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Prevention: the mess of masks
Contagion Double mask
Last week, Dr. Fauci, the main adviser to the White House during the pandemic, made a statement in which he affirmed that wearing two masks at the same time could be more effective than wearing just one and pointed out: "As long as they are placed correctly".
Unfortunately, only the first part of his statements has made the headlines and it is important to make some nuance because, in our context, wearing "double mask" may not only be unnecessary, but even counterproductive.
Spain, one step ahead
In Spain, unlike other countries where they do not have specific regulations for hygienic masks (those made of cloth), we have the UNE0065 standard, which guarantees not only adequate filtration (similar to that of surgical masks, which is superior 90%), but also a correct breathability.
In other words, in our country, unlike others, we were pioneers in implementing a regulation that regulates that reusable fabric masks protect us and let us breathe at the same time.
Once the fabric and the shape of the mask meet the requirements already established by our health authorities and tested in the relevant laboratories,
does it make sense to use a second layer and generate new conditions that have not been tested in the laboratory?
If this were necessary, it would have been included in the standards.
Let's take an example: if it rains and we cover our heads with a blanket we will be somewhat more protected, but just by putting two blankets on our heads we will not be twice as protected.
If one blanket creeps, the second one will also end up doing it.
Now, if we wear a good raincoat in the rain we will not get wet, whether we use one or two.
With masks, as with many other things in life, it is also a question of quality, not quantity.
Fit should be a priority
Perhaps the most important of Dr. Fauci's statements has been precisely what he pointed out and yet for the vast majority of the media it has gone unnoticed: his emphasis on the importance of a good fit of the mask.
And it is of little use to wear the "Ferrari" of the masks if there are spaces between the mask and the face, letting the viruses "escape" from the top (nose) or the sides before passing through the filter.
In the same way, it will be useless to use the best raincoat if we leave parts of the body uncovered.
Let's remember: it is essential that the masks have a nasal clip and that we make sure that they are properly adjusted with the rubber bands.
Double mask: in which cases yes and in which cases no?
In spite of everything, there are some scenarios in which, for specific reasons, it may be useful to use a double mask.
These are some of the possibilities and we analyze when it would be useful and when it would not.
Surgical mask on FFP2
This "modality" is common among healthcare professionals to avoid splashes and aerosols coming from patients.
In this way, the surgical mask acts as a barrier, like an umbrella that preserves the more expensive FFP2, extending its useful life.
To give an everyday example: if a patient sneezes on the professional with a "double mask", the latter can remove the surgical one and discard it, extending the useful life of the FFP2, which is more expensive.
FFP2 mask on surgical
Wearing an FFP2 mask over a surgical mask is a mistake as it can worsen the fit.
Do the test if you have these two types of mask at home and you will see how when you put the surgical mask first and then the FFP2, the FFP2, which is the one that offers the greatest protection and whose adjustment has been tested, does not fit directly to the face thus losing part of its effectiveness.
Cloth mask + cloth mask that does not comply with the UNE0065 standard
In the case of fabric masks that do not comply with the regulations and of which we do not know their filtration, that is, in the case of putting a "random" piece of cloth that we have at home in our mouth, it is possible to use two masks It could be better than just one
It could be ... but the reality is that we do not know.
If with this we get at least a better fit, we will have gained something.
The question is whether right now it is responsible to use "walk at home" masks at a critical point in the pandemic, with a high incidence and having a sufficient supply of all types, hygienic, surgical and FFP2 according to the regulations.
Surgical mask + surgical mask or surgical mask plus hygienic mask that complies with the UNE0065 standard
In this case, it depends.
With these modalities, the filtration percentage is not improved as much as one might think, however, in some cases a better fit could be achieved, something that is also interesting and that Dr Fauci influences.
What could make these options worse is breathability and this is important to assess individually.
It is likely that, if breathability worsens, in addition to the obvious loss of safety, we will notice some discomfort, we will start to sweat (the typical "mustache sweat") and that consequently the mask will get wet, losing effectiveness.
If all this happens it is also possible that we touch it more than necessary trying to be comfortable, something not desirable.
I insist: if someone uses these double mask "modalities" because they feel safer in public transport or in poorly ventilated crowded spaces, my advice is that,
if your pocket allows it, use an FFP2
.
In summary...
- Surgical on FFP2 YES, to protect it from splashes, especially in the healthcare or care environment.
- FFP2 over surgical NO, because adjustment of the FFP2 is lost, which is a fundamental part when evaluating its efficacy.
- Surgical + surgical or surgical + hygienic is not necessary in general.
It should only be done if you breathe properly with them and you get a better fit.
In spaces where the risk is high, it is better to avoid these "fixes" and use FFP2.
Mandatory FFP2 masks?
The European Union says "no".
Given the controversy generated in recent weeks about whether their use should be mandatory, as is the case in some areas of Europe, last Wednesday the European Commission ruled that it does not recommend them for the general public in line with the criteria of the European Centers for Disease Prevention and Control (ECDC).
It does not seem that, for the moment, they are going to be mandatory in our country, although it is interesting to use them in public transport or crowded and poorly ventilated spaces, especially in people at risk, as we discussed last week.
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