Is the Use of a Mask Useful in the Prevention of Covid-19 Disease? an Evidence Review Study



Golbabaei F^{1, 2} ; Rezaeihachesu V^{1, 2} ; Kazemi M^{1, 2} Show Affiliations
Source: Iran Occupational Health Published:2020

Abstract

Background and aims:Coronaviruses are important pathogens in humans and animals.In late 2019, a new coronavirus was identified as the cause of a group of pneumonia cases in Wuhan, Hubei Province, China. The disease spread rapidly, resulting in epidemics in China and reports of sporadic cases worldwide. In February 2020, the World Health Organization (WHO) identified COVID-19, which stands for Coronavirus 2019.The virus that causes COVID-19 has been identified as the Coronavirus virus, Severe acute respiratory syndrome2 (SARS-CoV-2), formerly known as 2019-nCoV. Coronavirus disease 2019 (COVID-19) is a name for the disease, and the virus that causes it is known SARS-CoV-2. The very rapid spread of the COVID-19 in China and in many other countries has caused fear among people across the world. The novel coronavirus outbreak declared a Public Health Emergency of International Concern on 30 January 2020. Due to the fact that one of the ways of transmitting the coronavirus is through respiration, one of the most important ways to prevent coronavirus is to use personal protective equipment, including masks, so the knowledge around the use of masks by the general public prevention COVID-19 disease transmission is advancing rapidly. Policymakers require guidance on how to use masks and how to use them for people in the community to combat the COVID-19 disease pandemic. In this article, the relevant literature to inform multiple areas include transmission characteristics of COVID-19 disease, filtering characteristics and efficacy of masks and estimated population impacts of widespread community mask use were synthesized. Methods: In this descriptive review study, all articles on mask wearing and its effect on the prevention of transmission of pandemic diseases, including COVID-19 and influenza, was examinesd and published in Farsi and English. PubMed, Web of Science, Google Scholar, Scopus and Embase databases were used to search for articles, focusing on the use of masks and the prevention of COVID-19 disease, and combining appropriate keywords (Masks,SARSCoV-2, COVID-19, Influenza, Epidemic, Prevention and Transmission) without restricting the type of study. Results: Corona virus size ranges from 80 to 160 nanometers, which can help in choosing the appropriate mask and respiratory protection. Anyone who comes in close contact (less than of two meters away) with a person with respiratory symptoms (such as sneezing, coughing, etc.) is at risk for exposure to potentially infectious respiratory particles. A main route of transmission of COVID-19 disease is likely via small respiratory droplets, and is known to be transmissible from presymptomatic and asymptomatic individuals that come out in talking, coughing or sneezing. The most common droplet size is at least 5 to 10 micrometers.SARS-CoV-2has a high transmission potential and its transmission rate to individuals is about 2.4. Disease spread was reduced by restrict contacts of infected individuals via physical distancing, contact tracing with appropriate quarantine and reduce the transmission probability percent act by wearing masks in public. The evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets. Public mask wearing is most effective at stopping spread of the virus when compliance is high. Therefore, one of the most important ways to prevent the coronavirus is to use personal protective equipment, including masks.The standard masks recommended by reputable organizations are surgical masks and N95 masks.The use of cloth masks is recommended as a last resort, and it has been stated that these types of masks are not part of personal protective equipment. Especially in people who are part of the medical staff and do patient care work. Because of the ability of these masks to protect the person is unknown, and caution should be exercised when using these masks. Ideally, these masks should be used with a protective device that covers the entire front of the face (chin and underneath) and both sides of the face.The N95 mask (American standard; equivalent to FFP2 in Europe) is recommended as a mask for health care workers who perform clinical care for patients with COVID-19 disease. So that, if these people use these masks well and according to the instructions, they will not have any problems during the epidemic.In this article, the use of surgical and clean masks by medical staff in medical centers to prevent Rhinovirus infection is recommendedand similar studies show that fabric masks have less filtration to the rhinovirus.The results of the above study on the use or non-use of fabric masks in the community cannot be used to control the source of coronavirus, which is a seasonal coronavirus. Another point is that wearing a mask as a source control is largely a cessation of this process, as large droplets become smaller particles suspended in the air that can spread more into the air. Homemade masks have the ability to filter out the normal range of droplets, just as they are effective in blocking droplets and particles, meaning that these masks help keep the droplets from spreading in space.There is no RCT study to evaluate the effect of masks on social transmission during a coronary heart disease. While, there is evidence of a flu outbreak, the current global epidemic is a unique challenge. According to a conservative assessment of COVID-19, the initial rate of proliferation is estimated at 2.4. If the mask is used and the efficiency of the mask is 50%, this amount will be reduced to 1.35. If the spread of the disease is completely stopped, the initial rate of proliferation will be less than one.As a result, the spread of the disease ends in the community.Wearing a mask may be critical to preventing a second wave of infection in the health care system - more research is needed. Conclusion: iA review of the use of masks in this article showed that proper use of masks at the community level has a significant impact on reducing the rate of disease transmission among people in the community.Non-medical masks use substances that prevent the release of droplets of the required size.Non-medical masks are very effective in reducing the transmission of influenza. The results show that non-medical masks are effective in small trials in blocking coronavirus transmission and in areas and periods when the use of masks was required and widely used; the transmission of the disease has decreased in the community. People are usually infected in the early period after infection, which usually has few or no symptoms during this period. It is also suggested that the general use of cloth masks is more effective than other health strategies, distance and patient diagnosis strategies in reducing the rate of disease transmission.It is suggested that government officials and relevant organizations strongly encourage the use of masks by the public and crowded environments as a requirement to reduce disease transmission. To reduce the transmission of respiratory viral disease, the following interventions should be preferred, preferably in combination: -Frequent washing with or without side disinfectants -Create a retainer such as using gloves, clothing and a mask equipped with a filter -Identify suspicious individuals by isolating possible cases However, it has been warned that long-term routine administration of some of the evaluated measures may be contagious without the threat of disease. Health officials need to provide specific guidelines for the production, use and disinfection or reuse of facial masks and to review their distribution on a regular basis so that they do not become deficient. According to the precautionary principle, the positive effect of wearing a public mask is scientifically acceptable but unclear. While researchers may logically disagree about the degree of reduction and flexibility of the transfer rate, it seems that the relatively low benefits due to the exponential distribution of the transfer process can be collectively profitable. Models show that wearing public masks is most effective in preventing the spread of the virus when acceptance is high. This is the situation seen with vaccines. Therefore, the use of masks should be done extensively with confidence based on this principle in society. All countries suggest that masking is a low-risk but highly potentially positive action, so that many countries with a high prevalence of the disease have been able to reduce mortality with the widespread use of masks. It is recommended that governments apply the requirements for the use of masks, and that organizations that provide public services, such as public transport providers or stores, apply the rules: Without masks, no services are provided. These rules should be accompanied by measures to ensure that people have access to masks, possibly without problems in the mechanisms of distribution and storage of masks, and to focus on the benefits of public health. Health officials also need to provide specific guidelines for the production, use and disinfection or reuse of face masks, and review their distribution on a regular basis to avoid deficiencies. Also, clear and applicable guidelines can help increase public acceptance of the use of masks at the community level and assist co the mmunities to achieve the goal of ultimately stopping the spread of COVID-19. © 2020 Iran University of Medical Sciences. All rights reserved.