• Rami Sommerstein, Christoph Andreas Fux, Danielle Vuichard-Gysin, Mohamed Abbas, Jonas Marschall, Carlo Balmelli, Nicolas Troillet, Stephan Harbarth, Matthias Schlegel, Andreas Widmer, and Swissnoso.
• Department of Infectious, Diseases and Hospital Hygiene, Freiburgstrasse, 3010, Bern, Switzerland. rami.sommerstein@insel.ch.
• Antimicrob Resist Infect Control. 2020 Jul 6; 9 (1): 100.

ObjectivesTo determine the risk of SARS-CoV-2 transmission by aerosols, to provide evidence on the rational use of masks, and to discuss additional measures important for the protection of healthcare workers from COVID-19.MethodsLiterature review and expert opinion.Short ConclusionSARS-CoV-2, the pathogen causing COVID-19, is considered to be transmitted via droplets rather than aerosols, but droplets with strong directional airflow support may spread further than 2 m. High rates of COVID-19 infections in healthcare-workers (HCWs) have been reported from several countries. Respirators such as filtering face piece (FFP) 2 masks were designed to protect HCWs, while surgical masks were originally intended to protect patients (e.g., during surgery). Nevertheless, high quality standard surgical masks (type II/IIR according to European Norm EN 14683) appear to be as effective as FFP2 masks in preventing droplet-associated viral infections of HCWs as reported from influenza or SARS. So far, no head-to-head trials with these masks have been published for COVID-19. Neither mask type completely prevents transmission, which may be due to inappropriate handling and alternative transmission pathways. Therefore, compliance with a bundle of infection control measures including thorough hand hygiene is key. During high-risk procedures, both droplets and aerosols may be produced, reason why respirators are indicated for these interventions.

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