Never would I have imagined when thinking about this blog that I would write a headline that said that CDC recommended wearing a mask outside our homes. This of course is not something I celebrate—it is a sign of how serious this pandemic is, an indicator of how many lives have been lost. Several celebrities, including the great folksinger John Prine, have died due to COVID-19. Eventually all of us will likely know someone who died of the coronavirus. But the CDC decision is a victory for the #masks4all movement, and if people take the recommendation seriously enough, it will be a victory for all of us.
In my last post, I had been critical of the confusing and misleading advice the CDC had been giving in regards to wearing masks to protect against the coronavirus. While I strongly supported their efforts to address the shortage of masks by reserving them for medical staff, the CDC had nothing to say to people like me who would be susceptible to serious complications from the virus and couldn’t maintain social distancing in certain circumstances.
Because of the shortage of masks, many people began to make cloth masks which would be “better than nothing” for hospital workers, or would help disposable masks last longer by providing a washable cover for them. The volunteer effort for this has been remarkable. Many people began to post instructions for how someone could make their own mask.
And then the Czech Republic spoke up and said “We have an important message for all of you.”
This video went viral starting in late March. It talked about how the Czech Republic reduced transmission of COVID-19 by requiring everyone to wear masks when stepping outside. The narrator boiled it down to a simple phrase: “When we both wear masks, I protect you. And you protect me.” While people would have initially been laughed at for wearing them, various influencers in the country began sharing pictures of themselves with their masks under the hashtag #masks4all. Within just a few days, the Czech Republic adopted the practice.
Within a few more days, more and more people in the US began to put forth this same argument in social media and on YouTube. Within a few more days, discussions about this were occurring across mainstream media and finally, at the highest level of the US Center for Disease Control. Finally, on Friday, April 3, the CDC recommended wearing a mask when going out in public. They said this was based on new data that showed that asymptomatic people were responsible for much of the spread of COVID-19.
I question how “new” this knowledge was. And I think there’s a direct link between the #masks4all movement and the CDC decision.
Now that the CDC has recommended wearing a mask in public, what matters most is that it’s implemented effectively. There is, at least temporarily, a cultural shift in the West that encourages mask use. But because it is something so new, a lot of Americans are confused about the proper use of masks and even why they are wearing them.
When the woman in the above video said “When we both wear masks, I protect you, and you protect me,” she meant that we need to wear these masks so that we can protect other people. The cloth homemade masks are better for protecting others than for protecting the wearer. Though they do protect the wearer a little bit. If worn, these masks need to be washed once per day. They can usually be easily handwashed.
The earloop surgical masks you usually see at hospitals and clinics usually protect the wearer better than the cloth masks do. But even those are primarily designed to protect others from the wearer’s germs. Though it is true that some of them—often called “procedure masks” are designed to be worn for a short while by a medical practitioner to protect themselves from the patient’s germs. They can’t be worn too long or else they’ll become damp and less able to protect.
Masks that are mainly designed to protect the person actually wearing the mask usually fall under the category of N95, or any combination of N, R, or P with the numbers 95, 99, or 100. The numbers represent percentages of particles filtered at .03 microns or larger (with 100 actually referring to 99.97%), and N means that no oil is present in the air (which is often true when used for industrial applications). R means that the mask protects against some oil in the air but which can’t be used beyond one eight-hour shift and P is the most effective against any oils in the air. Note that many viruses are .01 microns wide but often travel with particles of water vapor which would then make them larger. These masks may have an exhalation valve which makes the mask feel less hot and stuffy. Note, however, that you are not protecting others if your mask has an exhalation valve—that valve allows exhaled air to bypass the filter. You could potentially cover the valve with tape and force all air that you exhale through the filter. I do that with one of my masks, but it might make the mask harder to breathe through.
The disposable masks in the N, R, or P classes really ought to be reserved for healthcare workers, but there are many masks in this category that aren’t likely to be used in healthcare settings. Enter “anti-pollution masks” into your web browser and you’ll find a number of reusable masks with replaceable filters that the manufacturer says can be used to protect against germs. Many cartridge respirators fit into these categories as well. One Austrian woman wears one such respirator when going to the grocery store, and then switches out the filters.
In this COVID-19 pandemic, you should wash your hands before putting on a mask. You should keep the mask on until you leave the area where you might be exposed to illness and are done using the mask. You should try to make sure that all the air you inhale and exhale goes through the mask and not around it.
You should avoid touching the mask or filter while wearing, otherwise, you might contaminate your hands. You also dramatically increase the chance that you’ll infect yourself with the germs your mask blocked if you 1) frequently remove the mask and put it back on, or 2) pull the mask down and wear it under your chin only to pull it up again. I’ve even seen many doctors and nurses make that mistake. Operating room personnel are always taught that the outside of PPE—masks, gloves, gowns—are considered “dirty” after being used and should not be touched. When you take off the mask, try not to touch the mask itself if you can avoid it. Try to remove the mask by the straps if you can, and try to keep the mask from touching any part of your body. Once you’ve taken it off, make sure to wash your hands again.
Now that the CDC has recommended wearing a mask in public, Westerners are now in a strange and unfamiliar world. Over the last three decades the protective face mask had been surging in popularity in Asia, but had been much more slowly coming into popularity in the West. Now a pandemic has now caused its popularity to soar in the West, even as most people hardly know how to wear them. Indications are that masks are going to be critical for our protection as we come out of isolation back to jobs, in order to minimize the still-present risk of infection.
As horrible as the pandemic is, one possible silver lining is that more people will begin to see the value of masks. Perhaps people will see the opportunity to use a mask to protect themselves against pollution, allergies and other toxins, and will become more “normal,” whatever normal actually is.
In any case, mask fashion is becoming more recognized as a thing, as the video below shows: