A face mask is a protective covering for the face to prevent one from breathing infected formit (substance) in the air or from spreading germs in droplets from cough, sneeze, and speaking. The face mask can be medical or non-medical with respect to protection against infectious disease transmission. The medical face masks are made of materials purposely to combat infectious diseases spread. These are the masks with the weave and construction proven to be most effective against viruses including the SARS-CoV-2 infection (COVID-19). Examples of these are masks made from N95 (USA) or KF94 (South Korea). These masks are made from materials that are able to block about 95% of particulates that pass through.
Figure 1: Different types of home-made face mask from cotton.
The challenges of getting medically qualified masks globally has necessitated the local production of masks. “While the intents behind such efforts are admirable, it will be important to have the design and manufacturing of such masks follow the science of N95 respirators”. Local production of masks from some materials have shown superiority over the approved medical masks. In one of such, it was found to block 99.9% of particulates which meant that the masks produced locally were about 4% more effective at blocking particulate material than the N95 masks.
Just like what the CDC advised in the USA, the President of Ghana has initiated the local production of face mask to enable widespread use of the mask among the populace. People are even encouraged to make their own at home.
From the CDC, “it is known from recent studies that a significant portion of individuals with coronavirus lack symptoms (“asymptomatic”) and that even those who eventually develop symptoms (“pre-symptomatic”) can transmit the virus to others before showing symptoms. This means that the virus can spread between people interacting in close proximity—for example, speaking, coughing, or sneezing—even if those people are not exhibiting symptoms”.
The CDC therefore recommends wearing cloth face coverings in public settings. Simple cloth face coverings can help to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. “Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure”.
Issues surrounding the use of face mask
The President of Ghana in his 7th COVID-19 address to the nation on 19th April 2020, admonished all Ghanaians to use face masks whenever they are out of their homes in addition to all prescribed directives in fighting against COVID-19. It is a known fact that the use of face masks to protect ourselves against COVID-19 has met a lot of controversies even at the international level among bodies that make global health decisions.
The World Health Organization (WHO) recommends that not all people need to wear masks to protect themselves against COVID-19. That only those that are ill with COVID-19 symptoms (especially coughing) or looking after people who may have COVID-19 should wear masks. That it is a waste to wear a face mask if you are not ill or looking after someone who is ill. The position of the WHO could be that they want to avoid unnecessary wastage of precious resources and mis-use of masks especially when there are reports of world-wide shortage of masks. The WHO has also been categorical that no evidence of protection against COVID-19 has been found with the use of face masks. Instead of relying on the use of face masks, the WHO advises the most effective ways to protect ourselves against COVID-19 is to frequently clean our hands with soap and running water, cover our cough with the bend of elbow or tissue and maintain distancing.
The Centers for Disease Control and Prevention (CDC), USA, on the other hand, advises individuals to wear cloth face cover when they have to go out in public but should not use a facemask meant for the healthcare workers. The CDC admonished that the use of face cloths should not be a substitute for all other effective measures against COVID-19.
It is an undisputable fact that people who have symptoms of COVID-19 are to use a medical mask to prevent transmitting to others as advised in Singapore, Hong Kong, Germany, and Japan.
In China, one of the countries known to have managed COVID-19 well issued the guide below on the use of medical and non-medical face masks.
• People at moderate risk of infection: surgical or disposable
mask for medical use.
• People at low-risk of infection: disposable mask for medical
use.
• People at very low risk of infection: do not have to wear a
mask or can wear a non-medical mask (such as cloth mask).
What material should be used to make a face mask?
As described earlier, the material used for making N95 masks is weaved to be able to block certain particulates from passing through while it does not also let the user suffocate. As we strive to make our own masks, e may not get exactly the same material but we need to use materials at layers that may produce a similar level of protection especially against viruses.
Depending on the architecture of the material, infected droplets could pass through without any block.
The N95 which is the gold standard as far as protection against COVID-19 and with at least 95% filter efficiency, was studied with the aid of a light microscope to check the pore sizes. This was used as a benchmark to qualitatively evaluate the materials used for the local production of face masks. In using a sample of N95 nurse mask, the arrangement of the layers and texture was obtained as shown below.
Figure 4: A section of N95 nurse face mask revealing the N95 material and layer arrangement.
A view under the microscope revealed the pores presented in the micrograph.
Figure 5: Micrographs from N95 face mask material under a light microscope using x40 magnification
The information gathered from the layers of materials arranged in a sample of N95 face mask and the pores observed under the microscope, was used to evaluate the kind of material that should be used to manufacture an efficient face mask to reduce SARS-CoV-2 infection (COVID-19).
N35 face mask
This is made of a similar type of material like the N95 but with a filter efficiency of 35%. This has no indication to protect against viral agents. For that matter, materials used from local materials must be arranged to do better than the N35. This can be better observed by studying the pores as seen in Figure 7.
Figure 6: N35 face mask with an indication for protection against non-toxic dust
Local face mask from cotton material
Looking at the material composition of N95 face masks, and aspiring to produce clothed face mask with similar properties and filtering efficiency, masks made from cotton are suitable. The pieces of cotton material interlaced with lining was found to be appropriate when qualitatively checked compared to the weaving from the N95 mask under the microscope.
Figure 8: Examples of face masks made from cotton materials.
Figure 10: Pores from cotton face mask with lining interlaced from X40 magnification
Various designs of cloth face masks
With the texture and weaving of the face mask similar to the N95, one can develop it into several designs to be fit for purpose. The other good thing is that the face mask has the ability to retain its weaving composition even after washing with detergent (specifically Dettol).
Figure 11: Various designs of homemade face masks from cotton (Contact PORTDEN on +233-244297891 for your efficient face masks)
How to choose and wear a Cloth Face Covering
- fit snugly but comfortably against the side of the face
- be secured with ties or ear loops
- include multiple layers of fabric
- allow for breathing without restriction
- be able to be laundered and machine dried without damage or change to shape(https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html)
Figure 12: Pictorial demonstration of how to wear a mask
Signed:
Dennis Adu-Gyasi,
23Apr2020
NB: This was motivated by the presentation of MLS Emmanuel Asiamah shared with me by MLS Samuel Ahiabah.
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