What is the evidence on wearing masks to stop COVID-19?

masks 2020

(Maiko Valentino, Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: David Alexander Walcott, Global Shaper, Kingston Hub,

  • Eastern countries have advocated for the use of masks and have begun to contain the virus.
  • Healthcare workers should receive masks first. That does not mean they are ineffective for the general population.
  • Research shows masks are effective as stopping the spread of respiratory illnesses.

Masks are the new gold. Varying recommendations exist surrounding the use of N95 masks – the most popular commodity that has emerged in the face of this pandemic. Though all regions have universally aligned on the need for risk mitigation, the differences between recommendations on use of N95s is subtle but palpable.

While key Western institutions – the Centers for Disease Prevention and Control (CDC), Food and Drug Administration (FDA), and Surgeon General in the US and several other public health agencies in the West – advise against the donning of surgical or N95 masks by the general public, Eastern countries have strongly advocated for their use and have somehow begun to successfully contain the virus. Is there something we are missing?

Why are we not using masks?

Contrary to the Far East, our society has never had a culture of using masks among the general public, and – consistent with this – the stated position of several influential institutions has been that masks are not recommended in protecting the general public from COVID-19. Some have strengthened their position to state that masks are also not effective when used by the general population. One has to reflect on the origins of these recommendations.

A valid argument against the mass use of masks is the notion that they would deplete the resources available for healthcare workers. Many healthcare workers who require masks for adequate levels of personal protection are unable to access them, while they have been hoarded – and effectively weaponized – by fearful consumers and opportunistic merchants.

Masks must first go to our frontline soldiers. However, this does not immediately suggest that masks are ineffective in protecting the general population. These two points have unfortunately been conflated in the court of public opinion. Should we be aiming to best allocate the existing mask volumes to healthcare workers, or should we be aiming to best allocate masks to our healthcare workers and supply the general public? The difference between those two objectives is subtle but material.

Another common argument against widespread use of masks is built upon the acknowledgement that it is costly to furnish several billion people with masks that are disposable. Evidently, mass access to masks will come at a price, however it must first be considered that the alternative – potential economic disaster – is significantly more costly. Furthermore, while single use of masks is justifiable for a healthcare worker, it is not clear that masks cannot be reused by a healthy individual. Even if this individual were asymptomatically infected, masks may offer tremendous benefit in reducing the spread of disease by those without symptoms.

The case for masks

Many regions that have successfully controlled the incidence rate of COVID infections have entrenched cultures of wearing masks, perhaps with the exception of Germany – which had implemented early and meticulous testing protocols to quickly break chains of infection.

China, Japan, Hong-Kong and South Korea all exercised various degrees of austerity in promoting widespread use of masks, particularly for individuals who are likely to engage in interpersonal contact. Notwithstanding that additional strategies have also been implemented – thorough testing, effective contact tracing, mandated social distancing – all of these countries have effectively managed risk.

Areas that have not effectively managed risk, such as New York and Milan, do not have mandated widespread wearing of masks. Though it is currently impossible to conclusively attribute this difference in outcomes to widespread use of masks, we are invited to reconsider its effectiveness as an intervention.

In addition to anecdotal observations, several scientific studies show that masks reduce the risk of respiratory infection in healthcare workers. Meta-analyses showed that “surgical masks or N95 respirators were the most consistent and comprehensive supportive measuresin reducing risk of infection in healthcare workers. Many such studies are observational in nature and, naturally, one would request a randomized controlled trial (RCT) to be the ultimate arbiter of this debate. Fortunately, RCTs on mask usage exist, and one was indeed conducted in 2008 to examine the use of masks in households to prevent respiratory virus transmission. An 80% reduction in contracting respiratory illness among compliant patients was seen. When masks are worn, they are extremely efficacious.

What is the World Economic Forum doing about the coronavirus outbreak?

A new strain of Coronavirus, COVID 19, is spreading around the world, causing deaths and major disruption to the global economy.

Responding to this crisis requires global cooperation among governments, international organizations and the business community, which is at the centre of the World Economic Forum’s mission as the International Organization for Public-Private Cooperation.

The Forum has created the COVID Action Platform, a global platform to convene the business community for collective action, protect people’s livelihoods and facilitate business continuity, and mobilize support for the COVID-19 response. The platform is created with the support of the World Health Organization and is open to all businesses and industry groups, as well as other stakeholders, aiming to integrate and inform joint action.

As an organization, the Forum has a track record of supporting efforts to contain epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched – bringing together experts from government, business, health, academia and civil society to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.

What are we aiming for?

Ultimately, we must reflect on the key global outcome that is being pursued. If we are aiming for the pandemic to run out of steam, the central goal of any intervention should be to bring R0 (the average number of people that are infected by one infected person) below 1, implying that the infection rate no longer grows exponentially.

Masks have a compounding effect in that they both protect an individual from transmitting and being exposed to infection. The impact of this could, conceivably, be a dramatic reduction of R0. If we are to assume masks are 80% effective in preventing spread on an individual basis, the overall risk-reduction in a single interaction between two people should be 96%. If we are to be conservative and assume that low compliance and mask-quality reduce individual risk by 50% instead of 80%, the overall risk reduction within a single interaction between two people is 75%.

If R0 is approximately 4, and we practice existing risk-mitigating strategies such as hand-hygiene and social distancing in addition to wearing masks, it is highly plausible that R0 will be reduced to below 1. Any series of interventions which bring R0 below 1 is the difference between unconstrained growth and eventually stopping the spread of infection. This should be thoroughly considered.

We recognize and support the CDC, WHO and other key institutional leaders that are heroically leading the charge against COVID-19 and invite all stakeholders to acknowledge that – if there is even dubious benefit to the widespread use of masks – consideration is merited. In addition to the general low-risk nature of this intervention, the anecdotal and scientific evidence that surrounds their widespread use is indeed cause for pause, and our thoughts on their utility in this fight should be subjected to objective and sober scrutiny. It could very well be the proverbial little hinge that swings the big door in this fight for humanity.

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Electronic or conventional cigarettes – which is safer?

An economist explains how to value the internet

Young translators at EU schools – Commission opens registration for 2020 translation contest

Medicines from the sky: how drones can save lives

Peatlands are under threat. Here’s why we must act now to save them

Migration and asylum: EU funds to promote integration and protect borders

Globalization is changing. Here’s how your business can adapt

Stakeholder capitalism is urgently needed – and the COVID-19 crisis shows us why

Entrepreneurship in a newly shaped Europe: what is the survival kit for a young Catalan and British entrepreneur in 2018?

EU and Germany join efforts to support the African Union’s response to coronavirus

3 ways digitalization will help end crime

Draghi joined Macron in telling Germany how Eurozone must be reformed

If you build it, they will come: Why infrastructure is crucial to tourism growth and competitiveness

The first new university in the UK for 40 years is taking a very different approach to education

German heavy artillery against Brussels and Paris

Coronavirus: the truth against all myths

The EU wants to create 10 million smart lampposts

South Sudan: UN calls for end to inter-communal clashes, attacks against aid workers

‘Ground-breaking innovation’ needed in cities, where battle for sustainable development will be won or lost, says UN agency chief

Efforts to save the planet must start with the Antarctic

As Syria conflict enters ninth year, humanitarian crisis ‘far from over’, Security Council hears

UN chief hails ‘positive developments’ towards ending political crisis in Bolivia

Financial stability: Commission addresses risks of Libor cessation

Coronavirus – here’s the public health advice on how to protect yourself

5 ways the ocean can contribute to a green post-COVID recovery

Venezuela: MEPs call for free and fair elections in the crisis-torn country

A voice from Syria: the positive prospect of clinical research despite the excruciating circumstances

Third EU-Western Balkans Media Days: EU reaffirms comprehensive support to media freedom in the region

EU-Singapore trade agreement enters into force

LGBTQ+: The social evolution of a minority

These 3 countries are global offshore wind powerhouses

India’s future as a world power depends on 4 key relationships

Scientists are growing meat on blades of grass

The ECB again takes care of the bankers not the people

How Africa’s entrepreneurs are changing the direction of globalization

Ahead of UN summit, leading scientists warn climate change ‘hitting harder and sooner’ than forecast

UN underlines need for dialogue to resolve Israel-Palestine conflict

‘Being open about my mental health created a better work culture’

7 top things to know about coronavirus today

The Ukrainian crisis to destabilize Europe and the world for a long time

These scientists are using sound waves to filter plastic fibres from washing machine wastewater

A record number of people will need help worldwide during 2020: Global Humanitarian Overview

A vision for post-pandemic mobility in African cities

This app lets you order leftovers to help fight food waste

How global food safety protects the planet and begins on the farm

Nearly 900 children released by north-east Nigeria armed group

Children are so hungry in one British town they are eating from bins

Insurer CEOs Reveal Marketing Strategies that Communicate the True Value of Insurance Products & Services to the Customer

Coronavirus: EU global response to fight the pandemic

The drive for quality education worldwide, faces ‘mammoth challenges’

More billions needed to help Eurozone recover; ECB sidesteps German objections about QE

South Africa still hasn’t won LGBTQ+ equality. Here are 5 reasons why

Dignified and non-discriminatory heath care: does anyone even know what it means?

COP25: UN climate change conference, 5 things you need to know

A Sting Exclusive: “Stronger Cybersecurity for a safer EU against cybercrime and cyber threats”, by MEP Dalli

Why schools should teach the curriculum of the future, not the past

Working Muslim women are a trillion-dollar market

JADE Testimonial #3: Sebastian @ Fundraising

More women than ever before are running for political office in the US

UN migration agency launches $10 million appeal to support hurricane recovery in The Bahamas

More Stings?


Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s