TAlthough the first Covid-19 vaccines are now being given to healthcare professionals, other frontline workers and the elderly in the United States, it will probably be months before enough Americans are vaccinated to prevent the spread of SARS-CoV-2. And with a more infectious variant, called B.1.1.7, spreading globally – for which the vaccine’s effectiveness is still unknown – more must be done to prevents as many infections and save as many lives as possible. Wearing a mask can help with this.
Wearing a mask or facial cover in two high-risk settings can help prevent the spread of SARS-CoV-2, the virus that causes Covid-19. This includes being indoors with others outside your immediate social bubble, in places such as supermarkets, closed malls, restaurants, churches, public transport, and so on; and being in a crowd.
While most masks provide some level of protection for users and those around them, many masks, including the widely used cloth and surgical masks, only partially filter the small Covid-19 spread particles known as aerosols that people they emit when coughing, sneezing, breathing and talking. As demonstrated in a recent study, high filtration (hi-fi) masks like N95 masks are the best protection against these small particles.
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While the country awaits increased population immunity through vaccination, we need a National Hi-Fi Mask Initiative to produce masks that provide more protection against aerosolized droplets and viral particles and also reduce the number of them emitted to the environment by people infected with SARS-CoV-2.
Wearing a high-fidelity mask substantially reduces the chance of becoming infected with Covid-19 during close contact with someone who has the disease. Two of us (AK and RD) have direct experience with this: we used N95 masks last year while taking care of patients with Covid-19 and none of them caught Covid-19, demonstrated by regular negative PCR tests.
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These masks can have the same effect indoors and also help to reduce overspray events.
As the transmission of SARS-CoV-2 once again increases across the country, so are the chances that infectious aerosols are being emitted and remain in the air in closed spaces that people frequent. This can, to some extent, explain infections in people who were “doing it right” but were still infected.
We proposed the need for such masks at the beginning of the pandemic and stressed that masks would be a way to get people back to school or work safely. In July, we co-signed an open letter calling for a national mask initiative also signed by more than 70 scientists and public health advocates, including two former Senate majority leaders, two former Cabinet officials and several leading epidemiologists and diseases infectious specialists.
Later this month, a new government interested in acting on the pandemic plans to order 100 days of masking. It’s a good start. But the Biden government also needs to do something together: invoke the Defense Production Act to immediately increase production of already certified high-fidelity masks, as well as accelerate the development of new designs.
The South Korean government, for example, started buying and shipping large batches of KF-94 masks (its equivalent to N95s) early in the pandemic to ensure that everyone had access to them.
Ideally, a set of masks would be sent to every family in the United States each month – the costs of doing so are negligible compared to the pandemic’s tribute to lives and economics. The use of such masks, in combination with other risk reduction strategies, would create safer workplaces for essential workers, many who are currently not prioritized for receiving early vaccines.
Since the beginning of the pandemic, surgical and tissue masks have become widely available in pharmacies, supermarkets, hardware stories, online and elsewhere. High-fidelity masks must also be made available ubiquitously through these same locations, some of which are already in coordination with the federal government to launch Covid-19 vaccines.
Given the unprecedented scope of Covid-19 vaccination programs, their implementation may not go as smoothly as expected. Production and supply chain problems, along with fragmented absorption, are likely to mean delays until the country reaches the point of functional herd immunity.
More and better masks can help us get to that point with less infections and deaths. With projects validated on the market, mass production of high-fidelity masks can be done relatively quickly.
The value of a National Hi-Fi Mask Initiative would last long after this pandemic is extinguished. It is only a matter of time before we face another respiratory pathogen like SARS-CoV-2, or even a potential biological weapon, which could be even worse. In such scenarios – as in the case of Covid-19 – vaccines would take months to be ready.
Just as every home must have a fire extinguisher, everyone must have immediate access to a high-fidelity mask that can be used to protect against these threats.
Abraar Karan and Ranu Dhillon are doctors at Brigham and Women’s Hospital and Harvard Medical School. Devabhaktuni Srikrishna is the founder of Patient knowledge, which curates educational content for patients on YouTube, including a list of N95 masks and high-fidelity alternatives. The opinions expressed here are those of the authors and do not necessarily reflect the opinions and opinions of their institutions.