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Efficacy of surgical masks or cloth masks in the prevention of viral transmission: Systematic review, meta‐analysis, and proposal for future trial
Author(s) -
Nanda Akriti,
Hung Ivan,
Kwong Ava,
Man Vivian ChiMei,
Roy Pankaj,
Davies Lucy,
Douek Michael
Publication year - 2021
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/jebm.12424
Subject(s) - medicine , randomized controlled trial , face masks , cochrane library , transmission (telecommunications) , meta analysis , observational study , clinical trial , limiting , medline , systematic review , intensive care medicine , covid-19 , disease , mechanical engineering , political science , law , infectious disease (medical specialty) , electrical engineering , engineering
Objective Recommendations for widespread use of face mask, including suggested type, should reflect the current published evidence and concurrently be studied. This review evaluates the preclinical and clinical evidence on use of cloth and surgical face masks in SARS‐CoV‐2 transmission and proposes a trial to gather further evidence. Methods PubMed, EMbase, and the Cochrane Library were searched. Studies of SARS‐CoV‐2 and face masks and randomized controlled trials (RCTs) of n ≥ 50 for other respiratory illnesses were included. Results Fourteen studies were included in this study. One preclinical and 1 observational cohort clinical study found significant benefit of masks in limiting SARS‐CoV‐2 transmission. Eleven RCTs in a meta‐analysis studying other respiratory illnesses found no significant benefit of masks (±hand hygiene) for influenza‐like‐illness symptoms nor laboratory confirmed viruses. One RCT found a significant benefit of surgical masks compared with cloth masks. Conclusion There is limited available preclinical and clinical evidence for face mask benefit in SARS‐CoV‐2. RCT evidence for other respiratory viral illnesses shows no significant benefit of masks in limiting transmission but is of poor quality and not SARS‐CoV‐2 specific. There is an urgent need for evidence from randomized controlled trials to investigate the efficacy of surgical and cloth masks on transmission of SARS‐CoV‐2 and user reported outcomes such as comfort and compliance.