Back

Clinician Article

---

Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings : A Living Rapid Review.

---

---

• Chou R
• Dana T
• Jungbauer R
• Weeks C
• McDonagh MS

Read abstract Read full text

---

---

---

Clinical Comments

Emergency Medicine

Wear your mask!

Emergency Medicine

In the midst of a global pandemic, the extraordinary efforts to find and study strategies to prevent or treat COVID-19 have significantly challenged traditional journal editorial boards to provide meaningful peer-review of submitted research. One side effect has been the perception by some medical professionals that the tipping point of "peer-review" in favor of social media has been reached since podcasts and blog postings occur much more quickly than tedious editorial reviews behind "black curtains". Wearing masks is a prototypical example of this COVID-19 social media backlash - see http://thesgem.com/2020/03/sgem286-behind-the-mask-does-it-need-to-be-an-n95-mask/ AND http://thesgem.com/2020/05/sgem-xtra-mask4all-debate/. This living review returns rigorous research methods and quality peer-review to counter increasingly prevalent perceptions that social media has become the defacto source for trusted medical "truth".

General Internal Medicine-Primary Care(US)

Like all PPE, wearing a mask is a variable process that is much more streamlined in health care settings than outside hospitals and clinics. This is a complicated heterogeneous topic of study and my recommendations to mask up, wash your hands, and keep your distance in the time of COVID doesn't change on the basis of this study.

Hospital Doctor/Hospitalists

This is a timely article with good methods that directly addresses many concerns and questions raised by patients, colleagues, and friends.

Infectious Disease

It must be understood by all readers that this is NOT a COVID-19 paper and should NOT be misunderstood to suggest that routine masking by the public when in close proximity to others is not recommended to prevent the spread of COVID-19. That is not addressed by this paper.

Infectious Disease

This is relevant but I’m not sure it's helpful.

Infectious Disease

Very good methodology but not enough evidence to make a definitive decision.

Intensivist/Critical Care

Please disseminate this widely and immediately. With the politicization of mask-wearing, all evidence supporting wearing masks must be clearly and relentlessly disseminated to counter false information, such as "You can get CO2 poisoning from wearing a mask" "Your oxygen levels can go down by 60% if you wear a mask."!

Intensivist/Critical Care

This is a difficult topic to report on because the effectiveness of masks is difficult to measure and quantify. This is, however, a good addition to the knowledge base and is a living document, which means that it is subject to change. Changing guidelines need to be viewed in that context as more data emerges.

Internal Medicine

I take this SR on mask effectiveness to be at odds with the conclusions of the Lancet SR on PPE published recently by Chu et al, and funded by WHO.

Occupational and Environmental Health

Despite the fact that many OM physicians are likely tracking articles on mask use, the inclusion of an evidence map was a particularly useful way to quickly review the overall data. For that reason, this is a useful review.

Pediatric Neonatology

A meta-analysis that is based on a poor studies. Very few RCTs and they indicate that in those mask compliance was limited. This is a critical question, but it`s hard to do an RCT of mask vs no-masks for HCW in a high-risk situation (e.g., a COVID-19 unit). Thus, all this article does is illuminate our incomplete data. I still recommend wearing a mask.

Pediatrics (General)

Good review of studies of masks to prevent COVID and other respiratory infections.

Public Health

Covid-19 is spread primarily through contact with large respiratory droplets, and possibly through finer respiratory aerosols. Several types of face masks are available. Disposable N95 face masks are fitted and have been tested to show very high levels of blocking small airborne particles including aerosols. Surgical and medical masks are loose fitting and create a physical barrier to block large particles. Cloth masks are non-medical face coverings that vary in levels of fluid and in filtration efficiency and fluid resistance. This review is of 39 reports (18 were RCTs). As would be expected, study quality varied. Mask comfort was not specifically evaluated. Clearly, all masks are uncomfortable and are frequently removed by users (dangling from their necks). Nonetheless, the article is of interest and does remind readers of the variable mask efficiency in blocking larger airborne respiratory particles.