ArticleEClinicalMedicine2021
Mask use in community settings in the context of COVID-19: A systematic review of ecological data.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Non-pharmaceutical interventions in containing COVID-19 pandemic after the roll-out of coronavirus vaccines: a systematic review.BMC public health · 2024Pooled it
- The role of vitamin D in prevention OF COVID-19 and its severity: an umbrella review.Acta bio-medica : Atenei Parmensis · 2021Pooled it
- Synthesis challenges in complex evidence: A critical analysis of systematic reviews of face mask efficacy.Research synthesis methods · 2026Article
- Factors influencing mask use and physical distancing for COVID-19: A qualitative evidence synthesis.Journal of public health in Africa · 2025Review
- From evidence to policy: WHO's COVID-19 infection prevention and control guideline development process.Journal of public health in Africa · 2025Article
- Epidemiological impact of revoking mask-wearing recommendation on COVID-19 transmission in Tokyo, Japan.Infectious Disease Modelling · 2024Article
- Article
- Evaluation of the penetration capacity of bacteria through layers of different face mask types and wearing conditions.Scientific reports · 2024Article
- The effects of public health and social measures (PHSM) implemented during the COVID-19 pandemic: An overview of systematic reviews.Cochrane evidence synthesis and methods · 2024Review
- Article
- SARS-CoV-2 Contamination on Healthy Individuals' Hands in Community Settings During the COVID-19 Pandemic.Cureus · 2024Article
- Differential associations of mask mandates on COVID-19 infection and mortality by community social vulnerability.American journal of infection control · 2024Article
- Evolution of WHO COVID-19 mask guidelines amid intense demands for rapid advice.PLOS global public health · 2024Article
- Cost-effectiveness of mask mandates on subways to prevent SARS-CoV-2 transmission in the United States.PloS one · 2024Article
- Habitual Mask Wearing as Part of COVID-19 Control in Japan: An Assessment Using the Self-Report Habit Index.Behavioral sciences (Basel, Switzerland) · 2023Article
- Differential practice and associated factors of COVID-19 personal preventive measures among the slum and estate communities of Uganda: A community-based cross-sectional survey.Journal of global health · 2023Article
- Cessation of Face Mask Use after COVID-19 Vaccination in Patients with Diabetes: Prevalence and Determinants.International journal of environmental research and public health · 2023Article
- Impacts of public health and social measures on COVID-19 in Europe: a review and modified Delphi technique.Frontiers in public health · 2023Review
- Article
- Protective behavior and SARS-CoV-2 infection risk in the population - Results from the Gutenberg COVID-19 study.BMC public health · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe wearing of medical and non-medical masks by the general public in community settings is one intervention that is important for the reduction of SARS-CoV-2 transmission, and has been the subject of considerable research, policy, advocacy and debate. Several observational studies have used ecological (population-level) data to assess the effect of masks on transmission, hospitalization, and mortality at the region or community level.
methodsWe undertook this systematic review to summarize the study designs, outcomes, and key quality indicators of using ecological data to evaluate the association between mask wearing and COVID-19 outcomes. We searched the World Health Organization (WHO) COVID-19 global literature database up to 5 March 2021 for studies reporting the impact of mask use in community settings on outcomes related to SARS-CoV-2 transmission using ecological data.
findingsTwenty one articles were identified that analysed ecological data to assess the protective effect of policies mandating community mask wearing. All studies reported SARS-CoV-2 benefits in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes. Few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing, and information about compliance to these policies was lacking.
interpretationEcological studies have been cited as evidence to advocate for the adoption of universal masking policies. The studies summarized by this review suggest that community mask policies may reduce the population-level burden of SARS-CoV-2. Methodological limitations, in particular controlling for the actual practice of mask wearing and other preventive policies make it difficult to determine causality. There are several important limitations to consider for improving the validity of ecological data.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.