Why choosing the right mask matters

As the novel coronavirus spread wildly across the globe, one country after another came to a standstill. Despite imposing an early lockdown, the Indian government recently started relaxing lockdown measures, reopening businesses and travel after three months, but this, in turn, caused positive cases to grow exponentially.

India crossed the UK to become the 4th worst-hit country, as coronavirus positive cases crossed the 3 hundred thousand mark on Friday. A strict lockdown cannot be extended anymore as it has started to affect the lives of hundreds of thousands badly with a massive amount of loss of jobs, livelihoods, and companies dishing out pay cuts. While there’s a debate going on whether to shut down businesses again, it is really important to consider the worst-case scenario and move ahead with a plan.

A mural showing images of frontline workers after the government eased a nationwide lockdown imposed as a preventive measure against the COVID-19 coronavirus in New Delhi on June 11. Xavier Galiana/AFP via Getty Images

Doctors have repeatedly advised people to wash their hands with soap and wear masks to cover the mouth and nose when around other people.

Ever noticed people who wear their masks covering the chin and not the nose? Like them, have you also experienced unusual breathlessness and difficulty in breathing when you step out of your home wearing a mask? That happens because the carbon dioxide level within the mask increases rapidly and makes it difficult for one to breathe with lowered oxygen levels. There should be a healthy balance between breathing in oxygen and breathing out carbon dioxide, but this balance is ruined when you hyperventilate, and you start feeling lightheaded, and weak.

A research article observed elevated volume of fraction of respired air during inspiration. In this simplified model above 60% of respired air reentered the nasal cavity during the consecutive respirational cycle. 

It said that N95 mask trapped respired air within it which increased the volume of fraction of respired air during inspiration — which might be one of the major contributors to elevated carbon dioxide level while wearing N95 respirator.

Given the widespread of COVID-19, there’s no other way to control the infection if not by wearing masks. Healthcare workers have been doing this for months now. Being around positive patients and treating them day and night, healthcare workers have to wear masks constantly. Now, if and when offices, schools and colleges reopen all over the country everyone might have to continue wearing masks for hours at a stretch. How will it affect our breathing?

When and where to wear a mask?

Talking about how one can deal with this side effect of wearing masks, Dr Himanshu Sekhar Mahapatra, HOD Nephrology, Ram Manohar Lohia Hospital, says, “We don’t need to wear masks all the time, only when we are going out and around unknown persons in relatively crowded places. Whereas while walking or jogging in a park with very few people one doesn’t need to wear a mask. The virus is transmitted through human contact, so someone in a secluded place does not need to wear a mask.”

He further adds, “With offices reopening, it is the responsibility of the management to maintain social distancing. Employees need not wear masks throughout their work-shifts if there’s enough distance among each other. However, it is best to work from home now as long as possible. It is also important to carry a hand sanitizer in your pocket when you know you have to touch surfaces and objects used by many.”

Choosing the right mask

There are majorly three types of masks available in the market – N95 mask, 3 ply mask, and anti-pollution casual mask. Dr Ashutosh Roy suggests choosing the right mask is important as their use determine how it may affect one’s breathing.

“What matters is how you choose a mask. Hyperventilating for long by wearing N95 or KN95 will rapidly increase the CO2 level in one’s body. The N95 masks have fewer micropores, which does not let the carbon dioxide to escape from the mask and you end up inhaling that. And as soon as the CO2 level increases in your body, you start feeling dizzy. Your choice of the mask also depends on where you are and how long you have to wear it. If you are required to wear a mask for 24 hours, you should not opt for N95, but go for a 3 ply mask,” suggests Dr Ashutosh Roy, Hind Institute of Medical Sciences, Lucknow.

Reusing and disposing

Dr Roy shares his thoughts on reusing masks, “Initially we only had single-use masks. But now with a shortage of masks, if one doesn’t have enough to switch frequently and want to reuse, it is advisable to keep the mask out in the sun for a few hours before reusing. Masks that are labelled reusable should be dipped in lukewarm water with antiseptic liquid, and then left out in the sunlight.”

Unlike hospitals, common people do not have the option of disposing masks separately from their daily garbage at home. People often dump used masks and tissues along with their kitchen waste and they get carried away and dumped in a common ground by the garbage collector.

Talking about the right way of disposing infectious items, Dr Roy suggests, “Before disposing of anything that you’ve used to safeguard yourself from the virus, lay it out in the sun, and store in a separate bag, away from the regular trash can. When the bag fills up dispose it off to the garbage collector separately from your daily trash. They would know where to discard infectious items.”

How long do we have to continue with this lifestyle?

It is high time that our government acknowledges community transmission and encourages asymptomatic persons to get tested as well. Dr Faheem Younus, chief of Infectious Diseases, University of Maryland Medical System, said in an interview with NDTV, that persons near a coronavirus positive patient must be tested whether they show symptoms or not.

As per Dr Ashish K Jha, director of Harvard Global Health Institute in Cambridge, vaccines might be available by the first half of 2021. However, with the virus being mutated in multiple forms, there’s about a 50-70% chance of the vaccine being effective. He also suspects that cases in India will rise to 100,000 – 200,000 per day, in the coming months if testing is not ramped up.

While it does sound scary, the truth is India might be heading toward herd immunity gradually. Herd effect is a form of indirect protection from an infectious disease when a large percentage of a population has become immune to the infection, either through previous infections, or vaccination (in this case, we cannot expect a vaccine until 2021). This eventually shields those who are not immune, as others around them are already immune to the diseases and cannot transmit it further. Gradually, the chain of infection is disrupted, and the spread of the disease either stops or slows down considerably.

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