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HICprevent

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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

CDC Urges Masks for All to Stall Pandemic

July 16th, 2020

By Gary Evans, Medical Writer

Hobbled by early testing mistakes and undercut politically, the Centers for Disease Control and Prevention (CDC) is trying to get a single message heard through the noise and chaos of the worst pandemic in a century: Wear masks.

“I really believe if the American public all embraced masking and we really did it rigorously, in the next four, six or eight weeks we could bring this epidemic under control,” said Robert Redfield, MD, director of the CDC.

There was a time when such an urgent plea by the most respected public health agency in the world would translate to broad action. Now it is an open question, which says all you need to know about the futility and infighting at the highest levels of the pandemic response in the United States.

The CDC cites an accumulating body of evidence in a recently published editorial that the “time is now” for all to wear masks to blunt the spread of SARS-CoV-2 .

“When asked to wear face coverings, many people think in terms of personal protection,” the CDC states. “But face coverings are also widely and routinely used as source control. For instance, if given the choice between having surgery performed by a team not wearing some covering over their mouths and noses vs. a team that does, almost all patients would reject the former. This option seems absurd because it is known that use of face coverings under these circumstances reduces the risk of surgical site infection caused by microbes generated during the surgical team’s conversations or breathing. Face coverings do the same in blocking transmission of SARS-CoV-2.”

Universal masking would lower asymptomatic spread, which may be a “critical driver” of ongoing transmission. The CDC cites the efficacy of this approach demonstrated in public, household, and hospital settings, but concedes it would be exceedingly difficult to do a randomized trial of mask effectiveness in the community.

"In the absence of such data, it has been persuasively argued the precautionary principle be applied to promote community masking because there is little to lose and potentially much to be gained,” the CDC stated. “Like herd immunity with vaccines, the more individuals wear cloth face coverings in public places where they may be close together, the more the entire community is protected. Community-level protection afforded by use of cloth face coverings can reduce the number of new infections and facilitate cautious easing of more societally disruptive community interventions such as stay-at-home orders and business closings."