Mask-Up! They're Still Important and Effective in the Covid-19 Fight

By: Ranier Simons, ADAP Blog Guest Contributor

The United States has entered into year three of the Covid-19 pandemic, and covid fatigue is real. People have dealt with chronic psychological and emotional distress due to isolation and quarantines. Losing loved ones and friends to Covid-19 has caused some to experience a level of PTSD. Those who have contracted Covid-19 have the physical and mental scars of suffering through its effects. Increasing numbers of people are reporting living with long-term post-covid health ailments. But it is important to remain vigilant, using the tools available to us...including masks!

Photo Source: Milwaukee Housing Authority

The proliferation of variants and increasing incidence of infection of fully vaccinated people indicates that Covid-19 is not going away in the immediate or even moderately distant future. Despite all the controversy surrounding Covid-19 vaccines, mask-wearing is still a significant cause célèbre. The mask is the physical, daily, tangible reminder that Covid-19 is the current status quo. Research also shows that mask-wearing is still one of the most effective ways to fight the spread of disease.

Because vaccine hesitancy isn't going away, mask-wearing is still very necessary. Masks are an excellent physical barrier not just for unvaccinated but also for fully vaccinated people. Research has shown that masks are also one of the best weapons to help life return to a bit of normalcy when everyone is compliant.

An experiment was done in Barcelona, Spain, on December 12, 2020, where 465 people attended an indoor concert with a result of zero incidences of Covid-19 infection.[1] The attendees were all given N-95 masks to wear, and mask-wearing was enforced by security. Social distancing was not enforced, people were allowed to sing and dance, and all access doors remained open the entire time for ventilation. The temperature inside the venue was kept at around 68 degrees Fahrenheit. The few performing artists were tested via rapid antigen testing as well as 58 venue employees. Movement around the venue was limited, and queues were prevented in restrooms as well as entry and exit doors. Hand sanitizer dispensers were also located throughout the venue.

This study is not simply anecdotal. Measures were taken before and after the concert to control the sample of the concert-goers as well as the control group. No one was allowed to participate who had tested positive for Covid-19 within the two weeks before the study, lived with elderly or immune-compromised individuals, or had any major pre-existing conditions.

Those attending were nasal swabbed 12 hours before attending for rapid testing, and those swabs were further analyzed with RT-PCR and cell culture. Eight days after the concert, there was a follow-up, patients were swabbed again, and contact tracing was done in addition to post-concert health questionnaires to compare to the ones administered pre-concert.

There were 495 participants in the control group who experienced the same pre-concert protocol, except they did not attend the concert. Out of the 465 people that attended the concert, there was zero transmission of Covid-19. Two members of the control group did test positive eight days after the concert. Ironically, this study was done before the advent of widespread vaccine availability. Enforcement of mask-wearing of this nature at an event today, combined with vaccination requirements, would potentially have an even more substantial effect.

Recently, there have been many narratives surrounding dropping mask mandates. Most recently, Gavin Newsom, the Governor of California, has announced an end to an indoor mask mandate for vaccinated residents.[2] This only applies to counties that do not already have their own mask mandates in place. Counties are allowed to opt to keep their mandates. The working theory is that Governor Newsom is still requiring masks for those who are unvaccinated, as well as in certain places such as public transit and nursing homes.

However, it is virtually impossible to tell who is and is not vaccinated in places where vaccination status is not required for entry. Regardless of covid fatigue and mask fatigue, it is essential to gird one's emotional intelligence and realize that mental fatigue does not negate the gravity of Covid-19. 

Mask wearing is one of the easiest and most effective tools against infection for everyone, including those living with HIV/AIDS. Proper positioning of the mask is essential, and one should cover both the nose and the mouth, secure it under the chin, and ensure that breathing is easy. Moreover, the U.S. Centers for Disease Control & Prevention (CDC) does not recommend masks with exhalation valves in terms of transmission control. Public behavior and the social climate make it harder to isolate and designate who is and who is not vaccinated. Intelligently using masks is one way to attempt to level the playing field.

For more information regarding HIV and Covid-19, the following readings will be helpful:

• HIV and Covid-19 Breakthrough Infections
• Living with HIV & Making Heads or Tails Over Covid-19 Vaccinations 

[1] Revollo B, et al. "Same-day SARS-CoV-2 antigen test screening in an indoor mass-gathering live music event: A randomised controlled trial" Lancet Infect Dis 2021; DOI:10.1016/S1473-3099(21)00268-1
[2] Rong-Gong, L., Money, L., Willon, P. (2022, February 7). California will lift mask mandate for vaccinated residents in indoor public places next week. Retrieved from https://www.latimes.com/california/story/2022-02-07/when-will-california-ease-mask-vaccine-rules

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.