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Since the beginning of the COVID-19 pandemic, the use of face masks and coverings to slow the spread of the virus has been debated. Recently, the CEO of a major movie theater chain drew criticism for telling Variety that the chain will not mandate all moviegoers wear masks when it reopens theaters this summer, to avoid being “drawn into a political controversy.” But are face coverings truly a matter of debate — or a principle of public health?

Current research (and a number of medical experts) would point to the latter. In a new pre-print study in the journal Health Affairs, researchers found that states that mandated the public use of face masks had a larger decline in daily COVID-19 growth rates after issuing the mandates than did states without mandates.

Fifteen states, plus the District of Columbia, mandated face mask use in public to prevent the spread of COVID-19 between April 8 and May 5, the period the researchers studies. The researchers found that face covering mandates lead to a reduction in the daily case rate of COVID-19 by:

  • 0.9 percent within one to five days of the mandate
  • 1.1 percent within six to 10 days of the mandate
  • 1.4 percent within 11 to 15 days of the mandate
  • 2 percent in 21+ days of a the mandate

While that might not sound like a lot, the percent drop translates to a large decease in the actual number of COVID-19 cases. The researchers estimated that as many as 230,000 to 450,000 cases may have been averted as a result of these face-covering mandates by May 22.

“These estimates are not small and represent nearly 16 to 19 percent of the effects of other social distancing measures (school closures, bans on large gatherings, shelter-in-place orders, and closures of restaurants, bars, and entertainment venues) after similar periods from their enactment,” note the study authors. “The estimates suggest increasing effectiveness and benefits from these mandates over time.”

The model did not see the same declines in daily COVID-19 growth rates in states that mandated that only certain employees wear face masks.

The calculations were determined through an event study, which allowed researchers to estimate the effects of mandates in the context of natural experiment by comparing pre-mandate and post-mandate changes in COVID-19 in various states.

That said, one limitation of this design was that researchers were unable to measure how often facial coverings were actually used in a given state (in other words, if people actually followed the rules). They were also unable to measure data on county-level mandates, which is worth noting because some states without state-level mandates still had counties that enacted them.

Still, the findings are important as businesses and other public spaces continue to reopen.

“As countries worldwide and states begin to relax social distancing restrictions, and considering the high likelihood of a second COVID-19 wave in the fall/winter, requiring use of face masks in public might help in reducing COVID-19 spread,” write the study authors.

The U.S. Centers for Disease Control & Prevention recommends wearing cloth face coverings in public settings where social distancing measures are difficult to maintain, because the COVID-19 virus mainly spreads from person to person through respiratory droplets emitted when an infected person sneezes, coughs, or talks.

While a cloth face covering may fully not protect the wearer, it can play a key role in preventing the wearer from spreading the virus to others — which is particularly important since COVID-19 can be spread by people without symptoms. This helpful CDC guide shows you how to make your own cloth mask, including a no-sew option.

Read more here if you are among the many who is having difficulty breathing in a face mask.

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About Cloth Face Coverings. U.S. Centers for Disease Control and Prevention. June 18, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html.

Wei Lyu, George L. Wehby. Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Health Affairs. June 18, 2020. Doi: https://doi.org/10.1377/hlthaff.2020.00818.