American College of Physicians: Best practice tips when using masks to prevent COVID-19

The American College of Physicians issued clinical advice regarding the effectiveness of N95 respirators, surgical masks and cloth masks when preventing COVID-19 in a "living document" published in Annals of Internal Medicine.

The practice points are based on "a rapid and living systematic evidence review" conducted by Portland, Ore.-based Pacific Northwest Evidence-based Practice Center and funded by Washington, D.C.-based Agency for Healthcare Research and Quality, according to a June 18 news release. When direct evidence was insufficient to evaluate the effectiveness and comparative effectiveness of various masks, ACP used indirect evidence from other coronaviruses, flu infections and other respiratory infections.

Five takeaways when using N95, surgical and cloth masks to prevent COVID-19 spread: 

1. Healthcare personnel should wear N95 respirators when in close contact with suspected or known COVID-19 patients. All healthcare staff, patients and visitors who aren't in close contact with COVID-19 patients should wear surgical masks to reduce transmission risk.

2. It is important that masks are handled properly to avoid self-contamination.

3. Even when wearing a mask, it's critical to take other infection prevention precautions and control procedures to reduce transmission.

4. The use of masks is not necessary at home, unless a household member has COVID-19. 

5. Clinicians and public health authorities should educate individuals and communities on the appropriate use and disposal of masks.

"It's important to note that lack of direct evidence does not mean that masks are effective or are not effective," said Jacqueline Fincher, MD, president of the ACP. "We will continue to monitor this and update these practice points as new evidence becomes available. In the meantime, we support following proper precautions and procedures to reduce infection transmissions."


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