Understanding the Impact of Face Mask Usage Through Epidemic Simulation of Large Social Networks

Evidence from the 2003 SARS epidemic and 2009 H1N1 pandemic shows that face masks can be an effective non-pharmaceutical intervention in minimizing the spread of airborne viruses. Recent studies have shown that using face masks is correlated to an individual’s age and gender, where females and older adults are more likely to wear a mask than males or youths. There are only a few studies quantifying the impact of using face masks to slow the spread of an epidemic at the population level, and even fewer studies that model their impact in a population where the use of face masks depends upon the age and gender of the population. We use a state-of-the-art agent-based simulation to model the use of face masks and quantify their impact on three levels of an influenza epidemic and compare different mitigation scenarios. These scenarios involve changing the demographics of mask usage, the adoption of mask usage in relation to a perceived threat level, and the combination of masks with other non-pharmaceutical interventions such as hand washing and social distancing. Our results shows that face masks alone have limited impact on the spread of influenza. However, when face masks are combined with other interventions such as hand sanitizer, they can be more effective. We also observe that monitoring social internet systems can be a useful technique to measure compliance. We conclude that educating the public on the effectiveness of masks to increase compliance can reduce morbidity and mortality.

[1]  E. Wilder-Smith,et al.  Headaches and the N95 face‐mask amongst healthcare providers , 2006, Acta neurologica Scandinavica.

[2]  M. Grunwalde Behind the mask , 1999, Trends in Cognitive Sciences.

[3]  Unt Libraries CyberCemetery https cybercemetery.unt.edu Great Pandemic: The United States in 1918-1919 , 1969 .

[4]  M. Bellis,et al.  Behind the mask. Journey through an epidemic: some observations of contrasting public health responses to SARS , 2003, Journal of epidemiology and community health.

[5]  Tiina Reponen,et al.  Do N95 respirators provide 95% protection level against airborne viruses, and how adequate are surgical masks? , 2006, American journal of infection control.

[6]  Gary S Settles,et al.  Can we reduce the spread of influenza in schools with face masks? , 2010, American journal of infection control.

[7]  M. Hilleman,et al.  Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control. , 2002, Vaccine.

[8]  Stephen C. Schoenbaum The impact of pandemic influenza, with special reference to 1918 , 2001 .

[9]  Steve Leach,et al.  Potential Impact of Antiviral Drug Use during Influenza Pandemic , 2005, Emerging infectious diseases.

[10]  M. Osterholm,et al.  Preparing for the next pandemic. , 2005, The New England journal of medicine.

[11]  Melanie R Taylor,et al.  Pandemic influenza in Australia: Using telephone surveys to measure perceptions of threat and willingness to comply , 2008, BMC infectious diseases.

[12]  Lisa M Brosseau,et al.  Surgical mask filter and fit performance , 2008, American Journal of Infection Control.

[13]  A. Nizam,et al.  Containing pandemic influenza with antiviral agents. , 2004, American journal of epidemiology.

[14]  S. Michie,et al.  Demographic and attitudinal determinants of protective behaviours during a pandemic: A review , 2010, British journal of health psychology.

[15]  J. Druce,et al.  A quantitative assessment of the efficacy of surgical and N95 masks to filter influenza virus in patients with acute influenza infection. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  J. Watmough,et al.  Reproduction numbers and sub-threshold endemic equilibria for compartmental models of disease transmission. , 2002, Mathematical biosciences.

[17]  Phillip D. Stroud,et al.  Pandemic simulation of antivirals + school closures: buying time until strain-specific vaccine is available , 2008, Comput. Math. Organ. Theory.

[18]  T. Hamamura,et al.  Regional Differences in Pathogen Prevalence and Defensive Reactions to the “Swine Flu” Outbreak among East Asians and Westerners , 2010, Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior.

[19]  Tiina Reponen,et al.  Respiratory Performance Offered by N95 Respirators and Surgical Masks: Human Subject Evaluation with NaCl Aerosol Representing Bacterial and Viral Particle Size Range , 2008, The Annals of occupational hygiene.

[20]  Sylvia Chong,et al.  Surgical mask vs N95 respirator for preventing influenza among health care workers: a randomized trial. , 2009, JAMA.

[21]  Nathaniel Hupert,et al.  Optimizing Tactics for Use of the U.S. Antiviral Strategic National Stockpile for Pandemic Influenza , 2011, PloS one.

[22]  Alberto Maria Segre,et al.  The Use of Twitter to Track Levels of Disease Activity and Public Concern in the U.S. during the Influenza A H1N1 Pandemic , 2011, PloS one.

[23]  T. Reponen,et al.  245. Efficiency of N95 Filtering Facepiece Respirators and Surgical Masks Against Airborne Particles of Viral Size Range: Tests with Human Subjects , 2005 .

[24]  Nathaniel Hupert,et al.  Correction: Optimizing Tactics for Use of the U.S. Antiviral Strategic National Stockpile for Pandemic Influenza , 2011, PLoS ONE.

[25]  Bradly J. Condon,et al.  Who is that masked person: the use of face masks on Mexico City public transportation during the Influenza A (H1N1) outbreak. , 2010, Health policy.

[26]  Phillip D. Stroud,et al.  Spatial Dynamics of Pandemic Influenza in a Massive Artificial Society , 2007, J. Artif. Soc. Soc. Simul..

[27]  D. Vesley,et al.  METHOD FOR EVALUATING EFFECTIVENESS OF SURGICAL MASKS , 1962, Journal of bacteriology.

[28]  Phillip D. Stroud,et al.  EpiSimS simulation of a multi-component strategy for pandemic influenza , 2008, SpringSim '08.

[29]  Allison E. Aiello,et al.  Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial , 2012, PloS one.

[30]  Xinghuo Pang,et al.  Evaluation of control measures implemented in the severe acute respiratory syndrome outbreak in Beijing, 2003. , 2003, JAMA.