Masks and Vaccines

In April 2020, when mask mandates were being instituted, a prominent doctor colleague kept questioning, in social media, the mandated use of masks, saying there was no evidence they worked.

It is well known that masks work in hospitals to prevent transmission of infections from patients to doctors and patients to other patient [1]. What was not clear when the pandemic started, is whether they would also work in the general population.

Let us look again at the hierarchical model of tests and interventions that I had written about earlier.

Every diagnostic test or treatment or preventive intervention needs to be proven to work in real-life settings. Just because something works in the laboratory does not mean it would necessary work with people at large and changes outcomes.

Once it was accepted that SARS-CoV-2 virus spreads through aerosols [2], it was intuitive that masks would make a difference [3]. But, while masks may work in the laboratory and in case reports, they need to be proven to work in real-life settings.

This review article by Jeremy Howard and his colleagues shows the evidence till date, which includes historical data, modeling data, case reports and a few comparative studies [4].  And just a couple of weeks ago, came this study by Benjamin Rader and his colleagues, who looked at self-reported mask use in a large US-based population compared with infection rates in the community, and showed that masks along with physical distancing make a big difference [5].

In short, masks work.

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