COVID-19 AND FACE MASKS
Since the start of the COVID-19 crisis, the mask shortage has led to the appearance of a large number of new manufacturers. Although for the majority of countries, mask-wearing was a cultural norm even before the coronavirus outbreak, many questions about masks, their type, and use remain.
According to mass media reports, data received from the Ministries of Health and Centers for Disease Control and Prevention of different countries is contradictory: someone says that wearing masks is not necessary, others recommend wearing masks everywhere.
When we talk about face masks, we refer to a particular type of Respiratory Protection Equipment, the disposable air-purifying particulate respirators, made from filter materials to remove contaminants from the air. They are only effective at protecting the wearer against particles (not gases or vapors) and are discarded when they become unsuitable for further use.
Although every disposable mask seems to be the same item functionally – a face mask covering the mouth and nose, the COVID-19 has clearly demonstrated a lack of clarity in the face mask market.
N95, FFP2, KN95 – What is the difference?
Everybody might have heard of N95, FFP2, and KN95. These masks are the most demanded on the market, but the distinctions between the different forms are still not clear for many people.
To start with, N95 – US National Institute for Occupational Safety and Health’s (NIOSH) has assessed the efficiency of these masks against solid particles. The N stands for “Not resistant to oil” and 95 for the percentage of particles collected by the filter. Thus, an N95 respirator refers to a filtering facepiece respirator (FFR) that seals tightly to the face and filters at least 95% of airborne particles. It is not resistant to oil.
There is a difference between standard N95 respirators and surgical N95 respirators. While standard N95 respirators reduce particles inhaled by the wearer, the surgical N95 respirators are designed to help reduce particles both inhaled and expelled by the wearer; they are fluid resistant, which makes them usable in situations when expelled particulates must be contained or fluid resistance is required. The surgical N95 is both certificated by NIOSH as an N95 respirator and also approved by the US Food and Drug Administration (FDA) as a surgical mask.
FFP2 is usually referred to as the European equivalence for N95. There are three categories of FFP masks classified depending on their filtration efficiency and the maximum percentage of inward leakage (due to the poor seal to the face). An FPP1 mask filters at least 80% of particles and has an inward leakage below 22%, while FFP2 filters 94% and has an inward leakage below 8% and FFP3 filters 99% with an inward leakage below 2%.
KN95 masks conform to the Chinese standard GB2626. They are equivalent to the European and US standards and have a filter efficiency of above 95% for non-oil-based particles such as those resulting from wildfires, PM 2.5 air pollution, volcanic eruptions, or bioaerosols (e.g., viruses).
VALVED OR NON-VALVED?
Many masks are equipped with an exhalation valve. It makes it easier to breathe and reduces moisture buildup inside the mask. However, according to the European Centre for Disease Prevention and Control, valved masks are not recommended for use as masks to prevent COVID-19 because air is exhaled through the valve without being filtered before entering the environment.
On March 13, 2020, the European Commission issued a recommendation stating that in the context of the current COVID-19 outbreak, non-CE marked PPEs were authorized in the European market. In Italy, the National Institute for Insurance against Accidents at Work (INAIL) issued a list of non-CE marked masks for placing on the market. The Dutch Minister of Health also temporarily allowed the marketing of non-CE marked face masks.
As for the United States, the FDA granted an Authorization for importing non-NIOSH approved KN95 respirators from China on April 3, 2020.
RECOMMENDATIONS OF DIFFERENT COUNTRIES ABOUT WEARING A MASK
As many countries are getting ready to reopen their borders and allow gatherings in public places, thus putting an end to the lockdown, the question remains whether mask use should become mandatory in public places. For Asian countries such as Taiwan, Japan, Hong Kong, where the use of masks was relatively common before the COVID-19 pandemic, the answer seems obvious. However, in other countries, there are many arguments against the mandatory wear of masks, such as the prioritization for health care workers in the context of mask shortage, the lack of direct evidence that non-medical masks are effective, and the creation of a false sense of security.
In Europe, there are still a few countries that consider face masks as a means of source control to reduce the spread of the disease. This category includes the Czech Republic (on March 18, the Czech Republic became the first European country to make wearing masks mandatory in supermarkets and on public transport), Slovakia, Bosnia and Herzegovina, Austria, Poland, and Germany. As for the USA, on April 3, the Centre for Disease Prevention and Control updated its guidelines to recommend that everyone should wear face masks in public settings where social distancing measures are difficult to maintain.
The main objective of this article is to make the world of masks clearer and underline the unregulated nature of the mask market. We strongly recommend being careful about the quality and efficiency of the masks available on the market.
STAY HEALTHY AND KEEP WELL!