A systematic review of mask disinfection and reuse for SARS-CoV-2 (through July 10, 2020)

We conducted a systematic review of hygiene intervention effectiveness against SARS-CoV-2, including developing inclusion criteria, conducting the search, selecting articles for inclusion, and summarizing included articles. We reviewed 104,735 articles, and 109 articles meeting inclusion criteria were identified, with 33 additional articles identified from reference chaining. Herein, we describe results from 58 mask disinfection and reuse studies, where the majority of data were collected using N95 masks. Please note, no disinfection method consistently removed >3 log of virus irrespective of concentration, contact time, temperature, and humidity. However, results show it is possible to achieve >3 log reduction of SARS-CoV-2 using appropriate concentrations and contact times of chemical (ethanol, hydrogen peroxide, peracetic acid), radiation (PX-UV, UVGI), and thermal (autoclaving, heat) disinfection on N95 masks. N95 mask reuse and failure data indicate that hydrogen peroxide, heat, and UV-GI are promising for mask reuse, peracetic acid and PX-UV need more data, and autoclaving and ethanol lead to mask durability failures. Data on other mask types is limited. We thus recommend focusing guidelines and further research on the use of heat, hydrogen peroxide, and UVGI for N95 mask disinfection/reuse. All of these disinfection options could be investigated for use in LMIC and humanitarian contexts.