Coronavirus (691) The Lancet: Physical distancing, face masks, and eye protection to prevent person-to-person transmission

2 June, 2020

These data also suggest that wearing face masks protects people (both health-care workers and the general public) against infection by these coronaviruses, and that eye protection could confer additional benefit.

Citation and extracts below. The data 'suggest that wearing face masks protects people (both health-care workers and the general public) against infection by coronaviruses'. It will be interesting to see how these new data (which are still incomplete) are integrated into current WHO guidance and national policymaking.

CITATION: Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

Derek K Chu et al. on behalf of the COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors

The Lancet

Published: June 01, 2020 DOI: https://doi.org/10.1016/S0140-6736(20)31142-9

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext

'We did a systematic review of 172 observational studies in health-care and non-health-care settings across 16 countries and six continents... Physical distancing of 1 m or more was associated with a much lower risk of infection, as was use of face masks (including N95 respirators or similar and surgical or similar masks [eg, 12–16-layer cotton or gauze masks]) and eye protection (eg, goggles or face shields)...'

'Implications of all the available evidence: The risk for infection is highly dependent on distance to the individual infected and the type of face mask and eye protection worn. From a policy and public health perspective, current policies of at least 1 m physical distancing seem to be strongly associated with a large protective effect, and distances of 2 m could be more effective. These data could also facilitate harmonisation of the definition of exposed (eg, within 2 m), which has implications for contact tracing. The quantitative estimates provided here should inform disease-modelling studies, which are important for planning pandemic response efforts. Policy makers around the world should strive to promptly and adequately address equity implications for groups with currently limited access to face masks and eye protection. For health-care workers and administrators, our findings suggest that N95 respirators might be more strongly associated with protection from viral transmission than surgical masks. Both N95 and surgical masks have a stronger association with protection compared with single-layer masks. Eye protection might also add substantial protection. For the general public, evidence shows that physical distancing of more than 1 m is highly effective and that face masks are associated with protection, even in non-health-care settings, with either disposable surgical masks or reusable 12–16-layer cotton ones, although much of this evidence was on mask use within households and among contacts of cases. Eye protection is typically underconsidered and can be effective in community settings. However, no intervention, even when properly used, was associated with complete protection from infection. Other basic measures (eg, hand hygiene) are still needed in addition to physical distancing and use of face masks and eye protection.'

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org