Updated: June 02, 2020
A new systematic review and meta-analysis article was released on “Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19”. The big take-aways are:
Physical distancing of 1m or more is a good preventive measure to lower viral transmission. Protective measures increase with increasing distance. (TAG recommends 2m or more)
Face mask use can lower reduction in risk of infection
Eye protection is also associated with less infection
TAG does not recommend the use of face shields as a replacement for face masks. We will discuss this further later this week.
the Food Industry
Global Mask Usage and Efficacy.
Since the start of the COVID-19 outbreak (December 2019), government and international health organizations' guidance on the efficacy of masks in reducing the transmission of SARS-CoV-2 (the virus that causes COVID-19) has varied, with some changing their guidance as the outbreak progressed. Additionally, a growing body of research indicates that widespread mask usage can reduce the immediate droplet spread of viral particles from infected individuals and the overall rate of societal transmission.
Several studies have analyzed masks reducing droplet spread, with a 2020 study determining that “surgical masks can efficaciously reduce the emission of influenza virus particles into the environment in respiratory droplets.”
Because transmission trials cannot be ethically conducted on humans, animal models are being used. One such Hong Kong study involving hamsters (which are highly susceptible to SARS-CoV-2) demonstrated a 75% reduction in the rate of transmission when surgical masks were used as a barrier in an experimental setting. While a direct correlation to humans wearing surgical masks in a community setting is not possible based on this research, the research does suggest that masks have barrier effects.
Recent analyses have determined that in countries with cultural norms or government policies that support public mask-wearing, the per-capita coronavirus mortality increased by just 5.4% on average each week, as compared with 48% in remaining countries. (medRxiv)
An April 2020 meta-analysis of 19 randomized controlled trials of mask-usage determined that “community mask use by well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic. The studies of masks as source control also suggest a benefit and may be important during the COVID-19 pandemic in universal community face mask use as well as in health care settings.”
A Global View. While stating that “There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or attendees of mass gatherings may be beneficial as a preventive measure,” the World Health Organization (WHO) added, “However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.”
In Europe, individual countries and states or regions within countries may set policies and rules regarding community mask usage. The European Centre for Disease Control and Prevention (ECDC) has stated that face masks may reduce COVID-19 spread by minimizing the excretion of respiratory droplets infect, by asymptomatic persons. However, because it is not known how much the use of masks can contribute to a decrease in transmission, face mask use “should be considered only as a complementary measure and not as a replacement for established preventive measures, for example, physical distancing, respiratory etiquette, meticulous hand hygiene, and avoiding touching the face, nose, eyes, and mouth.” Thus, as of mid-April, countries in Europe have adopted varying recommendations regarding community mask usage, with some governments enforcing use while others have only regional or specific use recommendations.
In the US, the CDC changed its initial stance. Initially, CDC stated masks were not needed. Then, they provided guidance for voluntary mask usage. Now, CDC recommends the use of masks or face coverings in public. In late May, CDC additionally recommended that, “Employees should wear a cloth face covering to cover their nose and mouth in all areas of the business”, including offices. The CDC’s new recommendation contains the wearer’s respiratory droplets and protects co-workers and members of the general public. While “[c]loth face coverings are not considered personal protective equipment,” CDC stated, “[t]hey may prevent workers, including those who don’t know they have the virus, from spreading it to others but may not protect the wearers from exposure to the virus that causes COVID-19. […] Wearing a cloth face covering, however, does not replace the need to practice social distancing.”
Some countries, particularly those in Asia, have a history of mask usage, with masks typically worn by symptomatic people as a societal courtesy to reduce the spread of transmission. These countries have seen the COVID-19 outbreak grow more slowly or come under control due to a variety of control measures, including more widespread mask usage in public. (Journal of Infection)
As of June 02, 2020 (11:11 ET), there are over 6,306,000 cases (>376,000 deaths) worldwide.
Due to the increasing number of cases in the United States, TAG will move from reporting counts per country to focus on the United States, please see here for the data. For further information regarding worldwide numbers, please refer to John Hopkin University’s aggregate map.
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