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Updated: March 2022
Get-go published: July 2020
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An overview of the current evidence regarding the effectiveness of face up masks.

A) Studies ⇓ B) WHO review ⇓ C) Existent-world evidence ⇓ D) N95/FFP2 masks ⇓ E) Boosted aspects ⇓ F) The droplets issue ⇓ G) Opposite prove ⇓ H) Mask-related risks ⇓ I) Decision ⇓

A) Studies on the effectiveness of confront masks

And then far, well-nigh studies found piddling to no bear witness for the effectiveness of face masks in the general population, neither as personal protective equipment nor as a source command.

A May 2020 meta-study on pandemic flu published past the US CDC establish that face masks had no issue, neither as personal protective equipment nor as a source command. (Source)
A WHO review of ten randomized controlled trials of face masks against influenza-like illness, published in September 2019, plant no statistically significant benefit. (Source)
A Danish randomized controlled trial with 6000 participants, published in the Annals of Internal Medicine in November 2020, found no statistically significant effect of high-quality medical face up masks against SARS-CoV-2 infection in a community setting. (Source)
A large randomized controlled trial with close to 8000 participants, published in October 2020 in PLOS One, found that face masks "did not seem to exist effective against laboratory-confirmed viral respiratory infections nor against clinical respiratory infection." (Source)
A Feb 2021 review by the European CDC found no high-quality evidence in favor of face masks and recommended their apply only based on the 'precautionary principle'. (Source)
A July 2020 review by the Oxford Centre for Prove-Based Medicine found that there is no prove for the effectiveness of face masks confronting virus infection or transmission. (Source)
A November 2020 Cochrane review institute that face masks did not reduce influenza-like affliction (ILI) cases, neither in the full general population nor in health care workers. (Source)
An Baronial 2021 written report published in the Int. Enquiry Journal of Public Health found "no association between mask mandates or use and reduced COVID-xix spread in U.s.a. states." (Source)
A big Spanish school study, published in March 2022, found that "mask mandates in schools were not associated with lower SARS-CoV-two incidence or manual." (Source)
A May 2020 article by researchers from Harvard Medical School, published in the New England Periodical of Medicine, concluded that face masks offering "little, if any, protection". (Source)
A 2015 study in the British Medical Journal BMJ Open establish that material masks were penetrated by 97% of particles and may increase infection chance by retaining moisture or repeated utilise. (Source)
An August 2020 review by a German professor in virology, epidemiology and hygiene found that there is no testify for the effectiveness of face up masks and that the improper daily use of masks by the public may in fact lead to an increase in infections. (Source)

For a review of studies claiming face masks are constructive, run across section G) below.

B) WHO review of face mask trials (2019)

In September 2019, shortly earlier the coronavirus pandemic, the World Health Organization (WHO) published a comprehensive report on "Non-pharmaceutical public health measures for mitigating the run a risk and affect of epidemic and pandemic flu".

The written report reviewed ten randomized controlled trials concerning the effectiveness of face masks against flu-like illness (ILI). Every bit the following table shows, none of the trials found a statistically significant benefit of face masks.

WHO: 2019 review of face mask RCTs (WHO report/annex)

C) Development of cases after mask mandates

In many states, coronavirus infections strongly increased after mask mandates had been introduced. The post-obit charts bear witness the typical examples of Republic of austria, Belgium, France, Germany, Ireland, Italy, Kingdom of spain, the UK, California and Hawaii. Furthermore, a direct comparison between US states with and without mask mandates indicates that mask mandates take made no difference. (Charts: Y. Weiss)

For an updated version of these charts, encounter the postscript below.

D) Effectiveness of N95/FFP2 mask mandates

In January 2021, the High german state of Bavaria was one of the first places in the world to mandate N95/FFP2 masks in well-nigh public settings. A comparison with other German states, which required material or medical masks, indicates that even N95/FFP2 masks have fabricated no difference.

Covid cases in the German language state of Bavaria (FFP2/N95 mandate since 01/21) vs. Germany overall (RKI/ISC)

In January 2021, Austria was the kickoff state in the earth to innovate an N95/FFP2 mask mandate at the national level. The mandate was further expanded in September 2021. Nevertheless, by November 2021 Austria reported the highest infection rate in the world.

Austria: Interventions and infections (IanMSC)

E) Additional aspects

There is increasing evidence that the novel coronavirus is transmitted, at least in indoor settings, not primarily by droplets only by much smaller aerosols. Withal, due to their big pore size and poor fit, most face up masks cannot filter out aerosols (see video analysis below): over 90% of aerosols penetrate or bypass the mask and fill a medium-sized room inside minutes.
The WHO admitted to the BBC that its June 2020 mask policy update was due non to new evidence simply "political lobbying": "Nosotros had been told past various sources WHO commission reviewing the evidence had not backed masks but they recommended them due to political lobbying. This point was put to WHO who did not deny." (D. Cohen, BBC Medical Corresponent).
To engagement, the only randomized controlled trial (RCT) on face masks confronting SARS-CoV-2 infection in a community setting found no statistically significant benefit (meet above). However, three major journals refused to publish this study, delaying its publication past several months.
An analysis by the U.s.a. CDC found that 85% of people infected with the new coronavirus reported wearing a mask "e'er" (70.6%) or "often" (14.4%). Compared to the control group of uninfected people, always wearing a mask did not reduce the risk of infection.
Researchers from the University of Minnesota found that the infectious dose of SARS-CoV-2 is just 300 virions (virus particles), whereas a single infinitesimal of normal speaking may generate more than 750,000 virions, making face masks unlikely to forbid infection.
Opposite to common belief, studies in hospitals found that the wearing of a medical mask by surgeons during operations didn't reduce post-operative bacterial wound infections in patients.
Many health authorities argued that face masks suppressed flu; in reality, influenza was temporarily displaced by the more infectious coronavirus. Indeed, influenza disappeared even in states without masks, lockdowns and schoolhouse closures (e.m. Sweden and Florida).
The initially low coronavirus infection charge per unit in some Asian countries was not due to masks, but due to very rapid border controls. For instance, Japan, despite its widespread use of face up masks, had experienced its nearly contempo influenza epidemic merely one twelvemonth prior to the covid pandemic.
Early in the pandemic, the advocacy group "Mask for All" argued that Czechia had few infections thanks to the early use of masks. In reality, the pandemic only hadn't reached Eastern Europe still; a few months later, Czechia had i of the highest infection rates in the world.
During the notorious 1918 influenza pandemic, the utilize of confront masks among the general population was widespread and in some places mandatory, merely they fabricated no difference.

F) The facemask aerosol event

In the post-obit video, Dr. Theodore Noel explains the facemask aerosol issue.

K) Studies challenge face masks are effective

Some recent studies argued that face up masks are indeed effective against the new coronavirus and could at to the lowest degree forestall the infection of other people. However, most of these studies endure from poor methodology and sometimes show the opposite of what they merits to show.

Typically, these studies ignore the issue of other measures, the natural evolution of infection rates, changes in test activity, or they compare places with unlike epidemiological weather. Studies performed in a lab or every bit a estimator simulation often aren't applicable to the real world.

An overview:

A meta-study in the journal Lancet, commissioned by the WHO, claimed that masks could reduce the chance of infection by eighty%, but the studies considered mainly N95 respirators in a hospital setting, not textile masks in a community setting, the forcefulness of the evidence was reported as "depression", and experts found numerous flaws in the study. Professor Peter Jueni, epidemiologist at the University of Toronto, chosen the WHO study "essentially useless".
A study in the journal PNAS claimed that masks had led to a decrease in infections in three global hotspots (including New York City), but the study did not accept into account the natural subtract in infections and other simultaneous measures. The written report was so flawed that over twoscore scientists recommended that the report exist withdrawn.
A US written report claimed that US counties with mask mandates had lower Covid infection and hospitalization rates, merely the authors had to withdraw their report as infections and hospitalizations increased in many of these counties shortly after the study was published.
A large written report run in People's republic of bangladesh claimed that surgical masks, but not fabric masks, reduced "symptomatic SARS-CoV-2 infections" by 0.08% (ARR), and merely in people over 50. But a subsequent re-analysis of the study by statisticians establish that there was in fact no benefit at all. According to 1 reviewer, the Bangladesh study was designed so poorly that it "ended before it even began".
A German report claimed that the introduction of mandatory face masks in German language cities had led to a significant decrease in infections. Just the information did non back up this claim: in some cities in that location was no change, in others a subtract, in others an increase in infections (encounter graph below). The city of Jena was an 'exception' merely considering it simultaneously introduced the strictest quarantine rules in Federal republic of germany, simply the study did not mention this.
A review by the University of Oxford claimed that face up masks are effective, just it was based on studies about SARS-1 and in wellness care settings, not in customs settings.
A review by members of the lobby group 'Masks for All', published in the journal PNAS, claimed that masks are effective as a source control against aerosol transmission in the community, merely the review provided no real-world evidence supporting this suggestion.
A written report published in Nature Communications in June 2021 claimed that masks reduced the risk of infection by 62%, just the study relied on cocky-reported online survey results and various modelling assumptions, not on actual measurements.
A meta-study published in the BMJ claimed confront masks reduced infections by 53%, but the meta-study was based on seven depression-quality observational studies. In response, the BMJ published an editorial acknowledging the "lack of good research" and the implausibility of the outcome.
A German written report, published in PNAS, claimed that N95/FFP2 masks are highly effective confronting coronavirus infections, simply the report consisted only of a mathematical model without any real-earth or lab data (see section D above).

The annex of the German Jena study showed that face masks weren't effective:

Mandatory masks in High german cities: no relevant bear upon. (IZA 2020)

H) Risks associated with face masks

Wearing masks for a prolonged period of time may not be harmless, as the post-obit evidence shows:

The WHO warns of various "side effects" such as difficulty breathing and peel rashes.
An Israeli-Canadian study, published in Cognitive Research in February 2022, institute that "face masks disrupt holistic processing and face perception in schoolhouse-age children".
Tests conducted by the University Hospital of Leipzig in Germany have shown that face masks significantly reduce the resilience and performance of salubrious adults.
A High german psychological written report with virtually k participants found "severe psychosocial consequences" due to the introduction of mandatory confront masks in Germany.
The Hamburg Environmental Institute warned of the inhalation of chlorine compounds in polyester masks also as issues in connectedness with confront mask disposal.
The European rapid alert system RAPEX has already recalled over 100 mask models because they did not see European union quality standards and could lead to "serious risks".
A written report past the Academy of Muenster in Deutschland plant that on N95 (FFP2) masks, Sars-CoV-2 may remain infectious for several days, thus increasing the risk of self-contamination.
In China, several children who had to wearable a mask during gym classes fainted and died; autopsies establish a sudden cardiac arrest as the probable crusade of death. In the Usa, a car driver wearing an N95 (FFP2) mask fainted and crashed due to CO2 intoxication.

Video: A mask-wearing, xix-yr-old US athlete collapsed during an 800-meter run (April 2021):

Decision

Face masks in the general population might be effective, at to the lowest degree in some circumstances, but in that location is currently little to no evidence supporting this proposition. If the coronavirus is primarily transmitted via indoor aerosols, face up masks are unlikely to be protective. Thus, health regime should non assume or suggest that face masks will reduce the rate or hazard of infection.

United States: mask mandates without do good

United states: mask mandates without benefit (IanMSC)

Postscript (August 2021)

A long-term analysis shows that infections have been driven primarily by seasonal and endemic factors, whereas mask mandates and lockdowns take had no discernible impact (charts: IanMSC).

Farther reading

The face up mask folly in hindsight (August 2021)

Run into too

Facts about covid
Covid vaccine review
Handling of covid

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