thelibertybeacon--2020-11-20--The Famous Danish Mask Study: Masks Do Not Protect From Coronavirus

The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50 % in a community with modest infection rates , some degree of social distancing , and uncommon general mask use .
The data were compatible with lesser degrees of self-protection .
A total of 3030 participants were randomly assigned to the recommendation to wear masks , and 2994 were assigned to control ; 4862 completed the study .
Infection with SARS-CoV-2 occurred in 42 participants recommended masks ( 1.8 % ) and 53 control participants @ @ @ @ @ @ @ difference was −0.3 percentage point ( 95 % CI , −1.2 to 0.4 percentage point ; P = 0.38 ) ( odds ratio , 0.82 [ CI , 0.54 to 1.23 ] ; P = 0.33 ) .
Multiple imputation accounting for loss to follow-up yielded similar results .
Although the difference observed was not statistically significant , the 95 % CIs are compatible with a 46 % reduction to a 23 % increase in infection .
Encouragement to follow social distancing measures for coronavirus disease 2019 , plus either no mask recommendation @ @ @ @ @ @ @ when outside the home among other persons together with a supply of 50 surgical masks and instructions for proper use .
Severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) , the cause of coronavirus disease 2019 ( COVID-19 ) , has infected more than 54 million persons ( 1 , 2 ) .
Measures to impede transmission in health care and community settings are essential ( 3 ) .
The virus is transmitted person-to-person , primarily through the mouth , nose , or eyes via respiratory droplets , aerosols , or fomites @ @ @ @ @ @ @ can survive on surfaces for up to 72 hours ( 6 ) , and touching a contaminated surface followed by face touching is another possible route of transmission ( 7 ) .
Face masks are a plausible means to reduce transmission of respiratory viruses by minimizing the risk that respiratory droplets will reach wearers ’ nasal or oral mucosa .
Face masks are also hypothesized to reduce face touching ( 8 , 9 ) , but frequent face and mask touching has been reported among health care personnel ( 10 ) .
Observational @ @ @ @ @ @ @ in health care settings ( 11 , 12 ) and as source control in patients infected with SARS-CoV-2 or other coronaviruses ( 13 ) .
An increasing number of localities recommend masks in community settings on the basis of this observational evidence , but recommendations vary and controversy exists ( 14 ) .
The World Health Organization ( WHO ) and the U.S. Centers for Disease Control and Prevention ( 15 ) strongly recommend that persons with symptoms or known infection wear masks to prevent transmission of SARS-CoV-2 to others ( source control @ @ @ @ @ @ @ WHO acknowledges that we lack evidence that wearing a mask protects healthy persons from SARS-CoV-2 ( prevention ) ( 17 ) .
A systematic review of observational studies reported that mask use reduced risk for SARS , Middle East respiratory syndrome , and COVID-19 by 66 % overall , 70 % in health care workers , and 44 % in the community ( 12 ) .
However , surgical and cloth masks were grouped in preventive studies , and none of the 3 included non–health care studies related directly to COVID-19 .
Another @ @ @ @ @ @ @ College of Physicians recommendations ( 19 ) concluded that evidence on mask effectiveness for respiratory infection prevention is stronger in health care than community settings .
Observational evidence suggests that mask wearing mitigates SARS-CoV-2 transmission , but whether this observed association arises because masks protect uninfected wearers ( protective effect ) or because transmission is reduced from infected mask wearers ( source control ) is uncertain .
Here , we report a randomized controlled trial ( 20 ) that assessed whether a recommendation to wear a surgical mask when outside the home among @ @ @ @ @ @ @ infection in a setting where public health measures were in effect but community mask wearing was uncommon and not recommended .
DANMASK-19 ( Danish Study to Assess Face Masks for the Protection Against COVID-19 Infection ) was an investigator-initiated , nationwide , unblinded , randomized controlled trial ( ClinicalTrials.gov : NCT04337541 ) .
The trial protocol was registered with the Danish Data Protection Agency ( P-2020-311 ) ( Part 10 of the Supplement ) and published ( 21 ) .
The researchers presented the protocol to the independent regional scientific ethics committee of @ @ @ @ @ @ @ did not require ethics approval ( H-20023709 ) in accordance with Danish legislation ( Parts 11 and 12 of the Supplement ) .
The trial was done in accordance with the principles of the Declaration of Helsinki .
During the study period ( 3 April to 2 June 2020 ) , Danish authorities did not recommend use of masks in the community and mask use was uncommon ( < 5 % ) outside hospitals ( 22 ) .
Recommended public health measures included quarantining persons with SARS-CoV-2 infection , social distancing ( including @ @ @ @ @ @ @ remained open ) , limiting the number of persons seen , frequent hand hygiene and cleaning , and limiting visitors to hospitals and nursing homes ( 23 , 24 ) .
Cafés and restaurants were closed during the study until 18 May 2020 .
Eligible persons were community-dwelling adults aged 18 years or older without current or prior symptoms or diagnosis of COVID-19 who reported being outside the home among others for at least 3 hours per day and who did not wear masks during their daily work .
Recruitment involved media advertisements @ @ @ @ @ @ @ .
Interested citizens had internet access to detailed study information and to research staff for questions ( Part 3 of the Supplement ) .
At baseline , participants completed a demographic survey and provided consent for researchers to access their national registry data ( Parts 4 and 5 of the Supplement ) .
Recruitment occurred from 3 through 24 April 2020 .
Half of participants were randomly assigned to a group on 12 April and half on 24 April .
Participants were enrolled and data registered using Research Electronic Data Capture ( REDCap @ @ @ @ @ @ @ participants were randomly assigned 1:1 to the mask or control group using a computer algorithm and were stratified by the 5 regions of Denmark ( Supplement Table 1 ) .
Participants were notified of allocation by e-mail , and study packages were sent by courier ( Part 7 of the Supplement ) .
Participants in the mask group were instructed to wear a mask when outside the home during the next month .
They received 50 three-layer , disposable , surgical face masks with ear loops ( TYPE II EN 14683 [ Abena @ @ @ @ @ @ @ ; made in China ) .
Participants in both groups received materials and instructions for antibody testing on receipt and at 1 month .
They also received materials and instructions for collecting an oropharyngeal/nasal swab sample for polymerase chain reaction ( PCR ) testing at 1 month and whenever symptoms compatible with COVID-19 occurred during follow-up .
If symptomatic , participants were strongly encouraged to seek medical care .
They registered symptoms and results of the antibody test in the online REDCap system .
Participants returned the test material by prepaid express courier @ @ @ @ @ @ @ antibody testing , oropharyngeal/nasal swabbing , and proper use of masks ( Part 8 of the Supplement ) , and a help line was available to participants .
In accordance with WHO recommendations for health care settings at that time , participants were instructed to change the mask if outside the home for more than 8 hours .
At baseline and in weekly follow-up e-mails , participants in both groups were encouraged to follow current COVID-19 recommendations from the Danish authorities .
Participants tested for SARS-CoV-2 IgM and IgG antibodies in whole blood @ @ @ @ @ @ @ test [ Zhuhai Livzon Diagnostics ] ) according to the manufacturer ’ s recommendations and as previously described ( 26 ) .
After puncturing a fingertip with a lancet , they withdrew blood into a capillary tube and placed 1 drop of blood followed by 2 drops of saline in the test chamber in each of the 2 test plates ( IgM and IgG ) .
Participants reported IgM and IgG results separately as “ 1 line present ” ( negative ) , “ 2 lines present ” ( positive ) , or @ @ @ @ @ @ @ I could not perform the test ” ( treated as a negative result ) .
Participants were categorized as seropositive if they had developed IgM , IgG , or both .
The manufacturer reported that sensitivity was 90.2 % and specificity 99.2 % .
A previously reported internal validation using 651 samples from blood donors before November 2019 and 155 patients with PCR-confirmed SARS-CoV-2 infection estimated a sensitivity of 82.5 % ( 95 % CI , 75.3 % to 88.4 % ) and specificity of 99.5 % ( CI , 98.7 % to @ @ @ @ @ @ @ We ( 27 ) and others ( 28 ) have reported that oropharyngeal/nasal swab sampling for SARS-CoV-2 by participants , as opposed to health care workers , is clinically useful .
Descriptions of RNA extraction , primer and probe used , reverse transcription , preamplification , and microfluidic quantitative PCR are detailed in Part 6 of the Supplement .
Participants received 4 follow-up surveys ( Parts 4 and 5 of the Supplement ) by e-mail to collect information on antibody test results , adherence to recommendations on time spent outside the home among @ @ @ @ @ @ @ diagnosis based on PCR testing done in public hospitals , and known COVID-19 exposures .
The primary outcome was SARS-CoV-2 infection , defined as a positive result on an oropharyngeal/nasal swab test for SARS-CoV-2 , development of a positive SARS-CoV-2 antibody test result ( IgM or IgG ) during the study period , or a hospital-based diagnosis of SARS-CoV-2 infection or COVID-19 .
Secondary end points included PCR evidence of infection with other respiratory viruses ( Supplement Table 2 ) .
The sample size was determined to provide adequate power for assessment of @ @ @ @ @ @ @ intention-to-treat analysis .
Authorities estimated an incidence of SARS-CoV-2 infection of at least 2 % during the study period .
Assuming that wearing a face mask halves risk for infection , we estimated that a sample of 4636 participants would provide the trial with 80 % power at a significance level of 5 % ( 2-sided α level ) .
Anticipating 20 % loss to follow-up in this community-based study , we aimed to assign at least 6000 participants .
Participants with a positive result on an antibody test at baseline were excluded @ @ @ @ @ @ @ of proportions assuming binomial distribution ( Clopper–Pearson ) .
The primary composite outcome ( intention-to-treat ) was compared between groups using the χ2 test .
Odds ratios and confidence limits were calculated using logistic regression .
We did a per protocol analysis that included only participants reporting complete or predominant use of face masks as instructed .
A conservative sensitivity analysis assumed that participants with a positive result on an antibody test at the end of the study who had not provided antibody test results at study entrance had had a positive result @ @ @ @ @ @ @ uncertainty of loss to follow-up , we did ( post hoc ) 200 imputations using the R package smcfcs , version 1.4.1 ( 29 ) , to impute missing values of outcome .
We included sex , age , type of work , time out of home , and outcome in this calculation .
Prespecified subgroups were compared by logistic regression analysis .
In a post hoc analysis , we explored whether there was a subgroup defined by a constellation of participant characteristics for which a recommendation to wear masks seemed to be @ @ @ @ @ @ @ , type of work , time out of home , and outcome in this calculation .
Two-sided P values less than 0.05 were considered statistically significant .
Analyses were done using R , version 3.6.1 ( R Foundation ) .
An unrestricted grant from the Salling Foundations supported the study , and the BESTSELLER Foundation donated the Livzon tests .
The funders did not influence study design , conduct , or reporting .
A total of 17 258 Danish citizens responded to recruitment , and 6024 completed the baseline survey and fulfilled eligibility @ @ @ @ @ @ @ 1 ; n = 2995 ) were randomly assigned on 12 April 2020 and were followed from 14 to 16 April through 15 May 2020 .
Remaining participants ( group 2 ; n = 3029 ) were randomly assigned on 24 April 2020 and were followed from 2 to 4 May through 2 June 2020 .
A total of 3030 participants were randomly assigned to the recommendation to wear face masks , and 2994 were assigned not to wear face masks ( Figure ) ; 4862 participants ( 80.7 % ) completed the @ @ @ @ @ @ @ , which were well balanced between groups .
Participants reported having spent a median of 4.5 hours per day outside the home .
Based on the lowest adherence reported in the mask group during follow-up , 46 % of participants wore the mask as recommended , 47 % predominantly as recommended , and 7 % not as recommended .
The primary outcome occurred in 42 participants ( 1.8 % ) in the mask group and 53 ( 2.1 % ) in the control group .
In an intention-to-treat analysis , the between-group difference @ @ @ @ @ @ @ −1.2 to 0.4 percentage point ; P = 0.38 ) ( odds ratio [ OR ] , 0.82 [ CI , 0.54 to 1.23 ] ; P = 0.33 ) in favor of the mask group ( Supplement Figure 1 ) .
When this analysis was repeated with multiple imputation for missing data due to loss to follow-up , it yielded similar results ( OR , 0.81 [ CI , 0.53 to 1.23 ] ; P = 0.32 ) .
Table 2 provides data on the components of the primary end point , @ @ @ @ @ @ @ a per protocol analysis that excluded participants in the mask group who reported nonadherence ( 7 % ) , SARS-CoV-2 infection occurred in 40 participants ( 1.8 % ) in the mask group and 53 ( 2.1 % ) in the control group ( between-group difference , −0.4 percentage point [ CI , −1.2 to 0.5 percentage point ] ; P = 0.40 ) ( OR , 0.84 [ CI , 0.55 to 1.26 ] ; P = 0.40 ) .
Supplement Figure 2 provides results of the prespecified subgroup analyses of the @ @ @ @ @ @ @ significant interactions were identified .
In the preplanned sensitivity analysis , those who had a positive result on an antibody test at 1 month but had not provided antibody results at baseline were considered to have had positive results at baseline ( n = 18 ) —that is , they were excluded from the analysis .
In this analysis , the primary outcome occurred in 33 participants ( 1.4 % ) in the face mask group and 44 ( 1.8 % ) in the control group ( between-group difference , −0.4 percentage point @ @ @ @ @ @ @ point ] ; P = 0.22 ) ( OR , 0.77 [ CI , 0.49 to 1.22 ] ; P = 0.26 ) .
Three post hoc ( not preplanned ) analyses were done .
In the first , which included only participants reporting wearing face masks “ exactly as instructed , ” infection ( the primary outcome ) occurred in 22 participants ( 2.0 % ) in the face mask group and 53 ( 2.1 % ) in the control group ( between-group difference , −0.2 percentage point [ CI , −1.3 @ @ @ @ @ @ @ = 0.82 ) ( OR , 0.93 [ CI , 0.56 to 1.54 ] ; P = 0.78 ) .
The second post hoc analysis excluded participants who did not provide antibody test results at baseline ; infection occurred in 33 participants ( 1.7 % ) in the face mask group and 44 ( 2.1 % ) in the control group ( between-group difference , −0.4 percentage point [ CI , −1.4 to 0.4 percentage point ] ; P = 0.33 ) ( OR , 0.80 [ CI , 0.51 to 1.27 ] @ @ @ @ @ @ @ the third post hoc analysis , which investigated constellations of patient characteristics , we did not find a subgroup where face masks were effective at conventional levels of statistical significance ( data not shown ) .
A total of 52 participants in the mask group and 39 control participants reported COVID-19 in their household .
Of these , 2 participants in the face mask group and 1 in the control group developed SARS-CoV-2 infection , suggesting that the source of most observed infections was outside the home .
Reported symptoms did not differ @ @ @ @ @ @ @ Supplement Table 3 ) .
In the mask group , 9 participants ( 0.5 % ) were positive for 1 or more of the 11 respiratory viruses other than SARS-CoV-2 , compared with 11 participants ( 0.6 % ) in the control group ( between-group difference , −0.1 percentage point [ CI , −0.6 to 0.4 percentage point ] ; P = 0.87 ) ( OR , 0.84 [ CI , 0.35 to 2.04 ] ; P = 0.71 ) .
Positivity for any virus , including SARS-CoV-2 , occurred in 9 mask @ @ @ @ @ @ @ control participants ( 0.8 % ) ( between-group difference , −0.3 percentage point [ CI , −0.9 to 0.2 percentage point ] ; P = 0.26 ) ( OR , 0.58 [ CI , 0.25 to 1.31 ] ; P = 0.19 ) .
In this community-based , randomized controlled trial conducted in a setting where mask wearing was uncommon and was not among other recommended public health measures related to COVID-19 , a recommendation to wear a surgical mask when outside the home among others did not reduce , at conventional levels @ @ @ @ @ @ @ compared with no mask recommendation .
We designed the study to detect a reduction in infection rate from 2 % to 1 % .
Although no statistically significant difference in SARS-CoV-2 incidence was observed , the 95 % CIs are compatible with a possible 46 % reduction to 23 % increase in infection among mask wearers .
These findings do offer evidence about the degree of protection mask wearers can anticipate in a setting where others are not wearing masks and where other public health measures , including social distancing , are in @ @ @ @ @ @ @ should not be used to conclude that a recommendation for everyone to wear masks in the community would not be effective in reducing SARS-CoV-2 infections , because the trial did not test the role of masks in source control of SARS-CoV-2 infection .
During the study period , authorities did not recommend face mask use outside hospital settings and mask use was rare in community settings ( 22 ) .
This means that study participants ’ exposure was overwhelmingly to persons not wearing masks .
The observed infection rate was similar to that @ @ @ @ @ @ @ the study period ( 26 , 30 ) .
Of note , the observed incidence of SARS-CoV-2 infection was higher than we had estimated when planning a sample size that would ensure more than 80 % power to detect a 50 % decrease in infection .
The intervention lasted only 1 month and was carried out during a period when Danish authorities recommended quarantine of diagnosed patients , physical distancing , and hand hygiene as general protective means against SARS-CoV-2 transmission ( 23 ) .
Cafés and restaurants were closed through 18 May @ @ @ @ @ @ @ group continued through 2 June .
The first randomized group was followed while the Danish society was under lockdown .
Reopening occurred ( 18 May 2020 ) during follow-up of the second group of participants , but it was not reflected in the outcome because infection rates were similar between groups ( Supplement Figure 2 ) .
The relative infection rate between mask wearers and those not wearing masks would most likely be affected by changes in applied protective means or in the virulence of SARS-CoV-2 , whereas the rate difference between the @ @ @ @ @ @ @ solely by a higher—or lower—number of infected citizens .
Although we saw no statistically significant difference in presence of other respiratory viruses , the study was not sufficiently powered to draw definite conclusions about the protective effect of masks for other viral infections .
Likewise , the study had limited power for any of the subgroup analyses .
The primary outcome was mainly defined by antibodies against SARS-CoV-2 .
This definition was chosen because the viral load of infected patients may be only transiently detectable ( 31 , 32 ) and because approximately @ @ @ @ @ @ @ asymptomatic ( 33 , 26 ) .
Masks have been hypothesized to reduce inoculum size ( 34 ) and could increase the likelihood that infected mask users are asymptomatic , but this hypothesis has been challenged ( 35 ) .
For these reasons , we did not rely solely on identification of SARS-CoV-2 in oropharyngeal/nasal swab samples .
As mentioned in the Methods section , an internal validation study estimated that the point-of-care test has 82.5 % sensitivity and 99.5 % specificity ( 26 ) .
The observed rate of incident SARS-CoV-2 infection @ @ @ @ @ @ @ trial design .
These rates were based on thorough screening of all participants using antibody measurements combined with PCR , whereas the observed official infection rates relied solely on PCR test–based estimates during the period .
In addition , authorities tested only a small subset of primarily symptomatic citizens of the entire population , yielding low incidence rates .
On this basis , the infection rates we report here are not comparable with the official SARS-CoV-2 infection rates in the Danish population .
The eligibility requirement of at least 3 hours of exposure @ @ @ @ @ @ @ add to this difference .
Between 6 April and 9 May 2020 , we found a similar seroprevalence of SARS-CoV-2 of 1.9 % ( CI , 0.8 % to 2.3 % ) in Danish blood donors using the Livzon point-of-care test and assessed by laboratory technicians ( 36 ) .
Testing at the end of follow-up , however , may not have captured any infections contracted during the last part of the study period , but this would have been true in both the mask and control groups and was not expected to @ @ @ @ @ @ @ masks provided to participants were high-quality surgical masks with a filtration rate of 98 % ( 37 ) .
A published meta-analysis found no statistically significant difference in preventing influenza in health care workers between respirators ( N95 [ American standard ] or FFP2 [ European standard ] ) and surgical face masks ( 38 ) .
Adherence to mask use may be higher than observed in this study in settings where mask use is common .
Some mask group participants ( 14 % ) reported adverse reactions from other citizens ( Supplement @ @ @ @ @ @ @ influence the protective effect of masks , sensitivity analyses had similar results across reported adherence .
How SARS-CoV-2 is transmitted—via respiratory droplets , aerosols , or ( to a lesser extent ) fomites—is not firmly established .
Droplets are larger and rapidly fall to the ground , whereas aerosols are smaller ( ≤5 μm ) and may evaporate and remain in the air for hours ( 39 ) .
Transmission of SARS-CoV-2 may take place through multiple routes .
It has been argued that for the primary route of SARS-CoV-2 spread—that is , @ @ @ @ @ @ @ , whereas masks would not be effective against spread via aerosols , which might penetrate or circumnavigate a face mask ( 37 , 39 ) .
Thus , spread of SARS-CoV-2 via aerosols would at least partially explain the present findings .
Lack of eye protection may also have been of importance , and use of face shields also covering the eyes ( rather than face masks only ) has been advocated to halt the conjunctival route of transmission ( 40 , 41 ) .
We observed no statistically significant interaction between wearers @ @ @ @ @ @ @ 2 ) .
Recent reports indicate that transmission of SARS-CoV-2 via fomites is unusual ( 42 ) , but masks may alter behavior and potentially affect fomite transmission .
The present findings are compatible with the findings of a review of randomized controlled trials of the efficacy of face masks for prevention ( as personal protective equipment ) against influenza virus ( 18 ) .
A recent meta-analysis that suggested a protective effect of face masks in the non–health care setting was based on 3 observational studies that included a total of 725 @ @ @ @ @ @ @ rather than SARS-CoV-2 ( 12 ) .
Of 725 participants , 138 ( 19 % ) were infected , so the transmission rate seems to be higher than for SARS-CoV-2 .
Further , these studies focused on prevention of infection in healthy mask wearers from patients with a known , diagnosed infection rather than prevention of transmission from persons in their surroundings in general .
In addition , identified comparators ( control participants ) not wearing masks may also have missed other protective means .
Recent observational studies that indicate a protective association @ @ @ @ @ @ @ and SARS-CoV-2 transmission are limited by study design and simultaneous introduction of other public health interventions ( 14 , 43 ) .
Several challenges regarding wearing disposable face masks in the community exist .
These include practical aspects , such as potential incorrect wearing , reduced adherence , reduced durability of the mask depending on type of mask and occupation , and weather .
Such circumstances may necessitate the use of multiple face masks during the day .
In our study , participants used a mean of 1.7 masks per weekday and 1.3 @ @ @ @ @ @ @ ) .
Wearing a face mask may be physically unpleasant , and psychological barriers and other side effects have been described ( 44 ) .
“ Face mask policing ” between citizens might reinforce use of masks but may be challenging .
In addition , the wearer of a face mask may change to a less cautious behavior because of a false sense of security , as pointed out by WHO ( 17 ) ; accordingly , our face mask group seemed less worried ( Supplement Table 4 ) , which may explain @ @ @ @ @ @ @ in the future ( Supplement Table 5 ) .
These challenges , including costs and availability , may reduce the efficacy of face masks to prevent SARS-CoV-2 infection .
The potential benefits of a community-wide recommendation to wear masks include combined prevention and source control for symptomatic and asymptomatic persons , improved attention , and reduced potential stigmatization of persons wearing masks to prevent infection of others ( 17 ) .
Although masks may also have served as source control in SARS-CoV-2–infected participants , the study was not designed to determine the effectiveness @ @ @ @ @ @ @ limitation is that the findings are inconclusive , with CIs compatible with a 46 % decrease to a 23 % increase in infection .
Other limitations include the following .
Participants may have been more cautious and focused on hygiene than the general population ; however , the observed infection rate was similar to findings of other studies in Denmark ( 26 , 30 ) .
Loss to follow-up was 19 % , but results of multiple imputation accounting for missing data were similar to the main results .
In addition , we @ @ @ @ @ @ @ tests , and blinding to the intervention was not possible .
Finally , a randomized controlled trial provides high-level evidence for treatment effects but can be prone to reduced external validity .
Our results suggest that the recommendation to wear a surgical mask when outside the home among others did not reduce , at conventional levels of statistical significance , the incidence of SARS-CoV-2 infection in mask wearers in a setting where social distancing and other public health measures were in effect , mask recommendations were not among those measures , and community @ @ @ @ @ @ @ , the findings were inconclusive and can not definitively exclude a 46 % reduction to a 23 % increase in infection of mask wearers in such a setting .
It is important to emphasize that this trial did not address the effects of masks as source control or as protection in settings where social distancing and other public health measures are not in effect .
Reduction in release of virus from infected persons into the environment may be the mechanism for mitigation of transmission in communities where mask use is common or mandated @ @ @ @ @ @ @ Thus , these findings do not provide data on the effectiveness of widespread mask wearing in the community in reducing SARS-CoV-2 infections .
They do , however , offer evidence about the degree of protection mask wearers can anticipate in a setting where others are not wearing masks and where other public health measures , including social distancing , are in effect .
The findings also suggest that persons should not abandon other COVID-19 safety measures regardless of the use of masks .
While we await additional data to inform mask recommendations , @ @ @ @ @ @ @ , uncertainty about the degree of source control and protective effect , and the absence of data suggesting serious adverse effects of masks ( 45 ) .

The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.
A total of 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%). The between-group difference was −0.3 percentage point (95% CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio, 0.82 [CI, 0.54 to 1.23]; P = 0.33). Multiple imputation accounting for loss to follow-up yielded similar results. Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.
Encouragement to follow social distancing measures for coronavirus disease 2019, plus either no mask recommendation or a recommendation to wear a mask when outside the home among other persons together with a supply of 50 surgical masks and instructions for proper use.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has infected more than 54 million persons (1, 2). Measures to impede transmission in health care and community settings are essential (3). The virus is transmitted person-to-person, primarily through the mouth, nose, or eyes via respiratory droplets, aerosols, or fomites (4, 5). It can survive on surfaces for up to 72 hours (6), and touching a contaminated surface followed by face touching is another possible route of transmission (7). Face masks are a plausible means to reduce transmission of respiratory viruses by minimizing the risk that respiratory droplets will reach wearers’ nasal or oral mucosa. Face masks are also hypothesized to reduce face touching (8, 9), but frequent face and mask touching has been reported among health care personnel (10). Observational evidence supports the efficacy of face masks in health care settings (11, 12) and as source control in patients infected with SARS-CoV-2 or other coronaviruses (13).
An increasing number of localities recommend masks in community settings on the basis of this observational evidence, but recommendations vary and controversy exists (14). The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (15) strongly recommend that persons with symptoms or known infection wear masks to prevent transmission of SARS-CoV-2 to others (source control) (16). However, WHO acknowledges that we lack evidence that wearing a mask protects healthy persons from SARS-CoV-2 (prevention) (17). A systematic review of observational studies reported that mask use reduced risk for SARS, Middle East respiratory syndrome, and COVID-19 by 66% overall, 70% in health care workers, and 44% in the community (12). However, surgical and cloth masks were grouped in preventive studies, and none of the 3 included non–health care studies related directly to COVID-19. Another systematic review (18) and American College of Physicians recommendations (19) concluded that evidence on mask effectiveness for respiratory infection prevention is stronger in health care than community settings.
Observational evidence suggests that mask wearing mitigates SARS-CoV-2 transmission, but whether this observed association arises because masks protect uninfected wearers (protective effect) or because transmission is reduced from infected mask wearers (source control) is uncertain. Here, we report a randomized controlled trial (20) that assessed whether a recommendation to wear a surgical mask when outside the home among others reduced wearers’ risk for SARS-CoV-2 infection in a setting where public health measures were in effect but community mask wearing was uncommon and not recommended.
Methods
Trial Design and Oversight
DANMASK-19 (Danish Study to Assess Face Masks for the Protection Against COVID-19 Infection) was an investigator-initiated, nationwide, unblinded, randomized controlled trial (ClinicalTrials.gov: NCT04337541). The trial protocol was registered with the Danish Data Protection Agency (P-2020-311) (Part 10 of the Supplement) and published (21). The researchers presented the protocol to the independent regional scientific ethics committee of the Capital Region of Denmark, which did not require ethics approval (H-20023709) in accordance with Danish legislation (Parts 11 and 12 of the Supplement). The trial was done in accordance with the principles of the Declaration of Helsinki.
Participants and Study Period
During the study period (3 April to 2 June 2020), Danish authorities did not recommend use of masks in the community and mask use was uncommon (<5%) outside hospitals (22). Recommended public health measures included quarantining persons with SARS-CoV-2 infection, social distancing (including in shops and public transportation, which remained open), limiting the number of persons seen, frequent hand hygiene and cleaning, and limiting visitors to hospitals and nursing homes (23, 24). Cafés and restaurants were closed during the study until 18 May 2020.
Eligible persons were community-dwelling adults aged 18 years or older without current or prior symptoms or diagnosis of COVID-19 who reported being outside the home among others for at least 3 hours per day and who did not wear masks during their daily work. Recruitment involved media advertisements and contacting private companies and public organizations. Interested citizens had internet access to detailed study information and to research staff for questions (Part 3 of the Supplement). At baseline, participants completed a demographic survey and provided consent for researchers to access their national registry data (Parts 4 and 5 of the Supplement). Recruitment occurred from 3 through 24 April 2020. Half of participants were randomly assigned to a group on 12 April and half on 24 April.
Intervention
Participants were enrolled and data registered using Research Electronic Data Capture (REDCap) software (25). Eligible participants were randomly assigned 1:1 to the mask or control group using a computer algorithm and were stratified by the 5 regions of Denmark (Supplement Table 1). Participants were notified of allocation by e-mail, and study packages were sent by courier (Part 7 of the Supplement). Participants in the mask group were instructed to wear a mask when outside the home during the next month. They received 50 three-layer, disposable, surgical face masks with ear loops (TYPE II EN 14683 [Abena]; filtration rate, 98%; made in China). Participants in both groups received materials and instructions for antibody testing on receipt and at 1 month. They also received materials and instructions for collecting an oropharyngeal/nasal swab sample for polymerase chain reaction (PCR) testing at 1 month and whenever symptoms compatible with COVID-19 occurred during follow-up. If symptomatic, participants were strongly encouraged to seek medical care. They registered symptoms and results of the antibody test in the online REDCap system. Participants returned the test material by prepaid express courier.
Written instructions and instructional videos guided antibody testing, oropharyngeal/nasal swabbing, and proper use of masks (Part 8 of the Supplement), and a help line was available to participants. In accordance with WHO recommendations for health care settings at that time, participants were instructed to change the mask if outside the home for more than 8 hours. At baseline and in weekly follow-up e-mails, participants in both groups were encouraged to follow current COVID-19 recommendations from the Danish authorities.
Antibody and Viral PCR Testing
Participants tested for SARS-CoV-2 IgM and IgG antibodies in whole blood using a point-of-care test (Lateral Flow test [Zhuhai Livzon Diagnostics]) according to the manufacturer’s recommendations and as previously described (26). After puncturing a fingertip with a lancet, they withdrew blood into a capillary tube and placed 1 drop of blood followed by 2 drops of saline in the test chamber in each of the 2 test plates (IgM and IgG). Participants reported IgM and IgG results separately as “1 line present” (negative), “2 lines present” (positive), or “I am not sure, or I could not perform the test” (treated as a negative result). Participants were categorized as seropositive if they had developed IgM, IgG, or both. The manufacturer reported that sensitivity was 90.2% and specificity 99.2%. A previously reported internal validation using 651 samples from blood donors before November 2019 and 155 patients with PCR-confirmed SARS-CoV-2 infection estimated a sensitivity of 82.5% (95% CI, 75.3% to 88.4%) and specificity of 99.5% (CI, 98.7% to 99.9%) (26). We (27) and others (28) have reported that oropharyngeal/nasal swab sampling for SARS-CoV-2 by participants, as opposed to health care workers, is clinically useful. Descriptions of RNA extraction, primer and probe used, reverse transcription, preamplification, and microfluidic quantitative PCR are detailed in Part 6 of the Supplement.
Data Collection
Participants received 4 follow-up surveys (Parts 4 and 5 of the Supplement) by e-mail to collect information on antibody test results, adherence to recommendations on time spent outside the home among others, development of symptoms, COVID-19 diagnosis based on PCR testing done in public hospitals, and known COVID-19 exposures.
Outcomes
The primary outcome was SARS-CoV-2 infection, defined as a positive result on an oropharyngeal/nasal swab test for SARS-CoV-2, development of a positive SARS-CoV-2 antibody test result (IgM or IgG) during the study period, or a hospital-based diagnosis of SARS-CoV-2 infection or COVID-19. Secondary end points included PCR evidence of infection with other respiratory viruses (Supplement Table 2).
Sample Size Calculations
The sample size was determined to provide adequate power for assessment of the combined composite primary outcome in the intention-to-treat analysis. Authorities estimated an incidence of SARS-CoV-2 infection of at least 2% during the study period. Assuming that wearing a face mask halves risk for infection, we estimated that a sample of 4636 participants would provide the trial with 80% power at a significance level of 5% (2-sided α level). Anticipating 20% loss to follow-up in this community-based study, we aimed to assign at least 6000 participants.
Statistical Analysis
Participants with a positive result on an antibody test at baseline were excluded from the analyses. We calculated CIs of proportions assuming binomial distribution (Clopper–Pearson).
The primary composite outcome (intention-to-treat) was compared between groups using the χ2 test. Odds ratios and confidence limits were calculated using logistic regression. We did a per protocol analysis that included only participants reporting complete or predominant use of face masks as instructed. A conservative sensitivity analysis assumed that participants with a positive result on an antibody test at the end of the study who had not provided antibody test results at study entrance had had a positive result at entrance. To further examine the uncertainty of loss to follow-up, we did (post hoc) 200 imputations using the R package smcfcs, version 1.4.1 (29), to impute missing values of outcome. We included sex, age, type of work, time out of home, and outcome in this calculation.
Prespecified subgroups were compared by logistic regression analysis. In a post hoc analysis, we explored whether there was a subgroup defined by a constellation of participant characteristics for which a recommendation to wear masks seemed to be effective. We included sex, age, type of work, time out of home, and outcome in this calculation.
Two-sided P values less than 0.05 were considered statistically significant. Analyses were done using R, version 3.6.1 (R Foundation).
Role of the Funding Source
An unrestricted grant from the Salling Foundations supported the study, and the BESTSELLER Foundation donated the Livzon tests. The funders did not influence study design, conduct, or reporting.
Results
Participants
A total of 17 258 Danish citizens responded to recruitment, and 6024 completed the baseline survey and fulfilled eligibility criteria. The first participants (group 1; n = 2995) were randomly assigned on 12 April 2020 and were followed from 14 to 16 April through 15 May 2020. Remaining participants (group 2; n = 3029) were randomly assigned on 24 April 2020 and were followed from 2 to 4 May through 2 June 2020. A total of 3030 participants were randomly assigned to the recommendation to wear face masks, and 2994 were assigned not to wear face masks (Figure); 4862 participants (80.7%) completed the study. Table 1 shows baseline characteristics, which were well balanced between groups. Participants reported having spent a median of 4.5 hours per day outside the home.
Figure. Study flow diagram.Inclusion and exclusion criteria are described in the Methods section, and criteria for completion of the study are given in the Supplement. SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.
Table 1. Characteristics of Participants Completing the Study
Adherence
Based on the lowest adherence reported in the mask group during follow-up, 46% of participants wore the mask as recommended, 47% predominantly as recommended, and 7% not as recommended.
Primary Outcome
The primary outcome occurred in 42 participants (1.8%) in the mask group and 53 (2.1%) in the control group. In an intention-to-treat analysis, the between-group difference was −0.3 percentage point (CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio [OR], 0.82 [CI, 0.54 to 1.23]; P = 0.33) in favor of the mask group (Supplement Figure 1). When this analysis was repeated with multiple imputation for missing data due to loss to follow-up, it yielded similar results (OR, 0.81 [CI, 0.53 to 1.23]; P = 0.32). Table 2 provides data on the components of the primary end point, which were similar between groups.
Table 2. Distribution of the Components of the Composite Primary Outcome
In a per protocol analysis that excluded participants in the mask group who reported nonadherence (7%), SARS-CoV-2 infection occurred in 40 participants (1.8%) in the mask group and 53 (2.1%) in the control group (between-group difference, −0.4 percentage point [CI, −1.2 to 0.5 percentage point]; P = 0.40) (OR, 0.84 [CI, 0.55 to 1.26]; P = 0.40). Supplement Figure 2 provides results of the prespecified subgroup analyses of the primary composite end point. No statistically significant interactions were identified.
In the preplanned sensitivity analysis, those who had a positive result on an antibody test at 1 month but had not provided antibody results at baseline were considered to have had positive results at baseline (n = 18)—that is, they were excluded from the analysis. In this analysis, the primary outcome occurred in 33 participants (1.4%) in the face mask group and 44 (1.8%) in the control group (between-group difference, −0.4 percentage point [CI, −1.1 to 0.4 percentage point]; P = 0.22) (OR, 0.77 [CI, 0.49 to 1.22]; P = 0.26).
Three post hoc (not preplanned) analyses were done. In the first, which included only participants reporting wearing face masks “exactly as instructed,” infection (the primary outcome) occurred in 22 participants (2.0%) in the face mask group and 53 (2.1%) in the control group (between-group difference, −0.2 percentage point [CI, −1.3 to 0.9 percentage point]; P = 0.82) (OR, 0.93 [CI, 0.56 to 1.54]; P = 0.78). The second post hoc analysis excluded participants who did not provide antibody test results at baseline; infection occurred in 33 participants (1.7%) in the face mask group and 44 (2.1%) in the control group (between-group difference, −0.4 percentage point [CI, −1.4 to 0.4 percentage point]; P = 0.33) (OR, 0.80 [CI, 0.51 to 1.27]; P = 0.35). In the third post hoc analysis, which investigated constellations of patient characteristics, we did not find a subgroup where face masks were effective at conventional levels of statistical significance (data not shown).
A total of 52 participants in the mask group and 39 control participants reported COVID-19 in their household. Of these, 2 participants in the face mask group and 1 in the control group developed SARS-CoV-2 infection, suggesting that the source of most observed infections was outside the home. Reported symptoms did not differ between groups during the study period (Supplement Table 3).
Secondary Outcomes
In the mask group, 9 participants (0.5%) were positive for 1 or more of the 11 respiratory viruses other than SARS-CoV-2, compared with 11 participants (0.6%) in the control group (between-group difference, −0.1 percentage point [CI, −0.6 to 0.4 percentage point]; P = 0.87) (OR, 0.84 [CI, 0.35 to 2.04]; P = 0.71). Positivity for any virus, including SARS-CoV-2, occurred in 9 mask participants (0.5%) versus 16 control participants (0.8%) (between-group difference, −0.3 percentage point [CI, −0.9 to 0.2 percentage point]; P = 0.26) (OR, 0.58 [CI, 0.25 to 1.31]; P = 0.19).
Discussion
In this community-based, randomized controlled trial conducted in a setting where mask wearing was uncommon and was not among other recommended public health measures related to COVID-19, a recommendation to wear a surgical mask when outside the home among others did not reduce, at conventional levels of statistical significance, incident SARS-CoV-2 infection compared with no mask recommendation. We designed the study to detect a reduction in infection rate from 2% to 1%. Although no statistically significant difference in SARS-CoV-2 incidence was observed, the 95% CIs are compatible with a possible 46% reduction to 23% increase in infection among mask wearers. These findings do offer evidence about the degree of protection mask wearers can anticipate in a setting where others are not wearing masks and where other public health measures, including social distancing, are in effect. The findings, however, should not be used to conclude that a recommendation for everyone to wear masks in the community would not be effective in reducing SARS-CoV-2 infections, because the trial did not test the role of masks in source control of SARS-CoV-2 infection. During the study period, authorities did not recommend face mask use outside hospital settings and mask use was rare in community settings (22). This means that study participants’ exposure was overwhelmingly to persons not wearing masks.
The observed infection rate was similar to that reported in other large Danish studies during the study period (26, 30). Of note, the observed incidence of SARS-CoV-2 infection was higher than we had estimated when planning a sample size that would ensure more than 80% power to detect a 50% decrease in infection. The intervention lasted only 1 month and was carried out during a period when Danish authorities recommended quarantine of diagnosed patients, physical distancing, and hand hygiene as general protective means against SARS-CoV-2 transmission (23). Cafés and restaurants were closed through 18 May, but follow-up of the second randomized group continued through 2 June.
The first randomized group was followed while the Danish society was under lockdown. Reopening occurred (18 May 2020) during follow-up of the second group of participants, but it was not reflected in the outcome because infection rates were similar between groups (Supplement Figure 2). The relative infection rate between mask wearers and those not wearing masks would most likely be affected by changes in applied protective means or in the virulence of SARS-CoV-2, whereas the rate difference between the 2 groups would probably not be affected solely by a higher—or lower—number of infected citizens.
Although we saw no statistically significant difference in presence of other respiratory viruses, the study was not sufficiently powered to draw definite conclusions about the protective effect of masks for other viral infections. Likewise, the study had limited power for any of the subgroup analyses.
The primary outcome was mainly defined by antibodies against SARS-CoV-2. This definition was chosen because the viral load of infected patients may be only transiently detectable (31, 32) and because approximately half of persons infected with SARS-CoV-2 are asymptomatic (33, 26). Masks have been hypothesized to reduce inoculum size (34) and could increase the likelihood that infected mask users are asymptomatic, but this hypothesis has been challenged (35). For these reasons, we did not rely solely on identification of SARS-CoV-2 in oropharyngeal/nasal swab samples. As mentioned in the Methods section, an internal validation study estimated that the point-of-care test has 82.5% sensitivity and 99.5% specificity (26).
The observed rate of incident SARS-CoV-2 infection was similar to what was estimated during trial design. These rates were based on thorough screening of all participants using antibody measurements combined with PCR, whereas the observed official infection rates relied solely on PCR test–based estimates during the period. In addition, authorities tested only a small subset of primarily symptomatic citizens of the entire population, yielding low incidence rates. On this basis, the infection rates we report here are not comparable with the official SARS-CoV-2 infection rates in the Danish population. The eligibility requirement of at least 3 hours of exposure to other persons outside the home would add to this difference. Between 6 April and 9 May 2020, we found a similar seroprevalence of SARS-CoV-2 of 1.9% (CI, 0.8% to 2.3%) in Danish blood donors using the Livzon point-of-care test and assessed by laboratory technicians (36). Testing at the end of follow-up, however, may not have captured any infections contracted during the last part of the study period, but this would have been true in both the mask and control groups and was not expected to influence the overall findings.
The face masks provided to participants were high-quality surgical masks with a filtration rate of 98% (37). A published meta-analysis found no statistically significant difference in preventing influenza in health care workers between respirators (N95 [American standard] or FFP2 [European standard]) and surgical face masks (38). Adherence to mask use may be higher than observed in this study in settings where mask use is common. Some mask group participants (14%) reported adverse reactions from other citizens (Supplement Table 4). Although adherence may influence the protective effect of masks, sensitivity analyses had similar results across reported adherence.
How SARS-CoV-2 is transmitted—via respiratory droplets, aerosols, or (to a lesser extent) fomites—is not firmly established. Droplets are larger and rapidly fall to the ground, whereas aerosols are smaller (≤5 μm) and may evaporate and remain in the air for hours (39). Transmission of SARS-CoV-2 may take place through multiple routes. It has been argued that for the primary route of SARS-CoV-2 spread—that is, via droplets—face masks would be considered effective, whereas masks would not be effective against spread via aerosols, which might penetrate or circumnavigate a face mask (37, 39). Thus, spread of SARS-CoV-2 via aerosols would at least partially explain the present findings. Lack of eye protection may also have been of importance, and use of face shields also covering the eyes (rather than face masks only) has been advocated to halt the conjunctival route of transmission (40, 41). We observed no statistically significant interaction between wearers and nonwearers of eyeglasses (Supplement Figure 2). Recent reports indicate that transmission of SARS-CoV-2 via fomites is unusual (42), but masks may alter behavior and potentially affect fomite transmission.
The present findings are compatible with the findings of a review of randomized controlled trials of the efficacy of face masks for prevention (as personal protective equipment) against influenza virus (18). A recent meta-analysis that suggested a protective effect of face masks in the non–health care setting was based on 3 observational studies that included a total of 725 participants and focused on transmission of SARS-CoV-1 rather than SARS-CoV-2 (12). Of 725 participants, 138 (19%) were infected, so the transmission rate seems to be higher than for SARS-CoV-2. Further, these studies focused on prevention of infection in healthy mask wearers from patients with a known, diagnosed infection rather than prevention of transmission from persons in their surroundings in general. In addition, identified comparators (control participants) not wearing masks may also have missed other protective means. Recent observational studies that indicate a protective association between mandated mask use in the community and SARS-CoV-2 transmission are limited by study design and simultaneous introduction of other public health interventions (14, 43).
Several challenges regarding wearing disposable face masks in the community exist. These include practical aspects, such as potential incorrect wearing, reduced adherence, reduced durability of the mask depending on type of mask and occupation, and weather. Such circumstances may necessitate the use of multiple face masks during the day. In our study, participants used a mean of 1.7 masks per weekday and 1.3 per weekend day (Supplement Table 4). Wearing a face mask may be physically unpleasant, and psychological barriers and other side effects have been described (44). “Face mask policing” between citizens might reinforce use of masks but may be challenging. In addition, the wearer of a face mask may change to a less cautious behavior because of a false sense of security, as pointed out by WHO (17); accordingly, our face mask group seemed less worried (Supplement Table 4), which may explain their increased willingness to wear face masks in the future (Supplement Table 5). These challenges, including costs and availability, may reduce the efficacy of face masks to prevent SARS-CoV-2 infection.
The potential benefits of a community-wide recommendation to wear masks include combined prevention and source control for symptomatic and asymptomatic persons, improved attention, and reduced potential stigmatization of persons wearing masks to prevent infection of others (17). Although masks may also have served as source control in SARS-CoV-2–infected participants, the study was not designed to determine the effectiveness of source control.
The most important limitation is that the findings are inconclusive, with CIs compatible with a 46% decrease to a 23% increase in infection. Other limitations include the following. Participants may have been more cautious and focused on hygiene than the general population; however, the observed infection rate was similar to findings of other studies in Denmark (26, 30). Loss to follow-up was 19%, but results of multiple imputation accounting for missing data were similar to the main results. In addition, we relied on patient-reported findings on home antibody tests, and blinding to the intervention was not possible. Finally, a randomized controlled trial provides high-level evidence for treatment effects but can be prone to reduced external validity.
Our results suggest that the recommendation to wear a surgical mask when outside the home among others did not reduce, at conventional levels of statistical significance, the incidence of SARS-CoV-2 infection in mask wearers in a setting where social distancing and other public health measures were in effect, mask recommendations were not among those measures, and community use of masks was uncommon. Yet, the findings were inconclusive and cannot definitively exclude a 46% reduction to a 23% increase in infection of mask wearers in such a setting. It is important to emphasize that this trial did not address the effects of masks as source control or as protection in settings where social distancing and other public health measures are not in effect.
Reduction in release of virus from infected persons into the environment may be the mechanism for mitigation of transmission in communities where mask use is common or mandated, as noted in observational studies. Thus, these findings do not provide data on the effectiveness of widespread mask wearing in the community in reducing SARS-CoV-2 infections. They do, however, offer evidence about the degree of protection mask wearers can anticipate in a setting where others are not wearing masks and where other public health measures, including social distancing, are in effect. The findings also suggest that persons should not abandon other COVID-19 safety measures regardless of the use of masks. While we await additional data to inform mask recommendations, communities must balance the seriousness of COVID-19, uncertainty about the degree of source control and protective effect, and the absence of data suggesting serious adverse effects of masks (45).


thelibertybeacon--2020-11-20--Some people must take the new vaccine immediately

Certain sectors of the public MUST TAKE THE COVID VACCINE IMMEDIATELY , here ’ s why .
I ’ ve been watching a debate on one of the gov websites about the new vaccines .
Personally I think you ’ d have to be a gullible idiot to willingly let someone inject you with the new vaccine because two notoriously untrustworthy sources ( the government and Pfizer ) promise you it is perfectly safe .
I ’ m not against vaccines per se – I ’ m sure the responsibly and honestly tested and trialed ones that are not booby @ @ @ @ @ @ @ reasonably safe and effective .
However , I am definitely extremely wary of something rushed through so fast , without long terms trials and so on , in order to “ protect us ” from a bug that the vast majority of us do not need protecting from as it is , according to the Chief Medical Officer himself , little to worry about unless we are very old and/or frail .
It seems like a lot of obscene haste in response to so small a threat .
So people are very right @ @ @ @ @ @ @ up to no good .
Of course , there is a small minority why are at risk from this bug – the very old and/or very frail .
But they would be similarly at risk from other bugs such as flu .
Should these people not take the new vaccine ?
Yes , if they want to but they need to bear in mind we do not know the short- , mid- or long-term effects of this vaccine upon the very frail .
It would be safer I think to isolate/quarantine the vulnerable @ @ @ @ @ @ @ them whilst a vaccine is properly and responsibly trialed ( as opposed to recklessly rushed onto the market ) along with potential cures such as hydroxychloroquine etc .
This would be especially any of the following : • those who argue strongly in favour of it for some reason • all ministers and MPs who favour it , • Bill and Melinda Gates and their children • all “ fact checkers ” who take down vax- safety posts .
If the vaccine works as well as we are being told by these people @ @ @ @ @ @ @ are in no danger .
They will be only too happy , considering their confidence in the vaccine , to be exposed asap to the live virus so they can show the world how nothing happens to them .
Personally , I think it is a gamble because we can not be certain it is safe in the long term but you never know , they might be all right .
Those experts in the field who are saying there could be very serious problems for the vaccinated might be wrong .
There @ @ @ @ @ @ @ in the absence of the usual long-term trials with which most vaccines are sensibly and responsibly tested : those of us who are wary can sit back and watch what happens to those brave enough to gamble , “ Russian Roulette ” style and take the vaccine .
If after a year or two , no serious adverse reactions are showing up , few people die or get seriously ill with this that or the other , then we ’ ll know we are safe to take it if we want to .
@ @ @ @ @ @ @ need to , what with the COVID mortality rate being so low , its impact on the vast majority of us being so mild and the average age of death from it being about a year older than the average age of death from all causes .
I do think it is very brave of people willing to take the vaccine immediately to volunteer to be unpaid guinea pigs .
I am sure the likes of Pfizer are grateful too because I imagine using the general public as guinea pigs saves them the @ @ @ @ @ @ @ .
I think if anyone does get sick from the vaccine because it wasn ’ t as safe as we were told , unethical shortcuts were taken in the testing and so forth , they or their surviving relatives should be able to sue the manufacturer or even have criminal charges brought for GBH , manslaughter , obtaining money under false pretences etc etc .
I ’ m not sure though whether the government has already acted to protect the manufacturer from prosecution .
Hope not .
I ’ d like to see @ @ @ @ @ @ @ end up getting shafted .
I ’ m sure Pfizer et al , being so confident their vaccine is safe will waive such indemnity in order to boost public confidence .
It would sure as hell boost mine because right now I do not trust these people an inch , considering their track record .
Nor do I trust their chums and proxies in government whom I have watched these past nine months pile lie upon lie , false stat upon false stat in an effort to spin terror from a bug that @ @ @ @ @ @ @ flu .
Nothing undermines confidence more than a manufacturer who hides behind immunity from consequences whilst assuring everyone , ‘ hand on heart ’ that their product is safe .
The Liberty Beacon Project is now expanding at a near exponential rate , and for this we are grateful and excited !
But we must also be practical .
For 7 years we have not asked for any donations , and have built this project with our own funds as we grew .
We are now experiencing ever increasing growing pains due to @ @ @ @ @ @ @ we represent .
So we have just installed donation buttons on our websites and ask that you consider this when you visit them .
Nothing is too small .
We thank you for all your support and your considerations … ( TLB )

by Caratacus
Certain sectors of the public MUST TAKE THE COVID VACCINE IMMEDIATELY, here’s why.
I’ve been watching a debate on one of the gov websites about the new vaccines.
Personally I think you’d have to be a gullible idiot to willingly let someone inject you with the new vaccine because two notoriously untrustworthy sources (the government and Pfizer) promise you it is perfectly safe.
I’m not against vaccines per se – I’m sure the responsibly and honestly tested and trialed ones that are not booby trapped with toxins and so on are reasonably safe and effective.
However, I am definitely extremely wary of something rushed through so fast, without long terms trials and so on, in order to “protect us” from a bug that the vast majority of us do not need protecting from as it is, according to the Chief Medical Officer himself, little to worry about unless we are very old and/or frail.
It seems like a lot of obscene haste in response to so small a threat. So people are very right to be suspicious of the government being up to no good.
Of course, there is a small minority why are at risk from this bug – the very old and/or very frail. But they would be similarly at risk from other bugs such as flu.
Should these people not take the new vaccine? Yes, if they want to but they need to bear in mind we do not know the short-, mid- or long-term effects of this vaccine upon the very frail. It would be safer I think to isolate/quarantine the vulnerable with full protocols in place to protect them whilst a vaccine is properly and responsibly trialed (as opposed to recklessly rushed onto the market) along with potential cures such as hydroxychloroquine etc.
But I propose all those who urge us to trust the government (LOL) and all those who argue that we must trust Pfizer (double LOL) SHOULD TAKE THE VACCINE asap.
This would be especially any of the following:
those who argue strongly in favour of it for some reason
all ministers and MPs who favour it,
all pharmaceutical company management,
Bill and Melinda Gates and their children
all media proponents of vaccines
all “fact checkers” who take down vax- safety posts.
If the vaccine works as well as we are being told by these people, they have nothing to fear and are in no danger.
They will be only too happy, considering their confidence in the vaccine, to be exposed asap to the live virus so they can show the world how nothing happens to them.
Personally, I think it is a gamble because we cannot be certain it is safe in the long term but you never know, they might be all right.
Those experts in the field who are saying there could be very serious problems for the vaccinated might be wrong.
There is only one way to find out in the absence of the usual long-term trials with which most vaccines are sensibly and responsibly tested: those of us who are wary can sit back and watch what happens to those brave enough to gamble, “Russian Roulette” style and take the vaccine.
If after a year or two, no serious adverse reactions are showing up, few people die or get seriously ill with this that or the other, then we’ll know we are safe to take it if we want to. Although most of us won’t need to, what with the COVID mortality rate being so low, its impact on the vast majority of us being so mild and the average age of death from it being about a year older than the average age of death from all causes.
I do think it is very brave of people willing to take the vaccine immediately to volunteer to be unpaid guinea pigs.
I am sure the likes of Pfizer are grateful too because I imagine using the general public as guinea pigs saves them the cost and hassle of conducting long-term trials.
I think if anyone does get sick from the vaccine because it wasn’t as safe as we were told, unethical shortcuts were taken in the testing and so forth, they or their surviving relatives should be able to sue the manufacturer or even have criminal charges brought for GBH, manslaughter, obtaining money under false pretences etc etc.
I’m not sure though whether the government has already acted to protect the manufacturer from prosecution. Hope not. I’d like to see the victims obtain justice if they do end up getting shafted.
I’m sure Pfizer et al, being so confident their vaccine is safe will waive such indemnity in order to boost public confidence.
It would sure as hell boost mine because right now I do not trust these people an inch, considering their track record. Nor do I trust their chums and proxies in government whom I have watched these past nine months pile lie upon lie, false stat upon false stat in an effort to spin terror from a bug that is less of a worry overall than flu.
Nothing undermines confidence more than a manufacturer who hides behind immunity from consequences whilst assuring everyone, ‘hand on heart’ that their product is safe.
••••
The Liberty Beacon Project is now expanding at a near exponential rate, and for this we are grateful and excited! But we must also be practical. For 7 years we have not asked for any donations, and have built this project with our own funds as we grew. We are now experiencing ever increasing growing pains due to the large number of websites and projects we represent. So we have just installed donation buttons on our websites and ask that you consider this when you visit them. Nothing is too small. We thank you for all your support and your considerations … (TLB)
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Comment Policy: As a privately owned web site, we reserve the right to remove comments that contain spam, advertising, vulgarity, threats of violence, racism, or personal/abusive attacks on other users. This also applies to trolling, the use of more than one alias, or just intentional mischief. Enforcement of this policy is at the discretion of this websites administrators. Repeat offenders may be blocked or permanently banned without prior warning.
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Disclaimer: TLB websites contain copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available to our readers under the provisions of “fair use” in an effort to advance a better understanding of political, health, economic and social issues. The material on this site is distributed without profit to those who have expressed a prior interest in receiving it for research and educational purposes. If you wish to use copyrighted material for purposes other than “fair use” you must request permission from the copyright owner.
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thelibertybeacon--2020-11-19--Georgia: Witnesses swear votes for Trump counted for Biden

Georgia recount witnesses swear to have seen votes for Trump counted for Biden Several witnesses to parts of the presidential recount in Georgia have signed sworn statements testifying that they observed ballots cast for President Trump counted instead for Democratic challenger Joe Biden .
Lin Wood , an attorney for the Trump campaign , filed affidavits with a federal court in Georgia earlier this week as part of an emergency motion to stop the certification of the election results in Georgia .
The recount officially ended at the end of the day on Wednesday .
Nine individuals sites in the @ @ @ @ @ @ @ ballots , almost uniformly cast for Biden .
The ballots were in pristine condition and had no creases on them , according to the affidavits , which seems to appear unusual considering mail-in ballots must be folded to fit into the envelope in which they are mailed .
“ It was pristine .
There was a difference in the texture of the paper – it was if they were intended for absentee use , but had not been used for that purpose .
There were no markings on the ballots to show where @ @ @ @ @ @ @ they had been processed .
I observed that the markings for the candidates on these ballots were unusually uniform , perhaps even with a ballot marking device , ” Susan Voyles , a poll manager with two-decades of experience , wrote in her affidavit about her time at a recount center in Fulton County .
“ By my estimate in observing these ballots , approximately 98 % constituted votes for Joe Biden , ” she continued .
Several additional witnesses documented seeing similar occurrences at recount sites across the state .
Three more @ @ @ @ @ @ @ Trump being placed in a pile with Biden votes .
Nicholas Zeher , a recount observer in Henry County , testified that “ based on my observations , I believe that additional absentee ballots were cast for Donald Trump but counted for Joe Biden .
I further believe that there was widespread fraud favoring Joe Biden.
” Consetta Johnson , who monitored the recount effort in Cobb County , said she witnessed similar activities taking place at her recount site , in addition to watching poll workers “ putting the already separated paper @ @ @ @ @ @ @ ’ and ‘ Jorgensen ’ tray , and removing them and putting them inside the Biden tray.
” Tally errors in several other Georgia counties that came out to falsely favor Joe Biden over President Trump by thousands of votes have been discovered because of the recount in Georgia .
The Liberty Beacon Project is now expanding at a near exponential rate , and for this we are grateful and excited !
But we must also be practical .
For 7 years we have not asked for any donations , and have built @ @ @ @ @ @ @ we grew .
We are now experiencing ever increasing growing pains due to the large number of websites and projects we represent .
So we have just installed donation buttons on our websites and ask that you consider this when you visit them .
Nothing is too small .
We thank you for all your support and your considerations … ( TLB ) Comment Policy : As a privately owned web site , we reserve the right to remove comments that contain spam , advertising , vulgarity , threats of violence , racism @ @ @ @ @ @ @ .
This also applies to trolling , the use of more than one alias , or just intentional mischief .
Enforcement of this policy is at the discretion of this websites administrators .
Repeat offenders may be blocked or permanently banned without prior warning .
Disclaimer : TLB websites contain copyrighted material the use of which has not always been specifically authorized by the copyright owner .
We are making such material available to our readers under the provisions of “ fair use ” in an effort to advance a better understanding of @ @ @ @ @ @ @ issues .
The material on this site is distributed without profit to those who have expressed a prior interest in receiving it for research and educational purposes .
If you wish to use copyrighted material for purposes other than “ fair use ” you must request permission from the copyright owner .

Georgia recount witnesses swear to have seen votes for Trump counted for Biden
Trump campaign attorneys are attempting to block the certification of the Georgia recount
By Sophie Mann
Several witnesses to parts of the presidential recount in Georgia have signed sworn statements testifying that they observed ballots cast for President Trump counted instead for Democratic challenger Joe Biden.
Lin Wood, an attorney for the Trump campaign, filed affidavits with a federal court in Georgia earlier this week as part of an emergency motion to stop the certification of the election results in Georgia. The recount officially ended at the end of the day on Wednesday.
Nine individuals sites in the affidavits swore to have seen suspicious mail-in ballots, almost uniformly cast for Biden. The ballots were in pristine condition and had no creases on them, according to the affidavits, which seems to appear unusual considering mail-in ballots must be folded to fit into the envelope in which they are mailed.
“It was pristine. There was a difference in the texture of the paper – it was if they were intended for absentee use, but had not been used for that purpose. There were no markings on the ballots to show where they had come from, or where they had been processed. I observed that the markings for the candidates on these ballots were unusually uniform, perhaps even with a ballot marking device,” Susan Voyles, a poll manager with two-decades of experience, wrote in her affidavit about her time at a recount center in Fulton County.
“By my estimate in observing these ballots, approximately 98% constituted votes for Joe Biden,” she continued.
Several additional witnesses documented seeing similar occurrences at recount sites across the state.
Three more individuals said they saw ballots cast for Trump being placed in a pile with Biden votes.
Nicholas Zeher, a recount observer in Henry County, testified that “based on my observations, I believe that additional absentee ballots were cast for Donald Trump but counted for Joe Biden. I further believe that there was widespread fraud favoring Joe Biden.”
Consetta Johnson, who monitored the recount effort in Cobb County, said she witnessed similar activities taking place at her recount site, in addition to watching poll workers “putting the already separated paper receipt ballots in the ‘No Vote’ and ‘Jorgensen’ tray, and removing them and putting them inside the Biden tray.”
Tally errors in several other Georgia counties that came out to falsely favor Joe Biden over President Trump by thousands of votes have been discovered because of the recount in Georgia.
_________
THE FACTS INSIDE OUR REPORTER’S NOTEBOOK
Links affidavit
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The Liberty Beacon Project is now expanding at a near exponential rate, and for this we are grateful and excited! But we must also be practical. For 7 years we have not asked for any donations, and have built this project with our own funds as we grew. We are now experiencing ever increasing growing pains due to the large number of websites and projects we represent. So we have just installed donation buttons on our websites and ask that you consider this when you visit them. Nothing is too small. We thank you for all your support and your considerations … (TLB)
••••
Comment Policy: As a privately owned web site, we reserve the right to remove comments that contain spam, advertising, vulgarity, threats of violence, racism, or personal/abusive attacks on other users. This also applies to trolling, the use of more than one alias, or just intentional mischief. Enforcement of this policy is at the discretion of this websites administrators. Repeat offenders may be blocked or permanently banned without prior warning.
••••
Disclaimer: TLB websites contain copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available to our readers under the provisions of “fair use” in an effort to advance a better understanding of political, health, economic and social issues. The material on this site is distributed without profit to those who have expressed a prior interest in receiving it for research and educational purposes. If you wish to use copyrighted material for purposes other than “fair use” you must request permission from the copyright owner.
••••
Disclaimer: The information and opinions shared are for informational purposes only including, but not limited to, text, graphics, images and other material are not intended as medical advice or instruction. Nothing mentioned is intended to be a substitute for professional medical advice, diagnosis or treatment.


thelibertybeacon--2020-11-19--Election Fraud … Coming Apart at the Seams

Election Fraud … Coming Apart at the Seams I don ’ t know about you but I wake up every morning , turn on my computer and look for new data about who has been arrested rather than the same old information put out by all the patriots .
So far , we ’ ve only seen the promise of mass arrests .
I love the spicy , tough Sydney Powell , including what she says about these arrests , but how many times can we watch the same clips of her , though wonderfully positive ?
It ’ s @ @ @ @ @ @ @ data comes in very handy , puts our minds at ease and provides us with paths to follow as well as create .
The mind is there to solve problems but we need to collect information and evaluate it properly .
There ’ s no time or room for panic .
One piece of data : there ’ s controversy over the “ water-marked ” ballots .
Some videos are saying these were created by the quantum voting system and assures us all legitimate ballots will be counted and the rest thrown out @ @ @ @ @ @ @ program , locate all ballots that were tossed , no matter where and even burned !
As well , all persons who voted , are known and that makes certain they are US citizens and OK to vote .
In this video , two people talk about all the details of these ballots .
They ’ re Christian and talk a lot about Jesus as the savior .
I ’ m not promoting that ; everyone has a constitutional right to their own religion and I greatly support that .
But the data @ @ @ @ @ @ @ It ’ s a wonder , though , that the White House has not said a word about them .
We will see , huh , as this monumental drama plays out .
But take heart , we all know , deep within , that Trump will win , has won and Biden and friends are headed for jail .
One great piece of data is that if this goes to the House ( 12th Amendment ) , all states , having one vote , MUST vote along party lines .
Since there @ @ @ @ @ @ @ s a shoe-in .
So what is all this fluff , worry and uncertainty about who will win ?
This nail-biting over the horror of Biden taking over the presidency ?
This and for many of us , possibly the great majority , has become the daily diet feeding our need to know .
It ’ s not necessary , though , to live in this constant “ maybe ” but if you choose , instead , to be cheerful about it , it sure beats Netflix .
You don ’ t want @ @ @ @ @ @ @ have fallen to the left .
On the other hand , the uncertainty actually lies in what will happen AFTER Trump is re-elected .
That is ingrained on many minds as an approaching tsunami .
The mantra has become , “ It will be rough for a while ” .
How ?
Since this is so generalized and ominous , we tend to fill in the mystery with fearful scenarios , although they all do say we will have much more violence , destruction and riots .
Okay , do we have to @ @ @ @ @ @ @ be prepared as far as food and protection , maybe even get out of Dodge , if necessary .
Personally , I ’ ve been paying a fortune at Costco , buying more non-perishable food than I ’ ve ever bought in my life !
But we don ’ t have to constantly or often keep creating it in our minds .
I ’ ve expressed this truth in so many articles I ’ ve written because it truly is the ultimate answer , way above the physical realities of this mind-boggling scene @ @ @ @ @ @ @ and CNN are crashing .
Looks like more and more people are coming out of clueless utopia .
But that ’ s quite evident at the more than million supporters who showed up Saturday in Washington and at many other rallies while Biden sat in his basement , secure the news will cover his ass .
The main , desperate tactic of evil when it is being uncovered is “ deny , deny , deny ” .
Well , what we do is “ expose , expose , expose ” – the main @ @ @ @ @ @ @ many jaws are dropping over the brazen lies by the media saying “ no evidence ” ?
They ’ re all taking the fifth , I guess .
That will play itself out .
Evil doers , no matter how bad , will always cave in the end .
Let ’ s just speed up the process .
We all need to get to life as it should be .
I won ’ t say “ as it was ” because I believe it will be much better .
Even without the pandemic @ @ @ @ @ @ @ hot on this planet , a prison one with a lifetime sentence of financial struggle , wars , suppression of rights , dictatorship , bad food , bad medicine , harmful drugs , etc .
But , despite the advice to grab your popcorn , sit back and watch the show , it ’ s not going to happen that way .
These deep state people are desperate and will kill the whole planet to save their black souls .
I know I ’ m not nearly as engaged as I should be @ @ @ @ @ @ @ .
We all need to do stuff .
Figure it out .
If you haven ’ t already , besides The Liberty Beacon , go to Newsmax , Bitchute , Rumble , x22report.com and others like that .
You probably know Youtube is traitorous and under investigation , along with Google and Facebook .
Awesome .
The closet doors are wide open .
Help keep them that way until they ’ re empty .
Then we close them and get out in the sunshine .
Read more great articles by Lucille here To @ @ @ @ @ @ @ visit Lucile here The Liberty Beacon Project is now expanding at a near exponential rate , and for this we are grateful and excited !
But we must also be practical .
For 7 years we have not asked for any donations , and have built this project with our own funds as we grew .
We are now experiencing ever increasing growing pains due to the large number of websites and projects we represent .
So we have just installed donation buttons on our websites and ask that you consider this when @ @ @ @ @ @ @ small .
We thank you for all your support and your considerations … ( TLB )

Election Fraud … Coming Apart at the Seams
Commentary by TLB Staff Author: Lucille Femine
I don’t know about you but I wake up every morning, turn on my computer and look for new data about who has been arrested rather than the same old information put out by all the patriots. So far, we’ve only seen the promise of mass arrests. I love the spicy, tough Sydney Powell, including what she says about these arrests, but how many times can we watch the same clips of her, though wonderfully positive?
It’s great to have faith but real live data comes in very handy, puts our minds at ease and provides us with paths to follow as well as create. The mind is there to solve problems but we need to collect information and evaluate it properly. There’s no time or room for panic.
One piece of data: there’s controversy over the “water-marked” ballots. Some videos are saying these were created by the quantum voting system and assures us all legitimate ballots will be counted and the rest thrown out. They can even, this highly-sophisticated program, locate all ballots that were tossed, no matter where and even burned! As well, all persons who voted, are known and that makes certain they are US citizens and OK to vote.
In this video, two people talk about all the details of these ballots. They’re Christian and talk a lot about Jesus as the savior. I’m not promoting that; everyone has a constitutional right to their own religion and I greatly support that. But the data is fascinating and hopefully very true. It’s a wonder, though, that the White House has not said a word about them. We will see, huh, as this monumental drama plays out.
••••

••••
But take heart, we all know, deep within, that Trump will win, has won and Biden and friends are headed for jail. One great piece of data is that if this goes to the House (12th Amendment), all states, having one vote, MUST vote along party lines. Since there are 31 republican states, that’s a shoe-in.
So what is all this fluff, worry and uncertainty about who will win? This nail-biting over the horror of Biden taking over the presidency? This and for many of us, possibly the great majority, has become the daily diet feeding our need to know. It’s not necessary, though, to live in this constant “maybe” but if you choose, instead, to be cheerful about it, it sure beats Netflix. You don’t want to support them, anyway since they have fallen to the left.
On the other hand, the uncertainty actually lies in what will happen AFTER Trump is re-elected. That is ingrained on many minds as an approaching tsunami. The mantra has become, “It will be rough for a while”. How? Since this is so generalized and ominous, we tend to fill in the mystery with fearful scenarios, although they all do say we will have much more violence, destruction and riots.
Okay, do we have to agree? It’s wise to be prepared as far as food and protection, maybe even get out of Dodge, if necessary. Personally, I’ve been paying a fortune at Costco, buying more non-perishable food than I’ve ever bought in my life! But we don’t have to constantly or often keep creating it in our minds. I’ve expressed this truth in so many articles I’ve written because it truly is the ultimate answer, way above the physical realities of this mind-boggling scene.
Take heart again, Fox News and CNN are crashing. Looks like more and more people are coming out of clueless utopia. But that’s quite evident at the more than million supporters who showed up Saturday in Washington and at many other rallies while Biden sat in his basement, secure the news will cover his ass.
••••
••••
••••
The main, desperate tactic of evil when it is being uncovered is “deny, deny, deny”. Well, what we do is “expose, expose, expose” – the main way out of this mess. How many jaws are dropping over the brazen lies by the media saying “no evidence”? They’re all taking the fifth, I guess. That will play itself out. Evil doers, no matter how bad, will always cave in the end. Let’s just speed up the process. We all need to get to life as it should be. I won’t say “as it was” because I believe it will be much better. Even without the pandemic, it hasn’t been so hot on this planet, a prison one with a lifetime sentence of financial struggle, wars, suppression of rights, dictatorship, bad food, bad medicine, harmful drugs, etc.
But, despite the advice to grab your popcorn, sit back and watch the show, it’s not going to happen that way. These deep state people are desperate and will kill the whole planet to save their black souls. I know I’m not nearly as engaged as I should be in this dire emergency to save ourselves. We all need to do stuff. Figure it out.
If you haven’t already, besides The Liberty Beacon, go to Newsmax, Bitchute, Rumble, x22report.com and others like that. You probably know Youtube is traitorous and under investigation, along with Google and Facebook. Awesome.
The closet doors are wide open. Help keep them that way until they’re empty. Then we close them and get out in the sunshine.
••••
Read more great articles by Lucille here
To find out more about her art, visit Lucile here
••••
The Dark Lane – A Great Novel By Author & Artist: Lucille Femine A fictional story yet one all too true in the world of psychiatric drugs. Two brilliant, young boys forced to take these drugs and the resultant havoc on their physical, emotional and spiritual selves. The fight is on to save them. (click on the image below to find out more about this outstanding book)
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Stay tuned to …
••••
The Liberty Beacon Project is now expanding at a near exponential rate, and for this we are grateful and excited! But we must also be practical. For 7 years we have not asked for any donations, and have built this project with our own funds as we grew. We are now experiencing ever increasing growing pains due to the large number of websites and projects we represent. So we have just installed donation buttons on our websites and ask that you consider this when you visit them. Nothing is too small. We thank you for all your support and your considerations … (TLB)
••••
Comment Policy: As a privately owned web site, we reserve the right to remove comments that contain spam, advertising, vulgarity, threats of violence, racism, or personal/abusive attacks on other users. This also applies to trolling, the use of more than one alias, or just intentional mischief. Enforcement of this policy is at the discretion of this websites administrators. Repeat offenders may be blocked or permanently banned without prior warning.
••••
Disclaimer: TLB websites contain copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available to our readers under the provisions of “fair use” in an effort to advance a better understanding of political, health, economic and social issues. The material on this site is distributed without profit to those who have expressed a prior interest in receiving it for research and educational purposes. If you wish to use copyrighted material for purposes other than “fair use” you must request permission from the copyright owner.
••••
Disclaimer: The information and opinions shared are for informational purposes only including, but not limited to, text, graphics, images and other material are not intended as medical advice or instruction. Nothing mentioned is intended to be a substitute for professional medical advice, diagnosis or treatment.