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

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


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 "COVID19" 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.

Publication types

  • Review

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / prevention & control*
  • COVID-19 / transmission
  • Communicable Disease Control / instrumentation*
  • Humans
  • Masks*
  • Pandemics / prevention & control*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology
  • SARS-CoV-2