To contain the COVID-19 pandemic, governments introduced strict Non-Pharmaceutical Interventions (NPI) that restricted movement, public gatherings, national and international travel, and shut down large parts of the economy. Yet, the impact of the enforcement and subsequent loosening of these policies on the spread of COVID-19 is not well understood. Accordingly, we measure the impact of NPIs on mitigating disease spread by exploiting the spatio-temporal variations in policy measures across the 16 states of Germany. While this quasi-experiment does not allow for causal identification, each policy’s effect on reducing disease spread provides meaningful insights. We adapt the Susceptible–Exposed–Infected–Recovered model for disease propagation to include data on daily confirmed cases, interstate movement, and social distancing. By combining the model with measures of policy contributions on mobility reduction, we forecast scenarios for relaxing various types of NPIs. Our model finds that in Germany policies that mandated contact restrictions (e.g., movement in public space limited to two persons or people co-living), closure of educational institutions (e.g., schools), and retail outlet closures are associated with the sharpest drops in movement within and across states. Contact restrictions appear to be most effective at lowering COVID-19 cases, while border closures appear to have only minimal effects at mitigating the spread of the disease, even though cross-border travel might have played a role in seeding the disease in the population. We believe that a deeper understanding of the policy effects on mitigating the spread of COVID-19 allows a more accurate forecast of disease spread when NPIs are partially loosened and gives policymakers better data for making informed decisions.

Masks have been widely recommended as a precaution against COVID-19 transmission. Several studies have shown the efficacy of masks at reducing droplet dispersion in lab settings. However, during the early phases of the pandemic, the usage of masks varied widely across countries. Using individual response data from the Imperial College London—YouGov personal measures survey, this study investigates the effect of mask use within a country on the spread of COVID-19. The survey shows that mask-wearing exhibits substantial variations across countries and over time during the pandemic’s early phase. We use a reduced form econometric model to relate population-wide variation in mask-wearing to the growth rate of confirmed COVID-19 cases. The results indicate that mask-wearing plays an important role in mitigating the spread of COVID-19. Widespread mask-wearing associates with an expected 7% (95% CI: 3.94%—9.99%) decline in the growth rate of daily active cases of COVID-19 in the country. This daily decline equates to an expected 88.5% drop in daily active cases over 30 days compared to zero percent mask-wearing, all else held equal. The decline in daily growth rate due to the combined effect of mask-wearing, reduced outdoor mobility, and non-pharmaceutical interventions averages 28.1% (95% CI: 24.2%-32%).

Background Masks have been widely recommended as a precaution against COVID-19 transmission. Several studies have shown the efficacy of masks at curbing droplet dispersion in lab settings. Using individual response data from the Imperial College London-YouGov personal measures survey, this study investigates reported mask use and its association with the spread of COVID-19. Methods We examine the association of reported mask-wearing in a population within a country with the growth rate of active cases COVID-19 cases. The analysis uses country-wide data from weekly surveys of individuals mask-wearing behavior in public places, as well as other concurrently implemented nonpharmaceutical interventions, mobility changes, new cases of COVID-19 data and other control variables. The mask-wearing data were obtained from the Imperial College-YouGov multi-country survey of peoples personal habits before and during COVID-19. Because mask-wearing showed substantial variation across countries and over time, we use a reduced form econometric model to relate population-wide changes in mask-wearing to the growth rate in COVID-19. Results The results indicate that reported mask-wearing could play an important role in mitigating the growth of COVID-19. Widespread mask-wearing within a country associates with an expected 7% (95% CI: 3.94%-9.99%) decline in the growth rate of daily active cases of COVID-19 in the country. This daily decline equates to an expected 88.5% drop in the growth of daily active cases over a 30-day period when compared to zero percent mask-wearing, all else held equal. The decline in daily growth rate due to the combined effect of reported mask-wearing, reduced social mobility, and non-pharmaceutical interventions averages 28.1% (95% CI: 24.2%-32%). These estimates remain robust across multiple sensitivity analyses. Conclusions Face mask usage as a preventative measure against the transmission of COVID-19 varies widely across countries. This observational study uses data from 24 countries and finds that reported face mask usage associates with a decline in new COVID-19 cases. Even though the model controls for a large variety of variables that affect spread, and we run a number of robustness checks, it remains possible that some of the decline associated with face masks is related to confounding variables not included in the model. In summary, due to the confounding variables and the variations in the type of mask and its usage, randomized control trials of mask usage in populations are needed to determine the true effect of mask wearing on mitigating the transmission of infectious respiratory diseases.

Masks have been widely recommended as a precaution against COVID-19 transmission. Several studies have shown the efficacy of masks at reducing droplet dispersion in lab settings. Using individual response data from the Imperial College London — YouGov personal measures survey, this study investigates the effect of mask use on the spread of COVID-19. Mask-wearing shows substantial variations across countries and over time. We use a reduced form econometric model to relate population-wide changes in mask-wearing to the growth rate of confirmed COVID-19 cases. The results indicate that mask-wearing plays an important role in mitigating the spread of COVID-19. Widespread mask-wearing within a country associates with an expected 7% (95% CI: 3.94% — 9.99%) decline in the growth rate of daily active cases of COVID-19 in the country. This daily decline equates to an expected 88.5% drop in daily active cases over a 30-day period when compared to zero percent mask-wearing, all else held equal. The decline in daily growth rate due to the combined effect of mask-wearing, reduced outdoor mobility, and non-pharmaceutical interventions averages 28.1% (95% CI: 24.2%-32%).

Masks have been widely recommended as a precaution against COVID-19 transmission. Several studies have shown the e cacy of masks at reducing droplet dispersion in lab settings. Using individual response data from the Imperial College London-YouGov personal measures survey, this study investigates the effect of mask use on the spread of COVID-19. Mask-wearing shows substantial variations across countries and over time. We use a reduced form econometric model to relate population-wide changes in mask-wearing to the growth rate of con rmed COVID-19 cases. The results indicate that mask-wearing plays an important role in mitigating the spread of COVID-19. Widespread mask-wearing within a country associates with an expected 7% (95% CI: 3.94%-9.99%) decline in the growth rate of daily active cases of COVID-19 in the country. This daily decline equates to an expected 88.5% drop in daily active cases over a 30-day period when compared to zero percent mask-wearing, all else held equal. The decline in daily growth rate due to the combined effect of mask-wearing, reduced outdoor mobility, and non-pharmaceutical interventions averages 28.1% (95% CI: 24.2%-32%).