Using face masks in the community ECDC TECHNICAL REPORT
5
(five days) [12]. The authors indicated that many secondary transmissions would have already occurred at the
time when symptomatic cases are detected and isolated.
Modes of transmission. In most instances, coronaviruses are believed to be transmitted from person to person
via large respiratory droplets, either being inhaled or deposited on mucosal surfaces. Other routes implicated in
the transmission of coronaviruses include contact with contaminated fomites and inhalation of aerosols produced
during aerosol-generating procedures. SARS-CoV-2 virus has been detected in respiratory and faecal specimens.
Viral RNA has also been detected on rare occasions in blood specimens but there is no evidence of transmission
through contact with blood [26]. The relative role of droplet, fomite and aerosol transmission for SARS-CoV-2
remains unclear, as does the level of protection provided by the different components of personal protective
equipment and the transmissibility of the virus at different stages of the disease.
Face mask use in the EU. As of 1 April 2020, the countries below recommend the use of face masks for
persons going out in public:
Lithuania:
http://sam.lrv.lt/uploads/sam/documents/files/KORONA/20200330_Rekomendacijos_AAP_kiti_sektoriai.
pdf; residents are recommended to wear protective face masks, respirators, or other protective
equipment to cover the nose and mouth in public places, except when driving motor vehicles. Parks and
other open public places are requested to be visited by groups of no more than two people (excluding
members of the same family), observe safe contact (greater than two meters and less than 15 minutes),
and hygiene requirements.
Austria: https://www.sozialministerium.at/Informationen-zum-Coronavirus/Coronavirus---Aktuelle-
Ma%C3%9Fnahmen.html; https://www.sozialministerium.at/dam/jcr:5d5ba721-6051-4c66-b059-
c554227cc11d/20200403_Fragen%20und%20Antworten%20zum%20Mund-Nasen-Schutz.pdf
Czechia: https://www.vlada.cz/en/media-centrum/aktualne/the-government-has-decided-to-require-the-
wearing-of-protective-equipment-and-reserved-time-for-senior-citizens-to-do-their-food-shopping-180465/
Slovakia: Official document for obligatory wear of masks (or other respiratory protection equipment),
effective 25 March 2020:
http://www.uvzsr.sk/docs/info/covid19/Opatrenie_UVZSR_povinnost_nosit_ruska_24032020.pdf
Bulgaria: http://www.mh.government.bg/bg/novini/aktualno/grazhdanite-koito-se-namirat-v-zakriti-ili-na-
otkr/
References
1. National Institute for Occupational Safety and Health (NIOSH). Use of respirators and surgical masks for
protection against healthcare hazards [internet]. Atlanta: CDC; 2018 [accessed 1 April 2020]. Available
from: https://www.cdc.gov/niosh/topics/healthcarehsps/respiratory.html
2. European Centre for Disease Prevention and Control (ECDC). Safe use of personal protective equipment in
the treatment of infectious diseases of high consequence. Stockholm: ECDC; 2014. Available from:
https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/safe-use-of-ppe.pdf
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8. Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the
rapid dissemination of novel coronavirus (SARS-CoV2). Science. 2020:eabb3221.
9. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV
infection from an asymptomatic contact in Germany. New England Journal of Medicine. 2020.
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COVID-19 based on symptom onset data. medRxiv. 2020:2020.03.05.20031815.
11. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory
Specimens of Infected Patients. N Engl J Med. 2020 Mar 19;382(12):1177-9.