Wearing a face mask can help reduce the spread of COVID-19 in the community by reducing the release of respiratory droplets from asymptomatic / pre-symptomatic individuals or those with mild non-specific symptoms. The use of face masks for this purpose may be adopted to reduce the societal impact associated with absence from work or healthcare pressures due to infection, or to protect vulnerable individuals in particular settings.
The 2021 ECDC systematic review of the literature on the effectiveness of face masks in the community concluded that there was evidence of low to moderate certainty for the use of medical face masks providing a small to moderate protective effect against COVID-19 in the community, both in terms of personal protection and protection of others.
The results of studies published after the systematic review are consistent with this conclusion.
For outdoor settings: When the public health objective is to limit community transmission and physical distancing is not possible, wearing a face mask should be considered in crowded outdoor settings.
For indoor settings: In areas where the public health objective is to reduce ongoing community transmission of COVID-19, wearing a face mask should be considered as one of a range of possible measures in confined public spaces, such as stores, supermarkets, transportation hubs (e.g., ports, airports, train/coach stations) and in public transport.
In households: the use of a medical face mask or a respirator should be considered for people with symptoms of COVID-19 or confirmed COVID-19 and for the people who share their household, especially when isolation of the person with symptoms of or confirmed COVID-19 is not possible.
In care settings: face masks should be considered, to protect vulnerable people such as the elderly and people with underlying medical conditions. In this case, face masks can be recommended both for vulnerable people and for persons regularly interacting with this population.
Important considerations when using face masks
- the appropriate use of face masks is important
- the face mask should completely cover the face from the bridge of the nose down to the chin
- the mask should be correctly adjusted on the bridge of the nose and to the face to minimise open space between the face and the mask
- selecting the type of face mask should consider access, availability, and tolerability, in addition to effectiveness:
- respirators are in general expected to be more effective than medical masks
- community face coverings are expected to be less effective than medical face masks
- people vulnerable to severe COVID-19 should consider wearing a respirator, if available and tolerated, including:
- the elderly
- those with underlying medical conditions
- high-risk contacts of COVID-19 cases who cannot stay in quarantine for the full recommended quarantine period
- COVID-19 cases who cannot isolate for the full recommended isolation period
The document also outlines what options for public health policy on face masks should be considered, taking into consideration the proportionality to other measures, the acceptability by the population, and the environmental impacts.