Healthcare workers have been at the forefront of treating the 2019 coronavirus outbreak (COVID-19). Naturally, they have been exposed to severe respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, at a much higher frequency than those in most other professions – especially the those working in emergency services and intensive care units (ICUs). Effective personal protective equipment (PPE), including medical masks, is essential for this class of workers.
Due to a global shortage of surgical masks, a quick review appeared in the magazine recently Family medicine history in January 2021, addressing the potential use of clothing masks in health care settings.
Use and application of clothing masks
About 58% of primary care clinicians in the U.S., by April 2020, reported using or using home-made PPE. This was due to the focus on city hospitals struggling to care for critically ill people among COVID-19 patients, in the first wave of the pandemic. After seven months, about a third said they did not have PPE or had to reuse PPE to the point where it felt dangerous.
To date, the researchers argue, not all clinicians can access PPE to appropriate levels, either from their hospitals or health care systems, or from the National Strategic Source, because they do not have enough resources. The data on relevant PPE go through additional issues, being both controversial and unclear. This is no longer more apparent than in the case of mask use, where public health bodies have implemented a U-turn on the need for mask use, in general.
Many individuals and health care systems have taken steps such as PPE rationing, mask reuse and recycling, and using home face protectors as clothing masks.
Unknown about mask use
The U.S. Centers for Disease Control and Prevention (CDC) believes that clothing masks are a ‘last resort’ for clinicians, as it is not considered PPE and “its potential is currently unknown. clinical healthcare protection. ” The best design for a cloth mask in case PPE is not available, or the relative protection it offers, is both obscure.
Monitoring parameters
The study aimed to answer the question of whether the use of clothing masks is effective in reducing the risk of respiratory virus infections, including SARS-CoV-2, among clinicians. The researchers reviewed available studies, including randomized controlled trials (RCTs), observational and nonhuman studies.
The term ‘cloth mask’ here seems to refer to masks made of nonsynthetic or polyester woven fabric, and has been compared for effectiveness against industrial or surgical medical masks. The effectiveness in filtering bacteria or viruses was measured by their suitability. Their effectiveness has been measured in terms of the protection they offer against infection in clinical settings, as evidenced by infection levels.
Splitting
The researchers found, among relevant studies, four functional pathogens and one virus detected by colony formation and polymerase chain reaction (PCR), respectively. The mask material consisted of polyester, cotton, tea towel, and scarves, and the setting was in a laboratory. All studies concluded that linen restricts entry to only partially, and filters out biological substances (such as viruses and bacteria) as effective and different than masks medical.
Multiplication was more effective in their seeding effect. In particular, one study showed that one layer of polyester combined with four layers of paper heels had the same filtration efficiency as a medical mask. The study found that both polyester masks and paper-polyester towel blends could block 95% of grains with a size similar to SARS-CoV-2, as demonstrated by PCR. Nevertheless, the authors recommended the clinicians to use N95 inhaler.
It should be noted that these studies addressed non-coronavirus, bacterial or simulated aerosolized granules. The World Health Organization (WHO) believes that contact with contaminated secretions or environments, and respiratory droplets, is the primary route of viral transmission for SARS-CoV-2, rather than aerosol. This indicates that more research is needed before a firm conclusion can be drawn regarding the protective efficacy of a clothing mask in the context of COVID-19.
Fit
Commercial suitability systems were used in one study of clothing masks that were both made and worn by volunteers. Another used to let in grains to assess appropriateness, comparing homemade tea towel masks to medical masks. They found that, in each case, cloth masks prevented acne, but were worse than medical masks, and released more leaks. Poor positioning reduces the level of protection by allowing items to pass through gaps between the face and the mask.
Air flow
Two human studies measured airflow through cloth masks, and found that empty bags and tea towels, although associated with maximum filtration efficiency, allowed very little flow- air. This leads to breathing problems and leads to less compliance.
Efficiency
Two studies were intended to quantify the risk of infection in clothing mask users in clinical settings. The only RCT in this area to date compared infection rates in users who wore face masks or face masks under normal and routine clinical conditions. The authors concluded the effectiveness of masks in clinical settings.
Clothing mask users in this study were more than 13 times more at risk from influenza-like illness (ILI) than those who wore medical masks. It is not clear whether these decisions are due to the fact that medical masks offer more protection or because clothing masks are somewhat harmful to the wearer. On the other hand, the medical masks used here were of low quality, and it was found by the same researchers in an earlier study that there was little use in preventing viral infections. compared to N95 masks. This led them to conclude that the masks themselves were to blame for the increase in ILI in clothing mask users.
Reasons can include poor cleaning (80% of consumers clean the mask at home with soap and water), moisture retention, poor filtration efficiency, and reuse. However, the true pattern of clothing mask use was not explained in the study, which makes it difficult to come to correct conclusions regarding their daily use. The pathogens that were isolated in this study included human metapneumovirus, rhinoviruses, and influenza B virus, which are significantly different from SARS-CoV-2 in transmission and true growth.
In a study of foot and mouth virus, the researchers concluded that both business and cloth masks had little effect on the virus’ full-blown breath.
What is the impact?
There are major lacunae in the available studies, such as the viability of the virus on mask material, and how mask users behave compared to non-mask users in ways that may affect cause the spread of virus. For example, psychologists cite risk compensation theory, where people tend to take more risks when they feel safer.
Given the lack of quantity and quality of available literature, this review cannot provide a definitive reference to the protection of healthcare clinicians from COVID-19 with clothing masks. ”
However, if a primary care clinician cannot receive PPE, the researchers say that the use of a cloth mask is better than no mask, as long as the wearer keeps its limitations in mind. Further research is also needed to examine the efficacy and effectiveness of a mask against respiratory droplets rather than aerosols alone, before N95 inhalers can be said to be the best and most effective masks in COVID-19.
At the same time, cloth masks need to be changed frequently, packed with a plastic face shield, and washed to hospital laundry standards, if used. There is little evidence of their effectiveness in protection, calling for caution to use them for long periods of time.