Face Mask Research 2023

Authored by
Last reviewed
January 31, 2023
Content Overview
Face mask use prevents spreading of airborne viruses such as SARS-CoV-2 and Influenza.

Face Mask Research 2023

The U.S. National Institutes of Health (NIH) says wearing face masks can trap fluid droplets that exit the mouth while you're speaking, reducing the potential spreading of airborne viruses such as the SARS-CoV-2 coronavirus.

The peer-review journal Annals of Internation Medicines published its eighth update in September 2022: a living rapid review on the use of masks to prevent respiratory virus infections. The clinical evidence on the benefits of mask use when outside remains insufficient and inadequate.

Mask Recommendations 2023

The World Health Organization (WHO) continues to recommend (Jan. 2023) the use of masks by the public in specific situations. Masks are recommended following recent exposure to COVID-19 when someone has or suspects they have COVID-19, when someone is at high-risk of severe COVID-19, and for anyone in a crowded, enclosed, or poorly ventilated space. Previously, WHO recommendations were based on epidemiological situations.

As of September 23, 2022, the U.S. Centers for Disease Control and Prevention (CDC) no longer recommends universal N95 masking in healthcare settings unless the facilities are located in areas of high COVID-19 transmission. And noted that vaccination status is no longer used to inform source control, screening testing, or post-exposure recommendations.

The Burbio School Mask Policy Tracker highlights current trends in K-12 schools in the USA.

Medical Masks Vs. N95 Respirators

study published in the Annals of Internal Medicine found that the effects of medical masks versus N95 respirators on risk for SARS-CoV-2 infection confirmed by reverse transcriptase polymerase chain reaction were within the predefined noninferiority margin (hazard ratio, 1.14 [95% CI, 0.77 to 1.69]).

study published by the NIH in 2020: P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects - concluded the existing epidemiological evidence does not enable a definitive assessment of the effectiveness of respirators compared to surgical masks in preventing infection.

Airline Air Quality

A study conducted by the U.S. Department of Defense (DOD) supports the conclusion that the risk of COVID-19 exposure onboard airplanes is almost zero, thanks to advanced air filtration systems, required mask-wearing, and diligent cleaning protocols. And even when the plane is full, only 0.003% of infected air particles could enter the breathing zone of seated, masked passengers.

COVID-19 Mask News For 2022 - 2023

January 30, 2023 - The Cochrane Database of Systematic Reviews Review - Physical interventions to interrupt or reduce the spread of respiratory viruses: There is uncertainty about the effects of face masks. The low to moderate certainty of evidence means our confidence in the effect estimate is limited, and that the true effect may be different from the observed estimate of the effect. The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. 

November 29, 2022 - Original Research: Medical Masks Versus N95 Respirators for Preventing COVID-19 Among Health Care Workers. Conclusion: Among healthcare workers who provided routine care to patients with COVID-19, the overall estimates rule out a doubling in the hazard of RT-PCR–confirmed COVID-19 for medical masks when compared with HRs of RT-PCR–confirmed COVID-19 for N95 respirators. The subgroup results varied by country, and the overall estimates may be applicable to individual countries because of treatment effect heterogeneity.

November 24, 2022 - The NEJM published an ORIGINAL ARTICLE: Lifting Universal Masking in Schools — Covid-19 Incidence among Students and Staff. CONCLUSIONS: Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1,000 students and staff during the 15 weeks after the statewide masking policy was rescinded.

May 25, 2022 - The Lancet preprint published: Revisiting Pediatric COVID-19 Cases in Counties With and Without School Mask Requirements—United States, July 1—October 20, 2021. Findings: Replicating the CDC study shows similar results; however, incorporating a larger sample and a more extended period showed no significant relationship between mask mandates and case rates. 

May 11, 2022 - The European Union Aviation Safety Agency and ECDC issued an update to the health safety measures for air travel, dropping the recommendation for mandatory wearing of medical masks in airports and onboard a flight. The joint Aviation Health Safety Protocol update accounts for the latest developments in the pandemic.

May 3, 2022 - The journal Physics of Fluid published a study that found that the flow through the mask increases with increased mask porosity. On the other hand, the gap leakage is inversely proportional to the mask's porosity. And, wearing two face coverings does not offer more protection against respiratory protection. 

April 16, 2022 - A non-peer-reviewed study/article: To mask, or not to mask, 'Alice and Bob's dating dilemma. 'We suggest that the simple ABD game is sufficiently general for studying masking policies for populations and investigating other complex decision-making problems with the COVID-19 pandemic, including lockdown vs. reopening, herd immunity vs. quarantines, and aggressive tracing vs. privacy protection.

April 7, 2022 - A non-peer-reviewed study analyzed the use of face masks on the impact of COVID-19 incidence among 10–12-year-olds in Finland. 'According to our analysis, no additional effect seemed to be gained from this, based on comparisons between the cities and the age groups of the unvaccinated children (10–12 years versus 7–9 years).'

March 29, 2022 - Update Alert #7: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings. In summary, new evidence slightly strengthened the evidence of the benefit of masks versus no masks in community settings to low–moderate, with no change in insufficient strength of evidence for N95 versus surgical masks in health care settings. A final update is planned for six months.

March 22, 2022 - PNAS published a Research Article: We find it is likely that opening NFL stadiums in 2020 had no impact on local COVID-19 case counts. We find it is likely that opening stadiums had no impact on local COVID-19 case counts; this suggests that, for the 2020 NFL season, the benefits of providing a tightly controlled outdoor spectating environment—including masking and distancing requirements—counterbalanced the risks associated with opening.

March 16, 2022 - Hospitals such as Northwestern Medicine in Chicago and Munson Healthcare in Traverse City, Mich., ask patients to replace or cover their masks with a surgical mask supplied by the facility for quality control. Studies show that N95 masks protect against airborne viruses by creating a tighter seal around the face. 

Mar. 10, 2022 - The U.S. NIH reported schools with mandatory masking during the Delta surge had approximately 72% fewer cases of in-school transmission of the SARS-CoV-2 virus.

Feb. 11, 2022 - The CDC reported: Consistent use of a face mask or respirator in indoor public settings was associated with lower odds of a positive SARS-CoV-2 test result (adjusted odds ratio = 0.44). In addition, using respirators with higher filtration capacity was associated with the most protection compared with no mask use.

Feb. 7, 2022 - The ECDC reported that wearing a face mask should be considered in crowded outdoor settings where physical distancing is impossible when the public health objective is to limit community transmission. And the minimal scientific evidence regarding the use of respirators in the community does not support their mandatory use in service of other types of face masks in the community.