Health Services Research & Managerial Epidemiology (Nov 2021)
Efficacy of Generalized Face Masking Mandates
Abstract
This commentary discusses if targeted uses of face masks may provide better results than generalized face masks mandates to limit the spread of Covid-19. The study is based on a literature review, as well as the analysis of cases and fatalities of different countries adopting different mask mandates. Before the Covid-19 emergency, the literature was consistently against generalized masking for cold and flu viruses. The latest literature for Covid-19 infection is opposite mostly supportive for generalized masking, even if contrarian works exist. The Covid-19 recommendations are not based on randomized controlled trials of healthy individuals wearing or not masks, differentiating in between closed or open spaces. Countries that did not mandate face masks have not performed worse for the number of cases and fatalities than countries that adopted generalized face masking policies during the Covid-19 emergency. Face masks help against Covid-19 infection but also have downfalls. Their benefits are overestimated, while their risks are underestimated. Masks can block the larger droplets exhaled by an infected wearer, protecting the healthy from viral exposure, but their ability to filter out viruses is variable and generally poor especially in reused cloth masks worn by the public. New surgical masks should be used in crowded spaces especially indoors, preferring distancing without masks outdoor. There are serious unintended consequences from wearing face masks improperly and for too long that must be accounted for. There could be more advantages from targeted rather than generalized uses of only surgical face masks.