As states prematurely end mask mandates, mounting evidence continues to show that masks do indeed work! Despite the clear evidence that masks are effective at reducing COVID-19 transmission, political leaders are moving to downplay the importance of masks and choosing politics over public health. What’s especially troublesome is bolstering the idea that mask mandates may no longer be necessary in public schools (some states have already moved to end mandates in schools) again going against the strong evidence that masking in schools reduces transmission of COVID-19 as discussed in previous posts.

The data on the effectiveness of masks is clear (I have presented it before) and more data since has come out reaffirming this fact. Let’s review the most recent study delineating just how essential masking is AND once again highlighting that not all masks are created equal (refer to my prior post on the best masks). Here are some major findings of this study:

• Use of a face mask or respirator indoors was associated with a lower chance of infection with SARS-CoV-2 (the virus that causes COVID-19)
• Protection against SARS-COV-2 was highest in those who reported wearing a face mask or respirator all the time
• Infection was also lowest amongst those who usually wore an N95/KN95 respirator
• The group with the second lowest infection rate was those wearing surgical masks
• Cloth masks offered the least protections

Of course, every study including this one has limitations, which you can read about in the discussion section, but the overall message remains clear. I ask political leaders and the public to consider these points before making swift decisions that will impact our most vulnerable populations:

• Children under 5 years old are still not yet eligible for vaccination
• Only 50% of those eligible for booster shots in the US have received them (recent data highlights the necessity of a booster shot in light of omicron)
• Vaccine inequity is a major issue (recent data shows how low-income workers are disproportionately affected)
• The US has the highest death rate of high-income countries surpassing a death toll of 900,000 and a lower percentage of people vaccinated compared to many European countries that are relaxing protections (many of these countries also have paid sick leave, universal healthcare etc.) thus, parallels cannot be drawn

While many states are ending their mask mandates, the responsibility to protect ourselves, our loved ones and the society we inhabit falls on each of us. Community is an important aspect of the fight against COVID-19 and has been since the beginning. Until protection is widespread and equitable, defeating COVID-19 will be an insurmountable feat. Please mask up and take care of each other.

References:

https://abcnews.go.com/Health/dozen-states-move-end-masking-mandates-covid-19/story?id=82806903

Andrejko KL, Pry JM, Myers JF, et al. Effectiveness of Face Mask or Respirator Use in Indoor Public Settings for Prevention of SARS-CoV-2 Infection — California, February–December 2021. MMWR Morb Mortal Wkly Rep 2022;71:212–216. DOI: http://dx.doi.org/10.15585/mmwr.mm7106e1external icon.

Budzyn SE, Panaggio MJ, Parks SE, et al. Pediatric COVID-19 Cases in Counties With and Without School Mask Requirements – United States, July 1-September 4, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(39):1377-1378. Published 2021 Oct 1. doi:10.15585/mmwr.mm7039e3

Brooks JT, Butler JC. Effectiveness of mask wearing to control community spread of SARS-CoV-2. JAMA 2021;325:998–9. https://doi.org/10.1001/jama.2021.1505external icon PMID:33566056external icon

Chughtai AA, Seale H, Macintyre CR. Effectiveness of cloth masks for protection against severe acute respiratory syndrome coronavirus 2. Emerg Infect Dis 2020;26:e200948. https://doi.org/10.3201/eid2610.200948external icon PMID:32639930external icon

Andrejko KL, Pry J, Myers JF, et al.; California COVID-19 Case-Control Study Team. Predictors of SARS-CoV-2 infection following high-risk exposure. Clin Infect Dis . Epub December 21, 2021. https://doi.org/10.1093/cid/ciab1040external icon PMID:34932817external icon

Thompson MG, Natarajan K, Irving SA, et al. Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:139–145. DOI: http://dx.doi.org/10.15585/mmwr.mm7104e3external icon.