Make no mistake, masks are vital source control barriers to COVID-19 transmission. Biologists have a unique opportunity to lead by example with effective mask-wearing. We can take it further by incorporating sustainability into mask use. To do this well, we need to consider the mask issue from multiple perspectives. The CDC and an analysis by the University of College London (UCL) Plastic Waste Innovation Hub each provide key insights to help assess mask designs.

Wearing the right type of mask the right way

The American CDC urges universal mask-wearing in part because asymptomatic people are still potentially infectious. Both multilayered cloth and non-medical disposable types of masks are able to block droplets that would evaporate into potentially infectious aerosolized particles. But with so many mask variations how does that capability play out in the real world?

As of this writing, there is no published randomized controlled trial on masks as source control for SARS-CoV-2, but today’s best available evidence offers good news. The CDC is providing guidance based on studies that show that increasing mask-wearing can reduce mortality and prevent lockdowns. The CDC cited numerous “real world” effectiveness studies on community masking showing that it reduced outbreaks of SARS-CoV-2 by 70%-79%.

Since mask-wearing is such a critical source control barrier to COVID-19, why do people resist wearing masks?

The elephant in the room is dysfunctional mask design.

Facing the problems with masks

Masks are less than perfectly user-friendly. The most annoying aspect of mask-wearing is poor breathability. Effective mask wearing is hampered by several inadequate design features that result in improper wearing, or outright aversion.

Many reusable cloth masks available on the market have ineffective designs. Some consist of only one layer and no filter panel. Adding a filter between layers of a cloth mask makes it even more unbreathable. Few masks fit facial contours exactly. They all seem to unpleasantly trap moisture. Who hasn’t witnessed the nose out mask wearer in public? Cloth masks with exhalation valves, whether or not they are supposed to be for respirator use, are problematic. Exhaling air directly through these valves misses the point.

Even though disposable masks are easier to breathe in and cheaper upfront than cloth masks, they are problematic from a society wide perspective The adjustable wire that you can press around your nose can make them a better fit. But it’s still way too easy to forget and wear it unadjusted. That allows sideways unfiltered air to come in and out. Again missing the point. The low cost of disposables is both a blessing and a curse. On the one hand, their low cost is very important since many countries are facing a severe mask shortage. This is why community use of medical-grade disposable masks should be avoided. It depletes this resource for healthcare workers. On the other hand, single-use masks are so especially cheap and lightweight, I have often seen them on the ground in parking lots, having no doubt escaped someone’s grip in a light breeze. Logic dictates that cheap, non-medical disposable masks are currently generating streams of potentially contaminated waste for communities to deal with.

Sustainable solutions for masks

Given that improper masking is a consequential health issue and the pandemic has resulted in copious volumes of contaminated medical waste and plastic pollution worldwide, good reusable masks are a more sustainable choice.

This concept was proposed by the University of College London(UCL) Plastic Waste Innovation Hub in their analysis: The environmental dangers of employing single-use face masks as part of a COVID-19 exit strategy. It’s a timely study urging a public health campaign for simple instructions on how to properly wear and care for reusable masks.

Scientists can help to communicate to this important information to the public to help reduce community spread. Why not also lead by example by wearing better designed reusable masks?

There are several new reusable mask approaches out that provide better breathability and peace of mind. The simplest reusable solution that I found is this reusable cloth face mask from 3M which provides a bendable nose piece and a bit more breathing space. The Wall Street Journal just published an article explaining that a few manufacturers are now able to relieve the pressure on disposable N95 mask suppliers with improved reusable masks. One manufacturer offers the ENVO mask. Even though these masks might have a somewhat menacing appearance, the key is that they are comfortable, reusable, and effective, although costly, at ~$80. Another one worth a look is the Aeras N95 reusable mask. It is less intimidating to wear since it’s smaller and lighter. The trade off is that you only get ten re-uses.

There is also interesting research taking place on reusable masks. MIT engineers and Brigham and Women’s Hospital produced an autoclavable, silicone reusable N95 and published a feasibility study on it. The Berkeley Lab released its own breathable prototype with a a rechargeable, wire-mesh active filter instead of the current N95 polypropylene filter that loses its electrostatic charge over time. That’s a double boon to overcoming supply shortages in a crisis. Really, any of these design options are poised to move the needle on mask safety and sustainability.

Let us know if you have a reusable mask that works well for laboratory work!

Please stay safe and thank you for being part of labconscious!

Further resources for the Labconscious community:

1. Preprint Review viewed 35K times: Face Masks Against COVID-19: An Evidence Review

2. PLOS ONE: Mask or no mask for COVID-19: A public health and market study

3. Considerations for Wearing Masks Help Slow the Spread of COVID-19

4. CDC Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2

5. Face mask and medical waste disposal during the novel COVID-19 pandemic in Asia

6. Management and use of filter masks in the “none-medical” population during the Covid-19 period