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A study of more than 340,000 people in Bangladesh offers some of the strongest real-world evidence to date that the use of masks can help communities slow the spread of Covid-19.
The research, conducted in 600 villages in rural Bangladesh, is the largest randomized trial to demonstrate the effectiveness of surgical masks, in particular, in curbing the transmission of the coronavirus. While previous, smaller studies in labs and hospitals have shown that masks can help prevent the spread of Covid, the new findings demonstrate this effectiveness in the real world – and on a huge scale.
“This is really solid data that combines the monitoring of a laboratory study with actual actions of people around the world to see if we can get people to wear masks and if the masks work,” said Laura Kwong, assistant professor of environmental health sciences at the University of California, Berkeley, and one of the study’s co-authors.
The preprint study was published online Wednesday by the nonprofit Innovations for Poverty Action and is currently under peer review. The research was led by Kwong, Jason Abaluck from Yale University, and Steve Luby and Ashley Styczynski from Stanford University.
The study’s findings have important implications for countries that rely on mitigation measures to slow the spread of the virus until vaccines are more readily available. But there are also applicable lessons for countries like the United States, where some communities are reimposing mask mandates to stem epidemics of the delta variant.
“The political question we were trying to answer was, if you can hand out masks and get people to wear them, do they work? said study co-author Mushfiq Mobarak, professor of economics at Yale.
For five months starting last November, Mobarak and his colleagues followed 342,126 adult Bangladeshis and randomly selected villages to roll out programs to promote their use, which included distributing free masks to households, providing information on their importance and strengthening their use in the community.
Among the estimated 178,000 people who were encouraged to wear them, scientists found that wearing masks increased by almost 30% and that the change in behavior persisted for 10 weeks or more. After the program was put in place, researchers reported an 11.9% decrease in symptomatic symptoms of Covid and a 9.3% reduction in symptomatic seroprevalence, indicating that the virus was detected in blood tests. .
Although the effect may appear small, the results provide some insight into the importance of masks, Mobarak said.
“A 30% increase in mask wear resulted in a 10% drop in Covid, so imagine if there was a 100% increase – if everyone wore a mask and we saw a 100% change” , did he declare.
Scientists said the masks significantly reduced symptomatic infections in the elderly and found surgical masks to be more effective than fabric versions.
Kwong said these findings could be particularly important for countries like the United States, where people spend much more time indoors than those in rural Bangladesh.
“Right now places say to cover your face but they don’t say what type of face covering,” she said. “If schools and workplaces and other indoor public spaces are going to impose masks, they should work to impose surgical masks. “
Ajay Sethi, epidemiologist and associate professor of population health sciences at the University of Wisconsin-Madison, who was not involved in the study, called the research “well thought out” and “impressive on many levels. “.
He added that the project has demonstrated that strategies can be effectively implemented in communities to change the behavior of masks. In the United States, public health officials have struggled to promote their use after masks were politicized at the start of the pandemic.
“Normative behavior is what needs to be targeted,” Sethi said. “It’s not just the use of masks that needs to be embraced, it’s also understanding why masks should be used and reinforcing that the virus is serious.”
Kwong and his colleagues are now expanding their research to include other villages and towns in Asia and sub-Saharan Africa. The researchers also plan to monitor the effect of masks on asymptomatic transmission.
Dr Isaac Bogoch, an infectious disease physician and associate professor of medicine at the University of Toronto, said the research was helping to strengthen what was known about the effectiveness of masks, but noted that people should consider them as one of the many interventions needed to stop the spread of Covid.
“We need vaccinations, better indoor ventilation, crowd control, physical distancing – all these different layers of extra protection,” he said. “The masks are certainly helping, but we cannot mask our way out of the pandemic. “
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