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Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis

BACKGROUND: The burden of severe disease and death due to SARS-CoV-2 (COVID-19) pandemic among healthcare workers (HCWs) worldwide has been substantial. Masking is a critical control measure to effectively protect HCWs from respiratory infectious diseases, yet for COVID-19, masking policies have var...

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Detalles Bibliográficos
Autores principales: Lu, Yijun, Okpani, Arnold Ikedichi, McLeod, Christopher B., Grant, Jennifer M., Yassi, Annalee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier B.V. on behalf of Australasian College for Infection Prevention and Control. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932689/
https://www.ncbi.nlm.nih.gov/pubmed/36863978
http://dx.doi.org/10.1016/j.idh.2023.01.004
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author Lu, Yijun
Okpani, Arnold Ikedichi
McLeod, Christopher B.
Grant, Jennifer M.
Yassi, Annalee
author_facet Lu, Yijun
Okpani, Arnold Ikedichi
McLeod, Christopher B.
Grant, Jennifer M.
Yassi, Annalee
author_sort Lu, Yijun
collection PubMed
description BACKGROUND: The burden of severe disease and death due to SARS-CoV-2 (COVID-19) pandemic among healthcare workers (HCWs) worldwide has been substantial. Masking is a critical control measure to effectively protect HCWs from respiratory infectious diseases, yet for COVID-19, masking policies have varied considerably across jurisdictions. As Omicron variants began to be predominant, the value of switching from a permissive approach based on a point of care risk assessment (PCRA) to a rigid masking policy needed to be assessed. METHODS: A literature search was conducted in MEDLINE (Ovid platform), Cochrane Library, Web of Science (Ovid platform), and PubMed to June 2022. An umbrella review of meta-analyses investigating protective effects of N95 or equivalent respirators and medical masks was then conducted. Data extraction, evidence synthesis and appraisal were duplicated. RESULTS: While the results of Forest plots slightly favoured N95 or equivalent respirators over medical masks, eight of the ten meta-analyses included in the umbrella review were appraised as having very low certainty and the other two as having low certainty. CONCLUSION: The literature appraisal, in conjunction with risk assessment of the Omicron variant, side-effects and acceptability to HCWs, along with the precautionary principle, supported maintaining the current policy guided by PCRA rather than adopting a more rigid approach. Well-designed prospective multi-centre trials, with systematic attention to the diversity of healthcare settings, risk levels and equity concerns are needed to support future masking policies.
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spelling pubmed-99326892023-02-16 Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis Lu, Yijun Okpani, Arnold Ikedichi McLeod, Christopher B. Grant, Jennifer M. Yassi, Annalee Infect Dis Health Review BACKGROUND: The burden of severe disease and death due to SARS-CoV-2 (COVID-19) pandemic among healthcare workers (HCWs) worldwide has been substantial. Masking is a critical control measure to effectively protect HCWs from respiratory infectious diseases, yet for COVID-19, masking policies have varied considerably across jurisdictions. As Omicron variants began to be predominant, the value of switching from a permissive approach based on a point of care risk assessment (PCRA) to a rigid masking policy needed to be assessed. METHODS: A literature search was conducted in MEDLINE (Ovid platform), Cochrane Library, Web of Science (Ovid platform), and PubMed to June 2022. An umbrella review of meta-analyses investigating protective effects of N95 or equivalent respirators and medical masks was then conducted. Data extraction, evidence synthesis and appraisal were duplicated. RESULTS: While the results of Forest plots slightly favoured N95 or equivalent respirators over medical masks, eight of the ten meta-analyses included in the umbrella review were appraised as having very low certainty and the other two as having low certainty. CONCLUSION: The literature appraisal, in conjunction with risk assessment of the Omicron variant, side-effects and acceptability to HCWs, along with the precautionary principle, supported maintaining the current policy guided by PCRA rather than adopting a more rigid approach. Well-designed prospective multi-centre trials, with systematic attention to the diversity of healthcare settings, risk levels and equity concerns are needed to support future masking policies. Published by Elsevier B.V. on behalf of Australasian College for Infection Prevention and Control. 2023-02-16 /pmc/articles/PMC9932689/ /pubmed/36863978 http://dx.doi.org/10.1016/j.idh.2023.01.004 Text en Crown Copyright © 2023 Published by Elsevier B.V. on behalf of Australasian College for Infection Prevention and Control. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Review
Lu, Yijun
Okpani, Arnold Ikedichi
McLeod, Christopher B.
Grant, Jennifer M.
Yassi, Annalee
Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis
title Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis
title_full Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis
title_fullStr Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis
title_full_unstemmed Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis
title_short Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis
title_sort masking strategy to protect healthcare workers from covid-19: an umbrella meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932689/
https://www.ncbi.nlm.nih.gov/pubmed/36863978
http://dx.doi.org/10.1016/j.idh.2023.01.004
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