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PloS One 2021Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. In the United States, policies on mask wearing have varied from...
Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. We used state-level data on mask wearing policy for the general public and on proportion of residents who stated they always wear masks in public. For all 50 states and the District of Columbia (DC), these data were abstracted by month for April ─ September 2020 to measure their impact on COVID-19 rates in the subsequent month (May ─ October 2020). Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. Of the 8 states with at least 75% mask adherence, none reported a high COVID-19 rate. States with the lowest levels of mask adherence were most likely to have high COVID-19 rates in the subsequent month, independent of mask policy or demographic factors. Mean COVID-19 rates for states with at least 75% mask adherence in the preceding month was 109.26 per 100,000 compared to 249.99 per 100,000 for those with less adherence. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. This association between high mask adherence and reduced COVID-19 rates should influence policy makers and public health officials to focus on ways to improve mask adherence across the population in order to mitigate the spread of COVID-19.
Topics: COVID-19; Disease Transmission, Infectious; Guideline Adherence; Health Policy; Humans; Masks; Pandemics; Patient Compliance; Public Health; SARS-CoV-2; United States
PubMed: 33852626
DOI: 10.1371/journal.pone.0249891 -
Mayo Clinic Proceedings Oct 2020Management of the global crisis of the coronavirus disease 2019 pandemic requires detailed appraisal of evidence to support clear, actionable, and consistent public... (Review)
Review
Management of the global crisis of the coronavirus disease 2019 pandemic requires detailed appraisal of evidence to support clear, actionable, and consistent public health messaging. The use of cloth masks for general public use is being debated, and is in flux. We searched the MEDLINE and EMBASE databases and Google for articles reporting the filtration properties of flat cloth or cloth masks. We reviewed the reference lists of relevant articles to identify further articles and identified articles through social and conventional news media. We found 25 articles. Study of protection for the wearer used healthy volunteers, or used a manikin wearing a mask, with airflow to simulate different breathing rates. Studies of protection of the environment, also known as source control, used convenience samples of healthy volunteers. The design and execution of the studies was generally rigorously described. Many descriptions of cloth lacked the detail required for reproducibility; no study provided all the expected details of material, thread count, weave, and weight. Some of the homemade mask designs were reproducible. Successful masks were made of muslin at 100 threads per inch (TPI) in 3 to 4 layers (4-layer muslin or a muslin-flannel-muslin sandwich), tea towels (also known as dish towels), made using 1 layer (2 layers would be expected to be better), and good-quality cotton T-shirts in 2 layers (with a stitched edge to prevent stretching). In flat-cloth experiments, linen tea towels, 600-TPI cotton in 2 layers, and 600-TPI cotton with 90-TPI flannel performed well but 80-TPI cotton in 2 layers did not. We therefore recommend cotton or flannel at least 100 TPI, at least 2 layers. More layers, 3 or 4, will provide increased filtration but there is a trade-off in that more layers increases the resistance to breathing. Although this is not a systematic review, we included all the articles that we identified in an unbiased way. We did not include gray literature or preprints. A plain language summary of these data and recommendations, as well as information on making, wearing and cleaning cloth masks is available at www.clothmasks.ca.
Topics: Adult; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Masks; Pandemics; Pneumonia, Viral; SARS-CoV-2; Textiles
PubMed: 33012350
DOI: 10.1016/j.mayocp.2020.07.020 -
Environmental Science and Pollution... Apr 2022A massive increase in the use and production of masks worldwide has been seen in the current COVID-19 pandemic, which has contributed to reducing the transmission of the...
A massive increase in the use and production of masks worldwide has been seen in the current COVID-19 pandemic, which has contributed to reducing the transmission of the virus globally. This paper aims to evaluate the life cycle environmental impacts of disposable medical masks to identify the life cycle stages that cause the highest impact on the environment. A further goal is to estimate the total environmental impacts at the global level in 2020. The inventory data was constructed directly from the industry. The system boundary of the study is from cradle to grave comprising raw material extraction and processing, production, packaging, distribution, use, and disposal as well as transport and waste management along the supply chain. Eleven environmental impacts have been estimated. The results suggest that the global warming potential of a disposable medical mask is 0.02 g CO-eq. for which the main contributor is the raw material supply (40.5%) followed by the packaging (30.0%) and production (15.5%). Sensitivity analysis was carried out to test the environmental impacts. In total, 52 billion disposable medical masks used worldwide consumes 22 TJ of energy in 2020. The global warming potential of disposable medical masks supplied in a year of the COVID-19 pandemic is 1.1 Mt CO eq. This paper assessed the hotspots in the medical mask. The findings of this study will be of interest to policymakers, global mask manufacturers, and users, allowing them to make more informed decisions about the medical mask industry.
Topics: Animals; COVID-19; Carbon Dioxide; Environment; Humans; Life Cycle Stages; Masks; Pandemics
PubMed: 34841484
DOI: 10.1007/s11356-021-17430-5 -
Italian Journal of Dermatology and... Apr 2021During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks... (Comparative Study)
Comparative Study Observational Study
Masks use and facial dermatitis during COVID-19 outbreak: is there a difference between CE and non-CE approved masks? Multi-center, real-life data from a large Italian cohort.
BACKGROUND
During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks increased in the general population. We aimed to quantify the prevalence of mask-related cutaneous side effects and the differences between CE and non-CE approved masks.
METHODS
In this multicenter prospective observational study conducted from March 20, 2020 to May 12, 2020(during and after quarantine), patients attending emergency departments for a dermatological consult were clinically assessed and their masks were inspected to detect CE marks and UNI (Italian National Unification Entity) norms. Patients with history of facial dermatoses or under current treatment for facial dermatoses were excluded.
RESULTS
We enrolled 412 patients (318 during quarantine and 94 after quarantine). CE-approved masks were observed 52.8% vs. 24.5%, whilst subsets of non-CE approved masks were 9.7% vs. 14.9% (Personal protective equipment (PPE)-masks), 16.4% vs. 12.8% (surgical masks [SM]), and 21.1% vs. 47.9%(non-PPE) and (non-SM masks), respectively during and after quarantine. Remarkably, non-CE-approved masks resulted in patients displaying a statistically significant higher incidence of facial dermatoses and irritant contact dermatitis compared to CE-approved masks, and these differences were mainly driven by non-PPE non-SM masks. Comparing quarantine and after quarantine periods, no statistically significant differences were found for CE-approved masks, whilst differences were detected in non-CE-approved masks regarding incidence of facial dermatoses (P<0.0001)and irritant contact dermatitis (P=0.0041).
CONCLUSIONS
Masks are essential to prevent COVID-19 but at the same time higher awareness regarding mask specifications should be promoted in the general population. Non-PPE and non-SM masks should undergo more rigorous testing to prevent the occurrence of cutaneous side effects and future patients' lawsuit damages.
Topics: COVID-19; Dermatitis, Occupational; Disease Outbreaks; Facial Dermatoses; Humans; Italy; Masks; Personal Protective Equipment; Prospective Studies
PubMed: 33960753
DOI: 10.23736/S2784-8671.21.06895-4 -
Cell Reports Methods Sep 2023We introduce a generative data augmentation strategy to improve the accuracy of instance segmentation of microscopy data for complex tissue structures. Our pipeline uses...
We introduce a generative data augmentation strategy to improve the accuracy of instance segmentation of microscopy data for complex tissue structures. Our pipeline uses regular and conditional generative adversarial networks (GANs) for image-to-image translation to construct synthetic microscopy images along with their corresponding masks to simulate the distribution and shape of the objects and their appearance. The synthetic samples are then used for training an instance segmentation network (for example, StarDist or Cellpose). We show on two single-cell-resolution tissue datasets that our method improves the accuracy of downstream instance segmentation tasks compared with traditional training strategies using either the raw data or basic augmentations. We also compare the quality of the object masks with those generated by a traditional cell population simulation method, finding that our synthesized masks are closer to the ground truth considering Fréchet inception distances.
Topics: Computer Simulation; Masks; Microscopy
PubMed: 37725984
DOI: 10.1016/j.crmeth.2023.100592 -
Tomography (Ann Arbor, Mich.) Jan 2023Background and Purpose: Fully automated methods for segmentation and volume quantification of intraparenchymal hemorrhage (ICH), intraventricular hemorrhage extension...
Background and Purpose: Fully automated methods for segmentation and volume quantification of intraparenchymal hemorrhage (ICH), intraventricular hemorrhage extension (IVH), and perihematomal edema (PHE) are gaining increasing interest. Yet, reliabilities demonstrate considerable variances amongst each other. Our aim was therefore to evaluate both the intra- and interrater reliability of ICH, IVH and PHE on ground-truth segmentation masks. Methods: Patients with primary spontaneous ICH were retrospectively included from a German tertiary stroke center (Charité Berlin; January 2016−June 2020). Baseline and follow-up non-contrast Computed Tomography (NCCT) scans were analyzed for ICH, IVH, and PHE volume quantification by two radiology residents. Raters were blinded to all demographic and outcome data. Inter- and intrarater agreements were determined by calculating the Intraclass Correlation Coefficient (ICC) for a randomly selected set of patients with ICH, IVH, and PHE. Results: 100 out of 670 patients were included in the analysis. Interrater agreements ranged from an ICC of 0.998 for ICH (95% CI [0.993; 0.997]), to an ICC of 0.979 for IVH (95% CI [0.984; 0.993]), and an ICC of 0.886 for PHE (95% CI [0.760; 0.938]), all p-values < 0.001. Intrarater agreements ranged from an ICC of 0.997 for ICH (95% CI [0.996; 0.998]), to an ICC of 0.995 for IVH (95% CI [0.992; 0.996]), and an ICC of 0.980 for PHE (95% CI [0.971; 0.987]), all p-values < 0.001. Conclusion Manual segmentations of ICH, IVH, and PHE demonstrate good-to-excellent inter- and intrarater reliabilities, with the highest agreement for ICH and IVH and lowest for PHE. Therefore, the degree of variances reported in fully automated quantification methods might be related amongst others to variances in ground-truth masks.
Topics: Humans; Retrospective Studies; Reproducibility of Results; Masks; Cerebral Hemorrhage; Edema
PubMed: 36648995
DOI: 10.3390/tomography9010008 -
The American Journal of Managed Care Jul 2021As of May 2021, the United States remains the world leader with 33 million of 165 million cases worldwide (20%) and 590,000 of 3.4 million deaths worldwide (17%) from...
As of May 2021, the United States remains the world leader with 33 million of 165 million cases worldwide (20%) and 590,000 of 3.4 million deaths worldwide (17%) from COVID-19. Achieving herd immunity by disease spread and vaccination may result in 2 million to 4 million total US deaths. The future perfect of the vaccine should not be the enemy of the present good, which is masking. Masking, especially when combined with social distancing, crowd avoidance, frequent hand and face washing, increased testing capabilities, and contact tracing, is likely to prevent at least as many premature deaths as the widespread utilization of an effective and safe vaccine. Worldwide, masking is the oldest and simplest engineered control to prevent transmission of respiratory pathogens. Masking has been a cornerstone of infection control in hospitals, operating rooms, and clinics for more than a century. Unfortunately, since the epidemic began in the United States, masking has become politicized. All countries, but especially the United States, must adopt masking as an urgent necessity and a component of coordinated public health strategies to combat the COVID-19 pandemic. Any economic advantages of pandemic politics are short-lived and shortsighted in comparison with public health strategies of proven benefit that can prevent needless and mostly avoidable premature deaths from COVID-19. During the worst epidemic in more than 100 years, most Americans (75%) trust their health care providers. As competent and compassionate health care professionals, we recommend that effective strategies, especially masking, and not pandemic politics, should inform all rational clinical and public health decision-making.
Topics: COVID-19; Contact Tracing; Humans; Infection Control; Masks; Physical Distancing; United States
PubMed: 34314121
DOI: 10.37765/ajmc.2021.88670 -
Indoor Air Oct 2022The protection provided by facemasks has been extensively investigated since the beginning of the SARS-CoV-2 outbreak, focusing mostly on the filtration efficiency of... (Review)
Review
The protection provided by facemasks has been extensively investigated since the beginning of the SARS-CoV-2 outbreak, focusing mostly on the filtration efficiency of filter media for filtering face pieces (FFP), surgical masks, and cloth masks. However, faceseal leakage is a major contributor to the number of potentially infectious airborne droplets entering the respiratory system of a susceptible individual. The identification of leaking spots and the quantification of leaking flows are crucial to estimate the protection provided by facemasks. This study presents a critical review on the measurement and calculation of facemask leakages and a quantitative analysis of their role in the risk of SARS-CoV-2 infection. It shows that the pairing between the mask dimensions and the wearer's face is essential to improve protection efficiency, especially for FFP2 masks, and summarizes the most common leaking spots at the interface between the mask and the wearer's face. Leakage is a crucial factor in the calculation of the protection provided by facemasks and outweighs the filtration performances. The fit factors measured among mask users were summarized for different types of face protection. The reviewed data were integrated into a computational model to compare the mitigation impact of facemasks with vaccination with consideration of new variants of SARS-CoV-2. Combining a high adoption rate of facemasks and a high vaccination rate is crucial to efficiently control the spread of highly infectious variants.
Topics: Humans; Masks; COVID-19; SARS-CoV-2; Air Pollution, Indoor; Vaccination
PubMed: 36305058
DOI: 10.1111/ina.13127 -
The Pan African Medical Journal 2022on 16 March 2020, Tanzania announced its first COVID-19 case. The country had already developed a 72-hour response plan and had enacted three compulsory infection...
INTRODUCTION
on 16 March 2020, Tanzania announced its first COVID-19 case. The country had already developed a 72-hour response plan and had enacted three compulsory infection prevention and control interventions. Here, we describe public compliance to Infection Prevention and Control (IPC) public health measures in Dar es Salaam during the early COVID-19 response and testing of the feasibility of an observational method.
METHODS
a cross sectional study was conducted between April and May 2020 in Dar es Salaam City. At that time, Dar es Salaam was the epi centre of the epidemic. Respondents were randomly selected from defined population strata (high, medium and low). Data were collected using a structured questionnaire and through observations.
RESULTS
a total of 390 subjects were interviewed, response rate was 388 (99.5%). Mean age of the respondents was 34.8 years and 168 (43.1%) had primary level education. Out of the 388 respondents, 384 (98.9%) reported to have heard about COVID-19 public health and social measures, 90.0% had heard from the television and 84.6% from the radio. Covering coughs and sneezes using a handkerchief was the most common behaviour observed among 320 (82.5%) respondents; followed by hand washing hygiene practice, 312 (80.4%) and wearing face masks, 240 (61.9%). Approximately 215 (55.4%) adhered to physical distancing guidance. Age and gender were associated with compliance to IPC measures (both, p<0.05).
CONCLUSION
compliance to public health measures during the early phase of COVID-19 pandemic in this urban setting was encouraging. As the pandemic continues, it is critical to ensure compliance is sustained and capitalize on risk communication via television and radio.
Topics: Adult; COVID-19; Cross-Sectional Studies; Humans; Masks; Pandemics; Tanzania
PubMed: 35573435
DOI: 10.11604/pamj.2022.41.174.31481 -
PloS One 2021Public health and social interventions are critical to mitigate the spread of the coronavirus disease 2019 (COVID-19) pandemic. Ethiopia has implemented a variety of...
Public health and social interventions are critical to mitigate the spread of the coronavirus disease 2019 (COVID-19) pandemic. Ethiopia has implemented a variety of public health and social measures to control the pandemic. This study aimed to assess social distancing and public health preventive practices of government employees in response to COVID-19. A cross-sectional study was conducted among 1,573 government employees selected from 46 public institutions located in Addis Ababa. Data were collected from 8th to 19th June 2020 using a paper-based self-administered questionnaire and analyzed using SPSS version 23.0. Descriptive statistics were used to summarize the data. Binary logistic regression analyses were used to identify factors associated with outcome variables (perceived effectiveness of facemask wearing to prevent coronavirus infection, and COVID-19 testing). Majority of the participants reported facemask wearing (96%), avoiding close contact with people including handshaking (94.8%), consistently followed government recommendations (95.6%), frequent handwashing (94.5%), practiced physical distancing (89.5%), avoided mass gatherings and crowded places (88.1%), restricting movement and travelling (71.8%), and stayed home (35.6%). More than 80% of the participants perceived that consistently wearing a facemask is highly effective in preventing coronavirus infection. Respondents from Oromia perceived less about the effectiveness of wearing facemask in preventing coronavirus infection (adjusted OR = 0.27, 95% CI:0.17-0.45). About 19% of the respondents reported that they had ever tested for COVID-19. Respondents between 40-49 years old (adjusted OR = 0.41, 95% CI:0.22-0.76) and 50-66 years (adjusted OR = 0.43, 95% CI:0.19-0.95) were less likely tested for coronavirus than the younger age groups. Similarly, respondents from Oromia were less likely to test for coronavirus (adjusted OR = 0.26, 95% CI:0.12-0.56) than those from national level. Participants who were sure about the availability of COVID-19 testing were more likely to test for coronavirus. About 57% of the respondents perceived that the policy measures in response to the pandemic were inadequate. The findings showed higher social distancing and preventive practices among the government employees in response to COVID-19. Rules and regulations imposed by the government should be enforced and people should properly apply wearing facemasks, frequent handwashing, social and physical distancing measures as a comprehensive package of COVID-19 prevention and control strategies.
Topics: Adolescent; Adult; COVID-19; COVID-19 Testing; Cross-Sectional Studies; Ethiopia; Female; Government Employees; Hand Disinfection; Humans; Male; Masks; Pandemics; Physical Distancing; Surveys and Questionnaires; Young Adult
PubMed: 34492089
DOI: 10.1371/journal.pone.0257112