Thursday, November 30, 2023
This activity is intended for primary care clinicians, infectious disease specialists, nurses, pharmacists and other clinicians who care for patients at risk for COVID-19.
The goal of this activity is to evaluate the efficacy of different forms of masks against infection with COVID-19.
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CME / ABIM MOC / CE Released: 3/31/2021
Valid for credit through: 3/31/2022, 11:59 PM EST
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Masks are a proven means to prevent the spread of SARS-Cov-2, the virus that causes COVID-19, but a previous study by Sickbert-Bennett and colleagues suggested that not all masks may be equal in this regard. In this study, researchers evaluated 29 nonfitted masks for fitted filtration efficiencies (FFE) in a controlled laboratory environment. Their results were published in the August 11, 2020 issue of JAMA Internal Medicine.[1]
As expected, N95 respirators outperformed other masks, with FFE in excess of 95%; however, a less expected finding was that N95 respirators that had expired or that had been sterilized with ethylene oxide and hydrogen peroxide were still highly effective. KN95 respirators, many of which are produced in China, were substantially less effective, with FFE of 53.2% to 85.1%. Surgical masks with ties offered reasonable efficacy (FFE = 71.5%), but surgical masks with ear loops were associated with an FFE of 38.1% alone.
The current study by Clapp and colleagues provides more evidence regarding the efficacy of masks in preventing the spread of molecules with size similar to SARS-CoV-2. In particular, this study addresses means that purportedly can increase mask effectiveness.
Centers for Disease Control and Prevention (CDC) officials emphasized the importance of wearing face masks that properly fit the face to slow the spread of SARS-CoV-2, the virus that causes COVID-19.
Mask fitters, which are small reusable devices that cinch a cloth or medical mask, can create a tighter fit against the face.
“Fitters have been scientifically demonstrated to improve filtration performance by as much as 90% or more,” John Brooks, MD, chief medical officer of the CDC’s COVID-19 Response, said January 29 during a media briefing with the Infectious Diseases Society of America.[2]
That range of filtration efficiency meets the same standards as N95 respirators, he said.
“The more choices we can offer people, the more likely they are to find something that suits them and that they’ll adopt,” he said.
Wearing masks remains a key part of slowing the spread of COVID-19, particularly with the new spread of coronavirus variants, Brooks said. He reiterated that masks aren’t a substitute for social distancing and that people should still wear masks when they stand 6 feet apart from others, especially indoors and around those who do not live in the same household.
Throughout the pandemic, the CDC has studied the best combination of materials that block and filter respiratory particles, along with fit, comfort, durability, and consumer appeal.
Double masking, for instance, could be effective to further reduce the spread of the virus, Brooks said. People can wear a cloth mask with a high thread count over a medical mask, where the medical mask acts as a filter and the cloth mask adds an extra layer of filtration that better fits the contour of the face to prevent leaking.
CDC scientists are now conducting experiments to evaluate the efficacy of wearing 2 masks and will share the data as soon as it is available, Brooks said.
“It’s thought that this specific combination of a cloth and a medical mask could block over 90% or more of those respiratory droplets and particles,” he added.
Mask fitters could achieve a similar goal of preventing leakage, he said. For consumers who are interested, mask fitters are available for sale online, and several websites provide instructions on how to make one at home. A smartphone app also allows consumers to scan their face and use a 3D printer to create a better custom fit for the contours of their face.
“Any mask is better than no mask,” he said. “Regardless of what we use, it’s critical that as many of us as possible mask up.”
