Masking up against COVID-19

Edited to add in January 2022: There is no longer a shortage of medical grade N95 masks in the US as we had at the start of this pandemic in 2020 (see next), but, sadly many are reticent (hesitant) to wear them still. Also, KN95’s and K94s are 95 and 94% effective, whence their names. So they are a decent substitute, and more affordable and available to some extent.

The WHO is now recommending the above or else a multilayer cloth mask with a filter sandwiched in the middle if possible otherwise during the current Omicron surge (January 2022). But, as per my original post below, I still posit that ANY cloth mask worn over the mouth and nose (both), even just a bandana, is still better than nothing, in my opinion. Obviously it won’t be as effective against finer aerosols if not tightly fitted, but can still cut down on the amount being emitted and inhaled, along with blocking spittle. And yes, I’d consider wearing a cloth or paper mask over a vogmask with an exhalation valve, if you need to use one of those for your MCAS.

In other words, anything is better than nothing, as long as it covers BOTH the nose and mouth, but obviously an N95 or better is ideal. I just realize not all have access to that level of Personal Protective Equipment (PPE) for various reasons including access and income. As you were…

Original Post:

April 8, 2020 Jan Groh, author (I seriously started this in late March and it kept getting away from me! Written from the POV of the western US.)

Phew! What a roller coaster ride it’s been! First it was – “no big deal, it’s not even here, and may not even come”, don’t mask up against COVID-19. It’s overkill.

Then, “it’s here, but no worse than the flu” (which is no cake walk and kills millions every year still, ahem). Don’t mask against COVID-19 unless you’re a doctor treating a known COVID-19-positive patient. (We were battling a shortage of N95s at that time.)

Then it’s “OMG it’s here and spreading fast!!” But still don’t mask – just let the medics mask, since we’ve got a shortage. Just stay home and only go out if really needed. Unless you’re a megachurch in the US bible belt or the Florida beach apparently, sigh.

Someone wisely quipped that’s the equivalent of peeing in the pool – it’s not going to stay contained in the corner, right? A somewhat gross – but effective – analogy IMHO.

In case anybody has been hiding under a rock and for some strange reason I’m your only connection to the outside world – uhm, well, we’re right in the upswing of a major pandemic of the first SARS-type Coronavirus (SARS-COV) since the original SARS outbreak in 2002-2003. 

This virus itself is in fact called SARS-COV2 accordingly. It causes essentially the same thing as the first SARS virus did but seems more virulent for various reasons. The syndrome this one causes has been named COVID-19 to be clear. (Because the disease erupted in 2019.)

Then suddenly: okay, it’s not only spreading faster than we thought, but farther, and more effectively than the flu. (Read: more lethal.) So start social-distancing, and consider masking against COVID-19.

Like, it’s spreading much faster and worse than the flu (we apparently shed virus longer before becoming symptomatic), and we can apparently catch it from aerosolized particles, not just larger “droplets” you can physically detect in person. (Say it, don’t spray it, right?)

Save the doctors!

Well, good thing I saw not one but two whole groups spring up organically over three weeks ago on both NextDoor and Facebook in my local Portland, Oregon, USA area. (Area doctors and nurses were begging for backup masks and equipment on NextDoor in mid-March, no kidding. Scary!) 

And our local news called for any spare N95s and similar medical grade PPE to be donated to our local county health department for redistributing to hospitals. Local aestheticians and tattoo shops and vets stepped up then.

But the local crafting groups led me to a couple of larger worldwide groups on Facebook and Twitter scrambling to find and / or sew backup cloth masks for doctors and nurses, some as per hospital specifications.

Because while everyone first thought they were just trying to back up the hospitals and doctors at first due to lack of medical PPE, then suddenly we ALL needed to mask up if we could! And the race was on…

(I feel like I need a cervical collar from the whiplash from all these fast moving developments. That’s also why this post took so long to get out – I was struggling to keep up with the fast-breaking developments while coping with being sick and needing to do a lot more cleaning. Wait for meee…!)

So, this has naturally led to loads of confusion around the value of cloth masks, their safety – both for the medical professionals and “civilians” as I will call the rest of us in this war on COVID-19.

When it was first thought they were to be used as backup Personal Protective Equipment (PPE) for actual hospital personnel (doctors, nurses, and allied health care professionals) everyone was on board. Multnomah County where I live even coordinated drop offs so that we did not inundate increasingly busy (and dangerous) local ERs and doctors with our offerings.

And to ensure they were handing out only acceptable items to medical personnel in that case. (Do call or inquire ahead if you can, don’t just head to your ER, you will expose yourself to COVID-19, and clog up what is now an extremely busy area for all hospitals.)

This also raised the legitimate question: how can we ensure the masks we give them are safe, and not COVID-19 infected? Especially since we ourselves can’t be sure we’re not infected between the lack of testing, and the long asymptomatic infectious period it has? 

The groups all wisely advised practicing excellent hygiene: no food, drink, pets, scents, etc. in your work space. Wipe down your work space. Wear a mask of your own while working. Wash your hands twice. Launder and iron all mask fabrics before sewing, and even after. Handle with care.

Coordinate delivery with local health agencies and hospitals to avoid sowing (and sewing) chaos or gumming up the works.

But any good doctor will tell you even that can’t guarantee it. So I was relieved to read that someone figured out how to autoclave some in a batch at the hospital. Further, putting them in the dryer on high heat should help nuke any bugs. As could the hospital laundry service.

Some hospitals even started putting out acceptable mask patterns and even some fabric kits for people to use in direct calls to the public for backup PPE in case of emergency, and for their ancillary staff. The demand for these mask fabric kits was heartwarming to see – the community is there and eager to respond to our front line medical workers! (We still are!)

So the neighborhood started humming with the sound of hundreds of crafty people madly sewing up masks in various patterns. As well as some clapping and honking and cheering every night around 7 -8pm to thank all of our frontline workers I learned on NextDoor. (When a common area nursing shift turns over at least here in Portland.)

Now save everybody!

Then the “All Mask Up!” directive came out a week later, and it was every sewist for themselves so to speak! And many other secondary sources and no-sew ideas arose thanks to the increase of 3D printing. (The ingenuity is super inspiring to see. Especially from many youth.)

So, I thought I would separate the good from the bad and the ugly to save you a little sifting.

THE GOOD

Yes, as I suspected, even simply made cloth masks help slow the spread of COVID-19 and other bugs a little. Because they help keep our spittle and breath contained so they don’t travel nearly as far as they would otherwise.

So think of it as protecting your neighbors, doctors and co-workers and grocery clerks, just as we do by physical distancing also. You need these people, so this is really helping yourself in the end.

And, the cloth masks can also be used by doctors and nurses to help protect their precious rare N95 masks (respirators) to extend their use in extreme cases. (Not normal procedure except in dire situations – like now!) Again, don and doff carefully.

DO: Sew or make your own cloth mask as able or for friends and family to help ease the demand. Even just wearing a bandana over your nose and mouth can help protect others from your spittle a bit and is better than nothing.

Here are a couple of no sew ideas:

• Bandana mask with 2 rubber bands (or hair ties) 1 minute How To video
• Six-pack of re-usable frames (2 sets of 3 sizes) from the Garden Tower project (USA) [ETA 8/11/20: these didn’t work so well for me actually.]
• 3D printed masks with housing for refillable filter material of choice (I see more daily on Twitter)

Here are some ideas and links for those equipped and able to manage some sewing:

Info Type	Sewing project links
Page	https://www.cnn.com/2020/04/04/health/how-to-make-your-own-mask-wellness-trnd/index.html
Page	https://sweetredpoppy.com/how-to-sew-a-bias-tape-surgical-face-mask-with-flexible-nose/
Page	https://www.nbcnews.com/health/health-news/making-your-own-face-mask-some-fabrics-work-better-others-n1175966
Hospital	https://www.providence.org/lp/100m-masks
Hospital	https://www.phoebehealth.com/patients-and-visitors/coronavirus/mask-production
Hospital	https://www.stcharleshealthcare.org/covid-19/hand-sewn-masks
Video	https://www.youtube.com/watch?v=tDt02kUpP9Q (one of many examples)
Video	https://www.youtube.com/watch?v=gm2Xu75iFOc  (fastest dude ever!)
FB Group	https://www.facebook.com/groups/sewtostopcovid19/ “Sew to Stop COVID 19”
FBGroup	https://www.facebook.com/groups/143738306998655/ “Corona Masks for Medical Heroes”
FB Group	https://www.facebook.com/groups/659895354776166/ “Crafters against Covid-19 *PDX* (Portland) – there’s one for Seattle too and I’m sure others starting.
Page	https://Nextdoor.com Sign up for your neighborhood and start swapping ideas and materials. My neighborhood already has a hardy Face Mask Brigade going.

THE BAD

No, cloth masks will not fully prevent you from catching COVID-19! We know this, very well, thank you. Only a properly-fitted N95 “respirator” (well-fitted medical mask) can do that, and again, only if properly-fitted and donned and doffed. (Clearly, I can’t say that enough.)

ETA 8/11/20: But… they are much better than nothing it’s turning out.

The key being: the N95s are both as air tight as possible (some may have to shave closely to help this along), and, as the article notes, brand new ones come “charged” to attract and trap the tiniest droplets to the electret mesh inner layer. 

If the charge is lost, they will still filter a bit, but not to specification. This is why the N95s are being reserved for our hospital doctors and nurses who are in close contact with actual COVID-19 patients on the job and highly exposed. We need them well-protected! But there is currently a shortage of these for a variety of tragic reasons I’ll leave for others to cuss and discuss.

What about surgical masks?

These medical-grade N95s are also not to be confused with the “medical-looking” usually white or blue paper surgical masks which are not well-fitted. (These are what you see people wearing the most on the news in Asia, or on medical soaps like Chicago Med.)

Those are no better than clean well-made cloth masks, and are originally intended to catch spittle from surgeons to keep it out of their sterile surgery field (your body).

Conversely, to keep them from inhaling any fluids that may arise from the surgical field. But not in an air-tight way like with the N95 “respirator”.

That is because, air can seep in around the nose and sides where it isn’t tightly fitted like an N95.

This PDF may help show the difference.

THE UGLY (AKA the details)

So what are the rest of us, chopped liver? Nope – but we’re urged to only use home-made cloth masks due to the shortage of the above. But:

DON’T: Do NOT use HEPA filters and vacuum bags to make any face masks or shields, these can lodge fiberglass particles in your lungs!! I also just read you can’t breath sufficiently through them either. (We aren’t high-speed vacuums after all, smile.)

DON’T: Don’t reach under your mask to scratch your face if it itches! Your hand is contaminated, and you will have just defeated one point of wearing the mask. (Another reason they were originally discouraged, they’re itchy.)

Consider the outside contaminated at all times. And wash and thoroughly dry them daily if possible, carefully. If you must scratch, do so from the outside of the mask/cloth/bandana and then wash your hands if able.

DON’T: Don’t let them get too soggy from your breath or other moisture for too long. This harbors bacteria, and can lead to yet other bad lung infections, including bacterial pneumonia. Try having a few on hand, so you can swap out as needed, at least daily if possible. Maybe carry a paper bag to store an extra in if needed.

Sew… what?

Sadly, in the United States at least, we have bungled our response so badly, that we have now been directed to find or make our own cloth masks to wear as civilians, to help offset the growing mask shortage we read about daily.

But we have been caught so short-sighted, short-handed and flat-footed that almost no one has ready supplies. So millions are madly scrambling to fashion masks almost any way they can.

Some crafters only wish to supply doctors.

Others, only to supply their own families and friends.

And still others, only to make a buck, or $30 per mask.

A small handful (like me once I get set up – I’m not yet) are happy to make them for anybody and everybody that needs them, period. Cuz we’re only as strong as our weakest (most-exposed) link right?

Further, there is no single coordinating organization, and new clubs and groups spring up almost daily. (I would check NextDoor and Facebook for your area.) And quality varies widely.

And my beloved “vogmask” so well known in MCAD circles is not only long out of stock, but also not the best option: it’s not designed for re-washing much, and if it has an exhaust valve like mine does, you are still exhaling breath and possibly spit out of that too. (Details!)

So it’s not really protecting  your nearby cohorts (family, friends, co-workers) as thoroughly as we’d like. But it is still better than nothing if you have one. 

I was just thinking about adding a scarf under or over mine the other night – I’ll let you know how that goes.

The other “ugly”, is that it can be hard not to fog up your glasses if you happen to wear some. (Another downside to poorly fitted masks.) One friend just thought of trying toupée tape to help – I’m curious to hear how that goes! It sounds practical to me… (Update June 2020: it works! Just may feel a little “funny”.)

Others suggest stuffing a tissue underneath the part that goes over your nose to help block the air from escaping.

And wearing bandanas isn’t such a great idea if you’re Black. 🙁

So… As you can see, the devil is really in the details. But… something is better than nothing, if handled properly (kept clean and dry, handled carefully), and obviously proper PPE is best for our medical personnel (doctors and nurses). 

I pray this bug touches you lightly if at all. And leaves your loved ones intact. But I’m afraid that’s just not going to be the case for too many of us, it is so insidious and virulent. So please keep staying home as much as you can, and I will pray for the safety of all those that can’t.

Please feel free to share more mask making resources and links in the comments.

To your health,

Jan(droid) April 8, 2020 (phew) / Edited again 8/11/20/ And again on 1/16/22