We are seeing more and more people wearing masks locally since we started writing about the benefits of wearing masks in late March. Since then, the World Health Organization and the US Centers for Disease Control (CDC) have all concluded that masks can substantially slow transmission of the coronavirus, which is now spreading rapidly in many states including California, where Governor Newsom ordered everyone, on June 18, to wear masks in public.
“We are not defenseless against COVID-19,” said CDC Director Dr. Robert R. Redfield. “Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus – particularly when used universally within a community setting. All Americans have a responsibility to protect themselves, their families, and their communities.”
Redfield made those comments in a press statement released earlier this week by the CDC, which reported the review of two case studies, one from Journal of the American Medical Association (JAMA), showing that adherence to universal masking policies reduced SARS-CoV-2 transmission within a Boston hospital system, and one from CDC’s Morbidity and Mortality Weekly Report (MMWR), showing that wearing a mask prevented the spread of infection from two hair stylists to their customers in Missouri. Said the CDC:
“The results of the Missouri case study provide further evidence on the benefits of wearing a cloth face covering. The investigation focused on two hair stylists — infected with and having symptoms of COVID-19 — whose salon policy followed a local ordinance requiring cloth face coverings for all employees and patrons. The investigators found that none of the stylists’ 139 clients or secondary contacts became ill, and all 67 clients who volunteered to be tested showed no sign of infection. The finding adds to a growing body of evidence that cloth face coverings provide source control – that is, they help prevent the person wearing the mask from spreading COVID-19 to others. The main protection individuals gain from masking occurs when others in their communities also wear face coverings.”
In addition, RedField co-authored an editorial in JAMA, published earlier this week, advocating for the immediate and widespread use of face masks. Authors John T. Brooks, MD1Jay C. Butler, MD1Robert R. Redfield, MD1 wrote:
“Covering mouths and noses with filtering materials serves 2 purposes: personal protection against inhalation of harmful pathogens and particulates, and source control to prevent exposing others to infectious microbes that may be expelled during respiration. When asked to wear face coverings, many people think in terms of personal protection. But face coverings are also widely and routinely used as source control. For instance, if given the choice between having surgery performed by a team not wearing some covering over their mouths and noses vs a team that does, almost all patients would reject the former. This option seems absurd because it is known that use of face coverings under these circumstances reduces the risk of surgical site infection caused by microbes generated during the surgical team’s conversations or breathing. Face coverings do the same in blocking transmission of SARS-CoV-2.”
In a recent article published on the University of California San Francisco (UCSF) website, UCSF epidemiologist George Rutherford, MD, said initial concerns about the limited supply of surgical masks and N95 respirators should not have prevented health officials from recommending the usage of masks.
“We should have told people to wear cloth masks right off the bat,” said Rutherford.
“I think the biggest thing with COVID now that shapes all of this guidance on masks is that we can’t tell who’s infected,” added UCSF infectious disease specialist Peter Chin-Hong, MD. “You can’t look in a crowd and say, oh, that person should wear mask. There’s a lot of asymptomatic infection, so everybody has to wear a mask.”
The UCSF article cites several studies that demonstrate that masks slow the rate of the infection even in high risk situations.
“I think there’s enough evidence to say that the best benefit is for people who have COVID-19 to protect them from giving COVID-19 to other people, but you’re still going to get a benefit from wearing a mask if you don’t have COVID-19,” said Chin-Hong.
Masks may be more effective as a “source control” because they can prevent larger expelled droplets from evaporating into smaller droplets that can travel farther. But the physicians cautioned that it is still possible to still catch the virus through membranes in your eyes, so wearing a mask does not eliminate the risk entirely. But if you do get the disease, you are more likely to get a mild case because the mask is filtering out some of the viral load.
Dr. Monica Gandhi, UC San Francisco professor of medicine and medical director of the HIV Clinic at Zuckerberg San Francisco General Hospital told the Los Angeles Times this week that research shows that masking can still protect you from a more severe form of the disease.
“There is this theory that facial masking reduces the [amount of virus you get exposed to] and disease severity,” Gandhi, who is also director for the Center for AIDS Research at UC San Francisco, told the LA Times.
But the masks are most effective when widely used in communities, and there’s a lot of misinformation about masks that’s not helping.
“This anti-mask rhetoric is mind-blowing, dangerous, deadly and polarizing,” Dr. Chin-Hong told the Los Angeles Times this week. “There is no evidence that it [wearing a mask] is dangerous.”
But the CDC’s Redfield is not giving up.
“If we could get everybody to wear a mask right now, I really think in the next four, six, eight weeks, we could bring this epidemic under control,” Redfield said on a JAMA Live webcast earlier this week, reported STAT, a news outlet produced by Boston Globe Media.
Public information efforts seem to working as more Americans understand the benefits of wearing masks. According to the CDC more Americans are willing to wear face masks than they were a few weeks ago:
“CDC analyzed data from an internet survey of a national sample of 503 adults during April 7–9 and found that about 62% said they would follow the newly announced recommendations to wear a face mask when outside the home. A repeat survey during May 11-13 showed that the percentage of adults endorsing face mask wearing increased to more than 76%. The increase was driven largely by a significant jump in approval by white, non-Hispanic adults, from 54% to 75%. Approval among Black, non-Hispanic adults went up from 74% to 82%, and remained stable among Hispanic/Latino adults at 76% and 77%. There was also a large increase in face-mask approval among respondents in the Midwest, from 44% to 74%. Approval was greatest in the Northeast, going from 77% to 87%.”
The New York Times is also tracking where people are wearing masks around the country. According to data gathered for the Times’ interactive map, “mask use is high in the Northeast and the West, and lower in the Plains and parts of the South. But it also shows many fine-grained local differences. Masks are widely worn in the District of Columbia, but there are sections of the suburbs in both Maryland and Virginia where norms seem to be different. In St. Louis and its western suburbs, mask use seems to be high. But across the Missouri River, it falls.”
Locally, thanks to Buzz contributor Dan Kegel, we’ve also have been keeping track of mask usage on Larchmont Blvd. And the good news is that even though mask usage has been pretty high and pretty consistent for the last few weeks, it has even improved this week, according to Kegel’s counts as we’ve been recording them:
|Date||# Wearing Masks||# Not Wearing Masks||# Eating/Drinking (No Mask Required)||Percent Masked, of those Required||# Wearing Mask Incorrectly (Nose Not Covered)||% Wearning Mask Incorrectly (Nose Not Covered)|
|Saturday, June 27||129||20||28||86|
|Tuesday, June 30||90||9||11||91|
|Wednesday, July 1||72||27||18||73|
|Friday, July 3||88||14||21||86|
|Saturday, July 11||70||12||24||85||3||4|
|Wednesday, July 15||85||3||8||97||2||2|