Wouldn’t it be funny (or sad) if the solution to Coronavirus was right under your nose (literally)? In 1918, the government required anyone going out in public to wear a mask. Back then they didn’t have the same disposable surgical facemasks we see our doctors wearing. They wore facemasks made out cotton or materials similar to household paper, towels and clothes. We probably wouldn’t even call those “facemasks.” These days, it would be near impossible to get your hands on a “surgical mask” used in a hospital setting and doing so might even be a bad thing, as it could keep it out of the hands of health care workers who need them to care for many sick individuals. This is what prompted the surgeon general last week to tweet “Seriously people Stop Buying Masks.”

Still facemasks can stop the spread of Coronavirus COVID-19 which is transmitted in most cases by large droplets in contact with the mouth, nose and eyes. The government is smart to reserve the most reliable masks (N95 and surgical masks) for healthcare workers, since they are the ones who are exposed to the sickest individuals. They also need those masks for other activities–like surgery or situations when they are exposed to splashing bodily fluids. N95 masks are useful for protecting against airborne particles (other than Coronavirus — which is much more likely to spread by droplets). But even if you aren’t using a surgical mask, you can protect yourself with other face coverings.

A “dust mask” can still be purchased. An even simpler solution is to just make your own. I will show you how a little later. First let’s explain why wearing any face covering in public makes sense.

  Source control – prevent the spread of illness from a wearer

 Say someone with Coronavirus sneezes or coughs. The virus travels in droplets can travel between 3 -6 feet and then land on a face, surface (like a cup) or someone’s hand. How do you stop this? Stay far away from everyone. But this might be hard to do in public. Another solution is just to put something in front of the nose or mouth like a wall, the crack of your elbow or a mask (just remember not to hoard surgical masks). Public health experts refer to preventing the spread of illness from a sick person as source control. Any face covering should do a good job at source control and if everyone wears a mask when they go out in public it could save millions of lives.  Wearing a mask in private when near other people (especially older or sicker individuals) is also a good idea, especially if you have any symptoms–even if its just a cough, a runny nose or a fever. Keep reading to learn more about another good reason to wear a face covering–protecting yourself from catching COVID-19.

 Any face covering will also prevent droplets from settling in your mouth or your nose. Some materials might do it better than others but any mask is better than no mask. Still, this would not stop a virus from landing on your eyes, your hands or a doorknob nearby that you later touch. The only thing that can do that is source control, by having sick persons wear a mask. However, since not everyone identifies as being sick–even when they are, the best solution at this point is for everyone to wear a face covering.  There is not a lot of data identifying exactly which materials work better than others. After spending a lot of time looking into research on face coverings and masks, it was hard to find comparative statistics for cloth masks. There does not appear to be a whole lot of clinical research that has led practitioners to where facemasks. The real reason we do it is probably just good old-fashioned common sense. Just because it isn’t proven in a double-blinded, controlled study with the right amount of power, doesn’t mean it isn’t the right thing to do. Not having data doesn’t disprove something. For example, you don’t need research to tell you not to jump out of a plane without a parachute. You just know it’s a really bad idea. Similarly, wearing a face covering is common sense. Any covering is better than none to prevent catching the disease and it will certainly work to stop spreading disease to others. The challenge is how to get a face covering without depleting the supply of masks for healthcare workers. 

 Wearing Masks to stop Coronavirus Will Actually Help Healthcare Workers

The best solution is to wear a paper or cloth mask when going out in public. It can be fashioned with several layers of cloth, paper, a t-shirt or thin cardboard and then disposed after using it. You can also wrap your mouth and nose in a scarf or towel. In general, face coverings shouldn’t be reused. But if you have no replacement and aren’t showing symptoms like coughing or sneezing, you may have to consider reusing a facemask.  It is definitely better to dispose of a mask if you can replace it. But you may not have this option.  You can fashion a disposable mask out of paper or paper towels and a rubber-band like this: 

 You can get creative and create your own from other materials as well. Many people have posted videos online which I will share on my YouTube channel at https//:cutt.ly/VirusTV or in another post shortly. If you are concerned about Coronavirus, here is your chance to do something about it. Cover it up! If everyone covers their face when they go out in public it will reduce the overall transmission rate, decrease the demand for masks, help (not hurt) healthcare workers and, hopefully, save millions of lives.

 Prior Research and Public Recommendations Non-surgical Masks

 The first study of the use of facemasks by healthcare workers was after the Spanish Flu in 1918 finding lower rates of infection in individuals who listened to instructions and used a cloth mask. Cloth masks were replaced by disposable masks in developed countries as they became available in the mid-20th century. Thereafter, disposable masks became the standard in the health care field. While there is relatively little clinical research on any facemasks, there are a few research articles and guidelines that consider the use of cloth masks. For example, some regional pandemic influenza plans (such as the Sonoma County Department of Health in 2006) recommended the use of cloth masks in the event of a shortage of N95 and surgical masks for pandemic influenza plans, implying they may offer some protection against droplets as well as airborne particles that are smaller. The CDC has also recommended that healthcare workers use cotton masks when surgical masks are not available when caring for patients with viral hemorrhagic fevers in Africa. Anecdotally, we know the use of cloth masks in health care are widespread in non-developed nations by and were used effectively during SARS outbreaks in the early 2000s.

What Should Governments Do?

The government has complex decisions ahead of them, but they should urgently recommend the following:

  1. Recommend (or require) anyone wear a mask when in public, at private gatherings or when near other individuals who are old, infirm or pregnant.
  2. Procure or manufacture and distribute paper-based non-surgical masks commonly known as “dust masks.” New York State has started manufacturing and distribution of their own hand sanitizer and I think this would be a great addition to their product line.
  3. Restrict the sale of surgical masks and N95 respirators to the public. I believe this will help to overcome any possible mask hoarding. 
  4. Provide clear messaging. Educational videos should explain how various face masks can act as barriers to help to stop large droplet transmission, how to fashion face coverings at home, how to handle masks-including removal, and how to clean masks etc.

The government is in a tricky spot. They don’t want people to panic–though they may be too late for that. I believe the public can handle any news, but they need to be able to trust that they are being told the most accurate information. They need to act promptly. As the Corona virus will infect twice as many individuals every 6 days, we are running out of time. Any delay in implementation of this very simple and obvious solution could be very costly.

What should individuals do

I’m sure I have communicated the importance of facemasks for prevention of Coronavirus. But once you are armed with this knowledge, please make sure every person who you know understand the importance and wears a mask whenever they go out. Share this with as many people you know and contact your representatives to let them know that they need to pressure government to implement these recommendations immediately!

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