Many, including me, are wondering how to handle the mask edicts from on high. Are these requirements legal? Do cloth masks work? This article focuses on the latter question. Below is the CDC guideline:
- CDC is recommending the use of a cloth face covering to keep people who are infected but do not have symptoms from spreading COVID-19 to others.
- The cloth face cover is meant to protect other people in case you are infected.
- The cloth face coverings recommended are not surgical masks or N-95 respirators. Medical face masks are critical supplies that should be reserved for healthcare workers and other first responders, as recommended by CDC.
- The cloth face cover is not a substitute for social distancing.
- CDC continues to recommend that people try keep about 6 feet between themselves and others.
The corona virus is approximately .125 micron in diameter. A micron is a unit of length equal to one millionth of a meter. That is small. However, it often travels in biological aerosols from coughing and sneezing which range in size from 0.5-3 micron.
The N of the much discussed N95 mask means “Not resistant to oil”. In other words, N95s protect against solid and liquid airborne particles that do not contain oil. The 95 means that it is 95% efficient in blocking down to 0.3 micron particles. So a well fitted N95 mask will make you feel reasonably confident around someone with corona.
Surgical masks offer less protection than N95. According to the FDA, “While a surgical mask may be effective in blocking splashes and large-particle droplets, a face mask, by design, does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures. Surgical masks also do not provide complete protection from germs and other contaminants because of the loose fit between the surface of the face mask and your face.”
What about cloth masks? My goal was to look for studies that occurred prior to the pandemic to avoid “studies” that are intended to influence behavior. I found a study conducted in 2015 by a team from University of New South Wales, Sydney, Australia, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam and Beijing Centers for Disease Control and Prevention. “ The aim of this study was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). The null hypothesis is that there is no difference between medical masks and cloth masks.” Not surprisingly rates of all infection outcomes were highest in the cloth mask group. In the interest of transparency, please note the study was funded in part by 3M.
Do cloth masks do anything? I found a 2013 Cambridge University study which concluded “both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask.” While a cloth mask may not protect as well as a surgical mask, they do offer protection.
I spoke with a family member who has spent his life studying viruses. While he is not fond of wearing a cloth mask, he says they are helpful but not perfectly effective. He believes a big benefit of wearing a mask is keeping your hands off your face. I also spoke with friends and family members in healthcare. The message was consistent. Masks offer protection. Cloth at the bottom, followed by surgical then N95. Wash hands frequently and do not touch your mask or your face.
So what’s the bottom line? My initial reaction to the mask edict was “I will wear one when I see every politician wearing one and only if I can pick their fabric”. After researching, I have modified my opinion and will wear a mask when social distancing (I hate that phrase) is not possible. Surgical masks are my first choice. Would I wear a mask outside biking or walking. No. When I see masked folks engaged in solitary endeavors, my first thought is they should recalibrate their fear meter and realize breathing fresh air is a good thing. But who am I to judge? If it makes someone more comfortable to wear a mask, it might reduce stress and help with immunity. Would I enter a high risk area with a cloth mask? No. I would wear a surgical mask or N95 depending on the situation.
My conclusion is wearing a mask, cloth or otherwise, will reduce the risk. Perhaps on an equal footing is hand washing and not picking your nose. If masks will help get this country open, I am all in. Heck, I will wear a bunch of them at once. Unfortunately for many of our so called leaders, masks will do nothing to overcome their urge to posture for federal money, pander to their base or use corona as a stepping stone to higher office. It’s very sad for our country that it’s an election year.
Details:
- For references on data and actual studies, please click on links embedded above.
- Smart Air Filters has done studies on the efficiency of masks to block particles. I would recommend checking out their site if you are interested in a deeper dive. They have also have tested various fabrics for their virus blocking abilities.
- Both Smart Air and Vaniman utilize the 2013 Cambridge study in their material. In Vaniman’s summary they only included the first sentence of the Cambridge conclusion and neglected to mention that surgical masks reduced transmission by a factor of 3 over cloth masks. Interesting and a reminder that one always has to go to the source to find the whole story.
- N95 masks are not available to the public due to shortages. Note that FDA approved the use of KN95 masks for healthcare workers. These masks are often identical to N95 masks and are the “N95 equivalent” for medical usage in China. According to Vaniman they offer the same filtration as N95 face masks with a rating of 95% at 0.3 Micron. Vaniman has them available for May delivery if interested. Comparison shopping might be a good idea. https://www.vaniman.com/product/k-n95-face-masks/
- Here is the FDA’s guidance on cloth, surgical and N95 masks. https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respirators-and-surgical-masks-face-masks. They do not recommend N95 for the public. I agree N95s should be reserved for medical personnel if they are in short supply. When N95s or KN95 become available, having some on hand for emergencies is a good idea regardless of what the FDA or CDC says.