Impact of community masking on COVID-19: A cluster-randomized trial in Bangladesh

Abstract

Persuading people to mask Even in places where it is obligatory, people tend to optimistically overstate their compliance for mask wearing. How then can we persuade more of the population at large to act for the greater good? Abaluck et al . undertook a large, cluster-randomized trial in Bangladesh involving hundreds of thousands of people (although mostly men) over a 2-month period. Colored masks of various construction were handed out free of charge, accompanied by a range of mask-wearing promotional activities inspired by marketing research. Using a grassroots network of volunteers to help conduct the study and gather data, the authors discovered that mask wearing averaged 13.3% in villages where no interventions took place but increased to 42.3% in villages where in-person interventions were introduced. Villages where in-person reinforcement of mask wearing occurred also showed a reduction in reporting COVID-like illness, particularly in high-risk individuals. —CA

Can a combination of vaccination and face mask wearing contain the COVID‐19 pandemic?

“…After state‐wide mask mandates, self‐reported mask wearing did not increase significantly in the US, indicating a disconnect between rules, messaging and actions, and that socio‐behavioural research is needed to reinforce mask wearing (Clapham and Cook, 2021 ). A discrepancy between self‐reported and observed mask wearing was also observed in developing countries such as Bangladesh and Kenya (Abaluck et al ., 2021 ; Jakubowski et al ., 2021 ). Mask wearing became even more difficult to encourage when masks were associated with the expression of political opinions (Mello et al ., 2020 ) and led to refusal of masks by populist movements in several countries.…”

“…The researchers noted that their data should not be taken to imply that mask wearing can prevent only 10% of COVID‐19 cases – this is only the value for a 29% increase in mask use. Greater effects might be expected by mandatory mask wearing in the public enforced by local authorities (Abaluck et al ., 2021 ).…”

Mask up! Testing strategies to increase mask usage in Kenya*

“…While point estimates are generally positive for the role model intervention, it did not lead to statistically significant improvements in mask usage, knowledge or attitudes. These gains are smaller in magnitude than other programs that have successfully increased mask adoption, such as [1] in Bangladesh. The intervention studied here was less intensive than the Bangladesh intervention, suggesting that more intensive interventions may be needed in order to change mask adoption behavior.…”

“…These gains are smaller in magnitude than other programs that have successfully increased mask adoption, such as [1] in Bangladesh. The intervention studied here was less intensive than the Bangladesh intervention, suggesting that more intensive interventions may be needed in order to change mask adoption behavior.…”

“…Second, the two months of follow-up data provides a sense of the short-run effects of the program, but longer-term effects may vary. Third, the size of the study is smaller compared to other randomized trials that have studied mask adoption, such as in Bangladesh [1]. This study was designed to be more exploratory, testing a large number of intervention features that could potentially be scaled up, but this reduces statistical power for some of our comparisons.…”