Title : Is masking in the community setting effective at preventing the spread of COVID-19, A systematic review
Abstract:
Prompted by recent media coverage of the Cochrane Review's analysis of the efficacy of community masking in controlling the spread of COVID-19, we conducted an independent literature review. Our search spanned PubMed, CINAHL, and Cochrane databases, focusing on peer-reviewed articles published in English within the past 5 years that explicitly studied COVID-19. Our PICO question was "Is masking in the community setting effective at preventing the spread of COVID-19?" We identified 6 relevant studies, including randomized control trials (RCTs), cluster RCTs, case control studies, systematic reviews, cross sectional studies, and retrospective cohort studies. Some study interventions included distributing masks with and without extra public health coaching and some studies analyzed self-reported data on an array of transmission control measures, but no studies directly compared masking in one cohort to not masking in another cohort. Accordingly, most study results were inconclusive regarding the efficacy of community masking. Studies reporting positive correlations were limited by small sample sizes, restricting the generalizability of their findings. Interpretation of each of these studies is complicated by the presence of numerous confounding factors such as enhanced hygiene practices, social distancing, school and business closures, limitations on mass gatherings, and travel restrictions. The global implementation of these concurrent public health measures, and the variability of their adherence on an individual level, makes it challenging to isolate the specific impact of masking on disease transmission. The implications for clinical practice are significant. In a time where patients frequently conduct their own research, to maintain public trust, clinicians must approach hot-button topics with humility and without bias. We must acknowledge the limitations of current research and, where necessary, advocate for more rigorous studies to bring clarity to these issues. Additionally, clinicians should be prepared to assist our patients in learning to critically analyze references available to the public to help our patients make informed healthcare decisions. In summary, while current research on the efficacy of community masking in preventing COVID-19 transmission is inconclusive, there is a need for better designed studies to assess the individual impact of the many factors at play in a complicated disease transmission scenario.
Audience Take Away Notes
- After participating in this session, 100% of the learners should be able to interpret the importance of critically appraising scientific studies, especially in the context of community masking and COVID-19, identify the confounders in studies related to public health measures and their impact on the validity of research findings and promote evidence-based practice among patients and peers, emphasizing the need for high-quality research.
