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Comparative Study
. 2020 Aug 6;9(1):126.
doi: 10.1186/s13756-020-00779-6.

Use of medical face masks versus particulate respirators as a component of personal protective equipment for health care workers in the context of the COVID-19 pandemic

John Conly  1 , W H Seto  2 , Didier Pittet  3 , Alison Holmes  4 , May Chu  5 , Paul R Hunter  6 ; WHO Infection Prevention and Control Research and Development Expert Group for COVID-19
Collaborators, Affiliations
Comparative Study

Use of medical face masks versus particulate respirators as a component of personal protective equipment for health care workers in the context of the COVID-19 pandemic

John Conly et al. Antimicrob Resist Infect Control. .

Erratum in

Abstract

Currently available evidence supports that the predominant route of human-to-human transmission of the SARS-CoV-2 is through respiratory droplets and/or contact routes. The report by the World Health Organization (WHO) Joint Mission on Coronavirus Disease 2019 (COVID-19) in China supports person-to-person droplet and fomite transmission during close unprotected contact with the vast majority of the investigated infection clusters occurring within families, with a household secondary attack rate varying between 3 and 10%, a finding that is not consistent with airborne transmission. The reproduction number (R0) for the SARS-CoV-2 is estimated to be between 2.2-2.7, compatible with other respiratory viruses associated with a droplet/contact mode of transmission and very different than an airborne virus like measles with a R0 widely cited to be between 12 and 18. Based on the scientific evidence accumulated to date, our view is that SARS-CoV-2 is not spread by the airborne route to any significant extent and the use of particulate respirators offers no advantage over medical masks as a component of personal protective equipment for the routine care of patients with COVID-19 in the health care setting. Moreover, prolonged use of particulate respirators may result in unintended harms. In conjunction with appropriate hand hygiene, personal protective equipment (PPE) used by health care workers caring for patients with COVID-19 must be used with attention to detail and precision of execution to prevent lapses in adherence and active failures in the donning and doffing of the PPE.

Keywords: Airborne; COVID-19; Contact; Droplet; Infection prevention; Medical mask; N95 respirator; SARS-CoV-2; Transmission.

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Conflict of interest statement

The authors declare that they have no competing interests. The members of the World Health Organization (WHO) COVID-19 Infection Prevention and Control Research and Innovation Advisory Group who participated in the development of this manuscript, provide independent advice to WHO in their capacity as individuals with expertise in infection prevention and control.

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