Why does the spread of COVID-19 vary greatly in different countries? Revealing the efficacy of face masks in epidemic prevention

• Published in: Epidemiology and infection Vol. 149; p. e24
• Main Authors: Wei, Jincheng, Guo, Shurui, Long, Enshen, Zhang, Li, Shu, Bizhen, Guo, Lei
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 2021
• Subjects: Aerosols; Breathing masks; Coronaviridae; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 - transmission; Disease control; Droplets; Efficiency; Epidemics; Filtration; Humans; Masks; Masks - standards; Nasopharynx; Nasopharynx - virology; Original Paper; Oropharynx - virology; Pandemics; Particle Size; Prevention; Public health; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Social interactions; Viral diseases; Viral Load; Viruses; Singapore; Taiwan; COVID-19; filtration efficiency; spread risk; public health; mask
• ISSN: 0950-2688; 1469-4409; 1469-4409
• DOI: 10.1017/S0950268821000108

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is highly contagious, and the coronavirus disease 2019 (COVID-19) pandemic caused by it has forced many countries to adopt ‘lockdown’ measures to prevent the spread of the epidemic through social isolation of citizens. Some countries proposed universal mask wearing as a protection measure of public health to strengthen national prevention efforts and to limit the wider spread of the epidemic. In order to reveal the epidemic prevention efficacy of masks, this paper systematically evaluates the experimental studies of various masks and filter materials, summarises the general characteristics of the filtration efficiency of isolation masks with particle size, and reveals the actual efficacy of masks by combining the volume distribution characteristics of human exhaled droplets with different particle sizes and the SARS-CoV-2 virus load of nasopharynx and throat swabs from patients. The existing measured data show that the filtration efficiency of all kinds of masks for large particles and extra-large droplets is close to 100%. From the perspective of filtering the total number of pathogens discharged in the environment and protecting vulnerable individuals from breathing live viruses, the mask has a higher protective effect. If considering the weighted average filtration efficiency with different particle sizes, the filtration efficiencies of the N95 mask and the ordinary mask are 99.4% and 98.5%, respectively. The mask can avoid releasing active viruses to the environment from the source of infection, thus maximising the protection of vulnerable individuals by reducing the probability of inhaling a virus. Therefore, if the whole society strictly implements the policy of publicly wearing masks, the risk of large-scale spread of the epidemic can be greatly reduced. Compared with the overall cost of social isolation, limited personal freedoms and forced suspension of economic activities, the inconvenience for citizens caused by wearing masks is perfectly acceptable.