Evaluation of different types of face masks to limit the spread of SARS-CoV-2: a modeling study
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Abstract
We expanded a published mathematical model of SARS-CoV-2 transmission with complex, age-structured transmission and with laboratory-derived source and wearer protection efficacy estimates for a variety of face masks to estimate their impact on COVID-19 incidence and related mortality in the United States. The model was also improved to allow realistic age-structured transmission with a pre-specified R0 of transmission, and to include more compartments and parameters, e.g. for groups such as detected and undetected asymptomatic infectious cases who mask up at different rates. When masks are used at typically-observed population rates of 80% for those ≥ 65 years and 60% for those < 65 years, face masks are associated with 69% (cloth) to 78% (medical procedure mask) reductions in cumulative COVID-19 infections and 82% (cloth) to 87% (medical procedure mask) reductions in related deaths over a 6-month timeline in the model, assuming a basic reproductive number of 2.5. If cloth or medical procedure masks’ source control and wearer protection efficacies are boosted about 30% each to 84% and 60% by cloth over medical procedure masking, fitters, or braces, the COVID-19 basic reproductive number of 2.5 could be reduced to an effective reproductive number ≤ 1.0, and from 6.0 to 2.3 for a variant of concern similar to delta (B.1.617.2). For variants of concern similar to omicron (B.1.1.529) or the sub-lineage BA.2, modeled reductions in effective reproduction number due to similar high quality, high prevalence mask wearing is more modest (to 3.9 and 5.0 from an R 0 = 10.0 and 13.0, respectively). None-the-less, the ratio of incident risk for masked vs. non-masked populations still shows a benefit of wearing masks even with the higher R0 variants.
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SciScore for 10.1101/2021.04.21.21255889: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The pandemic literature does contain a minority of reports that do not confirm the efficacy of masks, although these studies have some important limitations. In particular, commentaries have been written about the methodological limitations of a recent publication by Bundgaard et al. that appears to question the efficacy of face masks …
SciScore for 10.1101/2021.04.21.21255889: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The pandemic literature does contain a minority of reports that do not confirm the efficacy of masks, although these studies have some important limitations. In particular, commentaries have been written about the methodological limitations of a recent publication by Bundgaard et al. that appears to question the efficacy of face masks [34]. [35, 36]. Specifically, the study was only powered to test if the wearer protection efficacy of medical procedure masks (referred to as “surgical masks” in Bundgaard et al.) was >50% and was not designed to measure their effect as source control (because it was estimated only 5% of the population were wearing masks at the time of the study). The Bundgaard et al. results were underpowered to detect wearer protection efficacies of medical procedure and cloth masks. This is similar to another randomized controlled trial (RCT) of cloth face masks as wearer protection against influenza virus infection among healthcare workers by MacIntyre et al. [2]: the study was designed to evaluate only the wearer protection effectiveness, not the source control effectiveness. Critically, the MacIntyre et al. study did not compare cloth masks to no mask, only to masks of the health workers’ choosing, potentially including medical procedure masks. Hence, this RCT in a healthcare setting did not have the negative control of not wearing a mask to help inform definitive conclusions about the efficacy of cloth face masks for the general population in non-healthca...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a protocol registration statement.
Results from scite Reference Check: We found no unreliable references.
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