Why Wear a Cloth Mask?

A Few Facts and Some Patterns To Get You Started

People are asking, "why wear a cloth mask if we know they aren't 100% effective against airborne viruses?"  I'm here to say it is worth it, and here's why... [If you're just here for patterns, skip to the bottom. ;)]

First of all, it's important to be aware that every virus has a "target" in the body where it is most effective at making a person sick. When a virus reaches its target location, it then has the best resources it needs to grow and become most dangerous to the body. Covid-19's target is the lungs. So it makes sense to put on a barrier to prevent it from directly reaching its target. People will often argue that the virus can still get into our bodies through our eyes and ears. That may be true, but this means that the body's immune system will have more time to fight viruses off before they reach their target locations and become more formidable.

Second, it's also important to be aware that the amount of virus particles you are exposed to can drastically affect your chances of fighting it off. If you are directly breathing in the air of an infected person, millions of virus particles are going directly into your lungs. This can be overwhelm your immune system, and will take much longer to fight off. If you can reduce that amount by at least 50% with a mask (paired with distancing), you're giving your body a much better fighting chance. You might even give your body a chance to build up immunities.

It is true: studies show that common cloth materials used for masks are only about 50-73% effective at filtering airborne particles, but that is better than nothing! In some situations, 50% really matters. For example, say you go to the grocery store and someone with the virus sneezes nearby. If you were a fair distance away and then walk towards them, that 50% might have been all you needed in that situation to protect yourself from getting ill, because your DIY mask protected you from breathing in those last few virus-filled droplets of water still lingering in the air...

Another concern with cloth masks is that moisture can collect on your mask. Over time, more airborne particles can collect, eventually causing you to ingest or breathe it in, which in some cases can have the opposite effect of protection. Again, that's still better than breathing it in directly, but this is why you should still practice social distancing when wearing them, and also why you should not be wearing the same mask for hours and hours. Two hours is plenty of time to wear a mask.

As a former lifeguard and first-responder, I learned that you breathe out at least 20% of the oxygen you breathe in, hence we are taught in emergencies to breathe into drowned peoples' lungs with the use of a barrier. This tells me you're not going to asphyxiate if you wear a cloth mask unless you psych yourself out, especially since most cloth masks do let oxygen through. People with medical conditions should consult their doctors on this matter. But overall, you should make sure your mask material is a decent enough barrier while being breathable (see facts below).

My research about masks began back in February, when my mother-in-law (who is a dental hygienist) mentioned that her office might run out due to shortages. I wanted to make her something which could act as a barrier for her so that she wouldn't have to be out of work, so I began researching on a medical level. I even made my own prototype with polyethylene materials and had her put it through the autoclave at work to see if it would hold up (it did). I began to learn more and more about masks, filtration, and covid-19. This and discussions with my siblings (doctors, dental assistants, and a microbiologist) has helped me get a handle on surgical masks, how they are used, and how hospitals were/are dealing with mask shortages.

Also--disclaimer--I am not a medical professional, and obviously this should not supersede any medical advice from your doctor or health care professional. I am compiling my research for your benefit. If you find anything incorrect here, please let me know!

A Few Facts About Masks

• Surgical masks are not primarily designed to filter air, but to act as a barrier to prevent larger particles in the air from going directly into the lungs (for example, droplets from a person's breath, or kicked up particles from dental drills)
• Masks designed to filter air are those which fully seal around your nose and mouth. (surgical masks don't seal, but again, still act as a good barrier)
• n95 is a non-woven, spun plastic (polyethylene) material made to filter out the tiniest airborne virus particles. It has been heavily tested and found to be nearly 100% effective at filtering airborne bacteria and viruses. It is the standard material used to make medical-grade quarantine masks. (click here for stats and studies)
• People often use the term n95 to refer to medical-grade quarantine masks made from n95 material.
• Masks with pleats, or that stick out from your face, and have multiple layers are more effective because they have more surface area to filter particles.
• Concerning materials used at home, dish towels were the most effective common material tested at 74% filtering effectiveness (probably due to the threads which stick out, creating greater surface area for filtration).
• Cotton blend t-shirt material comes in second place at 70%
• 100% cotton fabric filters out 51% of virus-sized particles. A lot of people are making masks out of this material because of its breath-ability, but they should also be lining them with filter materials.
• Many baby wipe brands make their wipes out of n95 material. (I do not know which specific brands use the material, so if you find out, let me know!), and can be used as filter material in cotton masks.
• Dust masks also seem to be only around 50% effective.
• No mask is 100% foolproof. Even n95 quarantine masks have a tiny margin of error.
• There are many different kinds of surgical masks which have a wide range of uses and effectiveness and are not all created equal. Again, their main purpose is to be a barrier from splatter or dust. They are usually made from water resistant materials (made from stable, lightweight breathable plastics such as polyethylene) to avoid wet particles sticking to the masks. 
• Due to shortages, many hospitals are using masks in creative ways. For example, at my sister's hospital in Tulsa, doctors and nurses are using lightweight washable cotton masks over their n95 quarantine masks to make the n95's go further. So, call your local hospitals to find out what kind of masks they need and continue to make them and donate them!

Wearing/handling/washing masks

1. If you are an essential worker who has to be around people all day: make yourself 5 or 6 surgical masks (or buy them), and switch them out after 1-2 hours during your 8-hour workday. Take breaks outside and away from people so you can have time to get fresh air without having to wear a mask. When you get home, throw your clothes--and cloth masks--in the wash and then go take a shower (see # 4 below)
2. While wearing a mask, your breath sucks all the airborne particles towards your face, concentrating it on the front of your mask... so be sure not to touch the front of your mask (I see people doing this constantly), but pull it off from the ear or back of the head, depending on how they stay on.
3. Leaving your nose uncovered is useless. It may utilize your body's natural air filtration system, being slightly better than breathing through your mouth,  but you can still easily breathe virus particles directly into your lungs through your nose as well as breathe virus particles directly out.
4. You do not need to wear masks outside unless you are in close proximity to people, as your breath quickly dissipates in the atmosphere (indoors it does not dissipate nearly as quickly)
5. Keep clean masks in one sealed plastic bag, and put used masks in a separate plastic bag.
6. For washing cloth masks, the CDC says putting them through the laundry is sufficient for cleaning. You can also leave them out for 24 hours for any virus particles to die off (if they are plastic or polyester, leave for 72 hours, preferably in the sun when possible).

Misc. facts

• Washing your hands is far more effective than using hand sanitizer because any remaining living virus or bacteria particles are rinsed away (I wrote a post about washing produce, which will give you more confidence in your common dish and hand soaps)
• Hand dryers in public bathrooms can kick up a lot of bacteria and virus particles, so it's best to just avoid them.

Mask Patterns

These are some good ones I've found so far...

1. CDC's guide for wearing and making face masks . This has a lot of good information and three simple patterns; one is even a simple folded bandana for people with no sewing skills.
2. HOW TO MAKE FACE MASK WITH FILTER POCKET AND ADJUSTABLE WIRE | SEWING TUTORIAL (YouTube). Here's a pattern for a cotton surgical mask with a pocket for replacing filters. It also allows the elastic band to be replaced if it breaks. I have made several of these with some modifications and everyone says these are super comfortable compared to many others. (I use a 16-gauge wire to line the width of the mask with a 1.5-inch slit in the center so you can remove the wire).
3. Joann's also has a simple mask pattern with fusible interfacing. I haven't made these, but I would be concerned about comfort with the interfacing rubbing the face and nose
4. Four different face masks... (YouTube). For a legit quarantine-worthy mask pattern, here's a video of a doctor explaining how mask tests are done, materials she used for four different types of masks, and even gives a pattern tutorial at the end of the mask which passed the test. She does mention, for small chins, this one requires tape to be fully effective. So, if you can get your hands on n95 material (or halyard as she suggests), you might be able to make a legit, fully-effective quarantine mask.
5. While I was waiting for my fabric to come in, I was drying out baby wipes and sewing them into dust masks as liners for grocery shopping (since the dust mask has a decent seal around the face, but only minimal filtration). It only takes 10 minutes to pleat a couple of dried baby wipes and quick stitch them into the inside of a dust mask. These, however, are one-time-use only dust masks because they aren't washable (or, I suppose you can set them aside for 3 days to let the virus die off and then reuse).

I will be updating this when I come across new information. Until then, I hope this helps you on your pandemic endeavors! And if you have more info to share, please do!

Other Sources:

Simple Respiratory Protection—Evaluation of the Filtration Performance of Cloth Masks and Common Fabric Materials Against 20–1000 nm Size Particles.  Some studies on masks of varying materials and their effectiveness against airborne particles as compared to n95 material.

Mask Selection Guide. One company's chart with different masks and their purposes/effectiveness.

Photo by Laura Dewilde on Unsplash