Global projections of lives saved from COVID-19 with universal mask use

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Abstract

BACKGROUND

Social distancing mandates (SDM) have reduced health impacts from COVID-19 but also resulted in economic downturns that have led many nations to relax SDM. Until deployment of an efficacious and equitable vaccine, intervention options to reduce COVID-19 mortality and minimize restrictive SDM are sought by society.

METHODS

A susceptible-exposed-infectious-recovered (SEIR) deterministic transmission model was parameterized with data on reported deaths, cases, and select covariates to predict infections and deaths from COVID-19 through March 01, 2021. We explore three scenarios: a “non-adaptive” scenario where neither mask use or SDM adapt to changing conditions, a “reference” where current national levels of mask use are maintained and SDM reintroduced when deaths rise, and an increase in mask use to 95% coverage levels (“universal mask”). We reviewed published studies to set priors on the magnitude of reduction in transmission through increasing mask use.

RESULTS

Mask use was estimated at 59.0% of people globally on October 19, 2020. Universal mask use could avert 733,310 deaths (95% UI 385,981 to 1,107,759) between October 27, 2020 and March 01, 2021, the difference between the predicted 2.95 million deaths (95% UI 2.70 to 3.35) in the reference scenario and 2.22 million deaths (95% UI 2.00 to 2.45) in the universal mask scenario over this time period.

CONCLUSIONS

The cumulative toll of the COVID-19 pandemic could be substantially reduced by the universal adoption of masks before the availability of a vaccine. This low-cost, low-barrier policy, whether customary or mandated, has enormous health benefits with presumed marginal economic costs.

Article activity feed

  1. SciScore for 10.1101/2020.10.08.20209510: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: Thank you for sharing your code.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The findings of this study should be interpreted while taking into account its limitations (further elaborated in the Supplementary Appendix): (i) the number of studies on general mask use in the population remains low; (ii) all the assumption of any type of SEIR model are also applicable here;24 prediction accuracy is highly spatially variable and compound into the future;25 (iv) death reporting globally is subject to regionally and nationally specific errors and biases for which we cannot fully control; (v) models is sensitive to death trend in last 7-14 days and (vi) self-reported mask use by surveys will also have an set of errors and biases that are not completely known. Universal mask use can save many lives and avoid or delay the need for re-imposition of SDM. This will contribute to ameliorating the negative effects of COVID-19 on national economies. Until an affordable and effective vaccine becomes universally available, we find encouraging or mandating mask use is the least disruptive policy option available to countries currently experiences resurgences in infections and deaths. Simple face coverings are cheap and effective; one of the few available interventions that is widely available to everyone. Countries with currently low mask use will need to determine the optimal balance between encouraging the use of masks through advocacy and information about their benefits, and governance of a compulsory use associated with penalties for non-compliance.39

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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