Battling a virus with masks

Mask use, mask etiquette, and mask maintenance can go a long way in our fight against COVID-19

Information about SARS-CoV-2 is now being disseminated widely, if somewhat haphazardly. Concerns over the impact on our health, and the health of our loved ones, continue to dominate our thoughts and headlines. These concerns are of course justified; at the time of publishing this, India has recorded 1,39,868 confirmed cases of COVID-19.

The importance of using masks

The fact that the disease is spread by respiratory droplets and contact is now well understood. While mask use has been made a priority, there is insufficient information in the public domain about the role masks play in the containment of this disease, specifically about mask maintenance and mask etiquette. The maximum transmission distance of the virus aerosol — particles generated in the air during breathing, talking, coughing and sneezing — is about 4 metres. In a study conducted by the National Institute of Health, even after speaking, salivary particles were found to remain floating in the air for eight minutes. These points further emphasise the importance of mask usage.

With the rise in the number of infected individuals, many of whom remain asymptomatic, it is essential not just to wear a face mask but also to choose the right one. Disposable surgical masks are now more readily available in the market. It is crucial to avoid reuse of these masks due to the extreme drop in efficacy after even a single-use; additionally, surgical masks can’t be washed. Cloth masks bring with them the advantages of easy production and easy availability. Most importantly, cloth masks can be washed and reused. It is important to note that a study published in the Annals of Internal Medicine did not find a difference in the effectiveness of blocking SARS-CoV-2 between cloth and surgical masks.

In a study published by The Lancet, the virus was found to remain viable on surfaces for up to seven days, with the longest viability being noted on plastic and stainless steel surfaces. The question arises as to the ability of the virus to remain viable on masks. A study in The Lancet on the presence of the virus on face masks found that the inner and outer layer of used masks contained the virus up to seven days. A study published in the Annals of Internal Medicine reported higher contamination rates over the outer layer than the inner layer of the face mask, no doubt from the constant interaction between our hands and our masks, further reiterating the importance of hand hygiene.

Adopt best practices

Rather than worry about studies around the virus and its ability to remain on masks, we must embrace this opportunity to adopt the best practices available right now for mask maintenance. It is crucial to wash your cloth mask every day with detergent in a washing machine set to at least 60°C. If that is not possible, the cloth mask must be scrubbed by hand with soap for 30 seconds, while ensuring it soaks for at least 15 minutes before being rinsed in hot water. Attention should be paid to the duration of soaking. A study in The Lancet reported that the virus continued to be detected when the soaking time was reduced from 15 minutes to five minutes. It would be ideal, but not compulsory, to replace cloth masks after around 20 washes due to the reducing filtration capacity of cloth masks over time.

To obtain the best protection from your mask, ensure that it covers the mouth and nose and as much as possible, avoiding gaps between the face and the mask. Avoid touching your mask once you have worn it. While removing your mask, do not touch the front of it; the mask must be untied from behind. Before and after removing your mask, clean your hands with an alcohol-based hand rub or wash with soap and water. During use, if the mask becomes damp/ moist, change it immediately. Mask use, mask etiquette, and mask maintenance can go a long way in our fight against COVID-19. As responsible citizens we should help our government in this battle against the virus.

Nikita Mehra is an Assistant Professor of Medical Oncology & Researcher in Molecular Oncology at Adyar Cancer Institute. Views are personal