What Experts Want You To Know About Face Masks And COVID-19

Why do we need masks?

“Current evidence suggests that the SARS-CoV-2 virus enters the human body in two ways. The first is when virus-laden droplets are released into the air by an infected person while coughing, sneezing or simply talking, and are then inhaled by a bystander. Secondly, virus-laden droplets land on a surface (table, counter top, light switch or the ground), is touched by hand and transferred to the eyes, nose or mouth into one’s body, explains Dr Sundeep Salvi, director of Pulmocare Research and Education Foundation in Pune. “So the need for face masks is two-fold: To protect oneself from inhaling the virus released by an infected person and to protect others from receiving the virus you may have released.”

Are face masks only for those who are sick?

There seems to be some contention among whether masks should be worn by everyone or only by COVID-19-positive people and their caregivers. Says Salvi, “If you are a corona-infected patient you must certainly wear a mask. Every time you cough or sneeze, around 5,000 droplets are released into the air, and can reach up to 2 metres away. So anyone who has COVID-19 or is treating and caring for a COVID-19 individual, must wear a mask,”

However, there are many people who are aymptomatic, which means they may have caught the SARS-CoV-2 virus in their system but are not showing any symptoms of the disease. They are likely to spread the disease to others and so face masks and gloves are a good protective measures for everyone, especially when they step outside or are in public spaces.

The WHO guidelines on use of face masks (updated 6 April 2020), however, stipulate that masks alone may not be enough and healthy people who wear masks could still catch the virus: “The use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted.” This means that social distancing protocols, frequent handwashing, surface-disinfection and prevention of mouth, nose or eye touching must continue side-by-side.

Can masks ever fail to protect?

“There are two important factors that determine the effectiveness of a mask. One: it should fit correctly and tightly around your face. You could have the best mask available but not wearing it properly will render this tool useless. So,ensure there is no leakage through gaps along the sides of your nose or on the sides,” Salvi says.

“Second, the mask should be able to filter out the droplets in the air. This is ensured by an appropriate pore size in the mask. Masks made of a material that has the smallest pore size will offer the most protection.” However, masks with small pore size, while high on defence can be hard to breathe through.

With revised WHO guidelines stating that there is no evidence that wearing a mask in the community prevented healthy people from contracting COVID-19, keeping up with hygiene and keeping distance are equally important and wearing a mask does not mean you can expose yourself to crowds. 

Are there right and wrong masks?

“Only N95 masks, the US classification, or its European equivalent—FFP-2(full face protection), have small enough pores to offer the best (90 per cent) protection from the virus entering your body through the nose and mouth,” according to Salvi.

However, with global shortages in PPEs (personal protection equipment, which includes face protection), the WHO encourages that medical masks such as the N95 be reserved for healthcare workers or COVID-19 patients who are more in need of these levels of protection.

Uninfected people who cannot acquire or afford these masks can opt for other face protection measures—cotton nose-and-mouth coverings such as a T-shirt, handkerchief or dupatta, homemade cloth masks or surgical masks can offer between 20 to 40 per cent protection.

The Indian government has also now issued an advisory asking the wider public to wear homemade face coverings "especially for people living in densely populated areas across India" as well as details on how to make such masks and other guidelines. (See link for the full guidelines from the Ministry of Health and Family Welfare.)

The Centers of Disease Control and Prevention also stipulates that cloth masks should have multiple layers of fabric, allow for breathing without restriction and should be washed in a way that retains the layers, fit and shape.

“Some store-bought masks come with a valve, which allows the exhaled air to be released. I would not recommend those especially for those who are COVID-19 positive, since the air they exhale is filled with the pathogen,” Salvi warns.  

Along with wearing the masks, limit outside time, stay at least six feet away from others, avoid touching your face or mouth and maintain proper hygiene—experts say that neglect and errors are the major reasons masks don’t work.

Can I reuse my masks?

There is an easy and unforeseen way to spread or catch the infection despite following all the above guidelines—while removing and by reusing masks for longer than the stipulated duration. According to WHO guidelines, do not touch the mask while wearing or removing it and if you do clean hands well after, always dislodge the mask from behind, replace masks as soon as they become damp, never share masks with others, never reuse single-use masks, and dispose them immediately upon removal and always wash cloth masks before reusing.