I suspect that there hasn’t been this much talk of masks for generations. Outside of the medical field, chances are that the only time you’ve ever given much thought to buying or wearing a mask is if you’ve thought about doing some particularly dusty or dirty DIY.
Covid-19 has definitely put masks at the forefront of many of our minds.
Whether we should all be wearing masks in public has been a topic that has been discussed right from the beginning of the Covid-19 outbreak. Some countries have required citizens to wear masks in public, others have advised it and more still have left it up to the individual to make the decison.
In the early stages of lockdown, the UK government were clear that they did not require the public to wear masks and went as far as to advise against the wearing of masks in order to prioritise scarce supplies for key workers.
As lockdown eases, however, masks are coming into sharp focus as businesses begin to prepare for the “new normal” and individuals plan to head back out into a world where Covid-19 continues to be a risk.
The UK government will require the wearing of a mask on public transport, as of the 15th of June, and many businesses who are unable to provide services in line with social distancing will rely on masks to reopen and proctect themselves and their customers.
The aim of wearing a mask is to protect those around you from you.
But, none of us are mask experts….so how do we know what to wear and when?
I’m not a mask expert, I didn’t give them much thought before Covid-19 either!
With that said, however, the mask supply chain has gone bonkers during Covid-19 and making sure that we’re able to operate safely has taken a lot of research into masks; which ones will do the job and spending hours and hours trying to buy them!
That doesn’t make me an expert, though, so everything that follows is my opnion based on the research we’ve done over the past 10 weeks.
Hopefully, in this blog post, I’ll at least be able to answer some of the questions that you might have about masks in plain English and demystify some of the terms that you’re hearing and seeing.
If you have a question that isn’t covered in this post, or anything in particular that you’re confused about, please do comment or get in touch!
Fabric Face Coverings
Fabric face masks are the most easily available option at the moment; we could all wrap a scarf around our face, after all!
Many governments are encouraging the public to opt for a fabric face covering, or mask, to ensure that medical grade masks are available to healthcare professionals and that makes sense.
A quick search on youtube will bring up hundreds (probably thousands) of tutorials, showing you how to make various types of fabric mask. There are options that require a sewing machine, some that can be hand sewn and even some that don’t require any sewing at all. An old t shirt and 2 hair bobbles is all you need to make the most basic option!
Many clothing brands have also turned their hands to creating face masks. The British Fashion Council have even launched an initiative seeing British brands such as Mulberry and Julian McDonald producing masks!
But are they any good and how on earth do you choose?
The annoyingly unclear answer is: IT DEPENDS!
It depends on you and how you intend to use it.
As a basic rule of thumb, you’re going to want a fabric face mask to have several layers; the more layers your mask has, the more you are protecting those around you. Aim for a minimum of 3 layers.
If you’re thinking of making your own, you’ll need to consider the fabric that you’re using.
It will need to be comfortable (so no scratchy fabrics), fit your face snugly (a slight stretch would be good) and be a reasonably tight knit fabric (if you can see holes in between the stitches, when you stretch it, it’s probably not a great choice). The sort of cotton that is used for men’s T-shirts, would be a decent option for a DIY mask project.
It might take a few tries, before you make one with the right fit! You’ll need the mask to comfortably cover your nose and mouth, with a reasonably close fit. To check the fit, try placing your hands at the top, bottom and sides of your mask and see if you feel your breath as you exhale….or put on your glasses or sunglasses and see if you steam up!
If it doesn’t fit, it isn’t protecting anyone!
If you’re not one for a craft project, there are hundreds of fabric options available online.
When buying a face mask online, your priorities are the same as if you were to make one; you’re looking at fabric, thickness and fit!
When you’re looking at masks to purchase, you may also notice that there are fabric versions that include vents (steer clear, I’ll explain why later on!) and others that include “filters”.
Pre-Covid, these masks were predominantly marketed to people living in high pollution areas as a way to filter out pollution while you were out and about.
Masks with filters aim to filter the air that you’re breathing in, but don’t necessarily filter the air you breath out. Their rating is based on filtering the air that you breath in, they aren’t tested on breathing out, so there is no way of knowing how effective they are at stopping you from potentially infecting those around you (which is the point of mask wearing during Covid-19). That being said, you could logically assume that a mask with a filter will filter more of the air that you breath out than a mask without one; because at the very least it adds more layers for your breath to travel through.
Even in these crazy times, you should be able to purchase a good quality, reusable, fabric face mask for under £15.
How often should I swap or wash my fabric mask?
This where fabric masks come into their own; they’re reusable!
If you’re going to wear a fabric face mask, the important thing to note is that they aren’t usually waterproof in any way. As the breath that you exhale is usually warmer than the air around you, it will condense on your mask and the mask will get a bit soggy over time. The soggier the mask gets, the less effective it becomes.
Chances are, you’ll only be wearing your mask for short periods, on public transport, to the shop etc, so this shouldn’t be a massive issue but it’s something to be aware of as you go through the day.
If your mask has gone soggy, you’ll need to swap it for a fresh one.
The outside of your mask will be covered in particles, so the minute you take it off, or break the seal that was against your face, that’s game over for that mask and time to swap it.
It would make sense, to always carry a spare, for that reason!
Another thing to bear in mind when it comes to reuse is how you wash the mask.
I know most of us stick everything in the wash at 30 degrees and hope for the best (no, just me?), but that won’t be good enough for your mask.
You should aim to wash your mask on a hot wash, to make sure any nasties on it are killed before you next put it near your face.
TL;DR (too long, didn’t read) crew summary:
- There’s nothing wrong with a DIY mask, as long as it fits well, is at least three layers thick and made of a tight weave fabric.
- The same principles apply when it comes to buying a fabric face mask.
- If the mask doesn’t fit well, it isn’t protecting anyone.
- A fabric mask with a filter may provide additional protection, but they are only tested on breathing in, not breathing out (and filtering your breath when you breath out is the most important thing!).
- Avoid fabric masks with vents.
- Change your mask as soon as it becomes wet from condensation, or you take it off.
- Wash your mask on a hot wash.
Surgical Masks
You’ve all seen surgical masks before.
They aren’t all created equally though, so don’t be fooled into spending a fortune on surgical masks for your trips out.
The most common surgical masks that you’ll see available for general sale is a standard 3-ply mask. They are sometimes made of a blue/green/pink material, other times from a white papery material.
A 3-ply surgical mask is unlikely to offer any more protection than a 3 layer fabric mask. In fact, they may well offer less protection as they tend to be baggy around the sides, allowing lots of your breath to escape.
Standard 3-ply surgical masks are not medical grade and have not usually been tested, so how good they are at filtering harmful particles is unknown.
As they aren’t tested against any standards, the quality varies massively between suppliers and batches.
At the time of writing, you can purchase a pack of 50 3-ply masks for anything from around £10, up to £35(ish).
If you opt for 3-ply surgical masks, rather than a fabric mask, you’ll still need to change the mask regularly as it has no moisture resistance and will become less effective as your breath condenses on it, to the point of becoming useless. Similarly, as soon as you take it off, you shouldn’t put it back on (this is potentially more risky, than not wearing it at all!), so don’t succumb to the urge to wear it on one ear or under your chin from time to time.
So, if 3-ply surgical masks are no good, which are the good ones?
When it comes to Covid-19, the best surgical mask to wear is a type IIR mask.
Type IIR masks are certified for medical use. They’re tested on how good they are at filtering particles out of our breath as we breath out; this means that theyre tested on how well they protect the people around us. To be certified as IIR the mask needs to filter 98% of particles that you breath out. They must also pass tests to ensure that they are splash resistant, to ensure that they can cope with a sneeze or other bodily fluids.
As these masks are medical grade, they are difficult to source and are expensive due to Covid-19. The price of a box of type IIR surgical masks has gone up from around £4 for 50, to £40+ for the same box of 50.
While these masks are better, the key consideration for you as an individual when thinking of buying them is ethical. Healthcare professionals are working in high risk jobs and need medical grade PPE. If members of the public purchase medical grade PPE, it means there is even less in the market for healthcare professionals to buy.
If you decide that you still wish to buy type IIR masks, it is worth bearing in mind that fit can still be problematic due to the design.
Type IIR masks are not reusable, so as soon as you remove it, it must be replaced by a new one.
The same rule of thumb applies as fabric and 3-ply masks in that they put you at more risk if you fidget with them (pulling it up and down your face, taking it off one ear and replacing it, wearing it under your chin while you talk etc).
Type IIR surgical masks will be what we provide and ask our clients to wear during their appointments.
TL;DR Crew Summary:
- Standard 3-ply surgical masks are unlikely to offer any more protection than a well made and well fitted fabric mask.
- Standard 3-ply surgical masks are not tested, so quality varies wildly, as does the price.
- Surgical masks don’t protect anyone, if they don’t fit you well.
- Type IIR surgical masks are medical grade, splash resistant and filter 98% of particles that you breath out; but consider the implications of the public buying them on healthcare professionals who need them.
- You may be at a higher risk if you wear a mask and fidget with it/ wear it around your chin/ hanging from one ear and then replace it, than from not wearing one at all (as the mask will catch germs, which you will be spreading all over your face when you move it around).
Respirators
Respirators are different to surgical and fabric masks in a very important way.
Surgical masks and face masks aim to filter your breath on the way out (exhalation), to protect the people around you.
Respirators are tested on their efficiency in filtering the air as you breathe it in (inhalation).
You’ll likely have seen respirators in B&Q and on builders, as they are designed to limit the amount of dust (or other particles) that you breath in while working; your first thought probably wouldn’t have been healthcare!
For very good reason, the supply chain for respirators has been redirected to the NHS and many types of respirators are now not available to purchase privately in the UK.
If you have been keeping an eye on the news recently, you’ll know that this is a key stumbling block for private healthcare providers such as dentists (and us!) in their road to reopening.
So, if you’ve seen or heard anything about respirators you’re probably thinking, “What on earth does FFP whatever mean? And what about the N’s and K’s?”
Respirators are tested and certified as meeting certain filtration standards.
There are reasonably similar standards across the world, but just to make things easy, most countries use different classifications, or names, for their masks.
In the UK and Europe, respirators are classed as FFP1, FFP2 or FFP3.
FFP1 respirators are for use in mildly dusty environments.
FFP2 respirators are comparable with N95 (American certification), KN95 (Chinese certification) and P2 (Australian certification).
FFP2 masks must filter at least 94% of airborne particles, although some international counterparts require 95% filtration. They’re tested on 0.3 micron particles, which is tiny, but not as tiny as coronvairus! Don’t panic though, because the science says that 0.3micron particles are actually the most difficult to catch!
Particles smaller than 0.3 microns don’t travel in straight lines; they bounce around as they hit gas molecules in the air so are very unlikely to make their way through the fibres of the mask. Want to know more? Google Brownian motion, and be a geek, like me!
The masks are also tested on how much air leaks into the mask without passing through the it. There has to be less than 8% leakage to be certified as FFP2.
FFP3 respirators are comparable with N99 (American certification), KN99 (Chinese certification) and P3 (Australian certification).
FFP3 respirators have to filter 99% of particles out of the air you breathe in and have an internal leak rate of no more than 2%.
We’ve talked about how respirators protect you , but what about the people around you?
Particularly during the pandemic, our primary reason for wearing masks is to protect people around us.
Respirators are usually used to protect the wearer rather than those around them, but that’s not to say that they CAN’T protect those around us.
This is where valves come in to play.
Many FFP rated respirators are valved. There is a good reason for this. Respirators are made of layers of thick filtration materials that make them uncomfortable to breathe in; they get hot, humid and it can become difficult to catch your breath. So often, the mask is fitted with a valve, so that your breath can travel out of the mask easily to make it more comfortable to wear.
The downside of your breath travelling easily out of the mask, is that it stops you from protecting the people around you.
So, valved respirators are perfect for doing dusty work, but are not recommended in a pandemic.
With one, important exception. Masked respirators, usually FFP3, are worn by health care workers on wards containing only Covid-19 positive patients. As these patients already have Covid-19, there is no advantage to filtering the staff’s exhalations.
FFP2 and FFP3 respirators without valves are currently extremely difficult to source.
Usually, in the UK, we would always use masks tested and certified to our standards.
As we are in the midst of a pandemic and there is a chronic shortage of respirators, KN95 masks are becoming the only readily available non-valved respirator in the UK.
These are available for between £3 and £10 per respirator, at the time of writing.
While these can be worn for longer periods, up to a maximum of 8 hours (we call this “sessional use” in the biz!), they must be disposed of once removed. This means even if you just stop for a sip of water!
Much like type IIR surgical masks, if you are thinking of purchasing a respirator, please consider that these are required by medical professionals and frontline personnel and are already in short supply.
TL;DR Crew Summary:
- You’ve got minimal chance of being able to purchase a respirator at the minute, as the majority are being directed straight to the NHS.
- If you can purchase them, you shouldn’t, as the few that remain in the supply chain are required by those practitioners undertaking risky aerosol generating procedures
- They can be used for several hours, but a new one must be used once it’s taken off.
- If it doesn’t fit well, it doesn’t protect anyone!
Now this is the important bit, isn’t it?
I would usually say, in true Kirkby fashion, that “owt is better than nowt”, but it doesn’t always hold true when we’re talking about masks.
If you plan to have it swinging from one ear, bunched under your chin or only over your mouth (we’ve all seen it!), whichever type of mask you’ve chosen, it won’t be better than “nowt”. In fact, it might be worse than “nowt”. Firstly because every time you move it around, you’ll be spreading the particles that it has caught all over your face and secondly, because it might give you a false sense of security.
For you as the general public, chances are you only need a mask for short periods of time when you’re around other people (like on public transport or in a shop).
A fabric mask should do the job, whether you make it or buy it, as long as it fits you well, is 3 or more layers thick and you wear and wash it correctly.
As 3-ply surgical masks are not tested or certified, there is no way of knowing their quality, so it would be unwise to assume that they are any safer than a well made fabric face mask.
You’ll also need a new one each time you take it off, so there’ll be additional waste and cost to factor in. Don’t be tempted to reuse and put those around you at risk.
Medical grade surgical masks and respirators really should be avoided while ever they are in such scarce supply that health care practitioners are struggling to procure them. They are probably far more than you need for a quick trip out.
In clinic, we’ll be asking clients to wear a type IIR masks during their treatment. This is because we’ll be in close contact with several people throughout the day, we don’t know the quality of the mask you arrive in (or how long you’ve had it on for) and need to protect ourselves.
We’ll be wearing FFP2, or equivalent (most likely KN95) respirators to protect you from us and to protect us from the dust and aerosols that we are creating when using our drills (nail dust is a carcinogen and protecting our lungs is really important).
We also have a stock of reusable valved FFP3 respirators as a back up plan. If we do end up needing to wear these due to inability to source non-valved respirators, we’ll wear them with a type IIR mask under or over them to ensure that our exhalations are filtered to protect you.
Has this blog answered your questions? Let us know if you have any other questions!
