A Truly Effective Mask Wearing Level is 99% Not 80%. US Seat Belt Wearing is 91%

More public mask-wearing is very important to curbing the spread of COVID-19, but is 80% of the population complying with mask-wearing good enough?

Above the picture shows Mask compliance but no seatbelt. Getting to Hong Kong levels of 99% mask-wearing and other new hand and surface hygiene levels will require technology, ergonomics, policy and other levers.

Marc Benioff supports mask-wearing and says if we can get US mask-wearing to 80% then this would be enough to suppress COVID-19 spread in a month.

This issue is unfortunately a highly political matter in the USA. Democrats have about 80% mask compliance while Republicans have about 45%.

Wearing more masks will help, but Singapore has 90-92% mask-wearing and still has significant spread of COVID-19. This is also in spite of Singapore having a very hot climate.

Singapore had 8650 diagnosed cases per million while the US has 13000 diagnosed cases per million. Singapore has 500 cases per day with a population that is about 60 times less than the US. This would be 30,000 cases per day which is better than the US 60,000 cases per day. Singapore has much higher population density but population density does not have tight correlation with the disease spread. Correlation is with how many people are in the same house or apartment.

What is a truly effective public mask-wearing level?

The American Journal of Respiratory and Critical Care Medicine has an article that shows Hong Kong has 98.8% mask-wearing compliance. The countries with effective hygiene have populations that fully have lives with face mask use, hand washing and social distancing. Those are all important components of the non-pharmaceutical measures against COVID-19.

This means 19 out of 20 Democratic Americans also need to shift to mask-wearing compliance and 54 out of 55 Republican Americans need to shift to mask-wearing compliance.

I personally know people who live in the high compliance countries of Hong Kong, Taiwan, Malaysia and Thailand. I can tell you that the behaviors and culture go beyond mask-wearing. There is also frequent hand cleaning, cleaning of frequently touched surfaces.

Twenty-five years ago in 1995, I worked in Hong Kong and Taiwan. The office cleaning crews would thoroughly wipe down keyboards and phones with Lysol. This was before SARS in 2003.

After SARS, the public mask-wearing in many Asian countries became standard practice.

The 99% level of public mask-wearing will not happen in the USA based upon public service messages and tweeting.

Seat belt usage in the USA ranges from 70-97%. The Nationwide average is 90.7%. This is in spite of seat belt fines in the $500 range, significant enforcement and cars that will sound alarms when there is no seat belt being worn.

US businesses have about 90-95% compliance with workplace safety. Occupational Safety and Health Administration had about 50,000 inspections and there were 524 willful violations, 3100 repeat violations, 43,000 serious violations etc… The extensive business regulations and fines have cut the number of workplace fatalities by about 65% over decades. This is too slow and not a good enough standard.

All stores in Northern California were denying entry and service to customers that did not wear masks. However, this is no longer strictly enforced even in the SF Bay Area.

There is an Asian supermarket in Oakland, KP Asian Market, they do not allow entry without mask-wearing and gloves. The store gives ALL customers disposable masks and gloves if the customers do not have their own. Customers are provided cleaner to wipe down the carts and items. This is the level of behavior needed at every office, factory and retail outlet.

American restaurants give out napkins and ketchup packets for free. Fried chicken restaurants give sanitary wipes. There needs to be completely subsidized PPE. $200 of PPE per person in the US is $66 billion per year. This is vastly less than the trillions being spent on financial bailouts.

Also, the CDC reports that the US has and average of $87 billion in business losses each year from flu and $40 billion from other respiratory diseases. Face masks, face shields, personal and group sanitizer, wipes and gloves needs to be more abundant than free napkins and ketchup packets.

Also, forget about saying that people are just not educated enough. US Hospitals have not had over 90% hand cleaning compliance. It cannot be said that doctors and nurses are not educated about disease spread. A University of Zurich Hospital study indicated that the ergonomics of personal sanitizer bottle caps discouraged the compliance with hand cleaning. Achieving 99% compliance means e everything about masks, shields, hand cleaning, cleaning surfaces and distancing has to be easy and completely friction-free. It needs to be free for the end-users. It has to be as ergonomic and easy as possible. Every checkpoint and entry needs to reinforce or require compliance.

People know how much effort and product (car) adjustment has gone into seatbelt compliance. This is still at 91% US-wide. 99% compliance is beyond almost any prior US behavior and cultural norm.

We need to use the best technology, ergonomics and policy. McDonald’s hands out as many free ketchup packets and napkins as customers want. KFC gives out free alcohol wipes for customers who get greasy fingers. But both do not give masks or sanitizer to customers. All governments, offices and retail need to give out masks, face masks, gloves, sanitizer, and wearable sanitizer that is fully subsidized for the world.

SOURCES- Twitter, NHTSA, CDC, The American Journal of Respiratory and Critical Care Medicine, Worldometers, Statistica
Written By Brian Wang, co-founder of Wryst (wearable hand sanitizer device company). Nextbigfuture.com

70 thoughts on “A Truly Effective Mask Wearing Level is 99% Not 80%. US Seat Belt Wearing is 91%”

  1. Since serfdom was once the norm I have to ask why was it the norm and how did we manage to free ourselves from it.

  2. Not sure about that. Big variation in human intelligence tells me there is a lot of room for improvement in average intelligence. Then there is that weird thing called creativity which seems to be different from intelligence. As for EQ I think there is also room for improvement especially since we now live in larger groupings.

  3. Masks may or may not work, but even if there is only a small benefit they are worth it. What is the big deal? Most people buy insurance for something that probably will not happen.

  4. Maybe masks are effective or maybe they are absolutely useless. But if I lived in a place where they have Covid I would wear one, when we had it here I did. They cost little and maybe they work. Even if you get only mildly sick, it is bound to cost and inconvenience you more than buying and wearing masks.

  5. No, the stupid ones are the ones who don’t or can’t follow simple instructions and/or procedures that will keep them disease free. They will probably end up sick. Unfortunately, most of them will live.

  6. I was drawing a distinction between those who tested positive and those who died. 22,800 tested positive. Unfortunately, I don’t have any data as to how many were symptomatic and how many were not. Anecdotally I can tell you that almost all the Marines that I know who tested positive were asymptomatic. Very, very few had symptoms and those that did were mild. Pls disregard my other reply. I initially misunderstood what you meant.

  7. Simple, I don’t want to wear one. I don’t like being forced to wear one. And I’ll vote anyone out of office who tells me I have to. But probably most of all they’re not feasible because they’re useless. If you truly want to stop COVID then forget about masks. It’s just a way for the idiot masses to fool themselves into believing that they’re safe. If you truly want prevent yourself from getting the disease then eat right, exercise, maintain a healthy body weight, don’t smoke or do drugs, and properly manage your underlying medical condition if you have one. All those things actually work and the CDC has stressed that since day 1. Or you can be unhealthy, wear a mask, touch a surface that has the virus, then touch your mouth or nose, and get infected.

  8. Concur. I would add though that they are just doing what the stupid masses want. Lots of folks are very scared by COVID. Doesn’t matter that it’s not the 1918 flu or the Black Death in 1346. They ignore the evidence and hold on to their fear. Politicians are smart in one sense. They know their political fortunes depend on listening to the public. Ignore the public and you get voted out of office.

  9. If you’re at risk, be careful. If you’re not, make your own choices and sleep in the bed you make. The current path of government ‘saving’ us all is a slippery slope on the road to serfdom.

  10. On top of that, many deaths attributed to Covid are in fact not Covid. CDC has mandated that ANY death with Covid-like symptoms involved have to be counted as Covid as primary cause of death. Complete nonsense that inflates mortality rate. You could be in the hospital and in a coma, die from flu-like symptoms and get counted as a Covid death. S

  11. Guvmint and politicians need to point to some action they took that saved everyone. Masks will be that thing. It has no effect, but they can take credit. Typical douchbaggery of that class of people.

  12. See UK and Swedish rates. UK peaked in April and the implemented masks in July. Cow was out of the barn and then they closed the doors. Sweden never had any policy, and they peaked and fell without it. Nobody can pinpoint why, but a theory is that far more people have been exposed than what data show. The heard gets thinned, low hanging fruit dies first, then you see a rapid fall in deaths etc. Virus attenuates over time also. The # of people with it is less important than deaths and hospitalizations. I’m sure masks help in some minimal way, but it is not a primary inhibitor spreading the disease. Washing your hands and limiting contact in public is easier to do and more effective. On May 28th BLM riots started in AZ. That helped spread the disease too. One problem with your theory is the rate of compliance with the mask policy. Who knows what that is? According to Brian you need much higher compliance to get the effect you describe.

  13. Keep the Wuhan Virus cases coming, please. Squashing the bug thru reduced liberty and choice is a harmful idea. Killing the economy and wracking up more debt is a stupid idea. A vaccine may or may not be coming soon, but we know more infections amid falling mortality rates is a good thing overall. Many deaths assigned to Covid are in fact flu and other disease. Somehow politicians have moved from, “don’t overwhelm the hospitals”, to “nobody can get infected”. Dumb, dumb, dumb. The panic around ventilators and ICU beds NEVER even came close to materializing. As I said from the beginning, if you’re in a high risk group or interact with those in that group, be very careful! Otherwise, you should take measures you deem appropriate for you and your family, not government mandates. If this were the rapid spread of something like Ebola, sign me up for lock downs etc. However, this is not that.

  14. Foreigners! We should have known.
    Fact is that most wars, smuggling and international problems all involve foreigners.

  15. I just don’t get it. A mask is such a trivial annoyance. It’s like people getting upset and breaking the law because they don’t like wearing a seatbelt or using their indicators at corners.

  16. What possible reason is there that masks are not long term feasible?
    It’s a minor annoyance, akin to having to wear pants in summer.

  17. All that proves is that people infected with COVID died from the disease. It doesn’t speak to how they got it, or whether they were wearing a mask or not. Moreover, most of these deaths were people over the age of 65 and/or with an underlying health condition. In other words, peoples whose immune systems were compromised to being with.

  18. Well put. I definitely see much logic in what you say. That said, this isn’t the Black Death of 1346. We aren’t seeing 40-50% mortality rates within 3-6 months of the onset of the virus. What’s lacking in this discussion is a firm grasp of the true danger of this disease. As the senior Navy surgeon at my unit said, if you’re healthy then your risk is very low. That would appear to indicate that the average person is either already immune to the virus, or that that virus is simply not that dangerous and thus for most people herd immunity or even a vaccine isn’t needed. Much like masks.

  19. IFR is around 0.26% based on antibody tests. If you include TCell immunity then that number is effectively halved bringing it inline with a bad flu season.

    In countries like India the IFR is below 0.1% based purely on antibody tests.

  20. Just a reminder, the place people are catching the virus most is their own house.
    Also those with the virus only stay immune for a few months.
    Also, the virus mutates constantly,

    So Two choices.
    1)Hide for more months. Lose everything as all the food, and products run out and the economy just dies.

    2)People who are weak immune system wise stay at home order as much as you can. Take lots of vitamin C and D. Those who aren’t go outside take the above vitamins and try and stay healthy. If you get sick stay home,

  21. Except there actually is excellent evidence from good RCTs that Masks in the OR do NOT help.

    World J Surg . May-Jun 1991;15(3):383-7; Postoperative wound infections and surgical face masks: a controlled study

    Cochrane Database Syst Rev. 2016 Apr 26;4(4); Disposable surgical face masks for preventing surgical wound infection in clean surgery

    If a mask is not enough to protect someone immunocompromised with an open wound while they are being breathed on for over an hour against bacterial infections when worn by experts properly trained in how to wash, don and doff a mask then…
    It is hard to support that wearing a mask by the general public with limited access to hand washing, frequently donning and doffing them incorrectly, having periods where they are wearing them incorrectly or not at all would be effective against preventing spread a viral infection while they minimize close contact with a generally healthy public.

    Masks are not magic.

  22. I am sure that is why doctors in operation rooms wear masks all the time, because clearly they are not helping…

  23. So long as immunity duration is below a certain level and the virus can transmit asymptomatically, it will be here in reoccurring waves depending on the R0. If above roughly 2 with immunity under 6 months, it will keep coming. No guarantee a mutation will impact its mortality, selection would only occur to reduce it if it was high enough to burn itself out quick. Natural selection favors its ability to spread on reproductive. No guarantee the traits for its negative health impact on humans shares a loci with those that allow it to spread and have a short immunity.

  24. Research COVID type viruses, humans don’t have a good track record in developing long term immunity against them. HIV immunity is genetic, I wouldn’t rely on natural selection for a quick fix.

  25. “Democrats have about 80% mask compliance while Republicans have about 45%.”
    So effectively, the Dems are no better than the GOP. Got it.

  26. I do, but natural selection and survival of the fittest can only take you so far. We humans seem to have reached a ceiling in terms of IQ and EQ.

  27. If there is a difference in infections due to wearing a mask and not wearing a mask then the unmasked people will get processed by the virus and either die or become immune. It will take several months more. Once that is done then the virus will die out.

  28. What do you make of Pfizer’s work on a vaccine? I read last week that the Federal Government has contracted with them to buy it, even though it hasn’t finished trials.

  29. Looking more closely at the dates, most of the mask ordinances went into effect around June 17-18, only a few days after the governor rescinded the anti-mask-ordinance order. The plateau in cases appears to start around July 4-6. So it actually was “over 2 weeks” rather than “within a week” as I originally posted. I’ll edit the original post.

    While improved testing might have magnified the new cases, I don’t see how it would have led to a subsequent decline in daily cases after a 10x increase.

  30. There are always outliers in any biological system… hence some people immune to diseases that will infect 99% of the rest.

  31. No… do just the opposite. People who’ve had it should give blood samples, because those antibodies are important to study. It could lead to an effective vaccine.

  32. To top it off, up until cv1984, they taught that surgical/cloth masks in the hands of untrained professionals actually increase your risk of contagion.

  33. Holy cow, I did not know that!!!! I stand corrected. Thx for the link. Very informative! Nice to read a good news science article for once.

  34. I always like your posts!
    One can only hope that genetic engineering vastly improves human intelligence and wisdom…

  35. The testing policies and procedures affect the statistics to a much greater degree than mask wearing. Most COVID statistics are questionable in accuracy.

  36. New Orleans has been wearing mask for several weeks. Cases still increasing. If masks do have an effect we haven’t seen it here yet.

  37. The simple fact is that with or without masks, social distancing, lockdowns, etc the virus is not going away. Sure you can slow the spread, but economically and culturally speaking none the above are feasible long term. Only herd immunity, mutation to non fatal strain, or a vaccine will end the outbreak.

  38. ROTFLMAO. As if I claimed every virus were like the varicella zoster virus.

    There’s a very good chance the coronavirus is far too similar in mutation rate to the rhinovirus, thus no effective vaccine will be developed, because once a vaccine is developed, the virus mutates, and the vaccine is no longer effective.

    So long as there’s no effective vaccine, the best thing we can do is treat this virus like influenza, by protecting the cohort most susceptible to the virus, while allowing the virus to spread naturally throughout a population. Hospitalize as needed, and prescribe medications to act as prophylactics or treat symptoms. Once herd immunity is achieved, the susceptible cohort, while still vulnerable, is protected by the herd immunity until the virus mutates… Rinse. Wash. Repeat.

    You never know, as more people get COVID and recover from it, the more subjects there are to study whose antibodies might provide necessary clues for developing an effective vaccine.

  39. True, nothing is guaranteed, but natural immunity is a long standing, well proven concept. True also that humans are not able to build natural immunity to some diseases, like HIV for instance. That said, I haven’t seen any evidence that corona viruses fall into that category. Many epidemiologists continue to predict that herd immunity is possible.

  40. It’s unfortunate there are so many that graduate from the american school system that are functionally illiterate. Nowhere did I suggest in my post that the “virus is nothing.”

    It has been scientifically proven, though, that the masks that are being worn are completely ineffective at preventing the spread of this virus.

    Also, FYI, at the hospitals that I’m familiar with, one is not permitted to spend “4 hrs walking through the ICU”. I am over 55. I plan on using HCQ + AZT + zinc if needed instead of a useless mask.

    I think you’re a troll, but then what would one expect from a lump of flying spaghetti that can’t read?

  41. Even if he does all that, he won’t probably wont get infected if he’s under the age of 65 and healthy. And if he does, the chances of him dying are very low. A little over 22,800 U.S. Marines have tested positive with COVID-19. 3 have died. As the CDC has said repeatedly, if you take care of your itself, the danger is very low.

  42. Could you just imagine the “average joe” living in space, moon, mars, stations, o’neills etc.
    It’s absolutely laughable.

  43. Just before reading this, I read the following about Hong Kong today:

    “Also, Hong Kong today reported a daily record total, with 145 new cases, the Center for Health Protection said in a statement. All but three are locally acquired cases. The continued rise in cases, the region’s third such spike, prompted even tougher new distancing measures, which curb all dining in restaurants and mandate wearing masks in public outdoors, the South China Morning Post reported. Some of Hong Kong’s cases are related to outbreaks at two nursing homes.”

  44. Thanks for posting an article that proves nothing. If you think this virus is nothing, I suggest you show us how sure you are by spending 4 hrs walking through the ICU of a hospital in a COVID hot bed with no PPE. Then go visit your extended family giving everyone a hug, make sure to give every family member over 55 a kiss.

  45. You do know that without an effective vaccine herd immunity is not guaranteed? Most viral immunity from successfully fighting a virus is not permanent, hence you need boosters for many vaccines. Every virus is not Chickenpox.

  46. “Now everyone had to wear a mask any time they entered a business. …And within a week of that, new cases leveled off, and then started declining.”

    Sounds like a coincidence of timing to me, unfortunately. Given the virus’s typical incubation time, long pre-symptomatic period, and typical test turnaround time, any changes directly caused by the adoption of masks would take a lot longer than “within the week” to show up in the stats — lockdown and social distancing were in place a lot longer than that before new case growth rates started declining in most locations. You would also have to make sure you eliminated expansion of testing as a “cause” of the new cases — those figures represent only positive tests, not actual verified new infections. And the death rates are likely to be declining now in any event, as the virus burns through the most vulnerable populations and moves into the less frail.

    This is not to say that masking won’t have an effect, simply that I think that effect is very unlikely to be large enough to justify the government enforcement needed to deploy it — unless, of course, the minor probability reduction in transmission is *just* large enough to knock the R0 rate from just above 1 to just below 1. Which is certainly possible, but also not something I’d bet on.

  47. Likely the level of mask wearing necessary to extinguish the pandemic varies according to local conditions, such as population density. If people aren’t crowded, or using mass transit, they won’t need to work so hard to avoid passing the virus along.

  48. Utter nonsense!

    “Not a single randomized controlled trial with verified outcome has been able to detect a statistically significant advantage of wearing a mask versus not wearing a mask, when it comes to preventing infectious viral illness
    If there were any significant advantage to wearing a mask to reduce infection risk to either the wearer or others in the vicinity, then it would have been detected in at least one of these trials, yet there’s no sign of such a benefit
    There is no evidence that masks are of any utility for preventing infection by either stopping the aerosol particles from coming out, or from going in. You’re not helping the people around you by wearing a mask, and you’re not helping yourself avoid the disease by wearing a mask
    Infectious viral respiratory diseases primarily spread via very fine aerosol particles that are in suspension in the air. Any mask that allows you to breathe therefore allows for transmission of aerosolized viruses
    All-cause mortality data are not affected by reporting bias. A detailed study of the current data of all-cause mortality shows the all-cause mortality this past winter was no different, statistically, from previous decades. COVID-19 is not a killer disease, and this pandemic has not brought anything out of the ordinary in terms of death toll”


  49. My favorite grocery requires masks, but the employees don’t wear them properly (they wear them pushed under their noses, I suppose to make breathing easier). Doing this makes wearing masks pointless. There were several older people at the store wearing masks pushed under their noses or not fitted properly at all. I don’t know if they even realize they were doing it wrong. None of the store staff were saying anything about this.

    My girlfriend’s parents have been awful about wearing masks. They seem very fatalistic about virus and unwilling to change habits.

  50. This is somewhat anecdotal, so take it for what you will, but…

    Arizona ‘opened up’ around mid May. Covid19 cases quickly took off, ultimately to hit 10x the level at the time of re-opening, with no signs of leveling off.

    Around mid-June, the governor – apparently wanting to do something but not willing to draw fire from “mask-freedom advocates” – rescinded a previous policy and allowed local governments to implement mask policies – which most did within about a week. Now everyone had to wear a mask any time they entered a business. Most people complied with the new orders – most likely had been willing to wear a mask but saw no point if no one else was, others reluctantly going along because they saw others doing it and didn’t want to stand out. Of course there are always hold-outs. There were ‘incidents’. But now it is very rare to see someone without one.

    And within a week of that, [edit: correction – it was a bit over 2 weeks] new cases leveled off, and then started declining. New cases are now down about 33%, with no sign that this trend will reverse. Daily deaths, always a lagging indicator, have now leveled off, pretty much mirroring the daily cases with a ~2 week delay.

    Could there be other changes that caused this? Re-closure of bars and gyms and movie theatres? Maybe – but those only affect a subset of Arizonans. It is difficult to dismiss the correlation of this one big change affecting everyone, and the quick and dramatic response in new cases.

Comments are closed.