Len Testa Talks Mask Compliance in Forbes Magazine
The data are clear and consistent — wearing a mask helps prevent the spread of COVID. Whether masks are required or not, and how well people comply with voluntary or required mask rules can vary wildly depending where you are in the United States. Since its reopening, Walt Disney World has had specific mask requirements that are enforced by Cast Members, and so compliance is high.
Here at TouringPlans, we love data, and so in addition to other data that we collect in the parks, we’ve been collecting mask compliance data. Recently, Forbes Magazine interviewed Len Testa of TouringPlans to discuss mask compliance at Walt Disney World and how the numbers play out.
Every day, Testa’s team picks a random location at a random Disney World theme park and counts 500 people. “Of those 500 people, we determine how many were wearing their masks exactly according to Disney’s mask guidelines,” explains Testa. That means wearing a face covering that is secure and covers the nose and mouth. “And the only time that you can take it off is when you are actively eating or drinking while stationary, not while walking around or in a ride queue,” he says.
At Epcot last Wednesday, compliance was 99%, which Testa says is pretty typical. “Also, when mask compliance isn’t 100%, it’s not like somebody’s walking around all day without a mask,” he says. “It’s generally someone walking who pulls the mask down for a second, takes a sip of soda, and puts it right back on.”
You can read the rest of the article here.
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Thanks again Julia for these references. It took me a long time to get through them, especially given the time of year, but I finally did. I’m glad that there is finally some research into effects of mask use, though I’m greatly disturbed that mandates came before research. That feels unethical to me. Overall, I find the level of evidence for mask safety to be improved, but still inadequate. In the adult studies, the sample sizes were quite small and include the possibility of selection bias (potentially towards those who can better tolerate masks and are therefore more willing to participate). The studies certainly lacked power to detect subsets of participants with detrimental effects, which is crucial when considering the universal mask mandates that apply to millions of people.
The one study in children was of good quality (randomized crossover with larger sample size, and probably without selection bias), but it was exceedingly limited in scope and never intended to apply to the situation we have today. It concluded that the masks were “safe for use in children 7 to 14 years old with no underlying medical conditions and in the setting of routine daily activities including brisk walking.” However, the children wore the masks for about 5 minutes at a time. Masks are now required for children all day at school, including during gym class and sports activities, and for children as young as 2 years old. This sort of use was not studied. On the other hand, there is a recent preprint (not yet published or peer reviewed) from Germany that is extremely interesting: https://www.researchsquare.com/article/rs-124394/v1. They set up a survey about effects of masks in children and in just a week had over twenty thousand responses from parents. They found that “Impairments caused by wearing the mask were reported by 68% of the parents. These included irritability (60%), headache (53%), difficulty concentrating (50%), less happiness (49%), reluctance to go to school/kindergarten (44%), malaise (42%) impaired learning (38%) and drowsiness or fatigue (37%).” There is almost definite selection bias of course, and the true percents would very likely be lower; however, the sheer numbers are impressive and I find the conclusion warranted: “The frequency of the registry’s use and the spectrum of symptoms registryed indicate the importance of the topic and call for representative surveys, randomized controlled trials with various masks and a renewed risk-benefit assessment for the vulnerable group of children: adults need to collectively reflect the circumstances under which they would be willing to take a residual risk upon themselves in favor of enabling children to have a higher quality of life without having to wear a mask.”
My apologies — that’s what I get for typing before coffee. 😉
Facemasks and the Cardiorespiratory Response to Physical Activity in Health and Disease
https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.202008-990CME
Thank you Julia. I will take a look at all those studies and get back to you with thoughts about the level of scientific evidence. I see that your 3rd and 5th reference are the same; was there a different one you intended?
Of note, I have a physical problem, not a psychological one. I am confident of this for a couple reasons. First, in the spring when masks were first mandated, I began to use one fully trusting the CDC’s statement that mask use is safe. I had no worries starting out. Second, in retrospect, I can see that this is not a new physical issue for me. I have never been able to wear a scarf over my mouth, like I see others do. It just never mattered and I never thought twice about it (literally, til a couple weeks ago when it was time to think about winter gear and the concept of scarfs suddenly hit me).
Hi, Felicia,
As a former copyeditor for several prominent medical journals (before walking away from the high stress of weekly publications for the much more enjoyable career with TouringPlans), and with a degree in Biology in addition to my degrees and certifications in technical editing, I have a background in researching and fact checking medical studies.
Although English language-based studies on mask efficacy, hypoxia, gas exchange, and so on were limited back in early 2020 (as western culture doesn’t have a long-standing tradition of focus on limitation of community spread through mask usage the way other cultures do), the scientific community has been able to quickly get up to speed with abundant research, including efficacy and hazard studies, and a variety of those studies have now been fully peer reviewed and published in a variety of journals (both national and international). These include community trials at this point and not just “lab-based” studies.
Since it sounds like, like me, you’ve been pretty much house-bound since March and will be through next summer, here’s some reading to help pass the time and alleviate your concerns about mask usage.
Peripheral Oxygen Saturation in Older Persons Wearing Nonmedical Face Masks in Community Settings
https://jamanetwork.com/journals/jama/fullarticle/2772655
Effect of Face Masks on Gas Exchange in Healthy Persons and Patients with COPD
https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202007-812RL
Wearing of Cloth of Disposable Surgical Face Masks has no Effect on Vigorous Exercise Performance in Healthy Individuals
https://doi.org/10.3390/ijerph17218110
Face Mask Effects of CO2, Heart Rate, Respiration Rate, and Oxygen Saturation on Instructor Pilots
https://commons.erau.edu/cgi/viewcontent.cgi?article=2554&context=publication
Wearing of Cloth or Disposable Surgical Face Masks has no Effect on Vigorous Exercise Performance of Healthy Individuals
https://www.mdpi.com/1660-4601/17/21/8110
A randomized clinical trial to evaluate the safety, fit, comfort of a novel N95 mask in children
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908682/
(This study was particularly interesting because it was done before COVID — it was done to examine the use of N95 masks for children, like me when I was younger, who suffer debilitating asthma in areas of the world with high pollution and particulate rates.)
What truly is lacking in the research community at this point are studies about people who have psychological issues and mask usage — there are a few studies out there, but they’re mostly from the standpoint of compliance and not about the psychosomatic implications, which is what it sounds like you (and many other people out there) face on a daily basis.
No one *likes* wearing masks, and there are a small number of people who are physically or psychologically unable to be fully compliant for extended periods of time. The good news is that this won’t last for forever, and eventually we’ll be able to get back to a more normal life. For those who can’t or choose not to wear masks at this time, I am hopeful that Walt Disney World will continue to be there for when everyone is able to safely travel again, and we’ll be happy to see one and all in the parks at that time! Just takes a little faith, trust, and pixie dust — and widespread vaccine distribution.
😉
It is so incredibly hurtful to me when people treat mask wearing as a simple thing that’s no big deal. As someone who medically cannot wear a mask for more than a very short time without bad side effects, there is so incredibly little I can do right now. Masks are pretty much controlling my life. When I realized the effect masks had on me last spring, I started to research possible harms of masks. I learned two things: (1) there are no comprehensive studies of adverse effects of mask use and none that I’ve seen which cover current uses such as exercise and use in children, and (2) there is censorship online regarding information on potential harms (try using duckduckgo vs. google to see the difference). The studies showing efficacy are also of low quality scientific evidence, as they are necessarily observational and mechanistic studies with inherent biases. (It would be practically impossible to do high quality research to better answer the question given the lack of equipoise and the fact that it would need to be done at a community level.) Thus, I would request tolerance towards alternate viewpoints and understanding that for many people mask wearing really is quite a lot to ask for a variety of reasons. If it’s not to you, then please count yourself as incredibly lucky.
Clearly masks DO NOT help as shown by hard, historical evidence:
https://rationalground.com/mask-charts/
The virus is now air born and does not require “water droplets” to be transported. The size of the virus is too small for standard 2-layer cloth masks to protect against.
Here in Australia we are Covid free other than cases that are coming in from overseas and as we now have mandatory quarantine in place these cases are not infecting the greater public as they are isolated in a quarantine hotel until they are clear. I am proud of the harsh stand our government has taken and the way our people have embraced the rules. Being in lockdown for as long as we were was very hard and even though our economy went into recession the financial data is showing that this last month we were already onto the road to economic recovery. We have had mandatory mask wearing for some time and now that we have no active cases the mask rules have been relaxed to only being needed at supermarkets and on public transport and if you are unable to safely socially distance. MASKS DO WORK. We are living and I reiterate LIVING proof of it. We have had very few deaths because of the way we as a whole people have embraced the rules. I see the statistics in the rest of the world and it saddens me. So many lives lost because so many people refuse to do such a simple thing as wear a mask. It is not impinging on your rights it is just common sense and common courtesy to your fellow man.
Mr. Cobb, that’s not research.
Ask doctors and nurses if this looks like the flu. I think if people lived a day in their shoes, they would do something as simple as wearing a mask. It’s not a lot to ask to possibly save a life and keep a nurse, doctor, friend or family member from watching someone suffer or die. Even if it doesn’t save a life, is it that big of a sacrifice to wear a mask in the off chance it might save someone? It’s time to start thinking of others instead of me, my rights, the government can’t make me, etc.
Uh – no. No credible science supports any of Mr. Cobb’s assertions. Just the opposite. Sadly, beliefs like those are a large part of why so many hospitals nationwide are packed and some 300,000 are dead.
Who Knows I Just Am Ready For All Of It To Be Over! Sorry If I Sounded Like I Don’t Care I Really Do But Gosh I Think The Flu Is Much Worse Than This As I Have Discovered? To Me This Takes All The Fun Out Of Being At Universal Or Disney! Just Saying!
Any observations at universal?
Well to be totally honest wife and I are AP and DVC Owners and love Disney! But we have cancelled our DCL trips and WDW until this Mask Mandate is over and all the COVID-19 is done! This is not a 3rd world country and this virus is not as bad as the Media is making it and scaring everyone to comply or else! Sorry I wish to wait, this is not even as bad as the FLU virus and Doctors are saying that the masks will not stop the spread of the virus! I have done lots of digging and research! So guess we will just have to dream until all goes back to normal. NO MASKS for US! To each his own and no vaccines! I will not even take a flu vaccine makes me sick. I just do not trust it. Have read to many warning by certified doctors who suggest not to get one. Take other means such a vitiams zinc and so on. I do this already and have never had a problem being around others. Never been sick once! This is just my belief and I will not be controlled! If it take 5 yrs before I come back I guess well that is the way it has to be. Other can and will do what this choose! I respect that!