People taking with and without wearing masks

The combination of social distancing and wearing a mask provides the best protection from a virus that spreads mostly through the air, according to the research.

ARIZONA — Masks have become a cultural flashpoint, in the long shadow of the pandemic.

Masks – or the lack of masks – have spurred bitter arguments in the checkout lines, attacks on store clerks, defiance by small-town mayors, fashion statements and political rants.

Nonetheless, doctors, governors and the federal Centers for Disease Control now urge everyone wear masks in public – especially if they can’t stay six feet apart.

So how did advice from doctors become so controversial?

Why did the US Surgeon General initially warn people not to wear masks?

Most importantly — will widespread mask-wearing blunt the frightening second wave of infections now plaguing Arizona and much of the West and South?

Short answer to that last crucial question?

Yes.

A growing body of research suggests that widespread mask wearing by the healthy and the sick alike can slow down the spread of the virus as effectively as closing businesses and rarely leaving the house.

In fact, one recent study concluded that mandatory face mask orders issued in 15 states may have already reduced the total number of infections by 300,000 or 400,000. Studies show that widespread mask wearing could have just as big an impact on slowing the spread of COVID-19 as the shutdown of schools and businesses and the stay-at-home orders that have caused such economic carnage.

So why has the message changed from the early days of the pandemic when the US Surgeon General said people shouldn’t rush out and buy masks already in short supply for doctors and nurses?

Mostly, this is because doctors have discovered that people who aren’t coughing, sneezing, feverish or in any way symptomatic can still spread the virus. In fact, perhaps as many as 40 percent of those infected never develop noticeable symptoms, but still spread the virus when they breathe or talk. The other 60 percent may be most infections a day or two before symptoms develop.

That conclusion has emerged from a growing body of research, both in the real world and in the laboratory. As a result, near-universal mask wearing in public remains one of the best ways to slow the spread of the virus and buy time, while doctors continue to search feverishly both for effective treatments and vaccines.

That doesn’t mean people in masks can safely gather in big crowds or ignore social distancing rules. But the combination of social distancing and wearing a mask provides the best protection from a virus that spreads mostly through the air, according to the research.

Masks work because the virus spreads mostly in microscopic, airborne droplets. People who are infected breath out these droplets constantly, with the viral load and range increasing when we talk, cough, sing or shout. Fortunately, cloth masks made of a finely woven fabric stops most of those droplets, even if the mesh of the cloth is larger than the virus itself. To spread efficiently, the virus must be protected and wafted aloft while riding cocooned in the droplet of moisture. Such droplets can travel 30 feet and linger in an enclosed space for hours.

Some anecdotal evidence suggests wearing a mask can make a dramatic difference in the rate of spread. Of instance, a man infected with COVID-19 flew from China to Toronto. He had a dry cough, but wore a mask on the flight. The 25 people sitting closest to him were all subsequently tested for the virus and none were infected, in CMAJ, a Canadian medical journal.

In another case, two hair stylists in Missouri had close contacts with 140 clients while sick with COVID-19. Everyone wore a mask and none of the clients tested positive, according to the case report published in a medical journal.

Many researchers now argue that the widespread use of masks to cope with air pollution in many Asian cities may account for the much greater success of countries like China, South Korea, Singapore and Japan in containing the virus. China managed to contain the initial outbreak to Wuhan, even as the virus spread to every state in the US. China also contained a second outbreak in Bejing. Many people in urban areas of China already wore surgical masks daily due to the dangerous level of air pollution in China’s major cities.

So here’s a summary of some of the latest research on how COVID-19 spreads and how wearing a mask will make a difference.

“Stay Healthy”: One lab-based study found quietly saying “stay healthy” generates hundreds of droplets ranging from 20 to 500 micrometers, but nearly all those droplets were blocked by covering the mouth with a damp washcloth, according to the study published in the New England Journal of Medicine.

Masks work: Wearing a surgical mask significantly reduced the viral particles emitted in droplets and aerosols by 246 people with the flu or the common cold, according to a study published in NatureMedicine. People wearing masks released about 1,000 particles in 30 minutes while people without masks released about 100,000,000,000 particles.

States compared: A study in Health Affairs found mask mandates in 15 states slowed the spread of the virus, compared to 15 states without such a statewide mandate. The mandate slowed growth by 1 percent immediately and 2 percent over the first three weeks. That doesn’t sound like much, but it was likely enough to reduce the total number of infections by as much as 450,000 in the 15 states.

Countries compared: Countries in which most people wore masks in public had a much lower rate of spread of COVID-19, according to a study of 198 countries published in ResearchGate. In countries with “government policies” or “cultural norms” supporting widespread mask wearing practices deaths increased by 8 percent per week, compared to 54 percent in similar countries where people generally didn’t wear masks. The average of the population, obesity rates and curtailment of international travel also affected the mortality rate. Lockdowns, testing rates and contact tracing also had an impact on mortality rates, but much less than mask-wearing.

80 percent: If 80 percent of people wore masks in public it would slow the spread of the disease more than a strict lockdown according the results of a computer modeling program based on research on the effectiveness of various interventions, according to an international study by researchers from UC Berkeley, Cambridge and elsewhere. The study suggested that if 80 percent of people reliably wear masks in public it slows the spread of the virus by 60 percent. However, if fewer than 50 percent of people wear masks, it has little impact on the overall spread. The computer projection concluded effective social distancing after lockdowns end would eventually produce 1.1 million deaths in the US. An indefinite lockdown would produce 180,000 deaths. Masking levels of 50 percent after lockdowns end would produce 240,000 deaths. Masking levels of 80 percent after lockdowns end would produce 60,000 deaths.

Saving lives: Another projection by Health Metrics and Evaluation concluded that if 95 percent of people wear masks in public it would save 33,000 lives by Oct. 1.

Cloth masks work: Surgical masks and cloth masks with a triple-layer, fine woven cloth work almost as well as custom fitted, N95 surgical masks for non-medical personnel outside the hospital, according to a study by engineers from Northeastern University. The homemade cloth masks tested removed 38 to 96 percent as many viral particles as surgical maps. However, more crude masks like simply wearing a bandana or even a face shield that doesn’t make contact with the face around the mouth and nose were ineffective.

Masks slash infections: A Texas A&M study concluded that face mask use in New York from April 17 to May 9 reduced cases by 66,000. In Italy from April 6 to May 9, masks reduced infections by 78,000. The authors – including Nobel prizewinning atmospheric chemist Mario Molina from US San Diego, concluded mask-wearing can do more to stop the spread of the virus than hand washing or social distancing – although they still urged the public to practice those measures. The research has come under fire after publication in the scientific journal PNAS for statistical methods that potentially.

Peter Aleshire covers county government and other topics for the Independent. He is the former editor of the Payson Roundup. Reach him at paleshire@payson.com

(14) comments

MtnWitch

Mask do not work. Stop spreading misleading information. Support Herd Immunity. Our economy is crashing. Our lives are in ruin. The Dems are are ruining our housing market. Ruining everything to discredit the election year. Time to take our COUNTRY back. OUR HISTORY back. I will wear a mask...when you physically force it on my face. And good luck with that. TRY!!! I dare you.

2rusty

MtnWitch...YES!! Agree with every word you said here. When reading charts and 'data,' keep in mind: "CASES" do not matter. Due to continuous testing, 'cases' will always be in flux. The only meaningful numbers are PERCENTAGES of deaths to population. Ie: 100 deaths per 100K population = 0.1%. Hope you'll keep yelling, I plan to be a witch right along with you.

Gandolf

Thank you, Peter Alshire, for your rare voice of reason during this pandemic among the journalists at the WMI. Navajo County is one of the worst hotspots in the nation.Good to see science is not completely swept under the rug.

JEG

Great article. Now how to get folks in the White Mountains to accept the advocacy of mask wearing as a way to stop the spread and not as an infringement on their “rights?”

ArizAl

I think it's past time to do an extrapolation to bring about front and center what the republican party stands for. First of all, the republican party wants to do away with Obamacare, which gives benefits to over 60 million people (Medicare people included) and replace it with the "Trumpdon'tcare" plan, "If you get sick, hurry up and die."That would cause the deaths of over 40,000 americans per year. Second, currently,women have a constitutional right to have an abortion if they so chuse, in a clean, safe clinic or hospital setting. The republican party is trying their best to take away that constitutional Right from women. Their alternative is to hand women a coat hanger and tell them, do it yourself and if you get a septic infection, the republican's "Trumpdon'tcare" health plan answer is: "If you get sick, hurry up and die." Third,130,000 and more americans have died due to the Corona virus. Trump and the republican's have released the details of their most recent unfolding of their healthcare plan "Trumpdon'tcare", to combat the virus. "If you get sick, Learn to live with it." If that don't work and you're still sick ,"Hurry up and Die." Fourth, Trump and his republican followers resisting wearing a face mask to save the lives of thousands of our fellow americans is a true indicator that they have no interest in legislating an Obamacare replacement healthcare plan whose goal would be to save lives. "Learn to live with it!"

Peter999

This type of propaganda is shameful. There is no evidence that wearing a mask will even help curb the virus. What little protection they provide is completely eliminated by the fact the few people wear them, change them, or sterilize them properly.

They have required the use of masks on the reservation for over a month, yet that is where the greatest number of new "cases" are coming from. Rather than spewing theoretical benefits, why not show were the use of the masks has actually helped. I've yet to hear that AT ALL.

2rusty

Peter999...AGREED! It's a scam and Aylshire is not doing us any favors by pedaling it. I haven't worn a mask yet and don't intend to start now. People who need to protect themselves should do so with lab-certified masks, not the paper placebos being handed out.

Vets

Let's see, "anecdotal evidence" – an oxymoron. Computer simulation models. Data dredges. Laboratory setting simulations. Studies with such absurd claims that even mainstream readers have been able to debunk it. A paper by a Nobel Prize winning chemist that was so bad that 50 of the countries top leading scientists wrote to Proceedings of the National Academy of Sciences calling for its retraction. Misapplying papers in medical settings and use by sick people to calling for mask mandates for the entire population of healthy people. Ignoring 50 years of evidence and randomized clinical trials. Not understanding the difference between detecting a viral particle and replication and ability to transmit infection.

There's a reason, the author didn't properly cite the studies or provide links to the papers he's calling "research": it would have too quickly exposed, to anyone who looked, that there is no real science at all.

Gandolf

For those who like the freedom of not wearing a mask, you're really going to hate a ventilator. This virus is no joke and it's spreading like wildfire.

RockyRidge

I wish Mr. Aleshire was as concerned about the negative health effects of USFS prescribed burn/managed wildfire smoke as he is about the mandatory wearing of masks. Smoke effects everyone and this type of smoke is completely unnecessary. The body does not "adapt" to smoke, as suggested by USFS and we grow weary of your repetitive articles telling us what a necessary evil smoke is for White Mountain citizens. Mr. Aleshire, please encourage the USFS to put wildfires out as they occur. It will save lives, which based on this article you seem to care deeply about.

AZMountainGeek

I would suggest that those of you who refuse to wear a mask watch what our good neighbors at Summit Healthcare say about it. They have to deal with the results of the pandemic in our area. Here is the link to this weeks update on YouTube - please watch to the end.

https://www.youtube.com/watch?v=icyRYajvcow

dsj

It is hard to understand how people can ignore the medical community and believe the Trump line about masks. So this is a hoax or scam that people are pulling on you because.. why? Do they make money or gain power if you wear a mask? It’s a Democratic Party hoax to make some republicans look stupid? No need for that. The problem is that our hospitals are becoming full with fools that won’t wear a mask, so it impacts all of us. I suppose you will be the first to demand medical care when you get the virus.

gtucker

I don't see any proper references (journal, author, date, vol, and page) to the studies cited for the conclusions made.

ronzim

Thank you Peter for a well-researched and professionally presented article. As we see, there is no amount of objective, scientific fact or data which will convince the outliers in our society. Fortunately, the science-deniers are a minority who have very little understanding of science and how it works (partly, at least, a failure of our education system).

About 15% of Americans still insist that climate change is a hoax, all evidence to the contrary. On June 29th, the PEW Research Center published: "64% of U.S. adults say CDC mostly gets the facts about the outbreak right; 30% say the same about Trump and his administration. This vocal minority languishes in conspiracism , based on science illiteracy, willful ignorance and superstitious beliefs. They virtually never yield to the truth.

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