With the COVID-19 pandemic, face masks have been hard to come by. Due to the shortage, many people have begun to reuse masks and even hospitals have advised their staff to conserve PPE (Personal Protective Equipment) supplies such as face masks and gowns.
Since most masks were designed as disposable, single-use items, it begs the question - Is it actually safe to reuse masks during the COVID-19 pandemic?
Since there are many types of masks that are available, the answer to this question depends on the type of mask you are using. Now more than ever, it is crucial to understand the various types of masks and how they deal with the virus.
To help you, we’ve created this guide that details the various types of masks available along with the risks associated with reusing each one of them.
There are six different types of masks that we cover in this guide where we detail a few of their benefits and shortcomings and discuss how effective they are against coronavirus before going into how protective they are upon repeated uses.
The Types of Masks:
NIOSH (National Institute for Occupational Safety and Health) for fluid resistance, filtration efficiency (particulate filtration efficiency and bacterial filtration efficiency), flammability and biocompatibility.
The N95 certification specifically indicates that the filter is able to remove 95% of small ultra-fine particles with a diameter of 0.3 micron (PM 0.3). This includes all kinds of particles including dust, microbes, bacteria, smoke, allergens, chemical vapors, and more.
These respirators have all the same features as an N95, except they are able to filter out 99% of the ultra-fine particles.
P95 & R95
P95 and R95 filters have the same filtration efficiency as N95 filters but they provide additional protection from oil particulates (oil-based solutions that become airborne like pesticides). The P95 is semi-resistant to oil while the R95 is strongly resistant.
These two respirators are typically more expensive than N95’s for the extra protection that they provide. For consumer use and most healthcare settings, both of these respirators are unnecessarily excessive, especially if you are just trying to avoid viral infection.
The Issues with Fit
The respirator is designed to form a very tight seal but it needs to be placed on the face correctly. Failure to do so removes the benefit of using a respirator. Due to this, the CDC requires medical staff to be trained on how to properly wear it and must take a yearly test to show they can properly fit the device onto their face. If you have a respirator and are planning on using it, be sure to follow the manufacturers' guidelines on how to wear the respirator.
With this tight fit and the dense filter material, respirators tend to sacrifice the user’s comfort. A respirator can get very hot and humid around the mouth and nose because of how tightly it fits around the face. Because of this, it can be difficult to resist the temptation to fiddle with the respirator so make sure that you are conscious of this and avoid touching your mask at all costs.
Are Respirators Reusable?
We’ve established that the filtration effectiveness is pretty remarkable but are these N95 masks reusable? To put it simply, the answer is no.
The N95 respirators were designed as a single-use, disposable device. According to manufacturers, you should replace it when it becomes difficult to breathe or if the filter is dirty or damaged.
The reason they need to be replaced frequently is that particles get stuck into the filters and begin to ruin the breathability. These respirators work by filtering our particles through the air using a dense tangle of polypropylene filaments. The particles have to flow around the webs of the filter until they crash and get stuck within the fibers of the respirator.
This is exactly what is happening to the virus particles. From the air, they get sucked into the respirator where they get trapped within the fibers and are prevented from entering your lungs. More and more of these viral particles build up on the mask as you continually use it.
Reusing these respirators to prevent the spread of COVID-19 means that the virus is embedded within the mask where it could remain active for up to 3 days. With prolonged use, the N95 acts as a concentrator for all of the particles in the air, including the virus. Because of this, it is crucial to avoid touching the exterior of the respirator when taking it off and it is also important to avoid reuse to prevent the build-up of the virus on the material.
You may see medical staff have been reusing their respirators due to supply shortages and desperation rather than standard operating policies. To kill the virus on these respirators between use, some healthcare workers have taken to spraying the respirator with ethanol, but each time that happens, the fibers dramatically loosen and the respirator can no longer filter as efficiently. This exposes the wearer to the virus much more dramatically.
With these respirators, it is best to dispose of them each day.
FDA has stated that this looser fit makes these masks completely ineffective and useless at filtering out small particles. However, many scientific studies have proven otherwise. One such study showed that even accounting for the leakage, surgical masks could still filter 60% of 0.3 micron particles. They are even more beneficial when you consider the fact that microbes from the respiratory tract tend to spread by droplets or aerosols in the air that are much larger than these 0.3 micron particles.
In a pandemic, surgical masks can dramatically help to control the crisis by preventing those who are already infected from spreading the virus and by protecting those who are not yet infected by filtering out the viral particles.
Antimicrobial Surgical Face Masks
There are a few very coveted surgical face masks that inactivate 99% of viruses that come into contact with it. Curad was one of the first companies to create these masks for the consumer market. While the technology within the masks has not been tested with strains of coronavirus specifically, this mechanism of action should work to kill all kinds of viruses.
The Curad Biomask has undergone lab tests to show that their mask “inactivates 99 percent of tested flu viruses.” These types of masks are quite effective at ensuring the mask is sterile, but they are not as commonly produced as other masks such as N95 respirators or surgical masks.
These masks work by using a combination of citric acid, zinc and copper to inactivate the viral particles. The outside of the mask has a hydrophilic coating that helps to wick droplets.
Are Surgical Masks Reusable?
No. Surgical masks should not be reused. As soon as they are soiled or damaged, they are rendered useless.
These masks were created to be disposed of after interacting with patients or operating during a medical procedure so there are a few reasons why these are poor masks to reuse.
Surgical masks are rendered useless by moisture. A wearer’s saliva and moist breath will inevitably end up on the mask and will begin to damage it the longer it is worn. In accordance with CEBM, a mask’s efficiency drops once the mask is moist and should be disposed of immeadietly.
Surgical masks have a water resistant coating only on the front side of the mask. The back of the mask lacks this coating and renders the mask soiled from the inside out when moist.
A standard surgical mask provides some protection from COVID-19 as it acts as a physical barrier to protect you from the virus but also protects those around you from discharge from your own body (if you are harboring the virus or an asymptomatic carrier). If the mask is used when soiled or damaged, the mask acts more like a sponge for bacteria and viruses than a layer of protection.
The surgical mask works well for short instances (like a trip to the grocery store) but they are not well designed for use during long stretches of the day or through multiple uses. Having a pack of these masks is good in a pinch but we definitely do not recommend reusing them. Once they have been used, they should go in the trash.
Additionally, most are not good at dealing with bacteria or viruses for long periods of time. Unless you have an antimicrobial surgical face mask, the germs will remain on the mask for up to 3 days where they can spread to other items you have if the mask is not handled with care.
OURA Air Mask uses compounds such as silver oxide, titanium dioxide, and zinc oxide in order to inactivate the viral particles. Together, these compounds work to prevent microbial growth.
The antimicrobial effects combined with high levels of filtration make them ideal for preventing the spread of COVID-19 since they don’t just filter germs, they work to kill them.
One important thing to look for when choosing one of these masks is for the antimicrobial compounds to be embedded within the threads of the mask rather than just coated on the surface. This embedding process permanently locks the antimicrobial feature into the mask. Conversely, any coatings on a fabric will quickly fade away after the mask is washed and make the mask ineffective at killing germs in the long run.
Are these Antimicrobial Masks Reusable?
Yes! These masks are arguably the most ideal mask to reuse with COVID-19 in mind.
Since they are antimicrobial and washable, they can be used consistently without any loss of the antiviral functionality. Since these masks have antimicrobial properties, they also don’t have to be washed as frequently as other reusable masks since they are self-sterilizing
A study conducted in 2013 compared the filtration efficiency of masks made with household items to surgical masks. The study used masks that were made with linens, a kitchen towel, a scarf, pillowcase, a vacuum cleaner bag, and 100% cotton T-shirts.
Surgical masks had the highest filtration efficiency with the vacuum cleaner bag following in second. However, the vacuum cleaner bag was too thick to wear comfortably for extended periods of time. The 100% cotton T-shirt mask was noted to be most comfortable to wear but had just one-third of the filtration efficiency as a surgical mask.
A similar study was conducted in 2010 comparing surgical masks to common fabrics found in households. The results were conclusive with the findings from the 2013 study.
These particular masks can pose a serious threat. Even though these household items were inferior to the surgical masks, any form of protection is better than nothing. However, it is crucially important to make sure that you do not change your behavior and give into risk compensation since these household masks do not provide as much protection.
For better protection, when making the mask, it should have little to no airways. It is important to make sure the mask fits snuggly with your face.
Are homemade masks reusable?
Technically, yes. Just keep in mind that these homemade masks are drastically inferior to any manufactured, laboratory-tested face mask. There is a reason why many hospitals are not accepting these homemade sewn masks as donations.
However, since these masks don’t have any antimicrobial properties, it is crucial that you wash them on a daily basis in order to ensure that they are sterile before being placed on your face again.
Some Final Words
We hope this guide helped to clarify some of the differences in masks and what would best suit you during this pandemic. Now, it is more important than ever for us to stay educated on these matters. Regardless of the mask you choose, it is extremely important that you wear one while out in public during this time as they can dramatically help to mitigate the spread of the virus.
Above all else, we hope you stay safe and continue to take appropriate measures to protect yourself and those around you.
Together, we will get through this.