Covid-19: Wondering which mask gives best protection? Here's an easy guide to masking up during the pandemic

Q: As a doctor, what kind of mask would you suggest people wear, given that there are so many in the market?

Ans: This is the most important point when we talk of protection and prevention of Covid and it seems that this aspect got lost somewhere while managing the active infection of Covid. The masks available in the market are of many types such as cloth/fabric masks (which are single layered, double layered, triple layered), surgical masks, N95, N99 and respirator masks.

The selection of masks depends on the area where the mask is worn. For example, in hospitals the N95, N99 in Covid areas and good quality surgical masks in non-Covid areas provide adequate protection and these masks are not recommended for general public. For the general public, a three-layered mask as per guidelines of WHO and CDC are most suitable.

Q: Many use one-time use disposable masks. Are these safe in the current scenario?

Ans: If the quality of the disposable mask is good, and the three layers are incorporated, it offers good protection from droplet infection both ways, i.e., spray from cough or sneeze of the person wearing it, and droplets from others entering through the mask and infecting the person. The protection of surgical masks is far superior than cotton masks.

Dr Sushmita Bhatnagar
Dr Sushmita Bhatnagar

Q: What about cotton masks? For economical purposes many opt for washable and reusable masks. What’s your take on such masks?

Ans: For the general public who are moving about in public places and not in hospitals or infected areas, fabric/cotton masks are good enough, some of which may be even homemade and can be washed and reused. But most pertinent is the method of preparing of the fabric mask. The fabric masks, which the common man is nowadays wearing, are available everywhere — on the roadside, outside the stations, and in many other public places costing Rs 10-20.

But these masks are not made as per recommendations wherein three layers of fabric should be used and should be immediately banned. As regards protection, these masks probably do not offer more than 1% particle filtration.

The right way of manufacturing masks is to have the inner layer of absorbent material such as cotton, middle layer of non-woven non-absorbent material, such as polypropylene and then an outer layer of non-absorbent material like polyester or polyester blend. Densely woven cotton fabrics, such as quilting cotton, can also be used to provide at least 50-60% particle filtration.

While the government and health authorities are extremely tied up with so many major issues related to Covid, the least we can do is take responsibility of our own selves and our near and dear ones by following mask guidelines and not purchase masks indiscriminately without assuring that it actually provides protection.

In other words, though masks alone may not be enough in providing complete protection, they do play a very vital role and should not be taken lightly and should not be worn only as a show-off or to prevent fine by the police.

Q: What about kids, what kind of masks should they wear?

Ans: Kids are generally unable to follow the guidelines of wearing masks. They keep touching it, taking it off from the face, and do not carry out hand hygiene protocols as stringently. So, unless the guidelines of wearing masks are followed, any type of mask becomes ineffective. For older children, the guidelines are the same as adults.

Q: When it comes to hygiene, what’s the best way to dispose off a used mask?

Ans: The steps of disposing off a used mask are:

A: Wash/sanitise hands.

B: Hold the mask from behind the ears and pull it away from the face.

C: For disposable mask, do not put it directly in the bin. Wrap it in a bag and seal it before throwing in the bin and wash/sanitise hands again.

D: Wash the face with soap and water after completing the process of disposing of mask.

Q: And washable cotton masks, what’s the best way to clean them up?

Ans: For washable mask, follow the steps of removal from the face as mentioned above and then directly soak it in soap solution and wash/sanitise hands again. Drying these masks in the sun gives additional clearing up of coronavirus as UV rays affect the virus, though there is no conclusive evidence in the literature. This is the simplest, yet effective, way to clean up cotton masks.

Q: If there’s a Covid positive patient at home, should the family members mask up as well?

Ans: The protection of other family members when there is a Covid positive patient at home is most essential and thus, wearing appropriate mask (preferably surgical or N95 mask) is recommended especially for the older and younger members of the family.

Q: What about Asthma patients or the ones with breathing difficulties, is wearing masks advisable for them? If yes, what kinds should they opt for? If no, what alternative can they look at?

Ans: Asthma patients are more prone to severe form of Covid infection, and are at high risk. Thus, wearing masks is more important for these patients. Studies have shown that wearing masks does not worsen the asthma and it is safe to wear masks without drop in oxygen saturation. Those who have breathing difficulty and are uncomfortable wearing masks, should not travel in public places or attend social gatherings where wearing mask is mandatory.

Q: Is wearing two or more masks at a time an appropriate action?

Ans: Yes, wearing two masks or double masking is the latest recommendation by CDC and Dr Anthony Fauci, America’s leading infectious disease expert. However, there are certain guidelines of which two masks can be worn together and must be adhered to. Pairing is recommended with one surgical mask with one cloth mask. Any other pairing such as double surgical mask, double cloth mask, or N95 with any other mask is not recommended.

Q: What are the common mistakes people should avoid when it comes to wearing and selecting masks.

Ans: The common mistakes, which are hampering the protection offered by masks are multiple. First of all, selection of mask as mentioned above, and then proper technique of wearing mask (mask should properly fit the nose and mouth, not be loose, washing of hands before wearing the mask and sanitising after wearing mask if mask is used one), not touching or lowering the mask repeatedly, sanitising hands if mask is touched, proper removal of masks as described above and then finally, washing the mask as soon as it is wet or soiled or everyday even if it is not soiled are very important aspects for adequate and appropriate protection from Covid.

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