The Institute for Health Metrics and Assessment (IHME) COVID-19 forecasting team has indicated that wearing masks universally during the 2019 Coronavirus Disease (COVID-19) pandemic will save hundreds of thousands of lives and the need for mitigation measures such as -at-home guidelines.
Using a universal mask would reduce the number of deaths by more than 815,000 between August 26, 2020 and January 1, 2021, the team said.
The reduced need for control measures would also help lessen the adverse effects of COVID-19 on unemployment and the economy.
"The increasing number of COVID-19 pandemics can be significantly reduced by the universal introduction of masks," the researchers write. "This low-cost policy, whether common or mandatory, has tremendous health benefits and likely great economic benefits as well, as it delays the need to reintroduce social distancing mandates."
A pre-print version of the paper is available on the medRxiv * server while the article is being peer reviewed.
Proportion of the population who always reports outside of the house with a face mask on July 21, 2020.
Most nations have started easing social distancing measures
Since the first cases of COVID-19 were first identified late last year in Wuhan, China, the causative agent of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected and caused more than 37.7 million people worldwide a million deaths.
As of March 2020, almost all nations implemented social distancing mandates to reduce transmission. However, the ensuing economic downturn and spike in unemployment have caused most nations to relax these control measures.
With COVID-19 transmission and death rates rising in many low- and middle-income countries, as well as some high-income countries, policymakers are eager to find solutions to reduce death rates without re-introducing strict social distancing guidelines.
Percentage reduction in cumulative deaths on January 1, 2021 in the universal mask use scenario and in the reference scenario.
In some countries the use of masks is reluctantly accepted
One appealing option is wearing face masks in public places where social distancing is not an option.
However, the World Health Organization (WHO) initially advised against the use of masks and questioned the evidence for this practice, arguing that it could lead to a shortage of masks for healthcare providers.
In countries like the United States and Brazil, the use of masks has become a topic of political debate, with viewpoints on the ethics and legality of enforcement of mandates differing widely.
"This reluctance to use masks, as there are no real risks to use and there are significant potential health and economic benefits, is difficult to understand and justify," said Emmanuela Gakidou and colleagues.
"Evidence of the individual benefits, public health effects and potential economic benefits of increased mask use can be a useful contribution to these national debates," they add.
What did the researchers do?
Now, Gakidou and colleagues have presented a meta-regression-based analysis of 40 studies that assessed the impact of the use of cloth or paper masks on the transmission and mortality of COVID-19 in a general population environment and assessed current levels and trends in the Use of the masks globally.
The team used daily data from Facebook, YouGov and Premise surveys on the proportion of people who said they always wear a mask outside of their home in almost all countries.
"Global models for the effects of using scaled masks have not, to our knowledge, been published," says the team.
What did the study find out?
The researchers report that mass attrition reduces the transmission of COVID-19 by 40%.
The rate of global mask use is currently 59.0%, and if that rate were increased to 95% through mandates, the number of COVID-related deaths would decrease by 0.82 million by January 21, 2021.
The mask usage rate ranged from 41.9% in North Africa and the Middle East to 79.2% in Latin America and the Caribbean.
The beneficial effects of universal masking would be most significant in countries like India (where it would prevent 158,832 deaths), the United States (would prevent 93,495 deaths), and Russia (would prevent 68,531 deaths).
"The benefits of increased mask usage are greatest in environments with significant ongoing broadcast and low current mask usage regardless of sociodemographic status," say the authors. “This low-cost intervention, available and accessible to all population groups regardless of their socioeconomic status or other dimensions of inequality, has tremendous health benefits and can also lead to great economic benefits by delaying the need to reintroduce social distancing mandates. "
One of the best mitigation strategies available
The team says more COVID-related deaths are expected in the second half of 2020 than in the first six months of the year.
In addition to major epidemics in Latin America, the Middle East and South Asia, the seasonality suggests that a second wave can be expected in the northern hemisphere, say Gakidou and colleagues.
"It is one of the best strategies to ensure that individuals as well as local, national and global decision-makers do everything in their power to achieve the highest mask usage rates in all populations exposed to the pandemic in the months ahead," they conclude.
* Important NOTE
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.