A Prescription for Iowa
Iowa Physicians Prescribe a Statewide Face Covering Mandate
The scientific evidence is now convincing that mandatory use of face coverings in public is an effective and important measure needed to curb the spread of COVID-19. Iowa remains one of few states that has yet to enact any form of face covering mandate. We are calling on Iowa’s physicians to advocate for implementing this crucial, evidence-based public health policy.
If you are an Iowa physician and want to join your colleagues in urging Governor Kim Reynolds to enact a statewide face covering mandate, please read the open letter below and add your signature.
Dear Governor Reynolds,
In light of emerging evidence that demonstrates the effectiveness of face covering use by the general public in mitigating the spread of COVID-19, we strongly urge you to enforce a statewide face covering mandate. We remain deeply concerned that a surge of COVID-19 cases in Iowa is imminent as currently witnessed in numerous other states. Increased economic and social activity conducted without sufficient physical distancing and face coverings has been cited as a major contributor to the resurgence of this disease. We believe more can be done through state public health policy to help prevent Iowa from suffering the same fate.
Multiple scientific studies have now found evidence that the use of face coverings in public settings reduces community spread of COVID-19. (1) (2) (3) (4) (5) This holds true for widely-available cloth masks as well as face shields. Accordingly, since April 4, 2020, the Centers for Disease Control and Prevention has advised all individuals to wear cloth masks in public areas where physical distancing is not possible. This guidance was issued as new evidence emerged of the transmissibility of SARS-CoV-2 from asymptomatic and pre-symptomatic individuals infected with the virus. (6) (7) Mask use appears to be more effective preventing disease transmission when worn by infected individuals compared to when worn by healthy individuals. For this reason, given the considerably-high prevalence of asymptomatic and pre-symptomatic transmission, sound public health policy now relies on universal adoption of face coverings when in public.
Unfortunately, only 54% of Iowa respondents reported that they wear masks almost all or most of the time when in indoor public spaces. (8) Government recommendations and public education on use of face coverings therefore appear to be insufficient to compel widespread adoption of this important public health measure.
Early evidence, including that reported in a recent study conducted at the University of Iowa, suggests that state government mandates for face mask use in public are associated with a significant decline in the daily COVID-19 growth rate. (9) States that have imposed mask mandates are estimated to have prevented many thousand COVID-19 cases and likely numerous deaths. The benefits to public health are joined by favorable economic implications as well. A recent analysis by economists at Goldman Sachs projects that a government mask mandate would provide considerable economic benefit when used as an alternative to lockdown measures such as business closures and stay-at-home orders. (10)
For these reasons, we now believe there is sound scientific basis to mandate that the general public wear a cloth mask or face shield in public settings, especially where physical distancing of more than six feet cannot be consistently maintained. At a minimum this mandate should apply to adults and older children who can medically tolerate a face covering while inside indoor or enclosed public spaces.
We acknowledge that such a mandate will not be welcomed by some of your constituents. Wearing masks for hours on end as we tend to our patients, we personally attest that they can at times be uncomfortable. But as we directly witness the death and devastation waged by this virus, we gladly don the mask as the more comfortable alternative. We also acknowledge concerns that a face covering mandate might appear to be in opposition to the personal freedoms enjoyed by Iowans. We contend, however, that due to the unfortunate prevalence of asymptomatic viral transmission, individuals who choose not to wear a face covering infringe on the personal freedoms of others as they imperil the life and liberty of those around them.
Governor Reynolds, we applaud your conviction to use data to guide your policy decisions during this unprecedented crisis. We can confidently attest that the scientific evidence now indicates that a statewide mandate to use face coverings in public is urgently needed to help mitigate community spread of COVID-19. Your immediate action will be instrumental in uniting Iowans to cooperatively persevere through this trying moment in history.
Physicians of Iowa
- Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Derek K Chu, Elie A Akl, Stephanie Duda, Karla Solo, Sally Yaacoub, Holger J Schünemann, on behalf of the COVID-19 Systematic Urgent Review. Lancet, 2020.
- Rational use of face masks in the COVID-19 pandemic. Feng S, Shen C, Xia N, Song W, Fan M, Cowling BJ. Lancet Respir Med, 2020.
- Face masks for the public during the covid-19 crisis. Greenhalgh T, Schmid MB, Czypionka T, Bassler D, Gruer L. BMJ, 2020.
- Identifying airborne transmission as the dominant route for the spread of COVID-19. Renyi Zhang, Yixin Li, Annie Zhang, Yuan Wang, Mario Molina. PNAS, 2020.
- Moving Personal Protective Equipment Into the Community. Face Shields and Containment of COVID-19. Eli N. Perencevich, Daniel J. Diekema, Michael B. Edmond. JAMA, 2020.
- Evidence Supporting Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 While Presymptomatic or Asymptomatic. Furukawa NW, Brooks JT, Sobel J. Emerg Infect Dis, 2020.
- Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset. Chen, Hao-Yuan, Jian, Shu-Wan and Liu, Ding-Ping. JAMA Intern Med, 2020.
- Selzer & Co. The Iowa Poll. Des Moines Register and Mediacom, June 7-10, 2020.
- Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Wei Lyu, George L. Wehby. Health Affairs, 2020.
- Jan Hatzius, Daan Struyven, Isabella Rosenberg. Face Masks and GDP. Goldman Sachs Research. https://www.goldmansachs.com/insights/pages/face-masks-and-gdp.html.
Thank you for advocating for the health of Iowans. Please share this site with other physician colleagues in Iowa. This letter will be delivered to the Governor when a sufficient number of signatures have been collected to demonstrate consensus.
Updated July 31, 2020