Time to mandate medical-grade or double masks? Experts debate as COVID variants spread
With at least three more contagious variants of the coronavirus spreading in the U.S., infectious diseases experts are debating if it’s time to mandate medical-grade or double masks in the country.
Singapore and South Korea have already “mass-produced high-quality masks” and sent them directly to residents, The Washington Post reported. European countries have also begun mandating medical-grade masks such as surgical masks and N95s in public settings.
“I think as we see what’s happening over the next few weeks, that will inform what the CDC decides on this,” Dr. Becky Smith, the medical director of infection prevention and control and an infectious diseases specialist at Duke University Hospital in North Carolina, said Wednesday during a media advisory.
“If we see continued and sustained decreases in our daily case counts, that’s a really good sign that we’re seeing the light at the end of the tunnel. At this point … it depends.”
CDC Director Dr. Rochelle Walensky said Wednesday during a White House COVID-19 briefing that the rate of new coronavirus cases are back to pre-Thanksgiving levels, while deaths continue to rise, although the pace is slowing.
Still, that’s no green light to let our guards down, Smith said. “Should we just mandate two masks? I feel like some areas are just getting around to one mask. I’ve always said the mask someone wears that’s well-fitting is a great mask. So focusing on getting the one mask to be correct is a great first step.”
As of Feb. 3, there are more than 26.4 million confirmed COVID-19 cases in the U.S., and nearly 449,000 deaths, according to Johns Hopkins.
CDC waits for science before recommending double masks
No studies to date have tested, in controlled settings, if double masking is better at blocking aerosolized droplets carrying virus particles, but “there’s some logical sense that an additional layer of protection would reduce transmission,” Smith said.
White House coronavirus adviser Dr. Anthony Fauci agrees. He said last week during NBC’s “Today” show that layering two masks “just makes common sense that it likely would be more effective.”
“I often myself wear two masks. Can [the CDC] make a general recommendation that doesn’t have scientific basis yet? No,” Fauci said during the Wednesday White House briefing. “But when the science comes along, and tells us that it’s better or not, then you’ll see a recommendation being made by the CDC.”
Former CDC Director Dr. Tom Frieden took to Twitter with a similar thought: “Consider upgrading from a cloth mask to a surgical mask, or from a surgical mask to an N95/KN95/equivalent if available. Better masks may help reduce risk from more-contagious strains.”
One study published at the end of June found that respiratory droplets traveled about 2.5 inches after passing through a homemade cloth mask, about 8 inches with a cone-style disposable mask and a little over a foot with a folded handkerchief in a lab setting, McClatchy News reported.
But with a bandanna, cough droplets traveled about 3 feet 7 inches — the worst of them all aside from no mask — even though the material had the highest thread count compared to the other coverings.
Experts say replacing multi-layered cloth masks with a medical-grade one, or doubling up with two cloth masks or one cloth mask over a surgical one could help — but double masking may not be necessary.
More protection may be needed for crowded places, like airplanes
Dr. Rodger MacArthur, a professor of medicine at Augusta University in Georgia, told WRDW that “one mask in most situations probably does just fine …. in crowds, it may not.”
He recommends two masks for people at high risk of infection or while in crowded places, such as airports, where inappropriate face coverings may not be enough to prevent viral spread, even if everyone is wearing one.
President Joe Biden mandated face masks on planes, buses, in airports and on other public transportation networks. The rule went into effect Tuesday and follows CDC guidance on masks.
The agency says masks that do not cover the mouth and nose, face shields alone, loosely woven masks that allow light to pass through, those that contain valves or slits, as well as scarves, ski masks or bandannas, are not allowed through airport security.
“I don’t think [masks] need to be medical grade, but I think that if you have a multi-layer cloth mask, that should be sufficient,” Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, told McClatchy News. “What I think in general needs to happen is that people need to realize that all masks are not created equal. If you’re wearing a bandanna, it’s not going to be something that’s protective,” Adalja said.
He added that a mask and a face shield may be more preferable than trying to double or triple mask.
Smith of Duke University said, “if you must travel, my recommendation would be to wear a higher filtration efficacy mask if you have access to the more widely available K95 or N95. That’s what I would be wearing.”
“And I would also wear eye protection depending on what people are doing on the plane,” Smith said. She added that air flow and HVAC experts have recommended directing the fan to blow directly toward your face to dispel potential virus particles floating in the air.
Physicians at Brigham and Women’s Hospital in Boston admitted last year that it’s unknown how much coronavirus spreads through aerosols, and if N95s, for example, offer added protection, but “what is clear is that if we had better masks than current cloth and homemade ones, transmission could be substantially and quickly curbed,” they wrote for the Harvard Business Review.
Medical supplies still limited for general public
Although doubling up may be a logical and easy way to get ahead of viral spread, experts say the nation still faces medical supply shortages for the general public.
“There’s a big difference between having enough medical masks for all of the hospitals out there versus having a medical mask for every single person in our country,” Smith said. “That’s a big burden on our supply chain.
“I’m really curious to see what will come out of the CDC, because unless the mask makers have drastically ramped up their supply of masks, we would not have enough for everyone.”
Still, she said it may make sense to add an extra layer of protection in whatever way you can. “It’s pretty easy to do.”
This story was originally published February 3, 2021 at 12:41 PM with the headline "Time to mandate medical-grade or double masks? Experts debate as COVID variants spread."
