CATER Mask Decisions

February 4, 2021

Three Step Mask Program Tomorrow will Show that Masks are the Best Weapon to Combat COVID

Mask Efficiency will be as Important as Vaccine Efficacy

Masks can be Made Available More Quickly Than Vaccines

Important Findings on Mask use by PatientKnowhow

Two Percent Gap Can Cause Fifty Percent of the Air to Circumvent the Media

Comfort Clip Designed to Provide Optimal Mask Fit

______________________________________________________________________________

Three Step Mask Program Tomorrow will Show that Masks are the Best Weapon to Combat COVID

The webinar will provide further evidence that tight fitting efficient masks will save many thousands of lives. But it takes coordination of suppliers, researchers, and governmental organizations to make this happen.

The three steps are (l) launching an awareness blitz, (2) advise on which masks should be worn and (3) prioritize masks for the vulnerable.  The three steps are described in detail in previous Alerts.

January 27 - Description of the three step mask program

January 28 - Outline of the three steps

February 2 - Step 3

Devabhaktuni Srikrishna founder of PatientKnowhow will be reporting on his recent survey to  determine what masks  are being worn by the public and when do they use them. Some highlights are shown below.

Click here to register for the February 5 webinar:

 https://home.mcilvainecompany.com/index.php?option=com_rsform&view=rsform&formId=92

Mask Efficiency will be as Important as Vaccine Efficacy

Vaccines protect people who inhale COVID. Masks insure that people will not inhale COVID. If both transmitter and recipient are wearing masks which are 90% effective, the combined impact is a 99% risk reduction. However, mask wearers will not wear the masks at all times when they should. They will not wear masks while eating. So masks may end up being only 80% effective in reducing risk despite all the efforts to require adherence to safest guidelines.

If everyone were vaccinated there is the potential for a 94% risk reduction. Some vaccines are only 60% efficient. With new variants there may be ones developing that resist all the present vaccines. It is therefore reasonable to assess a risk reduction of 70%.

Sanitizing as a standalone measure provides low risk reduction. If the transmitter is wearing an effective mask there will be very little COVID reaching surfaces. Since the virus acts like perfume partitions are not effective as a stand alone measure and are even less effective if everyone is in tight fitting masks. 

The exception would be dining areas where people take off their masks. Partitions can help to direct air away from the potential recipient. But this is only where the HVAC and air filters are properly designed.

HVAC can play a role in making needed  reductions. It would be very costly to provide 100 fpm HEPA filtered air from the ceilings down past all occupants and then down through perforated floors as in a pharmaceutical cleanroom. Instead the HVAC can be working in tandem with effective masks to supply MERV 16 filtered air in general areas and HEPA filtered directed air in eating areas, elevators, speaker podiums, locker rooms, and other critical areas where masks cannot be worn or where the virus load is considerably higher than the average throughout the space.

If the HVAC is combined with effective masks and wide spread vaccination there is a risk reduction considerably higher than 99.0%.

Masks can be Made Available More Quickly Than Vaccines

In wealthy countries tight fitting efficient masks can be made quickly available. Vaccines will take more time. By July 1 in wealthy countries vaccines will cut the death rate by 30%. But in combination with masks the deathrate will be reduced 65%.  By January 1, 2022, the vaccines alone will account for a 60% drop in the deathrate.  But in combination with masks the deathrate will drop by 96%.

Due to the ability to protect people quickly with masks, they are the best weapon to fight COVID.  As more people are vaccinated in wealthy countries the combination of vaccines and masks provides a 99% risk reduction.

Masks make a bigger difference in the poorer countries. The risk reduction impact of vaccines will be very low in 2021. It will reach 20% in early 2022 and rise only to 70% by January 2024.

It will take longer to ramp up to supply masks to poorer countries. But by January 2022 vaccines alone will only create a 25% risk reduction whereas compared to over 50% for the mask, vaccine combination.

This assumes a cautious approach by mask makers. They do not scale up to provide all the masks which are needed initially. But as vaccines take on a bigger role in the wealthy countries, the mask makers divert production to the poorer countries.

Many more lives will be saved if the wealthy nations subsidize mask programs in the poorer countries. In this case the masks would be the primary weapon for risk reduction the next 12 months. Epidemiologists point out that the wealthy nations can justify subsidies to the poorer nations just on economic grounds.

This approach based on risk reduction does not address quantitative risk. Herd immunity will be achieved by a combination of masks and vaccines or even just by masks. The experts talk about herd immunity being when 70 to 80% of the people are immune.  With tight fitting masks this equivalent is achievable  easily. We have quoted experts predicting that the pandemic would be over in four weeks if everyone wore a tight fitting efficient mask.

Important Findings on Mask use by PatientKnowhow

Devabhaktuni Srikrishna founder of PatientKnowhow will be reporting on his recent survey to  determine what masks  are being worn by the public and when do they use them. Here are some of the findings.

This survey is very helpful in laying out the challenge ahead. Making the masks available is just one step. Guiding the purchaser to buy the right mask and then making sure he wears it properly and in appropriate settings are both equally important.

The full text is found at http://www.mcilvainecompany.com/PDF/maskusagestudy.pdf

Two Percent Gap Can Cause Fifty Percent of the Air to Circumvent the Media

FFP2 masks are the most recommended against coronavirus, as they protect others if you are infected and also prevent you from contracting the virus if used correctly. However, not knowing how to put them on properly can lead to some problems.

The latter is what a world expert on aerosol transmission José Luis Jiménez, a Spanish scientist who works as a professor at the University of Colorado (United States), warns against. Through a thread on his Twitter account, he has explained the dangers of not fitting the FFP2 mask correctly to the face:

The ADJUSTMENT is a very big problem for the use of masks for the general population. By holes that seem small to us passes half of unfiltered air. In this video (U Delft) three masks are seen, the N95 and surgical are poorly adjusted and have many leaks pic.twitter.com/UmgpFkybAd-

Jose-Luis Jimenez (@jljcolorado) February 1, 2021

"Through gaps that seem small to us, half of the air passes unfiltered," warns the expert, referring to the fact that aerosols can spread through the environment if the FFP2 is not properly placed. This could lead to new infections even when wearing the mask.

Jiménez explains that a 2% gap is enough for 50% of the unfiltered air to escape. And this does not only occur with FFP2 masks but can occur with any type of mask.

Fernando Simón points out which masks are the best for self-protection from COVID-19.

In his Twitter thread, the expert asks the population to look for the best possible fit when putting on the mask: "You have to work quite hard and adjust the nose portion very well so that it's really sealed." He also comments that intensive education campaigns are needed to teach people how to put the mask on properly.

"If they are worn badly, because of their shape, they can create more of a gap than good fabric masks, and in the end they work worse," says Jiménez, referring to FFP2 masks and their design, which, despite being safer, presents difficulties for a correct fit.

Finally, the Spanish scientist asks that in the future masks that are just as effective but easier to fit be manufactured and distributed free of charge among the population: "It would have a much lower cost than lockdowns, health expenses, closing bars and restaurants, general damage to the economy, etc."

Read the original article on Business Insider España. Copyright 2021.

Comfort Clip Designed to Provide Optimal Mask Fit

The Comfort Clip for Face Masks is an innovation by PACIFIC PPE that builds upon the USA's National Institutes of Health's clinically tested and open sourced Surgical Mask Tension Release Band for Ear Comfort & Extended Uses (Davis Becker, April 1, 2020). Harnessing geometric curvature and material-flex, the Comfort Clip is designed to provide an optimal fit for all head shapes and comes in Small, Medium and Large sizes (Extra Large Comfort Clip Coming Soon).