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Physicians at the University of Alabama at Birmingham say universal masking of health care workers at UAB Hospital led to an immediate 68% reduction in risk of exposure to COVID-19 in the early days of the pandemic. In a Clinical Infectious Diseases journal study, the authors go on to say that universal testing further decreased exposures by 77%.
“At the very beginning of the pandemic as we saw an increase of cases at UAB, we decided to implement universal masking for all health care workers and all patients/visitors to UAB Hospital in March of last year,” said Dr. Rachael Lee, assistant professor in the Division of Infectious Diseases at UAB and the study’s senior author. “Now, 18 months into this pandemic, we have real-world observational data supporting the use of masks in both children and adults.”
In addition to the UAB study, Lee references a study in China that found facemasks were 79% effective in preventing transmission in households. Another systematic review, sponsored by the World Health Organization, showed that physical distancing, facemasks and eye protection all reduce the risk of person-to-person transmission of COVID-19.
“Because we are in a pandemic, it is difficult to perform randomized controlled trials, due to ethical reasons,” Lee said. “However, we have strong observational data that show masks protect us and others from exposure and transmission of COVID-19 with minimal risks to the wearer.”
Lee said a study in North Carolina schools, authorized by the North Carolina Legislature and conducted by the ABC Science Collaborative through the Duke University Clinical Research Institute, also demonstrated the effectiveness of masking.
The authors of that study reported the scientific analysis of the data provided from 100 school districts and 14 charter schools from March to June 2021, representing more than 865,000 students and 160,000 staff, showed that proper masking was the most effective mitigation strategy to prevent secondary transmission in schools when COVID-19 is circulating and when vaccination is unavailable or there is insufficient uptake.
The study showed that distance was not a factor in the spread of COVID-19 when students/staff/teachers are masked. Masking was adequate to prevent within-school COVID-19 transmission, with no difference between schools requiring greater than 3 feet of distance between students compared to those requiring less than 3 feet.
Dr. Todd McCarty, assistant professor of infectious diseases at UAB, said numerous studies have shown that children are minimally affected by wearing facemasks.
“We have substantial observational data that all points in the same direction: that children fare well even while wearing masks in many of the socialization skills that are so important at a young age,” McCarty said.
McCarty offers four studies that bolster this argument:
- Face recognition is impaired to a minor degree, but minimal after age 5: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8185341/.
- Children can still recognize social/emotional cues from the unmasked parts of the face: https://pubmed.ncbi.nlm.nih.gov/33362251/.
- Children are able to do so consistently: https://pubmed.ncbi.nlm.nih.gov/33997986/.
- 2-year-olds can recognize words better through opaque masks than clear masks: https://pubmed.ncbi.nlm.nih.gov/33942441/.
“It is understandable that parents and other individuals are concerned about possible risks/harms of wearing masks,” McCarty said. “In all of the studies that have been done, these concerns have not been shown to have a measurable impact. While detractors point to the quality of data that supports the benefits of masking, that observational data still exceeds any study that has raised concern about risk. The balance of the data clearly shows benefits outweigh unknown or unsupported risks.”
“Historically, we have seen the results of many randomized controlled trials of other respiratory viruses such as influenza, which spread via droplets similar to COVID-19,” Lee said. “In a Cochrane Review of 67 randomized controlled trials and observational studies looking at reducing transmission of respiratory viruses, masks were found to be the best at performing interventions across populations.”
“We now have countrywide, international-based data on the efficacy of wearing masks,” said Dr. Jeanne Marrazzo, director of the Division of Infectious Diseases at UAB. “The evidence is very persuasive that masks work in public to prevent community spread of transmission.”
This story originally appeared on the UAB News website.
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