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Masks did not prevent infection
The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks.
There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers,
when used in routine care to reduce respiratory viral infection.
Do physical measures such as hand-washing or wearing masks stop or slow down the spread of respiratory viruses?
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full
Evidence published up to October 2022.
Background
Influenza (H1N1) caused by the H1N1pdm09 virus in 2009
Severe acute respiratory syndrome (SARS) in 2003
Coronavirus disease 2019 (COVID-19)
Update of a Cochrane Review last published in 2020.
We include results from studies from the current COVID-19 pandemic.
Main results
11 new RCTs and cluster-RCTs n = 610,872
Bringing the total number of RCTs to 78
Medical/surgical masks compared to no masks
Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness
wearing a mask may make little to no difference in how many people caught a flu-like illness/COVID-like illness
Risk ratio (RR) 0.95, (0.84 to 1.09)
9 trials, n = 276,917 participants
Moderate-certainty evidence.
Wearing masks in the community probably makes little or no difference to the outcome of laboratory-confirmed influenza/SARS-CoV-2
RR 1.01, (CI 0.72 to 1.42)
6 trials, n = 13,919
Moderate-certainty evidence
Harms were rarely measured and poorly reported
(very low-certainty evidence).
N95/P2 respirators compared to medical/surgical masks
We pooled trials comparing N95/P2 respirators with medical/surgical masks
We are very uncertain on the effects of N95/P2 respirators compared with medical/surgical masks on the outcome of clinical respiratory illness
Compared with wearing medical or surgical masks, wearing N95/P2 respirators probably makes little to no difference in how many people have confirmed flu and may make little to no difference in how many people catch a flu-like illness, or respiratory illness.
Confirmed influenza
RR 0.70, (0.45 to 1.10)
N = 7,779
Very low-certainty evidence
Influenza like illness
N95/P2 respirators compared with medical/surgical masks may be effective for ILI
RR 0.82
N= 8,407
Low-certainty evidence
The use of a N95/P2 respirators compared to medical/surgical masks
Probably makes little or no difference for laboratory-confirmed influenza infection
RR 1.10
N = 8,407
Moderate-certainty evidence
Restricting pooling to healthcare workers made no difference to the overall findings.
Harms were poorly measured and reported
Discomfort wearing medical/surgical masks or N95/P2 respirators was mentioned in several studies
Very low-certainty evidence
One new RCT
Medical/surgical masks were non-inferior to N95 respirators
N = 1,009 healthcare workers in four countries,
providing direct care to COVID-19 patients.
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