When people make claims about masks that are not working, they almost always refer to an early testimony by Dr. Anthony Fauci, in which he refused to endorse the wearing of masks for the general public. The most common reason cited later, including by Fauci, is that masks were in short supply back then, and there was real concern that the limited number of N95 virus filtering masks are no longer available to healthcare workers. That's right. And believe it or not, despite Donald Trump's brag about PPE manufacturing since then, there are still not enough of these high quality masks for the healthcare workers and first responders who desperately need them.
The bigger reason there wasn't a recommendation for masks when the pandemic started was simple enough: no evidence. That doesn't mean that Fauci and others thought masks wouldn't work. This means that in the absence of evidence, they were extremely reluctant to depress wearing masks for fear it might distract from the other things they already knew were effective – like social distancing.
What has changed since then is simple: evidence. Several studies around the world have shown that masks are highly effective at reducing COVID-19. So effective that in countries like Japan, where the disease emerged early and the government's response was slow and more than a little uncomfortable, the disease was still severely constrained by the public's habit of wearing masks. As of this writing, Japan (population 127 million) has fewer cases of COVID-19 than Utah (population 3 million). Masks are a big part of that difference.
However, if you are still skeptical, here are these studies.
Study 1: Kansas
Kansas Governor Laura Kelly was a real highlight in the Midwest when she enacted an ordinance on July 3 that required masks in public places in the box store and death threats against Kelly and local officials.
When the second spike in COVID-19 spread across the south in the summer, even Republican governors like Greg Abbott in Texas and Doug Ducey in Arizona allowed district officials to create their own masked mandates if they wanted – an action that spurred the growth of effectively ended that wave.
But Kelly did it the other way around: she gave a state mandate and then allowed the county governments to withdraw if they wanted. Since this is Kansas, 81 mostly rural counties have dropped the mandate in their area over the next several weeks. But 24 other counties retained the mandate. So Kansas became kind of a mess, with about a quarter of the state requiring masks and about three quarters disregarding their bare faces.
And how did that go?
After July 3, COVID-19 incidence decreased in 24 counties with mask mandates, but continued to increase in 81 counties without mask mandates.
Just like that. Despite in different parts of the state; despite a variety of conditions; Despite the unmasked counties as neighbors on all sides: Counties in which masks had to be used in public recorded a decline in COVID-19. And this effect was not small. The counties who wore masks included some with the highest pre-mandate COVID-19 rates. They moved from increasing cases before mandate to decreasing cases after mandate. Districts that didn't wear masks had only continued to gain weight.
All of this is available on the CDC website for analysis and discussion.
Study 2: St. Louis
For those who do not live in the area, St. Louis the City and St. Louis County are two separate things – two neighboring counties, rather than a city within a county. St. Louis is a medium-sized city with about 300,000 residents. St. Louis County includes several other small towns and about a million more total; One million people live in mostly suburban areas in the surrounding counties.
St. Louis and St. Louis Counties also happen to have Democratic leadership in an increasingly scarlet state. Unlike Laura Kelly in Kansas, Missouri Governor Mike Parson was strongly against a state mask mandate (even after catching COVID-19 himself at a mask-free political gathering). However, St. Louis City and St. Louis County have imposed mask mandates.
And how did that go?
Mask mandates in St. Louis and St. Louis Counties slowed coronavirus infection rates quickly and dramatically this summer compared to remote counties.
Twelve weeks later, the growth rate of COVID-19 in the mandate area was reduced by 40% compared to the surrounding counties without a mandate. In addition, the rate of “essential workers” who had to remain at work without the luxury of being able to work from home was further reduced. The result was that the mask mandate was particularly well suited to protecting color communities. Where there was no mask mandate, the communities were particularly hard hit as people were more likely to be involved in retail and the food industry, which put them in contact with more maskless people.
Neither in Kansas nor in St. Louis has a mask mandate cleared the COVID-19 threat. The St. Louis study did not even succeed in reversing the growth rate. It just reduced it significantly. Researchers have a pretty good idea why. Many of the people who work daytime in St. Louis and St. Louis Counties commute from the unauthorized counties in the area. The same type of emigration occurred in the Kansas counties with masked mandates. In these areas there was still a constant inflow of infections from the non-mandated districts.
Masks are not perfect. But then there is nothing. Not even the best vaccines. What masks are is cheap, easy, quick and very effective.