Officials Push Masks For COVID Despite Mixed Data

After the 2003 epidemic of SARS, which is a coronavirus similar to the one causing the current pandemic, a study in Hong Kong found that no health care workers who wore a surgical mask or respirator got infected, and only about 7% of those who wore a handmade mask got infected.

A 2013 study by researchers in the U.K. found that 100% cotton shirts used as homemade face masks could have 69% effectiveness for organisms that are about the same size as flu viruses, and linen had about 60% effectiveness. But with COVID-19, scientists can’t say for sure.

“Our findings suggest that a homemade mask should only be considered a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection,” the U.K. researchers wrote.

A small study in South Korea found neither surgical nor cotton masks effectively filtered the virus when an infected patient coughs. While the study has gained attention, it was only conducted on four patients, which is too small a study to apply to the world at large.

Still, the study found while the masks helped some, surgical masks prevented just 5% more virus droplets than no mask at all. Cotton masks fared better, with a 27% increase in blockage. Researchers also found higher amounts of the virus on the outside of masks than on the inside.

For now, health officials are encouraging people to wear masks and face coverings in public to stop the spread of COVID-19.

“Mass masking for source control is in our view a useful and low-cost adjunct to social distancing and hand hygiene during the COVID-19 pandemic,” public health researchers from the United Kingdom and China wrote in an April 16 article in journal The Lancet.

“As with parachutes for jumping out of aeroplanes, it is time to act without waiting for randomized controlled trial evidence,” researchers from several countries wrote in a BMJ article on April 9. The article outlines several systematic reviews they found of masks and respirators.

Which kinds of masks are better or worse?

The CDC recommends using cloth face coverings and has asked the public to reserve surgical masks and N95 respirators for health care workers who need supplies to treat COVID-19 patients.

Cloth face coverings can be made from household items such as fabric, shirts, pillowcases, or sheets.

With children, finding the right fit is important, according to the American Academy of Pediatrics. Pleated masks with elastic can be adjusted easily, but adult sizes and some kid sizes may still be too large. Find a size that fits the face and adjust it. The CDC says a mask should be snug against the side of the face, but not so tight as to be uncomfortable.

Putting a filter between the layers of fabric may help, and if you choose to do this, make sure the mask has a pocket for the filter so you can remove it to wash the mask. Experts say a cut piece of a HEPA filter, like those found in air conditioners or furnaces, work well. Some have even suggested cut pieces of vacuum cleaner bags.

What is the proper way to put masks on and take them off?

Believe it or not, there is a protocol to putting on and taking off masks. Wash your hands before you put the mask on your face, and grasp it by the edges. Loop the ties or fasteners behind your ears, and try not to touch the cloth that covers your mouth and nose, which can contaminate the surface.

While wearing the mask at the grocery store or another public setting, don’t touch the mask or pull it down. If the mask covers your mouth but not your nose, for instance, it’s still possible to spread the virus. Remember that the mask may have contaminants, so leave it on if you’re driving home from the store and take it off at home.

When removing the face covering, don’t touch your eyes, nose, or mouth. Wash your hands immediately after removing, the CDC says. Place the mask in a plastic bag until you’re ready to wash it. Masks should be considered “dirty” and contaminated after each use. Wash it in a washing machine with soap and hot water, and dry it in a dryer.

What kinds of fabrics should be used or avoided?

If you make a homemade mask, cotton fabric works well. Use rubber bands, cloth strips, hair ties, or repurposed straps for the ear loops. Tightly woven cotton, such as quilting fabric or cotton sheets, are a good option, according to the CDC, and T-shirt fabric and bandanas can work also. Thicker fabric with multiple layers is best.

Since face coverings should be washed after each use, synthetic fabrics that can’t be washed or dried on high heat may not be the best idea.

The CDC features three ways to make face coverings on its website, including a sewn cloth face covering from cotton fabric, a simple no-sew method by cutting and tying a T-shirt, and another no-sew option by folding and tucking a bandana. The page features two videos as well.

Should kids wear masks?

Children under age 2 should not wear masks, according to the American Academy of Pediatrics (AAP). Children and teens above age 2 should wear masks in public, following the same recommendations as adults.

If children are at home with usual family members or residents, they don’t need to wear a mask if they haven’t been exposed to anyone with COVID-19, the group says.  

In most cases, children don’t need to be in public under stay-at-home guidelines, especially if one family member runs errands or leaves the home for groceries, medications, or other essential purposes. If children can’t be left at home, or if they go into public in emergency situations such as a doctor’s appointment, masks are recommended.