The Great Mask Debate: A Debate That Shouldn't Be a Debate at All

Despite a rapidly growing and evolving literature, there continues to be a vigorous public debate about whether the community use of face coverings can mitigate the spread of COVID-19 ten months into the pandemic.

This article describes a semi-structured literature review of the use of face coverings to prevent the spread of coronaviruses and similar respiratory pathogens, with a focus on SARS-CoV-2 (COVID-19).

: The author conducted a semi-structured literature review using search terms "COVID19" or "SARS-CoV-2" crossed with "mask/s" or "face covering/s." Articles were evaluated through October 30, 2020 for inclusion, as were key references cited within the primary references and other references identified through traditional and social media outlets.

There is strong evidence to support the community use of face coverings to mitigate the spread of COVID-19 from various laboratory, epidemiological, natural history, clinical, and economic studies, although there was only 1 high-quality published randomized controlled trial of this topic at the time of review.

The evidence in favor of community face coverings to slow the spread of COVID-19 is strong. Although most of the benefit of wearing a face covering is conferred to the community and to bystanders, a face covering also can protect the wearer to some extent, both by reducing the risk of COVID-19 infection, and perhaps by reducing the severity of illness for those who contract a COVID-19 infection.