How efficient are facial masks against COVID-19? Evaluating the mask use of various communities one year into the pandemic (original) (raw)

2021, TURKISH JOURNAL OF MEDICAL SCIENCES

Introduction 1.1. Properties of face masks Face mask is a term used for a nonmedical/medical face mask or a respirator which is worn over the mouth and nose to prevent the splash and inhalation or release of infectious respiratory droplets, or for harmful substances. Types of face masks were demonstrated in Figure 1a as elastomeric respirators, in Figure 1b as N95 filtering facepiece, in Figure 1c as surgical mask, and in Figure 1d as cloth mask. Infectious respiratory droplets can be generated by breathing, speaking, coughing, or sneezing [1]. Masks can be used for source control or for the protection of the wearer. Source control is when it is used to prevent the spread of infectious respiratory particles like droplets or aerosols, and it is for the protection of others in the environment. Nonmedical face masks (e.g., cloth masks) used in community include many self-made forms or commercial masks, including masks made of disposable materials or textile which can be washed and reused. Because of not being standardized, they are not compatible for the use in healthcare facilities by healthcare workers (HCWs). The main three categories of masks are summarized in Table 1. Medical masks or surgical masks are loose-fitting disposable medical devices which can protect the users from large respiratory droplets or splashes produced by sneezing or coughing as physical barrier but not aerosols and airborne infection [2,3]. They vary in thickness and permeability. A medical face mask can also be used as source control to stop the spread of large respiratory droplets from the person wearing them [4]. Requirements for medical face masks, including the duration of use, are defined in the European Committee for Standardization's published standards. The EN 14683 standard, a European standard, describes the requirements and test methods for medical face masks. This standard has also been published Abstract: Face masks are devices worn over the mouth and nose to protect against splashes, infectious respiratory droplets, or aerosols generated during breathing or coughing according to their filtering capacity. Medical masks, respirators, or cloth masks have been used for source control and for the protection of the exposed. After the first case on March 11, 2020, in Turkey, National COVID-19 Scientific Advisory Board published various contents for the correct use of masks. Medical face masks have been used in healthcare settings for both source control and potential personal protection before the COVID-19 pandemic. Adverse events associated with using masks are very sparse and mainly associated with tight-fitting respirators or dermatitis due to prolonged use and should not be a reason for refusal to use. Studies suggest the use of masks mainly in the healthcare facilities but also in the community for source control of people who have respiratory symptoms of communicable diseases other than COVID-19. They are likely to be acceptable if recommended, particularly in more severe epidemics and pandemics. Metaanalysis, case control, cross sectional, cohort, retrospective, retrospective cross sectional, research, randomized controlled, and controlled comparison studies were reviewed on the protective effect of masks on COVID-19 with laboratory evidence. Optimum use of face masks with additional precautions has been found to be useful controlling the spread of the respiratory viruses such as SARS-CoV-2 in most of the studies and metaanalyses. As a conclusion, the recent evidence in COVID-19 pandemic is consistent with the previous studies which have shown association between face mask use and decreased risk of viral infections, and medical face mask use should be encouraged both for the community and healthcare facilities along with other infection control measures such as hand hygiene, during outbreaks when there is widespread community transmission.