Mask use and mask mandates were successful

"Specifically, the researchers found that during the first two weeks after states implemented the mask mandates, there was a 2.1 percentage-point decline in reported weekly Covid-19 hospitalization growth rates among adults ages 18 to 39, as well as a 2.9 percentage-point drop among adults ages 40 to 64. At three weeks after implementation, reported weekly Covid-19 hospitalization growth rates dropped by 5.5 percentage points among people ages 18 to 39 and among those ages 40 to 64, the researchers wrote."




"Average mask use across the United States has been declining since mid-February. Meanwhile, infection rates in some places have increased."


"...Around the same time that New Hampshire rescinded its rule, for example, COVID-19 cases in India began to surge. Strict mask mandates there had reined in the country’s first wave of infections last September.


"...“Wearing masks should probably be one of the last things we stop doing,” says Hoen, adding that she hopes no other countries are looking to the United States for guidance.


"The case for mask mandates was made relatively early in the pandemic. On 6 April 2020, the city of Jena, Germany, became one of the first communities in the world to require people to wear masks in public. Thomas Nitzsche, the town’s mayor, says he was sleepless for two nights before the policy went into effect. “I didn’t know if the public would comply,” he says. “Luckily, they did.”


"Researchers estimate that new cases in the city, home to around 110,000 people, dropped by about 75% during the 20 days after the rule was brought in3.


"But it wasn’t as simple as flipping a switch one day and then reaping the rewards. Evidence is building that, although a mandate can be a powerful measure, effective messaging and role models are crucial for public uptake.


"... Meanwhile, mask policies in most of the surrounding state of Thuringia and elsewhere in Germany lagged behind. There, officials generally adopted mandates only after case counts surged. Although there were no new COVID-19 cases in Jena five days after implementation of the mask mandate, for example, the virus continued to spread in nearby Erfurt, the state capital, and slowed only after a mask requirement was imposed, according to a preprint study4 by public-health leaders in Jena.


"It was a similar story around the globe, with a few exceptions. China and other Asian nations quickly adopted mask policies that probably prevented large-scale spread of the disease. Nitzsche says he was personally inspired by the Czech Republic, which began requiring masks in certain public places in mid-March 2020.


"...He and his colleagues used data from 401 regions in Germany to estimate the effect of mask mandates on SARS-CoV-2 transmission3. They took advantage of the regional variation to create artificial controls, and then estimated what would have happened had the intervention not been implemented. His team’s conclusion: requiring people to wear face masks decreases the daily growth rate of reported COVID-19 cases by more than 40%. The economists’ approach was “clever”, says Hoen. “This adds to the body of evidence that masks work.”


"In a similar study in the United States, published this January5, researchers found that a national mandate for employees to wear face masks early in the pandemic could have reduced the weekly growth rate of cases and deaths by more than 10 percentage points in late April 2020. The study suggests that this could have reduced deaths by as much as 47% (or by nearly 50,000) across the country by the end of May last year. Another preprint, published in October, linked mask mandates with a 20–22% weekly reduction in COVID-19 cases in Canada6.


"... The mandates do have an effect, “but when we looked at it, it was really the behaviour of the population that was a better metric”, says John Brownstein, an epidemiologist at Harvard Medical School in Boston, Massachusetts, and a co-author of the study. “There’s a difference between government policy and community buy-in.”


"The research builds on evidence from hundreds of observational and laboratory studies, which find that masks protect both the wearer and the people around them. Masks can block viral particles that hitch rides on droplets and aerosols. And a study from the US National Institutes of Health, published this February, further suggests that the humidity that builds up inside a mask could help to bolster the lungs’ defences against pathogens8.


"Although it’s unlikely that the United States and other Western nations will adopt the same level of mask use beyond this pandemic, van der Westhuizen anticipates it will become much more common and acceptable than before. “It’s truly remarkable how widespread this new habit has become,” she says. “We have gained a valuable preventative tool.”


"She is referring to more than COVID-19 and its variants, or even influenza. Tuberculosis, for example, has been a leading cause of death in South Africa and a long-time focus of her research. Although data show that masks could help to control the spread of that disease, social norms and stigma have impeded their adoption14. When initial COVID-19 guidelines suggested only people with symptoms needed to wear masks, she says, her thoughts immediately went to tuberculosis, for which public-health officials have made similar concessions. Thankfully, mask recommendations evolved. “The pandemic has broken that previous stigma,” says van der Westhuizen.


"Hassig is reminded of other public-health interventions. The use of vehicle seat belts first arrived in the United States and United Kingdom as a recommendation, then became a law, for instance. Eventually, police began fining those who were non-compliant, and buckling up became the norm. “Very rarely does a public-health intervention wind up being widely accepted without some kind of enforcement mechanism,” says Hassig, who still wears a mask despite being fully vaccinated, in part to encourage mask wearing."




 
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