On Inauguration Day, President Joe Biden swiftly ordered a simple public health measure capable of having an outsized positive effect on the Covid-19 pandemic: a national mask mandate requiring face masks on all federal property. The next day, he signed an executive order extending the mandate to airports, buses, trains, and planes.
According to physicians and public health experts, the mandate is more than symbolic. It can shift the tide in the fight against Covid-19.
"This is a really important mandate and one that was needed months ago," Sandra Albrecht tells Inverse. Albrecht is a professor and social epidemiologist at Columbia University.
We are in a perilous moment, Albrecht says. As hospitals overfill with patients and health care resources continue to stretch thin, masks can keep people from getting sick or setting foot in the hospital.
"Healthcare staff are exhausted and completely overwhelmed right now," Albrecht says.
"Anything we can do to ease their burden and to allow the healthcare system to keep functioning is critical."
The mask mandate may also positively influence individuals who aren't legally required to follow it by the parameters of the order. It signals "mask-wearing should be a social norm," William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, says
"The mask mandate is important symbolically as it sends a message that the new administration is taking a national, science-based approach to Covid-19," Schaffner tells Inverse.
The national mask mandate could also spur other state and city authorities to follow suit. However, given how "inexplicably polarizing" this issue has become, it’s hard to predict exactly how much more mask use this will prompt, Albrecht says. It may be too late to win back anti-maskers after months of scientifically dubious debate over the value of masks.
Mandate or no mandate, experts predict vigilant mask-wearing nationwide will help limit the country's current unbridled spread, curb new variants of the novel coronavirus, and keep the economy afloat.
Is it mandatory to wear a mask?
Contrary to some public confusion, the mandate doesn't require every American to wear a mask when they head out of their home (although many public health experts would argue this is a helpful and healthy move, especially in crowded spaces).
Instead, it requires wearing masks on public transport, planes, trains, ships, and intercity buses, as well as airports. The move also requires masks on federal property. The mandate leaves enforcement up to local agencies.
"This definitive step stresses that there is a lot of epidemiologic and physical sciences data behind masks blocking transmission of the virus and puts that data into policy action," Monica Gandhi tells Inverse. Gandhi is an infectious disease expert and physician at the University of California, San Francisco.
Do face masks provide protection from Covid-19?
While masks aren't 100 percent perfect at protecting against catching or spreading Covid-19, they are a relatively easy, cheap tool that "allows us to keep functioning as a society all the while Covid-19 infections continue to climb, and especially as new and concerning variants emerge," Albrecht says.
That's because, by reducing how many viral particles the mask wearer inhales, masks can protect the individual from catching Covid-19. If they do come down with the disease, scientists say they may, in turn, have a milder or asymptomatic infection. Masks also keep personal germs from spreading to others.
"Masks are an effective strategy to help limit transmission while also limiting the need for a lockdown," Albrecht explains.
"If everyone was to wear masks, this would allow us to move on while we wait for everyone to be vaccinated."
Masks are especially important if you happen to be indoors with those outside your "quarantine bubble."
Statewide mask mandates have already shown to make a major difference in curbing the 2020 summer surges in places like Kansas and Arizona. Meanwhile, an evaluation of 15 state mask mandates that stretch from April 8 to May 15, 2020, estimates these implementations averted more than 200,0000 Covid-19 cases.
According to an October 2020 study published in Nature Medicine universal mask use could "be sufficient to ameliorate the worst effects of epidemic resurgences in many states."
What type of face mask is best?
The type of face mask — cloth, surgical, or N95 — matters, although any face covering is better than nothing.
N95 masks are the most protective, blocking out about 95 percent of small viral particles. In lab experiments, surgical masks were about 60 to 70 percent effective at protecting others and 50 percent effective at protecting the wearer. Homemade or cloth masks are slightly less effective, although the exact percentage is variable.
As the pandemic wears on, public health experts say it's time to double up: layer a cloth mask on top of a surgical mask to protect yourself and others.
The power of a visual symbol — The symbolic importance of the national mask mandate can't be undervalued, Gandhi says.
"We tend to emulate behavior shown consistently in our leaders, including politicians and public health officials," she explains. Even seeing President Biden and his administration on television wearing masks can make a difference.
"Even people resistant to wearing face coverings may start seeing the normalization of this behavior and adopt it."
Some people may still refuse to mask up regardless of the mandate. However, the policy lays the groundwork for other businesses and institutions to encourage patrons to wear masks. To participate in society, we may all eventually need to mask up.
"If there are mandates in place that empower businesses to refuse service to customers without a mask on, it would force people to either wear a mask or take their business elsewhere," Albrecht explains. "If all businesses and other public areas require masks, eventually people will need to comply."
Why now? — Importantly, at the rate we are vaccinating now, a "very, very large proportion" of the population remains susceptible to illness, Albrecht says. Mask use remains imperative.
"Once we get to herd immunity with vaccination, masks will no longer be needed but we have six to eight more months to go with our current rate of vaccine roll-out," Gandhi predicts.
In the last two weeks, new Covid-19 cases in the United States appear to have declined more than 30 percent. But limited vaccine availability and the spread of new variants circulating from the United Kingdom, Brazil, and South Africa could cause this downward trend to reverse.
Masks aren't going away anytime soon.
Even after vaccination, masks are still necessary. Schaffner outlines three reasons why:
- The Moderna and Pfizer vaccines are approximately 95 percent effective in preventing disease, not 100 percent.
- The clinical trials determined that the vaccines prevented disease, but investigations still are ongoing to determine whether the vaccines prevent infection. You could be vaccinated, be without symptoms, and still spread the infection. More research is needed to know for sure.
- Wearing the mask reinforces the social norm that everyone should be masked when outside their homes.
"The mandate is part of a multi-faceted national approach to Covid-19 that includes enhanced testing, increased vaccine production, expanded immunization sites, and activity as well as clarity in communication," Schaffner says.
"We certainly hope that anti-mask sentiments will begin to fade and that vaccine hesitancy will diminish."