Dr. Patricia Farrell on Medika Life

Not Simply Masking, But Double Masking Is Needed

One face mask may not be enough to protect you. Now the trend is double masking for safety from COVID-19 and its variants.

“If you’re going to the grocery store or you are an essential worker coming in contact with a lot of people, I recommend wearing a cotton mask over a surgical mask which can catch more than 90% of respiratory aerosols.” — Joseph Allen, Harvard University

Ever want to be a superhero? Today, it’s as simple as wearing two masks, not one, during the COVID-19 pandemic. The move from calls for simply covering your face with a bandana or a folded t-shirt has now caught up with the science. One mask isn’t sufficient to protect you and us.

The idea that a single, homemade facemask would be adequate protection was thought of as a good idea by Dr. Jerome Adams, the Surgeon General of the United States. He encouraged people to follow his demonstration of a DIY mask that was uploaded to Youtube. “With items, you can find around the house.”

Making your own masks may be the only option for some people, but here it’s a matter of quality of the material.

If you’re making a cloth mask from 600-thread-count Egyptian cotton sheets, that’s different than making it from a cheap T-shirt that’s not very finely woven,” according to Dr. Ramzi Asfour, an infectious-disease physician.

Photo by Ramille Soares

Sorry, doc, that that ain’t good enough and it never was good enough. You tried, but it was a failed effort.

The N95 mask and other masks, used in healthcare settings and difficult to find in stores, were seen as the protection needed. But was it sufficient? Studies are now revealing that even this mask may not be adequately protective.

“…an N95 mask reduces the droplet leakage around the mask edges during the cough. However, the pressure inside the mask increases during coughs and the turbulent jet is directed through the front. Although both surgical and N95 masks decelerate the turbulent jet, none of them will prevent the droplets entirely from penetrating or escaping the mask, i.e., droplet transmission.”

Both mask leakage due to material construction and the saturation of the mask are prime factors requiring consideration in preventing droplet dispersion. Here, in the delicate interplay of weave and fiber characteristics, i.e., the smoothness or fuzziness of fiber, the true dynamics of a cough or virus spread must be calculated. While the CDC recommends cloth masks for the public, are they sufficient? Seemingly not.

What other factors besides the material of the mask must be considered? Numerous elements are brought into play, such as cough volume, droplet size, distance from an infected person, and the mask’s fit.

The mask-to -face fitting is important. Even in the case of a tight-fitting scenario, if there exist some small openings, this can lead to additional leakage of droplets around the mask, which cannot be ignored.

Copyright: Montian Noowong

The Case for Doubling Masking

The case has been made for the need to wear a mask and the seriousness of transmission of a virus. Even wearing a mask, depending on the type, nothing appears to provide 100% protection, and many masks offer more than slightly 50% to the wearer.

Concern is now being expressed regarding the new variants of the COVID-19 virus, its virility, and its high transmission rate. Both of these together may indicate that a smaller quantity of material may be just as deadly or result in more infections. The secret to this increased infection by variants lies in its molecular shape, which affords a more efficient bonding and access to cells.

The N501Y mutation seems to refine the shape of the puzzle piece, allowing a tighter fit and increasing the chance of a successful infection.

Whether or not this is the case, it makes sense to increase our protection as an additional measure to maintain health. Present vaccines may prove to have decreased effectiveness in treating these new variants. Masks need to be more efficient, and therein lies the rationale for double masking.

Based on these (research) findings, we recommend a three-layer mask consisting of outer layers of a flexible, tightly woven fabric and an inner layer consisting of a material designed to filter out particles. This combination should produce an overall efficiency of >70% at the most penetrating particle size and >90% for particles 1 μm and larger if the mask fits well.

The research may not have caught up with the variants yet. Is a three-layer, single mask the solution, or should a more aggressive approach be taken? The new attack of the virus variants has been a game-changer. Seemingly, the thinking is that two masks, not one, may be the answer even if it has three layers.

The reasoning is that wearing more than one mask may inhibit the viral blobs’ pathway that reaches you. If the masks can trap those particles, you may be safe, but they remain in the mask, don’t they? This, then, makes a case for changing your mask and not continuing to carry around a mask full of viruses.

Isn’t it worth your health to change your mask and not hang on to it?

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Pat Farrell PhD
Pat Farrell PhDhttps://medium.com/@drpatfarrell
I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.


Medika Editor: Mental Health

I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

Patricia also acts in an editorial capacity for Medika's mental health articles, providing invaluable input on a wide range of mental health issues.

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