COVID-19: What we talk about when we talk about masks

Fortaleza, Cristiane Ravagnani; de Souza, Lenice do Rosário; Rúgolo, Juliana Machado; Fortaleza, Carlos Magno Castelo Branco

Even though most current recommendations include the general use of masks to prevent community transmission of SARS-Cov-2, the effectiveness of this measure is still debated. The studies on this policy include physical filtering tests with inanimate microparticles, randomized clinical trials, observational studies, ecological analyses, and even computational modeling of epidemics. Much of the so-called evidence is inferred from studies on different respiratory viruses and epidemiological settings. Heterogeneity is a major factor limiting the generalization of inferences. In this article, we reviewed the empirical and rational bases of mask use and how to understand these recommendations compared to other policies of social distancing, restrictions on non-essential services, and lockdown. We conclude that recent studies suggest a synergistic effect of the use of masks and social distancing rather than opposing effects of the two recommendations. Developing social communication approaches that clarify the need to combine different strategies is a challenge for public health authorities.