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COVID-19 deaths

Face Coverings Could Save 130,000 American Lives from COVID-19 by March

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Wearing a mask
Credit: Diane Baker

The coronavirus disease 2019 (COVID-19) pandemic has already claimed the lives of more than 230,000 Americans, the population of a mid-sized U.S. city. As we look ahead to winter and the coming flu season, the question weighing on the minds of most folks is: Can we pull together to contain the spread of this virus and limit its growing death toll?

I believe that we can, but only if each of us gets fully engaged with the public health recommendations. We need all Americans to do the right thing and wear a mask in public to protect themselves and their communities from spreading the virus. Driving home this point is a powerful new study that models just how critical this simple, low-cost step will be this winter and through the course of this pandemic [1].

Right now, it’s estimated that about half of Americans always wear a mask in public. According to the new study, published in Nature Medicine, if this incomplete rate of mask-wearing continues and social distancing guidelines are not adhered to, the total number of COVID-19 deaths in the United States could soar to more than 1 million by the end of February.

However, the model doesn’t accept that we’ll actually end up at this daunting number. It anticipates that once COVID mortality reaches a daily threshold of 8 deaths per 1 million citizens, U.S. states would re-instate limits on social and economic activity—as much of Europe is now doing. If so, the model predicts that by March, such state-sanctioned measures would cut the projected number of deaths in half to about 510,000—though that would still add another 280,000 lives lost to this devastating virus.

The authors, led by Christopher Murray, Institute of Health Metrics and Evaluations, University of Washington School of Medicine, Seattle, show that we can do better than that. But doing better will require action by all of us. If 95 percent of people in the U.S. began wearing masks in public right now, the death toll would drop by March from the projected 510,000 to about 380,000.

In other words, if most Americans pulled together to do the right thing and wore a mask in public, this simple, selfless act would save more than 130,000 lives in the next few months alone. If mask-wearers increased to just 85 percent, the model predicts it would save about 96,000 lives across the country.

What’s important here aren’t the precise numbers. It’s the realization that, under any scenario, this pandemic is far from over, and, together, we have it within our power to shape what happens next. If more people make the decision to wear masks in public today, it could help to delay—or possibly even prevent—the need for future shutdowns. As such, the widespread use of face coverings has the potential to protect lives while also minimizing further damage to the economy and American livelihoods. It’s a point that NIH’s Anthony Fauci and colleagues presented quite well in a recent commentary in JAMA [2].

As we anxiously await the approved vaccines for COVID-19 and other advances in its prevention and treatment, the life-saving potential of face coverings simply can’t be overstated. I know that many people are tired of this message, and, unfortunately, mask-wearing has been tangled up in political perspectives at this time of deep divisions in our country.

But think about it in the same way you think about putting on your seat belt—a minor inconvenience that can save lives. I’m careful to wear a mask outside my home every time I’m out and about. But, ultimately, saving lives and livelihoods as we head into these winter months will require a collective effort from all of us.

To do so, each of us needs to follow these three W’s: Wear a mask. Watch your distance (stay 6 feet apart). Wash your hands often.

References:

[1] Modeling COVID-19 scenarios for the United States. IHME COVID-19 Forecasting Team. Nat Med. 2020 Oct 23.

[2] Preventing the spread of SARS-CoV-2 with masks and other “low-tech” interventions. Lerner AM, Folkers, GK, Fauci AS. JAMA. 2020 October 26.

Links:

Coronavirus (COVID-19) (NIH)

Institute for Health Metrics and Evaluations (University of Washington School of Medicine, Seattle)


Masks Save Lives

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Masks save lives

Reminding others that “masks save lives” isn’t just sound advice. It’s a scientific fact that wearing one in public can help to slow the spread of SARS-CoV-2, the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic.

I’m very careful to wear a mask outside my home whenever I’m out and about. I do it not necessarily to protect myself, but to protect others. If by chance I’ve been exposed to the virus and am currently incubating it, I wouldn’t want to spread it to other people. And any of us could be an unknowing superspreader. We owe it to everyone we encounter, especially those who are more vulnerable, to protect them. As my NIH colleague Tony Fauci recently demonstrated, it’s possible to wear your mask even while you’re outside exercising.

But there are still skeptics around. So, just how much does a facial covering protect those around you? Quite a bit, according to researchers who created a sophisticated mathematical model to take a more detailed look [1]. Their model shows that even if a community universally adopted a crude cloth covering that’s far less than 100 percent protective against the virus, this measure alone could significantly help to reduce deaths.

These findings, funded partly by NIH, were published recently in Nature Communications. They come from Colin Worby, Broad Institute of MIT and Harvard, Cambridge, MA, and Hsiao-Han Chang, National Tsing Hua University, Taiwan.

The researchers noted several months ago that recommendations on wearing a mask varied across the United States and around the world. To help guide policymakers, the researchers simulated outbreaks in a closed, randomly interacting population in which the supply and effectiveness of crude cloth or disposable, medical-grade masks varied.

Under different outbreak scenarios and mask usages, the researchers calculated the total numbers of expected SARS-CoV-2 infections and deaths from COVID-19. Not surprisingly, they found that the total number of deaths and infections declined as the availability and effectiveness of face masks increased.

The researchers’ model primarily considered the distribution of medical-grade, surgical masks. But because such masks are currently available in limited supply, they must be prioritized for use by health care workers and others at high risk. The researchers go on to note that the World Health Organization and others now recommend wearing homemade face coverings in public, especially in places where the virus is spreading. While it’s true the ability of these face coverings to contain the virus is more limited than medical-grade masks, they can help and will lead to many fewer deaths.

Another recent paper also suggests that while wearing a mask is primarily intended to prevent the wearer from infecting others, it may also help lower the dose, or inoculum, of SARS-CoV-2 that the wearer might receive from others, resulting in milder or asymptomatic infections [2]. If correct, that’s another great reason to wear a mask.

Already, more than 175,000 people in the United States have died from COVID-19. The latest estimates [3] from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine, Seattle, predict that the COVID-19 death toll in the U.S. may reach nearly 300,000 by December 1.

But that doesn’t have to happen. As this new study shows, face coverings—even those that are far from perfect—really can and do save lives. In fact, IHME data also show that consistent mask-wearing—starting today—could save close to 70,000 lives in the months to come. Saving those lives is up to all of us. Don’t leave home without your mask.

References:

[1] Face mask use in the general population and optimal resource allocation during the COVID-19 pandemic. Worby CJ, Chang HH. Nat Commun. 2020 Aug 13;11(1):4049.

[2] Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer. Gandhi M, Beyrer C, Goosby E. J Gen Intern Med. 2020 Jul 31.

[3] New IHME COVID-19 forecasts see nearly 300,000 deaths by December 1. Institute for Health Metrics and Evaluation. August 6, 2020.

Links:

Coronavirus (COVID-19) (NIH)

Colin Worby (Broad Institute of MIT and Harvard, Cambridge, MA)

Hsiao-Han Chang (National Tsing Hua University, Taiwan)

NIH Support: National Institute of Allergy and Infectious Diseases