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Effectiveness of Mask-Wearing Against COVID19

April 30, 2020

Effectiveness of Mask-Wearing Against COVID19

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By Nidiane Martinelli, PhD

The number of COVID-19 cases is increasing daily and although the scientists are working around the clock to develop a vaccine and find a treatment, we must do our part in this crisis which is social distancing and adhere to preventative measures.

The Coronavirus Disease (COVID-19) is considered a respiratory infection disease, similar to the influenza (the flu) and so masks can be used to block respiratory transmission from human to human. Due to the current world situation it is necessary to wear a mask when going out in public not only to avoid contracting COVID-19 but also to not spread it even more in case you are an asymptomatic patient. 

Since COVID-19 is very similar to the flu disease one can extrapolate the effectiveness of mask use to prevent flu spread to the current SARS-CoV-2 pandemic. Because the pandemic is still happening it is difficult for scientists to study the real effectiveness of masks for the prevention of COVID-19 among communities. We can make a parallel comparison between COVID-19, influenza and SARS because COVID-19 is also a respiratory disease and some approaches used against the flu and SARS would be effective as well in the current pandemic. 

A recent study using avian influenza virus to mock SARS-CoV-2, due to its similarities, showed that N95 masks blocked nearly all the mock virus, and medical masks blocked approximately 97% of the virus. The study calls attention for the fact that in countries such as China, Republic of Korea, and Japan where mask wearing and frequently hand hygiene have been implemented, the spread of the coronavirus has been fairly well controlled so far. They advise that common people should wear effective masks and bring an appropriate item for instant hand hygiene when needed, to slow the rapid spread of the virus worldwide.  Similarly, another study reported that wearing facemasks with appropriate level of protection was the most significant measure to reduce the risk of infection of SARS during the 2003 outbreak.

Another study analyzed the effectiveness of containment measures on COVID-19 in Hong Kong. In this study, based on two separate telephone survey made three weeks apart, approximately 74% and 97% of the general population reported wearing masks when going outside. The city was one of the places which were able to flatten the pandemic curve, ensuring the healthcare system is not overloaded. In Hong Kong, there were 1033 confirmed cases with four deaths as of April 22, 2020. It seems that non pharmacological interventions, such as mask use might have helped Hong Kong to flatten the curve against COVID-19, hopefully in a similar way it did against SARS in 2003.

The Czech Republic and Slovakia were the first two countries in Europe to issue decrees making masks compulsory since March 30, 2020. On April 21, 2020, the Czech Republic reported 6,961 confirmed cases of coronavirus (COVID-19) while Slovakia had 1,199 cases and 14 deaths by COVID-19. On the other hand, the United States had just crossed 800,000 confirmed cases. 

The graph shows that countries who imposed mandatory mask use or its population  has the practice of wear masks when feeling sick have flattened the curve much earlier compared with the United States, where the use of masks was encouraged later in time. As shown in Figure 1 in Slovakia and Czech Republic the number of cases is doubling every 6-8 days, while in USA the number of cases doubles every 3.5 days approximately. This could be due to quarantine, lockdowns and mask uses, the countries are being able to slow down the spread of SARS-CoV-2. Also, keep in mind that in countries that do very little testing the total number of cases can be much higher than the number of confirmed cases shown here.

The use of face masks is strongly encouraged in mainland China, Hong Kong, South Korea, Japan, Thailand and Taiwan, with the product even being widely distributed to homes and families in some areas. Morocco made wearing face masks mandatory starting on April, 7th, 2020 for anyone allowed to go out during the coronavirus outbreak as a tentative to slow the pandemic. Although, these countries had slowed the virus spread we cannot assume that is only due to face mask wearing, but probably is a result of a combination of preventive measures. 

A recent study showed that after a religion event in South Korea, where people did not wear masks, virtually all participants contracted COVID-19 from patient 31. Following this event, almost all persons in South Korea wore masks when they were outdoors or had public activities, as recommended by the South Korea Government and as result, the daily confirmed cases were significantly reduced after three weeks. The authors call attention for this measure in Korea in contrast to Italy and France, for example, where mask use was not recommended at the time and the number of cases kept increasing. This study concluded that wearing mask in general population is an effective way to control COVID-19, and should be recommended. 

Finally, since it is well known that wearing mask can prevent other airborne infectious diseases, such as pulmonary tuberculosis and influenza, we could assume it helps prevent contamination from SARS-CoV-2 as well. While waiting for the science to deliver an effective treatment and a vaccine, masks can be used to block respiratory transmission from human to human in a similar way to control the influenza. To end the COVID-19 epidemic, efforts to reduce the spread of the virus, such as social distancing and wearing masks at all times when in public, are absolutely crucial with the participation of the public. All these are pivotal to help the world to pull through this pandemic and avoid the tragedy of medical systems being overwhelmed by a surge of too many patients.

Nidiane Martinelli  has a Master’s in Cardiovascular Sciences and PhD in Molecular Biology and Genetics from Federal University of Rio Grande do Su. Her work ranges from cellular culture and animal models up to human studies.

Need to upgrade your facial protection to professional-grade KN95s or disposable surgeon masks? The/Studio is a responsibly-sourced, verified seller of protective personal equipment to international companies, family businesses, military groups and individuals. Place your order here.


References:

Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020.   J. Korean Med Sci. 2020 Mar;35(10):e112.   https://doi.org/10.3346/jkms.2020.35.e112

Estimating the reproductive number and the outbreak size of COVID-19 in Korea. Epidemiol Health. 2020;42:e2020011. Published online March 12, 2020. DOI: https://doi.org/10.4178/epih.e2020011

Lau JTF, Tsui H, Lau M, Yang X. SARS transmission, risk factors and prevention in Hong Kong. Emerging Infectious Diseases, 2004; 10:587–592

https://www.statista.com/statistics/1105425/hong-kong-novel-coronavirus-covid19-confirmed-death-recovered-trend/#statisticContainer accessed on April, 22, 2020.

https://www.dailymail.co.uk/news/article-8236891/Does-wearing-facemask-REALLY-curb-coronavirus-outbreaks-Rates-countries-suggest-do.html accessed on April, 22, 2020.

https://ourworldindata.org/coronavirus accessed on April, 25, 2020.

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