Get the Right One! Use It Properly
Why A Mask May NOT be Enough
Who am I? I am a dentist who has done a lot of thinking about prevention of, and protection from, infectious Disease. I have researched masks, and other protective equipment as part of my Avian Flu planning for my own dental Practice. For years now, we dentists have protected ourselves from blood borne viruses (hepatitis and HIV). Now we confront a more difficult problem, Bird Flu airborne virus. I don't claim to have all the answers on this one (research into mask efficacy and use is ongoing and there are experts with diverse opinions). My hope is that the site supplies ideas for your further thought and investigation.
A disclaimer: This site is offered for informational purposes only. The intention is not to provide professional advice, since everyone's situation is different. Ads that appear in the margins are not selected or endorsed by me. I do not know what ads will appear. Thanks for visiting. Please prepare, stay calm, remember that we are all in this together (humans and all species) and make wise decisions.
Lynne Heckert, DDS, JD
Do You Need a Face Mask?
Whether non-health care workers, and those who are not bird cullers and first responders, need a face mask is being questioned by some 'experts.' There are two concerns: First, if the public buys all the masks, hospitals will not get them; Second, masks worn without a concept of how the virus behaves may give people a false sense of security.
My own opinion is simple: If I think I may contact a virus, one that is known to kill, and I know that virus is transmitted by my breathing it in, I want a mask. I want the best mask I can get. I want something between me and that virus when someone on a bus or airplane sneezes. The fact that a mask may not give me one hundred percent protection will not stop me from doing the best I can in the situation. Partial efficacy is better than no barrier at all.
How Do Humans Catch Bird Flu?
In this question lies the key to prevention. Right now, the modes of transmission are not totally clear but we do know certain things:
Bird Flu Protection From Infected Birds: Look out for bird droppings (where infectious birds are in the area). These can be on the ground, in dust on dead birds. Do not butcher birds that could be infected, nor kiss them, allow their fresh blood or saliva into your mouth. Do not pick up dead birds. Cook poultry and eggs well before eating them. Workers culling birds will have stricter guidelines. Photos all over the Internet show workers without the proper clothing, masks and eye protection. This is sad.
Bird Flu Protection from Infected Humans: Assuming the virus mutates/recombines so that it can be spread human to human, we can guess how it is most likely to be transmitted. Sneezes and coughs will propel droplets from the mouth and nose into a wide area. Mucous from noses and mouths (possibly eyes) will spread via hands and sneezes to other people's noses and eyes, food served, door knobs, surfaces, etc. Human feces may be a problem as well and possibly even human blood. But the major consideration for most people is going to be airborne and surface spread. Protect mucous membranes, wash hands, watch what you touch and keep your hands out of your mouth.
Flu Face Masks: Wear the Right Mask
Consideration in choosing a mask include Bacterial filtration efficiency, sub-micron (e.g., virus) particle filtration, resistance to fluid/ blood, "breathability" and cost.
Viruses are much smaller than bacteria. Flu viruses are very small viruses. An N-95 mask is best for filtration when one is dealing closely with flu. The virus is carried in mucous and thus the mask should be fluid resistant. Unfortunately, the better a mask filters, the harder it is to breathe when using that mask. And the N-95 masks are more expensive. Do you want to trade comfort and cost for safety? I cannot answer that question for you. If you are a nurse working with flu patients, you will want the N-95 it is available. If you are riding a bus or taking a walk, you may compromise.
Here are the choices:
A. N-95 Mask: The Ultimate, but not always easy to breathe. Fluid resistant and at least 95% efficient against solid and liquid particles larger than .03 microns, excluding those containing oil. (The "N" stands for Not oil proof) The N-95 or higher is a best choice if one expects to be exposed to influenza. The fit is important so that there are no leaks between the mask and face. Consider smaller sizes for children.
A " Duck-Billed" shape N-95 is available that allows extra breathing room for the face and nose.
B. Fluid Resistant Surgical Procedure Mask: Not optimal but not a good second choice. These are not recommended for those working with patients infected with flu. They do offer some protection and are more comfortable and less expensive. High performance surgical masks exceed 99% filtration efficiency at 0.1 microns. Again, fit is important with airborne disease.
Procedure masks that would be fine for dentistry and surgery, blood splatter and blood borne pathogen protection (hepatitis B and HIV) do not filter smaller airborne viruses like influenza. Still, it seems likely that they would offer some protection and would be better than nothing.
Not to be relied upon are simple dust masks and procedure masks not meeting these fluid resistant and filtration standards. Most are not fluid resistant nor do they filter flu virus.
Flu Face Masks: Wear the Mask Right!
The Face Mask Must fit Correctly. Loose fits where the mask meets the face allow airborne particles to flow under the mask. The mask should have metal that firms to the nose and it should extend under the chin.
The Mask Must Be Worn Correctly When Worn. The mask should be either worn or not worn. It should not be allowed to be worn half way, hanging from the ear, etc.
The Mask Must be Removed Correctly. Perhaps you have encountered the virus while wearing your mask. It protected you! Then you forget that virus particles have landed on the OUTSIDE OF THE MASK. This can be fatal. Wear the mask once and remove by placing it into a plastic bag and then disposing of it. Use gloves to handle and discard the gloves.
Can Masks be Re-worn?
Officially, the answer is "no." Still, in a mask shortage, re-wearing may be necessary. Results of studies will be coming out soon regarding disinfection, reuse, etc. Used masks get wet and soggy from exhalation as well. The virus lives for days (weeks?) on surfaces so mask handling is going to be quite an issue.
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