The science around the use of masks by the public to impede COVID-19 transmission is advancing rapidly. Population impact, transmission characteristics, source control, wearer protection, sociological considerations, and implementation considerations.
A primary route of transmission of COVID-19 is via respiratory particles, and it is known to be transmissible from presymptomatic, paucisymptomatic, and asymptomatic individuals.
A surgical mask (medical mask) is a loose-fitting disposable mask that protects the wearer's nose and mouth from contact with droplets, splashes and sprays that may contain germs. A surgical mask also filters out large particles in the air. Surgical masks may protect others by reducing exposure to the saliva and respiratory secretions of the mask wearer.
Reducing disease spread requires two things:
- limiting contacts of infected individuals via physical distancing;
- other measures and reducing the transmission probability per contact.
The preponderance of evidence indicates that mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts. Public mask wearing is most effective at reducing spread of the virus when compliance is high. Given the current shortages of medical masks, we recommend the adoption of public surgical mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies.
Because many respiratory particles become smaller due to evaporation, we recommend increasing focus on a previously overlooked aspect of mask usage: mask wearing by infectious people with benefits at the population level, rather than only mask wearing by susceptible people, such as health care workers, with focus on individual outcomes. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.
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Inappropriate use of masks and respirators can be associated with risk:
It is plausible, but unproven, that their use may give a false sense of security and lead to neglect of more important measures. These include, physical distancing, hand and respiratory hygiene. Touching the mask during use or when removing it can contaminate the hands or vice versa. Reuse of masks or respirators compounds the risks Discard masks after use unless specified as reusable.; If reusable, masks and respirators should be reprocessed according to manufactures instructions. Masks and respirators are less effective if they become damp or damaged. They should be used in line with manufacturers guidance. This also applies in clinical environments, where they should be used in accordance with established clinical protocols.