The introduction of a mandatory mask policy was associated with significantly reduced COVID-19 cases in a major metropolitan city

Abstract

Background Whilst evidence of use of face masks in reducing COVID-19 cases is increasing, the impact of mandatory use across a large population has been difficult to assess. Introduction of mandatory mask use on July 22, 2020 during a resurgence of COVID-19 in Melbourne, Australia created a situation that facilitated an assessment of the impact of the policy on the epidemic growth rate as its introduction occurred in the absence of other changes to restrictions. Methods and findings Exponential epidemic growth or decay rates in daily COVID-19 diagnoses were estimated using a non-weighted linear regression of the natural logarithm of the daily cases against time, using a linear spline model with one knot (lspline package in R v 3.6.3). The model’s two linear segments pivot around the hinge day, on which the mask policy began to take effect, 8 days following the introduction of the policy. We used two forms of data to assess change in mask usage: images of people wearing masks in public places obtained from a major media outlet and population-based survey data. Potential confounding factors (including daily COVID-19 tests, number of COVID-19 cases among population subsets affected differentially by the mask policy–e.g., healthcare workers) were examined for their impact on the results. Daily cases fitted an exponential growth in the first log-linear segment (k = +0.042, s.e. = 0.007), and fitted an exponential decay in the second (k = -0.023, s.e. = 0.017) log-linear segment. Over a range of reported serial intervals for SARS-CoV-2 infection, these growth rates correspond to a 22–33% reduction in an effective reproduction ratio before and after mandatory mask use. Analysis of images of people in public spaces showed mask usage rose from approximately 43% to 97%. Analysis of survey data found that on the third day before policy introduction, 44% of participants reported “often” or “always” wearing a mask; on the fourth day after, 100% reported “always” doing so. No potentially confounding factors were associated with the observed change in growth rates. Conclusions The mandatory mask use policy substantially increased public use of masks and was associated with a significant decline in new COVID-19 cases after introduction of the policy. This study strongly supports the use of masks for controlling epidemics in the broader community.

Associations of the Initial COVID-19 Lockdown on Self-Reported Happiness and Worry about Developing Loneliness: A Cross-Sectional Analysis of Rural, Regional, and Urban Australian Communities

“…At the time of data analysis, records from 1593 adult individuals were included in our analysis (See Table 1 for sample characteristics). Survey protocol, questionnaires, collection protocols, and data availability are described in detail in [ 12 , 13 , 14 ]. Ethics was approved by the Monash University Human Research Committee, ID: 23584.…”

Medical Waste from COVID-19 Pandemic—A Systematic Review of Management and Environmental Impacts in Australia

“…This has created challenges and put enormous pressure on waste management and disposal agencies [7,10]. Ensuring that waste management services in Australia's states and territories are keeping up with industry and local standards in terms of safety, hygiene, and efficiency is therefore critical [7,15,75,76]. The management and disposal of coronavirus-related wastes commences with appropriate estimation of the amounts generated.…”

“…In Australia, a number of factors are responsible for the variations in COVID-19 waste generation and these include (a) the type of facility, (b) the of the facility, (c) the number of people receiving treatment, and (d) the type of treatments provided at the various facilities [42,77]. Prior to the pandemic, in 2019, Australia produced about 67 million tons of medical waste [6,15]. Due to the pandemic, the amount of medical waste generated globally has significantly increased [16,23,42].…”

“…This warrants the need to examine the management and disposal practices implemented in Australia to effectively manage the virus. Previous studies [6,7,13,15] stated that the transmission and spread of the virus may increase due to inappropriate management and disposal of medical waste generated from COVID-19. Consequently, ensuring that COVID-19 waste are efficiently and safely disposed of has become an important part of the fight against the pandemic.…”

“…While there are prior studies [6,7,10,13,15,20] on the COVID-19 pandemic in Australia, no study has investigated management and disposal practices adopted in handling medical waste from COVID-19 and its impacts on public health and the environment. There are several major issues relating to COVID-19 waste management practices in many countries, including Australia: (a) absence of workable and sustainable medical waste management strategies, (b) lack of adequate knowledge and awareness, (c) absence of strict regulation and legislation, (d) insufficient funding, and (e) implementation [2,3,21].…”