Fact check: New England journal article taken out of context, didn't bash face masks

The claim: Authors of medical journal article wrote that masks outside hospitals provide 'little, if any' protection

The authors of a medical journal article that questioned the use of masks outside health care settings say they support widespread mask wearing when people are in close quarters and that their words have been taken out of context.

The May 21 issue of The New England Journal of Medicine included a "perspective" article titled "Universal Masking in Hospitals in the COVID-19 Era" that questioned the usefulness of mask wearing outside a hospital or other health care facility. The article was first published on the journal's website on April 1.

"We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to COVID-19 as face-to-face contact within 6 feet with a patient with symptomatic COVID-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching COVID-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic," the journal article states.

Many Facebook posts have shared a screenshot of that paragraph online, with the first and last sentences highlighted.

"THE NEW ENGLAND JOURNAL OF MEDICINE, MAY 21, 2020!!" one Facebook post stated. The post also referenced "Plandemic," a widely shared online video that promoted several discredited conspiracy theories about the coronavirus.

Article's authors say they intended to 'push for more masking'

In a follow-up letter to the New England Journal of Medicine published online June 3 and in print July 9, three of the article's authors, Drs. Michael Klompas, Charles Morris and Erica Shenoy, wrote some people were using their article "as support for discrediting widespread masking."

"We understand that some people are citing our perspective article as support for discrediting widespread masking. In truth, the intent of our article was to push for more masking, not less. It is apparent that many people with SARS-CoV-2 infection are asymptomatic or presymptomatic yet highly contagious and that these people account for a substantial fraction of all transmissions. Universal masking helps to prevent such people from spreading virus-laden secretions, whether they recognize that they are infected or not," the three authors wrote in the letter.

More:New report from CDC says face masks can protect you and others from COVID

Klompas, an associate professor of infectious diseases at Harvard Medical School and associate hospital epidemiologist at Brigham and Women's Hospital in Boston, wrote in an email to USA TODAY that the intention of the original article was to explain the decision to implement a universal mask wearing policy in his hospital system. At the time the original article was written, public health officials had not begun recommending universal mask use.

"The sentiments we expressed in favor of masking in this paper were ahead of common practice in most hospitals," Klompas wrote. "The world has changed rapidly since then, and masking is now an accepted norm, both in and out of hospitals."

More:10 popular face masks everyone is buying on Amazon

Short, not long, interactions was the focus

The phrase "little, if any, protection from infection" in the original article was intended to refer to brief encounters in public places, not prolonged interactions, the authors wrote.

"As the rest of the paragraph makes clear, we intended this statement to apply to passing encounters in public spaces, not sustained interactions within closed environments," they wrote. "A growing body of research shows that the risk of SARS-CoV-2 transmission is strongly correlated with the duration and intensity of contact: the risk of transmission among household members can be as high as 40%, whereas the risk of transmission from less intense and less sustained encounters is below 5%."

The authors went on to say that recent research has associated mask wearing with less transmission of the coronavirus, "particularly in closed settings."

More:Fact check: What's true and what's false about face masks?

"We therefore strongly support the calls of public health agencies for all people to wear masks when circumstances compel them to be within 6 ft of others for sustained periods," the authors concluded.

Klompas echoed that sentiment in his email, saying "we strongly support masking for people within six feet of one another."

"If you’re outside, it’s not crowded, and people are reliably more than six feet away at all times, then a mask probably doesn’t add much additional value. But if you’re indoors, in crowded space or in a situation where people may intermittently come within six feet, then masking is desirable," Klompas said.

CDC recommends most people wear face coverings to prevent spread of COVID-19

The U.S. Centers for Disease Control and Prevention recommends people 2 years old and older wear cloth face coverings in public settings and when around people who don't live in the same household.

The face coverings help prevent respiratory droplets from spreading when someone sneezes, coughs, talks or speaks loudly, the CDC's website states.

The recommendation to mask up applies to the general public, including people without symptoms of COVID-19.

"COVID-19 can be spread by people who do not have symptoms and do not know that they are infected. That’s why it’s important for everyone to wear cloth face coverings in public settings and practice social distancing (staying at least 6 feet away from other people)," the CDC states on its website.

People who know they have or think they might have the coronavirus should also wear face coverings, the CDC recommends.

"The cloth face covering helps prevent a person who is sick from spreading the virus to others. It helps keep respiratory droplets contained and from reaching other people," the CDC's website states.

Our ruling: Partly false

The Facebook posts share an accurate screenshot of an article in the New England Journal of Medicine's May 21 issue that states that face masks offer "little, if any, protection from infection" outside health care facilities.

However, the posts lack context. The authors of the referenced article say that the quoted statement referred to brief encounters in public places rather than sustained contact in close quarters. The authors say they support public health agencies' calls for all people to wear masks when they cannot keep 6 feet away from others for sustained periods of time.

The Facebook post is misleading to the extent that it implies the journal article offers evidence against universal face mask policies. The authors of the journal article say they support such policies. Therefore, we rate this claim as PARTLY FALSE.

Our fact-check sources:

Stephen Gruber-Miller covers the Iowa Statehouse and politics for the Register. He can be reached by email at sgrubermil@registermedia.com or by phone at 515-284-8169. Follow him on Twitter at @sgrubermiller.

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