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EXPLAINER: Face masks 101

Face masks have become as essential as water and money in surviving a pandemic. For more vulnerable groups, the right face mask could spell the difference between life and death. 

The coronavirus is expected to be a part of our daily lives for much of the near future. You may ask yourself: Do I have the right face masks at home? What if I can’t sustain buying medical or disposable masks?

Here are some things you should know about donning face masks to protect yourself and others from the coronavirus:

Wait, how does COVID-19 spread again?

The novel coronavirus spreads mainly from person to person through respiratory droplets expelled when infected persons sneeze, cough, talk, or raise their voices. These droplets can land or end up in the mouths or noses of people nearby, who could possibly inhale them into their lungs.

Infected people who don’t show symptoms of COVID-19, such as loss of the sense of taste, dry cough or fever, could still spread the virus.

This is why governments around the world have almost identical general prescriptions for reducing the spread of the virus: wearing face masks, practicing physical distancing, and disinfecting hands frequently.

How do face masks work? Do they protect the wearer, or the people around?

According to the US Centers for Disease Control and Prevention (CDC), a mask may not protect the wearer, but it prevents the wearer from spreading the virus to others.

Meanwhile according to Dr Norberto Francisco, research chief at the Lung Center of the Philippines, it depends on the mask. The N95 respirator protects the wearer because it’s harder for particles to reach you. A surgical mask may not be able to protect the wearer, since particles can still get through the gaps between your face and the mask.

“If you wear a surgical mask, you are protecting others. If they wear their mask, they are protecting you, because the droplet form of COVID will be filtered at the level of your mouth if you are wearing the mask. So it won’t be able to spread. That’s good enough if everyone is wearing a mask. If there are 10 of you, everyone should be wearing one. If even one doesn’t wear a mask, COVID will spread if that person is infected,” Francisco said in a mix of English and Filipino during a phone interview.

Meanwhile, the tight-fitting N95 masks will protect the wearer, “which the surgical mask cannot do,” Francisco said. N95 masks filter or reduce the wearer's exposure by around 95% of particles that are around 0.3 microns, when fitted and used properly.

N95 masks must be taken care of – if one gets deformed or damaged, it may compromise the wearer.

The World Health Organization (WHO) says it is critical that medical masks and respirators should be prioritized for healthcare workers. Francisco makes the same recommendation, as the Philippines has limited supplies.

Is there a hierarchy of masks?

A new study in Duke University ranked 14 types of commonly available masks, finding that medical masks offer significantly more protection against droplet spread than cotton alternatives – while bandanas protect less, and neck fleeces don’t do much at all.

The study revealed that different masks eliminated droplet spray by the following percentages, from the best to worst:

  1. N95 - 99.9%
  2. Surgical or polypropylene masks - 90%
  3. Cotton face coverings - 70% to 90%
  4. Bandanas - 50%

Neck fleeces, meanwhile, were found to expel more droplets than with no mask at all, probably by dispersing the largest droplets into many smaller droplets.

"The notion that 'anything is better than nothing' didn't hold true," said Eric Westman, one of the study's co-authors.

What makes a good cloth mask?

The WHO said fabric masks should ideally have 3 layers: an outer layer, an inner layer, and a middle layer that can be an insert, or another fabric layer.

The inner layer that comes in direct contact with your face should be made of a hydrophilic material, which means it will easily absorb droplets from your exhaled breath. Cotton is an example. The WHO said it’s important to select a light color like white so you can better see if it is soiled or wet.

The middle layer should go into a pocket between the inner and outer layer, and should act like a filter. The WHO said the ideal middle layer is a strip of polypropylene fabric.

The outer layer should be a hydrophobic material, the opposite of the inner layer. This means that the fabric repels droplets and moisture. This can be made of a synthetic material like polyester, or a polyester and cotton blend.

What about masks with valves or vents?

Some may find it uncomfortable to wear masks for an extended period of time because it’s difficult to breathe. A mask with an exhalation valve may look appealing since it looks like it will help you breathe easier. Valved masks are used mostly for dust and construction.

The CDC does not recommend the use of masks with valves. Valves allow for exhaled air to be expelled through the holes in the material, defeating the purpose of preventing droplets from reaching others.

How do I use masks correctly?

The WHO issued the following guidelines on the correct use of masks:

  • Place the mask carefully, making sure it covers the nose and mouth, and minimize gaps between the face and mask
  • Avoid touching the mask while wearing it
  • When removing it, don’t touch the front of the mask but untie it from behind
  • After removal, disinfect your hands with alcohol or wash your hands
  • Replace masks as soon as they become damp with a new, clean, dry mask
  • Do not reuse single-use masks
  • Discard single-use masks after each use, and dispose immediately
How can I safely wash my cloth mask?

If you are using a washing machine, you can include your mask with your regular laundry, according to the CDC. Use regular laundry detergent and the warmest appropriate water setting for the cloth from which the mask was made.

The CDC issued the following bleach solution for washing masks by hand:

  • 5 tablespoons household bleach per gallon of room temperature water, or
  • 4 teaspoons household bleach per quart of room temperature water

Check if the bleach you are using is intended for disinfection. Make sure the bleach is not past its expiration date, and never mix household bleach with ammonia or any other cleanser.

Next, soak the mask in the bleach solution for 5 minutes, and rinse with cool or room temperature water.

When drying, use the highest heat setting in the machine and leave in the dryer until completely dry. When air drying, place the mask in direct sunlight and allow it to completely dry.

Although masks are essential, the WHO reminds the public: the use of a mask alone is not sufficient to provide an adequate level of protection. 

People should still practice physical distancing, avoid groups of people in enclosed spaces, perform hand hygiene, cover their mouth and nose when coughing or sneezing, and refrain from touching their mouth, nose, and eyes. – with a report from Agence France-Presse/Rappler.com

Michelle Abad

Michelle Abad is a researcher-writer at Rappler. Possessing the heart and soul of a feminist, she is working on specializing in women's issues in Newsbreak, Rappler's investigative arm.

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