Saturday, July 11, 2020

Life with Chronic Disease: Mask Wearing 101


At the beginning of Covid-19 pandemic in the US, the public was not encouraged to wear face masks for two reasons:
1)    Not a lot of data was available to know of its effectiveness
2)    There was a major concern the public would horde N95s and other types of personal protective equipment (PPE), which were in severe shortage, thereby jeopardizing the front line worker.

By late March, the Centers for Disease Control (CDC) had reversed their initial message and urged all Americans to wear cloth facial coverings while reserving higher grade protective equipment like N95s for hospitals and health care workers. They viewed this as altruistic prevention, since wearing a covering would protect others from the germs that could be carried by the wearer.

Since then, new data has come out which shows that not only can masking stop the spread of Covid and even the flu, but even a cloth covering will provide some protection to the wearer.
• May 27 Nature, Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals. 
 • June, a World Health Organization study  found that masks may protect the wearer more than originally thought and that social distancing of 2 M (a little over 6 feet)  is more effective than 1 M (a little over 3 feet) in stopping the spread.

In the last week, a letter was sent to WHO, signed by 239 scientists from 32 countries, stating that the coronavirus can stay aloft for hours in tiny droplets in stagnant air, potentially infecting people as they inhale. WHO responded by saying "The possibility of airborne transmission in public settings, especially in very specific conditions — crowded, closed, poorly ventilated settings — cannot be ruled out. However, the evidence needs to be gathered and interpreted."

As it is, what is known is that the most effective way to transmit Covid is via droplets- A virus-filled particle of breath or spittle that comes out of the nose or mouth of an infected individual when they breathe, speak, cough or sneeze. Droplets generally fall to the ground within a few feet of the person who expels them. If the droplet lands on your eyes, nostrils or mouth-the person coughs in your face-you run the risk of becoming infected.

Aerosols probably have some contribution to the spread but to what extent isn’t known at this time. Viral spread via air currents has been documented in certain indoor environments: a restaurant in China where people were sitting downstream from an air conditioner and at a March choir practice in Washington state. In the latter situation, choir members became sick after most likely breathing in tiny airborne particles generated by individuals who were infected but symptom-free at the time. How long the virus lingers in the air, how far it travels (possibly through a room but not down the street) and how commonly it spreads this way are unknown.

In short, the best way to protect yourself is wear a facial covering, stay at least six feet away from people and avoid crowded places as much as possible. If you still have questions, watch this video. Actually watch the video as it's pretty amazing how they've been able to demonstrate the impact of wearing a mask. The photography/video is amazing.

So now for the myth busing portion of the program. Continued or prolonged use of face masks results in breathing too much of one’s own exhaled carbon dioxide, which can cause health problems, including hypoxia. Not true. Surgical and cloth masks do not fit tight enough to cause problems. Neither the CDC nor the World Health Organization have issued warnings suggesting the use of surgical face masks would result in dangerous oxygen level depletion within the general public.

Wearing a cloth or surgical mask does not cause you to breathe in unhealthy amounts of carbon dioxide.

Sore Throat from wearing a mask?: Recently, I was at a Memorial, were I wore a surgical mask for about four hours. I found that I had a sore throat and an ear ache afterwards. However, this was because the ear pieces were causing pressure. If I wear a tied mask, I have no problem and I’ve worn them for up to 5 hours at a time.

If you do not clean your mask, or your hands are dirty when putting on your mask, you can take in bacteria from the environment causing a sore throat. So be sure hands are clean when putting on your mask.  

How to wear a cloth face mask: Mayo Clinic offers some good tips on this.  Place your mask over your mouth and nose.
  • Tie it behind your head or use ear loops and make sure it's snug. (Really hate it when peoples’ noses are sticking out)
  • Don't touch your mask while wearing it.
  • If you accidentally touch your mask, wash or sanitize your hands.
  • Remove the mask by untying it or lifting off the ear loops without touching the front of the mask or your face.
  • Wash your hands immediately after removing your mask.
  • Regularly wash your mask with soap and water in the washing machine. It's fine to launder it with other clothes.
  •  
When masks are not advisable: Don't put masks on anyone who has trouble breathing, or is unconscious or otherwise unable to remove the mask without help.
  • Don't put masks on children under 2 years of age.
  • Don't use face masks as a substitute for social distancing.
  •  
Can I get a face mask exemption or waiver?: There is no such animal, even though fake cards and flyers abound. 

What kind of mask should I wear?: Look for masks made with at least 2 layers of fabric, preferably thick cotton. Hold the fabric up to the light. The fewer tiny holes you can see, the better it will work. It should cover your nose and mouth without large gaps. Look for a mask with a bendable border around the top so you can bend it to around the bridge of your nose.

What about creating my own filter?: Data is inconclusive on its effectiveness and some of the filters people are posting on-line could actually cause problems

Surgical Masks: These are often given out by hospitals and clinics and are designed for one time use. However, if you are careful, they can be reused, though not every day for weeks on end. Also you can’t wash them.


What to do if you encounter people not wearing masks Yes, you want to shout at them but don’t waste your breathe. Just move as far away from them as possible. If they continue to move towards you, just tell them you are social distancing and back away as quickly as possible.

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