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Problems that arise out of mask-wearing

“I thought I was not going to last an hour. It was so uncomfortable. Hot, sweaty, the smell of your breath… just very unpleasant. But you get used to it. In any case, we have no choice,” says a Paris resident gesturing at his blue surgical masks. The new French law made it mandatory for almost all employees to wear face masks in the workplace.

Figure 1: Mask wearing is likely to become the norm as experts predict a future with more pandemics, rising levels of air pollution.

In some places where mask-wearing is still not the norm despite government advisories, mask wearers have been shunned or even attacked.

Three-time Olympic gold medalist and Beach Volleyball star Kerri Walsh Jennings is facing a wave of criticism after posting on Instagram her story of shopping without a face mask.

Jennings bemoaned the damage the COVID-19 had done to American culture, saying that, “Public health measures have crushed our society, people’s livelihoods, our children’s spirits, and the fabric of our world. We become a country and a world estranged from each other and it is more deeply unhealthy than any virus could ever be.”

However, her going shopping without a face mask goes against what is recommended in preventing the spread of the Coronavirus by numerous public health experts.

Shop owners in the UK fear that mandatory face coverings in stores could result in rising in shoplifting.

Earlier in May this year, Representative of the American state of Ohio Nino Vitale, also a Republican, publicly rejected mask-wearing on the plea that covering one’s face disgraces God.

Research from the University of Illinois found that a used T-shirt made of 100 percent silk was more effective at filtering high momentum droplets, likely because silk has electrostatic properties that can help trap smaller viral properties.

According to the report run by the Conversation, the rejection of masks is higher in populations that associate with conservative politics.

Canada’s Chief Public Health Officer Dr. Theresa Tam has advised his countrymen that they wear masks during sexual intercourse and avoid kissing new people to reduce the spread of the Coronavirus.

Infectious diseases experts suggested that sex be avoided if either person has Covid-19 symptoms.

In such a situation, New York City Health Dept. says face masks make sex safer in the time of COVID-19.

Current evidence indicates that Coronavirus is less likely to spread through semen or vaginal fluids. On the contrary, scientists have found the Coronavirus in feces and men’s semen even after the men with the COVID-19 have begun to recover. Consequently, the virus could be sexually transmitted. But some scientists think it is unlikely.

Researchers from the National Institute of Standards and Technology (NIST) found that face masks are causing a facial recognition algorithm to fail as frequently as 50 percent of the time.

One of the US companies offers masks with customers’ faces printed on them so that they can unlock their smartphones without having to remove it.

Figure 2: WHO suggested that non-medical face-coverings be worn in public settings where social distancing is very difficult to practice.

During different movements in recent times, political activists have donned masks to evade detection on the streets.

Mask wearing is likely to become the norm for at least a proponent of us as experts predict a future with more pandemics, rising level of air pollution, permanent authoritarian regimes and a projected increase in bushfire producing dangerous smoke.

Facial recognition systems will need to adapt to the changed situation. Based on the features that remain visible such as the eyes, eye-brows and hairline, detection will be carried out.

Shortcomings of various masks

World Health Organization (WHO) suggested that non-medical face-coverings be worn in public settings where social distancing is very difficult to practice.

Social distance means to stay 2m (6 feet) away from anybody outside one’s household while self-isolation means staying at home and not leaving it.

Masks act as filters and capture the droplets and particles we expel. An ideal mask blocks both large respiratory droplets from coughs or sneezes (the primary method by which people pass the virus to others) and smaller airborne particles called aerosols which are produced when people loudly talk or sing or exhaled.

It should be sealed around the nose and mouth since any gaps, holes, or vents could allow droplets to leak out and potentially infect another person. The fabric should be woven as tightly as possible. So, fabrics with higher thread counts are better at filtering particles.

The WHO recommends that fabric masks have three layers: an inner layer that absorbs, a middle layer that filters, and an outer layer made from a non-absorbent material like polyester.

Surgical masks made out of thin fabric or paper do protect from large respiratory droplets. But they do not prevent smaller mist-like droplets and filter smaller particles. These masks do not seal around the face and so, are not effective in protecting people from Coronavirus transmission.

“Wearing surgical masks help you prevent sharing your germs if you are sick. They are better than nothing,” says an epidemiologist and infection prevention expert.

Surgical masks are one-time use only, they should be changed every day as they are not desired for repeat use, says an IEDCR official.

These respirators are difficult to get used to for people who are not working in a controlled environment like laboratories, said the IEDCR official adding that people with existing respiratory illnesses find respirators difficult to use.

Disposable surgical masks are also made out of non-woven fabric. A 2013 study found that surgical masks were about three times effective at blocking influenza aerosols than homemade face masks.

N95 respirators are face masks that filter at least 95% of airborne particles. Physicians are regularly fitted for the N95 respirators. The masks are the best because they seal tightly around the nose and mouth so that very few viral particles seep in or out. They also contain tangled fibers to filter airborne pathogens—the name refers to their minimum 95% efficiency at filtering aerosols.

A recent Duke study showed that more than 0.1% of droplets were transmitted through an N95 mask while the wearer was speaking. That’s why they are generally reserved by healthcare workers.

According to a report published on Sciencealert.com, N95 masks block the greatest number of droplets released by the person speaking, followed by surgical masks, then masks made polypropylene. Still, there are homemade options that come close to the level of protection of an N95 or surgical masks.

However, there is a proper way to wear N95 respirators to ensure there is no open space. It’s snugly against the face. People with no medical training might wear it incorrectly. N95 is quite uncomfortable to wear for a long period.

An April study from the University of Chicago determined that hybrid masks—combining two layers of 600-thread-count-cotton paired with another material like silk, chiffon, or flannel—filter at least 94 percent of small particles and at least 96 percent of larger particles. Two layers of 600-thread-count-cotton offer a similar level of protection against larger particles, but they weren’t as effective at filtering aerosols. Hybrid masks are among the safest homemade option.

Research from the University of Illinois found that a brand-new dishcloth was slightly more effective than a used 100 percent cotton T-shirts at filtering droplets. That study also found a used T-shirt made of 100 percent silk was more effective at filtering high momentum droplets, likely because silk has electrostatic properties that can help trap smaller viral properties.

Silk face coverings cause the least friction of any fabric, which helps to prevent those minor skin wounds in the cheek and nose that heal over clogging pore and causing spots in the process. Silk is also cool and breathable which is of significant help around the chin area.

All sorts of other masks including cotton masks and even knitted ones, showed an ability to block droplets, as did a valved version of the N95 masks which did not score as well as the fitted N95 masks due to its exhaust valve in terms of blocking droplets. Bandanas were among the less effective but worst of all is wearing a neck fleece, which the researcher found is worse than not wearing any kind of facial covering.

Bandanas and scarves have performed poorly in multiple studies. The Journal of Hospital Infection found that a scarf only reduced a person’s infection rate by 44 percent after they shared a room with an infected person for 30 seconds. After 20 minutes of exposure, the scarf only reduced the infection risk by 24 percent.

Figure 3: A face-shield is primarily used for eye protection for the person wearing it.

A face-shield is primarily used for eye protection for the person wearing it. At this time, it’s not known what level of protection a face shield provides to people nearby from the spray of respiratory droplets from the wearer. They have the added benefit of protecting one’s eyes and the discouraging wearer from touching the face by acting as a physical barrier, says Chirstopher Sulmonte, project administrator of the bio-containment unit at Johns Hopkins Hospital.

Centers for Disease and Prevention (CDC) does not recommend the use of a face shield as a substitute for masks. Plastic face-shields for new-born and infants are not recommended.

No health officials recommend clear plastic barriers as a substitute for masks. However, those who want extra protection can wear a face shield in addition to a mask.

According to a new study in the journal ‘Physics of Fluid’, face shields and valved masks –substitute for cloth mask coverings- appear to be less effective in blocking viral particles than regular masks. If the droplets are 10 microns or less, shields are unable to act as a deterrent. A micron is one-millionth of a meter, and viruses are in the rage of 0.3 microns.

Mask wearing is likely to become the norm for at least a proponent of us as experts predict a future with more pandemics, rising level of air pollution, permanent authoritarian regimes and a projected increase in bushfire producing dangerous smoke.

A cloth mask of at least two layers that cover the face from the nose to under the chin is the best option. Although a cloth or surgical masks offer more protection, experts say that any face covering is better than nothing at all.

CDC recognizes that wearing masks may not be possible in every situation or for some people.

Limitations of masks studies

Only some tests directly mimic the size of Novel Coronavirus particles while others evaluate performance based on viruses like influenza. Researchers are not still sure about the extent to which the virus spread via aerosols since those particles are extremely hard to trap and study without killing the virus. Some scientists even different ideas of what constitute an aerosol.

Why many governments are placing more importance on mask-wearing

According to the IHME, nearly 770,000 lives across the world would not be lost between now and January 1 if proven mitigation measures (such as mask-wearing and social distancing) were in place.

International studies have shown that masks are effective in curtailing the spread of the virus. They stopped asymptomatic people who might not know they are infected from passing it on to others. Universal masking has been associated with a significantly lower rate of infection.

Research shows people don’t get as sick when exposed to smaller amounts of viruses, says Dr. Monica Gandhi, a virus expert at the University of California.

Scientists in Singapore suggest the contagion risk is especially high in the 24-48 hours before an infected person is even aware he might have the disease.

World Health Organization (WHO) says there is emerging evidence of airborne transmission of the highly contagious virus.

Premier of the Australian state of Victoria (where stringent measure including mandatory mask-wearing to reduce the spread of the Coronavirus have been imposed) Daniel Andrews said, “Most of us would not leave home without our keys, we would not leave our home without our mobile phone, you (general people) won’t be able to leave home without your mask.” He said the cost of wearing masks is low but the reward is high.

Donald Low, a behavioral economist and professor at the Hong Kong University of Science and Technology, said, “Putting on a mask every day before you go out is like a ritual, like putting on a uniform, and in ritual behavior, you feel you have to live up to what the uniform stands for, which is more hygienic behavior like not touching your face or avoiding crowded places and social distancing.”

White House already made it compulsory for all staff to wear face masks.

Evidence shows the workplace is the biggest source of transmission.

The government in Bangladesh made masks wearing mandatory in public on July 22, 2020, to contain the spread of the virus.

Millions of people around the world have been diagnosed with the Coronavirus and more than 880000 have died, according to Johns Hopkins University. More than 17.9 million people have recovered.

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