Some health authorities say face masks are useless against COVID-19. Other health authorities demand that you wear one.
So what are the facts? Can face masks really protect us against COVID-19? And WHEN should you wear one?
Face Mask : What Type Do You Have?
When people say face mask, they generally mean the 3-ply surgical mask, although some may be talking about fashion masks, or even the N95 respirator.
Fashion masks are usually made from washable cotton and are reusable, but they often lack a filter. The N95 respirator, on the other hand, is designed to filter 95% of particles with a median diameter of 0.3 microns.
In this article, we are going to focus on the 3-ply surgical / medical mask, which has three layers – each with very specific functions :
- an outer hydrophobic layer, which repels water, blood and body fluids,
- a middle filter layer that is designed to filter bacteria, and
- an inner hydrophilic layer, which absorbs water, sweat and spit
The 3-ply surgical mask is the most common type of face mask used in China and most of Asia, to protect against SARS and now, COVID-19.
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Are Face Masks Effective Against COVID-19?
To be clear – studies are still underway to determine if the humble 3-ply face mask is effective against COVID-19. But here is what we know so far…
COVID-19 Is NOT Airborne
First, we should understand that COVID-19 is not airborne, and primarily spreads by droplets, which are heavy and fall within 1-2 meters.
Because these droplets are MUCH larger than the COVID-19 virus, they will be blocked by the outer hydrophobic layer of the 3-ply masks or N95 respirators, or caught by the filter in the middle.
Face Masks Prevent Face Touching
Many people get infected not by inhaling droplets, but by touching their faces with their hands, after touching a contaminated surface.
Hand washing can prevent that, but people often forget to do it, and it is human nature to touch our own faces.
Wearing a face mask helps to prevent face touching, so even if we forget to wash our hands, it lowers our risk of infecting ourselves with COVID-19.
Face Masks Are Working In China + Czech Republic
Anecdotally, the evidence is strong in China and the Czech Republic that face masks are effective in preventing the spread of COVID-19.
The Czechs are so enthusiastic about their experience, they created this video to spread word that face masks work, even if they are not 3-ply!
The Chinese believe in the effectiveness of face masks so much, they force their citizens to wear one whenever they leave the house.
Both the Chinese and Czech experiences are backed up by a CDC-sponsored study, which showed that surgical masks are as effective as N95 respirators in preventing influenza infections amongst healthcare workers.
This study is important because influenza is a similarly-sized respiratory virus that spreads by droplets too. So it makes sense that face masks would be similarly effective against COVID-19.
Why Did The WHO / CDC Recommend Against Wearing Face Masks?
The WHO or CDC earlier recommended against wearing face masks, because they feared that :
- people would gain a false sense of security, and not protect themselves adequately in other ways like washing hands and avoiding crowds.
- people would accidentally infect themselves by wearing or taking them off wrongly.
There is also the consideration that when there is limited supply, 3-ply face masks and N95 respirators should be reserved for healthcare workers who have much greater need of them.
That is why many countries are ordering the public to stay-at-home or shelter-in-place. This reduces the demand for face masks by the public.
The fact of the matter is – healthcare workers RELY on face masks, whether 3-ply surgical masks or N95 respirators, to keep them safe from COVID-19.
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When Should You Wear A Face Mask To Protect Against COVID-19?
No Community Spread
If there is no community spread of COVID-19 in your country, there is NO NEED to wear a face mask.
As long as health authorities can quickly trace and isolate contacts for testing, the virus is “not in the wild” and there is very low risk of infection, which can be mitigated by social distancing.
Keep your face masks in reserve. Using them now could mean you run out of face masks when you actually need them.
There Is Community Spread
Once there is community spread, all bets are off. The COVID-19 coronavirus is problematic because patients are contagious long before they show symptoms.
ANYONE can be COVID-19 positive, even if they don’t have symptoms. That includes you and your family, not just strangers you meet on the street.
To protect everyone, this is the time to start wearing a face mask.
In fact, everyone should be forced to wear a face mask, because it would help prevent asymptomatic / presymptomatic persons from spreading the coronavirus.
One way to reduce the need for face masks is a home quarantine / restricted movement / lockdown.
You do NOT need to wear a face mask while you are sheltering at home with your family.
You only need to wear a face mask during the limited occasions you leave your home to purchase food and other essential supplies. Or when you need to accept food deliveries or parcels from a delivery person.
To avoid wasting a face mask though, you can request that the food delivery or parcel be left at your doorstep.
Don’t Rely Solely On Face Masks
Now, opinions are definitely shifting towards the widespread adoption of face masks to protect against COVID-19. However, it is important to note that face masks alone cannot protect you from COVID-19.
You still need to adopt safe practices that health authorities have been advocating to prevent COVID-19 :
- Avoid suspected cases or disease hotpots, like hospitals, if possible!
- Avoid public events and crowds
- Keep our hands clean with soap or hand sanitiser
- Keep our home, office, vehicles, etc. clean
- If you need to wear a surgical mask, make sure you put it on and remove it properly!
- Wash your food with water (and soap) after purchase and before preparation
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What About Other Kinds Of Face Masks?
Cotton Face Masks / Fashion Masks : Partially Protective
Cotton face masks or fashion masks are what both the CDC and the Czech government recommend, because they do not deprive healthcare workers of 3-ply surgical masks or N95 respirators.
While the CDC keeps insisting that they are meant to prevent you from infecting other people, the Czechs say that their experience show that they are at least partially protective.
If you run out of 3-ply surgical masks, it is definitely a good idea to wear a cotton face mask / fashion mask. Some protection is certainly better than none at all.
N95 Respirators : Overkill
While N95 respirators are the gold standard, and what healthcare workers use while treating COVID-19 patients, it is overkill for the public.
A large CDC-sponsored study published in September 2019 showed that surgical masks are as effective as N95 respirators in preventing influenza infections amongst healthcare workers.
This study is important because influenza is a similarly-sized respiratory virus that spreads by droplets too. So it makes sense that 3-ply surgical masks would be similarly effective against COVID-19.
Li Lanjuan, a Chinese National Health Commission expert, confirmed this, saying that “ordinary people only need to wear face masks“.
Where To Buy Face Masks?
Where possible, use proper 3-layer surgical masks, but you should purchase fashion or cotton masks as a backup. Here are some online purchase options :
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