"To Mask or Not To Mask" -- Research For Stopping a Pandemic

The controversy over wearing masks during the COVID-19 pandemic continues. As most health organizations and medical experts recommend masking to stop the spread of the virus, some people still refuse to follow recommendations, and even directives, that they should mask in public.

I believe in wearing masks to stop the coronavirus. In fact, I consider wearing a mask to be part of my duty as a caring person and a functioning citizen. Allow me to share some findings from Science Direct and Elsevier global analytics to support my opinion.

Research findings suggest that face mask use should be as nearly universal (i.e., nation-wide) as possible and implemented without delay, even if most masks are homemade and of relatively low quality.

A report in the journal Infectious Disease Modelling (sic) concludes this about face masks:

“This measure could contribute greatly to controlling the COVID-19 pandemic, with the benefit greatest in conjunction with other non-pharmaceutical interventions that reduce community transmission. Despite uncertainty, the potential for benefit, the lack of obvious harm, and the precautionary principle lead us to strongly recommend as close to universal (homemade, unless medical masks can be used without diverting healthcare supply) mask use by the general public as possible.”

(Steffen E. Eikenberry, Marina Mancuso,Enahoro Iboi, Tin Phan, Keenan Eikenberry, Yang Kuang, Eric Kostelich, Abba B. Gumel. “To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic

Infectious Disease Modelling, Volume 5, Pages 293-308. 2020,)

Eikenberry et al. found notably, masks are found to be useful with respect to both preventing illness in healthy persons and preventing asymptomatic transmission.

The study's hypothetical mask adoption scenarios, for Washington and New York state, suggest that immediate near universal (80%) adoption of moderately (50%) effective masks could prevent on the order of 17–45% of projected deaths over two months in New York, while decreasing the peak daily death rate by 34–58%, absent other changes in epidemic dynamics.

The authors found even very weak masks (20% effective) can still be useful if the underlying transmission rate is relatively low or decreasing: In Washington, where baseline transmission is much less intense, 80% adoption of such masks could reduce mortality by 24–65% (and peak deaths 15–69%), compared to 2–9% mortality reduction in New York (peak death reduction 9–18%).

Their results suggest use of face masks by the general public is potentially of high value in curtailing community transmission and the burden of the pandemic. And, the community-wide benefits are likely to be greatest when face masks are used in conjunction with other non-pharmaceutical practices (such as social-distancing), and when adoption is nearly universal (nation-wide) and compliance is high.

Other studies confirm community-wide mask wearing may contribute to the control of COVID-19 by reducing the amount of emission of infected saliva and respiratory droplets from individuals with subclinical or mild COVID-19.

(Vincent Chi-Chung Cheng et al. “The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2.” Journal of Infection, Volume 81, Issue 1. Pages 107-114. July 2020,

Finally, further studies provide evidence that states in the US mandating use of face masks in public had a greater decline in daily COVID-19 growth rates after issuing these mandates compared to states that did not issue mandates. These effects are observed conditional on other existing social distancing measures and are independent of the CDC recommendation to wear facial covers issued on April 3.

The conclusion is that as countries worldwide and states begin to relax social distancing restrictions and considering the high likelihood of a second COVID-19 wave in the fall/winter, requiring use of face masks in public might help in reducing COVID-19 spread.

Wei Lyu and George L. Wehby. “Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US.”
Health Affairs. June 16, 2020.)

I will end my support with these conclusions from Howard et al.

“The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both laboratory and clinical contexts. Public mask wearing is most effective at stopping spread of the virus when compliance is high.

“The decreased transmissibility could substantially reduce the death toll and economic impact while the cost of the intervention is low. Thus we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.”

(Howard, J.; Huang, A.; Li, Z.; Tufekci, Z.; Zdimal, V.; van der Westhuizen, H.; von Delft, A.; Price, A.; Fridman, L.; Tang, L.; Tang, V.; Watson, G.L.; Bax, C.E.; Shaikh, R.; Questier, F.; Hernandez, D.; Chu, L.F.; Ramirez, C.M.; Rimoin, A.W. “Face Masks Against COVID-19: An Evidence Review.” Preprints 2020.)

Please, wear your mask. Follow science, not rumors. And, don't cave to discomfort and feelings of your inconvenience. Lives are in the balance.