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The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2.

Authors
  • Cheng, Vincent Chi-Chung1
  • Wong, Shuk-Ching2
  • Chuang, Vivien Wai-Man3
  • So, Simon Yung-Chun4
  • Chen, Jonathan Hon-Kwan4
  • Sridhar, Siddharth5
  • To, Kelvin Kai-Wang5
  • Chan, Jasper Fuk-Woo5
  • Hung, Ivan Fan-Ngai6
  • Ho, Pak-Leung5
  • Yuen, Kwok-Yung7
  • 1 Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China. , (China)
  • 2 Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China. , (China)
  • 3 Quality & Safety Division (Infection, Emergency, and Contingency), Hospital Authority, Hong Kong Special Administrative Region, China. , (China)
  • 4 Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China. , (China)
  • 5 Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China. , (China)
  • 6 Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China. , (China)
  • 7 Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China. Electronic address: [email protected] , (China)
Type
Published Article
Journal
The Journal of infection
Publication Date
Jul 01, 2020
Volume
81
Issue
1
Pages
107–114
Identifiers
DOI: 10.1016/j.jinf.2020.04.024
PMID: 32335167
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Face mask usage by the healthy population in the community to reduce risk of transmission of respiratory viruses remains controversial. We assessed the effect of community-wide mask usage to control coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region (HKSAR). Patients presenting with respiratory symptoms at outpatient clinics or hospital wards were screened for COVID-19 per protocol. Epidemiological analysis was performed for confirmed cases, especially persons acquiring COVID-19 during mask-off and mask-on settings. The incidence of COVID-19 per million population in HKSAR with community-wide masking was compared to that of non-mask-wearing countries which are comparable with HKSAR in terms of population density, healthcare system, BCG vaccination and social distancing measures but not community-wide masking. Compliance of face mask usage in the HKSAR community was monitored. Within first 100 days (31 December 2019 to 8 April 2020), 961 COVID-19 patients were diagnosed in HKSAR. The COVID-19 incidence in HKSAR (129.0 per million population) was significantly lower (p<0.001) than that of Spain (2983.2), Italy (2250.8), Germany (1241.5), France (1151.6), U.S. (1102.8), U.K. (831.5), Singapore (259.8), and South Korea (200.5). The compliance of face mask usage by HKSAR general public was 96.6% (range: 95.7% to 97.2%). We observed 11 COVID-19 clusters in recreational 'mask-off' settings compared to only 3 in workplace 'mask-on' settings (p = 0.036 by Chi square test of goodness-of-fit). Community-wide mask wearing may contribute to the control of COVID-19 by reducing the amount of emission of infected saliva and respiratory droplets from individuals with subclinical or mild COVID-19. Copyright © 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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