It’s settled, according to regulators: If you mingle in public in Wyoming, you’ve got to wear a face mask to help reduce the spread of COVID-19.
Masks — “a covering made of cloth, fabric, or other soft or permeable material, without holes, that covers the nose and mouth and surrounding areas of the lower face” — with some exceptions, are now required in businesses, healthcare facilities and on public transportation through Jan. 8, 2021.
Yet, mask use, effectiveness and even safety remain the subject of heated debate among many skeptical Wyoming residents, many of whom claim the science doesn’t support wearing masks.
Does it? According to health officials, it does.
Wyoming Health Officer Alexia Harrist on Dec. 7 signed the order that states “the most comprehensive, systematic review” found that face coverings reduce risk of transmission by some 85%.
Officials based their endorsements on many scientific studies. One “natural” or real-life experiment found “mandating face mask use in public is associated with a decline in the daily COVID-19 growth rate.” The paper, published in Health Affairs, estimated masks prevented more than 200,000 COVID-19 cases early this spring.
Masks work best when compliance is high, according to a literature review published in the Proceedings of the National Academy of Sciences. “The decreased transmissibility could substantially reduce the death toll and economic impact while the cost of the intervention is low,” the paper published this spring states.
Masks provide benefits in a couple of different ways, according to the federal Centers for Disease Control and Prevention.
First they contain some of the water droplets expelled from an infected person’s mouth and nose while breathing or speaking and limit the distance some other droplets, which could hold the novel coronavirus, spread when exhaled. By reducing the volume of potentially dangerous droplets and their distance of travel, masks reduce the opportunity for virus particles to reach and infect others. Though imperfect protection for any one individual, fewer opportunities means fewer cases in a population.
The second benefit comes when an uninfected person wears a mask to block inhalation of the coronavirus. The smallest, aerosolized exhaled droplets can linger in the air for three hours. Masks provide “filtration for personal protection” and can block 50% of the smallest particles, according to the CDC.
Clearly far from foolproof, 50% filtration of the smallest particles not only offers some protection to the individual, it can have a significant impact on a population scale.
See how one mask works in this video posted by the New England Journal of Medicine.
Masks should have two layers of cloth, the CDC states. It recommends that an individual “wear the mask over your nose and mouth and secure it under your chin.”
A mask should fit snugly and not have gaps. A good mask should have a large surface area and a pouch-like space in front of the mouth and nose to allow near-normal breathing, according to a guide in The New York Times.
The CDC offers other recommendations and tips, including which children should wear masks, how to deal with fogging glasses and the effectiveness of neck gaiters and face shields as alternatives to cloth masks.
The living dead
Viruses are infectious packages of protein and nucleic acid — the stuff that’s in genes. They are zombies, one educator explains metaphorically, not living but not quite dead. Viruses can’t reproduce without a host but can undergo genetic variation and evolve.
Masks are one of many tools that can help slow the spread of the virus. They are not foolproof, experts say, and not a panacea. People should continue to follow the numerous other precautions, including social distancing, frequent hand washing and avoiding congregating in enclosed spaces.
More than three-quarters of Wyoming residents responding to a University of Wyoming survey on Dec. 7 — before Harrist’s order — said they wear masks always or often when visiting indoor public spaces. That’s up from June, when only 41% of respondents wore masks, according to the Wyoming Survey and Analysis Center.
Many public officials have stressed the importance of wearing masks to help stymie the virus. “The science tells us that the more people are wearing masks, the more effective we’ll be in limiting transmission,” Harrist said last week.
Statewide, health experts agreed. “Education and encouragement alone have not achieved desired outcomes,” Wyoming county health officers, Wyoming Medical Society and the Wyoming Hospital Association wrote Gov. Mark Gordon Nov. 12. “We feel that a statewide [mask] mandate sends a more powerful and effective message in a more timely manner.”
Gov. Gordon, in a moment of frustration, had another way to describe those who resist community safety protocols backed by scientific studies — “knuckleheads.”
There are lots of ways to poke holes in calls for mask mandates, but most anti-mask arguments appear to lack widespread scientific support or have limited applications.
Masks work in the laboratory setting, but “mask-wearing policies seem to have had much less impact on the community spread of COVID-19,” two Australian professors wrote.
Cloth masks are not as effective as medical masks and “should not be recommended for [health care workers], particularly in high-risk situations,” they stated in the British Medical Journal.
Editors added a long note to a commentary published in the University of Minnesota’s Center for Infectious Disease Research and Policy after readers complained it was being used by anti-maskers to thwart public policy. The editors, who agreed data was limited, refused to retract the commentary and wrote that cloth face coverings are likely to have limited impact in some instances.
“…[T]hey have minimal ability to prevent the emission of small particles, offer limited personal protection with respect to small particle inhalation, and should not be recommended as a replacement for physical distancing or reducing time in enclosed spaces with many potentially infectious people,” the editors said.
The Minnesota editor underscored a point of many who advocate mask use by emphasizing that they are but one tool.
“We also worry that the public doesn’t understand the limitations of cloth masks and face coverings when we observe how many people wear their mask under their nose or even under their mouth, remove their masks when talking to someone nearby, or fail to practice physical distancing when wearing a mask,” the note reads.
— With staff reports