Face masks and COVID-19: What you need to know

Since the beginning of the COVID-19 pandemic, people all around the world have been using face masks, but what do we know about the different types of face masks and what they are useful for? Who should be using which kind? Should we order face masks online?

In an attempt to answer these and other questions regarding the use of face masks during the current pandemic, Kingstonist spoke to Dr. Azim Kasmani, a resident doctor with Kingston, Frontenac, Lennox and Addington (KFL&A) Public Health.

Key points

• Professional- and medical-grade face masks should be reserved for use by front line healthcare workers during the pandemic
• Front line healthcare workers cannot use homemade cloth masks
• Homemade masks to not protect the wearer from catching COVID-19 or any other virus, but they do protect others from the wearer’s secretions or droplets
• When using a mask, the manner in which you put it on and take it off (donning and doffing) is of utmost importance
• When using a reusable face mask, cleaning that mask directly after use is extremely important
• Ordering masks online is not advisable, as it is very difficult to decipher if those masks are made to Health Canada standards
• Staying home, physical distancing, frequent hand washing, and not touching the face are the best practices for stopping the spread of COVID-19

Medical- or professional-grade face masks

The masks we see the most on the streets the world over are surgical masks. However, as Dr. Kasmani pointed out, medical-grade masks (or professional-grade masks often used by those in the trades) should not be used by the general public. This directive has been made in order to ensure the supply of necessary masks for front line healthcare workers.

“Front line healthcare workers who are working in healthcare settings, they need medical-grade masks. And so cloth masks or even some of the 3D printed ones are not appropriate because they need to be certified to a certain standard to ensure that they will help or be useful,” Kasmani said. “Because the virus has disrupted our supply chain, have limited numbers of masks, so the advice is also based around saving those masks for the high-risk areas. Those masks should be saved for front line healthcare workers or workers in the ICU.”

As the pandemic continues, so too do the influx of online advertisements for face masks – particularly surgical masks and N95 masks – and other Personal Protective Equipment (PPE). Kasmani cautioned against ordering such products online.

“If you’re just ordering them online, not all of them, especially now, may be made to a certain standard, and it’s hard to verify that standard,” he said, reiterating that these types of masks should be reserved for front line healthcare workers at this time. Kasmani also explained that the N95 masks are really only needed by those performing an aerosol-generating medical procedure (such as a patient being intubated or having their breathing helped by a ventilator) or those in the room during such a medical procedure.

Homemade/cloth face masks

Kasmani explained that there are not clear guidelines or clear, sound science regarding the use of masks by the general public, simply because it’s difficult to get hard science on that practice based on the nature of how studies are done. This is part of the reason why there is much confusion around the use of face masks.

Having said that, Kasmani pointed to the Ontario Ministry of Health and the Public Health Agency of Canada as sources to look to for advice on the use of masks.

“There are some areas of the world where they suggest everybody wears a mask, there are some areas of the world where there’s no suggestion, and then there’s a lot of in between,” he said.

“Kingston will follow the provincial guidelines, and what the province suggests is that masks may have a role, and people who want to wear masks should follow certain guidelines in doing so.”

Kasmani stressed that the best way to help prevent the spread of COVID-19 continues to be staying at home, avoiding close contact with others outside your home, following physical distancing guidelines, washing your hands regularly, and not touching your face.

“Wearing a mask shouldn’t make you feel like you don’t have to do those things, or that you can start going out and socializing, because we’re not there yet. As the number of cases in Ontario changes, the advice from the Ministry may change, but for now, we shouldn’t think that we can do whatever we want because we’re wearing a mask,” Kasmani explained.

“When we wear masks, they don’t protect us from other people, they protect secretions, our droplets that we make when we cough, sneeze or even sometimes talk, from spreading from other people. And they’re not 100 per cent protective, but they provide some level of protection for that,” he continued.

Kingstonist author Jessica Foley has a list of local makers and businesses selling face masks on her website: Where to find masks in Kingston

Not for front line healthcare workers

For those who are looking to support our front line healthcare workers during this difficult time, Kasmani expressed that making homemade masks for them is not a solution.

“It’s hard to hear sometimes, but homemade masks don’t help frontline healthcare workers because they don’t provide enough coverage for them, and it can provide a false sense of security, as well, which can be even worse,” he said. “For use in that environment, we would ask them not to make them. I know KGH is not accepting homemade masks for wear for their frontline staff because of the risks associated with that.”

How you wear and care for homemade masks is important

Kasmani explained that, when students begin working in a hospital setting, one of the first things they are taught is how to put masks and other PPE on and how to take them off. Known in the profession as ‘donning and doffing,’ this practice is taught immediately because it is of utmost importance in ensuring people do not come in contact with contaminated PPE. This is also true for those wearing masks during the pandemic, Kasmani said.

“That procedure is really, really important – the order you do it, when you wash your hands, when you take on or off your gloves, where you touch the mask – it’s all very, very important because the outside of the mask is going to be contaminated, and the inside can also potentially be contaminated,” he said.

Kasmani said that if, for example, someone were to touch mask that’s been used and then tough their face without washing their hands first, that person has just created a route for transmission of the virus they spent time and effort to protect themselves from. He suggested those members of the public using masks watch videos on the donning and doffing procedures on the Public Health Ontario YouTube channel.

Kasmani also pointed to the guidelines from the Ontario Ministry of Health with regard to how to properly use, clean and dispose of facial coverings. Those guidelines are as follows below.

If you choose to use a face covering, you should:

• wash your hands immediately before putting it on and immediately after taking it off (practise good hand hygiene while you are wearing the face covering)
• make sure the face covering fits well around your nose and mouth
• avoid moving the mask around or adjusting it often
• avoid touching the covering while using it
• not share it with others

Face coverings should be changed when they get damp or soiled.

When removing a face covering, you should:

• throw it out into a lined garbage bin
• wash your hands

Do not leave any discarded face coverings in shopping carts or on the ground.

If the face covering can be cleaned, you should:

• put it directly into the washing machine or a bag that can be emptied into the washing machine
• wash with other items using a hot cycle with laundry detergent (no special soaps are needed), and dry thoroughly
• wash your hands after putting the face covering into the laundry

All face coverings that cannot be cleaned should be thrown out and replaced as soon as they get damp, soiled or crumpled.

“You should wash your hands immediately before putting it on and immediately after taking it off, and while wearing it, too,” Kasmani said, noting that fidgeting with face masks is also of concern.

“Don’t touch your face and don’t adjust the mask. I’ve seen a lot of people out there who will have the mask just under their nose because it’s a bit uncomfortable to breathe with it on,” he continued. “That doesn’t make it very helpful if it’s just covering lips and you’re constantly touching it to move it to get it to work well.”