Following the development of a cluster of COVID-19 cases in late December 2020 in Sydney’s northern beaches region, the NSW government introduced a requirement for mandatory mask use on all public transport, retail shops, cinemas and theatres from midnight on January 2, 2012. Fines ranged from $200 for individuals, $1000 for small businesses and $5000 for corporations.
With the ebbing of cases, this requirement was narrowed a few weeks later, with masks remaining mandatory on public transport and in close-contact occupational settings like hair salons, barbers, massage parlours and nail bars.
Throughout 2020, the government had resisted extensive and often impassioned calls from many public health experts, the state political opposition and many members of the public for masks use to be mandatory in public indoor settings and public transport.
Well before masks were mandated, on July 28, 2020 I spent 90 minutes on the platform of my local railway station between 7.15am-8.45am observing the prevalence of mask use. I used two mechanical thumb tally clickers to count both use and non-use on people on the platforms both waiting to board and alighting. With mask use being voluntary, I found 54 (7.2%) wearing masks and 695 (92.8%) not.
On February 3, 2021 after 17 consecutive days in NSW without a locally acquired COVID case and when the law still required those aged 12 years and older to wear masks on platforms and in trains, I repeated these observations for two and a half hours between 7.00am-9.30am on a platform of Town Hall station, one of Sydney’s busiest stations located in the downtown central shopping district. From an unobtrusive seated observation point, I counted all use and non-use in those on three clearly visible railway platforms, those visible in the stopped carriages immediately adjacent to my observation point and on two stairwells leading onto the platforms. I did not count any children in school uniform as discerning their age was likely to be unreliable.
Across the two hours, I counted 2758 people with masks (96.6%) and 96 without (3.4%).
The Council on Foreign Relations reported in August 2020 that “more than half” the world’s nations had mandated either total public space mask use or use in certain areas or circumstances. In view of this, I searched PubMed and remarkably, was unable to find a single observational report of mask use prevalence for any nation or region, post the advent COVID-19, with usage data reports being based on self-report (for example here). Given the volatility of the debate about mandatory mask use in some nations, social desirability bias is likely to cause reliability problems in self-reports of mask use.
These “citizen epidemiological” easily conducted and unambiguous observations of mask use are possibly the first time the impact of legislation on mask use has been reported by actual counting of mask use. Masks are accessible, cheap and most critically, a vital component on COVID-19 risk reduction recommended by the World Health Organization. The data in this small observational study should encourage those advocating for masks to be made mandatory in relevant crowded circumstances.
Having traveled often on public transport during January, the counts I tallied are consonant with my experiences of seeing almost everyone masked during this time. Future research could examine whether my tallies are also occurring across the greater Sydney rail network at different times and days of the week.
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