Continued use of face mask could save US bill

In recent weeks, many places in the United States have lifted requirements for indoor face masks, despite less than 70% of the population being fully vaccinated against Covid-19 and less than 45% having received the booster. . A new study published on March 8 in the Lancet Public Health suggests that maintaining consistent facemask use until various vaccine coverage thresholds are reached, or even two to 10 weeks beyond (e.g., 70-90% of those fully vaccinated) could not only prevent a significant number of cases, hospitalizations and deaths, but also end up saving money for businesses, the health care system, insurance companies, taxpayers and others.

Results from the study’s computer simulation model for the entire United States suggest that when the virus’s reproductive rate (e.g., variant contagiousness and infectivity) is five, corresponding to the variant delta, and that 80% of the population is fully immunized by May 1, maintaining face mask use until then could save a total of $2.9 billion in direct medical costs, which would benefit the health care system, insurance companies and anyone else paying for health care. This could save a total of $20.1 billion in lost productivity, which would benefit employers and taxpayers. If the same coverage (say, 80%) is achieved by July 1, maintaining the use of face masks until then could save a total of $3.3 billion in direct medical costs and $23.4 billion in lost productivity. All of this suggests that it would be worthwhile for employers, governments and insurance companies to invest in providing face masks and sustaining their use for up to two to 10 weeks after different target vaccination coverages have been achieved. .

The study was led by the Public Health Informatics, Computational, and Operations Research (PHICOR) team at the City University of New York Graduate School of Public Health and Health Policy (CUNY SPH) with a team from the National School of Tropical Medicine at Baylor College of Medicine. The team developed a computer simulation model of the entire United States that simulated the spread of the Covid-19 coronavirus, subsequent infection outcomes (eg, symptoms, hospitalizations), vaccination, l face mask usage at levels seen in the United States from March to July 2020, and the associated costs along the way.

“Messaging about face mask use has been inconsistent throughout the pandemic as there has been back and forth on face mask use,” says Dr. Bruce Y. Lee, CUNY SPH Professor, executive director of PHICOR and lead author of the study. . “There has been a tendency to focus on one intervention at a time. The focus was first on social distancing, then the focus shifted to wearing face masks. Then attention turned to Covid-19 vaccines once they came out. Instead, as long as the pandemic continues, there is a need to systematically layer multiple interventions on top of each other, as each complements and reinforces each other. »

The study suggests that there are benefits in maintaining face mask use two to 10 weeks beyond reaching target coverage levels (eg, 70-90% fully immunized). The duration beyond the achievement of vaccination coverage was longer in winter (up to 10 weeks) than in summer (at least two weeks). The study found that continuing facemask use for one more month beyond 70% coverage on March 1 provided additional value, avoiding an additional $1.5 billion in societal costs, 148 $.6 million in direct medical costs, $3.9 billion in lost productivity and 856,000 cases compared to if masks were not maintained for the additional month. Thus, the study provided evidence that Americans won’t need to wear face masks forever.

Face masks could offer even greater benefits with more infectious variants such as the omicron and its BA.2 sub-variant. For example, model results suggest that when the reproductive rate is 10, corresponding to the omicron variant, maintaining face masks would avoid $49.5 billion in societal costs (e.g. direct medical costs, losses productivity, face mask costs), $5.2 billion in direct medical costs, $48.8 billion in lost productivity, and 17.9 million cases from no mask use if 70% of the United States was fully vaccinated by March 1.

“Vaccines save lives but are not enough on their own to bring our society to a point where we can still safely free ourselves from the demands of Covid-19 like the use of face masks,” said Dr Peter Hotez , professor and dean of the National School of Tropical Medicine. at Baylor College of Medicine and co-author of the study.

It should be noted that the study looked at maintaining the level of face mask usage seen in the United States from March to July 2020, when many medical-grade face masks were not as readily available to the general public. Further increasing the use of face masks or using more efficient masks such as N95 respirators could further increase cost savings. For example, scenarios revealed that a 10% increase in the use of face masks from levels observed in March to July 2020 could increase cost savings and cases, hospitalizations and deaths averted by up to 20%.

Additionally, anything that further increases the infectivity of the Covid-19 coronavirus (eg, variants and sub-variants), decreases vaccine efficacy (eg, waning immunity, lack of boosters, emerging variants) or increases social interaction only increases the value of face masks. The study findings underscore the importance and value of implementing multi-level interventions, such as continued use of face masks during vaccination and social distancing.

“The study results suggest that it could be economically attractive for companies to provide and encourage the use of face masks,” said study co-author Dr. Maria Elena Bottazzi, Dean Fellow of the National School of Tropical Medicine at Baylor College of Medicine. “The results also provide goals to achieve in which we can drop the indoor mask requirements.”

“Maintaining Facemask Use Before and After Reaching Different Levels of COVID-19 Vaccine Coverage: A Modeling Study” was authored by Sarah M. Bartsch, Kelly J. O’Shea, Kevin L. Chin, Ulrich Strych , Marie C. Ferguson, Maria Elena Bottazzi, Patrick T. Wedlock, Sarah N. Cox, Sheryl S. Siegmund, Peter J. Hotez, and Bruce Y. Lee.

This work was supported by the Agency for Healthcare Research and Quality (AHRQ) through grant 1R01HS028165-01, the National Institute of General Medical Sciences (NIGMS) under the Models of Infectious Disease Agent Network Study under grants R01GM127512 and 3R01GM127512-01A1S1, National Science Foundation (NSF) proposal number 2054858, National Institutes of Health National Center for Advancing Translational Sciences (NCATS) via award number U54TR004279, and City University of New York (CUNY) in support of the Pandemic Response Institute (PRI). Statements in the manuscript do not necessarily represent the official views of the National Institutes of Health, AHRQ, US Department of Health and Human Services (HHS), CUNY, or PRI, or imply their endorsement.

For embargoed access to the article, please see: http://www.thelancet-press.com/embargo/facemasksUSA.pdf

For embargoed access to the appendix, please see: http://www.thelancet-press.com/embargo/facemasksUSAAppx.pdf

For embargoed access to the infographic, please see: https://www.dropbox.com/sh/lsups8yvmuvdxw7/AACuM4dyyz71r5Jmph_dShh_a?dl=0

About CUNY SPH

The CUNY Graduate School of Public Health and Health Policy engages in teaching, research, and service that creates a healthier New York City and helps promote equitable, effective, and evidence-based solutions to health issues. pressing issues facing cities around the world.

About PHICOR

Since 2007, Public Health Informatics, Computational, and Operations Research (PHICOR) has been developing methods, models, and computational tools to help decision makers better understand and address complex health and public health systems. Follow @PHICORTeam for updates.

About BCM

Baylor College of Medicine (www.bcm.edu) in Houston is recognized as a health sciences university and is known for its excellence in education, research, and patient care. Located in Texas Medical Center, Baylor is affiliated with seven teaching hospitals and jointly owns and operates Baylor St. Luke’s Medical Center, part of CHI St. Luke’s Health. Follow Baylor College of Medicine on Facebook (http://www.facebook.com/BaylorCollegeOfMedicine) and Twitter (http://twitter.com/BCMHouston).

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