So - tell me about wearing masks
March 31, 2020 6:40 AM   Subscribe

I'm getting mixed messages on masks. Apparently, they do offer some protection, but some things I've seen about them on Twitter have me confused. Do you have some real info?

I'm not particularly trusting the US government on this one, since we were told they wouldn't help healthy people at all, which is apparently untrue. I am not complaining about saving them for health care workers, by the way. People on my cancer board have been hoarding them, and that irritates the shit out of me.

I am given a mask when I go to the Cancer Center for my weekly infusion. I have to wear one when they access my port. In addition, someone I work with has offered to make me one out of cotton. I have some questions.

If I save the masks from the Cancer Center, is it OK to reuse them? Does it make a difference if I let them sit a few days?
I read something on Twitter that said there's no point in wearing a mask if you're going to take it off or move it away from your mouth for any reason whatsoever. At the Cancer Center, they have me move it to take my temperature a few times. Does that mean it's useless after that? Is it really true that if I move it to drink water (I'm there for hours), I might as well not have it on as well?
If you are a healthcare worker, do you have any issue with a patient who you need to wear a mask wearing one that is homemade, or would you still need to give that person one from your stash?
Your credentials or links to reliable resources are especially welcome.
posted by FencingGal to Health & Fitness (18 answers total) 18 users marked this as a favorite
I linked to a video by a NYC doctor working in a COVID ward. It's long but the takeaway regarding masks is that they keep you from touching your face, they don't have to be N95 or anything more than a couple sheets of cotton - it's basically a tool to teach you not to touch yourself absentmindedly. His advice is to wear some kind of mask any time you're outside your home. There's other stuff, where he feels that transmission is almost entirely limited to person to person contact, rather than touching things like handrails or doorknobs...but he Purells constantly, just in case. The thread follows up on the mask discussion.
posted by bonobothegreat at 6:54 AM on March 31, 2020 [2 favorites]

I feel like this short article sums things up pretty well.
posted by Tell Me No Lies at 7:02 AM on March 31, 2020

Best answer: There have been a zillion conflicting articles written on this topic in the last month. The trend has been towards "yes, masks can help". Here's one from yesterday. The key thing is any sort of barrier in front of your face and nose will help some in keeping you from spraying saliva and mucus on other people and inhaling same from others. For this purpose, loose surgical-style masks seem about as good as N95 masks and more comfortable.
posted by Nelson at 7:03 AM on March 31, 2020 [1 favorite]

Slate also ran a "maybe the early advice not to wear a mask was not the best advice" article yesterday.
posted by terretu at 7:05 AM on March 31, 2020 [4 favorites]

Here is an FAQ about personal protective equipment from the CDC. Here is a PDF linked from that FAQ, under the question "What makes N95 respirators different from facemasks (sometimes called a surgical mask)?", comparing surgical masks to N95 masks. The FAQ answer in part says "The role of facemasks is for patient source control, to prevent contamination of the surrounding area when a person coughs or sneezes.  Patients with confirmed or suspected COVID-19 should wear a facemask until they are isolated in a hospital or at home. The patient does not need to wear a facemask while isolated." In the PDF, the "Intended Use and Purpose" for surgical masks is given as "Fluid resistant and provides the wearer protection against large droplets, splashes, or sprays of bodily or other hazardous fluids. Protects the patient from the wearer’s respiratory emissions." The "Use Limitations" for surgical masks says "Disposable. Discard after each patient encounter."
posted by bright flowers at 7:09 AM on March 31, 2020 [1 favorite]

Your masks can be hung up in a sunny window, sunshine and circulating air will be good. Medical/surgical masks have an inner layer that is electrostatic and traps germs, washing harms this. They provide limited protection against viruses, but if the virus is attached to droplets, that gets blocked. N95 masks block 95% of particulates including viruses and should be sized and fitted properly to be effective. Homemade masks block droplets in either direction and they can be washed. Consider the mask a contaminated surface and try not to touch it, which is a non-trivial task.

I think certified med/surg masks should go to patients and health care workers 1st. N95 should absolutely be for health care, as health care workers are at very high risk, and should be protected.
posted by theora55 at 7:46 AM on March 31, 2020 [1 favorite]

Best answer: The WHO has some advice about masks and how and when to use them. They don't recommend re-using single use masks, and they should be discarded when they get damp.

From my experience of wearing N95 masks (air pollution in China, yay!), they are pretty uncomfortable, and I'm fairly sure that I was (a) not wearing them completely correctly and (b) touching my face more than usual to adjust the thing. (In that situation, this was fine, because all I was trying to do was reduce the amount of fine particles reaching my lungs, and not have coughing fits.)

Politico has an article on all the different arguments for and against the use of the different types of masks/coverings.
posted by scorbet at 7:48 AM on March 31, 2020 [1 favorite]

Best answer: To the extent that people are now advocating for (non-N95) masks, the theory is that it is less to protect you than to protect others, by stopping at least some of any sneeze or cough discharge that you produce from circulating. When you use your port, the mask is to stop you from contaminating it through similar mechanism. But you really have to understand that the protection it offers you is pretty limited (someone sneezing or coughing so close that it's still in a big droplet) and conduct yourself accordingly. (I'm dubious about the "it discourages you from touching your face" theory, but I guess there's no empirical studies to go one way or the other.)

There has been at least one study showing that heating to 170F for half an hour disinfects N95s while not excessively degrading them. It may affect fit or other qualities, and of course it would be insane for a health care professional to bring a mask home from the hospital to disinfect it. For personal cloth masks used by ordinary schlubs in non-health-care settings, fit is less of a concern (there is no seal) and the contamination is produced primarily by you, not others, so that would tentatively suggest that you could wash (if your laundry gets that hot) or bake a cloth mask. I don't know how that would work with surgical mask material, and, regardless, it would always be better to dispose of any mask after a single use. This is a "better than nothing" approach, but even then the better is more for the community (outside of the chemo setting, of course!) than for you.
posted by praemunire at 7:49 AM on March 31, 2020 [5 favorites]

Best answer: Official advice from Hong Kong's Centre for Health Protection (our version of the US' CDC) is more about protecting others through mask wearing, rather than yourself. There's a ton of information on our coronavirus website here, but the official advice from this 'Use Mask Properly' guidance document (PDF) says this:

People should wear a surgical mask when they have respiratory infection; when taking care of patient with respiratory infection; or when visiting clinics or hospitals during pandemic or peak season for influenza in order to reduce the spread of infection.

In separate documentation, there is also advice to wear masks:

- if you go somewhere crowded
- if you have to take public transport

This PDF goes into some detail about how to wear one properly. More in this PDF on disposal.

As to their efficacy: Had we not had a wave of imported cases from people fleeing the US and UK, we would not be at risk of sustained community transmission as we are now - the rise in people coming home to HK over a few days in mid-March, and people not following their quarantine rules, has endangered all of us. So far, though, because mask use is so prevalent (I don't usually see anyone without a mask most days), we've managed to limit transmission a lot, and as a bonus, the flu season is functionally over.

There's a lot more on mask use at the (sfw) Wear A F-ing Mask site here. You can also make your own, with at least some effectiveness, using the patterns on the HKMask site.
posted by mdonley at 8:02 AM on March 31, 2020 [4 favorites]

I spoke with a friend who's a nurse on an infectious disease ward (now the Covid-19 ward) who has done several rotations there and here are her thoughts she shared with me.

Proper use of N-95 masks is something that she is trained for, and fitting them is essential. She believes that to achieve the level of protection she has every day is unrealistic without training and fitting. Also essential is proper removal and disposal. If you are looking for a mask to prevent any transmission at all, it's not really likely to happen without those things. She's also really angry seeing people using those masks right now because we are experiencing shortages. She saw someone put one in their car's cupholder after taking it off (!!!) and she was really irate.

However, if what you are trying to do is increase awareness and lower your risk of transmission, either to you or from you, wearing a mask can help. A surgical mask definitely helps. A fabric mask is going to depend on the fabric too but it's got some barrier effect. If two people are wearing masks that stop 20% each, it does lower the risk.

It's also behavioural. Depending on where you are and what you're doing, people may stay further away from you if you have a mask on (for example, on public transit). And it may stop you touching your face, if it's not one that makes you touch your face. I just picked up groceries and I put a camping bandana on, not because I thought it would save me or the person taking my tap payment exactly but because it made us both lean back a bit.
posted by warriorqueen at 8:18 AM on March 31, 2020 [4 favorites]

She's also really angry seeing people using those masks right now because we are experiencing shortages.

To be fair, if you have a few hanging around from an old home improvement/art project, or which were bought for emergency purposes and have been sitting in the back of the closet for a few years, which I think could be the case for many people, it's not immediately obvious that they are wanted or how to pass them on if they are. (Opened, partially used medical supplies are not generally donatable!) My friend finally found a group that would take my "random leftovers in an opened bag," but I'm not entirely certain what happened to them. In the meantime, I'd been reusing an old one for grocery trips on the "better than nothing" theory. Pretty sure no one wanted that one.
posted by praemunire at 8:24 AM on March 31, 2020 [15 favorites]

CDC considering recommending general public wear face coverings in public (WaPo, Mar. 30, 2020)
In recent days, an assortment of scientists, health experts, pundits and influencers has vigorously advanced their position that everyone venturing into public or crowded places should wear a mask or face shield — even a homemade one — to lower the rate of transmission of covid-19, the disease caused by the coronavirus.

Thomas Inglesby, director of the Johns Hopkins Center for Health Security, said in an interview the CDC should urge people to use nonmedical masks or face coverings. “I think it would be a prudent step we can all take to reduce transmission” by people who are infected but have no symptoms, he said. DIY coverings — like the ones his children just fashioned from old clothes for his family — aren’t perfect and should not be used as an excuse to stop social distancing, he said.
and the FPP Asks for Masks includes links to more information (NECSI) and DIY instructions.
posted by katra at 8:50 AM on March 31, 2020 [1 favorite]

Best answer: If you're looking for objective, science-based advice, this article is comprehensive but readable.
posted by acridrabbit at 9:28 AM on March 31, 2020 [1 favorite]

To be fair, if you have a few hanging around from an old home improvement/art project, or which were bought for emergency purposes and have been sitting in the back of the closet for a few years, which I think could be the case for many people, it's not immediately obvious that they are wanted or how to pass them on if they are.

I guess? I just found two. I'm giving them to a doctor friend, who definitely, definitely wants them. She's getting one mask per week. I think...if you know anyone at all who works in healthcare, just ask them.
posted by the_blizz at 10:50 AM on March 31, 2020 [1 favorite]

Of course masks help somewhat if it's spread by droplets, the WHO and CDC lost a lot of credibility by claiming that physics didn't apply to this virus. I work in a building full of scientists and people literally rolled their eyes when that announcement came out.

A far as being angry at wearers- I have some old used N95s from painting projects that are no good for donating but I could wear out and about. My dada has a bunch for boat repairs that he cleans and reuses since fiberglass isn't infectious. I'd guess a lot of homeowners and crafty people are in that boat. As it happens I'm wearing my washable and reusable dust mite mask out in public because it's a lot more comfortable while still providing some droplet protection.
posted by fshgrl at 12:13 PM on March 31, 2020 [1 favorite]

Best answer: This is , imo, the single most comprehensive and well researched resource (while still being accessible to a lay audience) that i have come across so far: "LinLab COVID presentation"

It is a pdf of slides from a presentation by Dr Michael Lin MD-Phd, Associate Professor of Neurobiology and Bioengineering at Stanford. His twitter feed here, his lab's site, here. It has footnotes and notes about when it was last updated (as of today, 3/28.)

The first part of the presentation is epidemiology related, data visualization type of stuff, scroll down to end of presentation (it's a 30+ page document) for recommendations about hygiene and sanitary best practices.

I have been sharing it with everyone i know, mostly by actually saying to them in convo, "hey I found this great resource I'm going to send you" because .. I really really want folks to open it and look at it so much.

For those without energy to click the links (but please.. please have a look if you can muster the energy, and I know energy is scarce these days), the gist/conclusion the document arrives at is: YES masks help.

But it's really worth clicking through - Lin goes into detail about what might be best practice if you must re-use a mask, how you might disinfect it, according to a variety of studies like the one someone referenced above about heat.
posted by elgee at 12:23 PM on March 31, 2020 [16 favorites]

Response by poster: Thanks everyone, and wow, elgee, that presentation by the Lin Lab needs to go everywhere.
posted by FencingGal at 1:48 PM on March 31, 2020 [1 favorite]

One thing I haven't seen mentioned much is that wearing a mask makes people stay away from you. Especially where I am, where it seems about half and half with people keeping 6 feet of distance. I don't know if it's a reminder or if it's because I look like a weirdo or if people think I'm sick, but when I wear a mask I notice people stay the fuck away!
posted by fiercecupcake at 2:57 PM on March 31, 2020 [7 favorites]

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