Biden’s administration has one mask mandate require people to wear masks on federal property, and he encourages all Americans to wear them in public for 100 days. Face covers are also required on planes, trains, buses and airports, renewed questions about which types of masks offer the best protection COVID-19, as well as where to find them.
The aim of the “100 Days Masking Challenge” is to curb the rapid spread of the coronavirus, which has already killed more than 400,000 Americans. Indeed, a study published Jan. 19 in the Lancet Digital Health journal Studies found that an increase in mask wearing in the US by just 10% would significantly reduce coronavirus transmission.
According to medical experts, wearing a mask is even more effective when the face cover fits properly and efficiently filters aerosol particles.
“The most important factor in addition to filtration is fit,” said Devabhaktuni Srikrishna, founder of the global health platform Patient Know-how, which manages educational health content for the general public.
“Even if you wear a high quality mask, it will leak all over if it doesn’t make contact with your face. The best masks have a very strong, tight seal so no air leaks. Low fit equals low filtration,” said Srikrishna.
Megan Ranney, an emergency physician at Rhode Island Hospital, ranked commonly available mask alternatives from most effective to least effective, noting that any form of face covering is typically better than none at all.
N95s provide the most filtration, according to Ranney, followed by so-called KN95 masks. Regular surgical masks are the next best option, followed by double-layer cloth masks with a filter worn between the two layers. Double-layer and single-layer cloth masks without filters are usually the least efficient, she said.
“Every time you step up, you get a little bit more protection. In fabrics or homemade masks, things that make them better include two layers of fabric with a filter between the two layers, like a vacuum cleaner bag filter, and keeping the fabric taut. woven, ”Ranney said.
Dr. Tom Peace, who was the director of the Centers for Disease Control and Prevention from 2009 to 2017, reiterated Ranney’s advice in a tweet Sunday.
“N95 masks are the most protective masks, followed by three-layer surgical masks, then cloth masks. A cloth mask is much better than no mask, but if it is contagious we may need to step up our masking game. Covid variants are starting 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 thoroughly tested and verified by the federal government and filters at least 95% of airborne particles.
NIOSH maintains a list of approved respirators by brand. Because N95-approved masks are scarce, experts still recommend that they only be used by healthcare providers.
“I generally ask the public not to buy N95s, as the authentic ones are still scarce for health professionals,” Ranney said.
A good fit, whatever the key, is difficult for the layman to achieve.
“Within the healthcare sector, before we can start caring for patients with an N95 or equivalent mask, we have to undergo a fit test where they let us move our heads and see if a bitter spray comes through the mask. test, so we hesitate to recommend that the public wear N95s, ”added Ranney.
Brian Wolin, whose work as a chiropractor has slowed since the start of the pandemic, sells NIOSH-approved N95 masks through his company, Protective Health Gear, based in Paterson, New Jersey. Initially, his goal was to help meet the masking needs of hospitals. He is now urging the general public to wear the gas masks as well.
Protective health equipment
“We think it’s very important to sell to the general public now. I think if everyone on the planet wore one of these things for 30 days, we would take care of this thing,” Wolin said.
He recognized the importance of fit testing in healthcare, but stresses that ordinary people can easily mold Protective Health Gear’s masks to form a good seal on their face. A box of 50 gas masks costs $ 199 at protectivehealthgear.com.
While NIOSH approved N95 masks are among the most rigorously tested, including filtration, breathability and durability, there are other effective alternatives that are suitable for general use when N95s are not available.
Elastomeric masks
Srikrishna recommends reusable elastomeric masks, which are more durable and cost effective than disposable N95s.
Elastomeric masks provide a high level of respiratory protection and can be combined with disposable N95 filters. The masks themselves are made of a flexible material similar to rubber and can be adjusted to fit snugly over the wearer’s face.
A 2020 study published in the Journal of the American College of Surgeons found that of those health professionals who exchanged N95 disposable masks for the elastomeric variety – in conjunction with a P100 filter – none wore an N95 mask again.
“Our clinicians were very comfortable with the fit, knowing that it was an equivalent, if not superior, amount of protection, and that these masks were meant to be reused,” said Dr. Sricharan Chalikonda, the lead author of the study, said in a statement.
The elastomeric mask shell is sold separately from the filter. Srikrishna recommends combining the masks with a P95 filter, rather than a P100 filter, for easier breathability. Another plus of elastomeric masks: they are relatively easy to find. A 3M version is available for $ 15 on Amazon, as well as P95 filters – sold separately.
3M / Amazon.com
The Centers for Disease Control and Prevention also approve 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. Where N95 masks are NIOSH certified, KN95 masks meet the certification standards of the Chinese government.
Given that the quality of KN95 masks is hugely inconsistent, experts in the US are suspicious of them, especially the masks sold on platforms such as eBay and Amazon. A September report from ECRI, a nonprofit healthcare safety organization, found that up to 70% of KN95 masks did not meet US standards for effectiveness. In other words, they did not filter 95% of the aerosol particles, as their name suggests.
Of course, the average consumer is unlikely to have the time and tools to inspect the masks themselves.
“In healthcare, we generally avoid the KN95s at this point,” said ER physician Ranney. Ranney is a co-founder of GetUsPPE.org, a site that provides donated personal protective equipment to frontline workers and under-resourced communities.
Ranney said her organization has received batches of donated KN95s, some of which have failed the group’s inspection process. “Fabric masks that fit really well and have a filter between the layers will be more reliable,” she said.
However, the Food and Drug Administration provides a list of KN95 masks that it authorizes for emergency use by health care providers.
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 emergency use. Office Depot sells a 10-pack for $ 10.
Powecom / Office Depot
KF94s from South Korea
KF94 masks, which meet South Korean government standards, are generally perceived to be more consistent in quality than China’s KN95s, but are still not fully approved for use in US healthcare settings.
Korean cosmetics company Be Healthy sells KF94 masks imported from South Korea from various manufacturers. All products sold by the online company must comply with South Korean standards, and some are also approved for use in Europe.
A study from the National Center for Biotechnology Information, comparing the effectiveness of N95 and KF94 surgical masks, found that both types of masks were equally effective.
Exposing forgeries
Given the shortage of N95 masks, there are of course plenty of counterfeits. Telltale signs of fake N95 gas masks, according to the CDC, include masks with no markings or approval number on the facepiece and no NIOSH markings. Other red flags include decorative additions such as sequins and kids approval claims. According to the CDC, packaging that claims a product is “ legitimate ” or “ real ” can also indicate that this is not the case.