Better to wear face mask than a shroud

By: Dr. Adil Rasool Malik

In late 2019, a novel corona virus also called as COVID-19 emerged in China. Since then, it is rapidly spreading throughout the world. Some people with Covid-19 may sometimes experience very mild illness while others experience difficulty in breathing, pneumonia and even respiratory failure. Older people and those with underlying health conditions are at high risk.

With the increasing number of Covid-19 cases globally, countries have utilized precautionary measures against this pandemic. The effective method to prevent Covid-19 includes:

1. Use of face masks
2. Cleaning hands frequently with soap or alcohol based sanitizers
3. Practicing social distancing
4. Being conscious about the face region

One vital tool among Covid-19 preventive measures is the regular use of face masks. Masks may help prevent people who have Covid-19 from spreading the virus to others and vice versa. Masks are most likely to reduce the spread of Covid-19 when they are widely used in public settings. Masks are not Personal Protective Equipment (PPE) so; they are not appropriate substitutes for PPE.

Considerations for wearing masks:

1. CDC (Centers for Disease Control and Prevention) recommends that people wear masks in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain.
2. Masks may help prevent people who have Covid-19 from spreading the virus to others.
3. Masks are most likely to reduce the spread of Covid-19 when they are widely used by people in public settings.
4. Masks should not be worn by children below 2 years; people who have trouble in breathing and, people who are unable to remove the masks on their own.
5. Masks with exhalation valves or vents should not be worn.

There are three primary types of masks which can be used against this corona virus spread.

1. Home-made cloth face mask;
2. Surgical mask;
3. N95 respirator

Home-made cloth face masks

The center for disease control and prevention (CDC) is now recommending that everyone without symptoms of Covid-19 should wear cloth face mask to prevent corona virus spread. This recommendation is in addition to continued physical distancing and proper hygiene practices.

Recommendations include:

1. Wear cloth face mask in public settings especially in areas of significant community spread such as grocery stores and pharmacies
2. Use cloth masks rather than surgical or N95 respirators, as these critical supplies must be reserved for health care workers, and other medical workers
3. Health care professionals should exercise extreme caution when using home-made face masks. These masks should preferably be used in combination with a face shield that covers the entire front and sides of face and extends to the chin or below.
4. It is very important to wash homemade cloth face masks after every single use. When removing, everyone should be careful not to touch eyes, nose and mouth and wash hands immediately after the removal.

Benefits of cloth face mask include:

1. It can be easily made at home with common materials so there is an unlimited supply
2. These may lower the risk of people without symptoms transmitting the virus through speaking, coughing or sneezing
3. These are far better than not using any mask and offer some protection especially when social distancing is difficult to maintain

Risks of cloth face mask include:

1. These masks don’t reduce or replace the need for other protective measures
2. These masks should not provide a false sense of security and thus making people complacent about other precautions.

Surgical masks

Surgical masks are a disposable, loose fitting face mask that cover the nose, mouth and chin. They are typically used to protect the wearer from sprays, splashes and large particle droplets and also to prevent the transmission of potentially infectious respiratory secretions from the wearer to others.

Surgical mask can vary in design, but the mask itself is often flat and rectangular in shape with pleats or folds. The top of the mask contains metal strips that can be formed to the nose. Elastic bands or long straight ties help to hold a surgical mask in place while wearing it. These can be looped behind the ears or tied behind the head.

Surgical mask is used only if someone is currently ill with Covid-19 or are caring for someone at home who can’t wear a mask. Surgical masks are disposable, so caution to not reuse them.

N95 respirators

An N95 respirator is more tight fitting face mask. In addition to splashes, sprays and large droplets, this respirator can also filter out 95% of very small particles. This includes viruses and bacteria.

The respirator itself is generally circular or oval in shape and is designed to form a tight seal to the face. Elastic bands help to hold it firmly to the face. Some types may have attachment called an exhalation valve, which can help with breathing and the build-up of heat and humidity. But WHO recommends now not to use this N95 respirator with valves or vents since its efficiency against preventing Covid-19 spread is questionable.

Simply using masks won’t reduce risk of Coivid-19. It is very important to see how properly we use the masks. Below are important steps regarding proper use of masks:

1. Before wearing the mask, clean your hands either by washing with soap and water or by using alcohol based sanitizer and check whether or not the mask any tears of holes.
2. For surgical masks, locate the metal strip in the mask. Place that side of mask on the bridge of the nose molding the upper part to shape of the nose.
3. Carefully loop the band behind the ears or tie it behind the head.
4. Pull the bottom of mask down, ensuring that it covers the nose, mouth and chin.
5. Try to avoid touching the mask while wearing it. If you must touch or adjust the mask, be sure to clean the hands immediately afterward.
6. Mask should be immediately replaced when wet soiled or damaged.
7. Remove the mask with appropriate technique. Un-loop the bands from behind the ears or undo the ties behind head. Avoid touching the front of the mask which may be contaminated.
8. In case of cloth face mask, immediately wash properly with soap and water and incase of surgical mask promptly dispose of the mask in a closed garbage bin. Thoroughly clean the hands afterward.

–       The writer is Oral & Maxillofacial Pathologist in J&K Health Services