The 2019 (COVID-19), pandemic caused by extreme acute respiratory syndrome coronavirus 2 (SARSCoV-2), has seriously affected staff in the health care sector (HCWs).1 Hospitaller programs have thus begun to monitor for HCWs2 as well as to introduce infection control measures to mitigate decline and prevent the spread of disease. By March 2020, MGB adopted a multipurpose infection control strategy that included rigorous symptomatic HCWs monitoring and universal cover-up for both HCWs and surgical mask patients4. This research tested the combination of hospital masking policies with the SARS-CoV-2 rate of HCW infection.
We have classified three phases in the study period: a period of pre-intervention prior to universal masking of HCWs (1-24 March 2020); a period of transition to universal masking of patients (25 March to 5 April 2020) plus an extra lag time to allow symptoms to occur in the field (6-10 April 2020) as described before; and a period of intervention (5) (April 11-30, 2020).
Results 1271 (12.9 percent) of 9850 tested HCWs were positive for SARS-CoV-2 (median age, 39 years; 73 percent female; 7.4 percent physicians or trainees, 26.5 percent nurses or physician assistants, 17.8 percent technologists or nursing support, and 48.3 percent other). The SARSCoV-2 positive rate increased exponentially over the prevention period, from 0 percent, to 21.32 percent, with a weighted average increase of 1.16 percent per day and an increase in case of three .6 days (95 percent CI, 3.0-4.5 days). The positive rate was down from 14.65% to 11.46% during the intervention period, with an average weighted decrease of 0.49% per day and a net slope shift of 1.65% (95% CI, 1.13% -2.15%; P <-0.001) more per day in relation to the pre-intervention period. Universal masking has been associated with a significantly lower HCW-SARS-CoV-2 positivity score. The transmission between patients, HCWs and HCWs may also be reduced. Other interventions inside and outside the health system may confuse a reduction in HCW infection including restrictions on elective procedures, measures to separate people from social activities and increased public masking spaces, which are limitations in this report. Despite the local and state measurements, the number of cases continued to rise over the entire study period in Massachusetts,6 indicating that the positive incidence in the SARS-CoV-2 MGB HCW decreased before the general population decreased. Randomized tests of universal HCW masking are possibly not possible during a plague. Nevertheless, this research supports universal masking in healthcare environments as a district of a multi-faceted infection control strategy. In the overall public and societal sense, differences have been noted 1–8 as an example: The United States Surgeon General recommended against the procurement of masks that would be used by healthy people. The widespread use of facial masks is largely due to the protection of scarce resources in health-care settings. The statement that face masks do not provide adequate defense against coronavirus infection has also discouraged universal mask use in the population. The difference between the absence of proof and absence, however, is important. There is no evidence to support the successful defense of facial masks against respiratory infections in the Population, as is recognized in uk and Germany recommendations.7,8 However, facial maskings are commonly used as a neighborhood for gout precautions in the care of patients with respiratory infections. Avoid crowded environments and rationally use the surgical facial masks when exposed to high risk areas would be fair to recommend to vulnerable people. As it can be shown, before symptoms begin COVID-19 could be transmitted, communal transmission could decrease if everybody wears facial masks, including people who are infected but are asymptomatic and infectious. We have shown that the usage of masks greatly increases once local epidemics start, including N95 breathes (without other safety equipment) used in community settings. The recommendation on the use of face masks differs across countries. This rise in the use of facial masks by the general public exacerbates the global scarcity of facial masks, with prices rising,9 and risks constraining the availability of primary healthcare staff. In addition, some countries (e.g. Germany and South Korea) restricted exports of face masks in an attempt to prioritize local demand.10 WHO led to a 40 per cent rise in protective equipment assembly, including face masks 9. Masking on the health system and its outcomes among healthcare providers worldwide
References
1. Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic.JAMA. 2020;323(15):1439-1440. doi:10.1001/jama.2020.3972
2. Hunter E, Price DA, Murphy E, et al. First experience of COVID-19 screening of health-care workers in England. Lancet. 2020;395(10234):e77-e78. doi:10.1016/S0140-6736(20)30970-3
3. Black JRM, Bailey C, Przewrocka J, Dijkstra KK, Swanton C. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet. 2020;395(10234):1418-1420. doi:10.1016/S0140-6736(20)30917-X
4. Klompas M, Morris CA, Sinclair J, Pearson M, Shenoy ES. Universal masking in hospitals in the Covid-19 era. N Engl J Med. 2020;382(21):e63. doi:10.1056/NEJMp2006372
5. Sen S, Karaca-Mandic P, Georgiou A. Association of stay-at-home orders with COVID-19 hospitalizations in 4 states.JAMA. 2020;323(24):2522-2524. doi:10. 1001/jama.2020.9176
6. Massachusetts Department of Public Health COVID-19 dashboard—April 30, 2020. Accessed June 27, 2020. https://www.mass.gov/doc/covid-19- dashboard-april-30-2020/download
7 National Health Service. Are face masks useful for preventing coronavirus? 2020. https://www.nhs.uk/conditions/coronavirus-covid-19/commonquestions/ (accessed March 5, 2020).
8 Federal Ministry of Health, Germany. Daily updates on the coronavirus: is wearing a surgical mask, as protection against acute respiratory infections, useful for members of the general public? 2020. https://www.bundesgesundheitsministerium.de/en/press/2020/coronavirus.html(accessed March 5, 2020).
9 WHO. Shortage of personal protective equipment endangering health workers worldwide. March 3, 2020. https://www.who.int/news-room/detail/03-03-2020-shortage-of-personal-protective-equipmentendangering-health-workers-worldwide (accessed March 17, 2020)
10.Tsang A. EU seeks solidarity as nations restrict medical exports. March 7, 2020. https://www.nytimes.com/2020/03/07/business/euexports-medical-equipment.html (accessed March 17, 2020).
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