The role of masks in reducing the risk of new waves of COVID-19 in low transmission settings: a modeling study
Abstract
Objectives
To evaluate the risk of a new wave of coronavirus disease 2019 (COVID-19) in a setting with ongoing low transmission, high mobility, and an effective test-and-trace system, under different assumptions about mask uptake.
Design
We used a stochastic agent-based microsimulation model to create multiple simulations of possible epidemic trajectories that could eventuate over a five-week period following prolonged low levels of community transmission.
Setting
We calibrated the model to the epidemiological and policy environment in New South Wales, Australia, at the end of August 2020.
Participants
None
Intervention
From September 1, 2020, we ran the stochastic model with the same initial conditions(i.e., those prevailing at August 31, 2020), and analyzed the outputs of the model to determine the probability of exceeding a given number of new diagnoses and active cases within five weeks, under three assumptions about future mask usage: a baseline scenario of 30% uptake, a scenario assuming no mask usage, and a scenario assuming mandatory mask usage with near-universal uptake (95%).
Main outcome measure
Probability of exceeding a given number of new diagnoses and active cases within five weeks.
Results
The policy environment at the end of August is sufficient to slow the rate of epidemic growth, but may not stop the epidemic from growing: we estimate a 20% chance that NSW will be diagnosing at least 50 new cases per day within five weeks from the date of this analysis. Mandatory mask usage would reduce this to 6–9%.
Conclusions
Mandating the use of masks in community settings would significantly reduce the risk of epidemic resurgence.
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