The Biden administration issued a mask mandate requiring individuals to wear masks on federal properties, and he is encouraging all Americans to wear them in public for 100 days. Facial coverings are also necessary on planes, trains, buses and airports, renewing questions about what types of masks provide the best protection against COVID-19as well as where to find them.
The aim of the “100 Days Masking Challenge” is to stem the rapid spread of the coronavirus, which has already claimed the lives of more than 400,000 Americans. In fact, a study published on January 19 in the Lancet Digital Health Studies found that increasing the use of masks in the United States by just 10% would significantly reduce coronavirus transmission.
The use of the mask is even more effective when the facial covers fit properly and filter aerosol particles efficiently, according to medical experts.
“In addition to filtering, tuning is the most important factor,” said Devabhaktuni Srikrishna, founder of the global health platform Patient Knowhow, which curates educational health content for the general public.
“Even if you are wearing a high quality mask, if it does not come in contact with your face, it will leak on all sides. The best masks have a very solid and firm seal so that the air does not leak. Low adjustment is the same low filtration, “said Srikrishna.
Megan Ranney, an emergency physician at Rhode Island Hospital, rated the generally available mask alternatives from the most effective to the least effective, noting that any type of facial coverage is usually better than none.
The N95s provide the highest filtration, according to Ranney, followed by so-called KN95 masks. Regular surgical masks are the second best option, followed by double layer fabric masks with a filter used between the two layers. Double-layer and single-layer fabric masks without filters tend to be less efficient, she said.
“Whenever you take a step forward, you get a little more protection. In fabrics or homemade masks, the things that make them better include two layers of cloth with a filter between the two layers, like a vacuum bag filter, and have the fabric well woven, “said Ranney.
Dr. Tom Frieden, who was director of the Centers for Disease Control and Prevention from 2009 to 2017, echoed Ranney’s advice in a tweet Domigo.
“N95 masks are the most protective masks, followed by three-layer surgical masks and then fabric masks. A fabric mask is much better than no mask, but we may need to intensify our mask game if it’s contagious. Covid variants start to spread widely, “he said.
The N95 – king of all masks
An N95 approval rating by the National Institute for Occupational Safety and Health means that a mask has been rigorously tested and verified by the federal government and filters at least 95% of the airborne particles.
NIOSH maintains a list of approved respirators by brand. As the N95 approved masks are still scarce, experts still recommend that they be used only by healthcare professionals.
“I generally ask the public not to buy N95s because the authentic ones are still in short supply for healthcare professionals,” said Ranney.
Proper adjustment, however, which is also essential, is difficult for the layperson to achieve.
“In the health area, before we can take care of patients with an N95 mask or equivalent, we have to pass an adjustment test, where they make us move our heads and see if a bitter spray passes through the mask. can do a fit test, that’s why we hesitate to recommend that the public use N95, “added Ranney.
Brian Wolin, whose work as a chiropractor has declined since the pandemic began, has been selling NIOSH approved N95 masks through his company, Protective Health Gear, based in Paterson, New Jersey. Initially, its goal was to help meet the needs of hospital masks. He is now encouraging the general public to use respirators as well.
Health protective equipment
“We think it is very important to sell to the general public now. I think if everyone on the planet used one of these things for 30 days, we would take care of that,” said Wolin.
He acknowledged the importance of fit testing in healthcare settings, but insists that normal individuals can easily mold Protective Health Gear masks to form a firm seal on their faces. A box with 50 respirators costs $ 199 at protectionhealthgear.com.
Although NIOSH approved N95 masks are among the most rigorously tested for a variety of factors, including filtration, breathability and durability, there are other effective alternatives suitable for general use when N95s are not available.
Elastomeric masks
Srikrishna recommends reusable elastomeric masks, which are more durable and economical than disposable N95s.
Elastomeric masks provide a high level of respiratory protection and can be combined with disposable filters. The masks themselves are made of a flexible material similar to rubber and can be adjusted to fit comfortably on the user’s face.
A 2020 study published in the Journal of the American College of Surgeons found that of the healthcare professionals who switched disposable N95 masks to the elastomeric variety – combined with a P100 filter – none returned to using the N95 mask.
“Our doctors were very comfortable with the adjustment, knowing that it was an equivalent, if not greater, amount of protection, and that these masks should be reused,” said Dr. Sricharan Chalikonda, the study’s lead author, in a communicated.
The elastomeric shell of the mask is sold separately from the filter. Srikrishna recommends pairing the masks with a P95 filter, as opposed to a P100 filter, to facilitate breathability. Another advantage of elastomeric masks: they are relatively easy to find. A 3M version is available for $ 15 on Amazon, as well as P95 particulate filters – sold separately.
3M / Amazon.com
The Center for Disease Control and Prevention also approves the use of elastomeric masks, calling them “equivalent protection” to N95 masks.
KN95s from China
KN95 masks are similar to N95 masks, but meet completely different standards. While N95 masks are certified by NIOSH, KN95 masks meet Chinese government standards for certification.
Given that the quality of KN95 masks is totally inconsistent, experts in the U.S. are wary of them, especially those sold on platforms like eBay and Amazon. A September report by ECRI, a non-profit health safety organization, found that up to 70% of KN95 masks did not meet US efficiency standards. In other words, they did not filter 95% of the aerosol particles, as their name suggests.
Of course, average consumers are unlikely to have the time and tools to inspect the masks on their own.
“In the health field, we generally avoid KN95s at this point,” said doctor ER Ranney. Ranney is a co-founder of GetUsPPE.org, a website that provides donated PPE to frontline workers and resource-poor communities.
Ranney said his organization received lots of donated KN95s, some of which failed the group’s inspection process. “Fabric masks that fit very well and have a filter between the layers will be more reliable,” she said.
The Food and Drug Administration does, however, provide a list of KN95 masks that it authorizes for emergency use by healthcare professionals.
Among them are Chengde Technology’s KN95 masks, which cost $ 15 for a pack of 10. They are available here.
Powecom KN95 masks are also FDA approved for use in emergencies. Office Depot sells a pack of 10 for $ 10.
Powecom / Office Depot
South Korea’s KF94s
KF94 masks, which meet the standards set by the South Korean government, are generally seen as more consistent in quality than China’s KN95 masks, but are not yet fully approved for use in healthcare facilities in the U.S.
Korean cosmetics company Be Healthy sells KF94 masks imported from South Korea by various manufacturers. All products sold by the company online must meet South Korean standards and some are also approved for use in Europe.
A study by the National Center for Biotechnology Information, comparing the effectiveness of surgical masks N95 and KF94, concluded that both types of masks are equally effective.
Unmasking counterfeits
Of course, given the scarcity of N95 masks, counterfeits abound. The telltale signs of fake N95 respirators, according to the CDC, include masks without markings or approval numbers on the facepiece and without NIOSH markings. Other red flags include decorative complements, such as sequins and approval claims for children. The packaging claims that a product is “legitimate” or “genuine” can also be indicative that it is not, according to the CDC.