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Observational studies, randomised controlled trials (RCTs), and mask filtration testing have been used to evaluate the effectiveness of masks. Most of the evidence for the efficacy of masks against COVID comes from observational studies.[1] One paper did not consider RCTs a "gold standard" of evidence, since most effective public health policies had never been evaluated through an RCT, but that, overall, there was "robust data" support the use of face masks to reduce community transmission of COVID.[2] Another review pointed out the undue weight being placed on RCTs, and that non-RCT evidence cannot be ignored.[3]

Various reviews on RCTs find that masking reduces the rate of respiratory infection.[4][5][6][7][8] A 2022 systematic review and meta-analysis of randomized controlled trials on face mask use in PLOS One showed that with 95% confidence, masks reduced respiratory infection incidence by between 3% and 19% in a community setting.[9] However, one review found 70% of RCTs it studied had a high rate of bias, and could not support a masking policies based on the trials studied.[10] Concerning the precedent of mask efficacy in limiting transmission of respiratory viral illnesses other than COVID, a clinical trial meta-analysis in May 2021 showed no significant evidence of efficacy. The authors noted the evidence to be poor quality and subject to confounding factors like consistent mask usage adherence.[11]

A review from the Cochrane Collaboration, updated in 2023, claimed that masking had little effect on the spread of viral illness.[12] This Cochrane review was criticized by a communication published in JAMA.[13]

Observational studies, including four reviewed in a 2020 Lancet meta-analysis, have found that masks offer statistically significant protection from infection, although the level of protection varies according to the mask type and setting.[14]

In terms of filtration, one paper noted that both N95 and surgical outperform cloth masks, which the general public has used based on their greater availability during mask supply shortages.[15] Cloth and fabric masks have been evaluated as protecting wearers from COVID-19, with some variability,[16] such as fabric type, layer count, and mask fit.[17] Evaluation of cloth mask efficacy is further complicated by the wide variation in fabric and fit, among other factors.[15] Protection efficiency can also be evaluated by generated aerosol. In a paper evaluating the efficacy of various N95, surgical and cloth masks, the tested N95 respirator (a 3M 8210) performed the best in filtration in both inhalation and exhalation, while the surgical (from BYD Care) and cloth masks (Forever Family and Maskfit Proshield) performed similarly in filtration, with cloth masks performing worse than surgical masks in SPS30 readings, and double-masking providing little benefit. The tested N95, when not fitted, performed as well as a surgical or cloth mask, depending on the exercise.[18]

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Slightly older:

Sidenote: https://www.nature.com/articles/nm0310-248b Note to self: Two noted sources, already on Wikipedia are criticizing source C. Namely:[2] and [3] (which cites a preprint)

See also (ironically OR)

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References

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  1. ^ "COVID-19: examining the effectiveness of non-pharmaceutical interventions" (PDF). The Royal Society.
  2. ^ a b Cash-Goldwasser, Shama; Reingold, Arthur L.; Luby, Stephen P.; Jackson, Lisa A.; Frieden, Thomas R. (2023-10-31). "Masks During Pandemics Caused by Respiratory Pathogens—Evidence and Implications for Action". JAMA Network Open. 6 (10): e2339443. doi:10.1001/jamanetworkopen.2023.39443. ISSN 2574-3805. PMID 37906187. S2CID 264673924.
  3. ^ a b Greenhalgh, Trisha; MacIntyre, C. Raina; Baker, Michael G.; Bhattacharjee, Shovon; Chughtai, Abrar A.; Fisman, David; Kunasekaran, Mohana; Kvalsvig, Amanda; Lupton, Deborah; Oliver, Matt; Tawfiq, Essa; Ungrin, Mark; Vipond, Joe (2024). "Masks and respirators for prevention of respiratory infections: A state of the science review". Clinical Microbiology Reviews. 37 (2): e0012423. doi:10.1128/cmr.00124-23. hdl:1959.4/102268. PMC 11326136. PMID 38775460.
  4. ^ Cite error: The named reference royalsoc was invoked but never defined (see the help page).
  5. ^ Cite error: The named reference Talic was invoked but never defined (see the help page).
  6. ^ "Science Brief: Community Use of Masks to Control the Spread of SARS-CoV-2". CDC. 11 February 2020. Experimental and epidemiologic data support community masking to reduce the spread of SARS-CoV-2, including alpha and delta variants, among adults and children. [...] Mask use has been found to be safe and is not associated with clinically significant impacts on respiration or gas exchange under most circumstances, except for intense exercise. The limited available data indicate no clear evidence that masking impairs emotional or language development in children. [I]n combination with other contextual cues, masks are unlikely to produce serious impairments of children's social interactions. A study of 2-year-old children concluded that they were able to recognize familiar words presented without a mask and when hearing words through opaque masks. Among children with autism spectrum disorders (ASD), interventions including positive reinforcement and coaching caregivers to teach mask-wearing have improved participants' ability to wear a face mask. These findings suggest that even children who may have difficulty wearing a mask can do so effectively through targeted interventions.
  7. ^ Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J (July 2021). "COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection". BMC Infect Dis (Review). 21 (1): 710. doi:10.1186/s12879-021-06357-4. PMC 8314268. PMID 34315427.
  8. ^ Ford N, Holmer HK, Chou R, Villeneuve PJ, Baller A, Van Kerkhove M, Allegranzi B (August 2021). "Mask use in community settings in the context of COVID-19: A systematic review of ecological data". eClinicalMedicine. 38: 101024. doi:10.1016/j.eclinm.2021.101024. PMC 8287197. PMID 34308320.
  9. ^ Ollila HM, Partinen M, Koskela J, Borghi J, Savolainen R, Rotkirch A, Laine LT (1 December 2022). "Face masks to prevent transmission of respiratory infections: Systematic review and meta-analysis of randomized controlled trials on face mask use". PLOS ONE. 17 (12): e0271517. Bibcode:2022PLoSO..1771517O. doi:10.1371/journal.pone.0271517. PMC 9714953. PMID 36454947.
  10. ^ Sandlund J, Duriseti R, Ladhani SN, Stuart K, Noble J, Høeg TB (December 2023). "Child mask mandates for COVID-19: a systematic review". Arch Dis Child (Systematic review). 109 (3): e2. doi:10.1136/archdischild-2023-326215. PMC 10894839. PMID 38050026.
  11. ^ Nanda A, Hung I, Kwong A, Man VC, Roy P, Davies L, Douek M (May 2021). "Efficacy of surgical masks or cloth masks in the prevention of viral transmission: Systematic review, meta-analysis, and proposal for future trial". Journal of Evidence-Based Medicine. 14 (2): 97–111. doi:10.1111/jebm.12424. PMC 8014575. PMID 33565274.
  12. ^ Jefferson T, Dooley L, Ferroni E, Al-Ansary LA, van Driel ML, Bawazeer GA, Jones MA, Hoffmann TC, Clark J, Beller EM, Glasziou PP, Conly JM (January 2023). "Physical interventions to interrupt or reduce the spread of respiratory viruses". The Cochrane Database of Systematic Reviews. 1 (1): CD006207. doi:10.1002/14651858.CD006207.pub. PMC 9885521. PMID 36715243.Verification note: As of 9 November 2024, the Aelami 2015 PubMed link does not link to the correct paper. Archive Today
  13. ^ "The effectiveness of the intervention might vary greatly depending on the type of mask, masking behavior in the nonintervention group, force of infection in the community, whether the intervention is designed for individual protection or for source control, uptake of the intervention, and characteristics of the circulating pathogen. If any of these components vary among studies, different interventions are being tested. Lumping studies together because they include a mask can yield invalid conclusions and conceal important findings of individual studies. The results of a Cochrane review of RCTs and cluster RCTs on interventions to reduce the spread of respiratory viruses14 exemplified this pitfall." Cash-Goldwasser, Shama; Reingold, Arthur L.; Luby, Stephen P.; Jackson, Lisa A.; Frieden, Thomas R. (2023-10-31). "Masks During Pandemics Caused by Respiratory Pathogens—Evidence and Implications for Action". JAMA Network Open. 6 (10): e2339443. doi:10.1001/jamanetworkopen.2023.39443. ISSN 2574-3805. PMID 37906187. S2CID 264673924.
  14. ^ Cite error: The named reference lan-chu was invoked but never defined (see the help page).
  15. ^ a b Cite error: The named reference Ju was invoked but never defined (see the help page).
  16. ^ Ataei M, Shirazi FM, Nakhaee S, Abdollahi M, Mehrpour O (October 2021). "Assessment of cloth masks ability to limit Covid-19 particles spread: a systematic review". Environmental Science and Pollution Research International. 29 (2): 1645–1676. doi:10.1007/s11356-021-16847-2. PMC 8541808. PMID 34689269.
  17. ^ Sharma SK, Mishra M, Mudgal SK (2020). "Efficacy of cloth face mask in prevention of novel coronavirus infection transmission: A systematic review and meta-analysis". Journal of Education and Health Promotion. 9: 192. doi:10.4103/jehp.jehp_533_20. PMC 7497125. PMID 33015206.
  18. ^ Cite error: The named reference cloth_v_surgical was invoked but never defined (see the help page).
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