Mask wearing rates in the UK are among the lowest in the world – it’s time for #MasksForAll

As social distancing measures are relaxed in Northern Ireland and elsewhere, it is vital that everything possible is done to attempt to prevent a secondary wave of Covid-19 infections.

Of the actions that citizens and policymakers can take to mitigate against the risk of another wave of the coronavirus, Northern Ireland and Great Britain are amongst the world’s laggards on what has been found to be the most effective intervention against the virus; the universal wearing of masks.

The chart at the top of the post shows the percentage of the population by country who wear masks outside the home (either always, frequently, or sometimes), from survey data published by YouGov. The data is colour coded by region, with European countries in blue, countries in the Asia-Pacific region coloured orange and the Americas in red.

Except for Norway, Finland, Sweden and the Netherlands, the UK had the lowest incidence of mask wearing, with Northern Ireland having the lowest numbers in the UK (there was no data for the Republic of Ireland).

Science around the effectiveness of masks to impede Covid-19 infections is developing rapidly. This preprint contains an excellent summary of the evidence in favour of wearing masks. A key message was the results of modelling that found that “if 70% of the general public wear masks and contact tracing is conducted at 60% efficiency within a 4-day time frame, epidemic growth will be flattened in the hardest hit countries.

The chart below shows how the R number can be suppressed with greater mask efficacy (how well the mask blocks the virus) and adherence (the proportion of the public that wears masks).

In Northern Ireland and Great Britain, adherence is in the region of 25%. For masks to be properly effective against future waves of Covid-19, it would need to increase significantly. However, other countries have shown that such a rapid shift in public behaviour can be done in a short amount of time. For instance, in Germany, only 2% of people wore masks in public in the middle of March, and within 2 months this had risen to 64%.

This Medium post by Nassim Nicholas Taleb is a good summary of the errors made by those arguing against the effectiveness of masks. It is now clear that the initial WHO guidance (that masks were ineffective) was disastrous.

One common argument made against the wearing of masks was that they made people feel more secure and therefore less likely to adhere to social distancing measures. There was never any evidence provided for this claim, and it has now been comprehensively debunked. This paper from the University of Padua used sensor data to show that people were more likely to keep physically distanced when masks were worn.

Economic modelling has suggested that the economic value of each cloth mask could be worth thousands of dollars due to decreased mortality risks and the decreasing probability of future lockdowns.

Countries including Japan, Belgium and Singapore are distributing cloth masks to their entire populations. It is worth noting that Taiwan, which has had 441 cases in total (fewer than the Lisburn and Castlereagh council area), has never had a lockdown but has, in line with other countries in the region with very few cases, seen near universal levels of mask wearing.

As of today, the 15th of June, masks are compulsory on public transport in England and on Stena Line ferries between Northern Ireland and Great Britain.

The science is now absolutely crystal clear that the wearing of masks helps to reduce the spread of Covid-19 and to save lives. Their use should absolutely be mandatory in indoor environments such as shops and public transport.

Perhaps the most succinct summary on the matter is from this study:

“We conclude that wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine, and contact tracing, represents the most likely fighting opportunity to stop the COVID-19 pandemic.”

We now have an opportunity to crush the curve; it’s time for #MasksForAll.

 

Impact of public mask wearing under the full range of mask adherence and efficacy scenarios was taken from Howard, J.; Huang, A.; Li, Z.; Tufekci, Z.; Zdimal, V.; van der Westhuizen, H.; von Delft, A.; Price, A.; Fridman, L.; Tang, L.; Tang, V.; Watson, G.L.; Bax, C.E.; Shaikh, R.; Questier, F.; Hernandez, D.; Chu, L.F.; Ramirez, C.M.; Rimoin, A.W. Face Masks Against COVID-19: An Evidence Review. Preprints 2020, 2020040203 (doi: 10.20944/preprints202004.0203.v2) and is licensed under CC BY 4.0.


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