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Call for Immediate Adoption of Wearing Face Masks and Coverings

Author: Oxford University(i) : Contact: ox.ac.uk

Published: 2020-07-07

Synopsis and Key Points:

Cloth face coverings and homemade masks made with the correct material effective in reducing spread of COVID-19 for the wearer and surrounding people.

Next to hand washing and social distancing, face masks and coverings are one of the most of widely adopted non-pharmaceutical interventions for reducing the transmission of respiratory infections.

Behavioural factors, including how people understand the virus and their perceptions of risk, trust in experts and government, can adversely affect mask wearing.

Main Digest

Cloth face coverings, even homemade masks made with the correct material, are effective in reducing the spread of COVID-19 - for the wearer and those around them - according to a new study published today from Oxford's Leverhulme Centre for Demographic Science.

The report, investigates the effectiveness of different face mask types and coverings, including an international comparison of policies and behavioural factors underlying usage. It is published jointly today by the British Academy and the Royal Society as part of Royal Society's SET-C (Science in Emergencies Tasking - COVID-19) group,

Professor Melinda Mills, Director of the Leverhulme Centre and author of the study, Face masks and coverings for the general public: Behavioural knowledge, effectiveness of cloth coverings and public messaging, says, 'The evidence is clear that people should wear masks to reduce virus transmission and protect themselves, with most countries recommending the public to wear them. Yet clear policy recommendations that the public should broadly wear them has been unclear and inconsistent in some countries such as England.'

The Oxford study shows that, just days after the WHO announced the pandemic in mid-March, many countries (some 70) immediately recommended mask wearing. That number grew to more than 120 countries. Most require mask wearing everywhere in public. Asian countries with previous experiences of the SARS' outbreak saw early and virtually universal mask usage.

But Professor Mills maintains, 'We lacked a comprehensive systematic literature review that went beyond medical research. There has been a blind spot in thinking about the behavioural factors of how the general public responds to wearing masks. Also, by looking at lessons learned about face mask wearing from previous epidemics and other countries, we get a broader and clearer picture.'

Person wearing a scarf and face mask with red lips imprint.
Person wearing a scarf and face mask with red lips imprint.

Key Findings:

Professor Mills maintains, 'The public is confused about wearing face masks and coverings because they have heard the scientific evidence is inconclusive and advice from the WHO and others has changed. People also feared they might be competing with scarce PPE resources and they need clear advice on what to wear, when to wear them and how to wear them.'

Around the world, the study finds, 'Next to hand washing and social distancing, face masks and coverings are one of the most of widely adopted non-pharmaceutical interventions for reducing the transmission of respiratory infections.'

But, the study shows, some coverings are not as effective as others. Loosely woven fabrics, such as scarves have been shown to be the least effective.

'Attention must also be placed on how well it fits on the face; it should loop around the ears or around the back of the neck for better coverage,' Professor Mills says. 'The general public does not need to wear surgical masks or respirators. We find that masks made from high quality material such as high-grade cotton, multiple layers and particularly hybrid constructions are effective. For instance, combining cotton and silk or flannel provide over 95% filtration, so wearing a mask can protect others.'

Today's report also finds that wearing a cotton mask protects the mask wearer as well - combining all research on cloth masks in a new meta-analysis.

Professor Mills says, 'There is a general assumption that countries such as the UK, which have no culture or history of mask wearing, will not rapidly adopt them. But this just doesn't hold when we look at the data. As of late April, mask-wearing was up to 84% in Italy, 66% in the US and 64% in Spain, which increased almost immediately after clear policy recommendations and advice was given to the public.'

The study concludes, 'Public communications must be clear, consistent and transparent with inconsistent and premature information raising scepticism and lowering compliance,' and reports 'Wearing a face mask in the UK has had a very low uptake (around 25% as of late April 2020)'.

The report finds that a lack of clear recommendations was likely attributed to an 'over-reliance on an evidence-based approach and assertion that evidence was weak due to few conclusive RCT (randomized control trial) results in community settings, discounting high quality non-RCT evidence.'

Professor Mills insists, 'RCTs don't fit well when looking at behaviour and it was clear that high quality observational and behavioural research had been largely discarded. It is hard to understand why the policy resistance has been so high. There have been no clinical trials of coughing into your elbow, social distancing and quarantine, yet these measures are seen as effective and have been widely adopted.'

By learning from mask-wearing experiences from previous epidemics, such as SARS, H1N1 and MERS, today's review revealed five key behavioural factors underpinning the public's compliance to wearing a mask.

The Leverhulme Center for Demographic Science was launched in 2019 and brings together researchers from different disciplines to bring science into demography.

ADA and COVID-19 Fraudulent Face Mask Flyers - U.S. Department Of Justice warns of inaccurate flyers and postings regarding the use of face masks and The Americans With Disabilities Act.

(i)Source/Reference: Oxford University. Disabled World makes no warranties or representations in connection therewith. Content may have been edited for style, clarity or length.

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