Masking Up

Masking Up

New dad look :)

I have had a request to discuss masks as there is a lot of conflicting information floating around out there right now.  To begin, let’s discuss a little basic virology.  

Most viral infections are spread by contact or droplet. The virus is shed in our secretions (snot, tears, mucous, etc) and can be expelled into the environment by a cough or sneeze or it can be wiped or touched with a hand and then transferred from another surface, such as door knobs, eating utensils, keyboards, telephones, etc.  Typically, when expelled via a cough the particles can be found 2-3 feet from the source.  A six foot radius, therefore, provides adequate protection from those around you.  A person infected with a virus who is merely breathing will not appreciably expel any infectious particles.  

Some viral particles or bacteria are so small that they can be carried longer distances in air currents such as the chicken pox virus, tuberculosis or measles.  The COVID-19 virus is actually quite a large virus. It is not felt to be an airborne virus.  As such, is there really any need to wear a mask at all?  The answer is “yes”, but for two different reasons.  

The first scenario is for health care workers who are present within that 3-4 foot parameter of the patient during an episode of aerosolization.  This is a term denoting the virus being incorporated into a fine mist. A cough is a crude form of that process. There are procedures in the hospital that initiate this process such as high flow oxygen, non invasive ventilation (air flow through a mask), intubation (when the breathing tube is placed in the airway), nebulizer treatments and bronchoscopy (scope down the air tubes down into the lungs).  These scenarios have been shown to carry a very high risk of spreading the virus.

In the hospital, such events are avoided whenever possible, and when it is unavoidable, highly filtered masks and other protective equipment are used to avoid viral spread.  These are the “N-95” masks you may have heard of.  They are currently in short supply and are life saving for the medical community.  

The second scenario when a mask is useful is to simply help remind an individual to keep their hands away from their face.  Over the last month, I have been on many “Zoom” meetings and I can tell you that we all touch our faces more than we realize.  I see it all the time on the screen.  The likelihood that we will contract the COVID-19 virus by breathing it in the air is almost negligible if we are not in the hospital.  The most likely way to contract the virus is by touching something that is contaminated and then touching our face and introducing it into our body.  This virus has been shown to be highly contagious, it only takes a very small amount of virus can cause infection.

A basic masked I used on the night shift

As such, home made masks out of fabric or other material are very helpful.  In fact, many health care workers are using these masks during their shift.  If they need to enter a room, the N-95 mask will be put on and then the other mask can be placed on top of it. This keeps our fingers off of the N-95 mask, so it can be worn again.  We currently are using a brown paper bag to place the N-95 in so it can be reused.  This is not ideal, but sufficient until more masks are available. 

When using a mask, take care to hold it by the elastic or tie strings, so as to avoid touching the mask itself with your fingers.  This is important both when putting it on as well as taking it off.  Make sure to wash your hands just prior to handling it. Once it is safely taken off and stored, wash your hands again. 

 Those with medical conditions that would lend themselves to getting more severe disease have an even greater reason to wear a mask. These include patients with chronic lung, kidney or heart disease, cancer or any conditions that weakens the immune system, which includes pregnancy.  Just today my daughter-in-law has been admitted to the hospital to deliver her baby.  She was appropriately given a mask to wear through the whole process as was my son.  We trust that all will go well and this precious little baby girl will be with us soon.  As always, be careful and stay safe!