Optimal physical distance, face mask, and eye protection to prevent COVID-19 from spreading

Includes 172 observational studies investigating how physical distance, face masks, and eye protection affect the spread of COVID-19, SARS, and MERS in both 16-country communities and healthcare settings , The first review of all evidence available. A physical distance of at least 1 meter reduces the risk of COVID-19 infection, but a distance of 2 meters is more effective. Face covers and masks may protect both healthcare professionals and the general public from COVID-19 infections, and protective eye covers may also offer additional benefits (although certainty of evidence Is low in both forms of protection). Importantly, even when used and combined properly, these interventions do not provide complete protection and other basic safeguards (such as hand hygiene) are essential to reduce infection. Systematically, wearing face coverings and eye protection at least one meter away from others, both inside and outside the medical facility, can reduce the likelihood of viral or COVID-19 infections. A review and meta-analysis that summarizes all the evidence available from the published scientific literature in May Be The Best Way Lancet..

However, none of these interventions, when properly used and combined, provide complete protection from infection. The authors point out that some of the findings, especially those related to face masks and eye protection, are supported by less certain evidence. [1], Randomized trials addressing COVID-19 for these interventions have not been completed (Table 2).

This study, conducted to inform the WHO Guidance Document, is the first study to systematically investigate the optimal use of these protective measures in COVID-19 both in the community and in the healthcare environment. The authors reduced the current COVID-19 pandemic and future waves by providing information to disease models, and who was “potentially exposed” (ie, within 2 meters) for contact tracking. There are immediate and significant implications for standardizing the definition of.

Based on limited information, many countries and regions offer conflicting advice on physical distances to reduce COVID-19 transmission. In addition, the question of whether masks and eye covers reduce COVID-19 infection in the general population, and the optimal use of masks in the medical setting, has been discussed during the pandemic.

“Our findings are the first to combine all direct information on COVID-19, SARS, and MERS, and the best currently available on the optimal use of these common and simple interventions. Provide evidence of “flatten the curve” and inform pandemic response efforts. “In the community,” says Holger Schunemann, a professor at McMaster University in Canada. “Governments and the public health community can use our results to give clear advice to community settings and healthcare professionals on these protective measures to reduce the risk of infection.” [2]

The best evidence currently available is that COVID-19 is most commonly breathed, especially when people cough, sneeze, intrude directly through the eyes, nose, mouth or by touching contaminated surfaces. It suggests that it is spread by the droplets. Currently, there is a consensus that SARS-CoV-2 diffuses primarily through contact with large droplets, but the role of aerosol diffusion continues to be debated.

In the current analysis, an international research team systematically reviewed 172 observational studies assessing distance measurement, face masks, and eye protection, confirming or possible COVID-19, SARS, or MERS infections. Prevented infections between sexually-affected patients and nearby individuals (eg caregivers, family members, health workers), until May 3, 2020.

The meta-analysis included a pool of estimates from 44 controlled studies with 25,697 participants. Of these, seven studies focus on COVID-19 (6,674 participants), 26 on SARS (15,928), and 11 on MERS (3,095).

The COVID-19 study included in the analysis consistently reported the benefits of the three interventions, with similar findings to the SARS and MERS studies.

Analysis of data from nine studies investigating physical distances and virus transmission (SARS, MERS, COVID-19 overall, 7,782 participants) showed that keeping more than one meter away from others , Less than 1 meter (risk of infection was 3% if more than 1 meter away from infected individual, 13% if less than 1 meter), but modeling added all up to 3 meters away Risks have been suggested for meters. Infection or transmission can be halved (Figure 3). The authors point out that their evidence of physical distance is moderately certain [1] Also, while a meta-analysis provided an estimate of risk, no study quantitatively evaluated whether distances greater than 2 meters would be more effective.

Thirteen studies focusing on eye protection (all three viruses, including 3,713 participants) showed that face shields, goggles, and glasses were found to have no eye covering (infection or wearing eye protection). It has been found that the risk of infection is lower compared to the risk of infection). 16% vs.% without eye protection). Authors point out that evidence for eyecover is less certain [1]..

Evidence from 10 studies (all three viruses, including 2,647 participants) showed similar benefits for face masks in general (though wearing a mask had a 3% risk of infection or infection) , 17% without a mask). Evidence from this study was primarily focused on the use of masks at home and among case contacts and was also based on less certain evidence. [1]..

For healthcare professionals, N95 and other mask-type masks may offer better protection from viral infections than surgical masks (eg, reusable 12-16 layers of cotton or gauze masks). For the general public, face masks may be associated with protection either by a disposable surgical mask or a reusable 12-16 layer cotton mask, even in non-healthcare settings. .. However, the authors note that heavy use of face masks raises concerns that there is a risk of bypassing supplies from health care workers and other caregivers at the highest risk of infection.

It also underscores the need for policymakers to quickly address facemask access issues and make them equally available to all. “Manufactured to overcome global shortages due to lack of masks such as N95, surgical masks, eye protection and the desperate need of healthcare workers at the forefront of treating COVID-19 patients.” There is an urgent need for increased capacity and reuse.” Co-author of Dr. Derek Chu, Assistant Professor at McMaster University. “I also think we need to find a solution to make face masks publicly available. However, wearing a mask is a basic measure such as physical distance, eye protection, or hand hygiene. It must be clarified that it is not a replacement for. An additional layer of protection.” [2]

The author also emphasizes the importance of using information on how acceptable, viable, resource-intensive, and equally accessible to all uses of these interventions in devising recommendations. Emphasize “Across 24 studies of all three viruses, including 50,566 people, most participants found these personal protection strategies acceptable, feasible and reassuring, but with frequent discomfort and facial skin problems. Of harm and challenges such as breakdowns, increased difficulty of clear communication, and reduced empathy from care providers by those they were taking care of,” said Bellit University of America in Lebanon. Dr. Sally Yaakub says. [2]

Karla Solo, co-author of McMaster University in Canada, said: “Our results are moderate and uncertain evidence, but this is the first study to combine all the direct information from COVID-19 and therefore provides the best evidence available today. Optimal Use of These Common and Simple Interventions” [2]

Despite these important findings, the review has some limitations, few studies have assessed the effects of interventions in non-healthcare settings, and most evidence comes from SARS and MERS studies. It was. Finally, the effect of exposure duration on the risk of infection was not specifically considered.

Writing linked comments, lead author Reina McIntyre of the Kirby Institute at the University of New South Wales in Australia (who was not involved in the study) described the study as a “significant milestone,” “For health”. For caregivers in the COVID ¬ 19 ward, a ventilator should be the standard of care. This study by Chu and colleagues should prompt a review of all guidelines that recommend medical masks to healthcare professionals caring for COVID¬19 patients. Protecting and occupational health and safety of health care workers should be a top priority and the precautionary principle should be applied. “

She continues.”[They] It also reports that ventilators and multilayer masks are more protected than single layer masks. This finding is important to signal the proliferation of homemade cloth mask designs, which are often single layer. A properly designed cloth mask must have water resistant fabrics, multiple layers, and good facial fit… with the use of a universal face mask, resume normal activity You can safely remove the restrictions of your community and protect people in crowded public environments and homes.”