The Time for Universal Masking of the Public for Coronavirus Disease 2019 Is Now

Gandhi, Monica; Havlir, Diane V.

doi:10.1093/ofid/ofaa131

Cited by 23 publications

(31 citation statements)

References 35 publications

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“…9 There are two likely reasons for the effectiveness of facial masks: The first-to prevent the spread of viral particles from asymptomatic individuals to others-has received a great deal of attention. 10,11 However, the second theory-that reducing the inoculum of virus to which a mask-wearer is exposed will result in milder disease [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] -has received less attention and is the focus of our perspective which compiles virologic, epidemiologic and ecologic evidence.…”

mentioning

confidence: 99%

Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer

2020

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Although the benefit of population-level public facial masking to protect others during the COVID-19 pandemic has received a great deal of attention, we discuss for one of the first times the hypothesis that universal masking reduces the "inoculum" or dose of the virus for the maskwearer, leading to more mild and asymptomatic infection manifestations. Masks, depending on type, filter out the majority of viral particles, but not all. We first discuss the near-century-old literature around the viral inoculum and severity of disease (conceptualized as the LD50 or lethal dose of the virus). We include examples of rising rates of asymptomatic infection with population-level masking, including in closed settings (e.g., cruise ships) with and without universal masking. Asymptomatic infections may be harmful for spread but could actually be beneficial if they lead to higher rates of exposure. Exposing society to SARS-CoV-2 without the unacceptable consequences of severe illness with public masking could lead to greater community-level immunity and slower spread as we await a vaccine. This theory of viral inoculum and mild or asymptomatic disease with SARS-CoV-2 in light of population-level masking has received little attention so this is one of the first perspectives to discuss the evidence supporting this theory.

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confidence: 99%

Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer

2020

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“…While the effectiveness of masks to prevent viral spread has been hotly debated, scientific studies have shown that even homemade masks can be effective at reducing virus spread 5,6 . Importantly, homemade masks were shown to primarily protect uninfected neighbors of infected individuals and were not as effective at protecting the wearer 7 .…”

Section: Impact Of Covid‐19 On Food Safetymentioning

confidence: 99%

The impact of COVID‐19 on food systems, safety, and security—a symposium report

Cable¹,

Jaykus

Hoelzer

et al. 2020

Annals of the New York Academy of Sciences

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Our food systems depend on complex interactions between farmers and food producers, local and federal governments, and consumers. Underlying these interactions are economic, environmental, and societal factors that can impact the types of food available, access to food, affordability, and food safety. The recent SARS‐CoV‐2 global pandemic has affected multiple aspects of our food systems, from federal governments’ decisions to limit food exports, to the ability of government agencies to inspect food and facilities to the ability of consumers to dine at restaurants. It has also provided opportunities for societies to take a close look at the vulnerabilities in our food systems and reinvent them to be more robust and resilient. For the most part, how these changes ultimately affect the safety and accessibility of food around the world remains to be seen.

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“…After the Asian pandemic, the COVID-19 spread more rapidly in Europe and the US, but was gradually brought under control in Asia, due to the implementation of strict public protection measures in the region. For example, the Taiwanese Center for Disease Control requires people to wear masks in public places, including public transport, and that will be fined if they fail to comply, and until now Taiwan has maintained good control of the epidemic without a mandatory suspension of work and school [ 10 , 11 ]. Can masks play an effective role in the prevention and control of the spread of COVID-19?…”

Section: Introductionmentioning

confidence: 99%

“…Because they carry the virus, with a high concealment, it makes it more difficult to prevent and control the epidemic. The shedding of the virus from the asymptomatic carriers poses a great risk of transmission to the vulnerable population [ 10 , 28 ]. The results of the ‘Diamond Princess’ cruise liner incident showed that 18% of all infected individuals with SARS-CoV-2 in nasopharyngeal and oropharyngeal swabs did not show any symptoms [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…A study on the effect of face masks on the spread of COVID-19 in Germany using the synthetic control method indicate that the early introduction of face masks in Jena has resulted in a drop in newly registered COVID-19 cases of around 75% after 20 days [ 40 ]. Some countries and regions strictly implement public policy to wear mask to loosen the lockdown interventions and to promote the resumption of normal life, and so far the epidemic has not broken out again, providing a stable guarantee for a return to normality [ 10 ]. Therefore, compared with the initial stage of the epidemic, European and American countries have gradually begun to change their views on wearing masks.…”

Section: Introductionmentioning

confidence: 99%

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Why does the spread of COVID-19 vary greatly in different countries? Revealing the efficacy of face masks in epidemic prevention

et al. 2021

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The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is highly contagious, and the coronavirus disease 2019 (COVID-19) pandemic caused by it has forced many countries to adopt ‘lockdown’ measures to prevent the spread of the epidemic through social isolation of citizens. Some countries proposed universal mask wearing as a protection measure of public health to strengthen national prevention efforts and to limit the wider spread of the epidemic. In order to reveal the epidemic prevention efficacy of masks, this paper systematically evaluates the experimental studies of various masks and filter materials, summarises the general characteristics of the filtration efficiency of isolation masks with particle size, and reveals the actual efficacy of masks by combining the volume distribution characteristics of human exhaled droplets with different particle sizes and the SARS-CoV-2 virus load of nasopharynx and throat swabs from patients. The existing measured data show that the filtration efficiency of all kinds of masks for large particles and extra-large droplets is close to 100%. From the perspective of filtering the total number of pathogens discharged in the environment and protecting vulnerable individuals from breathing live viruses, the mask has a higher protective effect. If considering the weighted average filtration efficiency with different particle sizes, the filtration efficiencies of the N95 mask and the ordinary mask are 99.4% and 98.5%, respectively. The mask can avoid releasing active viruses to the environment from the source of infection, thus maximising the protection of vulnerable individuals by reducing the probability of inhaling a virus. Therefore, if the whole society strictly implements the policy of publicly wearing masks, the risk of large-scale spread of the epidemic can be greatly reduced. Compared with the overall cost of social isolation, limited personal freedoms and forced suspension of economic activities, the inconvenience for citizens caused by wearing masks is perfectly acceptable.

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The Time for Universal Masking of the Public for Coronavirus Disease 2019 Is Now

Cited by 23 publications

References 35 publications

Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer

Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer

The impact of COVID‐19 on food systems, safety, and security—a symposium report

Why does the spread of COVID-19 vary greatly in different countries? Revealing the efficacy of face masks in epidemic prevention

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