A mask won’t provide 100% protection from viruses. But it’s a barrier that is effective at reducing transmission. (For Spectrum Health Beat)

With many states seeing a resurgence in COVID-19 activity, policymakers are now redoubling efforts to control the spread of the virus.

And a mask remains a leading defense, doctors say.

The topic has stirred plenty of debate.

“There’s a lot of controversy around wearing masks for one reason or another,” said Liam Sullivan, DO, an infectious disease specialist with Spectrum Health. “But more and more data is showing that when there’s widespread mask usage, it really substantially cuts down on transmission of the virus.”

Hand-washing and social distancing remain critical components, but health officials have also pegged masks as an essential tool.

In Michigan, Gov. Gretchen Whitmer issued an executive order requiring masks to be worn in public indoor spaces and outdoor crowded areas and redoubled the state’s efforts on the #MaskUpMichigan initiative.

Other states are also taking steps in hopes of changing the trajectory of the virus.

If everyone would wear masks in public for the next four to 12 weeks, it could drastically reduce the number of COVID-19 cases, Robert Redfield, MD, director of the Centers for Disease Control and Prevention, said in a recent online presentation.

“Face coverings are the key,” Dr. Redfield said.

Cities and towns could avoid shutting down their economies again and instead resume something resembling a normal life by simply recognizing the value of masks, Dr. Sullivan said.

“A mask is the way to do this,” Dr. Sullivan said. “It’s not the most convenient thing in the world, but it’s what we have to do.”

Sick without symptoms

When the COVID-19 pandemic began to unfold in the U.S. months back, the at-risk population accounted for the bulk of sicknesses and hospitalizations, Dr. Sullivan said.

Children and those in less vulnerable age groups didn’t contract the virus quite as much in March, April and early May.

“Things then settled down a little bit because of all the lockdowns we did and all the mitigation efforts to slow the spread of the virus,” Dr. Sullivan said.

In May, many states began lifting restrictions, allowing business and social activities to resume.

But this introduced new dynamics.

“Now what you’re seeing is this incredible breakout of infections, really mostly amongst younger people, 20s and 30s,” Dr. Sullivan said.

California displayed evidence of this trend in July.

“That’s probably a reflection that younger people tend to think that, ‘OK, I’m not going to get as sick from this,” Dr. Sullivan said. “You see news reports all over, about them going to bars and attending large gatherings. That’s why you’re seeing younger people get sick with this.”

CDC data shows the age 18-49 cohort accounts for 50% of all cases, but about 5% of the overall deaths.

The 75 and older crowd accounts for about 10% of cases but nearly 60% of deaths.

What should young adults and middle-aged folks now keep in mind? Many people will indeed encounter few problems if they’re infected with COVID-19—but they can still widely spread the disease to vulnerable people—friends, coworkers, neighbors, grandparents, parents.

“It’s the asymptomatic and pre-symptomatic people where, really, the mask is the biggest thing,” Dr. Sullivan said.

An asymptomatic individual will show no signs of the virus, while a pre-symptomatic person can spread the virus days before showing any signs of infection.

“They have no idea they have the virus or if they’re shedding it,” Dr. Sullivan said.

If you’re in close proximity to someone like that and they’re not wearing a mask, they could spread respiratory pollution just by talking, laughing, coughing or sneezing, he said.

“(They’re) shooting virus all over to the people around you, within your sphere, so to speak,” he said.

If that person wore a mask, it could cut down on their viral spread by reducing the expulsion of respiratory droplets.

“A mask substantially drops that down,” Dr. Sullivan said. “You have a barrier there and those droplets are hitting that mask. It’s not 100% effective, but it’s much more effective than nothing.”

If the other person wears a mask and you also wear a mask?

“Now you have two barriers up,” Dr. Sullivan said.

In a CDC study in July, researchers found two hairstylists with COVID-19 wore masks while treating 139 clients over a period of time. The clients all wore masks, too, and not one of them later reported experiencing COVID-19 symptoms.

Pertaining to an asymptomatic or pre-symptomatic person, simply wearing a mask can minimize harmful impact.

“We’re not even asking people to wear a mask 100% of the time,” Dr. Sullivan said. “Just in situations where it’s difficult to maintain social distance, where you’re in a crowd, where there’s going to be a lot of talking, exposure to other people and generation of respiratory droplets.”

In open-air environments where it’s not crowded, you’re unlikely to need a mask.

Out walking the dog in your neighborhood?

“There you don’t, generally speaking, need to wear a mask,” Dr. Sullivan said. “Your exposure to other people is brief and you’re outside where there’s lots of air circulation.”

Avoid the crowds

To keep your exposure at a minimum, avoid large gatherings.

Studies of COVID-19 are increasingly pointing to crowded events as a primary driver of the pandemic. Just one ill person can spread the disease to countless people nearby.

“It’s amazing,” Dr. Sullivan said. “Those type of events are the biggest drivers of this pandemic. And they continue to be.”

By washing your hands, avoiding large crowds and wearing a mask around others, you can cut down on the spread of the virus.

“Hopefully, as time goes on and over the next several weeks, you’ll see more leaders emphasize masks and talk about it more,” Dr. Sullivan said. “Hopefully the message will start to hit home for people and they’ll start to use (masks) in the appropriate situations.”

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