Editorial: To mask or not to mask—that is still the question

Despite the association between mask mandates/mask wearing and reduced death rates during the pandemic, masking remains controversial and highly politicized, with many people still asking, "Do masks work, and should they be recommended?"

In an editorial about the use of surgical face masks in public, published today, Aug. 23, in the BMJ, Northwestern Medicine internal medicine experts Drs. Jeffrey Linder and Rachel Amdur make the case for masking but acknowledge it's not a cut-and-dried topic.

The editorial is in response to recent findings from a Norwegian study published in the BMJ, which found modest benefits from masking.

"The way masks work is more complicated than simply blocking the transmission of infectious droplets or virus between people," said Linder, chief of general internal medicine at Northwestern University Feinberg School of Medicine. "The mixed, subtle nature of the evidence means leadership decision-making is still going to be really hard."

"This recent study shows that masking can lead to reduction in transmission, but there are likely behaviors (i.e. avoiding crowds, isolating when ill) that also contribute to reduced transmission," said Amdur, assistant professor of medicine (general internal medicine) at Feinberg.

"Public health officials would need to consider multiple measures, including mask mandates, if more dangerous variants emerge or in the case of future pandemics."