Respiratory protection for healthcare workers and SARS-CoV-2: evidence is equivocal but does that matter?

So, a double blog day today! I couldn’t resist reading the latest statement from a UKHSA expert group on “The role of respirators and surgical masks in mitigating the transmission of SARS-CoV-2 in healthcare settings: an overview of evidence (2022)”, published yesterday, as soon as it hit my desk. “Equivocal” is a word that I try to avoid. It’s one of those ‘jargony’ and overly technical words that is best worded-around in my view. But for this, it’s about right. The evidence from well controlled clinical trials that respirators (FFP2/3 or N95s) offer superior protection to healthcare workers than surgical masks is equivocal (“open to more than one interpretation”). But does that matter? If we look to the physics of SARS-CoV-2 transmission, there is a risk that the type of small, virus-laden particles emitted by patients infected with SARS-CoV-2 could circumvent the level of protection provided by surgical masks. And so, it now seems reasonable to recommend FFP2/3 or N95s for healthcare workers caring for patients with SARS-CoV-2 (and influenza for that matter). However, given the uncertainty of the evidence base, as highlighted by this review, I can understand why some have decided to continue with a policy of surgical masks when caring for patients with SARS-CoV-2 infection in most settings.

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