Universal Masking to Prevent SARS-CoV-2 Transmission--The Time Is Now (JAMA)
John T. Brooks, MD; Jay C. Butler, MD; Robert R. Redfield, MD
(Robert Redfield is the director of the Center for Disease Control)
https://jamanetwork.com/journals/jama/fullarticle/2768532?
. . . excerpt:
"Two reports published this week in Morbidity and Mortality Weekly Report provide additional new data about face coverings. One report indicates that use of face coverings increased following the April 3, 2020, announcement by the White House Coronavirus Task Force and the CDC that recommended their adoption in public to slow the spread of COVID-19. In an internet-based survey among 503 adults during April 7-9, 2020, and a similar survey among another sample of 502 adults during May 11-13, 2020, the self-reported prevalence of use of cloth face coverings among those who reported leaving their homes within the previous week increased from 61.9% to 76.4%.12 Another report from investigators in Missouri found that adherence to universal masking for source control as mandated by city ordinance and company policy helped prevent transmission of SARS-CoV-2 from 2 symptomatically infected stylists at a hair salon in Springfield, Missouri. Before they were diagnosed as having COVID-19, the hair stylists had served 139 clients but had been required to wear masks at all times while working with them. After public health contact tracing with the hair salon clients and after 2 weeks of follow-up, no symptoms of COVID-19 were identified among the exposed clients or their secondary contacts. Among 104 interviewed clients, 102 (98%) reported wearing face coverings for their entire appointment.13 In addition, another analysis published by Goldman Sachs Research suggests that expanding community masking by 15% could prevent the need to bring back stay-at-home orders that would otherwise cost an estimated 5% of gross domestic product, or a projected cost of $1 trillion.14
For the person assessing personal exposure risk when going out in public, minimizing the number of nonhousehold contacts, maintaining a physical distance of at least 6 ft, and limiting the amount of time around others, especially while indoors and in poorly ventilated areas, are all important considerations. An additional factor in this calculus is the extent that individuals and communities will also be practicing source control by wearing masks. Several state and local governments have issued temporary mandates for face coverings in public places and some business are requiring mask wear by customers and employees. However, face covering is not needed all the time. It is probably safe for individuals and safe for others to drive alone or to walk or jog alone on an uncrowded route without a face covering. But when individuals choose to go out or must be close to others in public, a cloth face covering can help reduce the spread of COVID-19 from asymptomatic individuals or others. With cloth face coverings, personal protection is derived from their use by all members of the community.
How then can individuals make the most of this intervention? First, public health officials and leaders need to ensure that the public understands clearly when and how to wear cloth face coverings properly and continue building the evidence base for their effectiveness. Second, although cloth face coverings are generally well tolerated for short periods, with prolonged use they can be irritating or difficult for some people to breathe through, especially in hot or humid environments. Innovation is needed to extend their physical comfort and ease of use. Third, the public needs consistent, clear, and appealing messaging that normalizes community masking. At this critical juncture when COVID-19 is resurging, broad adoption of cloth face coverings is a civic duty, a small sacrifice reliant on a highly effective low-tech solution that can help turn the tide favorably in national and global efforts against COVID-19."
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