Masks: What is the Deal?

Viral Updates for Pregnancy and Kids? No, not really. I perused the literature and a few review articles have come out, but the consensus continues to be similar. Kids with COVID-19 experience very mild illness, and perhaps a third of them are completely asymptomatic. Pregnant women seem to have a course similar to non-pregnant patients in their age group, which is to say that although they can have serious illness, it is fairly rare. Vertical transmission (mother to fetus) may be possible, but it is extremely rare if it happens at all. At this point the epidemic is (unfortunately) far enough along that I think we’d know if we were wildly off base on any of these facts. Masks People often ask me how I got started on writing Expecting Better and I tell them the truth: I started this research in the service of my own pregnancy. I had a lot of questions, and I needed a lot of answers. Now, increasingly the research I do about pregnancy and little kids is not in service of my own experience. The shop is closed for babies over here. But: there are still times when it’s back to the data for family questions. This week, it was masks. The CDC says to wear home-made cloth masks. Trump says they are “optional”. People shopping at Whole Foods have some combination of N95 medical masks, bandannas, home-made masks and nothing. So what’s the real deal? What does the evidence say? Let’s start with the basics: the main purpose of wearing a cloth mask is to protect other people. From what? From you. The data is increasingly suggesting that a fairly large share of people with COVID-19 are asymptomatic. This study from Iceland which tested the general population (WHICH WE SHOULD BE DOING EVERYWHERE) found that about 35% of infected individuals are asymptomatic. But: asymptomatic individuals can still spread the virus (not as effectively as those with symptoms, but still to some extent). So the basic concern is that you may be infected with COVID-19 and not know it. You go to the grocery store. You cough in the vicinity of the salad boxes. Now they’re infected. You didn’t mean to! The problem is that if asymptomatic individuals are all around, it’s not enough to tell those with symptoms to self-isolate. Why would masks help? If you cough or breath or sneeze into a mask, fewer virus particles get into the air. We know that from studies which have tested home-made masks, like this one which looked at masks made of old t-shirts or this one which shows 95% of virus particles are blocked by a mask made of cloth and paper. Bottom line: wearing a mask is very likely helpful for protecting others. Like much of what we are doing these days, it’s an investment in the social good. But you have more questions… Is this as good as a surgical mask? No. In the several studies which analyze masks, it’s pretty clear that medical-grade masks are better than stuff people can make at home (I mean, I would hope so). Medical-grade masks block more particles. However we do not have enough of these for people who really need them to protect themselves so, please, until we get better PPE please do not use these for this purpose. What about protecting myself? The main purpose of a cloth mask is to protect other people. It probably affords some protection for you, as well. A hospital-based study showed that cloth masks are clearly worse than hospital grade masks. If you are in a vulnerable population, and you absolutely have to go out, a hospital-grade mask will provide better protection. However, please see note above: we do not have enough of these for doctors, so until the supply improves, we should not be using them unless absolutely necessary. Do I wear this like, ALL THE TIME? If you are hiking alone in the forest, or with your family, there isn’t much reason to think a mask would help. Yes, in principle you could cough, touch a tree, the virus could live for a while, someone else could touch that same spot, etc, etc. But this is really a very very small probability event. Logic dictates this is most important when you’ll be in closer contact with other people. Groceries or pharmacy (or other essential stores). Maybe walking around if you think you’ll end up close to others. Public transit for sure if you are still taking that. What about my kids? On the one hand, kids seem to be the worst of the asymptomatic carriers. Because the virus is thankfully mild in them, it seems like a larger share are infected without knowing it. So in a way they’d be the ones you most want to see in masks. On the other hand, my kids at least are a bit resistant to wearing these. My 9 year old is more willing than the 5 year old, but even she finds them uncomfortable. Honestly, it is probably easier not to bring your kids to stores. Um, so how do I make a mask? Is a bandanna fine? Scrap fabric, and a pattern. I used this one but there are a million floating around online. It’s not a hard sewing task, although if you do not have a machine or do not know how to sew this is more of a challenge. (Little known fact: I used to make all of my own clothes. Now I am relegated to American Girl doll clothes and random pillows, but this was not beyond me.) Is a bandanna equivalent? Not quite. One of the issues is fit — a sewn mask will cover your face more completely than a bandanna. However, bandanna is likely better than nothing. Bottom Line I made masks for me, the kids and Jesse. Only Jesse and I wear them regularly. Mine is flowers on the outside, Halloween on the inside. Jesse went with basic black, but the inside is leopard. Gotta be creative.

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