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Modelling the impact of healthcare worker masking to reduce nosocomial SARS-CoV-2 transmission under varying adherence, prevalence, and transmission settings.

Research Square
2024
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Article Description

Objectives To understand the scenarios where health care worker (HCW) masking is most impactful for preventing nosocomial transmission. Methods A mathematical agent-based model of nosocomial spread with masking interventions was used. Masking adherence, community prevalence, disease transmissibility and proportion of breakroom (unmasked) interactions were varied. The effectiveness of masks for reducing transmission to and from the wearer was also varied. The main outcome measure is the total number of nosocomial infections in patients and health care worker populations over a simulated three-month period. Results HCW masking around patients and universal HCW masking reduces median patient nosocomial infections by 15% and 18% respectively. HCW-HCW interactions are the dominant source of HCW infections and universal HCW masking reduces HCW nosocomial infections by 55%. Increasing adherence shows a roughly linear reduction in infections. Even in scenarios where a high proportion of interactions are unmasked ‘breakroom’ interactions, masking is still an effective tool assuming adherence is high outside of these areas. The optimal scenarios where masking is most impactful are those where community prevalence is at a medium level (around 2%) and transmissibility is high. Conclusions Masking by HCWs is an effective way to reduce nosocomial transmission to both patients and, especially, HCWs at all levels of mask effectiveness and adherence. Increases in adherence to a masking policy can provide a small but important impact. HCW-HCW transmission is the dominant source of HCW infections so universal HCW masking policies are most impactful should policy makers wish to target HCW infections. The more transmissible a virus/ variant in circulation is the more impactful masking by HCWs is for reducing nosocomial infections. Policy makers should consider implementing masking at the point when community prevalence is optimum for maximum impact.

Bibliographic Details

Timothy Whiteley; James Stimson; Colin Brown; Julie Robotham; Stephanie Evans

Springer Science and Business Media LLC

Biochemistry, Genetics and Molecular Biology; Immunology and Microbiology; Medicine; Neuroscience; Psychology; Dentistry

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