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New findings reported Tuesday in a University of Louisville study challenge what has been the prevailing belief that mask mandates are necessary to slow the spread of the Wuhan coronavirus. The study notes that "80% of US states mandated masks during the COVID-19 pandemic" and while "mandates induced greater mask compliance, [they] did not predict lower growth rates when community spread was low (minima) or high (maxima)." Among other things, the study—conducted using data from the CDC covering multiple seasons—reports that "mask mandates and use are not associated with lower SARS-CoV-2 spread among US states."

"Our findings do not support the hypothesis that SARS-CoV-2 transmission rates decrease with greater public mask use," notes the U of L report. Researchers stated that "masks may promote social cohesion as rallying symbols during a pandemic, but risk compensation can also occur" before listing some observed risks that accompany mask wearing:

Prolonged mask use (>4 hours per day) promotes facial alkalinization and inadvertently encourages dehydration, which in turn can enhance barrier breakdown and bacterial infection risk. British clinicians have reported masks to increase headaches and sweating and decrease cognitive precision. Survey bias notwithstanding, these sequelae are associated with medical errors. By obscuring nonverbal communication, masks interfere with social learning in children. Likewise, masks can distort verbal speech and remove visual cues to the detriment of individuals with hearing loss; clear face-shields improve visual integration, but there is a corresponding loss of sound quality.

More at link.

New findings reported Tuesday in a University of Louisville study challenge what has been the prevailing belief that mask mandates are necessary to slow the spread of the Wuhan coronavirus. The study notes that "80% of US states mandated masks during the COVID-19 pandemic" and while "mandates induced greater mask compliance, [they] did not predict lower growth rates when community spread was low (minima) or high (maxima)." Among other things, the study—conducted using data from the CDC covering multiple seasons—reports that "mask mandates and use are not associated with lower SARS-CoV-2 spread among US states." "Our findings do not support the hypothesis that SARS-CoV-2 transmission rates decrease with greater public mask use," notes the U of L report. Researchers stated that "masks may promote social cohesion as rallying symbols during a pandemic, but risk compensation can also occur" before listing some observed risks that accompany mask wearing: Prolonged mask use (>4 hours per day) promotes facial alkalinization and inadvertently encourages dehydration, which in turn can enhance barrier breakdown and bacterial infection risk. British clinicians have reported masks to increase headaches and sweating and decrease cognitive precision. Survey bias notwithstanding, these sequelae are associated with medical errors. By obscuring nonverbal communication, masks interfere with social learning in children. Likewise, masks can distort verbal speech and remove visual cues to the detriment of individuals with hearing loss; clear face-shields improve visual integration, but there is a corresponding loss of sound quality. More at link.

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From the study itself: https://www.medrxiv.org/content/10.1101/2021.05.18.21257385v1

Results Case growth was not significantly different between mandate and non-mandate states at low or high transmission rates, and surges were equivocal. Mask use predicted lower case growth at low, but not high transmission rates. Growth rates were comparable between states in the first and last mask use quintiles adjusted for normalized total cases early in the pandemic and unadjusted after peak Fall-Winter infections. Mask use did not predict Summer 2020 case growth for non-Northeast states or Fall-Winter 2020 growth for all continental states.

Conclusions Mask mandates and use are not associated with slower state-level COVID-19 spread during COVID-19 growth surges. Containment requires future research and implementation of existing efficacious strategies.

Competing Interest Statement The authors have declared no competing interest.

Funding Statement Start-up funds from the University of Louisville College of Arts and Sciences supported this project. No external funding supported this work.

Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.