Should the fabric mouth mask be back in the closet?


“Only allow medical mouth masks.”. A fabric mask has no use what', says Marc Boone, dermatologist and doctor of medical sciences at the Erasmus Hospital in Brussels. Through his interest in allergies, he has accumulated expertise in mouth masks over the years. He is a great opponent of wearing non-medical masks.

The mouthnose cover continues to provide discussion. Especially fabric mouth masks are controversial. “The government must force the surgical mouth mask as soon as possible.”

Should the fabric mouth mask be back in the closet? “Only allow medical mouth masks.”


Mouth masks are essential in the fight against covid-19. They slow down the spread of SARS-COV-2 and provide a milder disease course of covid-19. We now know that not every type of mouth mask is an equally good barrier between the face and the outside world. But how problematic is that?

Medical mouth masks adequately protect against viral infections. The most efficient are without a doubt the professional 'Filtering Face Piece Breathing Protectors (FFP). They protect the carrier well against viruses, but they should be reserved for surgical interventions at risk of spreading pathogens, such as intubation.
Fabric mouth mask is not a protection

Fabric specimens, whether or not homemade, are of a different caliber. In the meantime, it is clear that the scarf or bandana originally proposed by the government as a mouthnose cover does not belong in the category 'mouth masks'. But also the self-made or purchased cotton mouth masks do little to protect us from covid-19. Even their function as a barrier mask (to protect others when the carrier is infected) is debatable.

A fabric mouth mask should consist of as much as 12 to 16 layers to be as efficient as a surgical mask, a comprehensive meta-analysis in The Lancet. Most of the fabric mouth masks consist of only two to four layers and do not contain an additional filter because many people experience that their breathing is hampered.

Also, the World Health Organization (WHO) remains vague about the meaning and nonsense of fabric face protection, but stresses that fabric mouth masks do not serve as personal protective material. Ze raadt het gebruik ervan voor gezondheidswerkers, risicogroepen en 65-plussers expliciet af.

'A fabric mask has no use what', says Marc Boone, dermatologist and doctor of medical sciences at the Erasmus Hospital in Brussels. Through his interest in allergies, he has accumulated expertise in mouth masks over the years. He is a great opponent of wearing non-medical masks.

“The virus that causes covid-19 is about 0.1 micrometer in size, ten thousandth of a millimeter,” explains Boone. 'To imagine something: a hair is 50 micrometres thick. So, the virus is 500 times finer than a hair. It is contained in carriers that manifest as droplets of saliva or aerosols less than five micrometers. Artisanally made masks with filter can at best hold particles up to 2.5 micrometres. Meshes between the cotton fibres are, as it were, cathedral gates that are wide open to mice. The main thing is that the space you enter does not get infected. Then you need a mask with a minimum pore capacity of 6 micrometers since the drops leaving our mouth are not smaller than that.

The problem of the fabric mouth masks Boone became apparent this summer when remarkably many patients came across the floor with him for allergies due to grass rolls. Despite the fact that they used a fabric covid mask, the grass rolls, which are 250 times larger than a virus, went loose through.
Mask as a fashion accessory

Boone bothers the fact that some people consider their DIY mask to be a fashion accessory rather. 'Those masks do not have a filter and do not fit properly on the face, creating a ventilation gap between the skin and the upper part of the mask. People complain that their glasses are bedammed when wearing a mask. This is the logical consequence if the mask does not fit properly. Whoever wears something like that better not put anything on.”

He advocates the promotion of medical masks and the untrading of the fabric copies. 'I was pleasantly surprised when studies showed that surgical masks with filter capacity of 1 micrometer can hold small virus articles in a contaminated room quite well.. If you want a fabric equivalent of such a surgical mask, it should have 12 layers and preferably contain a filter. To do this, you should already look at a HEPA filter, but they are not suitable for long-term use in a mouth mask. Try breathing through that.”
getty
© getty

An argument against surgical masks is that in time they are very expensive, and especially extremely burdensome for nature. They consist of polypropylene, a plastic that takes 450 years before nature can break them down. A lot of mouth masks do end up on the streets and in the oceans. 'Climate and environment are extremely important to me, 'says Boone. 'I suffer from severe lung problems due to air pollution. But we need to keep in mind what is the goal at the moment. Covid really does not compare with flu. In the virology department of the Erasmus Hospital, I witnessed three covid patients suffering from acute short-term memory loss in one month. This virus destroys a lot.”
Cotton masks on a large scale

Still, wearing imperfect mouth masks on a large scale is not completely nonsensical. The widespread use of non-covidproof facial cover could delay the spread of coronavirus, according to research. 'The cotton mask needs to be improved, but the masks we are already wearing can potentially change the course of this pandemic, especially if we wear them as well as all. '

In the United States, after the introduction of a mouth mask duty at different times in different states, the daily growth ratio fell by 1 percent after five days and by 2 percent after 21 days. The Institute for Health Metrics and Evaluation in Seattle recently predicted that 770,000 lives could be saved worldwide by the end of 2020 if more people were wearing a mouth mask, combined with the physical distance measure.

From the medical world therefore sounds a loud voice for a general mouth mask duty. Italy, Poland and parts of Spain force the mouth mask even outdoors, and the British Medical Association advises the British Government to do the same.
Avoid lockdown by mouth mask duty

In Belgium, it is only mandatory to wear a mouth mask in public indoor areas where many people meet, on public transport, at the hairdresser and the doctor.

Boone also argues for a general mouth mask obligation, even in children because they are as contagious as adults, he believes. 'It is everyone's responsibility to keep the living space in which people are together corona-free. If we have to wait for the civic spirit, we're still far from home. Mandatory wearing of a surgical mask with a filter capacity of 1 micrometer is the only way to eliminate the unpredictable behavior of the population. Without that obligation, all those who wear a mask out of solidarity for their fellow human beings are for the trouble. In combination with the other hygienic measures, this can avoid a new lockdown, which we really can't afford anymore. Instead of a complete restriction of freedom by a lockdown, we can opt for a restriction of freedom by a mouth mask. But then an efficient mouth mask and no substances nothing. '

'The government can now correct where it went into the fog at the beginning of the pandemic. Initially, it was stated by virologists that mouth masks did not do anything. I almost fell back when virologist Steven Van Gucht came to tell me he wasn't wearing a mouth mask to go to the supermarket. Or when Koen Geens thought that a bandana or scarf can serve as a substitute for a mouth mask! Unfortunately, this has remained with the general public and has ensured that there is no social support for the generally obligatory wearing of the mouth mask. '
How can you make sure that your barrier mask is as efficient as possible?

Provide as many layers as possible

Disposable filters such as household paper and coffee filters are not a good option.

Use a water-resistant fabric for the outer layer

Opting for a densely woven fabric (for example, quality cotton bedding). Loose woven fabrics are transparent and therefore less good.

Op for a combination of fabrics such as cotton/silk, cotton/chiffon or cotton/flannel. They offer more protection and are more comfortable to wear.

Make sure your mask fits well and fits around the face.

Wash your mask daily after use. WHO recommends washing the mask in the washing machine at 60°C. #moonmaskers

Source: knack