• PublicHealthRising

Loose Lips Lose Lives

It’s time to make sure we’re putting those lips behind masks that really work to reduce the risk of COVID, while vaccination rolls out.

With new federal leadership emerging for our COVID response and making references to war-time footing, we’re borrowing from WWII-era messaging intended to guard against careless talk that could be intercepted. In our current moment in history, the concept of “careless talk” translates easily into “careless covers” -- face covers

Vaccination remains our key exit strategy from this pandemic, but masks remain a critical issue. While there has been news this week that the accelerating pace of COVID may be leveling off in the U.S., we remain at extraordinarily high levels of infection and death, with some health systems overwhelmed (which does increase your risk of dying). Community immunity through vaccination is still months away, at minimum. Even if we see a sustained COVID plateau or decline in coming weeks, the pattern in the U.S. has been rapid increase with a short decline, establishing a higher baseline than before -- and then repeat. The graph below shows this clearly with the number of cases in the U.S., starting from March of 2020 through today:

Adapted from

Based on our performance to date, the new plateau following our current peak may be higher than ever. We have also seen over the course of this pandemic that the initial and most recent surges in the U.S. have followed surges in Europe, and we have high concern about more transmissible variant strains widely circulating there as well as an emerging variant in South Africa.

Strong indicators point towards the need to intensify our pandemic control efforts, while we continue to accelerate vaccination rates, despite any short-term improvements we might see in the COVID infection trends. And we must do this now, before the next surge begins accelerating, considering that we will not have broad vaccine-induced immunity soon enough to head off the next, even worse, COVID surge. We know that in combination with minimizing proximity to others, correct and consistent use of appropriate face masks reduces the spread of COVID. Not all masks, however, are equally effective. Material and fit really matter. There are several options to meet optimal material and fit characteristics in a face mask, but it can get confusing pretty quickly. We should aim to set some standards and simplify so that we see face coverings with appropriate material and fit: surgical masks. No more noses hanging out, bandannas that do little more than redirect air, or thin coverings that don’t filter. Surgical masks should be ubiquitously available, free, and easily accessible.

Availability is only one step towards better masking for COVID control. To see free, widely available surgical masks actually put to use, there needs to be some saturation in messaging, some leadership, and some efforts to use all the channels available to distribute surgical masks. Messaging can take the usual forms (“loose lips might sink ships”). Distribution and encouragement to use surgical masks can be pursued through schools. Just like school kids learn about fire safety and might get a kit to bring home with reminders to check the smoke detectors, schools and teachers should be supported to provide kids with surgical masks for their own use, as well as surgical masks to bring home. It will also be helpful to see Congress unified with appropriate face coverings. We can establish these norms. It’s been done before, in the face of great resistance -- as happened with other basic public health measures like seat belts. But we don’t have the time to see this shift happen over years. Hopefully strong leadership will be effective, and we’ll find some degree of solidarity in our fight. Members of Congress should be willing to get on war footing to fight an enemy that has taken more of our neighbors than the Axis. The next frontier: social media. COVID is a national security risk, and we’d like to see the discussion start to focus more on the responsibility we all hold to protect our communities. The 100 day mask challenge is critically important, and it can work if people have access to masks that work -- and wear them.

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