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Do face masks help prevent the spread of respiratory viruses?

The Bottom Line

  • Respiratory viruses—such as influenza, SARS, and COVID-19—can lead to significant illness and death. Globally, COVID-19 has caused over 118 million cases and upwards of 2.6 million deaths. 
  • Research supports face mask wearing in combination with other infection control strategies such as handwashing and physical distancing. 
  • Wearing a face mask can decrease the spread of respiratory viruses from one person to another in both health care and non-health care populations. 
  • Don’t forget to mask up and stay up to date on recommendations and best practices for mask usage by regularly seeking information from government and public health organizations.  

From the seasonal flu to the 2003 severe acute respiratory syndrome (SARS) outbreak to the current COVID-19 pandemic, battling respiratory viruses is part of our past, present, and future. These outbreaks and pandemics may vary in length and scale but are similar in that they can cause significant death and illness. Take, for example, COVID-19, which to date is responsible for more than 118 million cases and over 2.6 million deaths globally (1). Canada accounts for nearly 900 thousand cases and over 22 thousand deaths (2). These numbers demonstrate just how infectious some respiratory viruses can be.


The spread of respiratory viruses generally occurs through droplets expelled from an infected individual—for instance, via the nose or mouth when talking, sneezing, or coughing. Therefore, close contact with an infected person or an object containing germs from these droplets can increase the risk of infection (3-5). Efforts to decrease the transmission of respiratory viruses often rely on multiple strategies done in combination with one another. These include: handwashing with soap and water; the use of alcohol based hand sanitizers/rubs; etiquette around coughing and sneezing (e.g., coughing or sneezing into a tissue or the bend of your arm), avoiding touching one’s face, eyes, nose, and mouth; physical distancing; isolation of sick individuals; quarantines; vaccines; and face masks (5;6).


Despite being a widely used practice in certain parts of the world, even in everyday non-pandemic situations, the wearing of face masks has become a controversial issue during the present pandemic. Behind the controversy is the question of whether masks are effective in preventing the transmission of respiratory viruses from one person to another. A comprehensive systematic review looking at the usage of different types of masks (including medical, surgical, and cotton), multiple types of respiratory viruses (influenza, SARS, and COVID-19), and two populations (health care workers and non-healthcare workers) investigated the issue further (3).


What the research tells us

Mask up! The results are positive and lend support to recommendations around mask wearing.


More specifically, the review found that wearing a mask can decrease the transmission of respiratory viruses in both health care workers and non-health care workers. To better understand the results, let’s break them down with numbers. In health care workers, the results translate into an average of 44 less people out of 100 getting infected, compared to no mask use. Even better, in non-health care workers, the results translate into an average of 78 less people becoming infected (3).


Now, do these results mean we can just rely on mask wearing alone? The answer is NO. Mask wearing must be practiced in addition to other public health strategies such as hand hygiene, coughing and sneezing etiquette, physical distancing, vaccines, and so on.


Unfortunately, no comment can be made on which type of mask is most effective amongst those included in the review. However, you can stay up to date on current recommendations by regularly referring to government and public health organizations websites’ or other trusted groups—such as the World Health Organization—for information.


The “do’s” of non-medical face masks

For comprehensive guidance on when the general public needs to wear a mask; materials, construction, and fit; proper use; safety considerations; and answers to other mask-related questions, please visit the Government of Canada's website (7). A few current recommendations include:

  • wearing a non-medical mask when in a shared indoor or outdoor space with people outside of your household;
  • wearing a non-medical mask that is well-made and provides a proper fit;
  • wearing a non-medical mask with multiple layers—such as three-layer mask in which two-layers are composed of tightly woven fabric (e.g., cotton) and one middle layer is composed of a filter-style fabric (e.g., non-woven polypropylene);
  • making sure the mask’s materials are breathable;
  • washing or sanitizing your hands before putting your mask on, adjusting it, or removing it; and
  • keeping your mask clean when it’s not in use or when eating or drinking by placing it in a clean paper or cloth bag until it’s put on again.

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References

  1. Johns Hopkins Coronavirus Resource Center. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). [Internet] 2021. [cited March 2021]. Available from https://coronavirus.jhu.edu/map.html
  2. Government of Canada. Coronavirus disease (COVID-19): Outbreak update. [Internet] 2021. [cited March 2021]. Available from https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html 
  3. Liang M, Gao L, Cheng C, et al. Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis. Travel Med Infect Dis. 2020; 36:101751.
  4. Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV1. N Engl J Med. 2020; 382:1564-1567. doi: 10.1056/NEJMc2004973.
  5. World Health Organization. Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care. [Internet] 2014. [cited March 2021]. Available from https://apps.who.int/iris/bitstream/handle/10665/112656/9789241507134_eng.pdf?sequence=1 
  6. Government of Canada. Coronavirus disease (COVID-19): Prevention and risks. [Internet] 2019. [cited March 2021]. Available from https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks.html
  7. Government of Canada. Non-medical masks: About. [Internet] 2021. [cited March 2021]. Available from https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-medical-masks-face-coverings.html

DISCLAIMER: Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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