![]() ![]() In 2015, we conducted a randomized controlled trial to compare the efficacy of cloth masks with that of medical masks and controls (standard practice) among healthcare workers in Vietnam ( 4). During the outbreak of severe acute respiratory syndrome in China, cotton masks were widely used by healthcare workers and the general public, and observational studies found them to be effective ( 8). In the middle of the 20th century, after disposable medical masks had been developed, use of cloth masks decreased however, cloth mask use is still widespread in many countries in Asia. During the 1930s and 1940s, gauze and cloth masks were also used by healthcare workers to protect themselves from tuberculosis ( 7). Gauze masks were used during the second Manchurian plague epidemic in 1920–1921 and a plague epidemic in Los Angeles in 1924 infection rates among healthcare workers who wore masks were low ( 6). During the 1918 Spanish influenza pandemic, masks made of various layers of cotton were widely used by healthcare workers and the general public. Cloth masks were also used to protect healthcare workers from diphtheria and scarlet fever. Rates of respiratory infections among healthcare workers who used masks made of 2–3 layers of gauze were low ( 5). In this article, we discuss the evidence to inform the use of cloth masks for prevention of respiratory infections and propose strategies for cleaning and decontamination to protect frontline healthcare workers and the general public.ĭuring the early 20th century, various types of cloth masks (made of cotton, gauze, and other fabrics) were used in US hospitals. To our knowledge, only 1 randomized controlled trial has been conducted to determine the efficacy of cloth masks ( 4). However, most studies of cloth masks were conducted in vivo and during the first half of the 20th century, before medical masks were developed. Historically, cloth masks have been used to protect healthcare workers and the general public from various respiratory infections ( 3). Heated debate surrounds healthcare workers having to either reuse or extend the use of disposable products, sterilize their respirator, or resort to wearing cloth or other homemade masks ( 1, 2). Respirators are fit around the face, designed for respiratory protection, and used mostly in healthcare settings. They are also used to prevent the spread of infection from sick or asymptomatic persons (also referred to as source control). Medical masks are used in both healthcare and community settings to protect from droplet infections and from splashes and sprays of blood and body fluids. The main difference in these 2 products is the intended use. Medical/surgical masks and respirators are commonly used as protection against respiratory and other infections. As a result of the coronavirus disease (COVID-19) pandemic, supplies of medical masks and respirators are limited globally. ![]()
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