but that asymptomatic transmission has merely been “suggested” in other reports.
The page also now states that “Risk of transmission is thought to be greatest when patients are symptomatic since viral shedding is greatest at the time of symptom onset and declines over the course of several days to weeks. However, the proportion of SARS-CoV-2 transmission in the population due to asymptomatic or pre-symptomatic infection compared to symptomatic infection is unclear.”
Note that this also contradicts Fauci’s claim that asymptomatic transmission is known to be common.
The CNN “Fact Check” article links to three studies cited by the CDC on that page. The first is among the studies presently cited by the CDC to support its statement that presymptomatic transmission has been documented. But it refers only to a single case in Nanjing, China, in which an elderly man was presumed to have transmitted the virus to three family members and who reportedly never developed any symptoms.
That study, published in Science China Life Sciences on March 4, 2020, shows that the asymptomatic man had traveled to the city of Huanggang in Hubei province, China, from January 19 – 20 and was home again on January 21. On January 25, his daughter-in-law developed symptoms including fever, as did his son on January 26 and his wife on January 30. All four tested positive for SARS-CoV-2 on February 2. Although there were other cases in Nanjing, the study authors concluded that it was the asymptomatic man who’d brought the virus into the household from his trip because the three relatives denied having contact with any other confirmed or suspected cases. They did not report that the man admitted having contact with any confirmed or suspected cases in Huanggang. They also did not comment on how they ruled out the possibility that one of the other family members had unknowingly been infected by someone else in Nanjing.
In sum, the CDC page is mistaken, and it should have cited this study as among those suggesting possible asymptomatic transmission, not proven presymptomatic transmission.
The second study CNN links to was cited by the CDC as suggestive of asymptomatic transmission. However, while the authors did indeed suggest that possibility, it was purely speculative. Published as a correspondence in Lancet Infectious Diseases on February 19, the authors reported the case of a family of three who traveled together by train from Wuhan in Hubei province to Guangzhou in Guangdong province, China, on January 22. On January 26, the father developed a fever, and on January 28, all three tested positive for SARS-CoV-2, but the wife and son remained asymptomatic through the end of the study observation period on January 29. The authors raised the possibility that the wife or the son may have infected the father. However, it may also have been that the father was the source of transmission. The authors don’t mention it, but it’s also possible there was no household transmission at all and that all three were infected by one or more other individuals during their trip.
In sum, it is true, as CNN states, that this study documented SARS-CoV-2 infection in asymptomatic patients. The CDC’s statement that it “suggested” asymptomatic transmission is also true, inasmuch as the authors did raise this possibility. However, this was purely speculative since it was equally if not more likely that asymptomatic transmission did not occur.
The third study CNN links to was cited by the CDC as documenting asymptomatic infections. However, the CDC says nothing about this study suggesting asymptomatic transmission, and, indeed, the study, published in Pediatrics, says nothing about either asymptomatic or presymptomatic transmission.
In sum, CNN’s statement that there are studies “documenting coronavirus in asymptomatic patients” is completely beside the point. The question is not whether asymptomatic infections occur but whether asymptomatic transmission is occurring and, if so, to what extent.
Returning to the CNN article attempting to discredit the WHO official’s statement that asymptomatic transmission appears to be “very rare”, it is true that “doctors and scientists have been saying the opposite for months.” But that does not make Van Kerkhove’s statement incorrect, and the “Fact Check” article presents no evidence to support the claim that it is a common occurrence.
Instructively, CNN relies primarily on a statement from Fauci that Van Kerkhove’s statement was “not correct” but declines to inform readers that Fauci had also previously claimed that there is “no doubt” that asymptomatic transmission is occurring on the basis of a study that CNN had elsewhere acknowledged to be “flawed”.
Just as instructively, the “Fact Check” article links to an even earlier CNN article that reported how the paper’s claim that the Chinese woman was presymptomatic during her stay in Germany had been shown to be false. CNN reached out to both Fauci and the CDC for comment but received no response.
Ironically, while the “flawed” paper was not being cited by the CDC on the linked webpage at the time CNN published it’s “Fact Check” article, it has since been added to the page. The CDC is presently citing it as among reports in which asymptomatic transmission “has been suggested”. Setting aside the quibble that it was rather presymptomatic transmission that was suggested, the CDC declines to inform visitors to the page that the key claim made by the paper’s authors has been proven false.
Moving on with CNN’s attempt to discredit the WHO official’s statement, as noted, it also cites the CDC’s estimate that “40% of coronavirus transmission happens before people feel sick.” CNN tells readers that, although subject to change, this is based “on real data collected by the agency”.
The link provided is to another CNN article published on May 22, which cites a CDC document titled “COVID-19 Pandemic Planning Scenarios”. However, that document cites no scientific studies to support the “40%” estimate and otherwise provides no information about how it was estimated.
The CDC document also suggests in its “best estimate” scenario that “an asymptomatic individual is just as likely to transmit as a symptomatic individual.” Once again, no studies are cited. Instead, the CDC notes that this is an “Assumption”.
It’s an assumption that is difficult to reconcile with the CDC’s statement elsewhere on its website that the risk of transmission “is thought to be greatest when patients are symptomatic”.
Ironically, CNN unquestioningly accepts the CDC’s estimate regarding presymptomatic transmission while attempting to cast doubt on the CDC’s estimate of the mortality rate of SARS-CoV-2.
On March 11, Anthony Fauci told members of Congress that “The flu has a mortality rate of 0.1 percent. This has a mortality of ten times that.” The problem with this statement is that Fauci could not possibly have known that because he had no way of estimating the total number of infections to include in the denominator into which to divide the numbers of reported deaths. He was relying only on reported cases for his number and should have explained to Congress and the public that this estimated case fatality rate (CFR) was inherently overestimated. (Since deaths are more visible than asymptomatic or mild cases, the underreporting in the denominator will always be proportionally larger than any underreporting of deaths in the numerator.)
At the time, cases were being ascertained using reverse transcription polymerase chain reaction (RT-PCR) assays, which detect the presence of viral RNA, indicating a current infection. Studies have since been done to estimate the true prevalence of infections by using serological assays, which detect the presence of specific antibodies to SARS-CoV-2, indicating a recent or past infection. These studies have consistently shown that far greater numbers of people have been infected than the reported case numbers indicate. The corollary is that the infection fatality rate (IFR) is much lower.
The CDC appears to have taken this body of science into account in providing its own “best estimate” of the overall symptomatic infection fatality rate (IFR-S), which is 0.4 percent.
One thing that’s important to keep in mind is that this number disproportionately represents elderly people with underlying medical conditions that place them at greater risk of dying from COVID-19, the disease caused by SARS-CoV-2. Age stratified, the estimated IFR-S is 1.3 percent for those aged 65 years and older, 0.2 percent for those aged 50 to 64, and 0.05 percent for those under the age of 50.
These are considerably less frightening numbers than the 1 percent presented by Fauci—not to mention the 3.4 percent presented by WHO Direct-General Tedros Adhanom in March that was widely propagated thereafter by the media. Adhanom, too, failed to convey that this was an inherently overestimated mortality rate, and the media followed suit in relaying the frightening number to the public, generating mass fear and panic and helping to manufacture consent for extreme lockdown measures.
CNN properly indicates that the CDC’s mortality estimates include only “people who show symptoms” in the denominator, which means that the numbers would be even lower if asymptomatic infections were included. CNN also notes the CDC’s estimate that “about a third of coronavirus infections are asymptomatic”.
However, rather than touting the dramatically lower numbers as good news showing that the virus is much less deadly than originally assumed, CNN attempts to cast doubt on them by quoting Carl Bergstrom, a biologist at the University of Washington, saying that, “While most of these numbers are reasonable, the mortality rates shade far too low.”
“Estimates of the numbers infected in places like [New York City] are way out of line with these estimates”, Bergstrom went on to say. He added that, “Given that these parameter sets underestimate fatality by a substantial margin compared to current scientific consensus, this is deeply problematic.”
A review of serological studies selected from locations around the world that have been hardest hit by the pandemic has been undertaken by John Ioannidis, a researcher at Stanford University who has been described by The Atlantic as “one of the most influential scientists alive”. He happens to be best known for exposing bad science underlying “scientific consensus” beliefs. As he has written in one of the most widely cited papers in the medical literature, “Empirical evidence on expert opinion shows that it is extremely unreliable.” Majority scientific opinion “may often be simply accurate measures of the prevailing bias.”
As he observes in his review, published on the preprint server medRxiv (“med archive”), which is a server for the rapid publication of potentially groundbreaking studies that have not yet completed the peer-review process for publication in print journals, an infection fatality rate of around 1 percent has “long continued to be widely cited and used in both public and scientific circles”—including the influential model published in March by Imperial College London researchers that was so central to policymakers’ justifications for extreme lockdown measures, which assumed a fatality rate of 0.9 percent.
However, estimates inferred from seroprevalence studies “tend to be much lower than original speculations”. From studies mostly done in pandemic epicenters, inferred infection fatality rates ranged from 0.02 percent to 0.86 percent, and for people under 70 years old, from 0.00 percent to 0.26 percent. This included one study from New York state and one from the borough of Brooklyn in New York City. The IFR estimates for those under 70 did not exceed 0.1 percent, with the exceptions of New York; Wuhan, China, where the outbreak originated; and Milan, Italy.
As Ioannidis commented, “The high IFR values in New York are also not surprising, given the vast death toll witnessed. A very unfortunate decision of the governors in New York and New Jersey was to have COVID-19 patients sent to nursing homes.”
According to data from the Kaiser Family Foundation updated on June 18, 6,387 COVID-19-related deaths in New York have been among residents or staff of long-term care facilities, amounting to 21 percent of all deaths in the state. New York alone also represents more than a quarter of all deaths in the US.
Tragically, the proportion of deaths in nursing homes in many other states that are reporting such data is even higher, including twenty-seven states in which the proportion is 50 percent or more. This includes New Jersey. Indicating just how ineffective extreme lockdown measures have been at protecting those at highest risk, in 89 percent of these states, governors had issued executive “stay-at-home” orders. Lockdown states in which at least half of deaths occurred in nursing home deaths also comprise 51 percent of the forty-seven states reporting data.
Other factors Ioannidis identifies as possibly contributing to New York’s higher fatality rate include some hospitals where optimal care may not have been offered due to having reached capacity, unnecessarily aggressive use of mechanical ventilation, and “an extremely busy, congested public transport system that may have exposed large segments of the population to high infectious load in close contact transmission and, thus, perhaps to more severe disease.”
It is also not surprising “that IFR may reach very high levels among disadvantaged populations and settings that have the worst combinations of factors predisposing to higher fatalities.” Yet even in such areas, “the IFR for non-elderly individuals without predisposing conditions may remain very low.” For example, in New York City only 0.6 percent of all deaths happened in people under the age of 65 who had no major underlying conditions. “Thus the IFR even in New York City would probably be lower than 0.01% in these people.”
The inferred infection fatality rate for New York state was 0.68 percent overall and 0.26 percent for people under the age of 70; for Brooklyn, the overall IFR was 0.41 percent and 0.15 percent for those under 70. (Corrected for estimated underassessment due to only one type of antibody test being performed, these numbers were even lower.)
These numbers are significantly lower than the 1 percent claimed by Fauci, but they could still represent overestimates because the absence of detectable antibodies in a person’s blood doesn’t necessarily mean that they haven’t been infected and acquired immunity. In fact, antibodies are neither always sufficient nor even necessary for the development of immunity.
Studies of antibody responses to SARS-CoV-2 have confirmed that many people clear the infection despite producing low or undetectable levels of antibodies. A preprint study by researchers from China found that, out of 175 recovered patients, about 30 percent had “a very low level” of SARS-CoV-2-specific neutralizing antibodies and 6 percent had no detectable titer. Another preprint study by researchers from Switzerland noted that “SARS-CoV-2-specific serum IgA titers in mild COVID-19 cases became positive eight days after symptom onset and were often transient, whereas serum IgG levels remained negative or reached positive values 9–10 days after symptom onset.” Higher antibody titers were associated with more severe disease. (Emphasis added.)
A recent study published in Cell further observed that cellular immunity, which is distinct from antibody (or humoral) immunity, plays an important role in the clearance of SARS-CoV-2 infection. Interestingly, they observed that about half of unexposed individuals already had SARS-CoV-2-reactive T cells, “suggesting cross-reactive T cell recognition between circulating ‘common cold’ coronaviruses and SARS-CoV-2.” In other words, infection with common human coronaviruses that are a common cause of colds may confer a level of cross-protective immunity against SARS-CoV-2, which might help to explain, along with other factors, why such a high proportion of infected individuals develop very mild or no symptoms, including most children.
In sum, CNN unquestioningly accepts the CDC’s alarming estimate of the proportion of transmission that occurs from presymptomatic individuals while attempting to discredit the CDC’s more reassuring estimate of the symptomatic infection fatality rate. This fits the general trend of major media reporting of sensationalizing and exaggerating information for the purpose of advocating extreme policy responses while ignoring or downplaying data that would serve to calm the general sense of fear and panic required for consent to be obtained for those same policies.
Returning to the article trying to discredit the WHO’s observation that asymptomatic transmission appears to be “very rare”, in answer to the question of how many people “get infected by someone without symptoms”, CNN cites a study published in the journal Science to support its claim that “about 4 in 5 people with confirmed coronavirus in China were likely infected by people who didn’t know they had it”.
But that is a highly deceptive characterization of the study, which did not estimate that about 80 percent of lab-confirmed cases were infected by people who didn’t know they had it because they’d experienced no symptoms at the time of transmission.
The study authors used a model “to estimate the contagiousness and proportion of undocumented infections in China”. They estimated that 86 percent of infections were undocumented. They also found that people with undocumented infections were less contagious, with a transmission rate of 55 percent compared with documented cases. (In other words, documented cases were nearly twice as contagious.) However, “due to their greater numbers, undocumented infections were the infection source for 79% of documented cases.”
CNN’s deception is that it characterizes the 79 percent of transmission from undocumented infections as though these individuals were all asymptomatic. But that is false. In fact, the researchers did not estimate the rate of asymptomatic or presymptomatic transmission. The category of “undocumented” infections rather included individuals who “were likely not severely symptomatic”, as compared to cases in which individuals had symptoms “severe enough to be confirmed”.
In sum, despite its best efforts to cast doubt on the WHO official’s statement that asymptomatic transmission appears to be “very rare”, CNN presents no evidence to support the opposing contention by Dr. Fauci that it is rather common. At best, its primary sources indicate that people who have not yet developed symptoms may be able to transmit the virus to others, but they are less contagious, and the extent to which this contributes to community spread remains unknown.
Recall that the CNN article relying on Fauci to cast doubt on the WHO official’s statement was cited in the more recent article of June 17 to support the assertion that “masks reduce the spread of the coronavirus” because “many people are contagious before they have symptoms”. The second implicit justification offered by CNN for universal mask-wearing orders was that the virus “can spread by just talking or breathing”.
The link for this second argument is to yet another CNN article from April 2, titled “Experts tell White House coronavirus can spread through talking or even just breathing”.
That article notes that, “According to the US Centers for Disease Control and Prevention, the virus spreads from person to person when people are within about 6 feet of each other ‘through respiratory droplets produced when an infected person coughs or sneezes.’”
That necessarily means that people with symptoms are the main drivers of community transmission. However, to support the characterization of asymptomatic people as a threat to others, CNN cites Dr. Harvey Fineberg, chairman of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats at the National Academy of Sciences (NAS).
CNN paraphrases Fineberg as saying that the CDC’s statement “is true, but that research shows that aerosolized droplets produced by talking or possibly even by just breathing can also spread the virus.”
The article reports that Fineberg responded to an inquiry from White House with a letter discussing this possibility. “Currently available research supports the possibility that [coronavirus] could be spread via bioaerosols generated by patients’ exhalation,” the letter stated. (The bracketed insertion is CNN’s curious replacement for “SARS-CoV-2”, the name of this particular coronavirus.)
CNN paraphrases, “His letter explains that research at a hospital in China shows the virus can be suspended in the air when doctors and nurses remove protective gear, or when floors are cleaned, or when staff move around. Research by the University of Nebraska shows that genetic material from the virus was found in patients’ rooms more than 6 feet away from the patients, according to the letter. Fineberg said it’s possible that aerosolized coronavirus droplets can hang in the air and potentially infect someone who walks by later.”
CNN further quotes Fineberg as saying, “While the current [coronavirus] specific research is limited, the results of available studies are consistent with aerosolization of virus from normal breathing.” Finally, at the very end of the article, CNN includes the caveat, “‘If you generate an aerosol of the virus with no circulation in a room, it’s conceivable that if you walk through later, you could inhale the virus,’ Fineberg said. ‘But if you’re outside, the breeze will likely disperse it.’”
However, CNN is selectively quoting from the letter to bolster the claim it proclaims as fact in its headline. Before examining the letter, though, it’s useful to take a closer look at what the CDC has to say about it.
The quote provided about spread through coughs and sneezes is from the CDC’s webpage “How Coronavirus Spreads” and was current as of April 2. However, the page was updated the same day to replace that statement with one acknowledging the possibility of transmission through speaking.
The CDC presently maintains that SARS-CoV-2 spreads mainly between people “who are in close contact with one another”, meaning “within about 6 feet”, through “respiratory droplets produced when an infected person coughs, sneezes, or talks.”
The CDC also notes that “Some people without symptoms may be able to spread the virus.” However, the page makes no statement about the extent to which asymptomatic individuals contribute to community spread. It emphasizes that, generally, “the more closely a person interacts with others and the longer the interaction, the higher the risk of COVID-19 spread.”
The CDC also acknowledges the theoretical possibility of fomite transmission, stating that “It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.”
Notably, the CDC does not say that transmission occurs via aerosols from speaking but rather implies that it occurs within short distances through larger respiratory droplets that fall to the ground more rapidly, the same as with transmission from coughing or sneezing. (Aerosols are smaller particles that linger in the air longer and can travel farther than larger respiratory droplets produced by coughs and sneezes.) The CDC also does not suggest that transmission occurs from simply breathing, presumably due to the lack of supporting evidence.
While CNN would have us believe differently, an examination of Fineberg’s letter reveals that CNN is once again misrepresenting its own source.
CNN does not provide a link to the letter, but it was published by the National Academy of Sciences on April 1. Contrary to CNN’s characterization, Fineberg described aerosol transmission not only from breathing but also from speaking as merely a “possibility”, not a proven fact.
Fineberg does say in his letter that “the presence of viral RNA in air droplets and aerosols indicates the possibility of viral transmission via these routes.” But what CNN fails to relay to its audience is that, as Fineberg also points out, “the presence of viral RNA may not represent viable virus in sufficient amounts to produce infection.” (Emphasis added.)
CNN also omits the caveat, with reference to the study by University of Nebraska researchers, that, “While this research indicates that viral particles can be spread via bioaerosols, the authors stated that finding infectious virus has proved elusive and experiments are ongoing to determine viral activity in the collected samples.” (Emphasis added.)
When Fineberg stated that the data was “consistent with” aerosol transmission, it was another way of saying that, despite the detection of viable virus remaining “elusive”, it remained a theoretical possibility.
Likewise, CNN states as fact in its June 17 article that SARS-CoV-2 “can spread by just talking or breathing”, while its own primary source acknowledges that this has yet to be scientifically proven.
CNN’s claim that the virus can be spread by speaking and breathing is used in conjunction with its claim that asymptomatic transmission is common to advocate widespread use of masks. Given the political context and public discourse surrounding this issue, CNN is implicitly advocating executive orders mandating mask use in many states.
But are these orders evidence-based?
In that study, researchers found that surgical masks did not significantly reduce the amount of shedding in a forward direction from people with rhinovirus infection, which is a cause of common colds. For influenza, masks significantly reduced shedding of larger respiratory droplets, but not aerosols.
For common human coronaviruses, the authors state that their findings “demonstrated the efficacy of surgical masks to reduce coronavirus detection and viral copies in large respiratory droplets and in aerosols”. However, only the result for aerosols was statistically significant. While subjects wearing a mask did not shed detectable virus, most of those not wearing a mask also “did not shed detectable virus in respiratory droplets or aerosols”.
This implied that “prolonged close contact would be required for transmission to occur, even if transmission was primarily via aerosols”.
Importantly, the researchers did not test masks for effectiveness of reducing transmission of SARS-CoV-2 and they “did not confirm the infectivity of coronavirus” detected in exhaled breath. They also only tested surgical masks, not cloth masks, the latter of which are the type that the public has been instructed to wear to preserve the supply of medical masks for medical workers.
Another study, published in Annals of Internal Medicine, did test mask effectiveness with COVID-19 patients and found that “Neither surgical nor cotton masks effectively filtered SARS-CoV-2 during coughs by infected patients.” Counterintuitively, they found a heavy viral load on the outside but not the inside of the mask, which they hypothesized was due to a “turbulent jet due to air leakage around the mask.”
A study by researchers in the UK published on the Cornell University preprint server arXiv on May 19 examined the effectiveness of cloth masks at preventing transmission of aerosol particles from breathing or coughing. They found that both surgical and cloth masks produced a “potentially dangerous leakage jet” with “the potential to disperse virus-laden fluid particles by several metres”. Consequently, there is “a false sense of security that may arise when standing to the side of, or behind, a person wearing a surgical, or handmade mask”.
Yet, while advising the public to wear cloth masks “in public settings where other social distancing measures are difficult to maintain”, the CDC also notes that, unlike N95 respirators and surgical masks, cloth masks “are not considered PPE”, or personal protective equipment, and so should only be used by health care workers “as a last resort.”
A “COVID-19 Frequently Asked Questions” page on the website of the Occupational Safety and Health Administration (OSHA) similarly notes that cloth face coverings “Are not considered personal protective equipment (PPE)”, and both surgical and cloth masks “Will not protect the wearer against airborne transmissible infectious agents due to loose fit and lock of seal or inadequate filtration.”
The ECDC also notes that “The role of asymptomatic infections in transmission is unknown.”
Additionally, there are potential harms associated with widespread mask use among the general public, including the risk that “improper removal of the face mask, handling of a contaminated face mask or an increased tendency to touch the face while wearing a face mask by healthy persons might actually increase the risk of transmission.”
The WHO also notes that there are studies suggesting that surgical or cloth masks might be effective in preventing transmission, but these studies also indicate that to become infected with the virus, “individuals would need to be in close proximity to an infected person in a household or at a mass gathering where physical distancing cannot be achieved”.
Universal mask-wearing policies are not evidence-based, the WHO diplomatically observes, by stating that, “At present, there is no direct evidence (from studies on COVID-19 and in healthy people in the community) on the effectiveness of universal masking of healthy people in the community to prevent infection with respiratory viruses, including COVID-19.”
Additionally, the potential harms of such orders must be considered, including the “potential increased risk of self-contamination due to the manipulation of a face mask and subsequently touching eyes with contaminated hands”; the “potential self-contamination that can occur if non-medical masks are not changed when wet or soiled”, which “can create favourable conditions for microorganisms to amplify”; and “potential headache and/or breathing difficulties, depending on type of mask used”.
Consequently, the WHO reasonably recommends mask use only “in specific situations and settings” where prolonged close contact with others is unavoidable.
Curiously, despite such guidance on mask use from agencies like the CDC, OSHA, the ECDC, and the WHO, you won’t find CNN doing journalism by pointing out how, for example, the governor of Michigan has issued a mask-wearing order that is not evidence-based and how the state government is misinforming the public that wearing a cloth mask will protect them from SARS-CoV-2 infection, thus potentially placing people at greater risk by causing them to have a false sense of security.
Instead, CNN is content with doing propaganda that serves to manufacture consent for such orders by claiming that community transmission is largely driven by people who show no symptoms but who nevertheless spread the virus by speaking or breathing, which narrative it sustains by grossly misrepresenting its own primary sources.
CNN, of course, is not alone. While its reporting serves as a useful case study, this exercise could be repeated ad nauseum by examining other major media sources. The lesson for the reader is to maintain healthy skepticism toward sensationally reported claims, pay close attention to the caveats that accompany alarming headlines, and check to ensure that cited sources actually support the claims being made to the whatever extent feasible.
Unfortunately, this means doing one’s own research and thinking for oneself, but the reward is that as you develop the habit, you’ll become increasingly immune to statist propaganda designed to compel your obedience to clueless government bureaucrats who pursue their political agenda of acquiring ever more power and control over others by executing their authoritarian policies in the name of “science”.
 Holly Yan and Madeline Holcombe, “10 states are seeing their highest average of daily new Covid-19 cases since the pandemic started”, CNN, June 17, 2020, https://www.cnn.com/2020/06/17/health/us-coronavirus-wednesday/index.html.
 Holly Yan, “Fauci says the WHO’s comment on asymptomatic spread is wrong. Here’s the difference between asymptomatic and pre-symptomatic spread”, CNN, June 10, 2020, https://www.cnn.com/2020/06/09/health/asymptomatic-presymptomatic-coronavirus-spread-explained-wellness/index.html.
 Elizabeth Cohen, “Experts tell White House coronavirus can spread through talking or even just breathing”, CNN, April 2, 2020, updated April 4, 2020, https://www.cnn.com/2020/04/02/health/aerosol-coronavirus-spread-white-house-letter/index.html.
 Yan, “Fauci says”.
 Dr. Maria Van Kerkhove, “Virtual Press Conference”, June 8, 2020, World Health Organization, https://www.who.int/docs/default-source/coronaviruse/transcripts/who-audio-emergencies-coronavirus-press-conference-08jun2020.pdf.
 Yan, “Fauci says”.
 Harvard Medical School, “If you’ve been exposed to the coronavirus”, Harvard Health Publishing, March 2020, updated June 17, 2020, https://www.health.harvard.edu/diseases-and-conditions/if-youve-been-exposed-to-the-coronavirus.
 Tara Subramaniam and Veronica Stracqualursi, “Fact check: Georgia governor says we only just learned people without symptoms could spread coronavirus. Experts have been saying that for months”, CNN, April 3, 2020, https://www.cnn.com/2020/04/02/politics/fact-check-georgia-gov-brian-kemp-coronavirus-no-symptoms-stay-at-home/index.html.
 Jacqueline Howard, “CDC director: Novel coronavirus ‘is probably with us beyond this season, beyond this year’”, CNN, February 13, 2020, https://www.cnn.com/2020/02/13/health/coronavirus-cdc-robert-redfield-gupta-intv/index.html.
 Subramaniam and Stracqualursi.
 Kai Kupferschmidt, “Study claiming new coronavirus can be transmitted by people without symptoms was flawed”, Science, February 3, 2020, https://www.sciencemag.org/news/2020/02/paper-non-symptomatic-patient-transmitting-coronavirus-wrong.
 Subramaniam and Stracqualursi.
 Centers for Disease Control and Prevention, “Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)”, CDC.gov, updated March 30, 2020, archived April 2, 2020, accessed June 24, 2020, http://web.archive.org/web/20200402201639/https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html.
 CDC, “Interim Clinical Guidance”, updated June 2, 2020, accessed June 24, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html.
 Zhiliang Hu et al., “Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China”, Science China Life Sciences, March 4, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7088568/.
 Yuanyuan Dong et al., “Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China” (pre-publication release), Pediatrics, March 16, 2020, https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0702.full.pdf. While CNN cites the pre-print version, the CDC cites the retitled print version: Yuanyuan Dong et al., “Epidemiology of COVID-19 Among Children in China”, Pediatrics, June 1, 2020, https://doi.org/10.1542/peds.2020-0702. I reviewed the final version.
 Jamie Gumbrecht et al., “Report that said Wuhan coronavirus can spread before symptoms was flawed”, CNN, February 5, 2020, https://www.cnn.com/2020/02/05/health/wuhan-coronavirus-flawed-report/index.html.
 CDC, “Interim Clinical Guidance”.
 Arman Azad, “CDC estimates that 35% of coronavirus patients don’t have symptoms”, CNN, May 22, 2020, https://www.cnn.com/2020/05/22/health/cdc-coronavirus-estimates-symptoms-deaths/index.html.
 Centers for Disease Control and Prevention, “COVID-19 Pandemic Planning Scenarios”, CDC.gov, reviewed May 20, 2020, accessed June 25, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html.
 CDC, “Interim Clinical Guidance”.
 Dr. Anthony Fauci, Testimony to the House Oversight and Reform Committee Hearing on Coronavirus Response, C-SPAN, March 11, 2020, https://www.c-span.org/video/?470224-1/dr-fauci-warns-congress-coronavirus-outbreak-worse&start=5863.
 CDC, “COVID-19 Pandemic Planning Scenarios”.
 Tedros Adhanom, “WHO Director-General’s opening remarks at the media briefing on COVID-19”, World Health Organization, March 3, 2020, https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—3-march-2020.
 David H. Freedman, “Lies, Damned Lies, and Medical Science”, The Atlantic, November 2010, https://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/308269/.
 John P.A. Ioannidis, “Why Most Published Research Findings Are False”, PLoS Medicine, August 30, 2005, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/.
 Kaiser Family Foundation, “State Data and Policy Actions to Address Coronavirus”, KFF.org, updated June 24, 2020, accessed June 25, 2020, https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/.
 Centers for Disease Control and Prevention, “Daily Updates of Totals by Week and State”, CDC.gov, updated June 25, 2020, accessed June 25, 2020, https://www.cdc.gov/nchs/nvss/vsrr/COVID19/. As the time of writing, the CDC is reporting 19,025 COVID-19-related deaths in New York City and 10,301 deaths elsewhere in the state, comprising 27 percent of the total number of deaths in the US of 108,684.
 Kaiser Family Foundation.
 Ioannidis, “The infection fatality rate of COVID-19”.
 Jeremy R. Hammond, “Paul Offit Unwittingly Exposes Scientific Fraud of FDA’s Vaccine Licensure”, JeremyRHammond.com, July 26, 2019, https://www.jeremyrhammond.com/2019/07/26/paul-offit-unwittingly-exposes-scientific-fraud-of-fdas-vaccine-licensure/.
 Fan Wu et al., “Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications”, medRxiv, April 20, 2020, https://doi.org/10.1101/2020.03.30.20047365.
 Alba Grifoni, “Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals”, Cell, May 14, 2020, https://www.cell.com/cell/fulltext/S0092-8674(20)30610-3.
 CDC, “COVID-19 Pandemic Planning Scenarios”.
 Ruiyun Li et al., “Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)”, Science, March 16, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164387/.
 Yan and Holcombe.
 Centers for Disease Control and Prevention, “How Coronavirus Spreads”, CDC.gov, reviewed March 4, 2020, archived at 02:54:40 on April 2, 2020, accessed June 25, 2020, http://web.archive.org/web/20200402025440/https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html.
 CDC, “How Coronavirus Spreads”, reviewed April 2, 2020, archived at 20:41:17 on April 2, 2020, accessed June 25, 2020, http://web.archive.org/web/20200402204117/https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html.
 CDC, “How Coronavirus Spreads”, updated June 16, 2020, accessed June 25, 2020, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html.
 Harvey V. Fineberg, “Rapid Expert Consultation on the Possibility of Bioaerosol Spread of SARS-CoV-2 for the COVID-19 Pandemic”, National Academies Press, April 1, 2020, https://doi.org/10.17226/25769.
 Yan and Holcombe.
 A useful list of statewide mask-wearing orders has been compiled by Littler Mendelson, “Facing Your Face Mask Duties – A List of Statewide Orders, as of June 25, 2020”, Littler, June 25, 2020, https://www.littler.com/publication-press/publication/facing-your-face-mask-duties-list-statewide-orders.
 Seongman Bae et al., “Effectiveness of Surgical and Cotton Masks in Blocking SARS–CoV-2: A Controlled Comparison in 4 Patients”, Annals of Internal Medicine, April 6, 2020, https://doi.org/10.7326/M20-1342.
 State of Michigan, “Should I wear a mask to protect myself?”, Michigan.gov, updated June 24, 2020, accessed June 25, 2020, https://www.michigan.gov/coronavirus/0,9753,7-406-98810-524158–,00.html.
 Centers for Disease Control and Prevention, “Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission”, CDC.gov, reviewed April 3, 2020, accessed June 25, 2020, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html. Centers for Disease Control and Prevention, “Strategies for Optimizing the Supply of Facemasks”, CDC.gov, reviewed March 17, 2020, accessed June 25, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html.
 United States Department of Labor, Occupational Safety and Health Administration, “COVID-19 Frequently Asked Questions”, OSHA.gov, accessed June 25, 2020, https://www.osha.gov/SLTC/covid-19/covid-19-faq.html.
 European Centre for Disease Prevention and Control, “Using face masks in the community”, ecdc.europa.eu, April 8, 2020, https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-use-face-masks-community.pdf.
 World Health Organization, “Advice on the use of masks in the context of COVID-19”, WHO.int, June 5, 2020, https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak.