Should members of the public be wearing face masks during the COVID-19 pandemic? It’s a controversial question, with different countries and authorities giving different advice.
We have reviewed the results of more than a dozen randomised trials of face masks and transmission of respiratory illnesses. We found the current best evidence suggests wearing a mask to avoid viral respiratory infections such as COVID-19 offers minimal protection, if any.
Two of the world’s major health organisations disagree on mask wearing. The World Health Organisation (WHO) currently discourages mask use:
There is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.
WHO does recommend special masks (N95 masks or equivalent) plus other protection for health-care workers working with people who have, or are suspected to have, COVID-19.
By contrast, the Centres for Disease Control and Prevention (CDC) in the United States has recently recommended everyone wear a (cloth) mask. However, this is to prevent infected people passing on the infection, not to prevent the wearer getting infected.
Who is right? Does wearing a mask protect the wearer? Does it protect others?
Understanding the spread
To examine this, we need to first look at how coronavirus spreads and how masks might stop it.
There are several possible routes to infection. An infected person can cough, sneeze or breathe while within about two metres of another person, and the virus lands in the other person’s eyes, nose or mouth (1).
Another route is when an infected person coughs or sneezes onto their hand or onto a surface. The uninfected person then shakes the hand (2a) or touches the surface (2b), and transfers the virus to their own eye, nose or mouth.
It is possible that an infected person can also cough or sneeze to create an airborne spread (3) beyond the close contact range – but it is controversial whether this last route is a major means of transmission.
We don’t know how much transmission occurs by each of these routes for COVID-19. It’s also unclear how much protection a mask would offer in each case.
Current best evidence
To resolve this question, we analysed 14 randomised trials of mask wearing and infection for influenza-like illnesses. (There are no randomised trials involving COVID-19 itself, so the best we can do is look at similar diseases.)
When we combined the results of these trials that studied the effect of masks versus no masks in health-care workers and the general population, they did not show that wearing masks leads to any substantial reduction of influenza-like illness. However, the studies were too small to rule out a minor effect for masks.
Why don’t masks protect the wearer?
There are several possible reasons why masks don’t offer significant protection. First, masks may not do much without eye protection. We know from animal and laboratory experiments that influenza or other coronaviruses can enter the eyes and travel to the nose and into the respiratory system.
While standard and special masks provide incomplete protection, special masks combined with goggles appear to provide complete protection in laboratory experiments. However, there are no studies in real-world situations measuring the results of combined mask and eyewear.
The apparent minimal impact of wearing masks might also be because people didn’t use them properly. For example, one study found less than half of the participants wore them “most of the time”. People may also wear masks inappropriately, or touch a contaminated part of the mask when removing it and transfer the virus to their hand, then their eyes and thus to the nose.
Masks may also provide a false sense of security, meaning wearers might do riskier things such as going into crowded spaces and places.
Do masks protect others?
Could masks protect others from the virus that might have been spread by the mask wearer? A recent Hong Kong laboratory study found some evidence masks may prevent the spread of viruses from the wearer.
They took people with influenza-like symptoms, gave half of them masks and half no masks, and for 30 minutes collected viruses from the air they breathed out, including coughs.
Masks did reduce the amounts of droplets and aerosols containing detectable amounts of virus. But only 17 of the 111 subjects had a coronavirus, and these were not the SARS-CoV-2 coronavirus. While the study is promising, it needs to be repeated urgently.
We also don’t know how this reduction of aerosols and droplets translates to reduction of infections in the real world. If there is an effect, it may be diluted by several factors such as ill people who don’t wear a mask and “well” people who have no symptoms but are still carrying and spreading the virus.
Masks for some?
If wearing masks does substantially reduce the spread of the infection to others, what should we do? We could ask everyone with any respiratory symptoms to wear masks in public. That could supplement other strategies such as social distancing, testing, tracking and tracing to reduce transmission.
To also capture infected people without symptoms, we could ask everyone to wear masks in indoor public spaces. Outdoors is more difficult, since most people pose little or no risk. Perhaps, as we reduce restrictions, masks could also be required at some outdoor crowd events, such as sporting events or concerts.
Another possibility is a “2 x 2” rule: if you are outdoors and within 2 metres of other people for more than 2 minutes you need to wear a mask.
Mask wearing for the possibly infected, to prevent spreading the infection, warrants rigorous and rapid investigation. It could be an alternative or a supplement to social distancing, hand hygiene, testing, and lockdowns.
The authors would like to thank John Conly, Liz Dooley, Lubna Al-Ansary, Susan Michie and Amanda McCullough for comments.
Ontario logs 138 new cases of COVID-19, two deaths – Sudbury.com
Ontario public health units reported 138 new cases of COVID-19 since Saturday, along with 183 recoveries, and two deaths, bringing the total number of active cases to 1,839.
There were also 23,792 tests logged during that time, of the 1,527,114 conducted in the province to date.
Of these active cases, 139 are currently hospitalized with the virus, including 39 in the Intensive Care Unit (ICU), and 23 in the ICU on a ventilator.
Among those active cases are 162 Long-Term Care (LTC) residents as well as 263 LTC staff, whose cases have been linked to 35 ongoing LTC home outbreaks.
Since the pandemic began, 5,515 LTC residents and 2,321 LTC health care workers have recovered from the coronavirus, while 1,718 LTC residents and seven LTC health care workers have died from it.
This data has contributed to a provincewide total of 35,794 cases since the pandemic began, of which 31,266 have presumably recovered, and 2,689 have died.
Included in this total are the 342 cases confirmed in Northeastern Ontario to date, of which 312 have reportedly recovered, and 12 have died. A total of 89,586 tests have been conducted in the region, including 17,381 by Public Health Sudbury and Districts.
The total number of COVID-19 cases, recoveries, and deaths reported by Northeastern Ontario health units are as follows:
- Public Health Sudbury and Districts: 67 cases, 65 recoveries, two deaths
- Northwestern Health Unit: 39 cases, 30 recoveries
- Algoma Public Health: 24 cases, 24 recoveries
- Timiskaming Health Unit: 18 cases, 18 recoveries
- Porcupine Health Unit: 67 cases, 58 recoveries, 8 deaths
- North Bay Parry Sound District Health Unit: 35 cases, 29 recoveries, one death
- Thunder Bay District Health Unit: 92 cases, 88 recoveries, one death
Nationwide, there have been 105,522 confirmed and 12 presumptive cases of COVID-19 reported as of 12:38 p.m. on July 5, as well as 69,329 recoveries and 8,684 deaths.
Across the globe, there have been 11,125,245 cases and 528,204 deaths reported in 216 countries, areas, and territories, as of July 5 at 2:24 p.m.
Five straight days of no new COVID-19 cases in Manitoba – CTV News Winnipeg
Manitoba has now gone five consecutive days without a new case of COVID-19.
Health officials announced on Sunday afternoon that as of 9:30 a.m., no new cases have been identified.
The number of lab-confirmed and probable cases in the province remains at 325.
As of Friday, there are 16 active cases in Manitoba and 302 people have recovered from COVID-19. The death toll remains at seven.
Since early February, 64,968 tests have been performed.
The province will provide an update data on case numbers, active cases and recoveries on Monday.
COVID-19 Updates: Cases continue to rise on Siksika First Nation | AHS reprimands two Calgary hookah bars – Edmonton Sun
With news on COVID-19 happening rapidly, we’ve created this page to bring you our latest stories and information on the outbreak in and around Calgary.
What’s happening now
COVID-19 deals blow to already-retreating Royal Canadian Legion
In Alberta, the membership number sits at about 35,000, one that shrinks three to five per cent a year, said Tammy Wheeler, executive director of the legion’s Alberta-Northwest Territories Command.
“Like everybody else, we’re struggling,” said Wheeler.
All nine of the Calgary branches are in some measure of financial peril, she said, adding the clearer picture of their fate will likely come in the fall, after all the locations have reopened and have a better gauge on revenues.
But Wheeler isn’t optimistic.
“This is going to hit big-time in September,” she said.
AHS reprimands two Calgary hookah bars for COVID-19 violations
Though Sunday marks exactly four months since Alberta first reported a case of COVID-19, some local businesses continue to attract attention from public-health officials for violations of orders meant to curb the ongoing COVID-19 pandemic.
Two Calgary restaurants are the latest to face sanctions from Alberta Health Services after patrons were found smoking hookah and shisha despite orders introduced by Alberta chief medical officer of health Dr. Deena Hinshaw.
Limited capacity, masking on some rides part of planned Calaway Park reopening
Calaway Park will reopen its gates ahead of schedule this summer after Alberta Health granted the Calgary-area amusement park an exemption to public-health orders that would have kept the park closed until Stage 3 of the province’s relaunch plan.
The park, located just west of Calgary in Springbank, is slated to open for its 2020 season on July 17 after the COVID-19 pandemic forced the attraction to remain closed through the early summer. Only season pass holders will be allowed in the first day, with the park opening to others afterwards.
COVID-19 cases continue to rise on the Siksika First Nation
Active COVID-19 cases on the Siksika First Nation reserve continue to rise totalling 11 on Saturday less than a month after their first recorded case.
That number almost doubles for all known novel coronavirus cases linked to the First Nation at 24, after having 22 confirmed yesterday, according to an update posted to the community’s Facebook page.
Hundreds more are “under active investigation and daily follow-up” for the deadly virus.
Alberta to release weekend COVID-19 numbers on Monday
Albertans used to checking in to see the province’s latest COVID-19 numbers will have to wait a bit longer.
For the first time since the pandemic began in March, the province is not going to provide numbers on Saturday or Sunday. They will give the totals on Monday.
Alberta’s chief medical officer of health Dr. Deena Hinshaw has said she is taking a break from her press conferences next week, but the numbers will go out daily by email.
Florida’s confirmed coronavirus cases rose by a record 11,458 on Saturday, the state’s health department said, the second time in three days that its caseload increased by more than 10,000.
The new record came a day after seven other states also reported record rises in cases of COVID-19, the disease caused by the coronavirus that has killed nearly 130,000 Americans.
The recent surge, most pronounced in southern and western states, has alarmed public health officials, who urged caution ahead of a July 4th holiday weekend to celebrate the Declaration of Independence of the United States in 1776.
Alberta set to resume public mask distribution program on July 13 – Globalnews.ca
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Ontario logs 138 new cases of COVID-19, two deaths – Sudbury.com
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