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  • Dr. Sruti Mohapatra

Masks - All You Want To Know

Face mask is a piece of cloth which covers our face. It can be a pallu, burqa, medical mask or simply a party mask. According to Encyclopaedia Britannica - Mask, a form of disguise or concealment usually worn over or in front of the face to hide the identity of a person and by its own features to establish another being. This essential characteristic of hiding and revealing personalities or moods is common to all masks. As cultural objects, they have been used throughout the world in all periods since the Stone Age and have been as varied in appearance as in their use and symbolism.


In the COVID-19 contest, a face mask is one which covers our mouth and nose. Face masks are widely used by medical workers as part of droplet precautions when caring for patients with respiratory infections.

Several states across India have made the wearing of face masks mandatory when people leave their homes, despite the World Health Organisation still advising that such measures are not necessary to stem the coronavirus pandemic. The orders that came into effect on April 9, 2020, Wednesday (TOI, 2020), saw Delhi, Mumbai, and the states of Uttar Pradesh, Madhya Pradesh, Odisha on Wednesday made the wearing of face masks mandatory for people stepping out of their homes. In the Union Territory of Jammu & Kashmir, the mandatory masks rule announced Wednesday was limited to all officers, staff and visitors to the Civil Secretariat, while in the UT of Ladakh it applied to the general public as well as government officials, including personnel of the armed force and violation was made a punishable offence. Punishments in other jurisdictions remained unclear, but all the measures were passed under the same colonial-era Epidemic Diseases Act (1897).


On its website, the WHO states that “if you are healthy, you only need to wear a mask if you are taking care of a person with suspected [Covid-19] infection”, or if you are exhibiting symptoms of the disease yourself, such as coughing and sneezing. WHO (WHO Advisory, 2020) stresses that it is critical that medical masks and respirators be prioritized for health care workers. The use of masks made of other materials (e.g., cotton fabric), also known as nonmedical masks, in the community setting has not been well evaluated. There is no current evidence to make a recommendation for or against their use in this setting. It further states persons with symptoms should wear a medical mask, self-isolate, and seek medical advice as soon as they start to feel unwell.


Question and Answers


What is the purpose of a Face Mask?


Cheng et. al., in The Lancet (2020) gives a vivid description of the benefits of mask usage - Mass masking is underpinned by basic public health principles that might not have been adequately appreciated by authorities or the public. First, controlling harms at source (masking) is at least as important as mitigation (handwashing). The population benefits of mass masking can also be conceptualised as a so-called prevention paradox—ie, interventions that bring moderate benefits to individuals but have large population benefits. Seatbelt wearing is one such example. Additionally, the use of masks in the community will only bring meaningful reduction of the effective reproduction number if masks are worn by most people—akin to herd immunity after vaccination. Finally, masking can be compared to safe driving: other road users and pedestrians benefit from safe driving and if all drive carefully, the risk of road traffic crashes are reduced.


When do you need to wear a cloth face covering?


CDC, 2020 - A cloth face covering should be worn whenever people are in a community setting, especially in situations where you may be near people. These settings include grocery stores and pharmacies. These face coverings are not a substitute for social distancing. Cloth face coverings are especially important to wear in public in areas of widespread COVID-19 illness.


Can a face mask protect me from coronavirus?


Devlin, 2020 - Wearing a face mask is certainly not an iron-clad guarantee that you won’t get sick – viruses can also transmit through the eyes and tiny viral particles, known as aerosols, can penetrate masks. However, masks are effective at capturing droplets, which is a main transmission route of coronavirus, and some studies have estimated a roughly fivefold protection versus no barrier alone (although others have found lower levels of effectiveness).

How long is cloth face mask effective?


A surgical mask should be worn for only one patient procedure or visit. If a mask gets wet or soiled it should be replaced. A cloth mask must be washed, cleaned and dried routinely.


How to Wear a Cloth Face Covering


CDC, 2020 - Cloth face coverings should—

  • fit snugly but comfortably against the side of the face

  • be secured with ties or ear loops

  • include multiple layers of fabric

  • allow for breathing without restriction

  • be able to be laundered and machine dried without damage or change to the shape.

What are the different types of masks?

Miller, et.al (2020). Surgical mask(disposable) – To be used by Surgeons (mainly, so they don't get germs on their patients). It can help protect wearers from getting others sick through their spit. It doesn't protect healthy people from acquiring an illness, and a loose fit leaves room for error. For Covid19 sick people must use it (to avoid infecting others), and caretaker.


Homemade mask (reusable if washed) - It is recommended for everyone for use in public places, like grocery stores. Homemade masks can be sewn, cut, or fashioned from a bandana. The masks should be washed routinely. It is low cost. For Covid19 it must be used by people in crowded places where it's difficult to maintain 6 feet of distance with others.


N95 respirator(disposable)- It is recommended only for health workers and those working with dust, mould, or medical/environmental emergencies. It only protects against particles, not gases or vapours. It can help protect healthcare workers from germs by blocking out at least 95% of small airborne particles — if worn correctly. In Covid19 it is recommended only for health workers.



References:


Devlin, H. (2020). The Guardian. Hannah Devlin. Science correspondent.Retrieved 24 Apr 2020 11.52 https://www.theguardian.com/world/2020/apr/11/can-a-face-mask-protect-me-from-coronavirus-covid-19-myths-busted

Miller, A.M, Brueck, H. (2020). All the different types of face masks, and who should wear them during the coronavirus outbreak. The Business Insider, Mar 12, 2020. Retrieved Apr 24, 2020. https://www.businessinsider.in/science/news/all-the-different-types-of-face-masks-and-who-should-wear-them-during-the-coronavirus-outbreak/articleshow/74585097.cms



TOI. (2020). More cities and states make masks in public compulsory. TNN | Updated: Apr 9, 2020, 15:39 IST. Retrieved Apr 22, 2020. https://timesofindia.indiatimes.com/india/more-cities-and-states-make-masks-in-public-compulsory/articleshow/75056539.cms

WHO. (2020). Advice on the use of masks in the context of COVID-19. Interim guidance 6 April 2020


Wingert, P. Masks. Encyclopaedia Britannica. https://www.britannica.com/art/mask-face-covering

Cheng, K.K, Lam, T.H, Leung, C.C (2020). Wearing face masks in the community during the COVID-19 pandemic: altruism and solidarity. The Lancet. Published: April 16, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30918-1

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