Is a surgical/medical mask just as effective as a respirator/N95/KN95 mask at reducing the spread of COVID-19?

Last updated: February 20, 2022
There is no consensus in the literature on this question. We encourage you to read the study summaries below or the studies themselves if you have access.
This short answer was generated by aggregating the answers that each of the studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong. For medical questions, don't rely on the information here. Consult a medical professional.
4
YES ANSWERS
0
NO ANSWERS
1
NO DATA ON ANSWER


Chart summary of 5 studies examining this question

All answers are assigned by State of K users. The label Couldn't Identify means that State of K was not able to determine whether a study answers the question "yes" or "no". This could be due to several factors. One possibility is that a study found some evidence to indicate that the answer to the question is "yes" and some evidence to indicate that the answer is "no". This often happens when a study uses two or more proxies to study the same phenomenon (i.e. firearm sales figures and self-reported firearm ownership rates as proxies for the prevalence of firearms) and the proxies yield different results when looking for correlations with another phenomenon (i.e. firearm-related deaths). Alternatively, the label may be applied if the phenomenon under study (i.e. whether breast milk improves cognitive function) is true for one group, but not another (i.e. true for girls, but not for boys). Yet another possibility is that a study found there was insufficient evidence to reach a conclusion regarding the question. Finally, the full text or abstract of a study may not have been written clearly or was inaccessible. This would make it difficult to determine how a study answered a question.

All labels of Literature Reviews and source quality are assigned by State of K. All labels of High Quality Source are assigned based on whether the publication in which the article appeared was ranked as Q1 by Scimago Institutions Rankings. Certain well-regarded think tanks are also given this label.

Literature Reviews
Although we recommend you consider all of the studies below, we believe the following studies are literature reviews, which survey and evaluate many studies on this question:

SUMMARIES OF STUDIES
Total studies in list: 5
Sorted by publication year
1
What is the efficacy of standard face masks compared to respirator masks in preventing COVID-type respiratory illnesses in primary care staff?
"Trials comparing different kinds of mask have been summarised in a recent highquality systematic review and provide cautious support for the use of standardsurgical masks in non AGPs, though the empirical studies underpinning thisconclusion were not in a COVID-19 population, and only one was in a communitysetting. It is clear from the literature that masks are only one component of acomplex intervention which must also include eye protection, gowns, behaviouralmeasures to support proper doffing and donning, and general infection controlmeasures. These wider aspects of PPE will be covered in a further rapid review(ongoing)."
AUTHORS
Xin Hui Chan,
Trish Greenhalgh
PUBLISHED
2020 CEBM Research
Yes
Yes
2
Masks or N95 Respirators During COVID-19 Pandemic–Which One Should I Wear?
"PurposeCoronavirus Disease 2019 (COVID-19) has caused suffering and death around the world. Careful selection of facial protection is paramount for preventing virus spread among healthcare workers and preserving mask and N95 respirator supplies.MethodsThis paper is a comprehensive review of literature written in English and available on Pubmed comparing the risk of viral respiratory infections when wearing masks and N95 respirators. Current international oral and maxillofacial surgery guidelines for mask and N95 respirator use, patient COVID-19 disease status, aerosol producing procedures were also collected and incorporated into a workflow for selecting appropriate facial protection for oral and maxillofacial surgery procedures during the current pandemic.ResultsMost studies suggest N95 respirators and masks are equally protective against respiratory viruses. Some evidence favors N95 respirators, which are preferred for high-risk procedures when aerosol production is likely or when the COVID-19 status of a patient is positive or unknown. N95 respirators may also be used for multiple patients or reused depending on the type of procedure and condition of the respirator after each patient encounter.ConclusionN95 respirators are preferred over masks against viral respiratory pathogens, especially during aerosol-generating procedures or when a patient’s COVID-19 status is positive or unknown."
AUTHORS
Mingzhu Zhang' Andrew Robert Emery
PUBLISHED
2020 Journal of Oral and Maxillofacial Surgery
Literature Review
Couldn't Identify
Couldn't Identify
3
Medical masks vs N95 respirators for preventing COVID-19 in healthcare workers: A systematic review and meta-analysis of randomized trials
"BackgroundRespiratory protective devices are critical in protecting against infection in healthcare workers at high risk of novel 2019 coronavirus disease (COVID-19); however, recommendations are conflicting and epidemiological data on their relative effectiveness against COVID-19 are limited.PurposeTo compare medical masks to N95 respirators in preventing laboratory-confirmed viral infection and respiratory illness including coronavirus specifically in healthcare workers.Data SourcesMEDLINE, Embase, and CENTRAL from January 1, 2014, to March 9, 2020. Update of published search conducted from January 1, 1990, to December 9, 2014.Study SelectionRandomized controlled trials (RCTs) comparing the protective effect of medical masks to N95 respirators in healthcare workers.Data ExtractionReviewer pair independently screened, extracted data, and assessed risk of bias and the certainty of the evidence.Data SynthesisFour RCTs were meta-analyzed adjusting for clustering. Compared with N95 respirators; the use of medical masks did not increase laboratory-confirmed viral (including coronaviruses) respiratory infection (OR 1.06; 95% CI 0.90-1.25; I2 = 0%; low certainty in the evidence) or clinical respiratory illness (OR 1.49; 95% CI: 0.98-2.28; I2 = 78%; very low certainty in the evidence). Only one trial evaluated coronaviruses separately and found no difference between the two groups (P = .49).LimitationsIndirectness and imprecision of available evidence."
AUTHORS
Mark Loeb
Waleed Alhazzani
Mohammed Abdul Malik Farooqi
Jessica J. Bartoszko
PUBLISHED
2020 Influenza and Other Respiratory Viruses
Literature Review
High Quality Source
Yes
Yes
4
Surgical masks vs respirators for the protection against coronavirus infection: state of the art
"Background: During the Covid-19 outbreak, a recurrent subject in scientific literature has been brought back into discussion: whether surgical masks provide a sufficient protection against airborne SARS-CoV-2 infections.Objectives: The objective of this review is to summarize the available studies which have compared the respective effectiveness of surgical masks and filtering facepiece respirators for the prevention of infections caused by viruses that are transmitted by the respiratory tract.Methods: The relevant scientific literature was identified by querying the PubMed database with a combination of search strings. The narrower search string "(surgical mask *) AND (respirator OR respirators)" included all the relevant articles retrieved using broader search strategies. Of all the relevant articles found, seven systematic reviews were selected and examined.Results: The currently available scientific evidence seems to suggest that surgical masks and N95 respirators/FFP2 confer an equivalent degree of protection against airborne viral infections.Discussion: Since surgical masks are less expensive than N95 respirators but seem to be as effective in protecting against airborne infection and they are also more comfortable for the user, requiring less respiratory work, they should be the standard protective device for health care workers and especially for workers who carry out non-medical jobs. Filtering facepiece respirators, whose extended use is less comfortable for the wearer, may be preferred for procedures which require greater protection for a shorter time."
AUTHORS
Francesco Saverio Violante
Tommaso Violante
PUBLISHED
2020 La Medicina del Lavoro
Literature Review
Yes
Yes
5
Comparative effectiveness of N95 respirators and surgical/face masks in preventing airborne infections in the era of SARS-CoV2 pandemic: A meta-analysis of randomized trials
"Background: Recently, several randomized controlled trials (RCTs) have evaluated the effect of N95 respirators compared with medical masks to protect against acute respiratory infections. However, these studies are limited by modest sample sizes and inconclusive results. Therefore, the goal of the present study was to review the relevant and available published RCTs with the aid of the increased power of meta-analytic methods in order to assess the effectiveness of medical masks and N95 respirators in reducing the risk of respiratory infections.Methods: This meta-analysis follows the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for conducting and reporting results. We searched PubMed, Web of Science, Embase, and Cochrane databases from inception through April 1, 2020 to identify potentially relevant studies. Two authors (LS and JS) independently searched the titles and abstracts of the potentially eligible articles. They independently retrieved required data from the eligible trials; the data were initially tabulated for statistical analysis. Two authors (JRL and LS) independently assessed the methodological quality of the included RCTs using the Cochrane Collaboration's tool for assessing risk of bias.Results: Six articles met the inclusion criteria. The pooled analysis showed that N95 respirators did not reduce the risk of infection with respiratory viruses compared with medical/surgical masks (5.7% vs. 7.9%; RR = 1.12; 95% CI: 0.88-1.41; p = 0.36); however, there was no statistically significant difference in laboratory-confirmed influenza between N95 and medical masks (RR = 0.91; 95% CI: 0.77-1.07; p = 0.26). Medical masks provided similar protection against other viruses, including coronavirus (RR = 0.74; 95% CI: 0.32-1.73; p = 0.49). Respiratory illness, as well as influenza-like illness were less frequently observed with N95 respirators.Conclusions: Our meta-analysis suggests that there are insufficient data to definitively determine whether N95 respirators are superior to medical masks in protection against transmissible acute respiratory infections. Further randomized trials are necessary to compare the above methods of respiratory protection in the context of COVID-19 incidence."
AUTHORS
Krzysztof Jerzy Filipiak
Lukasz Szarpak
Katarzyna Barycka
PUBLISHED
2020 PLoS One
Literature Review
High Quality Source
Yes
Yes