Nearly 3 years into the Covid-19 pandemic, the United States leads high-income nations in Covid-19–related mortality. Millions of persons now have long-term neurologic, cardiopulmonary, and other disabling conditions. Essential workers continue to face high workplace exposure to Covid-19 with few protections. To prevent Covid-19 transmission, 40 states and Washington DC implemented universal indoor masking policies in 2020. Most maintained these policies until May 2021, when the Centers for Disease Control and Prevention (CDC) replaced guidance that everyone wear masks with guidance according to vaccination status. Understanding the effects of universal masking policies as compared with individual masking is critical to minimizing the inequitable harms caused by Covid-19 and maximizing our ability to learn, work, and socialize during the pandemic.

Indeed, the use of face masks, covering both mouth and nose, has always had supporters and opponents, but evidence suggests that it is the best physical barrier to limit the dissemination of the virus. “Universal masking and individual masking are distinct interventions. Universal masking lowers the amount of virus exhaled into shared air, reducing the total number of cases of Covid-19 and making indoor spaces safer for populations that are vulnerable to its complications. Individual masking lowers the amount of virus that a masked person inhales from shared air, but only in environments with a relatively high amount of circulating virus and when others are unmasked. Furthermore, individual masking has little effect on population-level transmission.”

At the end of a detailed discussion about the use of face masks, the authors conclude that “These observations highlight the importance of universal masking as a layer of protection early in Covid-19 surges. Masking policies were associated with reduced transmission despite the transmissibility of the omicron variant and without the type of mask specified, although specifying high-quality masks could plausibly further reduce transmission.”1

You can read the full editorial here.

The original article can be found here.

References

  1. Raifman, J., & Green, T. (2022b). Universal Masking Policies in Schools and Mitigating the Inequitable Costs of Covid-19. New England Journal of Medicine, 387(21), 1993–1994. https://doi.org/10.1056/nejme2213556

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