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<h1 class="science-header dark-green center-text background-tertiary">The science behind masks</h1>
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<h2 class="center-text">How does COVID-19 spread?</h2>
<p style=font-size:24px>
The novel coronavirus disease (COVID-19) <a href="https://www.who.int/health-topics/coronavirus#tab=tab_1">spreads</a> mainly through droplets of saliva or discharge from the nose when an infected person coughs, sneezes, or even <a href="https://www.cdc.gov/widgets/micrositeCollectionViewerMed/index.html?chost=www.nih.gov&cpath=/health-information/coronavirus&csearch=fbclid%3DIwAR2Yhq8hp1zXbTRWmT35UEnnOW6H7UFWGb9ncsBgX677BMqlS0zX65RJA_4&chash=!%2Fdetail%2F403327&ctitle=Coronavirus%20(COVID-19)%20%7C%20National%20Institutes%20of%20Health%20(NIH)&wn=micrositeCollectionViewerMed&wf=/widgets/micrositeCollectionViewerMed/&wid=micrositeCollectionViewerMed1&mMode=widget&mPage=&mChannel=&cdcCollectionid=403305&cdcTheme=theme1&cdcGeotag=%7B%27continent%27:%20%276255149%27,%20%27country%27:%20%276252001%27,%20%27state%27:%20%27%27,%20%27region%27:%20%27%27%20%7D&cdcDataid=404908&chashOptMode=out#!/detail/403327">talks</a>. The virus may also spread through <a href="https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations">airborne transmission</a>, although research on this mode of transmission is ongoing.</p>
<p style=font-size:24px>What makes COVID-19 particularly dangerous is that it can spread through <a href="https://www.nytimes.com/2020/02/26/health/coronavirus-asymptomatic.html">asymptomatic carriers</a>: people who have the virus but show no symptoms. Any infected person without a mask, whether or not they show signs of the virus, risks spreading virus-containing droplets into the environment. When a healthy person breathes in these droplets or touches an infected surface and then their eyes, nose, or mouth, they may become infected.
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<center><img src="images/science/transmission.png" width="600" height="600" alt="Risk of COVID-19 spread between two people with and without masks" /></center>
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<h2 class="center-text">How does a mask help?</h2>
<p style=font-size:24px>Masks <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2007800">block</a> a significant portion of infection-carrying droplets from entering the environment, slowing the spread of COVID-19.</p>
<p style=font-size:24px>Virus spread is understood through the effective reproduction number (R<sub>e</sub>), which is the number of people in a population who can be infected by an individual at any specific time (<a href="https://www.cebm.net/covid-19/when-will-it-be-over-an-introduction-to-viral-reproduction-numbers-r0-and-re/">CEBM</a>). When R<sub>e</sub> falls below 1.0, the spread of the virus declines as each infected person infects fewer people. R<sub>e</sub> may be reduced due to growing immunity in a population or deaths of infected individuals, but it can also be brought down by precautions like social distancing and masks.</p>
<p style=font-size:24px>An international <a href="https://www.preprints.org/manuscript/202004.0203/v2">review</a> of the scientific research on masks concluded that near-universal adoption of non-medical masks in public (in conjunction with other measures like test & trace) can reduce R<sub>e</sub> below 1.0 and stop the community spread of the virus. Thus, masks save lives by reducing case numbers and preventing large burdens on our healthcare systems.</p><br /><br />
<center><img src="images/science/czechrepublic.jpg" width="600" height="600" alt="Czech Republic case study"/></center>
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<h2 class="center-text">Why widespread fabric masks?</h2>
<p style=font-size:24px>There are broadly three kinds of masks: N-95, surgical, and cloth masks (in order of highest to least protection offered to the wearer). Healthcare professionals are the most exposed to COVID-19 and therefore require N-95 masks or, at the very least, surgical masks. The COVID-19 pandemic is causing a <a href="https://www.who.int/news-room/detail/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwide">shortage</a> of these masks, so they should be reserved for healthcare professionals, while everyone else can make their own cloth mask. Wearing homemade cloth masks can still significantly reduce the spread of the virus.</p>
<p style=font-size:24px>Governments and organizations around the world are recognizing the importance of masks. Over <a href="https://masks4all.co/what-countries-require-masks-in-public/">100 countries</a> have recommended or made masks mandatory in public.</p>
<br /><br />
<center><img src="images/science/homemadevssurgical.png" width="600" height="600" alt="Comparison of homemade and surgical masks" /></center>
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<h2 class="center-text">The reasons are clear. fabric masks are a crucial defense against COVID-19.</h>
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<blockquote class="twitter-tweet"><p lang="en" dir="ltr">The <a href="https://twitter.com/hashtag/COVID19?src=hash&ref_src=twsrc%5Etfw">#COVID19</a> aerosol and droplets with speech, visualized. If <a href="https://twitter.com/hashtag/Masks4All?src=hash&ref_src=twsrc%5Etfw">#Masks4All</a> hadn't sunk in by this late juncture, seeing is believing. Loud speech is worse. <a href="https://twitter.com/NEJM?ref_src=twsrc%5Etfw">@NEJM</a> today <a href="https://t.co/CUkrienHzX">https://t.co/CUkrienHzX</a> <a href="https://t.co/qghKdKc1K7">pic.twitter.com/qghKdKc1K7</a></p>— Eric Topol (@EricTopol) <a href="https://twitter.com/EricTopol/status/1250529535843418113?ref_src=twsrc%5Etfw">April 15, 2020</a></blockquote>
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“The available evidence suggests that near-universal adoption of non-medical masks when out in public,
in combination with complementary public health measures could successfully reduce effective-R to below 1.0,
thereby stopping community spread.”
</div>
<div class="author">
<div class="name">Jeremy Howard, Austin Huang,Zhiyuan Li, and more</div>
<div class="organization"> Warren Alpert School of Medicine, Brown University, Massachusetts Institute of Technology, and more</div>
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<a class="dark-green" href="http://files.fast.ai/papers/masks_lit_review.pdf">SOURCE</a>
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<blockquote class="twitter-tweet"><p lang="en" dir="ltr">Doesn't have to be complicated. No mask is 100% effective or nurses and doctors wouldn't be getting sick, but they are way more effective than nothing. Look at South Korea, 205 deaths, Taiwan 6. They are right by China. They've been wearing masks the whole time. <a href="https://twitter.com/hashtag/Masks4All?src=hash&ref_src=twsrc%5Etfw">#Masks4All</a> <a href="https://t.co/SiI5cLGtuq">pic.twitter.com/SiI5cLGtuq</a></p>— #Masks4All cosmicprank (thomas) 🧢 (@cosmicprank) <a href="https://twitter.com/cosmicprank/status/1249288482746322950?ref_src=twsrc%5Etfw">April 12, 2020</a></blockquote>
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<div class="card-content" onclick="location.href = 'https://edition.cnn.com/2020/03/31/politics/public-wearing-masks-coronavirus-anthony-fauci-cnntv/index.html'">
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“If everybody [wears homemade masks], we’re protecting each other.”
</div>
<div class="author">
<div class="name">Dr. Anthony Fauci</div>
<div class="organization"> U.S. Director of the National Institute of Allergy and Infectious Diseases</div>
</div>
<a class="dark-green" href="https://edition.cnn.com/2020/03/31/politics/public-wearing-masks-coronavirus-anthony-fauci-cnntv/index.html">SOURCE</a>
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<blockquote class="twitter-tweet"><p lang="en" dir="ltr">This⬇️is why it must be mandatory for store employees/service workers, those out in public, those sick/have preexisting health conditions to wear a mask 😷. Reopening states without a surplus of masks or consistent drop in case is risky IMO.<a href="https://twitter.com/DrDenaGrayson?ref_src=twsrc%5Etfw">@DrDenaGrayson</a> <a href="https://t.co/MDCE8SVOYR">pic.twitter.com/MDCE8SVOYR</a></p>— John Sabol (@John_Sabol) <a href="https://twitter.com/John_Sabol/status/1251256111983976450?ref_src=twsrc%5Etfw">April 17, 2020</a></blockquote>
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<div class="card-content" onclick="location.href = 'https://www.theguardian.com/commentisfree/2020/apr/04/why-wear-a-mask-may-be-our-best-weapon-to-stop-coronavirus'">
<div>
“Research supported by Nobel prize-winning virologist Harold Varmus tells us that placing a layer
of cloth in front of a person’s face stops 99% of the droplets.”
</div>
<div class="author">
<div class="name">Jeremy Howard</div>
<div class="organization">The Guardian</div>
</div>
<a class="dark-green" href="https://www.theguardian.com/commentisfree/2020/apr/04/why-wear-a-mask-may-be-our-best-weapon-to-stop-coronavirus">SOURCE</a>
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<div class="card-content" onclick="location.href = 'https://www.wsj.com/articles/u-s-reviews-guidance-on-masks-to-fight-coronavirus-as-europe-embraces-their-use-11585676543'">
<div>
“Much of Central Europe is now following the example set by China, Taiwan and South Korea.
On [March 30th], Austria mandated its citizens wear masks when outside the home, after the Czech,
Slovak and Bosnian governments issued similar orders.”
</div>
<div class="author">
<div class="name"> Drew Hinshaw and Catherine Lucey</div>
<div class="organization">Wall Street Journal</div>
</div>
<a class="dark-green" href="https://www.wsj.com/articles/u-s-reviews-guidance-on-masks-to-fight-coronavirus-as-europe-embraces-their-use-11585676543">SOURCE</a>
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"Economic analysis suggests that the impact of mask wearing could be thousands of US dollars saved per person per mask.“
</div>
<div class="author">
<div class="name">Jeremy Howard, Austin Huang,Zhiyuan Li, and more</div>
<div class="organization"> Warren Alpert School of Medicine, Brown University, Massachusetts Institute of Technology, and more</div>
</div>
<a class="dark-green" href="http://files.fast.ai/papers/masks_lit_review.pdf">SOURCE</a>
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<blockquote class="twitter-tweet"><p lang="en" dir="ltr">The rationale and evidence for <a href="https://twitter.com/hashtag/Masks4All?src=hash&ref_src=twsrc%5Etfw">#Masks4All</a> in public is quite compelling, reviewed here by <a href="https://twitter.com/jeremyphoward?ref_src=twsrc%5Etfw">@jeremyphoward</a> and colleagues, and the <a href="https://twitter.com/WHO?ref_src=twsrc%5Etfw">@WHO</a> would be well advised to read it<a href="https://t.co/TPucU78uNf">https://t.co/TPucU78uNf</a> <a href="https://t.co/I4m44bhI4N">pic.twitter.com/I4m44bhI4N</a></p>— Eric Topol (@EricTopol) <a href="https://twitter.com/EricTopol/status/1249706069871353856?ref_src=twsrc%5Etfw">April 13, 2020</a></blockquote>
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<blockquote class="twitter-tweet"><p lang="en" dir="ltr"><a href="https://twitter.com/jeremyphoward?ref_src=twsrc%5Etfw">@jeremyphoward</a> <br>Here's a short video demonstrating the obvious on the efficiency of cloth masks filtering the majority of droplets and aerosols. Feel free to use and share.<a href="https://twitter.com/hashtag/Masks4All?src=hash&ref_src=twsrc%5Etfw">#Masks4All</a> <a href="https://t.co/CyNHWG6LzW">pic.twitter.com/CyNHWG6LzW</a></p>— Simon Fissette (@SimonFissette) <a href="https://twitter.com/SimonFissette/status/1250103958271660036?ref_src=twsrc%5Etfw">April 14, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
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<div class="card-content" onclick="location.href = 'https://www.theguardian.com/commentisfree/2020/apr/04/why-wear-a-mask-may-be-our-best-weapon-to-stop-coronavirus'">
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"Modeling by Yale researchers estimates that “the benefits of each additional cloth mask worn by the public are conservatively
in the $3,000-$6,000 range due to their impact in slowing the spread of the virus.”
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<div class="name">Jeremy Howard</div>
<div class="organization">The Guardian</div>
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<a class="dark-green" href="https://www.theguardian.com/commentisfree/2020/apr/04/why-wear-a-mask-may-be-our-best-weapon-to-stop-coronavirus">SOURCE</a>
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<h1>Need more convincing?</h1>
<a class="button button-secondary-outline" href="https://www.fast.ai/2020/04/13/masks-summary/">Evidence</a>
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