Knowing a Mask: Inside and Out

In recent times, masks have become integrated into our lifestyles and society. Today, while providing upfront protection, masks represent a powerful tool which will prove essential in defending our community during these unprecedented times. 

Knowing a Mask: Inside and Out

Tanya Vidhun, Science Editor/Contributing Writer, Yorba Linda CA

Before understanding the safety that masks provide us with, let’s first crack the course that enables viruses, like the SARS-CoV-2/2019 Novel Coronavirus, to create the pandemic we are facing today. Every time we exhale, our lungs release droplets of water into the air. If a bacteria or virus is present in our lungs, the pathogen will travel on the droplets which ultimately produces the concept of communicable transmission. Research has shown that the 2019 Novel Coronavirus is approximately 0.06 to 0.14 microns in size, which is incredibly small. Air pollution aerosols, for example, are 10 microns compared to this and they pose a great danger for our lungs already. Since the coronavirus is tinier and easily transmitted from person-person, it can spread much faster and severely affect our health which has led to the world-wide stay at home orders we are following today. Because the disease is potentially lingering in any public area where social distancing is difficult, masks can provide an extra protection measure to prevent the inhalation of unwanted droplets in the air.

 

Masks vs Respirators: Which is which?

To begin with, there are 3 types of masks that we commonly hear of today: N95, surgical masks, and cloth masks. However, the N95 is NOT a mask, but a respirator which is tightly sealed around the face and ideal for two-way protection. This means it filters out air being exhaled and inhaled. Masks, on the other hand, are loose-fitting and filter air exhaled, retaining specific droplets which can decrease the risk of disease in those around the wearer.

 

Taking a Closer Look Respirators

The N95 is an American respirator designed by the National Institute for Occupational Safety and Health (NIOSH) part of the CDC. It filters out 95% of small particles (less than 0.3 microns) and the N stands for “Not oil resistant”, so is fitting for cleaning airborne particles. The filtration material is electrostatic non-woven polypropylene fiber. But wait! The coronavirus is tinier than 0.3 microns sizing at ~0.1 microns. So, how does this work? Interestingly, research has shown that particles larger than 0.3 microns can be more easily predicted to trap and penetrate, but particles ranging less than 0.3 microns follow a more unexpected pattern known as Brownian motion. Brownian motion occurs when particles are so microscopic that they interact with the molecules in the air such as oxygen and nitrogen. This, subsequently, will change the system in which they are filtered which is why N95 respirators are so efficient and essential when facing Covid 19. 

Although the general public continue to hold N95’s at a high and effective value (which is very scientifically true), these respirators should be predominantly saved and used by physicians, nurses, healthcare workers, and the rest of our front-line support who are risking their lives to protect us, some without sufficient protection themselves. 

 

In terms of international use, respirators hold different standards and names. For example, in Europe, the FFP1 (filters at least 80%) and FFP2 (filters at least 94%). In China, KN95 filters out 95% of particles less than 0.3 microns. However, it is important to note that these standards are based on the corresponding region. Hence, they may vary depending on the environment the manufacturer is producing for.

 

Surgical Masks- More Powerful than they look?

Surgical masks are made up of 3 layers. Between the two non-woven fabrics, a melt-blown (melted plastic) layer is present which is the main mechanism functioning as protection. These masks are loose-fitting and, of course, do not serve as much protection as N95 respirators. However, the purpose of surgical masks are to reduce exposure to saliva and respiratory secretions of the mask wearer. This means, while they minimally filter large particles out of air flowing in, surgical masks refine air exhaled by the wearer which can establish its own benefits- which will be later discussed in the cloth masks section. 

In addition, a study was carried out comparing occurrences of Influenza between N95 mask wearers and surgical mask wearers. Although it is not yet comparable due to the lack of study of the coronavirus, Influenza and coronavirus are approximately similar in size, medical symptoms, and transmission. The results demonstrated that there were 207 laboratory confirmed cases in N95 wearers and 193 laboratory confirmed cases in the surgical mask wearers. This establishes that, for influenza, there is no significant distinction between the protection of N95 and surgical masks. Although this may not necessarily be true for Covid 19, it is a relevant situation to refer to.

Cloth Masks

Ultimately, cloth masks worn by the general public can slowly repair the damage and danger the 2019 Novel Coronavirus has brought onto society. These can be DIY or homemade and reusable too. The CDC has recommended cloth face masks to combat the face mask shortage. A guide created by the CDC also instructs individuals on the use of cloth masks (Use of Cloth Face Coverings to Help Slow the Spread of COVID-19). Here is also a short, easy tutorial to make a cloth face mask provided by the CDC: How to Make Your own Face Covering. Cloth face coverings can still reduce community transmission between person-person because if a person coughs or sneezes, their droplets will not be aerosolized. 

 

Furthermore, Face Masks Against Covid 19: An Evidence Review states, “Generally available household materials had between a 49% and 86% filtration rate for 0.02 μm exhaled particles whereas surgical masks filtered 89% of those particles… In another laboratory setup, a tea cloth mask was found to filter 60% of particles between 0.02 μm to 1 μm, where surgical masks filtered 75%. They designed and tested a mask made from heavyweight t-shirts finding that it offered “substantial protection from the challenge aerosol and showed good fit with minimal leakage”. Although cloth and surgical masks are primarily targeted towards droplet particles, some evidence suggests they may have a partial effect in reducing viral aerosol shedding.” Hence, cloth masks can still provide at the very least minimal benefit and should be worn by the general public to slow the spread of disease as discussed next.

So, What Should We Wear?

As students, we should be wearing cloth masks to reduce transmission at school. Both N95 respirators and surgical masks must be used by the healthcare workers, doctors, nurses, and those who are putting themselves at risk to protect their communities. Wearing cloth masks will still filter out some of our air and increase protection for those around us. 

“If everybody [wears a cloth mask], we’re each protecting each other.” -Dr. Anthony Fauci, the United States’ Leading Infectious Disease Expert 

 

A Masked Community: Slow the Spread

A possible solution to slow the spread of Covid 19 is If everyone in our community develops a habit of always wearing a mask (cloth masks included) in public areas. Because Covid 19 carriers are asymptomatic, they can easily pass the virus on, especially in crowded, frequently visited places such as stores, parks, and schools which is what caused the first lock down we are experiencing now. These carriers are not just infected, but contagious. If this person wears masks, they can somewhat filter out their own air protecting those around them. If everyone begins wearing a mask, we will begin to be less susceptible to the disease in the public and decrease our risks of contracting Covid 19. 

 

It is very simple to picture- After the lockdown ends (whenever that may be), Person A, an asymptomatic carrier, is wearing a cloth mask to a grocery store. Person B, the register, and Person C, the person behind Person A in line, are wearing cloth masks as well and come relatively close to Person A. Because they are all wearing cloth masks, the risk of contracting Covid 19 has already decreased. If Person A had not been wearing anything, Person B and C would have a greater chance of becoming infected and could pass it onto others in the community which could lead to potentially a second lock down if we are not careful and aware of health and safety guidelines.

 

In addition, Face Masks Against Covid 19: An Evidence Review adds that, “Telephone surveys during the SARS-CoV-2 outbreak in Hong Kong reported enhanced adherence to public mask wearing as the pandemic progressed over three weeks, 74.5% self reported mask wearing when  going out increasing to 97.5%, without mandatory requirements… This suggests that the public have enhanced awareness of their risk, and display higher adherence levels to prevention strategies than during other epidemics.” 

If we can learn to adapt to frequently using face masks in the public, the chances of a second lockdown will decrease and we can protect ourselves and others.

 

Apart from Masks???

It is so important to understand that the purpose of masks is not false reassurance. All other health guidelines and measures must still be followed to great extent. Social distancing and washing hands should not diminish when wearing a mask because they are the core for keeping our community healthy. 

For the key takeaways of this article in terms of new knowledge and habits:

  1. N95 masks are respirators and should be reserved for healthcare professionals.
  2. Surgical masks filter the outflow of air which in turn keeps those around you safe, but these should also be primarily used by healthcare professionals if there is a shortage like this pandemic.
  3. Cloth masks should be used by the general public, so we can still be provided with a level of protection.
  4. If our whole community learns to use masks in public, transmission levels will begin to slow. 
  5. Do not put away essential habits such as social distancing and hand washing even if you are wearing a mask. Only with these techniques put together- we can bring an end to the Covid 19 pandemic.