Masks work - especially surgical masks. One of the largest studies to date shows they save lives.

Our research, which is currently undergoing peer review, was conducted with 340,000 adults in 600 villages in Bangladesh and tested many different strategies to get people to wear masks.

Our research team settled on distributing masks directly to people's homes and in crowded public places like mosques, and markets.

WE provided information on why mask wearing was important, and involved religious and community leaders in that messaging. Finally, we had residents in each village politely ask anyone not wearing a mask to put one on, and give masks to whoever needed one.

While not everyone agreed to mask up, masked wearing increased by about 30 percentage points, among adults who were encouraged to so. This change led to a 9 percent reduction in Covid-19 overall. 

In communities where we promoted surgical mask use, Covid-19 cases dropped by 11 percent.

Our study did not measure the effect of universal mask wearing but the effect of a voluntary mask program. It resulted in an increase to four in 10 people using a mask from one in 10 people masking - a large rise in use, but still far from perfect. If everyone wore masks, the reductions in Covid-19 cases would have been substantially larger.

People over age benefited most, especially in communities where we distributed surgical masks. In these communities, Covid-19 cases fell by 23 percent for people aged 50 to 60 and by 35 percent for people over 60. 

Our study does not suggest that only older people need to wear masks, but rather that widespread community wearing reduces Covid-19 risk, especially for older people.

Let us put these in concrete terms. Our best estimate is that every 600 people who wear surgical masks in public areas prevent an average of one death per year given recent death rates in the United States.

Think of a church with 600 members. If a congregation learned that it could save the life of a member, would everyone agree to wear surgical masks in indoor, public areas for the next year?

We also tested the filtration of surgical masks that had been worn, crumpled up in pockets and purses, and washed with soap and water up to 10 times.

These masks still prevented more virus particles from passing through than typical cloth masks. Masks with even better filtration or fit than surgical masks, such as KF94 or KN95 masks, may provide even stronger protection than surgical masks if worn properly.

The bottom line is masks work, and higher quality masks most likely work better at preventing Covid-19. If you have the ability to choose between a cloth and a surgical mask, go with surgical. But the best mask is one that a person will actually wear and wear correctly.

Mask wearing need not be permanent. More surgical masks in high-risk areas today can mean less need for masks tomorrow, preventing many deaths along the way. In places where masks mandates are not feasible or possible,, softer alternatives - like a greeter handling out masks at a mall entrance - can be remarkably effective.

Our research suggests that if handed a mask and asked politely to please wear one, many people will do so. Not everyone will, but not everyone needs it for lives to be saved.

The World Students Society thanks authors Jason Abaluck, a professor of economics at Yale University School of Management.

Laura H. Kwong, an assistant professor in environmental health sciences at the University of California, Berkeley School of Public Health and -

 Stephen P. Luby a professor of medicine in infectious diseases division at Stanford University.


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