Longitudinal Participatory Surveillance Highlights Association Between Mask-Wearing and Lower COVID-19 Risk — United States, 2020

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? Numerous ecological and laboratory studies suggest face masks are an effective non-pharmaceutical intervention for reducing the spread of coronavirus disease 2019 (COVID-19), but cannot otherwise assess individual-level effects. WHAT IS ADDED BY THIS REPORT? Using a prospective cohort of individuals enrolled in a participatory, syndromic surveillance tool prior to the first case of COVID-19 in the United States, we present a novel longitudinal assessment of the effectiveness of face masks. WHAT ARE THE PUBLIC HEALTH IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? Our analysis demonstrates an association between self-reported mask-wearing behavior and lower individual risk of syndromic COVID-19-like illness while adjusting for confounders at the individual level. Our results also highlight the dual utility of participatory syndromic surveillance systems as both disease trend monitors and tools that can aid in understanding the effectiveness of personal protective measures.