In a new study, researchers found cloth face coverings, even homemade masks made of the correct material, are effective in reducing the spread of COVID-19, for the wearer and those around them.
The research was conducted by a team from Oxford’s Leverhulme Centre for Demographic Science.
The team examined the effectiveness of different face mask types and coverings, including an international comparison of policies and behavioral factors underlying usage.
They found that, after the WHO announced the pandemic in mid-March, some 70 countries immediately recommended mask-wearing. But more than 120 now require mask-wearing—most, everywhere in public.
Asian countries that had previous experiences of the SARS outbreak experienced early and virtually universal mask usage.
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 were given to the public.
The team found that cloth face coverings are effective in protecting the wearer and those around them.
Behavioral factors are involved, including how people understand the virus and their perceptions of risk, trust in experts, and government, which can adversely affect mask-wearing.
Face masks need to be seen as part of ‘policy packages’ with other measures such as social distancing and hand hygiene.
Clear and consistent policies and public messaging are key to the adoption of wearing face masks and coverings by the general public.
The team says 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 for 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 widely adopted non-pharmaceutical interventions for reducing the transmission of respiratory infections.
But some coverings are not as effective as others. Loosely woven fabrics, such as scarves have been shown to be the least effective.
The team says the general public does not need to wear surgical masks or respirators.
Masks made from high-quality material such as high-grade cotton, multiple layers, and particularly hybrid constructions are effective.
Wearing a cotton mask protects the mask wearer as well.
By learning from mask-wearing experiences from previous epidemics, such as SARS, H1N1, and MERS, this review revealed five key behavioral factors underpinning the public’s compliance with wearing a mask.
First, people need to understand virus transmission and how masks protect them and others. They need to understand the risks.
Socio-political systems, public trust in governments and experts, and previous experience with pandemics are also key.
Individual characteristics are also important with younger people and men having a lower threat perception and compliance of interventions.
Women have a higher incidence of compliance with public health measures such as wearing face coverings, which may a contributing factor to the higher COVID-19 deaths amongst men.
Barriers to wearing face masks were also isolated as paramount including lack of supply of surgical masks and perceived competition with medical resources, resource constraints to obtain coverings, and concerns about the comfort and fit of wearing them.
One researcher of the study is Professor Melinda Mills.
The study can be found here.
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