Response and Adaptation of the Cardiac Autonomic System to Functional High-intensity Interval Training with Respiratory Facemasks: Impacts of the Training Period and Facemask Modality During a COVID-19 Pandemic

Background: Following the SARS-CoV-2 pandemic in 2019, medical face masks were widely recommended for large numbers of people and for long periods of time. The effect of wearing surgical and N95 face masks during long-term high-intensity interval training on the cardiac autonomic system has not been reported. Methods: Eighteen healthy men were randomly divided into three groups (surgical mask, N95 mask, and no mask) and performed high-intensity interval training with (80-90%-heart rate max) intensity three times a week, three repetitions in a session for four weeks. Heart rate variability parameters were evaluated with an electrocardiogram device and Kubius software. The R-R interval was recorded for 5 minutes in a sitting position in the pre-and post-modified Bruce test before and after four weeks of interval training to extract parasympathetic (RMSSD, HF, SD1), sympathetic indices (LF, LF/HF) and RR mean. We used the two-way ANOVA test and the Bonferroni post hoc test. Results: In all groups, four-week functional HIIT exercises increased the resting parasympathetic indices (RMSSD, SD1) compared to baseline levels. This increase was more evident in the N95 mask group than in the surgical mask group. In addition, the five-minute recovery of the cardiac autonomic system after a modified Bruce test following functional HIIT exercise increased parasympathetic tone (RMSSD, HFn.u) in all groups compared to baseline levels. Therefore, a four-week adaptation to HIIT exercises leads to faster recovery of sympathetic indices (LFn.u, LF/HF) in the Nomask group, as compared to the surgical and N95 groups. Despite the above, there was no significant difference in the recovery and resting values of cardiac autonomic system indices between the two types of surgical masks and N95 compared to the control group (No mask). Conclusions: Four weeks of high-intensity interval training using surgical and N95 face masks improved the cardiac autonomic nervous system. This data is important for recommending the use of face masks during physical activity. © 2023, Author(s).

Surface Contamination of Reusable Respirators and Face Shields During Care of Critically Ill COVID-19 Patients.

BACKGROUND: With the emergence of SARS-CoV-2, healthcare workers (HCW) have relied on reusable personal protective equipment (PPE), including respirators and face shields (FSs). The effectiveness of decontamination procedures outside experimental settings is unclear. We examined the prevalence of surface contamination on reusable PPE used by HCWs at a hospital incorporating daily centralized decontamination and post-use wiping by sampling for common pathogens. METHOD: Samples were collected from HCWs' CleanSpace Halo respirator face masks (FMs) and FSs at the start of shift, immediately after use, and after cleaning with disinfecting wipes. Samples were analyzed for pathogens using the Applied Biosystems™ TaqPath™ COVID-19 Combo Kit and ThermoFisher TaqMan Array Card. Patient charts were reviewed for clinical correlation. FINDINGS: Of the 89 samples, 51 from FMs and 38 from FSs, none tested positive for SARS-CoV-2, despite 58 being obtained from PPE used in the care of patients with COVID-19, many with recent aerosol-generating procedures. Four samples tested positive (4.5%) for Staphylococcus aureus, two each from FMs and FSs. FMs that tested positive were not worn concurrently with FSs that tested positive. The FM and FS samples testing positive were worn in the care of patients without diagnosed S. aureus infection. No FMs tested positive following wipe-based disinfection, but both positive FS samples were found after disinfection wiping. CONCLUSION/APPLICATION TO PRACTICE: Contamination of reusable PPE appears uncommon, especially with SARS-CoV-2, when regular decontamination programs are in place. The rare presence of S. aureus highlights the importance of doffing procedures and hand hygiene by HCW to prevent surface contamination.

Pandemic reveals new concerns about facial protection products: Design may be the answer to altering behaviors, habits ushered into standard practice

The article examines what medical suppliers and providers learned about facial protection products after the Covid-19 pandemic of 2020-2022. Topics discussed include remarks from Jason Burnham, Senior Director of Facial Protection at Owens & Minor, evidence of pandemic-relaxed behaviors morphing into workflow acceptance, and statement from Gary Harris, Vice President of Sales and Marketing at Prestige Ameritech, about emergency use guidelines for personal protective equipment (PPE).

Experience of using an adapted snorkel mask as personal protective equipment in the COVID-19 pandemic

Introduction: During the COVID-19 pandemic and the cases of shortages of personal protective equipment (PPE), the utilization of modified snorkel masks has been documented, seeking to provide respiratory and facial pro-tection against SARS-CoV-2 aerosols. However, there is no report of changes in vital signs that can occur with its use, along with the perception of its wear by health personnel. Method(s): A case series was performed. Equipment: Snorkel mask, 3D adapter, and antimicrobial filter. CO2 level, respiratory rate, oximetry, pulse, and blood pressure were monitored for one hour. During the time of use, activities related to patient care were simulated. At the end, the usage characteristics were evaluated through a survey. Result(s): 14 volunteers were included in the study. After one hour of conti-nuous use, the clinical parameters were predominantly normal. 85% of the participants preferred this modified snorkel mask instead of personal protective equipment established for COVID-19 (goggles, N95 mask and visor). Conclusion(s): The adapted snorkel mask could be an alternative to PPE equipment in situations of scarce resources. This is only considered within the framework of its acceptability by a group of health professionals, in addition to the few effects on the vital signs evaluated in this case series. Further objective evaluations of usability and effectiveness are required. Copyright © 2023 Universidad de Antioquia.

Functional analysis of a negative pressure airborne infection isolation canopy unit for the prevention of transmission of droplets and aerosols- An experimental study.

Background and Aims: This study describes the functional analysis of a negative pressure canopy unit developed to reduce infective aerosol and droplet spread in ad-hoc wards created to handle patients suffering from infective respiratory illnesses such as those recently encountered in the COVID-19 pandemic. Methods: An experimental study was conducted to verify the functional analysis of a canopy unit for the following variables: a) Quantitative and qualitative analysis of aerosol generation, b) Efficacy of canopy as containment device and c) Aerosol clearance from canopy over a period. We describe the process in the form of a problem statement, a discussion of design considerations (including Computer Aided Design modelling and a functional analysis of the system using a variety of simulated conditions which included various experiments for the purpose of testing the safety and efficiency of the system. We also incorporated Computational Fluid Dynamics analyses to assist us in design modifications of the unit using Euler-Lagrange approach for aerosol tracking. Results: As demonstrated by the series of experiments, it was seen that the aerosol load under the testing conditions reduced significantly. The canopy unit restricted the aerosol particles which either got adhered to the canopy walls or went into recirculation inside the canopy. In experimental conditions, the fan-filter unit was able to operate at >95% efficiency. Conclusion: This device exhibited 95-99% efficiency in eliminating aerosols which would reduce the exposure of health care workers to infective aerosols, which is not only specific to severe acute respiratory syndrome coronavirus (SARS-CoV)-2, but also to other airborne transmitted diseases.

Management of aerosol generation during upper gastrointestinal endoscopy.

In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.

Effect of surgical and N95 facial masks on exercise tolerance, heart rate, respiratory rate and blood oxygen saturation

Background - Although wearing masks is inevitable these days, the effects of wearing them on physiologic parameters have not been reported. This study aimed to assess the effects of wearing no mask, a three-layer standard surgical mask, and wearing an N95 mask on blood oxygen saturation, aerobic tolerance, and performance during exercise. Methods - Twenty-one participants were enrolled in the study. Each participant was monitored with electrocardiography (ECG) while performing an exercise tolerance test using the Bruce treadmill protocol. Testing was conducted three times on different dates. Participants did not use any mask in the first test but did wear surgical and N95 masks during the second and third tests respectively. Respiratory rate (RR) was assessed for 10 seconds and then multiplied by 6. Heart rate (HR) was monitored by ECG, and oxygen saturation levels were monitored (O2Sat) via digital pulse-oximetry. Assessments were done before warm-up, at the middle and end of each Bruce stage, and as well at 1, 2, and 5 minutes into recovery (masks were worn during recovery). Results - HR, RR, and O2Sat measured data were all significantly different between the three trials at end-stage 3 of Bruce treadmill protocol (p<0.05). Although HR was still higher through the recovery period in the N95 trial in comparison with other trials (p<0.05), RR and O2Sat measured data were not different in the recovery phase. Conclusion - HR, RR, O2Sat and exercise tolerance are significantly affected by wearing surgical and N95 masks.

Prevention of droplet dispersal with 'e-mask': A new daily use endoscopic mask during bronchoscopy.

BACKGROUND AND OBJECTIVE: Bronchoscopy is an airborne particle-generating procedure. However, few methods for safe bronchoscopy have been developed. To reduce airborne particles during bronchoscopy, we created an 'e-mask', which is a simple, disposable mask for patients. Our objective was to evaluate the e-mask's protective ability against airborne particles and to assess respiratory adverse events and complications. METHODS: Patients with stage 2-4 chronic obstructive pulmonary disease were excluded. We performed visualization and quantifying experiments on airborne particles with and without the e-mask. We prospectively evaluated whether wearing the e-mask during bronchoscopy was associated with the incidence of patients requiring >5 L/min oxygen to maintain >90% oxygen saturation, and patients with >45 mm Hg end-tidal carbon dioxide (EtCO2 ) elevation, in addition to complications, compared to historical controls. RESULTS: In the visualization experiment, more than ten thousand times of airborne particles were generated without the e-mask than with the e-mask. The volume of airborne particles was significantly reduced with the e-mask, compared to that without the e-mask (p = 0.011). Multivariate logistic regression analysis revealed that wearing the e-mask had no significant effect on the incidence of patients requiring >5 L/min oxygen to maintain >90% oxygen saturation, (p = 0.959); however, wearing the e-mask was a significant factor in >45 mm Hg EtCO2 elevation (p = 0.026). No significant differences in complications were observed between the e-mask and control groups (5.8% vs. 2.5%, p = 0.395). CONCLUSION: Wearing the e-mask during bronchoscopy significantly reduced the generation of airborne particles during bronchoscopy without increasing complications.

Fiber-Based Masks and Respirators: Using Decontamination Methods and Antimicrobial Treatment to Improve Its Reusability during Pandemic

Shortage of personal protective equipment (PPE) is often projected in response to public health emergencies such as infection outbreaks and pandemics. Respiratory protective devices (RPDs), namely medical face masks and respirators, are considered the last defense for the front-line healthcare workers. Cleaning, decontamination and reuse of the disposable RPDs have been accepted by local health authorities during the pandemic period. To contribute to the mitigation of RPD shortage and ensure the safe adoption of decontamination protocols, this review discusses the regulated testing standards and the most commonly studied decontamination methods in the literature. The reuse of RPDs must fulfill three criteria: remove the microbial thread, maintain original function and structural integrity (including fitting tests) and leave no harmful residuals. Decontamination methods such as ultraviolet germicidal irradiation, moist heat and vaporized hydrogen peroxide appeared to be the most promising methods in balancing the above-mentioned criteria. However, the effectiveness of decontamination methods varies depending on the RPDs’ models, materials and design. Therefore, the adoption of protocols needs to be evidence-based with full validation in the local institutes. Additionally, new technology such as antimicrobial treated PPE that can reduce the risks of fomite during donning and doffing process with an extended lifespan should be encouraged. Overall, good training and guidance for appropriate reuse of RPDs are fundamental to ensure their efficiency in protecting front-line healthcare workers.

Evaluation of the Microbiological Effectiveness of Three Accessible Mask Decontamination Methods and Their Impact on Filtration, Air Permeability and Physicochemical Properties.

The need to secure public health and mitigate the environmental impact associated with the massified use of respiratory protective devices (RPD) has been raising awareness for the safe reuse of decontaminated masks by individuals and organizations. Among the decontamination treatments proposed, in this work, three methods with the potential to be adopted by households and organizations of different sizes were analysed: contact with nebulized hydrogen peroxide (H2O2); immersion in commercial bleach (NaClO) (sodium hypochlorite, 0.1% p/v); and contact with steam in microwave steam-sanitizing bags (steam bag). Their decontamination effectiveness was assessed using reference microorganisms following international standards (issued by ISO and FDA). Furthermore, the impact on filtration efficiency, air permeability and several physicochemical and structural characteristics of the masks, were evaluated for untreated masks and after 1, 5 and 10 cycles of treatment. Three types of RPD were analysed: surgical, KN95, and cloth masks. Results demonstrated that the H2O2 protocol sterilized KN95 and surgical masks (reduction of >6 log10 CFUs) and disinfected cloth masks (reduction of >3 log10 CFUs). The NaClO protocol sterilized surgical masks, and disinfected KN95 and cloth masks. Steam bags sterilized KN95 and disinfected surgical and cloth masks. No relevant impact was observed on filtration efficiency.

An Emergency Powered Air-Purifying Respirator From Local Materials and its Efficacy Against Aerosolized Nanoparticles.

We describe an approach used by a rural healthcare provider to convert surgical helmets into emergency powered air-purifying respirators (PAPRs) at the onset of the COVID-19 pandemic. The approach uses common materials and efficacy was demonstrated against aerosols measuring 7 nm to 25 µm in diameter.

The effect of respiratory protective masks on ventilatory efficiency and operating lung volumes in a recreational runner

We evaluated the effect of different respiratory protective masks (RPM) on ventilatory efficiency and operating lung volumes in a recreational runner. A healthy 36-years-old male runner underwent a pulmonary function test and cardiorespiratory exercise test with different RPM types and no mask (NM). Lung volumes and airflow resistance were similar regarding surgical and 3D knit masks compared to NM. Lower functional vital capacity and forced expiratory volume in 1 second were observed for N95 compared to NM. Regarding ventilatory efficiency analysis, lower values for VE/VCO2 slope in the interval at rest-respiratory compensation point and at rest-peak of exercise were observed for the surgical, 3D knit, and N95 masks compared to NM. Tidal flow volume loop analysis showed an increase in end-expiratory lung volume (EELV) in the interval 80% of the ventilatory anaerobic threshold-peak of exercise, while there was a decrease with NM. Lower VO2max was observed for surgical, 3D knit, and N95 masks compared to NM and lower speed at VO2max. The athlete reported greater comfort with 3D knit compared to surgical and N95 masks. The use of different RPM types during a progressive running exercise by a recreational runner showed lower ventilatory response and exercise tolerance, as well as increased EELV, perceived exertion, and respiratory discomfort. © 2021 Edizioni Minerva Medica. All rights reserved.

Influence of wearing masks on exhaled air aerodynamics.

Since aerosol inhalation is the most common mechanism for COVID-19 infection, the respiratory protective devices (RPDs) have the highest importance in personal protection. The aim of this study was to assess the efficiency of 10 different RPDs in shortening the travelling distance of exhaled air by range measurement using the schlieren imaging technique. When a RPD is worn by a person resting in a seated position, the expired air does not exceed the human convective boundary layer (CBL). Instead, the CBL lifts the expired aerosols vertically up. Thus, they have a prolonged travelling time in the surrounding air and become less harmful by several mechanisms of virus content decay. Coughing as well as expiration valves can cause far reaching expiration air clouds that cross horizontally the human CBL by opening leakage airway corridors into different directions. Measured by the range of expired air an FFP2 mask provided high security under all conditions tested. A non-vented full-face mask with two viral filters performed even better because of its airtight fit and the excellent filtering capacity of the viral filters during inspiration and expiration, even during cough manoeuvres.

The use of the respiratory protective devices by the population during the COVID-19 pandemic

Introduction. Wearing a face mask is an important measure against spread of infection during the COVID-19 pandemic. The purpose of the study was to analyze various aspects of the face masks use by the population during the pandemic. The questioner was used. Results. Almost all respondents (96.4%) wore respiratory protective devices during the pandemic;91.4% respondents worn face masks visiting grocery stores, pharmacies and medical organizations;64.0% — visiting non-food trade facilities;76.9% — travelling by surface transport, and 76.1% — being on the subway. Different types of face masks were used, 93.3% of respondents used disposable medical mask, 25.4% — reusable cloth masks. However, only 44.8% of respondents indicated that their protective equipment was made of non-woven material;26.1% did not know how many layers their protective equipment contained;about a third of respondents (20.1% — 30.21%) were not able to assess the effectiveness of different types of respiratory protection. A third of the respondents (33.6%) wore a disposable medical mask for 2 hours, 35.2% — more than 2 hours in one day, 28.0% — for several days. Conclusions. Most of the respondents wore the face mask. Disposable medical masks were most commonly used. Requirements for the duration of wearing of face masks were met by about third of the respondents, for the handling — half of the respondents. Spontaneous choice of face mask by respondents confirms the importance of the development of hygiene guideline for choosing the most effective respiratory protection. © AUTHORS, 2021.

Leveling up your mask game to respirators in the 6th wave of COVID

Vox.com/the-goods/22868641/chicago-school-closings-omicron-covid-remote-learning cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/types-of-masks.html tinyurl.com/WS-GuardMaskNerd tinyurl.com/WS-MaskNerdYT tinyurl.com/WS-FordFdnFilter tinyurl.com/WS-MinPhyMask1 tinyurl.com/WS-MinPhyMasks2 We are now entering the sixth upsurge of the U.S. COVID pandemic infections as we move back into often poorly ventilated indoor winter classrooms with stressed-out teachers, understaffed schools, and unvaccinated or partially vaccinated kids, and it's time to use the immense masking insights we have gained since fall 2020. There is no longer any reason for teachers (or anyone) to wear a cloth mask, a vented mask, or a paper surgical mask - we have much better alternatives. [Extracted from the article] Copyright of Physics Teacher is the property of American Institute of Physics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The effect of wearing an FFP3 mask (3MTM AuraTM) with an exhalation valve on gas exchange in medical staff.

OBJECTIVES: The physiological impact of wearing personal protective equipment (PPE), in particular filtering-face-piece 3 (FFP3) masks, has increasingly been gaining importance since the outbreak of coronavirus disease 2019 (COVID-19). So far, gas exchange has been examined using transcutaneously measured partial pressure of carbon dioxide (PaCO2), ergo-spirometry and impedance cardiography. MATERIAL AND METHODS: In this structured investigation, arterial blood gas analysis in a 30-year-old female resident was carried out during a 13-hour day shift on the COVID-19 Intensive Care Unit of the University Hospital of Innsbruck, Austria. An FFP3 mask (3MTM AuraTM) with an exhalation valve was continuously worn, except for 1 break of 20 min. Arterial blood samples were obtained before putting on the PPE, and after 5 h, 9 h and 13 h of working in the contaminated area. RESULTS: During the multi-hour wearing time, an increase in PaCO2 (the baseline value: 29.3 mm Hg, the max. value: 38.9 mm Hg) and a continuous decrease in partial pressure of oxygen (PaO2, the baseline value: 102 mm Hg, the min. value: 80.8 mm Hg) was detectable. CONCLUSIONS: All measured values were within the normal range, but a trend towards an insufficient gas exchange could be suspected. Int J Occup Med Environ Health. 2021;34(6):817-9.

Airborne protection for staff is associated with reduced hospital-acquired COVID-19 in English NHS trusts.

INTRODUCTION: The rate of hospital-acquired coronavirus disease 2019 has reduced from 14.3% to 4.2% over the last year, but substantial differences still exist between English National Health Service (NHS) hospital trusts. METHODS: This study assessed rates of hospital-acquired infection (HAI), comparing NHS hospital trusts using airborne respiratory protection (e.g. FFP3 masks) for all staff, as a marker of measures to reduce airborne spread, with NHS hospital trusts using mainly droplet precautions (e.g. surgical masks). RESULTS/DISCUSSION: The use of respiratory protective equipment was associated with a 33% reduction in the odds of HAI in the Delta wave, and a 21% reduction in the odds of HAI in the Alpha wave (P<0.00001). It is recommended that all hospitals should prioritize airborne mitigation.

Use of thin silicone dressings for prolonged use of filtering facepiece respirators: Lessons from the universal community testing programme during the COVID-19.

A universal community testing programme (UCTP) was initiated by the government of the Hong Kong Special Administrative Region of the People's Republic of China, as part of a territory-wide initiative to enhance the control of the coronavirus disease (COVID-19) pandemic, to facilitate the early identification of asymptomatic patients in the community-transmission chain. The authors (who were also engaged in this programme) observed that, at the end of their 6-hour shift, most of the HCPs sustained medical device-related pressure injuries (MDRPI), frequently on their faces, over the bridge of their nose, the upper cheeks, above the ears, lower jaws, and chin that caused pain and erythema. In this study, our team examined whether two different types of dressing (light silicone foam dressing and soft silicone perforated tape dressing) applied on the anatomical locations (including the bridge of the nose, upper cheek, above the ears, and lower jaw) would enable the wearer to pass the quantitative respirator fit testing that was conducted using a PortaCount Pro+ Respirator Fit Tester 8038. We also investigated if any skin reactions occurred after the participants worn the respirator with our applied dressing materials for 240 minutes in a safe laboratory setting. Lastly, we collected the qualitative feedback concerning how the participants felt about the performance of our dressing materials in preventing MDRPI associated with the prolonged use of tight-fitting FFRs. A small convenience sample of HCPs (n = 24) who participated in the UCTP was recruited. We randomly selected 12 participants for one type of dressing, and the rest for the second type of dressing. Quantitative fit testing showed an adequate seal of the respirators with the use of both types of thin dressings that were available in the clinical settings. All of the participants except one tolerated the dressings for prolonged use without any report of adverse skin reactions. Our findings may move a step forward in assisting the process of developing feasible pre-emptive skincare practice guidelines to reduce MDRPI during the prolonged use of nanofiber bacterial surgical respirators.

Facial Hair Decreases Fit Factor of Masks and Respirators in Healthcare Providers.

In response to the current state of the COVID-19 pandemic, healthcare providers are using common surgical masks and filtering respirators in conjunction with the presence of facial hair, which could lead to a large number of particles passing into their respiratory system. The purpose of this study was to determine the fit factor effectiveness of filtering respirators and surgical masks in bearded versus non-bearded healthcare providers. A controlled randomized clinical trial (NCT04391010) was carried out, analyzing a sample of 63 healthcare providers. The fit factors of surgical masks and FFP3 filtering respirators for healthcare providers with (n = 32) and without (n = 31) facial hair were compared. Fit factors were measured during an exercises protocol in which healthcare providers wore surgical masks and FFP3 filtering respirators. Surgical mask fit factor comparisons did not show significant differences (p > 0.05) between healthcare providers with and without facial hair. In contrast, filtering respirator fit factor comparisons showed statistically significant differences (p < 0.01) between both groups, indicating that healthcare providers with facial hair showed lower fit factor scores, which implies a worse fit factor with respect to healthcare providers without facial hair. The fit factor effectiveness of filtering respirators was reduced in healthcare providers with facial hair. The authors of this paper encourage healthcare providers to trim their beards during filtering respirator use or wear full-mask filtering facepiece respirators, especially during the COVID-19 pandemic.

Facemask and Respirator in Reducing the Spread of Respiratory Viruses; a Systematic Review.

INTRODUCTION: Respiratory viruses spread fast, and some manners have been recommended for reducing the spread of these viruses, including the use of a facemask or respirator, maintaining hand hygiene, and perfoming social distancing. This systematic review aimed to assess the impact of facemasks and respirators on reducing the spread of respiratory viruses. METHODS: We conducted a systematic review using MeSH terms, and reported findings according to PRISMA. PubMed, Embase, Cochrane Library, Scopus, ProQuest, Web of Science(WoS), and Google Scholar were searched for articles published between 2009 and 2020. Two independent reviewers determined whether the studies met inclusion criteria. The risk of bias of studies was assessed using Newcastle-Ottawa (NOS) and Consolidated Standards of Reporting Trials (CONSORT). RESULTS: A total of 1505 articles were initially retrieved and 10 were finally included in our analysis (sample size: 3065). 96.8% of non-infected participants used facemask or respirator in contact with people infected with a respiratory virus, facemask and respirator have a significant effect on reducing the spread of respiratory viruses. CONCLUSION: Evidence support that using a facemask or respirator can reduce the spread of all types of respiratory viruses; therefore, this result can be generalized to the present pandemic of a respiratory virus (SARS-COV-2) and it is recommended to use a facemask or respirator for reducing the spread of this respiratory virus.