Types of Masks

In the wake of the novel coronavirus pandemic, face masks are fast becoming an everyday reality in the life of people all over the world. And it seems more than likely that the practice of wearing masks and face coverings in public is here to stay, for the time being anyway.

Remember how airport security checks ramped up to an unprecedented degree post 9/11? And how it has remained pretty much the same after almost two decades of the event? We're not saying that we'll go on sporting a face mask every time we go out in public for the next two decades (then again, the way things are now, who can predict what is to happen), but one thing is for certain---the scar of the present pandemic will take a considerable time to heel.

However, to come back to the topic of face masks. Thanks largely to the mainstream media, we are being reminded practically every single hour of the day the necessity of wearing face masks, regular hand washing, and maintaining social distance norms for reducing the spread of the COVID-19. As recently as on June 12, the director of the CDC Robert Redfield again urged the common populace to 'continue to embrace' those oft-repeated 'principles'---namely, social distancing, hand hygiene, and wearing masks---in the bid to at least slow down the spread of the virus and thus reverting back to 'normal' as early as possible.  

And as far as the common populace is concerned, they for their part are also doing their best to adhere to that advice. However, in regard to face masks, there seems to be more than a few doubts going around as to what type of mask provides the optimal protection. There are lots of terms and names floating around: medical grade, surgical masks, non-medical grade, respirators, N95, KN95, single-use, reusables, fabric face cover and so on.  And in addition, government is now also encouraging people to wear homemade cloth face covers. To complicate situations further, some cities in US have already banned the use of N95 respirators (the types that come with air-valves). So, there's more than a little confusion among the general public as to what type or types of masks are the most effective in reducing the spread of the virus.

So, in this article, we'll try to provide a general overview of the different types of face masks and face coverings that are in use right now; discuss the benefits (as also limitations) of these different types; while also touching on briefly on some of the related issues and controversies around the use of certain types of these protective masks.

First of all, the two basic types in face masks and coverings include medical-grade masks and non-medical grade cloth masks or other face coverings (neck gaiters, bandanas, scarves, as well as handmade cloth face covers).

In the medical-grade category, you have the N95 respirators (and also others such as KN95 face masks, FFP2/3, etc.---but more on that later) and the disposable surgical grade face masks (the ones you have probably seen your dentist use). The surgical masks act as a shield against respiratory droplets (that release in the air when someone talks, coughs or sneezes) and large particles. The latter cannot enter or exit your mouth or nose when you are wearing one of these masks. These surgical grade masks are single-use disposable masks and are specifically meant for use in sterile medical environments such as an operation room. N95 respirators, on the other hand, are the tight-fitting masks that cover a larger area of your face and provide better protection against not only droplets and large particles, but also against smaller air-borne particulate matters. In addition, these respirators filter the air that go in or out of your mouth and nose.

On the other hand, all types of non-medical grade masks (premade cloth masks, fabric face masks bandanas, etc.) provide pretty much the same kind of protection as the disposable surgical grade masks. You may have seen people from certain East Asian countries wear the surgical type face masks in the street, particularly in cities where pollution levels are quite high. But those are worn as protection against smog and respiratory ailments. These masks are not able to block small particles or air-borne viruses.

N95 Respirators

Now, as opposed to masks, the so-called 'respirators' have grown in popularity in these times since most sources claim that these devices can block up to 95% of small, tiny particles in the air. The respirators are those tight-fitting devices that cover a large part of your face, starting right from the bridge of your nose. As to whether or not these protective covers shield you against air-borne viruses is still a matter of debate. A few studies claim that they block small particles as well as viruses. Whereas according to a recent study conducted by a team of European scientists, the viruses can also enter (or exit) our body through our eyes. As such, respirators, while providing a better protection against small air-borne particles, cannot be regarded as fool-proof protection against viruses.

As to N95 respirators, these are medical-grade devices regulated by NIOSH and CDC and are marketed by a number of different American manufacturers. These devices come in different sizes but almost all of them come in a tight-fitting style (for better protection). Another point to note is that the materials used to make these devices are non-biodegradable and therefore contribute to landfill waste. This is the reason why there are regulations in place as to the quantities in which any particular approved manufacturer can supply these masks.

But what about those other terms that have come up, e.g. KN95, FFP2/3 and so on? It is natural that common people will wonder as to the differences between these differently named respirators. Well, to put it simply, except for minor design or other particularities, these devices are pretty much the same as N95 respirators. The differences in names are owing to the fact that they are manufactured in different countries (or continents) and are regulated by the government or other regulatory bodies of the respective places. So, you have KN95 respirator masks from China, FFP2 and FFP3 from Europe (certified by European Union) and there are more still: P2/P3 (Australia), P95 (Mexico), Special 1st (Korea) and DL2/DL3/DS (Japan).

All of these respirators seal tightly around the face and provide about 95% protection against tiny particles. Under normal circumstances, these masks cannot be imported to US without authorized permission. However, in view of the current situation (where many cities are facing a shortage of N95 masks), FDA has allowed import of KN95 and FFP2 masks in the country.

N95 masks: the two varieties

One important thing about N95 masks is that they come in two varieties. The ones that contain a one-way external air valve and the others without it. Now, both these types filter the contaminants in the air that you breathe in, thus providing a higher level of protection. The ones with the valve come with the additional advantage that the valve helps release the air you breathe out more easily. Therefore, the valved designs are less stuffy and you can wear them for longer periods of time without feeling uncomfortable.

Now, the controversy we had mentioned surrounding certain designs refers mainly to these air-valve respirator masks. Since the air escapes quickly and easily through this valve design, this means unfiltered air (that you breathe out) gets to release in the air. And apparently CDC had an issue with that, although it is difficult to see why. (Since common cloth masks do not come with filtering abilities anyway. Yes, the breathed out air cannot escape as easily as with the valved respirators, but they escape anyway---backwards and sideways.) All the same, this concern with the air-valve fitted N95 masks has already led a few local governments to impose a ban on their use. For example, residents in the San Francisco Bay Area are asked by the local authorities to not use those masks.  

Are single-use masks better than the reusables?

Well, the thing here is that the benefits (or the lack of them) of different (especially non-surgical) masks in fighting viruses and other microorganisms are, for the most part, still unknown. Evidences have only started to emerge as more and more studies are being conducted in the wake of the pandemic. For example, one US study tells us about the household materials that are most efficient in removing particles of the diameter of .3-1.0 micron, the typical size of bacteria, pathogens and viruses. According to this study, quilted cotton material, natural silk, tightly woven twill or cottons, vacuum cleaner bags are some of the best options.

As for single-use or disposable masks, they may provide slightly better protection than reusable masks. But the concern with the disposable masks is that if too many people started using them, that would lead to the environmental issue of huge contaminated plastic waste. Which is why most authorities have advised the use of reusable cloth masks or fabric face cover. As long as you follow the right practices (take the mask off as soon as you reach home and put it in the washer; wash in hot water and dry in high heat, etc.), the multiple-use cloth mask should be fine.