Face masks should be used as part of a comprehensive strategy of measures to suppress transmission of the virus and save lives. As COVID-19 spreads mainly from person to person through respiratory droplets, a face mask is a must not only to protect self but also to put a check on the transmission.
India’s nightmare of pandemic refuses to end as the country has crossed more than 3 lakh death (*3,15,235 deaths at the time of this writing). While the country is tackling the second wave, face mask continues to be an integral part of our lives. However, people need to follow other infection prevention and control measures as the use of a face mask alone is not sufficient to provide an adequate level of protection against COVID-19.
After the second wave, people have become more cautious regarding face masks and even wear double masks to protect themselves and the people with whom they come in contact. The Indian Government has already issued guidelines regarding face masks right from the start of the pandemic.
The guidelines for wearing face masks are as follows :
1. Masks are protective devices and if used correctly, can save people from seasonal influenza, or any other air/droplet borne infections.
2. It is mandatory to use masks for all health professionals in an infective environment.
3. Masks should be used as per the exposure to the person.
4. The risk categorization can change according to the expected degree of environmental contamination and transmissibility of the virus.
Types of Face Masks* :
It has also been further stated by the government that two types of face masks are effective to combat the virus. These are :
1. Disposable Triple Layer Surgical Mask
Specification: The triple layer mask is of a Non-Woven, Hypoallergenic 3 ply construction with filter in between with 4 tie strings.
Three-layered medical mask of non-woven material with a nose piece, having filter efficiency of 99% for 3-micron particle size. A triple layer medical mask is a disposable mask, fluid-resistant, protect the wearer from droplets of infectious material emitted during coughing/sneezing/talking.
2. N95 Mask/Respirator
An N–95 respirator mask is a respiratory protective device with high filtration efficiency of 95% or more against particulate aerosols. To provide the requisite air seal to the wearer, such masks are designed to achieve a very close facial fit.
If correctly worn, the filtration capacity of these masks exceeds those of triple-layer medical masks. Since these provide a much tighter air seal than triple-layer medical masks, they are designed to protect the wearer from inhaling airborne particles.
Disposal: Triple layer mask should not be re–used. Masks used by patients/ care givers/ close contacts during home care and should be disinfected using ordinary bleach solution(5%)or sodium hypochlorite solution (1%) or appropriate concentration of Quaternary Ammonium household disinfectant and then disposed off either by burning or deep burial.
Face Mask *Instructions to the patients:
1. The patient should at all times use a triple layer medical mask. Discard the face mask after 8 hours of use or earlier if they become wet or visibly soiled.
2. In the event of the caregiver entering the room, both caregiver and patient may consider using N95 mask
3. Mask should be discarded only after disinfecting it with 1% Sodium Hypochlorite
Face Mask *Instructions for Caregivers:
1. The caregiver should wear a triple layer medical mask. N95 mask may be considered when in the same room with the ill person.
2. The front portion of the mask should not be touched or handled during use.
3. If the mask gets wet or dirty with secretions, it must be changed immediately.
4. Discard the mask after use and perform hand hygiene after disposal of the mask.
5. He/she should avoid touching own face, nose or mouth.
There are as such no guidelines or scientific evidence for the health benefits of triple-layer masks for the general public. In fact erroneous use of masks or continuous use of a disposable mask for longer times or overuse of the same mask can increase the chances of getting infected. Everyone at home must use disposable triple layer masks.
The government has issued that people use double masks to prevent the spread of virus considering the impact of second wave:
1. It has been found that compared to a single N95 or surgical mask, wearing a double mask reduces aerosol exposure from coughing. Aerosol exposure from breathing was also found to be less when both the source and the recipient wore double masks. So, if you’d like to start double masking, try it at home and see if it is a perfect fit for you.
Fabrics for Face Masks
2. The next thing to consider is that what type of fabric is best for masks. Some types available are cotton, nylon, paper materials and natural fibres. Out of these, it is generally recommended that people wear face masks made with breathable fabric (such as cotton) as they provide the best protection from COVID-19 and helps prevent the spread of the virus.
3. We should, however, be looking for the diameter, permeability and thread count when choosing our masks. Masks made with tightly woven fabric (i.e., fabrics that do not let light pass through when held up to a light source). This will ensure which mask is effective for us.
Washing the Face Masks
4. Washing our mask is also important as it can contain thousands or even billions of viruses and bacteria which we gather from the outside environment. If you have a disposable face mask, wear and after use, throw it away.
5. If you wash your masks in a machine, remember to include them with your regular laundry and use your regular laundry detergent and use the appropriate settings according to the fabric.
6. If washing by hand, wash it thoroughly under the tap and laundry or detergent soap. Rinse thoroughly with clean water to remove traces of detergent.
Drying the Face Masks
7. Dry your mask completely in a warm or hot dryer. You can also hang your mask in direct sunlight to dry completely. If you cannot hang it in direct sunlight, hang or lay it flat and let it dry completely.
WHO or CDC does not recommend Masks with exhalation valves or vents.
WHO does not advise using masks or respirators with exhalation valves. These masks are intended for industrial workers to prevent dust and particles from being breathed in as the valve closes on inhale. However, the valve opens on exhale, making it easier to breathe but also allowing any virus to pass through the valve opening. This makes the mask ineffective at preventing the spread of COVID-19 or any other respiratory virus.
WHO shares guidelines on who should wear when and how :
— World Health Organization (WHO) (@WHO) April 18, 2021
When people don’t find face masks, they resolve to wear scarves and bandanas to protect themselves from the virus. These can also be used provided that they are used effectively. Unfortunately, people handle masks improperly that leads to infections and are inefficient. These are non-standard masks that protect people only from dust and not the virus. They cannot prevent the virus from entering the body and especially the respiratory system. These sub-standard masks provide false confidence to the people and exposing them to infections.