People hate face masks. I hate face masks! But the spread of Omicron is so out of control that people need to be cautious for awhile longer. Hospitals are begging people to be extra careful. That’s because emergency rooms are overflowing with COVID cases. Even people who have been vaccinated and boosted are coming down with the latest variant. Even if it is “milder,” hospitals can’t cope with the onslaught. At last count (Jan. 19, 2022) the stats were daunting: There were 851,784 cases reported with a seven-day average of 758,002 cases per day. Deaths added up to 3,376 on Tuesday with a seven-day average of 1,974. That’s why most people should be wearing N95 masks whenever they are exposed to people outside their household.
COVID Cases Still Climbing!
We are approaching two years of pandemic. It feels like forever. I know that most people want to forget about the coronavirus and get on with their lives. So do we. But as I write this, more than 5.5 million people have died worldwide and we are at 859,503 deaths in the US.
We are not alone. COVID cases are still going up in India, Italy, Spain, Argentina, Australia, Brazil, Canada, Israel, the Netherlands, Switzerland, Portugal, Belgium and Colombia. That’s according to the Johns Hopkins Resource Center.
Dissing COVID-19:
We have heard from a lot of people who just don’t seem to care about COVID anymore. At first they denied that people were dying because of SARS-CoV-2. In their minds it was all a hoax. Many insisted that doctors, nurses and hospitals were inflating COVID cases to make money. Of course, most of the countries listed above do not make money from COVID. That’s because the governments pay for treatment. They have no incentive to inflate their cases.
Health care workers are exhausted, fed up and giving up. You may want to read this article: “Why Health-Care Workers Are Quitting in Droves.” If you think doctors and nurses are falsely labeling “normally” sick patients as COVID patients, this article will change your mind. We have talked to health care workers who are are hanging by a thread.
There is also the argument that the Omicron variant is no worse than influenza. Just suck it up and get on with life. Except people are dying in huge numbers. As mentioned above, the seven-day average is over 1,900 people dying daily.
What’s more, of the hundreds of thousands who are coming down with COVID daily, a substantial number will be left with long COVID. The long-term consequences of this chronic condition could be devastating for patients and the healthcare system. We read a poignant case of a woman who committed suicide because of long COVID. Don’t believe that? Here is the story. It will break your heart!
The Case for N95 Masks:
The Omicron variant is incredibly contagious. Because so many vaccinated and boosted people are coming down with Omicron, there is only one way to avoid catching it. Either stay completely isolated or wear a highly effective mask.
When the pandemic began, there were not enough high-quality N95 masks for everyone, so the CDC encouraged ordinary citizens to use cloth masks and save the most effective equipment for health care providers. At this point, however, there’s no longer a shortage.
Expert consensus is growing that all of us should be wearing a KN95 or an N95 mask whenever we are indoors with people outside our household. N95s are approved by the National Institute for Occupational Safety and Health. The 95 indicates that they filter out 95 percent of the particles that could make us sick. The CDC has a list of approved N95 respirators on its website.
Do Masks Really Work?
Let’s get one thing straight. Even N95 masks are not perfect! The fit is numero uno in importance. Most people seem semi-oblivious if the mask has gaps around the nose, the cheeks or under the chin. If your glasses fog, air is escaping. That means the mask is not working well. How we put them on and take them off also make a difference.
Despite such caveats, a study in the BMJ reveals that mask wearing works to help prevent COVID-19 transmission.
The authors note:
“Specifically, a natural experiment across 200 countries showed 45.7% fewer covid-19 related mortality in countries where mask wearing was mandatory.”
In the BMJ meta-analysis and systematic review, the authors screened 36,729 studies. They boiled those down to 72 studies that met their rigorous “inclusion criteria.” The bottom line: mask wearing reduced COVID-19 infections by 53%. They were not able to differentiate between type of mask, but other research suggests N95 masks that fit snugly with elastic behind the head offer the best protection.
Free at Last!
After almost two years there is talk that the government will be distributing free N95 masks to everyone. At last! We have been advocating this policy for months. That’s because the latest research suggests that cloth masks and surgical masks are not very effective against the Omicron variant.
Adults will be able to request three of these high-quality masks at pharmacies and community health centers across the country. They are being pulled out of the Strategic National Stockpile to try to slow the spread of the Omicron variant. N95 masks are far more efficient at blocking aerosol-borne viral particles than other face coverings. Most important, they fit snugly around the face to block virus from leaving or entering the breathing area.
The CDC’s Position on N95 Masks:
Here is what the CDC states on its website:
“DO NOT choose masks that:
“Are specially labeled ‘surgical’ N95 respirators, as those should be prioritized for healthcare personnel.”
We completely get it that nurses, doctors, first responders and all front-line medical personnel should have access to N95 face masks. But how is it possible that almost two years after the arrival of COVID-19 the CDC is still telling the public not to use N95 masks? We are told that the agency is poised to make a change. What has taken it so long?
Why N95 and KN95 Masks ARE Essential!
The controversy about masking has obscured a more fundamental question. How well do masks work to protect against airborne particles containing the coronavirus? A study published in the journal Physics of Fluids (July 21, 2021) attempted to answer that very concern.
The Canadian scientists simulated human breathing with mannequins used to train students in CPR. They compared different types of face masks, including surgical masks, those made of cloth and those rated N95 or KN95.
Neither cloth masks nor surgical masks were very effective for blocking exhaled particles. Three-ply cloth masks had 12% efficiency while surgical masks did not even achieve 10% effectiveness. The problem seems to be that there are gaps around the edges of both surgical and cloth masks, especially at the bridge of the nose but also at the cheeks and lower jaw.
N95 and KN95 masks are designed to fit the face more snugly. Their filtration efficiency was much better, but not perfect.
The authors summarize their findings:
“The results show that a standard surgical and three-ply cloth masks, which see current widespread use, filter at apparent efficiencies of only 12.4% and 9.8%, respectively. Apparent efficiencies of 46.3% and 60.2% are found for KN95 and R95 masks, respectively, which are still notably lower than the verified 95% rated ideal efficiencies.”
“The present results provide an important practical contrast to many other previous experimental and numerical investigations, which do not consider the effect of mask fit when locally evaluating mask efficiency or incorporating mask usage in a numerical model. Nevertheless, if worn correctly, high-efficiency masks still offer significantly improved filtration efficiencies (apparent and ideal) over the more commonly used surgical and cloth masks, and hence are the recommended choice in mitigating the transmission risks of COVID-19.”
The Bottom Line on This Study:
Fit is really important when it comes to face masks. If the mask keeps slipping down below your nose, it does not fit! If there are gaps around your cheeks or under your jaw, you are either spreading virus (if you have COVID-19) or you are breathing in virus if someone around you has COVID-19.
Most of the masks that people fasten around their ears will not fit snugly. Face masks with elastic that goes behind the head are far more likely to create a good seal. N95 and KN95 face masks that fit correctly are far more likely to prevent viral particles from exiting or entering your nose or mouth.
What About Availability?
A year ago NPR reported (Jan. 27, 2021):
“The Biden administration has invoked the Defense Production Act to prioritize production of N95s and other medical supplies. But even with those measures, U.S. hospitals remain worried about their supply of these medical masks — more formally called respirators — despite efforts by factories to churn out billions more.
“‘In most of the hospitals, nurses are wearing their N95s for five shifts,’ or up to 60 hours, says Mary Turner, president of the Minnesota Nurses Association and an intensive care nurse working with COVID-19 patients. ‘It’s becoming the norm to not wear N95s the way they’re supposed to be used.’”
Today, KN95 and N95 face masks are widely available. The Wirecutter.com website of the New York Times highly rates the Kimberly-Clark Professional N95 Pouch Respirator (53358), NIOSH-Approved mask. You can read the review at this link. The review also gives high marks to the Powecom KN95 respirator mask with headbands.
I personally have found the 3M VFlex 9105 N95 Particulate Respirator doesn’t fog my glasses when it fits snugly around my nose. The wire nose guard facilitates a good seal.
If I see one more person wearing a loose fitting cloth mask under their nose, I fear I will lose it. And then there are all those folks who refuse to wear a mask inside. Sorry folks, COVID is not done with us.
The CDC states that these respirators:
“…have demonstrated that they can filter out a minimum of 95% of airborne particles under worst case test conditions.”
The latest study from Canada calls the 95% effectiveness number into question, but clearly demonstrates that both N95s and KN95s are better than most other face coverings.
Airlines and Other Countries Are Tightening Mask Requirements:
Many organizations around the world are tightening their mask requirements to limit transmission of the Omicron variant of the SARS-CoV-2 virus. Some airlines are now mandating higher-quality face masks for their passengers. The German airline Lufthansa is preventing passengers from using bandannas, gaiters, scarves, cloth face masks and masks with valves. Passengers on Lufthansa airlines will be required to wear surgical, KN95 or FFP2 masks.
Finnair and Air France are also banning cloth masks or those with exhalation valves. Some American airlines are also instituting more rigorous requirements, but most have not yet banned cloth face masks.
In France, the Ministry of Health is now calling for surgical masks when people leave their homes. Their position is that standard fabric masks are inferior to surgical or N95 masks.
Other countries have made it easy for their citizens. For example, Hong Kong has sent six-layer masks to everyone. In Austria, people over 65 have been provided with medical masks similar to N95s. Next door in Germany, people are required to wear medical grade masks on public transit and in stores.
Why Not Wear an N95 Mask?
Dr. Joseph Allen is an associate professor and director of the Healthy Buildings program at Harvard’s T.H. Chan School of Public Health. He wrote an opinion piece for the Washington Post (Jan. 26, 2020) titled:
“Everyone should be wearing N95 masks now”
Dr. Allen points out that
“A typical cloth mask might capture half of all respiratory aerosols that come out of our mouth when we talk, sing or just breathe. A tightly woven cloth mask might get you to 60 or 70 percent, and a blue surgical mask can get you to 70 or 80 percent.
“But there’s no reason any essential worker — and, really, everyone in the country — should go without masks that filter 95 percent.”
In his Washington Post article Dr. Allen points out that a mask must fit really well. If air escapes out the top or sides, the mask is not really doing its job. It also has to fit snugly around the nose and chin.
Here is his take-home message:
“To see the true power of masks as a public health tool, we have to examine them in the context of everyone wearing them, where the power of each mask doubles. That’s because the particles have to pass through the material twice — once after being emitted and again before someone breathes them in. Take the example of two 70 percent efficient masks, which combine to reduce 91 percent of particles. Not bad. But two N95s result in greater than a 99 percent reduction in exposure.”
The People’s Pharmacy Perspective:
Many visitors to this website still complain that face masks don’t work. In some ways they are right. When people wear masks under their noses, they won’t work. When people wear a face mask as a chin strap, it won’t work. When people wear loose-fitting cloth masks that keep gapping at their cheeks or slipping down below their noses, they won’t work.
All health care workers must have ready access to N95 masks. That should also be true for front line workers who register you and take your insurance information. Grocery store workers, bank tellers and everybody who comes into contact with the public should have access to highly effective masks. And finally everyone who wants one should get N95 masks for free at their local pharmacy, post office or through the mail.
The sooner we can reduce exposure to the Omicron variant the better!
You can read about aerosol transmission of COVID-19 and why plastic COVID barriers were a huge boondoggle at this link. It will reinforce the need for highly effective face masks.
