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Coronavirus COVID-19

Fact check: Masks and vaccines are effective at combating COVID-19 spread

The claim: COVID-19 case numbers keep increasing, unaffected by vaccines and mask wearing

Coronavirus cases may be dropping all over the USA – down by almost 75% since peaking on Jan. 11 – but one Facebook post claims that is not the case. 

"Now you need 3 shots ... 2 masks ... The numbers just keep increasing because these interventions are simply not working," Melissa Floyd posted Feb. 16.

Accompanying her claim is a screenshot of philanthropist Bill Gates, co-founder of Microsoft, and text that there is "growing concern" the two-dose vaccines are ineffective against new coronavirus strains and that Gates suggested a third shot might be the ticket. 

Since the start of the pandemic, Floyd, a vaccination opponent, has tried to cast doubts on mask wearing, diagnostic testing and COVID-19 trends

Beneath the post, approval for her claims is overwhelming, as indicated by more than 1,000 interactions, nearly 600 shares and more than 290 comments. 

"Because all of this is not about controlling a virus, but controlling a populace," commented one Facebook user.

"If a vaccine isn't effective against a particular strain, how will two more of the same help?" asks another. 

USA TODAY was unable to reach Floyd for comment. 

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Masks stop COVID-19 spread

Floyd is not wrong about two masks: In mid-February, the U.S. Centers for Disease Control and Prevention released data recommending double masking for even better protection against COVID-19.

The claim that masks have not done their part to offset the virus does not align with research. 

A University of Iowa study, published in the journal Health Affairs in June, analyzed how mask mandates in 15 states and the District of Columbia affected COVID-19 growth rates. It found that there was a "greater decline in daily COVID-19 growth rates after issuing these mandates compared with states that did not issue mandates." This effect was more noticeable over time: In the first five days after a mandate, growth slowed by 0.9%; after three weeks, it was down by 2 percentage points.  

Although these numbers may seem small, authors Wei Lyu and George Wehby, professors at the University of Iowa College of Public Health, said the estimates "represent nearly 16 percent to 19 percent of the effects of other social distancing measures" such as sheltering in place, closures of restaurants, bars and other areas that attract large gatherings. 

A similar study out of Germany published in December in the Proceedings of the National Academy of Sciences found that in the city of Jena, first in the country to mandate face masks last April, early introduction of mask wearing "resulted in a drop in newly registered COVID-19 cases of around 75% after 20 (days)."

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In other German cities that initiated mask mandates weeks after Jena, the effect was slightly lower – about 47% reduction in the daily infection growth rate. The researchers noted the smaller impact was probably the result of social distancing and other public health measures implemented before mask mandates.

Mask wearing was also found to be helpful in reducing COVID-19-associated hospitalizations. The report from the CDC, looking at data collected from March to October 2020, discovered that in states that had statewide mask mandates, hospitalization among adults ages 40-64 declined by 2.9% within the first two weeks after a mandate.

After three weeks or more, the hospitalization growth rate declined by 5.6% among both the 40-64 age group and and those ages 18-39. 

There was less of decline observed among those 65 and older, an age group at highest risk for severe illness, but this could have been because older adults are more likely to mask up compared with young adults, thus having less of an effect overall on the COVID-19 growth trend.

Data shows vaccines work 

Though it's hard to parse out how much of the decrease in COVID-19 cases is directly related to vaccines – adherence to countermeasures such as social distancing and mask wearing, acquired immunity, possible seasonality of the virus being other contributing factors – new data suggests their contribution is not trivial. 

Connecticut, where vaccinations in nursing homes started Jan. 8 and most residents were fully vaccinated by early February, saw a nearly 70% decrease in coronavirus-related deaths over the course of four weeks, according to the Hartford Courant

New cases, which numbered 483 by the beginning of January, dipped to 101 by Feb. 2, an almost 80% decrease. Among nursing home staff vaccinated alongside residents, new cases dropped by 77%. 

This downward trend is particularly pronounced compared with Connecticut's statewide numbers, which are also declining, just not as steeply.  

"We're far enough into the nursing home vaccination program where clearly there's significant benefit coming through," Josh Geballe, Connecticut's chief operating officer, told the Courant in February. "As we're now well beyond two weeks after many (residents) have gotten certainly their first dose and many of them their second dose as well, clearly there's contributions and protections coming in from the vaccines at this point."

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A team of researchers found COVID-19 growth rates declined among more than 31,000 health care workers and long-term care residents weeks after receiving their first vaccine dose. Conversely, growth rates continued to climb for their unvaccinated counterparts.

The study, which surveyed more than 60,000 health records in the Mayo Clinic's health system spanning multiple states, found hospitalization rates among COVID-19 patients who had been vaccinated before infection were lower compared with unvaccinated patients. The researchers noted that "ICU admission and mortality rates were not significantly lower" in the vaccinated group because of an "inadequate number of patients with these outcomes in either group to date in our study." 

More evidence for vaccines cutting hospitalization rates comes from a Scotland-based study, which found Pfizer-BioNTech's vaccine reduced hospital admissions almost 85% four weeks after vaccination and Oxford-AstraZeneca's vaccine up to 94%, according to The Associated Press.

These preliminary findings, posted on The Lancet's preprint site on Feb. 19 and yet to undergo peer review, compared individuals who received one vaccine dose with those who had not from Dec. 8 to Feb. 15, a period when at least 21% of Scotland's population had been vaccinated. 

"These results are very encouraging and have given us great reasons to be optimistic for the future," Dr. Aziz Sheikh, director of the University of Edinburgh's Usher Institute, told the AP. "We now have national evidence – across an entire country – that vaccination provides protection against COVID-19 hospitalizations."

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How variants affect vaccination

Viruses mutate all the time, so it came as no surprise to scientists that COVID-19 would, too. Several strains have emerged since the start of the pandemic, three of which have raised serious concern: the U.K., or B.1.1.7, variant; the South Africa, or B.1.351, variant; and the Brazil, or P.1, variant. 

These three do not appear to affect disease severity, but they contain mutations in their spike protein – the surface proteins on the virus that attach to human cells – that may allow for quick spread, avoid immune and diagnostic detection and decrease the effectiveness of therapies such as monoclonal antibodies. 

According to the CDC, the number of COVID-19 cases caused by these variants is low, although the U.K. variant has been identified in more than 3,000 cases across the USA. Modeling data from the University of Washington's Institute for Health Metrics and Evaluation suggests mutated strains may drive a surge in COVID-19 cases and deaths in the coming warmer months.  

Does all this mean the global vaccination effort is a bust? Not necessarily. 

Gates suggested, as indicated by the Facebook post, three instead of two vaccine doses may be needed to ensure immunity. 

"The discussion now is do we just need to get a super high coverage of the current vaccine, or do we need a third dose that's just the same, or do we need a modified vaccine?" Gates told CBS Evening News' Norah O'Donnell in February.

A total of 20 million doses of Johnson & Johnson's COVID-19 vaccine are to be released by the end of March.

The rationale behind a third dose is rooted in the body's immune system: The more vaccine doses, the greater the antibody response and hopefully the better protection against the variants.

"We believe that the third dose at six months (after) the first dose – is what we're going to try right now – will raise the antibody response 10- to 20-fold," Pfizer CEO Albert Bourla told NBC News' Lester Holt on Feb. 25. 

Promising findings from a study published March 8 in the New England Journal of Medicine suggest Pfizer's two-dose vaccine may do the trick. It found that the antibody response to the U.K. and Brazil variants was nearly the same compared with the standard virus. The vaccine provoked a response to the South African variant, but not as strong.     

For Moderna's COVID-19 vaccine, a study published March 8 in Nature found that although the antibody response was unchanged against the U.K. variant, it fell 12.4-fold with the South Africa variant compared with the original virus.

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Moderna, like Pfizer, is testing a third dose and creating a booster shot specifically targeting the South Africa variant made with the same messenger RNA technology as the original COVID-19 vaccine. 

Johnson & Johnson's  single-dose vaccine, which uses an inactive common cold virus to carry the genetic instructions for COVID-19's spike protein instead of synthetic mRNA, is not as potent as its Pfizer and Moderna counterparts – a 72% efficacy rate in preventing moderate disease, 86% effective against severe disease – but it has had the benefit of running trials while some of the variants circulated. 

The U.S. Food and Drug Administration's review of J&J's data for its emergency use authorization found the vaccine worked against all variants but was 66% effective in South America and 57% effective in South Africa.

Our ruling: Partly false

We rate the claim that COVID-19 cases continue to rise because masks and vaccines are not working PARTLY FALSE, based on our research. Bill Gates suggested a third vaccine dose may be needed to protect against coronavirus variants – and testing is being done on that. But COVID-19 cases are on the decline. An abundance of emerging data has shown masks and vaccines have helped reduce the virus's growth in community spread and in hospitalizations. Claims to the contrary are false.

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