By Dr. Chitra Selvaraj
A question arises – are the masks that people are required to wear in many states helpful in protecting wearers against the coronavirus?
According to Dr. Anthony Fauci, at least at one point in this evolving saga, there is little reason to wear masks. They do not offer much personal protection from getting infected.
See video below.
Let us explore the actual nature of the spreading of the virus to analyze whether masks can help us.
Below is a video of an experiment done in a Japanese lab that shows how microdroplets stay in the air around us from an infected person, when the person coughs, sneezes, or even talks loudly.
The person could be a carrier and because he/she is asymptomatic, may not even know that he/she is a carrier.
When someone is a carrier, even talking loudly releases microdroplets containing millions of viruses into the immediate environment and anyone in proximity could inhale these viruses. It’s not known how much must be inhaled to contract an infection.
As you have seen in the video above, the microdroplets are 1/100th the size of a millimeter and smaller.
Here is the point: The masks or bandanas that people wear clearly do not ensure a complete seal required to block these tiny droplets measuring 0.001mm and smaller.
To the naked eye, a mask may appear to be a good seal, but the droplets are much smaller than the diameter of a hair. The space between the mask and the skin is very large to the droplets.
If a single strand of hair can easily pass through the space between your mask and your skin, then certainly the desired seal to block out the microdroplets that carry the virus has not been achieved. Facial hair that is in the way of the mask also does not permit a perfect seal.
Even not shaving for a day, can prevent a complete seal of even a well fitted N95 mask.
One way to check a good seal of the mask is to first make sure it’s fitted well. Then spray a scented aerosol in the air. If you can smell the fragrance, then the seal that is required is not achieved.
An aerosol also has tiny microdroplets similar to the microdroplets containing the virus. If the aerosol carrying the scent can pass through to inside your mask, then the microdroplets containing the virus will also definitely infiltrate your breathing zone.
Without achieving a perfect seal, droplets can easily infiltrate the breathing zone, and your chances of exposure to the virus are not reduced significantly. With a perfect fit, where the air has to pass through a filter, there are greater chances of filtering out the virus, as seen in the diagram below:
Another way to know if you have a perfect seal is to see how easily you can breathe. If you have achieved a perfect seal with your bandana, then there would be very little gaseous exchange, and you would have probably used up all the oxygen in the breathing zone that is not circulated/replenished. If you experience no such breathing difficulty, then you do not have the desired seal.
So the next question is how then do I breathe? Clearly this represents the whole problem with masks. If you can breathe easily, then you do not have a seal that protects you from microdroplets and obviously if you cannot breathe easily, how do you go out and perform your duties while wearing a properly sealed protective mask?
This obviously leads to the next question:, ‘Do I really need to wear a mask?”
If you are a health care worker and come into close proximity to COVID-19 positive patients who you must interact with, hence coming into contact with their secretions/fluids, then you really need much more then just a mask. For this purpose, a complete body seal is best. Their personal protective equipment [PPE] should be elaborate and when properly protected they wear a mask in combination with a shield, hood or respirator that filters up to 0.007 microns.
Infection control is a science in itself and has changed since the onset of the COVID-19 pandemic. Healthcare professionals throughout the world are receiving training on the new methods of donning and doffing PPE, specific to preventing contamination by COVID-19.
Here are some examples of a perfect seal achieved by high-risk healthcare professionals with PPE worn in combination with masks.
Social distancing and staying at home as much as possible reduces our exposure to the virus. When we do go to stores, we are required to maintain a distance of six feet. This ensures that if someone is a carrier, and if they cough, the big droplets that typically travel less than 6 feet fall to the ground.
But the microdroplets, as seen in the video simulation in the Japanese lab, and in the picture above, travel greater distances and linger around. This is just with one cough. If someone is infected, they’ll probably cough in intervals, and every time they cough or even breathe heavily, they release more viruses into the environment. Most stores are not well ventilated, and the viruses in these microdroplets could linger for a long time.
Should we be exposed to the virus at a grocery store, the fact is we will almost just as readily contract the infection with the mask as without.
In my opinion, if the government were to impose wearing something, I would suggest gloves over masks.
The glove actually covers the entire hands, and at a store, we touch many things that could be infected. Wearing a glove actually does prevent contamination of our hands through coming into direct contact with the infected item.
Same principle at the gas station or anywhere we go. We do not know who was previously there.
As the COVID-19 strain lives for a few hours to a few days outside of a living host depending on the material, and if a COVID-19 positive person touched an item and left the virus there, wearing a glove will protect us from being contaminated provided that one does not touch their face with their gloves and properly disposes of them, then washes one’s hands properly.
At this point, many people have learned to wipe down everything they bring in to the home from the store, so, by wearing gloves, we have reduced or eliminated contamination through physical contact and disinfecting purchased items.
However, going back to the masks, the COVID-19 virus is transmitted not just through direct contact but through microdroplet transmission. To protect oneself from microdroplet infection, one must have a mask with a complete seal.
This can be accomplished only with respirator masks. It’s really not that easy to breathe with a respirator mask. People with COPD, asthma, pregnant women and people with other breathing disorders may not react well to breathing in a respirator mask, where one should manually suck in air only through the filter. There are battery operator hood respirators. It still doesn’t make breathing much easier and one must consult a physician before doing so.
Additionally, wearing complex respirator masks itself can cause other infections, if proper sterilization methods aren’t followed.
It is not practical, at least at this time, to have the entire population wearing respirator masks. So coming back to the original question: Do basic masks or the bandanas that people are wearing really help?
The answer is really not that much.
Masks/bandanas have so much leakage around the edges that they do not protect the wearer from fine particle contamination. Period.
But some think that a mask, while it may not protect the wearer, can protect others to a degree from infected persons.
If someone coughs or sneezes, most of the cough or sneeze is caught in the mask and others are not exposed to as much of it. This is especially good if social distancing with six feet cannot be followed.
This may the most valid reason to have people wear masks in public places where social distancing cannot be followed.
According to another school of thought, this is precisely why we have social distancing. When a person coughs or sneezes, the droplets travel less than 6 feet. The microdroplets, however, form a cloud and can travel around 26 feet.
The argument is, if someone is a silent carrier of COVID-19, they are asymptomatic. They do not cough and but can contaminate through direct contact. If they touch an item at the store, and we touch that same item, while the virus is still alive, we can contract it.
If they are symptomatic and are coughing, the mask only mitigates it to a certain extent; the microdroplets are in the air no matter what.
Another consideration is that wearing a mask is not good for the wearer, if the have COVID 19, as they keep the virus in the breathing zone all the time. It’s best to avoid going anywhere if one is coughing consistently.
It is simply a fact that masks serve a limited purpose since microdroplets are released no matter what since most masks have leakages around the edges.
Wearing gloves, and maintaining social distancing offers more protection than wearing a leaky mask.
I would certainly choose wearing gloves over a mask to protect myself if I were to choose only one.
Of course, generally speaking, wearing a mask can’t hurt. It may be to some degree a placebo, but on the other hand, it can’t hurt.
So why not wear one when you cannot practice social distancing until the pandemic passes?