Rational use of face masks in the COVID-19 pandemic

Feng, Luzhao; Shen, Chen; Xia, Nan; Song, Wei; Fan, Mengzhen; Cowling, Benjamin J.

doi:10.1016/s2213-2600(20)30134-x

Cited by 1,200 publications

(1,185 citation statements)

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“…Perhaps, this led to significantly higher face-mask use by second-survey respondents, regardless of the presence of symptoms. This is an interesting and important phenomenon due to the divided scientific opinion on protective effects of usual face masks 19,28 , coupled with their scarce availability. Efforts are needed to impart an unbiased and clear guidelines on the use of face masks and their types to allay the fears, confusions and sense of inferiority (for people with no access to the masks) among general population.…”

Section: Discussionmentioning

confidence: 99%

A longitudinal study on the mental health of general population during the COVID-19 epidemic in China

Wang

Pan

Wan

et al. 2020

Brain, Behavior, and Immunity

2,136

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2,057

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In addition to being a public physical health emergency, Coronavirus disease 2019 affected global mental health, as evidenced by panic-buying worldwide as cases soared.Little is known about changes in levels of psychological impact, stress, anxiety and depression during this pandemic. This longitudinal study surveyed the general population twice -during the initial outbreak, and the epidemic's peak four weeks later, surveying demographics, symptoms, knowledge, concerns, and precautionary measures against COVID-19. There were 1738 respondents from 190 Chinese cities (1210 first-survey respondents, 861 second-survey respondents; 333 respondents participated in both). Psychological impact and mental health status were assessed by the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21), respectively. IES-R measures PTSD symptoms in survivorship after an event. DASS -21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. This study found that there was a statistically significant longitudinal reduction in mean IES-R scores (from 32.98 to 30.76, p<0.01) after 4 weeks. Nevertheless, the mean IES-R score of the first-and secondsurvey respondents were above the cut-off scores (>24) for PTSD symptoms, suggesting that the reduction in scores was not clinically significant. During the initial evaluation, moderateto-severe stress, anxiety and depression were noted in 8.1%, 28.8% and 16.5%, respectively and there were no significant longitudinal changes in stress, anxiety and depression levels (p>0.05). Protective factors included high level of confidence in doctors, perceived survival likelihood and low risk of contracting COVID-19, satisfaction with health information, personal precautionary measures. As countries around the world brace for an escalation in cases, Governments should focus on effective methods of disseminating unbiased COVID-19 knowledge, teaching correct containment methods, ensuring availability of essential services/commodities, and providing sufficient financial support. 4

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Section: Discussionmentioning

confidence: 99%

A longitudinal study on the mental health of general population during the COVID-19 epidemic in China

Wang

Pan

Wan

et al. 2020

Brain, Behavior, and Immunity

2,136

233

2,057

View full text Add to dashboard Cite

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“…Individual behaviour is crucial in controlling the spread of COVID-19. In early March 2020 Anderson et al (2020) described that in Western democracies personal action, rather than government action, might be the most important issue comprising of early self-isolation (within one day from symptom onset), seeking medical advice remotely unless symptoms are severe, and physical distancing. The same authors described the importance of the application of a combination of mitigation measures such as physical distancing in combination with the ban of mass gatherings, good diagnostic facilities and remotely accessed health advice, together with specialised treatment for people with severe COVID-19 infections.…”

Section: Socio-economic Restrictionsmentioning

confidence: 99%

“…Niu et al (2020) reported that transmission by people with mild or no symptoms can undermine the effectiveness of the isolation strategy because of reduced likelihood of isolating all cases and tracing all contacts. The identification and testing of potential cases needs therefore to be as extensive as is permitted by healthcare and diagnostic testing capacity-including the identification, testing, and isolation of suspected cases with no or mild disease (e.g., influenza-like illness).…”

Section: Socio-economic Restrictionsmentioning

confidence: 99%

“…International support mechanism; Avoiding an uncontrollable world pandemic requires the implementation of a global mechanism, built and empowered to act at an unprecedented speed (Niud, Y. and Xu, F., 2020). As Hellewell et al (2020) described, the time window of early response is potentially extremely short, signifying that, once the number of initial cases increases to a few tenths (40 cases seems to be a critical number), the probability of failure to control is high, i.e. at 80% even if 80% of contacts are traced and isolated.…”

Section: Socio-economic Restrictionsmentioning

confidence: 99%

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Initial impacts of global risk mitigation measures taken during the combatting of the COVID-19 pandemic

et al. 2020

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Disposable N95 Masks Pass Qualitative Fit-Test But Have Decreased Filtration Efficiency after Cobalt-60 Gamma Irradiation

Cramer

Tian

et al. 2020

Preprint

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The current COVID-19 pandemic has led to a dramatic shortage of masks and other personal protective equipment (PPE) in hospitals around the globe [1]. One component of PPE that is in particular demand are disposable N95 face masks. To alleviate this, many methods of N95 mask sterilization have been studied and proposed with the hope of being able to safely reuse masks [2]. Two major considerations must be made when re-sterilizing masks: (1) the sterilization method effectively kills pathogens, penetrating into the fibers of the mask, and (2) the method does not degrade the operational integrity of the N95 filters.We studied Cobalt-60 ( 60 Co) gamma irradiation as a method of effective sterilization without inducing mask degradation. Significant literature exists supporting the use of gamma radiation as a sterilization method, with viral inactivation of SARS-CoV reported at doses of at most 10 kGy [3], with other studies supporting 5 kGy for many types of viruses [4]. However, concerns have been raised about the radiation damaging the fiber material within the mask, specifically by causing cross-linking of polymers, leading to cracking and degradation during fitting and/or deployment [5,6].A set of 3M 8210 and 9105 masks were irradiated using MIT's 60 Co irradiator. Three masks of each type received 0 kiloGray (kGy), 10 kGy and 50 kGy of approximately 1.3 MeV gamma radiation from the circular cobalt sources, at a dose rate of 2.2kGy per hour.Following this sterilization procedure, the irradiated masks passed a OSHA Gerson Qualitative Fit Test QLFT 50 (saccharin apparatus) [7] when donned correctly, performed at the Brigham and Women's Hospital, in a blinded study repeated in triplicate. However, the masks' filtration of 0.3 µm particles was significantly degraded, even at 10 kGy.These results suggest against gamma, and possibly all ionizing radiation, as a method of disposable N95 sterilization. Even more importantly, they argue against using the qualitative fit test alone to assess mask integrity.

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Rational use of face masks in the COVID-19 pandemic

Cited by 1,200 publications

References 0 publications

A longitudinal study on the mental health of general population during the COVID-19 epidemic in China

A longitudinal study on the mental health of general population during the COVID-19 epidemic in China

Initial impacts of global risk mitigation measures taken during the combatting of the COVID-19 pandemic

Disposable N95 Masks Pass Qualitative Fit-Test But Have Decreased Filtration Efficiency after Cobalt-60 Gamma Irradiation

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