Whether you're pro- or anti- masks (I'm neither), it is important we assess any downsides & investigate ways these could be mitigated. We recently reviewed 37 studies on this which I'll summarise; preprint here ->https://www.medrxiv.org/content/10.1101/2020.06.16.20133207v1 …
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1. Adherence to face mask - in 8 trials that measured it was modest (average 47% more wearing in face mask group); but appeared similar in combined face mask + handwashing group (so no "risk compensation" - for which we found no other studies). Adherence decreased with time.pic.twitter.com/25BqM1mcLw
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2. Adherence was worse for N95 than surgical masks. This illustrates need to consider & measure discomforts (which is one possible explanation for why N95s appear no better than surgical masks in 4 RCTs of preventing flu, eg Radonovich 2019 ).pic.twitter.com/F2Mtd97gKh
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3. Commonest complaints were the discomfort, especially restricted breathing & facial. Communication was also a common problem - and a reason to discontinue use (mitigations might be face shield or transparent masks). Note special problem for lip readers.pic.twitter.com/Dpk8lwXfRZ
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4. Mitigation could be gained thru (1) limiting situations or duration of mask wearing or (2) alternatives such as transparent masks or face shields. Education appeared to have little impact.pic.twitter.com/7yXdKiIw35
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5. No head-to-head studies exist of masks versus face shields. Such trials seem urgent & important but, as well as prevention of viral transmission, should measure adherence and downsides. https://www.ijidonline.com/article/S1201-9712(20)30399-4/fulltext …
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Thank you for this! I know we have very little studies that relate directly to the current moment but this is great to have all in one place. I know such reviews can be a lot of work.
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