Public/Global Health

Politicians, scientists back masks: They work

Political leaders are increasingly embracing recommendations from scientists and public health experts that face masks can drastically slow transmission of the coronavirus, even as many right-wing commentators scorn their use.

The science is clear: Face masks reduce transmission of COVID-19 by about 85 percent. At least three dozen studies have been published in recent months. A review of recent studies published by 19 public health experts in May found dramatic reduction in spread even if only half the population of a given country wears masks.

Those findings make scientific sense based on what is known about other respiratory diseases: Similar studies of diseases like influenza, transmitted through aerosol droplets produced by coughs or sneezes, also find masks effective.

“There are enough studies on aerosols and aerodynamics to know that masks — even handmade fabric masks — really do provide a significant protective benefit to the people around the wearer,” said Nita Bharti, a biologist at the Center for Infectious Disease Dynamics at Penn State. “Masks primarily protect other people from the respiratory droplets of the mask wearer.”

Public health officials initially told Americans they didn’t need to wear masks, as a run on high-quality medical supplies threatened to leave front-line health care workers bereft of the personal protective equipment (PPE) they needed to work safely.

But as understanding of the virus and its means of transmission changed, so too did the advice from public health officials.

The Centers for Disease Control and Prevention has recommended since April that people wear cloth face coverings to reduce transmission. The coverings provide “source control,” the agency says, helping reduce the spread of the virus by those who are not showing symptoms.

World Health Organization guidance published June 5 recommends the general public wear masks in settings like the grocery store, work, social gatherings, schools and houses of worship.

“The U.S. didn’t have enough masks available for the general population and trying to keep everyone’s hands out of the health care workers’ dwindling PPE supply was a priority. Fabric masks became an option late in the game,” Bharti said.

“If we were to look back at all the things that went very wrong early in the outbreak, I wouldn’t put the failure to push mask-wearing at the top of the list,” he added. “It certainly didn’t help that people weren’t wearing masks, but it would have been like putting a Band-Aid on an ax wound — so many other things had already gone irreversibly wrong.”

Countries that mandate mask use, or where the use of masks is a cultural norm, have had significant success in reducing transmission of the virus.

Taiwan, which dramatically ramped up mask production in February, reported only five confirmed coronavirus infections in June. Just 55 of the 447 confirmed cases in Taiwan were the result of local transmission; the rest were confirmed in travelers arriving from abroad.

Venezuela, Vietnam, the Czech Republic, Slovakia and Bosnia and Herzegovina all required face masks in March. Vietnam and the Eastern European nations have seen few cases and have begun lifting restrictions. As other South American nations like Brazil, Peru and Chile have seen their viral transmissions skyrocket, Venezuela has reported only 5,800 cases; Peru and Chile, by contrast, have more than a quarter million confirmed cases.

In the U.S., states that have required residents to wear masks in public are faring better than those that have not. States where masks are mandatory saw a 25 percent decline in the number of confirmed coronavirus cases between the first and third weeks of June. In areas that did not require masks in any setting, the number of cases jumped 84 percent.

Eighteen states, mainly in the Northeast and West Coast, and the District of Columbia require residents to wear masks. Twenty states require people to wear masks in some settings. Four states — Iowa, Montana, South Dakota and Wisconsin — do not require masks in any setting.

Wearing masks has never been a common cultural practice in the United States, and President Trump has made fun of those who choose to do so. Conservative commentators have taken their cues from the White House, casting mask-wearing as somehow a show of weakness, a threat to masculinity or a health risk, which it is not.

“I put on a mask and literally within seconds, I am struggling to breathe,” pro-Trump commentator Bill Mitchell tweeted on Tuesday, to widespread derision.

Despite Trump’s comments, prominent Republicans are increasingly embracing mask-wearing. In a floor speech this week, Senate Majority Leader Mitch McConnell (R-Ky.) — who has been wearing a mask for months — said mask-wearing is key to preventing the spread of the virus.

“We must have no stigma, none, about wearing masks when we leave our homes and come near other people,” McConnell said Monday. “Wearing simple face coverings is not about protecting ourselves, it is about protecting everyone we encounter.”

Public health experts are worried that increasing politicization of the use of masks threatens to prolong and intensify the human toll of the outbreak.

“For some reason, the mask has become a symbol, and that’s not a good thing,” said Richard Besser, a former acting director of the Centers for Disease Control and Prevention who now heads the Robert Wood Johnson Foundation.

“If we don’t have the entire nation unified around the importance of wearing masks and social distancing, then what we’re seeing across many states in the South is going to be seen as well in states that have been able successfully to suppress the viral transmission,” he said.

Most Americans are siding with health experts and McConnell over Trump. Polls indicate the vast majority of Americans are wearing masks in public; a Pew Research Center survey conducted in early June found 65 percent of Americans said they were wearing masks all or most of the time in public, including a majority of Republicans. By late June, almost 9 in 10 Americans who left their homes within the last week said they wore a face covering, according to an ABC-Ipsos poll.

“Fox & Friends” host Steve Doocy on Tuesday advocated for Trump to wear a face mask in order to set an example for the American public. “More states every day are mandating people, their citizens, to wear masks and I think that if the president wore one it would just set a good example. He would be a good role model,” Doocy said while interviewing Republican National Committee Chairwoman Ronna Romney McDaniel.

That same day, Donald Trump Jr. said masks should be worn during the Republican National Convention in Jacksonville, Fla.

“You know, I don’t think it’s too complicated to wear a mask or wash your hands, follow basic hygiene protocols,” the president’s eldest son told Fox Business’s Maria Bartiromo.

Wearing masks, health experts caution, may be necessary but not sufficient to control the spread of the outbreak. Maintaining social distance also acts to reduce transmission, at rates of about equal efficacy to masks. Outdoor activity is far less risky than indoor when it comes to transmission. Combined, those three interventions — however basic — can crush the spread of the virus.

“There is a way to get through these next few months or a year,” said David Rubin, who runs the PolicyLab at the Children’s Hospital of Philadelphia. “That’s by committing to wearing masks in indoor locations and doing some distancing.”

Tags Coronavirus COVID-19 Donald Trump face masks facial coverings Maria Bartiromo Masks Mitch McConnell Pandemic Ronna McDaniel

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