Daily data on COVID-19 cases and deaths and on mask usage were obtained for all European countries. This analysis aimed to verify whether mask usage was correlated with COVID-19 morbidity and mortality.
Such heterogeneity in mask usage among neighbouring countries provided an ideal opportunity to test the effect of this non-pharmaceutical intervention on the progression of a strong COVID-19 outburst. The stringency of these measures varied among the different countries and they, therefore, resulted in different proportions of mask compliance, ranging from 5% to 95%. From March 2020 onwards, country after country instituted some form of mask mandate or recommendation. However, these studies were restricted to the summer and early autumn of 2020. Several studies that analysed the effect of masks on the general population (ecological studies) have concluded that masks were associated with a reduction in transmission and cases. Two large randomised controlled trials about mask effectiveness performed during the pandemic came out with mixed results. Face masks still are one of the most significant and controversial symbols in the fight against COVID-19. Universal masking has been introduced during the coronavirus disease 2019 (COVID-19) pandemic at an unprecedented global scale as an important tool to curb viral transmission among potential susceptible persons.
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