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The Great COVID-19 Mask Debate

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by Roy Chambers (subscribe)
Lover of all things interesting and new
Published July 11th 2020
Why to wear a mask, how to buy a good one and how to wear it
Many countries in the world not only recommend but require people to wear masks during these pandemic times. But some countries, such as Australia don't. With the emergent second wave in Australia being about community transmission, it is time to have another look at face mask-wearing. Here are the whys, wheres, whats, and hows of wearing face masks.

Image courtesy of Alex Borland @ Public Domain Images
Image courtesy of Alex Borland @ Public Domain Images

The emerging understanding of COVID-19

Disease is part of human existence, even now in contemporary times. But experts both believed that they understood how to manage them, while also being fearful of the exact scenario of COVID-19. Yet this coronavirus has proven to be different in many ways from previous coronaviruses, such as SARS, and it takes months to study and learn about a disease.

The first obvious issue is the fact that most people only get mild symptoms, and there is growing evidence from studies that test everyone in a population, that, in fact, most people get no symptoms at all. This created a lot of confusion because until they could test for the disease, healthcare professionals would see one person dying from pneumonia and organ failure, but none of the people that they came in direct contact had similar symptoms.

Image courtesy of Pixabay
Image courtesy of Pixabay

One of the biggest issues is asymptomatic or pre-symptomatic spread of the disease. With the flu, people can be infectious before they get symptoms, but the level of spread is very low. With other coronaviruses, such as SARS or the common cold, the disease is not spread by people who are asymptomatic or pre-symptomatic.

However, there is increasing evidence that both people, who never show any symptoms, can spread COVID-19 and that because the disease starts in the nose and upper respiratory tract, people who later get symptoms will start to spread the disease before then.

When we overexertion that young fit and healthy people can become infected and spread the disease to other young fit and healthy people, the disease can exist in the community without anyone being aware of it. Then, of course, many people will ignore minor symptoms. The must-play game of 2020 is, is it Coronavirus or a hangover from the party last night?

One intriguing issue of COVID-19 are cases where a single person at a large event will infect many people. South Korea, Italy, and Spain, all saw huge outbreaks from a single event. This means that one person at one event could get the ball rolling on the second wave in areas where the disease is essentially under control.

The case for wearing masks

The case for wearing masks is pretty straightforward. The biggest one is that if you have Coronavirus in your system and you are wearing a mask, it will stop most water particles from your mouth and nose from spreading the disease. That is, wearing a mask, especially surgical masks, has always been designed to protect other people.

Image courtesy of Cottonbro @ Pexels
Image courtesy of Cottonbro @ Pexels

If you wear a surgical mask, it will also protect you to some extent. While wearing a P2/N95 mask will provide even better protection.

In other words, if everyone is wearing masks, even just cheap surgical masks, the chance of spreading the disease is reduced. You don't even have to wear them all the time, just in higher-risk situations, such as crowded public transportation.

The problem and limits with masks

Masks are very effective when used correctly in clinical settings. They can be less effective in the real world. First of all, standard surgical masks are only considered to provide partial protection because they don't provide an airtight seal. P2/N95 masks are effective, but more expensive and also much more uncomfortable to wear.

Then the problem is that people don't use these masks correctly. The most common issue is that a surgical mask will become damp from your breath, creating the perfect place for viruses to live. You shouldn't wear them for more than an hour at a time, after which you should throw them away. In other words, they are great for your commute to work, but you should then throw that one away and use a different mask for the commute home, as well as using another mask for other situations where you need to use a mask during the day.

One mistake that people make when using a mask is that they will touch the mask or their face, transferring any collected disease to their hands or from their hands to their face. This is why masks used incorrectly can actually increase the chance of spreading the disease.

Another issue is reuse. You need a clean mask for every occasion. While it is possible to sterilise and reuse a mask, surgical masks, in particular, are designed to be single-use and most proper cleaning approaches that will effectively kill virus collected in the mask, will most likely damage the mask.

Then there is the issue of overconfidence. When we feel we protected, we take additional risks. So if you use a mask to protect you while doing something you have to do, such as take the train to work, it makes sense. But if you choose to go to a crowded place just because you think the mask will protect you, then you have increased your risk of exposure.

Image courtesy of Pixabay
Image courtesy of Pixabay

Finally, and most critically, when looking at Melbourne's second wave, much of the transmission is occurring in people's homes. It is through family gatherings that the disease has been transmitted. While the masks might help a little, the primary source of transmission is occurring in an environment where people don't wear masks.

Let's not forget that there are a whole range of other strategies that are also needed to effectively limit the transmission of COVID-19. So masks are just one part of the total strategy.

Getting the right masks

It is easy enough to search for surgical, COVID-19 or P2/N95 masks on the internet. But not all masks are equivalent. Modern surgical masks are 3 layers, with a middle layer of a melt-blown polymer, which acts as a filter. The outer layers are made of non-woven fabric. This creates a cheap breathable mask that is capable of most water droplets. Because it doesn't create a seal on your face, its focus is mostly to stop what you breathe out, but it can still reduce the risk of what you breathe in.

Image courtesy of Bicanski Bicanski @ Pixnio
Image courtesy of Bicanski Bicanski @ Pixnio

You can also buy or make your own cloth masks. These have been shown to be effective in the spread of COVID-19. Some countries recommend these over surgical masks, to reserve surgical masks for healthcare workers. Australia has a good supply of PPE, so it is not an issue at the moment. I can't find any good information on whether cloth masks are more or less effective than surgical masks. I think that it will depend on the nature of the cloth and the construction of the mask. However, one clear advantage is that cloth masks made from natural fibres can be effectively cleaned, by say putting them in boiling water. But remember, they will wear out over time.

The P2/N95 mask, also known as a respirator (though it is only one type of respirator mask), usually consists of a mask that forms a seal on your face and has a filter through which you breathe. Some of these masks are disposable and others have a replaceable filter. These are the best masks to get as they provide maximum protection. As they are expensive, you might use them only in the riskiest environments.

I would highly recommend buying these from a known Australian supplier. They are easily found in pharmacies and hardware stores. You can also order them from those places through their online shops.

If you want to save money you can buy them online. But there is no guarantee that the cheap mask you find online actually works.

There are also a number of decorative and fun masks that you can find online as well as guides on how to make your own. Once again, while these can work, it will depend on the fabric that you use and other factors.

Using your mask correctly

One of the key problems with masks is that people don't use them properly. When putting on a mask, you should not touch the fabric of the mask. In fact, you should wash your hands before you put on the mask. Then hold the strings or straps only to put it on. Don't touch the mask face to adjust it. Don't scratch under the mask. Surgical masks are designed to fan out as you put it on. Cloth masks are a little more difficult to achieve this without a bit of practice.

A surgical mask is good for about an hour. If it gets damp or wet from over exertion or the rain, then you should replace it immediately. Put the mask in a plastic bag and throw it away. The only time you shouldn't put it in a plastic bag to dispose of it is when it is going into a hazardous waste bin.

When you take off the mask, wash your hands or use hand sanitiser. The casual reader is probably thinking, this all seems a bit excessive. But healthcare professionals will tell you that this is the standard procedure.

Other precautions

As already said, a lot of the situations in which Coronavirus has recently spread in Australia have not occurred in situations where masks would normally be used or effective. This means, while it makes sense to wear a mask, it shouldn't be seen as the only means of stopping the spread of the pandemic in Australia.

  • Practice social distancing in all its forms. Basically, avoid crowds or even smaller intimate gatherings. It is much safer at this time to focus on small gatherings outdoors.

  • Avoid unnecessary contact with people. We have phones, computers and all sorts of technology that lets us connect without having to do it in person.

  • Shop less in person. Wandering around shopping centres is a risk. Research ahead, go in, and buy. Do big grocery runs once a week. Buy online. These can all help.

  • Don't forget to wash your hands or, if you can't do that, use hand sanitiser.

  • Think about how you greet people. No handshakes, hugs or kisses on the cheek (even for grandma).

  • Use the COVIDSafe app to help contact tracing. Don't forget to put your name down and correct contact details down when you go to restaurants and other places that ask you to do this. Contact tracing is an important part of stopping the spread.

  • Cooperate with authorities. Yes, there are plenty of times that they have exceeded or abused their power to the extent that human rights commissions in some states have invested this, but on the whole, we are better off being compliant.

  • Even mild symptoms should prompt you to take time off from business and avoid others socially. Also, get tested. It is free and now widely available.

  • Cooperate with testing programs. Their purpose is to catch the disease in the community before it spreads.

  • Be nice to each other. It will all work out better if we do this.

These days you can be tested at clinics, GPs or even in drive through testing centres
These days you can be tested at clinics, GPs or even in drive through testing centres

In Conclusion

Over the world, one thing distinguishes between the success and failure of governments and health authorities to respond to COVID-19. It is not democracy versus authoritarianism, nor is it developed versus developing countries. Rather, it is the willingness for a country to listen to experts and follow good practice. This has often been backed up by a population that is, on the whole, prepared to act in a sensible and responsible manner.

When it comes to face masks, the most important should always come from the government, health authorities, and healthcare professionals. In Australia, the authorities have done a reasonably good job. However, we too can take responsibility and change our behaviour.

At the very least, every household should have surgical masks at home if they need them. It is also a good idea to have P2/N95 masks as well. If you have symptoms, then definitely you should be using them. But it is best done in consultation by telephone with a healthcare professional.

Maybe it is also time for us to start regularly wearing masks when we are in public, especially at the shops or on public transportation. But that shouldn't lull us into a false sense of security, and we must keep up social distancing and other good practices, such as washing our hands.
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Why? We do this right, everyone lives!
Cost: Masks are cheap, lives are priceless
Your Comment
I subscribed for notifications on what is happening in Adelaide, not for fear mongering propaganda. In 2018 2,952 Australians died from accidental falls, so far there have been 108 covid deaths in Australia, that makes it 27 times more likely to die from simply falling over than this virus. Take your propaganda somewhere else.
by emanr (score: 1|14) 1064 days ago
Great article, one of the best and most thorough I have read out of many
by visio (score: 1|13) 1063 days ago
I dont believe this article is appropriate for the Weekender. Covid is real and we must all play our part in preventing it's spread. However, Chief Medical Officer has said this week that masks are good in areas of community transmission otherwise they are not needed. Best way to reduce the spread is good hand hygiene and social distancing. This article is misleading and putting people under pressure to pay extortionate amounts of money on masks they do not necessarily need, depending on where they live. Stick to telling us what's on in our local areas please.
by jenny (score: 0|4) 1060 days ago
Thanks Roy for your informative article.
by barbc (score: 1|88) 1063 days ago
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