Mask wearing in community settings reduces SARS-CoV-2 transmission

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  • Gavin Leech
  • Charlie Rogers-Smith
  • Joshua Teperowski Monrad
  • Jonas B. Sandbrink
  • Benedict Snodin
  • Robert Zinkov
  • Benjamin Rader
  • John S. Brownstein
  • Yarin Gal
  • Bhatt, Samir
  • Mrinank Sharma
  • Sören Mindermann
  • Jan M. Brauner
  • Laurence Aitchison

The effectiveness of mask wearing at controlling severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has been unclear. While masks are known to substantially reduce disease transmission in healthcare settings [D. K. Chu et al., Lancet 395, 1973–1987 (2020); J. Howard et al., Proc. Natl. Acad. Sci. U.S.A. 118, e2014564118 (2021); Y. Cheng et al., Science eabg6296 (2021)], studies in community settings report inconsistent results [H. M. Ollila et al., medRxiv (2020); J. Brainard et al., Eurosurveillance 25, 2000725 (2020); T. Jefferson et al., Cochrane Database Syst. Rev. 11, CD006207 (2020)]. Most such studies focus on how masks impact transmission, by analyzing how effective government mask mandates are. However, we find that widespread voluntary mask wearing, and other data limitations, make mandate effectiveness a poor proxy for mask-wearing effectiveness. We directly analyze the effect of mask wearing on SARS-CoV-2 transmission, drawing on several datasets covering 92 regions on six continents, including the largest survey of wearing behavior (n = 20 million) [F. Kreuter et al., https://gisumd.github.io/COVID-19-API-Documentation (2020)]. Using a Bayesian hierarchical model, we estimate the effect of mask wearing on transmission, by linking reported wearing levels to reported cases in each region, while adjusting for mobility and nonpharmaceutical interventions (NPIs), such as bans on large gatherings. Our estimates imply that the mean observed level of mask wearing corresponds to a 19% decrease in the reproduction number R. We also assess the robustness of our results in 60 tests spanning 20 sensitivity analyses. In light of these results, policy makers can effectively reduce transmission by intervening to increase mask wearing.

Original languageEnglish
Article numbere2119266119
JournalProceedings of the National Academy of Sciences of the United States of America
Volume119
Issue number23
Number of pages9
ISSN0027-8424
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 the Author(s).

    Research areas

  • Bayesian modeling, COVID-19, epidemiology, face masks, hierarchical modeling

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