Jan 28, 2020


Reprint from AFAR online Magazine, By Michele Baran 1/24/2020

As news of the coronavirus outbreak that originated in Wuhan, China, continues to evolve, nervous global travelers may be wondering how best to protect themselves from possible infection. One thing people might be considering is whether wearing a medical mask could help. But do those masks actually do much? Yes and no, according to medical and infectious disease experts.

“Most of the masks being used are the simple loop-around-the-ear things or the operating room masks, which are designed to keep my secretions away from you, not the other way around. We’re kind of using them backward. The people who ought to be using masks are the people who have symptoms,” said Dr. William Spangler, an emergency medicine physician and the global medical director for travel insurance provider AIG Travel.

“Is it helpful?” added Spangler. “Sure it is, for macro-organisms. However, [coronavirus] is a microorganism. The size of this virus, even though it hasn’t quite been quantified yet, is in microns.” The current outbreak comes from a newly identified type of coronavirus, a family of viruses that can cause the common cold as well as more serious illnesses, including severe acute respiratory syndome (SARS).

Spangler noted that the best thing the common paper medical mask can do to protect people is to serve as a reminder or a physical blocker so that they don’t touch their faces. The other issue is that people don’t use medical masks correctly. They often don’t cover their noses with them or reuse them multiple times when they’re intended for single use. Medical masks also don’t cover our eyes, which are another potential point of entry for viruses.

“Many of the masks that you see are kind of surgical masks or even painter’s masks. And they’re relatively thin. They work for keeping paint out of a painter’s mouth, and they work very well for keeping what’s in the surgeon’s mouth out of the wound. But that’s not the same as protecting you from a respiratory infection,” said Dr. William Schaffner, professor of preventive medicine at Vanderbilt University and an infectious diseases expert.

The N95 mask

Schaffner and other experts noted that for total protection from a respiratory infection, health care workers use something called an N95 respirator, which is much thicker and is fitted precisely to each user to make sure it is well sealed over the wearer’s nose, cheeks, and down around the chin.

While the N95 masks offer more foolproof protection, there’s no way to fit and train millions of people on how to wear them correctly, noted Schaffner. Thus, that leaves the regular traveling public with the more common and less protective paper surgical masks.

“When you see thousands or hundreds of people wearing those masks, it kind of cracks me up,” said Saskia Popescu, senior infection prevention epidemiologist at Honor Health and George Mason University. “In some ways, hey, if you’re sick, thanks for protecting everybody around you. But it’s really not going to help if it’s a disease that requires more small particle [protection].”

Popescu and others agreed that while the masks are not the strongest line of defense, they can’t hurt either, especially for higher-risk travelers like pregnant women or people with compromised immune systems. “It’s also respiratory virus season. We’re in the middle of flu season. That could also help you against other respiratory viruses that we know are transmitted by a cough,” said Popescu.

The best ways to reduce transmission

The concern that Popescu had was that wearing the masks could actually make people less diligent about some of the other precautions they should be taking that are actually more effective. For instance, for those who fall ill, social distancing (aka staying home when you’re sick) and avoiding large crowds are among the most important things people can and should do. Frequent hand washing and covering your cough are other important mitigators.

“But let’s take a deep breath and step back,” said Schaffner. He said that while the coronavirus can be transmitted person to person, “it is not readily transmitted . . . and that’s good news.”

He added that it’s important to note that the only people in the United States who are currently at risk of coronavirus infection are people who have recently come from China or who have come into very close contact with such a person. The two confirmed cases in the United States are “both being taken care of wonderfully and safely. So, general public wearing masks? Not unless you want to rob a bank.”