Why Wearing Mask Is A Must

Here I want to tell you everything about the Novel Coronavirus and the wearing of masks. As the article is a big long, you can look at the summary of each paragraph and choose the one you are most interested in to read. However, we suggest you read the complete article, and we are sure you won't regret doing it.

1. Foreword

• Necessary protective measures against COVID-19 suggested by WHO
• Why infected persons should wear a mask to prevent the virus spread in the droplets from their sneezes and coughs
• Western people don’t want to wear masks because of their culture

1. How masks avoid the spread of the Novel Coronavirus

• How does the virus spread by attaching to the droplets or droplet nuclei from sneezes/coughs/talking
• What are the BFE and PFE of the masks
• How do masks filtrate particles
• Filtration efficiency of different types of masks against various sizes of particles
• Diameter range of droplet nuclei and the filtration efficiency of different masks on this range

1. Significant misunderstandings about masks

• Healthy people do not need to wear masks; only sick people need to wear masks
• Disposable surgical masks can’t provide respiratory protection due to their loose-fitting
• A disposable mask and a surgical mask are equal to each other

1. The correct method of wearing a disposable mask
2. Mask types and recommendations for which ones people should use in different scenarios
3. Two masks which you could consider to have
4. Foreword

COVID–19 Coronavirus has become a dreaded infection, known to many people on the planet that has access to the Internet or media. Apart from the fact that it is plunging the global economy into disarray, it is also taking down the world’s population. According to the COVID-19 Coronavirus outbreak data on worldometers.info on April 12th, 2020, 16:42GMT 1,817,968 persons have been reported to be infected by the virus, and 112,370 persons have lost their lives to the dreaded COVID-19 Coronavirus disease.

Another factor that makes Coronavirus more frightening, aside from the death tolls that can result from infection is its creepy mode of transmission. The virus spreads like flu bugs and colds via droplets when an infected person coughs or sneezes. The droplets can land on the surface of objects and can be picked up by the hands of other people, or the droplets can even land on another person who is in close contact with the infected person at the time the person coughs on sneezes.

The Novel Coronavirus: called SARS-CoV-2 displayed in an electron microscope

A person can become infected when they touch their nose, eyes, or mouth with contaminated hands. The crafty transmission of Coronavirus is not without proven preventive measures. The World Health Organization (WHO) stated the following as the necessary protective measures against COVID-19 Coronavirus:

• Maintaining Social Distancing: There is a high risk of breathing in droplets, which contains the COVID-19 virus if an infected person coughs or sneezes. WHO advised that a distance of at least 1 meter should be maintained from anyone that is sneezing or coughing.
• Washing hand frequently: Washing of hands with water and soap or an alcohol-based rub kills the viruses that may be on the hands.
• Avoid touching nose, eyes, and mouth: Contaminated hands are the vectors of this virus. The virus can enter the body and make a person sick if the person touches their nose, eyes, or mouth with contaminated hands.

The preventive measures against COVID-19 prescribed by WHO emphasized guarding against contact with infected droplets, which proceeds from coughing or sneezing.

A mask is a useful material for capturing droplets. Some studies have revealed that masks provide estimated fivefold protection versus no barrier against pathogens. In the event of close contact or talking with an infected person, a mask cuts the chances of passing on the disease.

Therefore, it is expedient for an infected person or a person showing signs of infection to wear a mask to protect others from the disease. It is recommended for the family members who are caring for an ill person to wear a mask, and ideally, both the caregiver and the patient should wear masks.

It is not uncommon to see people in East Asian countries wearing surgical masks in public to protect themselves against pollution and pathogens even before the outbreak of Coronavirus. The Japanese even wear masks for non-medical reasons ranging from keeping warm during the winter to hiding a swollen lip or a red nose during the allergy season.

This is a crazy thing to do in Western society. This perception difference in wearing a mask is partly due to Western cultural norms about covering the face. Social interaction in Western society demands that you show your identity and make eye contact. Facial expression is essential in Western communications. Since, the wearing of masks has never been a part of Western culture, wearing one as a preventive measure against Coronavirus seems absurd.

1. How masks prevent the spread of the Novel Coronavirus

Although Western societies believe that wearing a mask in public is absurd, with the outbreak of COVID-19 and the preventive capability of wearing masks, the wearing of a mask is now portraying an individual to be socially responsible; one that cares about the well-being of everyone around. Each sneeze will produce over 10,000 droplets, which can travel up to 8 meters. Each cough will produce 1,000 to 2,000 droplets, which can travel up to 6 meters. Even talking produces about 500 droplets each minute. Now, imagine what could happen if these droplets are coming out from an infected person who has refused to wear a mask.

When an infected person sneezes or coughs, some of the thousands of big droplets (dia. greater than 100 μm) fall to the ground or surface of objects within 10 seconds and can be picked up by hands. This is why it is necessary to maintain good personal and communal hygiene by the washing of hands with soap and water or alcohol-based disinfectants.

The rest of the thousands of tiny droplets (dia. less than 100μm)form spray clouds, evaporate and gradually become droplet nuclei. These droplet nuclei flutter in the air and may infect people when they breathe them in and they come in contact with their mucosa. This emphasizes the strong need for wearing masks both by infected persons and non-infected persons; that is, everybody needs to get their masks on.

Why Masks?

Masks are very effective for capturing droplets. Some studies have also revealed that masks can provide estimated fivefold prevention against pathogens. Masks vary based on the materials used in producing them and for what purpose they are produced for. Examples include gauze masks, cotton masks, ordinary disposable medical masks, disposal surgical masks, and N95 respirator.

The ordinary disposable medical masks and the disposal surgical masks belong to the medical mask category. One of the critical points of the medical masks is the BFE – Bacterium Filtration Efficiency, which is usually required to be greater than 95%. This point is crucial for medical purposes because there are all kinds of bacteria in hospitals, and healthcare workers and patients can avoid germs invading them by wearing a medical mask. However, we can ignore this data when guarding against the Novel Coronavirus (called SARS-CoV2). Usually, bacteria have a diameter range from 0.5 to 5 μm and are much bigger than viruses, so the masks that can filtrate bacteria may not filtrate viruses.

There is another critical point of masks: the PFE – Particle Filtration Efficiency. The well-known N95 respirator is a kind of a mask that can filtrate a minimum of 95% of non-oil particulate aerosols. The N95 respirator is evaluated, tested and approved by NIOSH as per the requirements in 42 CFR Part 84. It is tested with 0.075 μm sodium chloride particles and ensures the concentration of particles in the mask is 95% lower than found outside the respirator.

Some studies found that not only the N95 respirator but also ordinary disposable masks have a good filtration ability with airborne particles. Commonly disposable masks have three layers. The outer layer is made up of non-woven fabric, which can block the big droplets. The middle layer is made up of melt-blown material, which can capture the tiny droplets by the electrostatic effect. And the inner layer is also made up of non-woven fabric, which can absorb the vapor you breathe out and ensures it won’t affect the middle filtration layer.

The following chart shows the capture efficiencies of different types of masks against various sizes of particles. These include the N95 respirator, surgical mask, ordinary medical mask, cotton mask, and gauze mask:

From the chart you can see for droplets larger than 10 microns, even the poorest one (Gauze Mask) has a capture efficiency close to 80%.

As we said before, the droplet nuclei from an infected person’s sneeze, cough or talk will flutter in the air and come to be a significant infection source. So, the crucial point of masks is how they prevent the droplet nuclei from contacting people’s mouths and noses. What size is a droplet nucleus? A study found that the diameter of 82% of the droplet nuclei of particles is between 0.74 and 2.12 microns.

What are the filtration abilities of the different masks for particles in this range?

From the chart above, you can see that the N95/KN95 Masks, Surgical Masks, and Ordinary Medical Masks have excellent efficiencies in capturing the droplet nuclei.

1. Significant misunderstandings about masks

• Healthy people do not need to wear masks; only sick people need to wear masks.

The US CDC website ever read: People who aren’t sick don't need to wear masks; only sick people need to wear masks.

Is this true?

Sick people do need masks because the primary way that people infected with the novel coronavirus pneumonia spread the virus is by droplets caused by sneezing, coughing and talking. To avoid infecting others, patients must wear masks to protect others around them or when they travel.

However, as we have analyzed before, masks have a good filter effect on droplets and droplet nuclei produced by patients, especially N95 masks, surgical masks, and ordinary medical masks. So, even for people who are not sick, it is recommended to wear masks in closed transportation (bus, subway, etc.) when participating in public activities or working in an office, especially when the distance between people is less than 6 feet.

Studies have shown that as long as patients do not sneeze or cough, the viruses inside the droplet nuclei do not exist more than 6 feet away from the patient's body, so it is essential to keep a safe distance of 6 feet away from strangers in public. At the same time, the research shows that in well-ventilated conditions, the droplet nuclei will quickly dissipate with the flowing air, so in well-ventilated indoor and outdoor environments, and ensuring that people are 6 feet away from each other, masks can be avoided.

Note that indoor ventilation here refers to natural ventilation rather than air conditioning, especially not central air conditioning. In the case of patients in a room equipped with central air-conditioning, the virus will spread everywhere. At the same time, when you are at home, you should frequently open the windows for ventilation.

Since a large number of novel coronavirus carriers are asymptomatic, these people are not detected as being infected. At the same time, the study points out that these asymptomatic carriers are also infectious. For these people, if they wrongly perceive that non-patients do not need to wear masks, they will become a source of transmission when they travel. So, even if you are not a patient or think you are not a patient, please put on a mask for your own safety and the safety of others.

In February, when the epidemic was at its most intense, China stipulated that all people who went out must wear masks. Now, even though the number of new cases in China has been dramatically reduced, China still hasn't relaxed the control of wearing masks. It's undeniable that in addition to the forced lockdown of cities and isolation of confirmed and suspected patients, the forced wearing of masks has contributed to China's rapid reduction in the transmission of the SARS-CoV-2. Meanwhile, Eastern Asian countries like Japan and Korea have done good jobs in controlling the spread of the COVID-19. People in those countries are more likely to accept wearing masks than people in Western countries, which shows a potential link.

At the same time, during this time of an epidemic, when people put on masks in public, it helps to maintain the confidence of people in other people. The subtext is that I care not only about my own health, but also the health of others. Don't ever create the idea that whoever wears a mask is a patient. Undoubtedly, such misconceptions will encourage the spread of the virus.

• Disposable surgical masks can’t provide respiratory protection due to their loose-fitting.

A surgical mask might prevent one from spreading the disease to others, but they provide no protection to the one wearing it.

Does a disposable surgical mask have any protective effect compared with an N95 mask? Scientists tested this question by randomly assigning over 2,000 nurses to wear N95 or surgical masks. Then they tracked how many of them caught the flu. The results are as follows:

Refer to the picture below:

Surgical masks have similar particle capturing capabilities as N95 masks, which may explain the results of the experiment. Some people think that the virus may enter the nose and mouth of the person through the edge of the mask due to the poor facial fit. As we said earlier, the SARS-CoV-2 can spread through droplets and droplet nuclei to the human oral and nasal mucosa to cause infection.

The size of the droplets is large, and the transmission distance is short. Even if some of the droplets come close to our mouth and nose, they are blocked by the front of the mask we wear. At the same time, due to the electrostatic effect, most of the droplet nuclei are absorbed by the inner fiber of the mask. Only a few of the droplets may reach the seams where the edge of the mask does not fit our face, and some of them may even reach our mouth and nose.

Would this amount of the virus infect us? I drew a demo picture below for an explanation.

The answer is it is possible, but if you are only facing one patient, the number of virus particles that reach the seam will be very few, as shown in the picture above. If you don’t wear a mask, say the infection rate may be 70%, but when wearing a mask, the infection rate may drop to 7% (this is not real data, but only an example).

Your infection rate will be lower when wearing an N95 mask, but the cost of an N95 is high. At the same time, because of its seals, wearing an N95 often feels suffocating, so you can choose to wear a disposable mask when the risk is not too high. What if you have ten infected patients in front of you? God willing, if you are not a medical staff member, you will not face such a situation! So, we can see why doctors in the front line of epidemic prevention are equipped with N95 or even N100 respirators, eye masks, protective coverall suit, etc.

• A surgical mask and a disposable mask are equal to each other.

Many people think that a disposable mask and a surgical mask are the same things because all disposable masks are not only similar in appearance but also basically three-layer in structure. Even the definition of surgical masks on Wikipedia:

A surgical mask, also known as a procedure mask, medical mask, or simply as a face mask, is intended to be worn by health professionals during surgery and during nursing to catch the bacteria shed in liquid droplets and aerosols from the wearer's mouth and nose.

This definition basically confuses surgical masks with disposable masks, which is really very lax.

The most significant difference between surgical masks and other disposable masks is that they must have the ability to prevent blood penetration (Fluid Resistance). That is to say, when surgeons operate on patients, blood from patients may accidentally splash on the doctor's mask, so the surgical mask must have an ability to prevent blood penetration; otherwise, the doctor is likely to be infected by the patient's blood.

The US Standard for surgical masks (ASTM F2100-11) states:

Surgical respirators are tested on a pass/fail basis at three velocities corresponding to the range of human blood pressure (80, 120, and 160 mmHg). The inside of the mask is then inspected to see if any synthetic blood has penetrated to the inside of the face mask.

There are many types of disposable masks, including medical surgical masks, ordinary medical masks, and civilian disposable masks. The difference between a medical surgical mask and an ordinary medical mask is that the ordinary medical mask cannot prevent blood penetration. T. The difference between the medical mask and the civilian mask is that the medical mask must have the bacterial filtration efficiency (BFE) more than 95%. As we mentioned earlier because the size of bacteria is much larger than that of viruses, masks that can filter bacteria may not be able to filter viruses, so this indicator has no significance for us when it comes to preventing the Novel Coronavirus.

Therefore, for virus prevention, the essential reference index for respiratory masks is particle filtration efficiency (PFE). The N95 respirators require the filtering ability of the masks for non-oil particles to be over 95% under the NIOSH standards; however, N95 masks do not need to have the ability to prevent blood penetration and filter bacteria. That's why the N95 Mask Certification Authority is NIOSH, not the FDA because it is a civilian mask.

In summary, if a disposable mask has a certain level of particle filtering ability (for example, more than 95%), it is equivalent to having that ability to defend against viruses. Although the airtightness of a disposable respirator is not as good as that of the N95 respirator, which cannot completely block the virus, as we analyzed earlier, the disposable respirator does have a strong ability to filter droplets and droplet nuclei. At the same time, we do not need to consider BFE if we are in a non-sterile environment. So, in a daily working and living environment, wearing disposable masks with a particle filtration efficiency of more than 80% of that of the civilian disposable respirators greatly reduces the risk of infection

1. The correct method of wearing a disposable mask:
2. Clean both hands before putting on the mask.
3. Pull the side of the mask with the metal strip upwards; hang the elastic strings on both sides onto the back of the ears; then fully unfold the outer folded surface to ensure that the mask completely covers the mouth, the nose, and the chin; finally, press the metal strip nose clip with both hands to make sure the mask entirely fits the face.
4. Try not to touch the mask again after wearing the mask. If it must be touched, wash your hands before and after wearing the mask.
5. When removing the mask, try not to touch the outer layer of the mask, and the mask should be removed by releasing the elastic string at the back of the ears.
6. After using the mask, it should be discarded into a garbage can and covered, and then wash your hands immediately.
7. Mask types and recommendations for which ones people should use in different scenarios：

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1. Two masks you could consider to have:

KN95 Face Mask, Disposable FFP2 Respirator with Elastic Ear Loop, 4-layer 3D Structure breathable

Features:

• Filtrate more than 95% of non-oil particles and aerosols in the air
• Four-Layer Protection:
  • The outer waterproof layer blocks large droplets.
  • The melt-blown layer captures tiny droplets due to Electrostatic Effect.
  • The structure layer builds a 3D space for non-contacts between your mouth and the respirator, which increases space to make you breathe smoothly.
  • The inner layer is made in soft materials to make contact with your face friendly.
• Premium grade elastic earband and adjustable hook & loop strap make the mask quite easy to wear, perfect to fit, and comfortable for long periods of wearing.
• Reliable quality with CE & FDA certified.

Ordinary Disposable Mask, 3-Ply, PFE greater than 80% against Virus, Non-medical

Features:

• Filtrate more than 80% of non-oil particles and aerosols in the air
• Three-Layer Protection:
  • The outer waterproof layer blocks large droplets.
  • The melt-blown layer captures tiny droplets due to Electrostatic Effect.
  • The inner layer is made in soft materials to make contact with your face friendly.
• Premium grade elastic earband and adjustable hook & loop strap make the mask quite easy to wear, perfect to fit, and comfortable for wearing.

Reliable quality with CE & FDA certified.