Face masks: what the data say
When her Danish colleagues first suggested distributing protective cloth face masks to people in Guinea-Bissau to stem the spread of the coronavirus, Christine Benn wasn’t so sure.To get more news about FFP2 protective mask, you can visit tnkme.com official website.
“I said, ‘Yeah, that might be good, but there’s limited data on whether face masks are actually effective,’” says Benn, a global-health researcher at the University of Southern Denmark in Copenhagen, who for decades has co-led public-health campaigns in the West African country, one of the world’s poorest.
That was in March. But by July, Benn and her team had worked out how to possibly provide some needed data on masks, and hopefully help people in Guinea-Bissau. They distributed thousands of locally produced cloth face coverings to people as part of a randomized controlled trial that might be the world’s largest test of masks’ effectiveness against the spread of COVID-19.
Face
masks are the ubiquitous symbol of a pandemic that has sickened 35
million people and killed more than 1 million. In hospitals and other
health-care facilities, the use of medical-grade masks clearly cuts down
transmission of the SARS-CoV-2 virus. But for the variety of masks in
use by the public, the data are messy, disparate and often hastily
assembled. Add to that a divisive political discourse that included a US
president disparaging their use, just days before being diagnosed with
COVID-19 himself. “People looking at the evidence are understanding it
differently,” says Baruch Fischhoff, a psychologist at Carnegie Mellon
University in Pittsburgh, Pennsylvania, who specializes in public
policy. “It’s legitimately confusing.”
To be clear, the science
supports using masks, with recent studies suggesting that they could
save lives in different ways: research shows that they cut down the
chances of both transmitting and catching the coronavirus, and some
studies hint that masks might reduce the severity of infection if people
do contract the disease.
But being more definitive about how well they work or when to use them gets complicated. There are many types of mask, worn in a variety of environments. There are questions about people’s willingness to wear them, or wear them properly. Even the question of what kinds of study would provide definitive proof that they work is hard to answer.At the beginning of the pandemic, medical experts lacked good evidence on how SARS-CoV-2 spreads, and they didn’t know enough to make strong public-health recommendations about masks.
The
standard mask for use in health-care settings is the N95 respirator,
which is designed to protect the wearer by filtering out 95% of airborne
particles that measure 0.3 micrometres (µm) and larger. As the pandemic
ramped up, these respirators quickly fell into short supply. That
raised the now contentious question: should members of the public bother
wearing basic surgical masks or cloth masks? If so, under what
conditions? “Those are the things we normally [sort out] in clinical
trials,” says Kate Grabowski, an infectious-disease epidemiologist at
Johns Hopkins School of Medicine in Baltimore, Maryland. “But we just
didn’t have time for that.”
Confidence in masks grew in June with
news about two hair stylists in Missouri who tested positive for
COVID-191. Both wore a double-layered cotton face covering or surgical
mask while working. And although they passed on the infection to members
of their households, their clients seem to have been spared (more than
half reportedly declined free tests). Other hints of effectiveness
emerged from mass gatherings. At Black Lives Matter protests in US
cities, most attendees wore masks. The events did not seem to trigger
spikes in infections2, yet the virus ran rampant in late June at a
Georgia summer camp, where children who attended were not required to
wear face coverings3. Caveats abound: the protests were outdoors, which
poses a lower risk of COVID-19 spread, whereas the campers shared cabins
at night, for example. And because many non-protesters stayed in their
homes during the gatherings, that might have reduced virus transmission
in the community. Nevertheless, the anecdotal evidence “builds up the
picture”, says Theo Vos, a health-policy researcher at the University of
Washington in Seattle.
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