Whose Evidence? What Rationality? The Face Mask Controversy

Optimizing Communication in Schools and Other Settings During COVID-19

(1) Background: Mask-associated dry eye (MADE) has been associated with increased dry eye symptoms, apparently due to reduced tear break-up time (TBUT). This study aimed to determine the short-term impact of surgical face mask (FM) on tear film stability by measuring non-invasive tear break-up time (NIBUT). (2) Methods: Twenty-six healthy participants had NIBUT evaluated without FM, with surgical FM and with a surgical FM secured to the skin with adhesive tape (TFM). NIBUT-first was measured with Keratograph 5M (K5M, Oculus, Wetzlar, Germany). Each participant had NIBUT measured in four sessions on four consecutive days. Session 1: without FM vs. with FM. Session 2: with FM vs. without FM. Session 3: without FM vs. with TFM. Session 4: with TFM vs. without FM (3). The time between each measured setting was 2 min. Results: The mean ± SD NIBUT without FM was 8.9 ± 3.7, with FM 10.2 ± 4.1, and with TFM 8.4 ± 3.8 s. No significant differences were observed in NIBUT in any of the evaluated settings: without FM vs. with FM (p = 0.247), without FM vs. with TFM (p = 0.915), and with FM vs. with TFM (p = 0.11). (4) Conclusions: This study did not find a significant short-term effect of FM on NIBUT. Other variables or longer periods of exposure might trigger the symptoms and ocular surface alterations in MADE.

Coronavirus disease 2019, also known as COVID-19, has become a global threat. In dealing with this global problem of the COVID-19 pandemic, flattening the curve of COVID-19 cases will be difficult unless residents take steps to stem the spread of this virus. The most critical measures during this epidemic are wearing a mask and maintaining social distance in crowded places. This research aims to propose the efficient deep learning model among the few of the most used models in the literature to detect face mask and social distancing violations. The deep learning models MobileNet, You Only Look Once (YOLO), and ResNet-50 are implemented, and their results are compared to ascertain people in a frame and scan for social distance by calculating the Euclidean/Manhattan distance between the bounding boxes generated. Similarly, the proposed model determines if the two people are within 6 feet of the frame; if not, a warning is issued. In this research, Face Mask Lite, Real-World Masked Face, MaskedFace-Net, and Face Mask Detection datasets are considered with 90:10, 80:20, 70:30, and 60:40 ratios to train and test these deep learning models. These deep learning models are processed in Anaconda + Python 3.x (3.8 or older) environment. The proposed model can be useful in hospitals and clinics, airports, shops and workplaces, and other crowded places where social distancing and face masks are required to avert the spread of not only COVID-19 but also other communicable diseases as well.

Introduction: Face masks use among Cameroonians is a new behavior. Many citizens have adopted face masks as a step to prevent the spread of COVID-19. Individuals might use face masks because of their profession, risk perception, and social status. This study aims at evaluating the relation between occupation and face masks use in COVID-19 setting in Cameroon. Our study hypothesizes that face masks use is not associated with occupation in Cameroon. Methods: A survey was conducted from May 13 to June 3, 2020, among Cameroonians ranging from ages 15 to 66+. Participants answered questions regarding face mask use, occupation, perceived susceptibility to COVID-19, and physicians' guidance. A binary logistic regression analysis was used to examine the association between face masks use and occupation. Results: A total of 1,525 persons responded to the survey among 837 males and 688 females. After adjustment, face masks use was not associated with the occupation. Guidance provided by physicians were positively associated with face masks use (OR=2.06, 95%CI:1.48-2.85). Face masks use was also associated with reported answers on whether: face masks protect against COVID-19 (OR=10.48, 95%CI: 7.20-15.25), ability to easily access physician’s guidance about COVID-19 on social media (OR=2.70, 95%CI: 1.94-3.75), and the belief that Africans are naturally resistant to COVID-19 (OR=1.73, 95% CI: 1.13-2.65). Conclusions: Our study provides evidence that face masks use in COVID-19 setting in Cameroon is not associated with occupation. However, physicians’ role has an impact on people’s behavior. The association between face masks use and the belief that Africans are naturally resistant to COVID-19 points to low perceived susceptibility that needs to be addressed by health professionals and competent civil authorities.

Masks remain a simple but powerful tool to help prevent the spread of COVID-19. They are especially important for children who are too young for the vaccine. Read on for answers to some frequently asked questions about masks, children, and COVID-19.A well-fitting high quality face mask reduces the chance of contracting COVID-19, as well as spreading COVID-19 infection to others. Face masks should not be worn by children if they are under 2 years old. Face masks are strongly encouraged for:Note: Infants and children under 2 years old are too young for the vaccine and too young to wear face masks. To protect them, people who have close contact with infants and young children should wear face masks.Well-fitting face masks worn by everyone 2 years old and older and adults, including child care teachers, regardless of vaccination status protects them as well as others—especially if they are not vaccinated.In K-12 schools, students, teachers, staff and visitors should be supported if they continue wearing masks. The same is true for anyone who continues wearing masks for sports.Face masks have been around for a couple of years, but mask wearing is still new to a child who is turning 2. Here are a few ideas that might help make your child more comfortable when they are getting used to wearing a mask:It may be challenging for very young children not to fidget with their face mask. Expect to give your child plenty of gentle reminders not to touch their face mask. When mask-wearing is reinforced by adults and peers, they will learn to follow directions. Just like children understand that they must wear bicycle helmets and buckle into their car seats, they will learn to wear masks correctly and routinely when needed.For children under 3, it's best to answer their questions simply in language they understand. If they ask about why people are wearing face masks, explain that sometimes people need to wear them to stay healthy.For children over 3, try focusing on germs. Explain that germs are special to your own body. Some germs and good and some are bad. The bad ones can make you sick. Since we can't always tell which are good or bad, the face masks help make sure you keep those germs away from your own body.Children with weakened immune systems or who have health conditions or special health care needs that put them at high risk for infections are encouraged to wear an N95 mask for protection. Those with medical conditions that interfere with cognitive or lung function may have a hard time tolerating a face mask. For these children, special precautions may be needed. Families are encouraged to have a plan and discuss appropriate masks and precautions with their pediatrician.Look for a well-fitting comfortable face mask that fits your child's face. The mask should fit securely under the chin but not impair vision, and cover the mouth and nose. It should fit snugly along the sides of the face without any gaps. Remember to wash hands before and after wearing it and avoid touching it once it's on. When back home, avoid touching the front of the face mask by taking it off from behind.Note: Face masks should not be worn when eating or drinking. Also, make sure the mask has no choking or strangulation hazards for young children.Along with COVID-19 vaccination and boosters, mask wearing when recommended and other safety measures such as physical distancing, testing and hand washing are key to reducing SARS-CoV-2 infection and spread. If you have any concerns about your child's health, talk with your pediatrician.American Academy of Pediatricswww.aap.org and www.HealthyChildren.orgAdapted from the HealthyChildren.org article Face Masks for Children During COVID-19 (4/21/22).The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

BackgroundFace mask use has been associated with declines in COVID-19 incidence rates worldwide. A handful of studies have examined the factors associated with face mask use in North America during the COVID-19 pandemic; however, much less is known about the patterns of face mask use and the impact of mask mandates during this time. This information could have important policy implications, now and in the event of future pandemics.ObjectiveTo address existing knowledge gaps, we assessed face mask usage patterns among British Columbia COVID-19 Population Mixing Patterns (BC-Mix) survey respondents and evaluated the impact of the provincial mask mandate on these usage patterns.MethodsBetween September 2020 and July 2022, adult British Columbia residents completed the web-based BC-Mix survey, answering questions on the circumstances surrounding face mask use or lack thereof, movement patterns, and COVID-19–related beliefs. Trends in face mask use over time were assessed, and associated factors were evaluated using multivariable logistic regression. A stratified analysis was done to examine effect modification by the provincial mask mandate.ResultsOf the 44,301 respondents, 81.9% reported wearing face masks during the 23-month period. In-store and public transit mask mandates supported monthly face mask usage rates of approximately 80%, which was further bolstered up to 92% with the introduction of the provincial mask mandate. Face mask users mostly visited retail locations (51.8%) and travelled alone by car (49.6%), whereas nonusers mostly traveled by car with others (35.2%) to their destinations—most commonly parks (45.7%). Nonusers of face masks were much more likely to be male than female, especially in retail locations and restaurants, bars, and cafés. In a multivariable logistic regression model adjusted for possible confounders, factors associated with face mask use included age, ethnicity, health region, mode of travel, destination, and time period. The odds of face mask use were 3.68 times greater when the provincial mask mandate was in effect than when it was not (adjusted odds ratio [aOR] 3.68, 95% CI 3.33-4.05). The impact of the mask mandate was greatest in restaurants, bars, or cafés (mandate: aOR 7.35, 95% CI 4.23-12.78 vs no mandate: aOR 2.81, 95% CI 1.50-5.26) and in retail locations (mandate: aOR 19.94, 95% CI 14.86-26.77 vs no mandate: aOR 7.71, 95% CI 5.68-10.46).ConclusionsStudy findings provide added insight into the dynamics of face mask use during the COVID-19 pandemic. Mask mandates supported increased and sustained high face mask usage rates during the first 2 years of the pandemic, having the greatest impact in indoor public locations with limited opportunity for physical distancing targeted by these mandates. These findings highlight the utility of mask mandates in supporting high face mask usage rates during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) spread rapidly worldwide, causing a severe outbreak. Because the disease is easily transmitted, face masks are a vital tool to slow the spread. The aim of this study is to investigate the impacts of face mask use on standard automated perimetry (SAP) results in glaucoma patients. All follow-up glaucoma patients who underwent SAP between May and October 2020 were enrolled in this study. In patients with low test reliability and/or visual field changes, SAP was repeated after repositioning and taping patients' face masks. A total of 127 patients (59 female and 68 male) with a mean age of 59.8±10.3 years were included in the study. While 101 patients (79.5%) wore surgical face masks, 26 patients (20.5%) wore cloth face masks. Low SAP reliability appeared in 23 patients (18.1%), and inferior visual field defects were present in 3 patients (2.4%). The main effects of poorly fitting face masks on SAP reliability were increased fixation losses and false-positive errors (for both, P=0.001). Low SAP reliability was significantly higher in patients wearing cloth face masks than in those wearing surgical face masks (47.8% vs. 9.9%; P=0.0001). The face mask-related fogging of eyeglasses before SAP is a strong predictor of fogging of the trial lenses-related low SAP reliability (odds ratio: 27, 95% confidence interval: 5.48-132.92, P=0.0001). In all repeated SAPs, the patients' reliability parameters improved, and inferior visual field artifacts disappeared. Unsuitable face masks can cause either visual field artifacts, which may be interpreted as glaucoma progression or low test reliability. Taping the face masks' upper edges is an effective technique to prevent visual field artifacts and obtain good test reliability.

Wearing face masks is essential for reducing infection during the COVID-19 pandemic. However, ordinary surgical face masks can provide only moderate protection. The N95 face masks should provide sufficient protection but may impose complaints about breathing difficulty or even impair respiratory health. This investigation proposed a novel face mask modified from the surgical face mask to improve both protection and comfort. The filter material of the surgical face mask was covered and sealed on a cardboard support frame but with openings for air permeating through. The modified face masks were worn by a test subject for measuring the air contents inside the face masks. The protection performance was evaluated by the overall PM1 filtration efficiency. The concentrations of CO2, O2, N2, and water vapor were adopted to evaluate the breathing comfort. The performance of the proposed face mask was compared with the market-available surgical and N95 face masks. In addition, CFD modeling was adopted to investigate the dynamic air exchange of the face mask with respiration and the surrounding air. Impacts of the air sampling tube positions on the measurement results were also examined. The results revealed that the overall PM1 filtration efficiency of the modified face mask could reach 96.2%, which was much higher than that of the surgical face mask and only slightly lower than the N95 face mask. As compared with the N95 face mask, the modified mask reduced the respiratory flow resistance and the concentrations of CO2 and water vapor and thus increased the O2 content and breathing comfort.

ABSTRACTWith shortages of face masks being reported worldwide, it is critical to consider alternatives to commercially manufactured face masks. This study aimed to test and compare the efficacy of various makes of locally made or homemade cloth face masks obtained from face-mask vendors in Kampala, Uganda, during the COVID-19 pandemic. The testing was performed to assess the bacterial filtration efficiency (BFE), breathability, distance-dependent fitness, and reusability of the locally made or homemade cloth face masks, while considering the most commonly used non-published face-mask decontamination approaches in Uganda. During laboratory experimentation, modified protocols from various face-mask testing organizations were adopted. Ten different face-mask types were experimented upon; each face-mask type was tested four times for every single test, except for the decontamination protocols involving washing where KN95 and surgical face masks were not included. Among the locally made or homemade cloth face masks, the double-layered cloth face masks (described as F) had better BFE and distance-dependent fitness characteristics, they could be reused, and had good breathability, than the other locally made or homemade cloth face masks. Despite these good qualities, the certainty of these face masks protecting wearers against COVID-19 remains subject to viral filtration efficiency testing.

Background: Indonesia has entered a new normal in the Covid-19 era and implemented strict health protocols in day-to-day activities. Transportation sectors, including air transportation, have been allowed to continue their services as long as they follow the health protocols, such as the mandatory use of face masks. Unfortunately, face masks now deal with several negative health issues, e.g., headache.Objective: To observe the association between face mask use and headache among airport officers and the average degree of the headache experience.Methods: The study was conducted at the Sultan Mahmud Badaruddin II (SMB II) International Airport in Palembang. The data were collected by a questionnaire gathered from December 2020 to January 2021. The data were processed using a quantitative approach with analytical methods.Results: From 207 airport officers, the major characteristics were female (57.9%), indoor workplaces (78.3%), face masks use ≤ 4 (four) hours per day (58.9%), and no headaches while using face masks (70.1%). There was a significant relationship between headache and face masks used > 4 hours per day (p < 0.001; 95% CI = 6.201 {3.215-11.958}). The mean of headaches degree using the VAS score was 2.3 (scale 0 - 10).Conclusion: Headaches could result from wearing facemasks for more than 4 hours per day. The mean degree of headaches due to facemasks used was relatively mild. The present research suggests that face masks must not cause other health problems. Improvement in face masks is the key to facing the Covid-19 pandemic and as important as washing hands and physical distancing.Keywords: Face mask; Headache; VAS Score

While increased face mask use has helped reduce COVID-19 transmission, there have been concerns about its influence on thermoregulation during exercise in the heat, but consistent, evidence-based recommendations are lacking. No physiological differences would exist during low-to-moderate exercise intensity in the heat between trials with and without face masks, but perceptual sensations could vary. Crossover study. Level 2. Twelve physically active participants (8 male, 4 female; age = 24 ± 3 years) completed 4 face mask trials and 1 control trial (no mask) in the heat (32.3°C ± 0.04°C; 54.4% ± 0.7% relative humidity [RH]). The protocol was 60 minutes of walking and jogging between 35% and 60% of relative VO2max. Rectal temperature (Trec), heart rate (HR), temperature and humidity inside and outside of the face mask (Tmicro_in, Tmicro_out, RHmicro_in, RHmicro_out) and perceptual variables (rating of perceived exertion (RPE), thermal sensation, thirst sensation, fatigue level, and overall breathing discomfort) were monitored throughout all trials. Mean Trec and HR increased at 30- and 60-minute time points compared with 0-minute time points, but no difference existed between face mask trials and control trials (P > 0.05). Mean Tmicro_in, RHmicro_in, and humidity difference inside and outside of the face mask (ΔRHmicro) were significantly different between face mask trials (P < 0.05). There was no significant difference in perceptual variables between face mask trials and control trials (P > 0.05), except overall breathing discomfort (P < 0.01). Higher RHmicro_in, RPE, and thermal sensation significantly predicted higher overall breathing discomfort (r2 = 0.418; P < 0.01). Face mask use during 60 minutes of low-to-moderate exercise intensity in the heat did not significantly affect Trec or HR. Although face mask use may affect overall breathing discomfort due to the changes in the face mask microenvironment, face mask use itself did not cause an increase in whole body thermal stress. Face mask use is feasible and safe during exercise in the heat, at low-to-moderate exercise intensities, for physically active, healthy individuals.

Given the massive use of facemasks (FMs) during the covid-19 pandemic, concerns have been raised regarding the effect of FMs wearing on overall health. This study aimed at evaluating the effect of surgical FM on brain neuro-electrical activity. Electroencephalography (EEG) background frequency (BGF) and background amplitude (BGA) was performed on 30 volunteers before (baseline), during and after wearing a FM for 60 min. Measurements were done during normal ventilation, hyperventilation and post-hyperventilation (PHVR). Blood gas levels were assessed at baseline and after FM use. EEG analysis concerning baseline (without FM) (BGA), was 47.69 ± 18.60 µV, wearing FM, BGA was 48.45 ± 17.79 µV, post FM use BGA was 48.08 ± 18.30 µV. There were no statistically significant differences between baseline BGA and BGA under FM and post FM. BGF, Baseline data were 10.27 ± 0.79, FM use 10.30 ± 0.76 and post FM use was 10.33 ± 0.76. There were no statistically significant differences between baseline BGF and BGF under FM and post FM. Venous blood gases, and peripheral oxygen saturation were not significantly affected by FM use. Short-term use of FM in young healthy individuals has no significant alteration impact on brain's neuro-electrical activity

Although Vietnam has been successful in the fight against the first wave of COVID-19, domestic outbreaks have continued to occur. Given university students constitute a significant proportion of the population in Vietnam, to improve the prevention and control of COVID-19 in Vietnam and comparable countries, we examined their knowledge, attitude, and practice (KAP) towards face mask use which is an important preventive measure and the association between the levels of COVID-19 knowledge and KAP towards face mask use. A cross-sectional survey was conducted on all students studying at Phenikaa University, Hanoi, using a self-developed questionnaire consisted of 42 questions regarding KAP towards face mask use as well as reuse of cloth mask, and COVID-19 knowledge. Among 728 participants, 40.9% (298/728) were male, 63.2% (460/728) were from health-related faculties, 46% (335/728) lived in urban areas, and 51.9% (378) had good levels of COVID-19 knowledge. Regarding face mask, most (89.7%, 653/728) participants had good knowledge scores, 72.8% (530/728) had positive attitudes, and 76.5% (557/728) had good practice scores. The most common types of masks used were surgical mask (57.6%, 419/728), followed by non-antibacterial cloth mask (23.1%, 168/728). Among 168 participants using non-antibacterial cloth mask, 43.5% reused masks (73/168), of whom 6.8% (5/73) did not wash their masks at least daily. Face mask use knowledge was statistically associated with COVID-19 knowledge (P < 0.001). Face mask use attitudes were statistically associated with education levels (P = 0.02), and COVID-19 knowledge (P < 0.001). Practice of face mask use was statistically associated with gender (P = 0.03), geographical distribution (P = 0.04), academic majors (P = 0.02), and COVID-19 knowledge (P = 0.01). The levels of KAP towards face mask use among Vietnamese university students are high. It is important to continue to enforce the mass masking policy, together with the ongoing community education with an emphasis on the route of COVID-19 transmission and how correct face mask use can stop the spread. To ensure the effectiveness of face masks, there is an urgent need to educate the community regarding the procedures for cloth masks re-use.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10900-021-00981-6.

Micro/nanofiber-based face masks are recommended as personal protective equipment (PPE) against particulate matter (PM), especially PM0.3. Ensuring thermal comfort in daily use face masks is essential in many situations. Here, radiative thermal management is introduced into face masks to elevate the user comfort. An interlayered poly(lactic acid) (PLA) micro/nanofibrous filter effectively captures PM0.3 (99.69%) with minimal pressure drop (49 Pa). Thermal regulation is accomplished by controlling the mid-infrared (MIR) emissivity of the face mask's outer surface. Cooling face masks feature cotton nonwovens with high MIR emissivity (90.7%) for heat dissipation, while warming face masks utilize perforated Al/PE films with minimal MIR emissivity (10.7%) for warmth retention. Skin temperature measurements indicate that the skin covered by the cooling face mask could be 1.1 °C lower than that covered by the 3M face mask, while the skin covered by the warming face mask could be 1.3 °C higher than that covered by the 3M face mask.

The Face Mask Wearing Image Dataset is a comprehensive collection of images aimed at facilitating research in the domain of face mask detection and classification. This dataset consists of 24,916 images, carefully categorized into two main folders: “Correct” and “Incorrect” representing instances of face masks being worn properly and improperly, respectively. Each folder is further divided into four subfolders, each denoting a specific type of face mask - Bandana, Cotton, N95, and Surgical. In the “Correct” folder, images depict individuals correctly wearing their respective face masks, while the “Incorrect” folder contains images of improper face mask usage. To capture variations in face mask application across different demographics, such as age and gender, each subfolder also includes three additional subfolders - Child, Male, and Female. The dataset's diverse content encompasses different face mask types, covering bandana-style, cloth, N95 respirators, and surgical masks, across various age groups and genders. This design ensures a comprehensive representation of real-world scenarios, enabling the evaluation of machine learning algorithms for face mask detection and classification. Researchers can leverage this dataset to develop and assess models that can accurately identify and distinguish between correct and incorrect face mask usage. By contributing to the advancement of face mask detection technologies, this dataset further supports public health initiatives and encourages proper mask-wearing behavior to mitigate the spread of infectious diseases, particularly during times of heightened health concerns such as the COVID-19 pandemic.