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Characteristics and Strength of Evidence of COVID-19 Studies Registered on ClinicalTrials.gov Looked at ClinicalTrials.gov identified 1551 studies registered fromMarch 1, 2011, to May 19, 2020, Lets look at the gold standard RCT Of the 664 RCT (76.1%) were single center. PROBLEM! Weather analysis! Only half of the rct looked at clinical course with only 8% of the rct looking at mortality and this is a problem because blinding was only reported for half of the trials so half of the time your outcome is clinical course and half the time you are not blinding them to the treatment do you think the people you knowingly got the treatment drug will ‘get better’ faster. And maybe they got better because they knew they were getting the good stuff or maybe they got better because eh provider knew they were getting the active. Both can be bias when they know if the patient is getting placebo or active arm. The authors state it best “evidence, the large proportion of studies with an expected low level of evidence is concerning. Rapid dis- semination of studies with low-quality evidence studies can influence public opinion, government actions, and clinical prac- tice in potentially harmful ways,3 And I couldnt agree more so lets talk about something else that has no evidence-- MASK Lets be clear about mask—we have no evidence that they work for what we think they work for—we have evidence they says they help decrease the spread of droplets when you speak but we don’t have evidence that then says that this decrease in droplets leads to a decrease in coronavirus cases and rememeber we don’t care about cases we care about deaths and does that lead to a decreaes in deaths. We don’t have evidence on this so ANYONE that has an opinon on mask is purely giving you their opinion—zero fact! Well my hospital sent out an email saying hey look at this study https://jamanetwork.com/journals/jama/fullarticle/2768533 In the journal of the american medical association PROOVES that mask actually work!!!! A research letter- https://jamanetwork.com/journals/jama/fullarticle/2768533 Association Between Universal Masking in a Health Care System and SARS-CoV-2 Positivity Among Health Care Workers The study assessed the association of hospital masking policies with the SARS-CoV-2 infection rate among HCWs. 12 hospitals and more than 75 000 employees in Mass General They looked at HCWs who tested + for SARS-CoV-2 between March 1 and April 30, 2020 This was broken down into 3 time periods before implementation of universal masking of HCWs (March 1-24, 2020) intervention period with universal mask (April 11-30, 2020). out of the 75000 employees – only 10k got test and only 1271 had a positive result- During the preintervention period, March 1-24, 2020, the SARS-CoV-2 positivity rate increased exponentially from 0% to 21.32%!! During the intervention period requiring mask from April 11-30, 2020 the positivity rate decreased linearly from 14.65% to 11.46% THUS Universal masking at mass general was associated with a significantly lower rate of SARS-CoV-2 positivity among HCWs. This association may be related to a decrease in transmission between patients and HCWs and among HCWs. MAY BE or may not!! Always be careful! The decrease in HCW infections could be confounded by other interventions inside and outside of the health care system (Figure), such as restrictions on elective procedures, social distancing measures, and increased masking in public spaces, which are limitations of this study. this study doesnt say that mask prevent infection because what we were doing during the rest of the time was drastically different!! how we handled covid on march 1 was drastically different than april1! they are not even close to the same, we shut down bards and restauranted by april 1 and we didnt do that by march 1 so if you want to say look at the huge benefit mask made then you have to say look at t a huge benefit mask, and social distance and limits to group gatherings and economic shut down had on the cases of covid19 for of health care workers--- this is just another article that spins the numbers come up with a covid conclusion that is not accurate or tell the whole story. As far as the answer on mask, the answers will vary wide and far – they are kind of like butts, everyone got one and none of them are evidence based or something like that But the next article has also hit the press and a popular title saying ‘kids don’t spread covid’ Which comes from this article Posfay-Barbe KM et al. COVID-19 in children and the dynamics of infection in families. Pediatrics 2020 May 26; 146:e20201576. (https://doi.org/10.1542/peds.2020-1576) What is a child’s role in transmission of COVID-19? This study looked at 39 patients