University of Wisconsin–Madison Medical College of Wisconsin

The Great Mask Debate: A Debate That Shouldn’t Be a Debate at All

John R. Raymond, Sr., MD

WMJ. 2020;119(4):229-239.

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Background: Despite a rapidly growing and evolving literature, there continues to be a vigorous public debate about whether the community use of face coverings can mitigate the spread of COVID-19 ten months into the pandemic.

Objectives: This article describes a semi-structured literature review of the use of face coverings to prevent the spread of coronaviruses and similar respiratory pathogens, with a focus on SARS-CoV-2 (COVID-19).

Methods: The author conducted a semi-structured literature review using search terms “COVID-19” or “SARS-CoV-2” crossed with “mask/s” or “face covering/s.” Articles were evaluated through October 30, 2020 for inclusion, as were key references cited within the primary references and other references identified through traditional and social media outlets.

Results: There is strong evidence to support the community use of face coverings to mitigate the spread of COVID-19 from various laboratory, epidemiological, natural history, clinical, and economic studies, although there was only 1 high-quality published randomized controlled trial of this topic at the time of review.

Conclusions: The evidence in favor of community face coverings to slow the spread of COVID-19 is strong. Although most of the benefit of wearing a face covering is conferred to the community and to bystanders, a face covering also can protect the wearer to some extent, both by reducing the risk of COVID-19 infection, and perhaps by reducing the severity of illness for those who contract a COVID-19 infection.

Author Affiliation: Medical College of Wisconsin, Department of Medicine (Division of Nephrology), and Office of the President, Milwaukee, Wis (Raymond).
Corresponding Author: John R. Raymond, Sr., MD, Office of the President, Medical College of Wisconsin, 8701 Watertown Plank Rd, Wauwatosa, WI 53226-0509; phone 414.955.8225; email
Funding/Support: None declared.
Financial Disclosures: None declared.
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