All you need to know about face masks during COVID-19

In January 2020, Centers for Disease Control (CDC) did not recommend the use of masks for people who were not sick. This allowed COVID-19 to spread rapidly throughout the United States as simple preventative measures were not taken. By April 3, COVID-19 raged throughout the United States, the infection rate was increasing and the death toll was rising. This is when the CDC recommended that cloth face coverings be worn.

Even when the CDC recommended that face masks be worn, proper face covers were not widely available. The national stockpile of masks were not enough to fulfill the needs of United States citizens. Since the US did not have a surgical mask supply chain, and everyone else in the world was scrambling to get a mask, alternatives were needed. Thus, handmade masks were needed to meet the demand. With various recommendation changes by the CDC and misinformation about proper mask wearing, it is understandable that people are confused about wearing masks. This article attempts to answer some basic questions related to mask wearing.

Why should masks be worn?

Masks have shown to effectively slow the spread of COVID-19 by lowering the probability that the virus is transmitted between contacts. It is especially effective when a large amount of people comply with mask wearing. Additionally, compliance is especially crucial when COVID-19 can spread asymptomatically, which means a person can be infecting others unknowingly.

Respiratory particles are generally in aerosolized form or droplet form, which are less than ten microns in size, and can be transmitted easily when a patient carrying the virus breathes, talks, sneezes, or coughs. Small aerosolized particles can be suspended in the air for a prolonged period of time. Thus, face masks can reduce the amount and distance aerosolized respiratory particles travel in the air which then limits chances of infecting others.

Who should wear a mask?

You! As well as everyone around you. Everyone plays a role and can contribute in stopping the pandemic.  COVID-19 is a peculiar disease in that it could be spread asymptomatically, therefore you could be positive for the disease and spreading it unknowingly. That is why it’s important that the entire community needs to wear a mask and everyone has equal responsibility in keeping the people around them safe from infection. Once everyone is on-board in following the guidelines from major health organizations, then the infection can effectively be slowed and many lives can be saved.

When should I wear a mask?

There has been debates and misinformation about when to wear masks. Some people believe that masks should be worn only if you’re sick, as initial CDC guidelines stated. Some believe that a mask is not enough to prevent you from getting COVID-19. Others believe that if you’re outdoors, then the virus will dissipate. There are several myths about when to wear a mask so clarification is needed. Below are several guidelines by University of Maryland Medical System:

If I’m outside, then I don’t need to wear a mask. It’s true that it’s generally safer to be outside than being inside since there is better airflow and distance can be maintained between other people. However, if a social distance of six feet cannot be maintained with the people when outdoors, then you should wear a mask.

If I’m not sick, then I don’t need to wear a mask. This is not true for COVID-19 because it could spread asymptomatically. People have tested positive without experiencing any symptoms. By consistently wearing a mask when you’re around others, you are protecting them from possibly getting infected if you’re asymptomatic. This is crucial when protecting people with underlying conditions and those who are more vulnerable to severe illness.

If I’m home, then I don’t need to wear a mask. It’s important that if you’re living with other people, especially those that are vulnerable, to wear a mask if you feel sick. During the pandemic, it’s important to wear a mask and isolate yourself if you have any mild symptoms.

If I had the COVID-19, then I wouldn't need to wear a mask. At this point in time, scientists do not know if having COVID-19 means that you’re immune and cannot spread the virus. Scientists do not know how long antibodies stay in your body for immunity to last, therefore, it’s still important to wear a mask to prevent a second infection.

Where should masks be worn? 

Anyone venturing out into public space or seeing people that are not within your household should wear a mask. For example, when you enter an indoor space such as a grocery store, a mask should be worn. Respiratory aerosols persist in the air for several hours. So even if you’re not standing next to someone, but merely pass by an area where someone has just sneezed, you can come in contact with infectious particles. However, a mask will be an additional barrier that can keep the virus away. Additionally, if you’re feeling sick at home and you are living with others, then you should wear a mask to prevent spreading the disease to members of your household.

What mask should I wear?

Currently, the US is reserving N95 and surgical masks for medical professionals. The WHO recommends the general public to wear a three-layers fabric mask. Ideally, the inner layer should be water absorbent, so that respiratory droplets expelled by yourself can be captured by the layer. The outer layer should be a water resistant layer that stops respiratory droplets from entering through your mask. The inner layer should be a filter that stops smaller particles from getting through the mask. 

These masks can be made of cloth. According to a study by the Wake Forest Institute of Regenerative Medicine, an 80% filtration efficiency can be achieved with a cloth mask made of the right number of layers. However, these cloth masks are made with heavyweight quilter’s cotton with a thread count of 180 or more. These masks are generally very stuffy and uncomfortable because of their weight and thickness. Cloth masks can be washed with soap and water. As long as their structural integrity and fabric layers are intact, they continue to have an 80% efficiency in filtration. 

Luckily, there is an even better alternative than melt-blown (N95 or surgical) or cloth masks. An Airllo Spyderweb™ ePTFE mask is able to effectively filter out 99% of particles, which is an even higher efficiency than the thickest, most protective cloth mask. Even with the high filtration efficiency, it is not stuffy and uncomfortable like N95s or cloth masks because the Airllo’s Spyderweb™ ePTFE layer providing the filtration is extremely thin. An Airllo Spyderweb™ ePTFE mask provides reusability, filtration efficiency, and comfort: all in one.

How do I properly wear a mask?

 Below are some guidelines to proper mask wearing.

• Masks should be put on and taken off with clean hands. After you touch your mask, wash your hands for 20 seconds using soap and water as there may possibly be infectious material on the mask.
• The mask needs to cover your nose, mouth, and chin. Make sure there are no large gaps between the mask and your face, as infectious particles could inadvertently come in contact with your nose or mouth.
• Glasses can fog up when the mask is too loose and not sealed tightly against the face. Make sure the nose bridge is adjusted nicely so that there are no gaps. Additionally, placing your glasses on top of your mask can help prevent your glasses from fogging up. There are also anti-fog lens wipes and gels that could stop your glasses accumulating moisture.
• Surgical masks made with melt-blown fibers should be disposed of after 4-6 hours of wear. Cloth masks should be washed everyday or disinfected with 70% ethanol after every use.
• Masks with valves should not be used because exhaled air freely passes through. If you are an asymptomatic carrier of the virus, then you are possibly spreading the disease to others as you exhale.

How do I properly take off a mask?

When you are home or need to take off your mask, handle the mask only by the ear loops. Fold the mask so that the outside corners are together. Then dispose of the single-use masks into a garbage bin with a lid or place them into a plastic bag if you are using a reusable mask. Disinfect and clean the mask before the next use. When you handle your mask, make sure you wash your hands with soap and water for at least 20 seconds or disinfect with at least 70% alcohol. 

What do I do after a mask is worn?

Melt-blown (N95 and surgical) masks

Normal surgical masks cannot be worn again after 4-6 hours of usage.  Normal surgical masks are generally made with melt blown material made by a process called melt blown extrusion. It is a material made from polypropylene polymer, a plastic, that is processed so that thousands of non-woven fibers are fused together so tightly that only air can pass through. It is electrostatically charged, which enhances filtration, without increasing air flow resistance. This charge will attract and bind particles to fibers. 

However, this material cannot come in contact with water or disinfected with ethanol because once it comes in contact with a liquid, it loses its charge, thus losing its filtration efficiency. Therefore, melt-blown masks such as N95 and surgical masks must be disposed of after one use. 

Cloth masks

Proper cleaning procedures must be followed to ensure that infectious particles are completely removed from the mask before subsequent uses. Use a washing machine and hot water to wash your mask and follow appropriate machine settings based on the fabric label. Otherwise, wash your mask with soap and water, scrubbing for at least 20 seconds.

Airllo’s Spyderweb™ ePTFE masks

Airllo’s Spyderweb™ ePTFE masks are reusable for at least 7 days. The Spyderweb™ ePTFE acts as a physical barrier between the user and the environment and is a sturdy material. Therefore, it could be disinfected with 70% ethanol or washed with soap and water. Unlike melt-blown masks where it will easily lose filtration efficiency, Spyderweb™ ePTFE will not become ineffective after multiple washes.  

Other misconceptions of mask wearing 

A cloth mask does not protect you. Yes, if you wear a mask it doesn’t completely prevent you from the COVID-19. However, some protection is better than none. Studies have shown that even a cloth mask can reduce the number of respiratory droplets getting released into the air as well as limit the number of respiratory particles that you come in contact with. Viral particles travel in respiratory droplets, thus the reduction by a cloth mask can slow the spread of disease. By adhering to recommendations, such as social distancing, it can increase your protection and has a higher chance of preventing you from getting the disease.

I can smell farts through my mask, therefore it’s not effective. Viral particles can range from 20 nanometers to 400 nanometers, while molecules, such as methanthial (CH3SH), in farts are 0.4nm. Which means viral particles are nearly 50 times to 1000 times larger than fart molecules. N95 masks can filter 95% of particles up to 300 nm and Airllo has a 99% filtration efficiency for particles that are 100 nm in size. Therefore, in both types of masks fart molecules can easily pass through the pores of the mask.

I can get hypoxia by breathing in too much carbon dioxide. Some believe that carbon dioxide will stay inside the mask, suffocating the user. However, cloth masks and even N95s are very breathable and have not caused any adverse health reactions for health care providers. Studies have measured the amount of oxygen of someone wearing a mask and found that there is no risk. Also, carbon dioxide will easily travel through your mask because a mask is only designed to trap viral droplets, which are much larger than oxygen or carbon dioxide molecules.

If I’m wearing a mask, I don’t have to follow any other recommendations. Mask wearing is one recommendation for slowing the spread of COVID-19. There are several other recommendations such as keeping 6 feet from other people, limiting in-person meetings, watching your hands often, etc.