Study shows probability of getting COVID for mask wearers vs. non-mask wearers

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In a recent study posted to the medRxiv* preprint server, researchers in the United States assessed the efficiency of facemasks in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevention.

In public spaces, facemasks have played a crucial role in preventing Coronavirus disease 2019 (COVID-19). While facemasks were recommended by the World Health Organization (WHO) in June 2020, there is still a lack of scientific evidence regarding the epidemiological efficacy of facemasks against COVID-19 transmission.  

Study: The Efficacy of Facemasks in the Prevention of COVID-19: A Systematic Review. Image Credit: Chaiwat Subprasom / ShutterstockStudy: The Efficacy of Facemasks in the Prevention of COVID-19: A Systematic Review. Image Credit: Chaiwat Subprasom / Shutterstock

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

About the study

In the present study, researchers analyzed the efficiency of facemasks in curbing SARS-CoV-2 transmission in the community as well as healthcare settings.

The team performed a systematic review to identify relevant studies. A literature search was conducted by a medical librarian using Cochrane, Embase, PubMed, and Web of Science library between April and August 2020. The team subsequently deduplicated the citations using Articles in only the English language were retrieved for the study, while all conference proceedings were excluded. The findings were reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria.

Three study team members reviewed the libraries to yield 1,732 articles. Among these, 61 full-text articles met the required criteria. Subsequently, a total of 13 studies were assessed in the study. The team estimated relative risk, frequencies, t-tests, and confidence intervals where necessary to calculate the variation between cohorts that did and did not report the usage of facemasks in the entire study group and community and healthcare settings.   


The study results showed that a total of 1,539 subjects were analyzed from 13 studies, including four community-based and nine healthcare-based studies. Among these, 243 subjects had SARS-CoV-2 infections, including 97 who did and 146 who did not wear facemasks. The team noted that the probability of contracting a COVID-19 disease was 7% for mask wearers and 52% for non-mask wearers. The relative risk of getting infected by SARS-CoV-2 was 0.13 for mask wearers.

In the healthcare setting, 9% of the mask wearers and 33% of the non-mask wearers tested COVID-19 positive. Furthermore, the relative risk of contracting COVID-19 was 0.20 for individuals wearing facemasks within the healthcare setting. Additionally, in community settings, the team noted that 6% of mask wearers and 83% of non-maks wearers tested SARS-CoV-2 positive. The relative risk of contracting COVID-19 in the community setting was 0.08 for mask wearers.

The results showed an association between using a facemask and testing positive for COVID-19 since over 92% of the subjects who wore a mask did not test COVID-19 positive. The correlation between COVID-19-positivity and wearing a facemask varied considerably between the healthcare and community settings. Overall, 50% of subjects who did not wear a mask did not contract COVID-19. Notably, 83% and 33% of the subjects who did not wear a facemask in the community and healthcare settings contracted COVID-19, respectively. Compared to healthcare settings, the correlation between contracting COVID-19 and wearing a facemask was greater in the community setting.      

Overall, the study findings indicated that mask wearers were less likely to contract COVID-19 in healthcare and community settings. It will be necessary to conduct further research as more information becomes available. The researchers believe that future studies are necessary to ascertain the impact of regulations related to facemask usage and other interventions on COVID-19 transmission.

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
Bhavana Kunkalikar

Written by

Bhavana Kunkalikar

Bhavana Kunkalikar is a medical writer based in Goa, India. Her academic background is in Pharmaceutical sciences and she holds a Bachelor's degree in Pharmacy. Her educational background allowed her to foster an interest in anatomical and physiological sciences. Her college project work based on ‘The manifestations and causes of sickle cell anemia’ formed the stepping stone to a life-long fascination with human pathophysiology.


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  1. Brett McIver Brett McIver New Zealand says:

    Hmmm I wonder if this is the same study that's just been torn to shreds on the peak prosperity yt channel.

  2. RCT
    Joe Tricomi Joe Tricomi United States says:

    Its amazing how when the data support their claims, no RCT is needed. There are too many variables to truly know if masks were the only reason there was a difference in the numbers. Mask wearers, in general, would tend to be more afraid of the virus and, therefore, more careful with hand hygiene, for one. More rigorous studies have shown that masks less than N95 were ineffective for influenza, a larger microbe than covid. It would likely follow the same would be true for a virus of smaller particle size.

  3. Darrell M Darrell M United States says:

    In the US, states with and without mask mandates experienced statistically the same level of spread during the same time period. Communal immunity is constantly changing as people are exposed to the virus. I didn't see any mention of controlling for these variables.

    Personally, I had a documented infection Mar 2020. Symptoms were similar to a mild flu, I was over it in 5 days. I lived as normally as possible and hadn't had as much as a sniffle until vaccinated in Nov '21. The vaccine put me in the hospital and felt 10x worse than my first bout with COVID. I recently (Jul '21) tested positive with an at home test. I felt fine, but had a slight  runny nose. My father in law had a "pretty bad cold" for a few weeks, testing negative a couple times. I tested myself at the first sign of any symptom mostly out of curiosity. I will gladly have a runny nose for a couple days every two years if I don't have to wear a mask most my waking life.

    I was onboard wearing masks at first if there was any chance of eradicating the disease. The virus is mutating and/or immunity waning too quickly for any chance of eradicating it. We have a new cold virus, I accepted that years ago, it's here to stay if one wears a mask or not. Watch a video of a person vaping in a mask if you need more evidence of their efficacy.

    • Matt E Matt E United States says:

      Except for some people, it's much worse than a cold. My mom is a chemo patient and has a compromised immune system due to the chemo drug, and had both shots+ the booster and still nearly died because her immune system wasn't strong enough for the vaccine to trigger an immune response. This was in late January, with omicron which is supposedly milder.  She never leaves the house except to buy groceries, took all the cautions etc. It's sad she nearly died alone and had to listen to so many people complain about mask. It's a minor inconvenience to mask for a few minutes. Surgeons wear them for a reason.

      • Kathleen M Kathleen M United States says:

        Its called being a part and doing your part in your community! Selfishness amongst these people is astonishing! Even the old ppl are sooooo ignorant here! So embarrassing to be a living witness to the horrible conspiracy theories that have taken these ideologies and impressed them so obviously on ignorant selfish Mericans! Grow up! Get the vaccines and wear a mask and stfu !!

  4. Chip Dennison Chip Dennison United States says:

    this study js such crap...they cherry picked 13 out of 1300 and still barely found any correlation. It is amazing how fast the media just blindly spew this garbage.

  5. Karen Catlin Karen Catlin United States says:

    This article was a complete waste of my time...

  6. albynospyder albynospyder United States says:

    Oh, please, first it was, "wear your mask, you won't get covid", then it was "wear your mask so you don't spread covid", then it was "get the vaccine,  you won't get covid", then it was "get the vaccine, it will make covid less severe",  then it's "we have to change the definition of vaccine because of these mrna clot shots are not working". To be honest, all you doctors took an oath and let your political views get in the way of that. And this site is just as bad. It's agenda pushing propaganda.

  7. Wil Nusser Wil Nusser United States says:

    So, I see no attempt to delineate covariables in this metastudy. Right off the bat, that's a huge red flag. You don't do univariate studies when the correlation you are studying has multiple independent variables. For example, people wearing masks are more likely to have received one or more vaccine doses. You have to control for that, along with behavioral differences. Mask-wearing undoubtedly has a positive correlation with other preventative measures. Studying only one of those variables (and likely the least effective one) will show a correlation that is NOT causally related.

    The selection criteria for the studies chosen for inclusion should be disclosed, particularly how 48 of the 61 that "met the criteria" were eliminated from consideration. Without that information, this result could be entirely due to cherry-picking the set that confirms the authors' a priori conclusion.

    This is likely another study that will never muster peer review, at least not in any reputable journal. It'll languish in pre-print while propagandistic sources tout it as a meaningful result.

  8. Riley Parrish Riley Parrish United States says:

    And yet, this article is yet another publication of individuals not actually studying the effect of mask use. No one has actually put a mask up in front of a source with the pathogen and studied what actually got thru it! You just promoted another misleading article that does little more than steal the results of other studies that just did systematic reviews. Come on, someone actually do the real research like a real scientist.

  9. Kim Anne Kim Anne United States says:

    Did the kind of mask matter or did I miss that part?

  10. Sugarsail1 Sugarsail1 United States says:

    I used to do contamination compliance measurements for biotech and nanotech with particle counters capable of detecting particles down to 80nm  (the size of a coronavirus).  In a controlled environment with laminar flow in a class one cleanroom there is no difference between wearing a mask or not with regards to particles in the sub-micron range when the sensor is placed about a foot in front of your face.  In fact, if you cough you get so many sub-half micron particles that the sensor of our machine needed to be sent back to the factory to be cleaned as it would ruin it.  There isn't a mask manufacturer out there that will claim their masks are capable of impeding viral transmission, in fact they state precisely the opposite on their packaging. There's no way any study, now that this issue has been so politicized and corrupted by bribed-science, is ever going to convince me that a simple mask in open air does jack against a viral particle anymore than a chain-link fence stops mosquitoes.   Every bit of my career experience says otherwise, as does the pre-Covid published literature.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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