The rising COVID-19 rates across the country and in many parts of the world make our efforts to protect ourselves and others more important than ever. Yes, the predictions are terrible, but we are not helpless. Experts estimate that if we all commit to wearing a mask and following known preventive measures, we can save hundreds of thousands of lives and greatly increase the chances of fighting the pandemic: maintaining physical distance; Wash hands frequently; Avoid others when you are sick. and isolate and get tested if you are in close contact with someone who has the disease.
Why do we think masks work?
At the start of the pandemic, experts expressed skepticism that masks would be helpful for the general public, especially in places where the virus has little or no spread to the community. To avoid worsening the shortage of medical masks for health professionals who needed this protection, masks have not been generally recommended.
However, we have seen a rapidly growing body of evidence supporting the usefulness of non-medical fabric masks and face covers. Some of the strongest pieces of evidence include these reviews (here and here) and observational studies (here, here, here, and here) which found that wearing masks resulted in lower rates of infection. And this impressive graphic display from the New York Times shows how masks help capture larger breath droplets and some of the smaller particles known as aerosols.
No single study is perfect or definitive; Indeed, it would be impossible to conduct such studies. But there is a lot to be done about wearing a mask, and there is little or no evidence that wearing a mask causes harm. So if you are a person who wants to avoid COVID-19, care about the health of others, and support rational, evidence-based decisions, wearing a mask should be easy.
Where are we still looking for answers?
Here are some of the most common and important questions that we don’t yet have good answers to.
- Which mask type is best? According to the CDC, it’s best to choose one with at least two layers of a “washable, breathable” fabric. Tightly woven cloth is a good choice. Gaiters and bandanas may offer little protection and are generally not the first choice as they are not designed for dense face coverage and generally only have one layer. Masks with ventilation slots or valves are also not recommended, as virus particles can more easily escape through them.
- Does wearing a mask protect others, the wearer, or both? At the beginning of the pandemic, when the evidence was limited, wearing masks was primarily recommended to protect others. Since then, we’ve learned a lot about how contagious the virus is and how it spreads. There is currently evidence that the person wearing a mask also has some benefits. A recent Danish study questioned the protective effect of masks on the mask wearer. However, in the community where the study was conducted, infection rates were not high and general mask use was uncommon. Appropriate use of the mask itself was also reported. More generally, research makes it clear that the greatest overall benefit comes from everyone wearing a mask.
- Do masks reduce the severity of infection? Because masks can reduce the “dose” of virus exposure and lower exposure can cause less severe infections, some have suggested that wearing a universal mask could induce immunity with less fatal infections. However, this remains controversial and unproven and should not be taken as true. One concern is that if mask wearers believe they are protected from serious infections, wearing a mask may relax social distancing or other harm reduction measures.
- Do I have to wear a mask outdoors? It depends on the situation. If you are walking outdoors and no one is around, wearing a mask is not required. However, if you are walking nearby, with other people, or at an outdoor gathering where it is not possible to keep your distance, wearing a mask is highly recommended. And of course, you should obey local health regulations and mandates.
Mask dos and don’s
- A mask should fit snugly around your nose and mouth, with no gaps around the edges of the mask.
- The more comfortable a mask is, the more likely you are to wear it. Try out a few styles and fabrics to find out which ones fit and feel best.
- Wash masks regularly.
- Anything other than a tight-fitting cover over your nose and mouth may not offer much protection for you and those around you. Avoid the “exposed nose,” “chin diaper,” “dangling earring,” and other creative approaches that prevent the mask from completely covering your nose and mouth.
The final result
If we are to make significant progress in ending, or at least slowing, the pandemic, we must consider science and the opinions of experts. We also need to recognize that there are areas of uncertainty and expect the recommendations to change as we learn more. Evolving guidelines do not mean that the “experts don’t know what they’re doing” (as I’ve heard more than once) – in fact, it is generally a sign that the experts are doing their job.
The best evidence available shows that we should all wear masks as it will reduce the spread of infection and save lives. It is much more difficult to make convincing arguments against wearing masks.
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For more information on COVID-19, please visit the Harvard Health Coronavirus Resource Center.