ACP: Use of N95, surgical, and cotton masks to prevent COVID-19

Editor's Note:

The American College of Physicians (ACP) on June 18 issued new practice points on the effectiveness of N95 respirators, surgical masks, and cloth masks for the prevention of COVID-19 in addition to standard precautions in healthcare and community settings.

The ACP Practice Points, which were funded by the Agency for Healthcare Research and Quality (AHRQ), are based on indirect evidence on other types of coronaviruses, influenza or influenza-like infection, and other respiratory infections.

Recommendations for community settings:

• ACP discourages the use of N95 respirators by asymptomatic or symptomatic persons to reduce the risk of COVID-19.
• The decision to use surgical or cloth masks by asymptomatic or symptomatic persons should take into consideration reproduction rate, daily case counts, hospitalizations, deaths, and if they are part of a high-risk population.
• Potential harms associated with mask use include self-contamination, breathing difficulties, and a false sense of security that could detract from taking precautions, such as social distancing.

Recommendations for healthcare settings:

• All healthcare workers in close contact with patients suspected or known to have COVID-19 should use N95 respirators.
• All patients with suspected or known COVID-19 should wear surgical masks.
• All healthcare workers, patients, and visitors who are not in close contact with patients with suspected or known COVID-19 should use surgical masks.
• Healthcare personnel should not use cloth masks. Cloth masks are not considered personal protective equipment because of the lack of evidence of their effectiveness against transmission of COVID-19.

Recommendations for reuse or extended use of N95 respirators in healthcare settings:

• No evidence is available on the effectiveness of reuse or extended use.

Ongoing surveillance of the literature is planned for 1 year, and the practice points will be updated alongside the evidence review, the authors say.