By NewsDesk  @bactiman63

Earlier this week, the Norwegian Institute of Public Health published a rapid review of evidence to inform a recommendation regarding people without respiratory symptoms wearing facemasks in the community to reduce the spread of Covid-19.

Image by leo2014 from Pixabay

They note there is evidence of a protective effect of medical facemasks against respiratory infections in community settings. Randomized trials from community settings indicate a small protective effect. There is no reliable evidence of the effectiveness of non-medical facemasks in community settings. There is likely to be substantial variation in effectiveness between products.

Potential undesirable effects of facemasks include the risks of incorrect use, a false sense of security (leading to relaxation of other interventions), and contamination of masks. In addition, some people experience problems breathing, discomfort, and problems with communication.

In defined areas with a high incidence and risk of spread, use of facemasks has been recommended, or mandated. Surveys indicate that facemasks are currently accepted by the healthy population in Norway. However, the extent to which facemasks are used correctly and if use leads to a false sense of security is uncertain.

The most important criteria for our recommendation were the problem priority (the baseline risk and seriousness of the spread of Covid-19 in the community from people without respiratory symptoms) and the balance of desirable and undesirable effects.

In situations where the incidence of Covid-19 is low and controlled, we do not recommend the use of facemasks by individuals without respiratory symptoms in the community who are not in close contact with people who are known or assumed to be infected.

In situations where the incidence is high, increasing or the spread is uncontrolled, either locally, regionally or nationally, use of facemasks should be considered even though study results of the protective effect vary greatly and the certainty of the evidence is low. A recommendation to use facemasks should be based on a risk assessment, not the incidence alone, and should be targeted to settings where distance cannot be kept indoors, including on public transport, and especially where contact tracing is difficult. Facemasks should only be recommended as an additional measure when the incidence cannot be controlled by less burdensome measures.

Medical facemasks or quality controlled non-medical facemasks with a documented filtration effect should be used. For personal protection, for example by people belonging to medical risk groups, only medical facemasks type II or IIR should be used.

If a recommendation to use facemasks is made, the community should be given information to ensure correct use and the risks should be explained, including the risks of a false sense of security and contamination of masks. The training should be tailored to the needs of different groups, including people with different levels of fluency in Norwegian and different socio-economic circumstances. There is some evidence that suggests information which emphasizes caring and fairness may improve compliance more than mandates that emphasize authority. Gender and age specific information may also increase compliance.

Facemasks should not replace other interventions such as physical distancing, avoiding situations where social distancing is not possible, hand washing, and use of disinfectants.

Health officials reported 3994 new cases of covid-19 in the week ending Nov. 14. The number of reported cases increased in 5 of 11 counties, and there are still large geographical variations in incidence both between and within counties. The number of reported cases of infection decreased in 6 counties. Oslo has seen the highest incidence in recent weeks.

There has been an increasing trend in new patients admitted to hospitals and the number of covid-19 associated deaths increases weekly, with 10 deaths reported last week.