Face Masks Against COVID-19: An Evidence Review

Abstract

The science around the use of masks by the general public to impede COVID-19 transmission is advancing rapidly. Policymakers need guidance on how masks should be used by the general population to combat the COVID-19 pandemic. Here, we synthesize the relevant literature to inform multiple areas: 1) transmission characteristics of COVID-19, 2) filtering characteristics and efficacy of masks, 3) estimated population impacts of widespread community mask use, and 4) sociological considerations for policies concerning mask-wearing. A primary route of transmission of COVID-19 is likely via small respiratory droplets, and is known to be transmissible from presymptomatic and asymptomatic individuals. Reducing disease spread requires two things: first, limit contacts of infected individuals via physical distancing and contact tracing with appropriate quarantine, and second, reduce the transmission probability per contact by wearing masks in public, among other measures. The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both laboratory and clinical contexts. Public mask wearing is most effective at stopping spread of the virus when compliance is high. The decreased transmissibility could substantially reduce the death toll and economic impact while the cost of the intervention is low. Thus we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.

A Joint Action in Times of Pandemic: The German BioImaging Recommendations for Operating Imaging Core Facilities During the SARS‐Cov‐2 Emergency

“…Therefore, masks help to control the spread of viral infection by reducing the shedding of droplets into the environment from asymptomatic individuals. This is consistent with the experiences of countries that have adopted this strategy, according to the Royal Society DELVE Initiative document (6,9).…”

Public Masking: An Urgent Need to Revise Global Policies to Protect against COVID-19

“…In any case, cloth masks have been adopted as an alternative when surgical masks are limited in supply. 17 Moreover, cloth masks are cheap, washable, easy to make, and can be used by the general population without imposing extra cost to local governments while they are already overwhelmed by lack of resources.…”

COVID ‐19: implementing sustainable low cost physical distancing and enhanced hygiene

“…Policy development and scientific review of the literature on community use of masks is very dynamic at this time. The US Centers for Disease Control and Prevention has made a recent recommendation that cloth masks be used at the community level and many recent reviews have come to divergent conclusions about the usefulness and risks of community mask use . Coherent policy development in this space will rely on transparently articulating the scientific evidence on community mask use with a public conversation on the potential risks in implementation.…”