How 100 Days of Ease COVID-19 Surge Mask Wearing Could Help


President-elect Joe Biden says he will ask Americans to wear masks for the first 100 days of his presidency.

Experts say that directive may be difficult to enforce, but they add that if the country goes along, it could significantly slow the spread of COVID-19.

Biden said during a CNN interview that it was important he and Vice President-elect Kamala Harris “set the pattern” by wearing masks.

He said he would make the policy mandatory in federal government buildings.

“Where the federal government has authority, I’m going to issue a standing order that in federal buildings you have to be masked. In transportation, in interstate transportation you must be masked, on airplanes and buses,” Biden said.

“I’m going to ask the public for 100 days to mask, just 100 days to mask. Not forever, 100 days. And I think we’ll see a significant reduction… if that occurs with vaccinations and masking, to drive down the numbers considerably,” he said.

As public health authorities brace for a surge in COVID-19 cases following Thanksgiving, experts in the infectious disease community welcome Biden’s plans.

“I think it’s brilliant. He will be able to require in all federal facilities throughout the country, those people be masked and observe social distancing. That will be very, very important,” Dr. William Schaffner, an infectious disease specialist at Vanderbilt University in Tennessee, told Healthline.

“He and his team will model wearing masks, so that will change the whole tenor, the whole environment,” Schaffner added. “If people in authority, people who are admired, model the appropriate behavior, I think we can slowly, slowly persuade people who have been reluctant or even disdainful of wearing masks to join the rest of us.”

Convincing the public

Last week, the Centers for Disease Control and Prevention (CDC) issued a reportTrusted Source noting that the United States has entered a “phase of high level transmission” of the new coronavirus, SARS-CoV-2, and called for “universal face mask use.”

But getting the public to universally wear masks, experts say, won’t be easy.

“We’re a very divided country, and I think the response will be divided. These are attitudes that are really baked in, and changing attitudes, feelings, emotions… is a large task,” Schaffner said.

“There are people who are undoubtedly committed to this and in their personal behavior are being very, very careful and mindful of themselves and others,” he said.

“There are others who… don’t even believe there is an epidemic and don’t understand it all, and others who find it either ‘unmanly’ or if you’re wearing the mask, that must indicate that you are of a certain political persuasion, and if they’re not of that persuasion, then they’re not going to wear a mask. That’s where the attitude comes in,” Schaffner said.

Dr. Anne Liu is an infectious disease physician at Stanford Health Care in California.

She said the amount of opposition to public health recommendations has been disheartening.

“I’m feeling a little discouraged by the amount of not just disregard for public health recommendations but also the amount of intensity people have expressed against public health recommendations,” she told Healthline.

“I’m really worried about how long this could continue to drag out because of these really intrenched beliefs now,” Liu added.

“But I hope there is some margin there. I hope there is some percentage of people in different places who will change their behavior, who are not so entrenched, who will hear consistent messaging and take that to heart,” she said.

Clear public health messaging, experts say, is crucial in securing cooperation from the public.

“The messaging has really changed throughout the pandemic and it’s been very confusing, so I think what this is, is an opportunity to reset communication of optimal prevention strategies. Masking for the first 100 days is kind of catchy and may be useful,” Dr. Dan Blumberg, head of pediatric infectious disease at the University of California, Davis, told Healthline.

“What I’m hoping is maybe if we do focus on masks and maybe not focus on all these other complicated rules, maybe that will be simpler, maybe that will be a more effective communication tool,” he added.

Blumberg said that if the public were to mask up for 100 days, there would be a significant reduction in COVID-19 cases.

“There’s no question in my mind that if people follow the recommendations for masking and social distancing, that we could get this virus under control without a vaccine,” he said. “We’ve seen this in other communities that have gotten this under control when there was buy-in from the public with masking and social distancing.”

Part of the problem in getting people to stick with mask wearing for an extended period, Liu said, is that the impact of mask wearing won’t be immediately obvious.

“You would see a really dramatic drop in cases, followed several weeks later by a drop in hospitalizations, followed several weeks later by a drop in the death rate. It’s all delayed, which makes it much harder for people to see the impact of their actions,” she said.

A decrease in COVID-19 would also mean businesses and schools could reopen sooner.

Liu said Biden’s plan is something that could have been implemented months ago by the current administration, but this proposal is better late than never.

“From the very beginning, we have been about 6 to 8 weeks from getting control of the virus and we haven’t done it,” she said. “It’s not that we don’t know how to do it, and it’s not that we don’t have sufficient knowledge. A lot of the epidemiology and transmission dynamics is now quite well understood, or sufficiently so that we know what we need to know in order to control the virus.”

Schaffner is hopeful a change in administration in January will allow the United States to have better control of the virus, and that it will provide a nationwide approach to issues like mask wearing.

“We hope it will put us on the right track at last. Because the president-elect has said he will base his policy on science and good, solid public health. I am feeling hopeful, but it’s guarded… I think we will have a new direction and a new national policy. I’ve always thought you can’t subcontract this to the various governors,” he said.

“If you’re fighting an onslaught that now kills now over 2,000 Americans daily, you do this on a national basis. You don’t subcontract it to the governors, and you don’t let the governors subcontract it to the cities and counties, which is what’s happening now. That’s ludicrous,” Schaffner said.

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