The effectiveness of face masks depends on the skill of the wearer
In the wake of the coronavirus outbreak, the current advice is that face masks should only be worn by people who have respiratory symptoms, not healthy members of the general public – but people are unlikely to follow this advice unless the reasoning behind it is clearly communicated.
Speaking on The Skeptic Zone podcast, Trish Hann, a Sydney-based diagnostic radiographer and Australian Skeptics Committee member, explains exactly why face masks should only be used by people who are ill, healthcare workers, or people travelling in areas with a high community transmission rate.
What are the different types of face masks?
There are two main types of face masks: the surgical type, which protects against direct splashes, and the disposable P2 type, which also protects against airborne threats.
“P2 masks, when worn correctly, create a seal around the face preventing air from bypassing the mask,” says Ms Hann. “Surgical masks do not. In fact, surgical masks are often worn for long periods of time and by design have gaps at the side to allow air to flow across the face. This inherently reduces their effectiveness.”
The effectiveness of both types of mask is hugely dependent on the skill of the wearer and the type of mask they use, she says.
Surgical masks are difficult to use correctly
“As someone required to wear [a surgical mask] for long periods at work, I can tell you that you really don’t want to if you don’t have to,” says Ms Hann.
“They are exhausting to wear and hugely impractical in scenarios where you have to move faster than a snail’s pace.
“They’re also very difficult to actually wear correctly. And I don’t just mean it’s a pain to put on. The inside of the masks quickly gather condensation from your breath. And as you breathe in and out, they inflate and deflate, touching your mouth. Instinctively, you pinch and pull the mask off of your mouth. Hello contamination! Then the elastic starts to roll up or down the back of your head and now the mask is touching your eyelashes. Great. Now it’s slipped down there’s a gap next to your nose. Do you wear glasses because now you can’t see as they are fogged up. Fantastic. Honestly, they’re a nightmare.
“But when I’m faced with a measles patient, I will tolerate the mask. In fact, generally in medical settings, we primarily ask the patients to wear the masks as it stops them from coughing and sneezing on furniture, equipment and other patients.”
What about P2 masks?
One of the best ways to spread a contagion quickly is to is to give personal protective equipment to everyone without training them in how to use masks, says Ms Hann.
“Unless you’re in a high-risk environment, like working in a clinic or an emergency department, or traveling in an area with many confirmed cases, realistically, no [you shouldn’t be wearing a face mask to protect youself], especially not if you haven’t been trained in how to use personal protective equipment,” says Ms Hann.
“The mask you’re using to protect yourself will just as easily be a vector for contamination if it’s not used properly,” she says. “One thing I see a lot of when out and about is people wearing masks badly.”
One of the main issues associated with poor technique is that instead of protecting yourself by wearing a mask, you could easily infect yourself instead, says Ms Hann.
“Every time you touch the mask, you should wash your hands. Every time you take the mask off your face, it should be thrown away and replaced. Think about it. If you’re wearing a mask and talking with Sam who has a respiratory infection but doesn’t know it yet, every time they talk, tiny droplets are hitting your mask. Later on, you go and talk with Joe. And while you’re talking your mask is cutting into your nose, so you pull it away from your face. Carry on talking and touch something maybe your phone. Then perhaps you hand your phone to Joe to recommend a podcast. Joe touches their mouth later you rub your eye.”
In this scenario, wearing a mask without regular handwashing or changing of the mask is potentially increasing the risk of disease transmission.
The other risk of widespread mask use is that it creates a false sense of security, says Ms Hann.
“During the bushfires, a very real danger was a false sense of safety that masks were giving people,” she says.
“The general health advice was to stay out of the smoke and only go outside when absolutely necessary. But I saw people sitting in the park wearing masks when there was literally ash falling from the sky. They must have assumed they were safe because of the mask, which is absolutely not true.”
Supply issues
Another problem with thousands of people wearing masks badly and unnecessarily is that there is only a finite amount of them, says Ms Hann.
“Suppliers are starting to take advantage [of the face mask shortage] and price gouging is already happening,” she says.
“There are signs up in the operating theatres where I work reminding us not to waste them because the stock is now being kept under lock and key due to short supply. We are running out of surgical masks in the operating theatres. Patients and visitors have been caught stuffing their pockets with them when they think no one’s looking.”
So, ultimately what can we do to protect ourselves?
There are many practical safety measures that the general public can take before reaching for a face mask, says Ms Hann.
- If it’s pathogens you’re concerned about, first off, make sure you’re fully vaccinated and get your flu vaccine if it’s available, she says.
- Practice excellent hand hygiene and test your skills. Put some moisturiser on your hands, close your eyes and pretend you’re washing your hands. Then open your eyes and see the spots that you’re routinely missing.
- Stop touching your face. Stop touching your face. Stop touching your face!
- Please clean your phone occasionally. Clean things like doorknobs and taps in your home. We don’t know how long some pathogens can survive on surfaces.
- Practice excellent respiratory etiquette. Don’t cough or sneeze without covering your mouth. Ideally, use a tissue or the crook of your elbow. If you must cough into your hand, use the back of your hand and immediately wash or use alcohol hand rub.
- Support the work of unions to protect paid sick leave so the people making your food and driving you places can afford to take time off when they’re unwell.
Listen to the full episode here.
