Cloth Masks Research Articles

Quantitative Method for Comparative Assessment of Particle Removal Efficiency of Fabric Masks as Alternatives to Standard Surgical Masks for PPE

In response to the COVID-19 pandemic, cloth masks are being used to control the spread of virus, but the efficacy of these loose-fitting masks is not well known. Here, tools and methods typically used to assess tight-fitting respirators were modified to quantify the efficacy of community-produced and commercially produced fabric masks as personal protective equipment. Two particle counters concurrently sample ambient air and air inside the masks; mask performance is evaluated by mean particle removal efficiency and statistical variability when worn as designed and with a nylon overlayer, to independently assess fit and material. Worn as designed, both commercial surgical masks and cloth masks had widely varying effectiveness (53%–75% and 28%–91% particle removal efficiency, respectively). Most surgical-style masks improved with the nylon overlayer, indicating poor fit. This rapid testing method uses widely available hardware, requires only a few calculations from collected data, and provides both a holistic and aspect-wise evaluation of mask performance.

Effectiveness of Cloth Masks for Protection Against Severe Acute Respiratory Syndrome Coronavirus 2.

Cloth masks have been used in healthcare and community settings to protect the wearer from respiratory infections. The use of cloth masks during the coronavirus disease (COVID-19) pandemic is under debate. The filtration effectiveness of cloth masks is generally lower than that of medical masks and respirators; however, cloth masks may provide some protection if well designed and used correctly. Multilayer cloth masks, designed to fit around the face and made of water-resistant fabric with a high number of threads and finer weave, may provide reasonable protection. Until a cloth mask design is proven to be equally effective as a medical or N95 mask, wearing cloth masks should not be mandated for healthcare workers. In community settings, however, cloth masks may be used to prevent community spread of infections by sick or asymptomatically infected persons, and the public should be educated about their correct use.

Characteristics of Adult Outpatients and Inpatients with COVID-19 - 11 Academic Medical Centers, United States, March-May 2020.

Descriptions of coronavirus disease 2019 (COVID-19) in the United States have focused primarily on hospitalized patients. Reports documenting exposures to SARS-CoV-2, the virus that causes COVID-19, have generally been described within congregate settings, such as meat and poultry processing plants (1) and long-term care facilities (2). Understanding individual behaviors and demographic characteristics of patients with COVID-19 and risks for severe illness requiring hospitalization can inform efforts to reduce transmission. During April 15-May 24, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had positive reverse transcription-polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 in outpatient and inpatient settings at 11 U.S. academic medical centers in nine states. Respondents were contacted 14-21 days after SARS-CoV-2 testing and asked about their demographic characteristics, underlying chronic conditions, symptoms experienced on the date of testing, and potential exposures to SARS-CoV-2 during the 2 weeks before illness onset (or the date of testing among those who did not report symptoms at the time of testing). Among 350 interviewed patients (271 [77%] outpatients and 79 [23%] inpatients), inpatients were older, more likely to be Hispanic and to report dyspnea than outpatients. Fewer inpatients (39%, 20 of 51) reported a return to baseline level of health at 14-21 days than did outpatients (64%, 150 of 233) (p = 0.001). Overall, approximately one half (46%) of patients reported known close contact with someone with COVID-19 during the preceding 2 weeks. This was most commonly a family member (45%) or a work colleague (34%). Approximately two thirds (64%, 212 of 333) of participants were employed; only 35 of 209 (17%) were able to telework. These findings highlight the need for screening, case investigation, contact tracing, and isolation of infected persons to control transmission of SARS-CoV-2 infection during periods of community transmission. The need for enhanced measures to ensure workplace safety, including ensuring social distancing and more widespread use of cloth face coverings, are warranted (3).

Adopting Who Guidance on Fabric Masks for COVID-19

On June 5, 2020, the World Health Organization (WHO) released updated guidance on the design and use of fabric masks for COVID-19. This Commentary discusses the new guidance on non-medical fabric masks as supplementary risk reduction strategies alongside physical distancing and hand hygiene, highlighting key differences from earlier Centers for Disease Control (CDC) guidelines. Notably, while the CDC recommended cotton masks with at least two layers, the WHO now recommends masks with at least three layers including a hydrophilic inner layer (e.g., cotton) to retain droplets and hydrophobic synthetic outer layers (e.g., spunbond nonwoven polypropylene, NWPP) to enhance filtration and reduce penetration of external contaminants through the mask. This key change is supplemented with additional guidance to assist mask users and makers in choosing materials with a balance of breathability and filtration performance. Cotton masks made according to the earlier CDC guidance can be adapted to comply with the WHO update by adding a single layer spunbond NWPP mask cover.

Characteristics Associated with Hospitalization Among Patients with COVID-19 - Metropolitan Atlanta, Georgia, March-April 2020.

The first reported U.S. case of coronavirus disease 2019 (COVID-19) was detected in January 2020 (1). As of June 15, 2020, approximately 2 million cases and 115,000 COVID-19-associated deaths have been reported in the United States.* Reports of U.S. patients hospitalized with SARS-CoV-2 infection (the virus that causes COVID-19) describe high proportions of older, male, and black persons (2-4). Similarly, when comparing hospitalized patients with catchment area populations or nonhospitalized COVID-19 patients, high proportions have underlying conditions, including diabetes mellitus, hypertension, obesity, cardiovascular disease, chronic kidney disease, or chronic respiratory disease (3,4). For this report, data were abstracted from the medical records of 220 hospitalized and 311 nonhospitalized patients aged ≥18 years with laboratory-confirmed COVID-19 from six acute care hospitals and associated outpatient clinics in metropolitan Atlanta, Georgia. Multivariable analyses were performed to identify patient characteristics associated with hospitalization. The following characteristics were independently associated with hospitalization: age ≥65 years (adjusted odds ratio [aOR]=3.4), black race (aOR=3.2), having diabetes mellitus (aOR=3.1), lack of insurance (aOR=2.8), male sex (aOR=2.4), smoking (aOR=2.3), and obesity (aOR=1.9). Infection with SARS-CoV-2 can lead to severe outcomes, including death, and measures to protect persons from infection, such as staying at home, social distancing (5), and awareness and management of underlying conditions should be emphasized for those at highest risk for hospitalization with COVID-19. Measures that prevent the spread of infection to others, such as wearing cloth face coverings (6), should be used whenever possible to protect groups at high risk. Potential barriers to the ability to adhere to these measures need to be addressed.

Correction to Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks.

Correction to Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks.

Use of N95, Surgical, and Cloth Masks to Prevent COVID-19 in Health Care and Community Settings: Living Practice Points From the American College of Physicians (Version 1).

Controversy exists around the appropriate types of masks and the situations in which they should be used in community and health care settings for the prevention of SARS-CoV-2 infection. In this ar...

Unlocking UK COVID-19 policy

Unlocking UK COVID-19 policy

GERAKAN 1000 MASKER : PEMBAGIAN MASKER KEPADA YAYASAN KAKAK ASUH BALI KARANGASEM

The outbreak of the Covid19 virus has impacted the world. In Indonesia, 3.512 people are infected as of April 10, 2020. One of the WHO's advice on the use of masks for the community, was supported by Ministry of Tourism and Creative Economy (Kemenparekraf) with Gerakan Masker Kain ( Cloth Mask Movement). Many people in Indonesia do not understand the importance of using masks, and it makes STD Bali held Gerakan 1000 Masker (1000 Masks Movement ) with students and lectures involved in production and distribution in several areas in Bali. Gerakan 1000 Masker is important considering that not many people have the awareness and education to use masks against the Covid19 outbreak. Gerakan 1000 Masker Sekolah Tinggi Desain Bali, were carried out in several areas and foundations such as Yayasan Kakak Asuh Bali Karangasem on April 20, 2020 with the aim of giving masks to underprivileged children in Karangasem and raising their awareness together against Covid19 outbreak.

Re-usable Cloth Facemasks in the Covid-19 Era

Following the World Health Organization designating the ‘corona virus disease 2019’ (COVID-19) a global pandemic, there has been a global demand for production of PPEs (Personal Protection Equipment) to help fight the scourge. As there has been growing numbers of people getting infected, respective global governments and WHO have suggested necessary needs and measures to reduce escalation. In Kenya, the government has taken steps such as insisting on social distancing, encouraged use of face masks and controlled movement among other measures to slow the rate of transmission. These actions prevent a strain on the healthcare system which already has shortages of key equipment. Using textile technology and design, this study seeks to implement knowledge of the field to focus on protective measures that will immediately address prevention of the spread. The study focused on the development and testing of face masks for the public to help in prevention of COVID -19 spread. These masks were made from natural cotton fibre that is affordable, available and reusable. The mask was made using three layers of 7’’ by 7’’ pieces of fabric. The two outer layers were made of poly-cotton, while the middle layer was polypropylene fabric, used as a filter. Users of this product breathe comfortably through a double-layer of brand new poly cotton. Putting masks on the sick reduces their ability to spread the virus. It is generally believed that the primary purpose of cloth masks is to prevent spread of infections from the wearer.

COVID-19 Preventative Measures: Do-It-Yourself Cloth Face Coverings (Mandarin Chinese)

This is the Mandarin Chinese translation of FSHN20-31/FS373: COVID-19 Preventative Measures: Do-It-Yourself Cloth Face Coverings. It provides guidance for making and caring for facemasks. Written by Natalie Seymour, Mary Yavelak, Candice Christian, and Ben Chapman, and published by the UF/IFAS Food Science and Human Nutrition Department, May 2020. FSHN20-31C/FS390: COVID-19 Preventative Measures: Do-It-Yourself Cloth Face Coverings (Mandarin Chinese) (ufl.edu)

Cloth masks versus medical masks for COVID-19 protection.

Cloth masks versus medical masks for COVID-19 protection.

High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice - Skagit County, Washington, March 2020.

On March 17, 2020, a member of a Skagit County, Washington, choir informed Skagit County Public Health (SCPH) that several members of the 122-member choir had become ill. Three persons, two from Skagit County and one from another area, had test results positive for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Another 25 persons had compatible symptoms. SCPH obtained the choir's member list and began an investigation on March 18. Among 61 persons who attended a March 10 choir practice at which one person was known to be symptomatic, 53 cases were identified, including 33 confirmed and 20 probable cases (secondary attack rates of 53.3% among confirmed cases and 86.7% among all cases). Three of the 53 persons who became ill were hospitalized (5.7%), and two died (3.7%). The 2.5-hour singing practice provided several opportunities for droplet and fomite transmission, including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice. The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization (1). Certain persons, known as superemitters, who release more aerosol particles during speech than do their peers, might have contributed to this and previously reported COVID-19 superspreading events (2-5). These data demonstrate the high transmissibility of SARS-CoV-2 and the possibility of superemitters contributing to broad transmission in certain unique activities and circumstances. It is recommended that persons avoid face-to-face contact with others, not gather in groups, avoid crowded places, maintain physical distancing of at least 6 feet to reduce transmission, and wear cloth face coverings in public settings where other social distancing measures are difficult to maintain.

Does Collective Interest or Self-Interest Motivate Mask Usage as a Preventive Measure Against COVID-19?

The revised guidance on masks from public health officials has been one of the most significant COVID-19 policy reversals to date. Statements made at the outset of the pandemic, including those from the World Health Organization (WHO), the United States Surgeon General, and the Chief Public Health Officer of Canada, all actively discouraged asymptomatic members of the general public from wearing masks. However, on April 3, 2020, the United States Center for Disease Control and Prevention (CDC) issued new recommendations that called for nonmedical masks, such as cloth face coverings, to be worn in public settings where other social distancing measures are difficult to maintain (Adams, 2020). Canadian public health officials quickly followed with their own guidance for wearing nonmedical masks or face coverings when out in public; however, they have stressed that doing so is optional for asymptomatic persons and should be seen as a complement to existing precautionary measures such as physical distancing and hand hygiene, particularly in cases where physical distancing may not be feasible (Public Health Agency of Canada, 2020). Emphasis was placed on nonmedical masks serving not to protect the wearer, but rather others who come within close proximity of the wearer. Echoing her public statements on the matter, Canada's chief public health officer Tweeted that “[w]earing a NON-MEDICAL mask in public settings has not been proven to add any protection TO the person wearing it, but it can be an additional way to prevent spread FROM an infected person to others” (Tam, 2020).

COVID-19 Outbreak Among Three Affiliated Homeless Service Sites - King County, Washington, 2020.

On March 30, 2020, Public Health - Seattle and King County (PHSKC) was notified of a confirmed case of coronavirus disease 2019 (COVID-19) in a resident of a homeless shelter and day center (shelter A). Residents from two other homeless shelters (B and C) used shelter A's day center services. Testing for SARS-CoV-2, the virus that causes COVID-19, was offered to available residents and staff members at the three shelters during March 30-April 1, 2020. Among the 181 persons tested, 19 (10.5%) had positive test results (15 residents and four staff members). On April 1, PHSKC and CDC collaborated to conduct site assessments and symptom screening, isolate ill residents and staff members, reinforce infection prevention and control practices, provide face masks, and advise on sheltering-in-place. Repeat testing was offered April 7-8 to all residents and staff members who were not tested initially or who had negative test results. Among the 118 persons tested in the second round of testing, 18 (15.3%) had positive test results (16 residents and two staff members). In addition to the 31 residents and six staff members identified through testing at the shelters, two additional cases in residents were identified during separate symptom screening events, and four were identified after two residents and two staff members independently sought health care. In total, COVID-19 was diagnosed in 35 of 195 (18%) residents and eight of 38 (21%) staff members who received testing at the shelter or were evaluated elsewhere. COVID-19 can spread quickly in homeless shelters; rapid interventions including testing and isolation to identify cases and minimize transmission are necessary. CDC recommends that homeless service providers implement appropriate infection control practices, apply physical distancing measures including ensuring resident's heads are at least 6 feet (2 meters) apart while sleeping, and promote use of cloth face coverings among all residents (1).

Ozone Disinfectants Like SoClean CPAP Sanitizer can be used to Sterilize Cloth and n95 Masks in the Protection against COVID-19

Ozone Disinfectants Like SoClean CPAP Sanitizer can be used to Sterilize Cloth and n95 Masks in the Protection against COVID-19

COVID-19 Preventative Measures: Do-It-Yourself Cloth Face Coverings

This one-page full-color handout depicts essential components of face coverings for non-medical use and includes the following information: Cloth face cover designs Selecting Fabric Caring for a Cloth Face Covering Sewing Cloth Face Coverings for Donation FSHN20-31/FS373: COVID-19 Preventative Measures: Do-It-Yourself Cloth Face Coverings (ufl.edu)

COVID-19 Preventative Measures: Cloth Face Coverings for Food Employees

This one-page full-color handout depicts essential components of a cloth face covering for use in food settings and provides information on the following topics: Wearing cloth face coverings in food settings Caring for a cloth face covering How should cloth face coverings be worn? FSHN20-33/FS375: COVID-19 Preventative Measures: Cloth Face Coverings for Food Employees (ufl.edu)

COVID-19 Preventative Measures: Bandanas as Cloth Face Coverings

This one-page full-color handout depicts two options for folding a plain bandana and describes the following: Using bandanas as cloth face coverings Caring for bandanas How should Bandanas be worn? FSHN20-32/FS374: COVID-19 Preventative Measures: Bandanas as Cloth Face Coverings (ufl.edu)

COVID-19 Preventative Measures: How to Use Cloth Face Coverings

This half-page fact sheet answers the following questions: How should face coverings be handled? How do masks and cloth face coverings work? How should face coverings be worn? FSHN20-30/FS372: COVID-19 Preventative Measures: How to Use Cloth Face Coverings (ufl.edu)