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  Recommendation Regarding the Use of Cloth Face Coverings Especially in Areas of Significant Community Based Transmission Notre


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  the Theory of Groups Collective Action and the Evolution of Social Norms Considerations in the Use of Homemade Masks


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  Hong Kong Nonpharmaceutical Interventions for Pandemic Influenza World Health Organisation Writing Group


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  The Case for Universal Cloth Mask Adoption and Policies to Increase Supply of Medical Masks for Health Workers Pandmie de Covid 19


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  china Artificial Adaptive Agents in Economic Theory Press Release Scientific Committee on Emerging and Zoonotic Diseases


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  Factors Influencing the Wearing of Facemasks to Prevent the Severe Acute Respiratory Syndrome Among Adult Chinese


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  coronavirus disease 2019 covid 19 pandemic State of connecticut executive order no 7bb Protection of public health and safety during covid 10 pandemic and response use of facemasks


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  The Case for Universal Cloth Mask Adoption and Policies to Increase Supply of Medical Masks for Health Workers Incubation


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  N95 Respirator Filtration Performance and Structural Integrity Centers for Disease Control and Prevention Far


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  Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation


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  N R or P and the level of efficacy 95 99 100 The first part of the respirator classification indicates the resistance of the filter


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  Center for Disease Control and Prevention Recommendation Regarding the Use of Cloth Face Coverings Physical


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  Disease Control and Prevention Interim Infection Prevention and Control Recommendations for Patients with Suspected


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  Recent Public Health Emergency Responses Health Secur Hospital Preparedness for Severe Acute Respiratory Syndrome


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  Centers for Disease Control and Prevention Strategies for Optimizing the Supply of Facemasks Sourcing Personal Protective Equipment


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  Maria Bernardes Henriques Amaral F Park D Paola Ceraldi Cameira A Augustinho Muniz da Cunha M Gutierrez Karl E Henderson S J title


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  Infection Prevention and Control of Epidemic and Pandemic Prone Acute Respiratory Infections in Health Care Guidelines


id: cord-289521-zun6tp2o
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  Department of Health and Social Care Public Health Wales Public Health Agency Northern Ireland Health Protection Scotland Public Health England Guidance


id: cord-289521-zun6tp2o
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  High Velocity Nasal Insufflation Therapy Using a Simple Surgical Mask Implications for High Flow Nasal Cannula Aerosol


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  Vega Wanyenze Rhoda K Dula Janeth Watanabe Takashi Delgado Ratto Christopher Driessche Koen Vanden Van


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  an Influenza Pandemic Facing the Flu Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases Personal Protective Equipment for Healthcare Workers


id: cord-301063-kqlra788
type: ORG
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  U S Food and Drug Administration Respirator Trusted Source Information Ancillary Respirator Information Aerosol


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type: GGP
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  Australas DOI 10 1111 1742 6723 13581 sha 8ca37ec3ff181586f772d7b6ef451d4572192d27 doc_id 316266 cord_uid 6m9g3bdr BACKGROUND


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  Recommendation Regarding the Use of Cloth Face Coverings Especially in Areas of Significant Community Based Transmission Use of Cloth Face Coverings


id: cord-296216-odzm7lml
type: ORG
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  EPA Chemical Disinfectants Disinfection Sterilization Guidelines Guidelines Library Infection Control


id: cord-296216-odzm7lml
type: ORG
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  Health Care Considerations for Routine and Surge Use Unmanned Assessment of Respirator Carbon Dioxide


id: cord-296216-odzm7lml
type: CHEMICAL
entity:
  D N Wagner MD P Miki MD R Kohn MD J Kohn Bitran MD D Pearson MD J Herrera MD C M Prakash M title Pneumask


id: cord-318660-47dqa1dd
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  Adult Critically Ill COVID 19 Patient COVID 19 Guidance Independent Health Facilities Using Personal Protective Equipment PPE Rational use of personal protective equipment PPE


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  Cureus DOI 10 7759 cureus 10423 sha 31201965afadcf3e427b60809a738deba5e92a00 doc_id 318660 cord_uid 47dqa1dd During the coronavirus


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id: cord-317047-86rb6hov
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  Wuhan China Occupational Safety and Health Administration Personal Protective Equipment Center for Disease Control and Prevention Interim Infection Prevention


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  Cureus DOI 10 7759 cureus 7737 sha 38c8922f3ef3b099036733bf55e7c44dadb1e54d doc_id 317915 cord_uid 0javg3m8 Introduction


id: cord-305419-l68ewxar
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  European Pressure Ulcer Advisory Panel National Pressure Injury Advisory Panel Pan Pacific Pressure Injury Advisory Panel Prevention


id: cord-309575-7orflz20
type: ORG
entity:
  Reuters Second Treatise of Government An Essay Concerning the True Original Extent and End of Civil Government On Liberty and


id: cord-324585-2rx84imv
type: WORK_OF_ART
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  Article How to Sew a Fabric Face Mask Transmission Routes of Respiratory Viruses Among Humans Exhalation of Respiratory Viruses by Breathing Coughing and Talking National Academies of Sciences Medicine Rapid Expert Consultation on the Possibility of Bioaerosol Spread of SARS CoV 2 for the COVID 19 Pandemic A Cluster Randomised Trial of Cloth Masks


id: cord-324585-2rx84imv
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  the University of Nebraska Documentary Research of Human Respiratory Droplet Characteristics Procedia Eng World Health Organization Annex C Respiratory


id: cord-324585-2rx84imv
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  Health Care Considerations for Routine and Surge Use A Strategy for Assessing and Managing Occupational


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  Saf Sci DOI 10 1016 j ssci 2020 104997 sha cc0075b64cff4f44da1fefb3b8195380c371c60e doc_id 342357 cord_uid g8m57t67 SARS CoV 2


id: cord-343535-r8rsbfs3
type: WORK_OF_ART
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  A Flexible Nanoporous Template for the Design and Development of Reusable Anti COVID 19 Hydrophobic Face Masks Testing of Air Permeability of Distant Knitted Fabrics


id: cord-316126-j51dik7f
type: ORG
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  National Health Commission Key Laboratory for Medical Virology National Institute for Viral Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing China 2020 Notes


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id: cord-347390-xz5a99cr
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# bib

id: cord-000166-36bfeoqv
author: Tracht, Samantha M.
date: 2010-02-10
txt: ./txt/cord-000166-36bfeoqv.txt
cache: ./cache/cord-000166-36bfeoqv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818714/
doi: 10.1371/journal.pone.0009018
summary:
  We construct and analyze a mathematical model for a population in which some people wear facemasks during the pandemic and quantify impact of these masks on the spread of influenza. The results show that if N95 respirators are only 20% effective in reducing susceptibility and infectivity, only 10% of the population would have to wear them to reduce the number of influenza A (H1N1) cases by 20%. With the implementation of N95 respirators Table 3 exhibits a reduction in the cumulative number of cases of almost 200,000, or a 19% decrease, when 10% of the population wears masks and they are 20% effective. With 10% of the population wearing N95 respirators with effectiveness at 20% in reducing both susceptibility and infectivity there is a 19% reduction in the cumulative number of cases. Even at 50% effectiveness in reducing both susceptibility and infectivity and with 50% of the population wearing surgical masks only a 6% reduction in the number of cumulative cases is seen.

title:
  Mathematical Modeling of the Effectiveness of Facemasks in Reducing the Spread of Novel Influenza A (H1N1)

abstract:
  On June 11, 2009, the World Health Organization declared the outbreak of novel influenza A (H1N1) a pandemic. With limited supplies of antivirals and vaccines, countries and individuals are looking at other ways to reduce the spread of pandemic (H1N1) 2009, particularly options that are cost effective and relatively easy to implement. Recent experiences with the 2003 SARS and 2009 H1N1 epidemics have shown that people are willing to wear facemasks to protect themselves against infection; however, little research has been done to quantify the impact of using facemasks in reducing the spread of disease. We construct and analyze a mathematical model for a population in which some people wear facemasks during the pandemic and quantify impact of these masks on the spread of influenza. To estimate the parameter values used for the effectiveness of facemasks, we used available data from studies on N95 respirators and surgical facemasks. The results show that if N95 respirators are only 20% effective in reducing susceptibility and infectivity, only 10% of the population would have to wear them to reduce the number of influenza A (H1N1) cases by 20%. We can conclude from our model that, if worn properly, facemasks are an effective intervention strategy in reducing the spread of pandemic (H1N1) 2009.


id: cord-017140-k4lzwfge
title: Protection of Upper Respiratory Tract, Mouth and Eyes
author: Andersen, Bjørg Marit
date: 2018-09-25
txt: ./txt/cord-017140-k4lzwfge.txt
cache: ./cache/cord-017140-k4lzwfge.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121627/
doi: 10.1007/978-3-319-99921-0_13
summary:
  • Patient with suspected contagious respiratory infection-during transport, examination, treatment, etc.; use a face mask-also on the patient-to protect others and the environment from contamination. Department management is responsible for training, use and control of face masks, respirators and eye protection and that the equipment and written guidelines are available [5] . P3 mask is used by the surgical team and during all sterile procedures: in the case of operative treatment of patients with special types of airborne infection such as tuberculosis, etc., see above. However, surgical masks are not approved as protection against airborne infections: [5, 14, 24, 25] "Harmful microorganisms (bacteria, viruses, fungi) or components of microorganisms (e.g. endotoxins) may occur in air, either in dust, smoke or aerosols, or even finer distributed as droplet nuclei where all liquid has dried in. Transmission of microbes via small particles and droplet nuclei from influenza patients is not adequately controlled by the use of surgical mask [50] [51] [52] .

abstract:
  Pathogenic bacteria and viruses may invade via upper and lower respiratory tract and via eye mucosa. When an infected person coughs or sneezes heavily, small, invisible droplets with the infective agent may reach a good distance from the source. By using the right form of protection at the right time, infection and disease are prevented. The present chapter is focused on the protection against airborne infections.


id: cord-025744-pynqwj5t
author: van der Linden, Clifton
date: 2020-05-14
txt: ./txt/cord-025744-pynqwj5t.txt
cache: ./cache/cord-025744-pynqwj5t.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264444/
doi: 10.1017/s0008423920000475
summary:
  Even though wearing a mask may indirectly protect the wearer in that increased mask usage by the general public may reduce overall transmission of COVID-19, Olson''s logic asserts that individuals would instead free ride based on the expectation that other group members would adopt mask usage. Going forward, how likely are you to voluntarily (i.e., without being required to do so) wear a mask or any sort of protective face covering out in public as a preventative measure against COVID-19? When compared with the control group, the collective interest treatment increases the average respondent''s inclination to wear a mask by 0.505 points on the 11-point continuous scale. The results of Model 1 demonstrate that Canadians are more willing to wear masks as a measure to protect others from COVID-19 rather than themselves.

title:
  Does Collective Interest or Self-Interest Motivate Mask Usage as a Preventive Measure Against COVID-19?

abstract:
  The revised guidance on masks from public health officials has been one of the most significant COVID-19 policy reversals to date. Statements made at the outset of the pandemic, including those from the World Health Organization (WHO), the United States Surgeon General, and the Chief Public Health Officer of Canada, all actively discouraged asymptomatic members of the general public from wearing masks. However, on April 3, 2020, the United States Center for Disease Control and Prevention (CDC) issued new recommendations that called for nonmedical masks, such as cloth face coverings, to be worn in public settings where other social distancing measures are difficult to maintain (Adams, 2020). Canadian public health officials quickly followed with their own guidance for wearing nonmedical masks or face coverings when out in public; however, they have stressed that doing so is optional for asymptomatic persons and should be seen as a complement to existing precautionary measures such as physical distancing and hand hygiene, particularly in cases where physical distancing may not be feasible (Public Health Agency of Canada, 2020). Emphasis was placed on nonmedical masks serving not to protect the wearer, but rather others who come within close proximity of the wearer. Echoing her public statements on the matter, Canada's chief public health officer Tweeted that “[w]earing a NON-MEDICAL mask in public settings has not been proven to add any protection TO the person wearing it, but it can be an additional way to prevent spread FROM an infected person to others” (Tam, 2020).


id: cord-031440-0irbypnt
author: Arango, Lázaro
date: 2020-09-04
txt: ./txt/cord-031440-0irbypnt.txt
cache: ./cache/cord-031440-0irbypnt.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473261/
doi: 10.1016/j.vgie.2020.07.013
abstract: nan
summary:
  title: Adaptation for endoscopy of a ventilation mask using a glove finger like a filter: trying to reduce aerosols Adaptation for endoscopy of a ventilation mask using a glove finger like a filter: trying to reduce aerosols Lázaro Arango, MD, FASGE, Claudia Díaz, MD, Fabián Puentes, Andrés Sánchez, MD, Mario Jaramillo We have adapted them using bands with holes that are anchored to the pins (Fig. 2) , thus creating an almost perfect seal with the patient''s face. 2. We place the mask on the patient''s face, making an almost complete seal in which the bands perfectly fit the pins (Fig. 5 ). 4. In the central hole of the ventilation mask, we place the glove finger (Fig. 7) and make a small cut with scissors (Fig. 8) . Use of a new face shield for patients of the endoscopy unit to avoid aerosol exchange in the COVID-19 era New protection barrier for endoscopic procedures in the era of pandemic COVID-19.

title:
  Adaptation for endoscopy of a ventilation mask using a glove finger like a filter: trying to reduce aerosols


id: cord-034298-9hpkmjvu
author: Palmer, Carl L.
date: 2020-07-09
txt: ./txt/cord-034298-9hpkmjvu.txt
cache: ./cache/cord-034298-9hpkmjvu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588711/
doi: 10.1017/s1743923x20000422
summary:
  Our online study conducted in early June 2020 shows that masculine toughness is consistently related to higher negative feelings and lower positive feelings about mask wearing. Table 1 presents the ordinary least squares (OLS) models for masculine toughness on negative reactions to mask wearing for the full sample and separately for subsamples of men and women. In each model, the effect of masculine toughness is positive and significant; a stronger belief that men should be tough corresponds to greater levels of negativity regarding mask wearing, in line with H 1 . Broadly, we find that men and women who embrace masculine norms of toughness are equally likely to feel negative affective responses toward the idea of wearing masks, even after accounting for other predictors such as partisanship and ideology. Additionally, while toughness predicts positive attitudes toward mask wearing for men and women, the negative effect is larger for men.

title:
  Toxic Mask-ulinity: The Link between Masculine Toughness and Affective Reactions to Mask Wearing in the COVID-19 Era

abstract:
  The COVID-19 pandemic has altered numerous elements of social, political, and economic life. Mask wearing is arguably an essential component of the new normal until substantial progress is made on a vaccine. However, though evidence suggests the practice is a positive for public health and limiting the transmission of COVID-19, there is variation in attitudes toward and practices of mask wearing. Specifically, there appears to be a sex-based divide in mask wearing, with men more likely to resist wearing masks. Utilizing an original survey, we test the correlation between masculinity and mask wearing. We find that identification with norms of masculinity has a significant influence on affective responses toward mask wearing.


id: cord-035203-dnoc0xcv
author: Vaňková, Eva
date: 2020-10-29
txt: ./txt/cord-035203-dnoc0xcv.txt
cache: ./cache/cord-035203-dnoc0xcv.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7603793/
doi: 10.7717/peerj.10259
summary:
  Complete decontamination of PLA surfaces from externally applied Staphylococcus epidermidis, Escherichia coli, Candida albicans and SARS-CoV-2 was achieved using all disinfectants tested, and human adenovirus was completely inactivated by sodium hypochlorite-containing disinfectant. In the present study, we have investigated FDM 3D-printed PLA structure and porosity after exposure to common chemical disinfectants including ethanol, isopropanol and a commercial disinfectant containing sodium hypochlorite, which are easily accessible. In addition, we examined the efficiency of PLA disinfection after artificial contamination with bacteria (Staphylococcus epidermidis, Escherichia coli), a yeast fungus (Candida albicans), viruses (SARS-CoV-2 and human adenovirus -HAdV) or natural contamination by wearing the masks. The effect of immersing in three chemical disinfectants (96% ethanol, 70% isopropanol and the commercial disinfectant and bleach SAVO Original, Unilever ČR s.r.o., Czech Republic containing 0.85% sodium hypochlorite diluted with water (2:9)) was tested by repeated (5 × 15 min) cycles and long-term (24 h) exposure. Effect of ethanol, isopropanol and sodium hypochlorite on disinfection of PLA material contaminated with bacteria, yeast fungus or viruses

title:
  Polylactic acid as a suitable material for 3D printing of protective masks in times of COVID-19 pandemic

abstract:
  A critical lack of personal protective equipment has occurred during the COVID-19 pandemic. Polylactic acid (PLA), a polyester made from renewable natural resources, can be exploited for 3D printing of protective face masks using the Fused Deposition Modelling technique. Since the possible high porosity of this material raised questions regarding its suitability for protection against viruses, we have investigated its microstructure using scanning electron microscopy and aerosol generator and photometer certified as the test system according to the standards EN 143 and EN 149. Moreover, the efficiency of decontaminating PLA surfaces by conventional chemical disinfectants including 96% ethanol, 70% isopropanol, and a commercial disinfectant containing 0.85% sodium hypochlorite has been determined. We confirmed that the structure of PLA protective masks is compact and can be considered a sufficient barrier protection against particles of a size corresponding to microorganisms including viruses. Complete decontamination of PLA surfaces from externally applied Staphylococcus epidermidis, Escherichia coli, Candida albicans and SARS-CoV-2 was achieved using all disinfectants tested, and human adenovirus was completely inactivated by sodium hypochlorite-containing disinfectant. Natural contamination of PLA masks worn by test persons was decontaminated easily and efficiently by ethanol. No disinfectant caused major changes to the PLA surface properties, and the pore size did not change despite severe mechanical damage of the surface. Therefore, PLA may be regarded as a suitable material for 3D printing of protective masks during the current or future pandemic crises.


id: cord-048483-umvrwgaw
author: van der Sande, Marianne
date: 2008-07-09
txt: ./txt/cord-048483-umvrwgaw.txt
cache: ./cache/cord-048483-umvrwgaw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/
doi: 10.1371/journal.pone.0002618
summary:
  METHODOLOGY: We assessed transmission reduction potential provided by personal respirators, surgical masks and home-made masks when worn during a variety of activities by healthy volunteers and a simulated patient. CONCLUSIONS/SIGNIFICANCE: Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection. This is different from deployment of masks in the general population during an outbreak of an infectious disease, where anyone may encounter the infectious micro-organism, implying much greater heterogeneity, in training levels (experience and understanding), goodness of fit of a mask, and activities interfering with mask use and thus reducing potential reduction of transmission. Three different experiments were undertaken to assess 1) shortterm protection for different types of masks worn during 10-15 minutes by the same volunteer following a standardized protocol, 2) long-term protection of a specific mask worn continuously by a volunteer for 3 hours during regular activities, and 3) effectiveness of different types of mask in preventing outgoing transmission by a simulated infectious subject.

title:
  Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population

abstract:
  BACKGROUND: Governments are preparing for a potential influenza pandemic. Therefore they need data to assess the possible impact of interventions. Face-masks worn by the general population could be an accessible and affordable intervention, if effective when worn under routine circumstances. METHODOLOGY: We assessed transmission reduction potential provided by personal respirators, surgical masks and home-made masks when worn during a variety of activities by healthy volunteers and a simulated patient. PRINCIPAL FINDINGS: All types of masks reduced aerosol exposure, relatively stable over time, unaffected by duration of wear or type of activity, but with a high degree of individual variation. Personal respirators were more efficient than surgical masks, which were more efficient than home-made masks. Regardless of mask type, children were less well protected. Outward protection (mask wearing by a mechanical head) was less effective than inward protection (mask wearing by healthy volunteers). CONCLUSIONS/SIGNIFICANCE: Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection. Masks worn by patients may not offer as great a degree of protection against aerosol transmission.


id: cord-102315-ncjdsbn4
author: Nazeeri, A. I.
date: 2020-04-16
txt: ./txt/cord-102315-ncjdsbn4.txt
cache: ./cache/cord-102315-ncjdsbn4.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.04.12.20059709v1?rss=1
doi: 10.1101/2020.04.12.20059709
summary:
  It is currently believed that these masks and respirators cannot be cleaned with 70 to 75% alcohol-water solutions, as past wet/dry experiments show that filtration efficiency can drop by ~40% after the first such treatment. The mechanism seems to be the removal of water molecules adsorbed on the fiber surfaces, a hypothesis which is supported by two independent observations: (A) the filtering efficiency increases non-linearly with the weight loss during drying, and (B) filtration efficiency shows an abrupt recovery as the vacuum pressure drops from 13 to 6 mBar, the range physically attributable to the removal of adsorbed water. We report here the discovery that decontaminating polypropylene microfiber filters in a 70% v/v solution of ethanol and deionized (DI) water, using standard medical procedures including air drying, does not permanently damage the microfibers as has been suggested 3, 4, 7 . We describe the easily constructed experimental setup that we use for measuring filtration efficiency, present results with 70% v/v ethanol treatment and the effectiveness of vacuum drying on .

title:
  An Efficient Ethanol-Vacuum Method for the Decontamination and Restoration of Polypropylene Microfiber Medical Masks & Respirators

abstract:
  A critical shortage of respirators, masks and other personal protective equipment (PPE) exists across all sectors of society afflicted by the COVID-19 pandemic, placing medical staff and service workers at heightened risk and hampering efforts to reduce transmission rates. Of particular need are the N95 medical face respirators that filter 95% of all airborne particles at and above 0.3 um in diameter, many of which use meltblown microfibers of charged polypropylene (e.g, the 3M 8200). An intensive search is underway to find reliable methods to lengthen the useful life of these normally disposable units. It is currently believed that these masks and respirators cannot be cleaned with 70 to 75% alcohol-water solutions, as past wet/dry experiments show that filtration efficiency can drop by ~40% after the first such treatment. This has been interpreted as the liquids disrupting the surface charge on the fibers and has led to a recent CDC/NIOSH advisory against using alcohol for their decontamination. We have replicated the drop in efficiency after alcohol treatment. However, we find that the efficiency can be recovered by more effective drying, which we achieve with a vacuum chamber. Drying at pressures of < ~6 mBar (0.6 kPa) restores the measured filtering efficiency to within 2% or so of the pre-washing value, which we have sustained for 5 cleaning-drying cycles so far in three models of N95 masks. The mechanism seems to be the removal of water molecules adsorbed on the fiber surfaces, a hypothesis which is supported by two independent observations: (A) the filtering efficiency increases non-linearly with the weight loss during drying, and (B) filtration efficiency shows an abrupt recovery as the vacuum pressure drops from 13 to 6 mBar, the range physically attributable to the removal of adsorbed water. These results are not compatible with the electrostatic discharge hypothesis, and rather suggest that water molecules adsorbed to the fiber surface are reducing the filtration efficiency via surface tension interactions (e.g., wicking between the fibers and coating their surfaces with a film). Such a degradation mechanism has two implications: (A) Respirators decontaminated by a soak in 70% v/v ethanol regain their filtration efficiency once they are fully dry. We employ vacuum chambers in this study, which are inexpensive and commonly available. (B) This mechanism presents the possibility that mask filtration performance may be subject to degradation by other sources of moisture, and that the mask would continue to be compromised even if it appears dry. The mask would need to be vacuum-dried to restore its performance. This study introduces a number of methods which could be developed and validated for use in resource-limited settings. As the pandemic spreads to rural areas and developing nations, these would allow for local efforts to decontaminate, restore, monitor, and test medical masks.


id: cord-104138-qagyaegp
author: Magee, Michelle
date: 2020-10-08
txt: ./txt/cord-104138-qagyaegp.txt
cache: ./cache/cord-104138-qagyaegp.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.10.06.327452
doi: 10.1101/2020.10.06.327452
summary:
  Here we investigated how three face mask types (N95, surgical and cloth) affect acoustic analysis of speech and perceived intelligibility in healthy subjects. We compared speech produced with and without the different masks on acoustic measures of timing, frequency, perturbation and power spectral density. Our data show that face masks change the speech signal, but some specific acoustic features remain largely unaffected (e.g., measures of voice quality) irrespective of mask type. Where the interaction was significant, planned comparisons were made for each 1Khz frequency band to determine differences between masks types compared to no mask. For recordings produced with the tabletop microphone, there was a significant effect of mask type for percentage of pauses (F3,7.87=8.17, p=0.008), and spectral tilt (F3,8.39=15.43, p=0.001) ( Table 1) . We observed significant differences in acoustic power distribution across relevant frequency bands for speech in all three mask conditions compared to no mask.

title:
  Effects of face masks on acoustic analysis and speech perception: Implications for peri-pandemic protocols

abstract:
  Wearing face masks (alongside physical distancing) provides some protection against infection from COVID-19. Face masks can also change how we communicate and subsequently affect speech signal quality. Here we investigated how three face mask types (N95, surgical and cloth) affect acoustic analysis of speech and perceived intelligibility in healthy subjects. We compared speech produced with and without the different masks on acoustic measures of timing, frequency, perturbation and power spectral density. Speech clarity was also examined using a standardized intelligibility tool by blinded raters. Mask type impacted the power distribution in frequencies above 3kHz for both the N95 and surgical masks. Measures of timing and spectral tilt also differed across mask conditions. Cepstral and harmonics to noise ratios remained flat across mask type. No differences were observed across conditions for word or sentence intelligibility measures. Our data show that face masks change the speech signal, but some specific acoustic features remain largely unaffected (e.g., measures of voice quality) irrespective of mask type. Outcomes have bearing on how future speech studies are run when personal protective equipment is worn.


id: cord-134278-pe41vebc
author: Kuhl, Niklas
date: 2020-10-20
txt: ./txt/cord-134278-pe41vebc.txt
cache: ./cache/cord-134278-pe41vebc.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2010.12026v1.pdf
doi: nan
summary:
  However, large-scale monitoring of mask recognition does not only require a well-performing Artificial Intelligence, but also ensure that no privacy issues are introduced, as surveillance is a deterrent for citizens and regulations like General Data Protection Regulation (GDPR) demand strict regulations of such personal data. In this work, we show how a privacy-preserving mask recognition artifact could look like, demonstrate different options for implementation and evaluate performances. While this solution entails many upsides, e.g., scalability and automation capabilities, it needs to be in-line with the privacy regulations such as the General Data Protection Regulation (GDPR) and it needs to be understood by citizens to trust and accept the approach: The protection of personal data, e.g., video streams revealing individuals'' faces, is regionally required by legal regulations, such as the GDPR in the European Union [5] 1 .

title:
  "Healthy surveillance": Designing a concept for privacy-preserving mask recognition AI in the age of pandemics

abstract:
  The obligation to wear masks in times of pandemics reduces the risk of spreading viruses. In case of the COVID-19 pandemic in 2020, many governments recommended or even obligated their citizens to wear masks as an effective countermeasure. In order to continuously monitor the compliance of this policy measure in public spaces like restaurants or tram stations by public authorities, one scalable and automatable option depicts the application of surveillance systems, i.e., CCTV. However, large-scale monitoring of mask recognition does not only require a well-performing Artificial Intelligence, but also ensure that no privacy issues are introduced, as surveillance is a deterrent for citizens and regulations like General Data Protection Regulation (GDPR) demand strict regulations of such personal data. In this work, we show how a privacy-preserving mask recognition artifact could look like, demonstrate different options for implementation and evaluate performances. Our conceptual deep-learning based Artificial Intelligence is able to achieve detection performances between 95% and 99% in a privacy-friendly setting. On that basis, we elaborate on the trade-off between the level of privacy preservation and Artificial Intelligence performance, i.e. the"price of privacy".


id: cord-148354-3nl3js2x
title: On the utility of cloth facemasks for controlling ejecta during respiratory events
author: Kumar, Vivek
date: 2020-05-05
txt: ./txt/cord-148354-3nl3js2x.txt
cache: ./cache/cord-148354-3nl3js2x.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2005.03444v1.pdf
doi: nan
summary:
  We simulate the aerodynamic flow through the mask and the spatial spread of droplet ejecta resulting from respiratory events such as coughing or sneezing. We present the viral load in the air and deposited around the person, and show that wearing even a simple cloth mask substantially decreases the extent of spatial spread of virus particles when an infected person coughs or sneezes. 30 Here, we employ Computational Fluid Dynamics (CFD) simulations to address the influence of homemade face masks on the turbulent clouds that result due to sneezing events, and on the lateral extent of spread of ejecta. When an infected person not wearing a mask sneezes or coughs, virus particles in the large droplets rapidly drop to the floor. Our simulation results conclusively demonstrate that wearing even just a simple cotton mask has a dramatic influence on the air flow and spread of ejecta after a respiratory event.

abstract:
  The utility of wearing simple cloth face masks is analyzed using computational fluid dynamics simulations. We simulate the aerodynamic flow through the mask and the spatial spread of droplet ejecta resulting from respiratory events such as coughing or sneezing. Without a mask, a turbulent jet forms, and droplets with a broad size distribution are ejected. Large droplets (greater than about 125 {mu}m in diameter) fall to the ground within about 2 m, while turbulent clouds transport a mist of small aerosolized droplets over significant distances (~ 5 m), consistent with reported experimental findings. A loosely fitted simple cotton cloth mask (with a pore size ~ 4 microns) qualitatively changes the propagation of the high velocity jet, and largely eliminates the turbulent cloud downstream of the mask. About 12% of the airflow leaks around the sides of a mask, considering a uniform gap of only 1 mm all around, between the face and the mask. The spread of ejecta is also changed, with most large droplets trapped at the mask surface. We present the viral load in the air and deposited around the person, and show that wearing even a simple cloth mask substantially decreases the extent of spatial spread of virus particles when an infected person coughs or sneezes.


id: cord-158415-qwxyuuz7
title: Multi-Stage CNN Architecture for Face Mask Detection
author: Chavda, Amit
date: 2020-09-16
txt: ./txt/cord-158415-qwxyuuz7.txt
cache: ./cache/cord-158415-qwxyuuz7.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2009.07627v2.pdf
doi: nan
summary:
  Our system consists of a dual-stage Convolutional Neural Network (CNN) architecture capable of detecting masked and unmasked faces and can be integrated with pre-installed CCTV cameras. Convolutional Neural Networks (CNNs) (LeCun et al., 1998 ) is a key aspect in modern Computer Vision tasks like pattern object detection, image classification, pattern recognition tasks, etc. Multiple algorithms based on Regional Proposal Network like Fast RCNN (Girshick, 2015) and Faster RCNN (Ren et al., 2015) have achieved higher accuracy and better results than most single stage detectors. The detected faces (regions of interest) extracted from this stage are then batched together and passed to the second stage of our architecture, which is a CNN based Face Mask Classifier. The output of this stage is an image (or video frame) with localized faces, classified as masked or unmasked.

abstract:
  The end of 2019 witnessed the outbreak of Coronavirus Disease 2019 (COVID-19), which has continued to be the cause of plight for millions of lives and businesses even in 2020. As the world recovers from the pandemic and plans to return to a state of normalcy, there is a wave of anxiety among all individuals, especially those who intend to resume in-person activity. Studies have proved that wearing a face mask significantly reduces the risk of viral transmission as well as provides a sense of protection. However, it is not feasible to manually track the implementation of this policy. Technology holds the key here. We introduce a Deep Learning based system that can detect instances where face masks are not used properly. Our system consists of a dual-stage Convolutional Neural Network (CNN) architecture capable of detecting masked and unmasked faces and can be integrated with pre-installed CCTV cameras. This will help track safety violations, promote the use of face masks, and ensure a safe working environment.


id: cord-171219-jkoegawm
author: Sheets, Donal
date: 2020-06-03
txt: ./txt/cord-171219-jkoegawm.txt
cache: ./cache/cord-171219-jkoegawm.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2006.02470v1.pdf
doi: nan
summary:
  We present and discuss both the pressure drop and the particle transmission as a function of flow to permit comparison of relative protection for a set of proposed filter and mask designs. Controlled flow of aerosolized air propagates from the IP chamber to the CE chamber and enters the MP chamber through either (a) a mask-donning dummy head or (b) a clamped-material tester depending on the state of two ball valves (Figure 2c ). The chambers are connected sequentially IP-CE-MP with gas flow fittings and feature calibrated sensors capable of measuring flow rate, pressure drops, and aerosol particle distribution in different size ranges. Aerosol particle distributions are measured before and after the mask or the filter material and the experiment is repeated with an open system and a control high-performance mask (3M-1860 N95 standard) for comparison.

title:
  An apparatus for nondestructive and rapid comparison of mask approaches in defense against infected respiratory aerosols

abstract:
  At the front lines of the world's response to the COVID-19 pandemic are hero-clinicians facing a lack of critical supplies including protective medical grade breathing masks and filtering materials. At the same time, the general public is now being advised to wear masks to help stop the spread. As a result, in the absence of centrally coordinated production and distribution efforts, supply chains for masks, respirators, and materials for advanced filtration technology are immensely burdened. Here we describe experimental efforts to nondestructively quantify three vital characteristics of mask approaches: breathability, material filtration effectiveness, and sensitivity to fit. We focus on protection against water aerosols $>$0.3$mu$m using off-the-shelf particulate, flow, and pressure sensors, permitting rapid comparative evaluation of these three properties. We present and discuss both the pressure drop and the particle transmission as a function of flow to permit comparison of relative protection for a set of proposed filter and mask designs. The design considerations of the testing apparatus can be reproduced by university laboratories and medical facilities and used for rapid local quality control of respirator masks which are of uncertified origin, monitoring the long-term effects of various disinfection schemes, and evaluating improvised products not designed or marketed for filtration.


id: cord-225145-m5udub60
author: Kai, De
date: 2020-04-22
txt: ./txt/cord-225145-m5udub60.txt
cache: ./cache/cord-225145-m5udub60.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2004.13553v1.pdf
doi: nan
summary:
  We present two models for the COVID-19 pandemic predicting the impact of universal face mask wearing upon the spread of the SARS-CoV-2 virus--one employing a stochastic dynamic network based compartmental SEIR (susceptible-exposed-infectious-recovered) approach, and the other employing individual ABM (agent-based modelling) Monte Carlo simulation--indicating (1) significant impact under (near) universal masking when at least 80% of a population is wearing masks, versus minimal impact when only 50% or less of the population is wearing masks, and (2) significant impact when universal masking is adopted early, by Day 50 of a regional outbreak, versus minimal impact when universal masking is adopted late. To validate these theoretical models, we compare their predictions against a new empirical data set we have collected that includes whether regions have universal masking cultures or policies, their daily case growth rates, and their percentage reduction from peak daily case growth rates.

title:
  Universal Masking is Urgent in the COVID-19 Pandemic: SEIR and Agent Based Models, Empirical Validation, Policy Recommendations

abstract:
  We present two models for the COVID-19 pandemic predicting the impact of universal face mask wearing upon the spread of the SARS-CoV-2 virus--one employing a stochastic dynamic network based compartmental SEIR (susceptible-exposed-infectious-recovered) approach, and the other employing individual ABM (agent-based modelling) Monte Carlo simulation--indicating (1) significant impact under (near) universal masking when at least 80% of a population is wearing masks, versus minimal impact when only 50% or less of the population is wearing masks, and (2) significant impact when universal masking is adopted early, by Day 50 of a regional outbreak, versus minimal impact when universal masking is adopted late. These effects hold even at the lower filtering rates of homemade masks. To validate these theoretical models, we compare their predictions against a new empirical data set we have collected that includes whether regions have universal masking cultures or policies, their daily case growth rates, and their percentage reduction from peak daily case growth rates. Results show a near perfect correlation between early universal masking and successful suppression of daily case growth rates and/or reduction from peak daily case growth rates, as predicted by our theoretical simulations. Our theoretical and empirical results argue for urgent implementation of universal masking. As governments plan how to exit societal lockdowns, it is emerging as a key NPI; a"mouth-and-nose lockdown"is far more sustainable than a"full body lockdown", on economic, social, and mental health axes. An interactive visualization of the ABM simulation is at http://dek.ai/masks4all. We recommend immediate mask wearing recommendations, official guidelines for correct use, and awareness campaigns to shift masking mindsets away from pure self-protection, towards aspirational goals of responsibly protecting one's community.


id: cord-253786-dvh2wnwj
author: Church, Lauren Elizabeth
date: 2020-08-03
txt: ./txt/cord-253786-dvh2wnwj.txt
cache: ./cache/cord-253786-dvh2wnwj.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/pbc.28634
doi: 10.1002/pbc.28634
abstract: nan
summary:
  title: Comment on: Frequency of face touching with and without a mask in pediatric hematology/oncology health care professionals: For application to the COVID‐19 pandemic Comment on: Frequency of face touching with and without a mask in pediatric hematology/oncology health care professionals: For application to the COVID-19 pandemic 2 It took place in health care professionals (HCP), who would have had access to and use of masks throughout training and practice. 4 There is no evidence that decreased face touches while wearing masks can be applied to public populations. Further studies should be completed, allowing for more personFurther to this, public health campaigns regarding correct mask protocol and avoiding face touching can be evaluated for efficacy; this could involve randomising groups to receive training and then observing mask use. Frequency of face touching with and without a mask in pediatric hematology/oncology health care professionals.

title:
  Comment on: Frequency of face touching with and without a mask in pediatric hematology/oncology health care professionals: For application to the COVID‐19 pandemic


id: cord-253827-5vodag6c
title: Face Masks, Public Policies and Slowing the Spread of COVID-19: Evidence from Canada
author: Karaivanov, A.
date: 2020-09-25
txt: ./txt/cord-253827-5vodag6c.txt
cache: ./cache/cord-253827-5vodag6c.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.09.24.20201178v1?rss=1
doi: 10.1101/2020.09.24.20201178
summary:
  We estimate the impact of mask mandates and other non-pharmaceutical interventions (NPI) on COVID-19 case growth in Canada, including regulations on businesses and gatherings, school closures, travel and self-isolation, and long-term care homes. 2 Counterfactual policy simulations using our empirical estimates suggest that mandating indoor masks nationwide in early July could have reduced weekly new cases in Canada by 25 to 40% on average by mid-August relative to the actually observed numbers, which translates into 700 to 1,100 fewer cases per week. Our results on business/gathering regulations and school closure suggest that reduced restrictions and the associated increase in business or workplace activity and gatherings or school re-opening can offset, in whole or in part, the estimated effect of mask mandates on case growth, both in our sample and subsequently. CKS (2020), whose estimation strategy we follow, exploit U.S. state-level variation in the timing of mask mandates for employees in public-facing businesses, and find that these mandates are associated with 9 to 10 percentage points reduction in the weekly growth rate of cases.

abstract:
  We estimate the impact of mask mandates and other non-pharmaceutical interventions (NPI) on COVID-19 case growth in Canada, including regulations on businesses and gatherings, school closures, travel and self-isolation, and long-term care homes. We partially account for behavioral responses using Google mobility data. Our identification approach exploits variation in the timing of indoor face mask mandates staggered over two months in the 34 public health regions in Ontario, Canada's most populous province. We find that, in the first few weeks after implementation, mask mandates are associated with a reduction of 25 percent in the weekly number of new COVID-19 cases. Additional analysis with province-level data provides corroborating evidence. Counterfactual policy simulations suggest that mandating indoor masks nationwide in early July could have reduced the weekly number of new cases in Canada by 25 to 40 percent in mid-August, which translates into 700 to 1,100 fewer cases per week.


id: cord-254861-lpzx878m
title: An Interim Solution to the Decreased Availability of Respirators Against COVID-19
author: Saggese, Nicholas P.
date: 2020-04-22
txt: ./txt/cord-254861-lpzx878m.txt
cache: ./cache/cord-254861-lpzx878m.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33035018/
doi: 10.1213/ane.0000000000004879
abstract: nan
summary:
  To the Editor W e read the recent article titled, "Utility of Substandard Facemask Options for Health Care Workers during the COVID-19 Pandemic" by Abd-Elsayed and Karru 1 with great interest. The respirator is comprised of an anesthesia mask, inline ventilator filter, or high-efficiency particulate air (HEPA) filter and elastic straps ( Figure A) . 3 Also, a case report from Singapore demonstrated 41 health care workers (HCWs) who came in contact with COVID-19 patients during aerosolizing procedures. Alternatively, the authors of this letter used 2 tourniquets fashioned together instead of rubber bands to create a better seal ( Figure C) . After using this technique and performing a user seal An Interim Solution to the Decreased Availability of Respirators Against COVID-19 Figure. Solutions to the shortage of N95 respirators are crucial for protecting health care workers from contracting the virus and becoming a vector of transmission to others. Utility of substandard face mask options for health care workers during the COVID-19 pandemic


id: cord-255062-7ozdmb09
author: Ogoina, Dimie
date: 2020-08-04
txt: ./txt/cord-255062-7ozdmb09.txt
cache: ./cache/cord-255062-7ozdmb09.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.4269/ajtmh.20-0886
doi: 10.4269/ajtmh.20-0886
summary:
  This article highlights the likely benefits of face mask containers in promoting safe, appropriate, and extended use of medical masks by healthcare workers in settings where a sustainable supply of medical masks may be limited. However, if medical masks are to be worn continuously by healthcare workers for up to 8 hours or more every working day, then there should be provision to temporarily and safely store them for extended use during the day, especially when they are not visibly soiled, wet, damp, or damaged. In the wake of global supply shortages, 7 appropriately designed face mask containers could be useful in promoting safe extended use of medical masks, especially in resourcelimited healthcare settings. With the growing call for universal masking as a key costeffective strategy to combat the COVID-19 pandemic, it is my view that the benefits of face mask containers in promoting appropriate use of masks and enabling extended and safe use far outweigh the risks.

title:
  Improving Appropriate Use of Medical Masks for COVID-19 Prevention: The Role of Face Mask Containers

abstract:
  Use of medical masks is a key strategy for COVID-19 prevention among healthcare workers. Unfortunately, there are global shortages of this essential commodity, and many have resulted in inappropriate usage to conserve supply. This article highlights the likely benefits of face mask containers in promoting safe, appropriate, and extended use of medical masks by healthcare workers in settings where a sustainable supply of medical masks may be limited.


id: cord-257519-mug5g92f
author: Baluja, A.
date: 2020-04-11
txt: ./txt/cord-257519-mug5g92f.txt
cache: ./cache/cord-257519-mug5g92f.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.04.07.20057224
doi: 10.1101/2020.04.07.20057224
summary:
  Results: The data obtained reveal that the dosage received inside the manufactured UVGI-irradiator depends not only on the distance between the luminaires plane and the base of the respirators but also on the orientation and shape of the masks. The data obtained reveal that the dosage received inside the manufactured UVGI-irradiator depends not only on the distance between the luminaires plane and the base of the respirators but also, on the orientation and shape of the masks. In this case, the exposure time should be calculated in order to warrant the dosage in the inner part of the FFRs. Some simulations were also made in order to find the shadows and areas with less irradiance inside the box. . https://doi.org/10.1101/2020.04.07.20057224 doi: medRxiv preprint Figure 4 : left) Representation of the experimental data obtained in the disinfection box; Right) simulated light distribution maps in pseudocolor maps inside the UVGI irradiator.

title:
  UV light dosage distribution over irregular respirator surfaces. Methods and implications for safety

abstract:
  Background and Objectives: The SARS-CoV2 pandemic has lead to a global decrease in protection ware, especially facepiece filtering respirators (FFRs). Ultraviolet-C wavelength is a promising way of descontamination, however adequate dosimetry is needed to ensure balance between over and underexposed areas and provide reliable results. Our study demonstrates that UVGI light dosage varies significantly on different respirator angles, and propose a method to descontaminate several masks at once ensuring appropriate dosage in shaded zones. Methods: An UVGI irradiator was built with internal dimensions of 69.5 x55 x 33 cm with three 15W UV lamps. Inside, a grating of 58 x 41 x 15 cm was placed to hold the masks. Two different respirator models were used to assess irradiance, four of model Aura 9322 3M of dimensions 17 x 9 x 4cm, and two of model SAFE 231FFP3NR with dimensions 17 x 6 x 5 cm. A spectrometer STN-SilverNova was employed to verify wavelength spectrum and surface irradiance. A simulation was performed to find the irradiance pattern inside the box and the six masks placed inside. These simulations were carried out using the software DIALUX EVO 8.2. Results: The data obtained reveal that the dosage received inside the manufactured UVGI-irradiator depends not only on the distance between the luminaires plane and the base of the respirators but also on the orientation and shape of the masks. This point becomes relevant in order to assure that all the respirators inside the chamber receive the correct dosage. Conclusion: Irradiance over FFR surfaces depend on several factors such as distance, angle of incidence of the light source. Careful dosage measurement and simulation can ensure reliable dosage in the whole mask surface, balancing overexposure. Closed box systems might provide a more reliable, reproducible UVGI dosage than open settings.


id: cord-257997-btj4ckkz
author: Wen, ZhanBo
date: 2012-12-23
txt: ./txt/cord-257997-btj4ckkz.txt
cache: ./cache/cord-257997-btj4ckkz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32214627/
doi: 10.1007/s10453-012-9286-7
summary:
  The masks protection performance against viral aerosol and face fit factor was determined in order to evaluate the protection efficiency of different level protection mask. Face fit factor of 150 Fig. 1 Rig for testing filtration efficiency of respiratory protection equipments against viral aerosol Aerobiologia (2013) 29:365-372 367 means that the air inside the mask is 150 times as clean as the air outside the mask. If do not consider the face fit factor, both the surgical mask and N95 or N99 mask had good protection efficiency against viral aerosol in our study. The surgical masks and N95 or N99 mask used in this study were sealed to the face of the manikin, so their efficiency determined during viral aerosol protection experiments is defined as the efficiency of the filter material. Though the efficiency of the filter material of tested masks against viral aerosol was all [95 %, the protection factors determined by TSI8020 and N95 components were different greatly.

title:
  Assessment the protection performance of different level personal respiratory protection masks against viral aerosol

abstract:
  New viral disease such as SARS and H1N1 highlighted the vulnerability of healthcare workers to aerosol-transmitted viral infections. This paper was to assess the protection performance of different level personal respiratory protection equipments against viral aerosol. Surgical masks, N95 masks and N99 masks were purchased from the market. The masks were sealed onto the manikin in the aerosol testing chamber. Viral aerosol was generated and then sampled simultaneously before and after the tested mask using biosamplers. This allows a percentage efficiency value to be calculated against test phage SM702 aerosols which surrogates of viral pathogens aerosol. At the same time, the masks face fit factor was determined by TSI8020. The viral aerosol particles aerodynamic diameter was 0.744 μm, and GSD was 1.29. The protection performance of the material of all the tested masks against viral aerosol was all >95 %. All the five surgical masks face fit factor were <8. F model N95 mask and H model N99 mask face fit factor were all >160. G model N95 mask face fit factor was 8.2. The protection performances of N95 or N99 masks were many times higher than surgical mask when considering the face fit factor. Surgical masks cannot offer sufficient protection against the inhalation of viral aerosol because they cannot provide a close face seal.


id: cord-258846-v6aaflzc
author: Shruti, V.C.
date: 2020-10-20
txt: ./txt/cord-258846-v6aaflzc.txt
cache: ./cache/cord-258846-v6aaflzc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.marpolbul.2020.111777
doi: 10.1016/j.marpolbul.2020.111777
abstract: nan
summary:
  In developing countries such as Thailand, Japan, Mexico, Vietnam, and South Africa, where surgical and N95 masks have been reserved for health care providers or are scarce, the main alternative for the general public seems to be the use of nonmedical reusable masks made up of fabric or cloth. Considering that plastic pollution in the marine environment is a global issue, in light of the COVID-19 pandemic-induced changes, an increasing number of research papers have raised concerns about plastic waste management and the improper disposal of PPE (Sharma et al., 2020; Silva et al., 2020) . As textiles have become an important source of microplastics, arguably, it is important to consider including reusable masks in microplastic research to address questions concerning its contribution to microfiber generation during machineand hand-laundering. Covid-19 face masks: a potential source of microplastic fibers in the environment

title:
  Reusable masks for COVID-19: A missing piece of the microplastic problem during the global health crisis


id: cord-258859-iaiosjlu
title: Mask use during COVID-19: A risk adjusted strategy()
author: Wang, Jiao
date: 2020-06-25
txt: ./txt/cord-258859-iaiosjlu.txt
cache: ./cache/cord-258859-iaiosjlu.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0269749120334862?v=s5
doi: 10.1016/j.envpol.2020.115099
summary:
  In the context of Coronavirus Disease (2019) (COVID-19) cases globally, there is a lack of consensus across cultures on whether wearing face masks is an effective physical intervention against disease transmission. This study 1) illustrates transmission routes of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2); 2) addresses controversies surrounding the mask from perspectives of attitude, effectiveness, and necessity of wearing the mask with evidence that the use of mask would effectively interrupt the transmission of infectious diseases in both hospital settings and community settings; and 3) provides suggestion that the public should wear the mask during COVID-19 pandemic according to local context. The mask is generally used 278 by general public, while the respirator or a filtering face piece, which is designed to 279 protect the wearer from exposure to airborne contaminants, is mainly used by health care 280 workers especially during AGP (European Centre for Disease Prevention and Control, 281 2020).

abstract:
  In the context of Coronavirus Disease (2019) (COVID-19) cases globally, there is a lack of consensus across cultures on whether wearing face masks is an effective physical intervention against disease transmission. This study 1) illustrates transmission routes of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2); 2) addresses controversies surrounding the mask from perspectives of attitude, effectiveness, and necessity of wearing the mask with evidence that the use of mask would effectively interrupt the transmission of infectious diseases in both hospital settings and community settings; and 3) provides suggestion that the public should wear the mask during COVID-19 pandemic according to local context. To achieve this goal, government should establish a risk adjusted strategy of mask use to scientifically publicize the use of masks, guarantee sufficient supply of masks, and cooperate for reducing health resources inequities.


id: cord-260429-5wsj003j
title: Widespread use of face masks in public may slow the spread of SARS CoV-2: an ecological study
author: Kenyon, Chris
date: 2020-04-06
txt: ./txt/cord-260429-5wsj003j.txt
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url: https://doi.org/10.1101/2020.03.31.20048652
doi: 10.1101/2020.03.31.20048652
summary:
  title: Widespread use of face masks in public may slow the spread of SARS CoV-2: an ecological study Individual level studies have found that the use of face masks was protective for the acquisition and transmission of a range of respiratory viruses including SARS CoV1. Methods At a country level, linear regression was used to assess the association between COVID19 diagnoses per inhabitant and the national promotion of face masks in public (coded as a binary variable), controlling for the age of the COVID19 epidemic and testing intensity. Conclusion Whilst these results are susceptible to residual confounding, they do provide ecological level support to the individual level studies that found face mask usage to reduce the transmission and acquisition of respiratory viral infections. /2020 In this ecological study we found that countries that promoted widespread face mask 185 usage had lower cumulative numbers of COVID-19 diagnosed after controlling for 186 testing intensity and age of the epidemic.

abstract:
  Background The reasons for the large differences between countries in the sizes of their SARS CoV2 epidemics is unknown. Individual level studies have found that the use of face masks was protective for the acquisition and transmission of a range of respiratory viruses including SARS CoV1. We hypothesized that population level usage of face masks may be negatively associated SARS CoV2 spread. Methods At a country level, linear regression was used to assess the association between COVID19 diagnoses per inhabitant and the national promotion of face masks in public (coded as a binary variable), controlling for the age of the COVID19 epidemic and testing intensity. Results Eight of the 49 countries with available data advocated wearing face masks in public: China, Czechia, Hong Kong, Japan, Singapore, South Korea, Thailand and Malaysia. In multivariate analysis face mask use was negatively associated with number of COVID19 cases/inhabitant (coef. -326, 95% CI -601- -51, P=0.021). Testing intensity was positively associated with COVID-19 cases (coef. 0.07, 95% CI 0.05-0.08, P<0.001). Conclusion Whilst these results are susceptible to residual confounding, they do provide ecological level support to the individual level studies that found face mask usage to reduce the transmission and acquisition of respiratory viral infections.


id: cord-261580-zghq7mcg
title: A cloth mask for under-resourced healthcare settings in the COVID19 pandemic
author: Sugrue, Michael
date: 2020-05-12
txt: ./txt/cord-261580-zghq7mcg.txt
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url: https://doi.org/10.1007/s11845-020-02241-3
doi: 10.1007/s11845-020-02241-3
summary:
  This work reports the design and fabrication steps of a simple cloth face mask, which may be considered as a last resort for those wishing to have some protection and protect others from aerosol and droplet spread. Van de Sande has suggested the deployment of masks in the general population during an outbreak of an infectious disease, where anyone may encounter the infectious micro-organism, implying much greater heterogeneity, Fig. 1 The pattern for the home made mask in training levels (experience and understanding), goodness of fit of a mask and activities interfering with mask use and thus reducing potential reduction of transmission [5] . In its current guidance to optimise use of face masks during the pandemic, the Centers for Disease Control and Prevention (CDC) identifies three levels of operational status: conventional, contingency and crisis [13] . The cloth face mask is simple, cheap and made from materials that are globally available.

abstract:
  INTRODUCTION: COVID19 pandemic poses a global threat, with many unknowns. The potential for resource limited countries to suffer huge mortality is of major concern. Prevention and risk reduction strategies are paramount in the current absence of effective treatment or a vaccine. There is a global shortage of personal protective equipment. AIMS: This short paper describes the rationale for and development of a cloth homemade mask and has a step by step video. RESULTS: The template is reproducible around the world and is both washable and cheap. CONCLUSION: This article describes a simple way to make a cloth mask, suitable if medical masks are not available.


id: cord-262200-2enorlii
title: Use of masks by health care workers
author: nan
date: 2020-05-30
txt: ./txt/cord-262200-2enorlii.txt
cache: ./cache/cord-262200-2enorlii.txt
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mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S000140792030337X
doi: 10.1016/j.banm.2020.05.096
abstract: nan
summary:
  authors: nan For healthcare workers, the choice of mask may vary depending on whether they are in contact with patients presumed to be healthy, suspect or affected by COVID-19, and according to the type of care [1] . In the context of the COVID-19 pandemic, three types of masks are available to healthcare workers: • surgical masks, also known as masks for medical use or anti-projection masks ( the National Academy of Surgery, May 23, 2020. These rules must apply even in the non-COVID sector, as any patient is a potential carrier of the coronavirus, • an FFP2 mask without protection valve during acts exposing to fine particle aerosols or viruses (ENT examination, nasal sampling, intubation/extubation, bronchial fibroscopy, dental care, respiratory physiotherapy. The creation of abacuses from the morphological parameters of the face could help in the choice of a personalized mask; • to use over-gowns, gloves and goggles in addition to the FFP2 mask in certain circumstances, as SARS-CoV-2 contamination may pass through other entry points than the respiratory tract.


id: cord-262920-yjsl6kck
author: Schilling, Katherine
date: 2020-08-06
txt: ./txt/cord-262920-yjsl6kck.txt
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url: https://www.ncbi.nlm.nih.gov/pubmed/32764709/
doi: 10.1038/s41370-020-0258-7
summary:
  With the intent of evaluating filtration efficiency without purporting to replicate NIOSH equivalency, the methods designed in this study are aimed at testing masks with relevant, reproducible aerosol distributions at face velocities appropriate for human respiration. and for the purposes of this study was further substantiated by measuring across a series of dilution factors (with and without mask material in place) to gain multi-point measurements across a range of test aerosol concentrations at a given face velocity (see Section S4 and Fig. S6 ). We also evaluated a rapid screening approach with the understanding that initial screening of large inventories is necessary to determine which masks/respirators warrant further testing and also that some communities and facilities may be constrained in terms of available instrumentation for aerosol measurement and flow control. The methods presented here rely upon regular comparisons to NIOSH N95 benchmark masks, as absolute filtration efficiencies will vary with changes in flow rates and aerosol sizes measured (e.g., Fig. 5 ).

title:
  An accessible method for screening aerosol filtration identifies poor-performing commercial masks and respirators

abstract:
  BACKGROUND: The COVID-19 pandemic has presented an acute shortage of regulation-tested masks. Many of the alternatives available to hospitals have not been certified, leaving uncertainty about their ability to properly protect healthcare workers from SARS-CoV-2 transmission. OBJECTIVE: For situations where regulatory methods are not accessible, we present experimental methods to evaluate mask filtration and breathability quickly via cost-effective approaches (e.g., ~$2000 USD) that could be replicated in communities of need without extensive infrastructure. We demonstrate the need for screening by evaluating an existing diverse inventory of masks/respirators from a local hospital. METHODS: Two experimental approaches are presented to examine both aerosol filtration and flow impedance (i.e., breathability). For one of the approaches (“quick assessment”), screening for appropriate filtration could be performed under 10 min per mask, on average. Mask fit tests were conducted in tandem but are not the focus of this study. RESULTS: Tests conducted of 47 nonregulation masks reveal variable performance. A number of commercially available masks in hospital inventories perform similarly to N95 masks for aerosol filtration of 0.2 μm and above, but there is a range of masks with relatively lower filtration efficiencies (e.g., <90%) and a subset with poorer filtration (e.g., <70%). All masks functioned acceptably for breathability, and impedance was not correlated with filtration efficiency. SIGNIFICANCE: With simplified tests, organizations with mask/respirator shortages and uncertain inventories can make informed decisions about use and procurement.


id: cord-266123-q75f12vh
author: Lin, Che-huei
date: 2020-10-19
txt: ./txt/cord-266123-q75f12vh.txt
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mime: text/plain
url: https://doi.org/10.1186/s12962-020-00239-3
doi: 10.1186/s12962-020-00239-3
summary:
  Cost Effectiveness and Resource Allocation *Correspondence: lmh.roger@msa.hinet.net † Wang Jong Yi and Lin Ming Hung contributed equally to this work 1 Department of Pharmacy and Master Program, Tajen University, Pintung 90741, Taiwan Full list of author information is available at the end of the article enhance the distribution-related outcomes of scarce public health management resources to target populations and communities. Given their proven performance record as being a reliable resource for helping to implement public health promotion initiatives by the Taiwanese government, community pharmacies were enlisted to assist in the distribution of face masks to citizens across the country. The community pharmacy-based approach to the distribution and sale of prevention face masks to citizens for the ongoing COVID-19 pandemic has proven to be a new and innovative engagement of pharmacists in contributing to the efficient, reliable, equitable, and costeffective implementation of public health promotion and protection initiatives by the government.

title:
  The pharmaceutical practice of mask distribution by pharmacists in Taiwan’s community pharmacies under the Mask Real-Name System, in response to the COVID-19 outbreak

abstract:
  BACKGROUND: Pharmacists hold to their promise to foster, implement and promote the health of the population and to prevent disease, given their knowledge, skills, and proximity to the locals. The objective of this study was to foster equality and cost-effectiveness in the distribution and sale of masks to all Taiwanese citizens, in response to the COVID-19 pandemic. METHODS: All 6336 special community pharmacies participating in the NHI (National Health Insurance) served as mask-selling sites. Access to masks by citizens was determined and controlled, based on the weekly rationing of the number of purchasable masks per citizen and the last digit of their NHI card number. Masks were available on different weekdays for holders of cards ending with odd and even numbers, except on Sundays, when everyone was eligible to buy a mask. RESULTS: Implementing the program has provided equal access to masks for all citizens across Taiwan. It has stabilized the pricing of masks and mitigated the public’s anxiety of a perceived likely market shortage. CONCLUSION: The community pharmacy-based approach to the distribution of prevention face masks to citizens represents a new and innovative engagement of pharmacists in public health promotion and protection initiatives. Community pharmacies can greatly improve the efficiency, reliability, and cost-saving of the distribution of public health resources to local communities, especially in the face of an epidemic.


id: cord-266377-3krv9ekb
author: Nakayachi, Kazuya
date: 2020-08-04
txt: ./txt/cord-266377-3krv9ekb.txt
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url: https://www.ncbi.nlm.nih.gov/pubmed/32849127/
doi: 10.3389/fpsyg.2020.01918
summary:
  In our survey, we examined six possible psychological reasons for wearing masks: three involved individuals'' perception of the severity of the disease and the efficacy of masks in reducing the infection risks both for themselves and for others; the remaining three involved other psychological driving forces. By contrast, frequency of mask usage depended much less on the participants'' perceived severity of the disease and the efficacy of masks in reducing infection risk both for themselves and for others. Even though the expectation of risk reduction (personal or collective) explained only small portion of mask usage, motivations superficially irrelevant to disease mitigation strongly promoted mask-wearing behavior; conformity to the social norm was the most prominent driving force for wearing masks. Despite these limitations, this study has empirically revealed that the expectation of risk reduction does not greatly promote mask-wearing countermeasures against COVID-19, suggesting that the nudge approach (i.e., taking advantage of people''s conformity) may be more promising.

title:
  Why Do Japanese People Use Masks Against COVID-19, Even Though Masks Are Unlikely to Offer Protection From Infection?

abstract:
  Wearing masks against 2019 coronavirus (COVID-19) is beneficial in suppressing pandemic spread, not through preventing the wearer from being infected but by preventing the wearer from infecting others. Despite not providing much protection, the custom of wearing masks has prevailed in East Asia from the early stages of the pandemic, especially in Japan, to such an extent that it caused a shortfall in supply. Why do many Japanese people wear masks during the COVID-19 pandemic, even though masks are unlikely to prevent them from getting infected? We examined six possible psychological reasons for wearing masks: three involved expectations about the risk of infection and three involved other driving psychological forces. The results of our nationwide survey revealed that people conformed to societal norms in wearing masks and felt relief from anxiety when wearing masks. However, risk reduction expectations did not affect mask usage. The social psychological motivations successfully explained much about mask usage. Our findings suggest that policymakers responsible for public health should consider social motivations when implementing public strategies to combat the COVID-19 pandemic.


id: cord-266814-0l78gpg3
title: Utility of Cloth Masks in Preventing Respiratory Infections: A Systematic Review
author: Mondal, A.
date: 2020-05-11
url: https://doi.org/10.1101/2020.05.07.20093864
doi: 10.1101/2020.05.07.20093864
abstract:
  Background: Using face masks is one of the possible prevention methods against respiratory pathogens. A number of studies and reviews have been performed regarding the use of medical grade masks like surgical masks, N95 respirators etc. However, the use of cloth masks has received little attention. Objectives: The purpose of this review is to analyze the available data regarding the use of cloth masks for the prevention of respiratory infections. We intended to use data from both clinical and non-clinical studies to arrive at our conclusion. Methods: We used PubMed, Cochrane Library and Google Scholar as our source databases. Both clinical and non-clinical studies, which had data regarding the efficacy of cloth masks, were selected. Articles not containing analyzable data including opinion articles, review articles etc. were excluded. After screening the search results, ten studies could be included in our review. Data relevant to our objective was extracted from each study including clinical efficacy, compliance, filtration efficacy etc. Data from some studies were simplified for the purpose of comparison. Extracted data was summarized and categorized for detailed analysis. Qualitative synthesis of the data was performed. But the heterogeneity between the studies did not allow for a meta-analysis. Discussion: The review was limited by a lack of sufficient clinical studies. Lack of standardization between studies was another limitation. Although cloth masks generally perform poorer than the medical grade masks, they may be better than no masks at all. Filtration efficacy varied greatly depending on the material used, with some materials showing a filtration efficacy above 90%. However, leakage could reduce efficacy of masks by about 50%. Standardization of cloth masks and appropriate use is essential for cloth masks to be effective. However, result of a randomized controlled trial suggest that they may be ineffective in the healthcare setting.


id: cord-267699-h7ftu3ax
author: MacIntyre, C. Raina
date: 2020-04-30
txt: ./txt/cord-267699-h7ftu3ax.txt
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extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0020748920301139
doi: 10.1016/j.ijnurstu.2020.103629
summary:
  title: A RAPID SYSTEMATIC REVIEW OF THE EFFICACY OF FACE MASKS AND RESPIRATORS AGAINST CORONAVIRUSES AND OTHER RESPIRATORY TRANSMISSIBLE VIRUSES FOR THE COMMUNITY, HEALTHCARE WORKERS AND SICK PATIENTS METHODS: A systematic review of randomized controlled clinical trials on use of respiratory protection by healthcare workers, sick patients and community members was conducted. A systematic review of randomized controlled clinical trials on use of respiratory protection by healthcare workers, sick patients and community members was conducted. The aim of this study was to review the randomised controlled trials evidence for use of masks and respirators by the community, health care workers and sick patients for prevention of infection. (17) We conducted a randomised controlled trial comparing the targeted strategy tested in the two North American studies, with the wearing of respiratory protection during an entire shift, and showed efficacy for continual (but not targeted) use of a respirator (19) .

title:
  A RAPID SYSTEMATIC REVIEW OF THE EFFICACY OF FACE MASKS AND RESPIRATORS AGAINST CORONAVIRUSES AND OTHER RESPIRATORY TRANSMISSIBLE VIRUSES FOR THE COMMUNITY, HEALTHCARE WORKERS AND SICK PATIENTS

abstract:
  BACKGROUND: The pandemic of COVID-19 is growing, and a shortage of masks and respirators has been reported globally. Policies of health organizations for healthcare workers are inconsistent, with a change in policy in the US for universal face mask use. The aim of this study was to review the evidence around the efficacy of masks and respirators for healthcare workers, sick patients and the general public. METHODS: A systematic review of randomized controlled clinical trials on use of respiratory protection by healthcare workers, sick patients and community members was conducted. Articles were searched on Medline and Embase using key search terms. RESULTS: A total of 19 randomised controlled trials were included in this study – 8 in community settings, 6 in healthcare settings and 5 as source control. Most of these randomised controlled trials used different interventions and outcome measures. In the community, masks appeared to be more effective than hand hygiene alone, and both together are more protective. Randomised controlled trials in health care workers showed that respirators, if worn continually during a shift, were effective but not if worn intermittently. Medical masks were not effective, and cloth masks even less effective. When used by sick patients randomised controlled trials suggested protection of well contacts. CONCLUSION: The study suggests that community mask use by well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic. The studies of masks as source control also suggest a benefit, and may be important during the COVID-19 pandemic in universal community face mask use as well as in health care settings. Trials in healthcare workers support the use of respirators continuously during a shift. This may prevent health worker infections and deaths from COVID-19, as aerosolisation in the hospital setting has been documented.


id: cord-269665-byuv48wi
author: MacIntyre, Chandini Raina
date: 2011-01-27
url: https://www.ncbi.nlm.nih.gov/pubmed/21477136/
doi: 10.1111/j.1750-2659.2011.00198.x
title:
  A cluster randomized clinical trial comparing fit‐tested and non‐fit‐tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers

abstract:
  Please cite this paper as: MacIntyre et al. (2011) A cluster randomized clinical trial comparing fit‐tested and non‐fit‐tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers. Influenza and Other Respiratory Viruses DOI: 10.1111/j.1750‐2659.2010.00198.x. Background We compared the efficacy of medical masks, N95 respirators (fit tested and non fit tested), in health care workers (HCWs). Methods A cluster randomized clinical trial (RCT) of 1441 HCWs in 15 Beijing hospitals was performed during the 2008/2009 winter. Participants wore masks or respirators during the entire work shift for 4 weeks. Outcomes included clinical respiratory illness (CRI), influenza‐like illness (ILI), laboratory‐confirmed respiratory virus infection and influenza. A convenience no‐mask/respirator group of 481 health workers from nine hospitals was compared. Findings The rates of CRI (3·9% versus 6·7%), ILI (0·3% versus 0·6%), laboratory‐confirmed respiratory virus (1·4% versus 2·6%) and influenza (0·3% versus 1%) infection were consistently lower for the N95 group compared to medical masks. By intention‐to‐treat analysis, when P values were adjusted for clustering, non‐fit‐tested N95 respirators were significantly more protective than medical masks against CRI, but no other outcomes were significant. The rates of all outcomes were higher in the convenience no‐mask group compared to the intervention arms. There was no significant difference in outcomes between the N95 arms with and without fit testing. Rates of fit test failure were low. In a post hoc analysis adjusted for potential confounders, N95 masks and hospital level were significant, but medical masks, vaccination, handwashing and high‐risk procedures were not. Interpretation Rates of infection in the medical mask group were double that in the N95 group. A benefit of respirators is suggested but would need to be confirmed by a larger trial, as this study may have been underpowered. The finding on fit testing is specific to the type of respirator used in the study and cannot be generalized to other respirators. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN: ACTRN12609000257268 (http://www.anzctr.org.au).


id: cord-270766-rasjpg8v
title: A Reusable Mask for Coronavirus Disease 2019 (COVID-19)
author: Luan, Phan Thien
date: 2020-04-10
txt: ./txt/cord-270766-rasjpg8v.txt
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extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0188440920303325?v=s5
doi: 10.1016/j.arcmed.2020.04.001
summary:
  In this article, we aim to give an idea on how to save the number of face masks used but still provides the same protective values using a Cardiopulmonary resuscitation (CPR) mask and a common surgical facemask. In this article, we aim to give an idea on how to save the number of face masks used Arch Med Res E20_298 2 but still provides the same protective values using a Cardiopulmonary resuscitation (CPR) mask and a common surgical facemask. Because of the above reasons, this commentary aims to provide a novel idea on how to combine the use of a reusable CPR mask and a piece of the surgical face mask to limit the amount of face mask uses but still have the same protective value. By proving that the CPR mask is totally sealed with the isolation examination experiment, the filter is 100% provided by the surgical facemask thus giving the exact same protection value.

abstract:
  Abstract The outbreak of Novel Coronavirus is causing an intensely feared globally. World Health Organization has even declared that it is a global health emergency. The simplest method to limit the spread of this new virus and for people to protect themselves as well as the others is to wear a mask in crowded places. The sudden increase demand on face mask has caused manufacturers the inability to not provide enough products in a short time and the situation properly will stay the same for a period of time. In this article, we aim to give an idea on how to save the number of face masks used but still provides the same protective values using a Cardiopulmonary resuscitation (CPR) mask and a common surgical facemask.


id: cord-271822-ohkki0ke
title: Visualizing the effectiveness of face masks in obstructing respiratory jets
author: Verma, Siddhartha
date: 2020-06-01
txt: ./txt/cord-271822-ohkki0ke.txt
cache: ./cache/cord-271822-ohkki0ke.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1063/5.0016018
doi: 10.1063/5.0016018
summary:
  We use qualitative visualizations of emulated coughs and sneezes to examine how materialand design-choices impact the extent to which droplet-laden respiratory jets are blocked. We outline the procedure for setting up simple visualization experiments using easily available materials, which may help healthcare professionals, medical researchers, and manufacturers in assessing the effectiveness of face masks and other personal protective equipment qualitatively. 7 The rationale behind the recommendation for using masks or other face coverings is to reduce the risk of cross-infection via the transmission of respiratory droplets from infected to healthy individuals. 8, 9 The pathogen responsible for COVID-19 is found primarily in respiratory droplets that are expelled by infected individuals during coughing, sneezing, or even talking and breathing. Various studies have investigated the effectiveness of medical-grade face masks and other personal protective equipment (PPE) in reducing the possibility of cross-infection via these droplets.

abstract:
  The use of face masks in public settings has been widely recommended by public health officials during the current COVID-19 pandemic. The masks help mitigate the risk of cross-infection via respiratory droplets; however, there are no specific guidelines on mask materials and designs that are most effective in minimizing droplet dispersal. While there have been prior studies on the performance of medical-grade masks, there are insufficient data on cloth-based coverings, which are being used by a vast majority of the general public. We use qualitative visualizations of emulated coughs and sneezes to examine how material- and design-choices impact the extent to which droplet-laden respiratory jets are blocked. Loosely folded face masks and bandana-style coverings provide minimal stopping-capability for the smallest aerosolized respiratory droplets. Well-fitted homemade masks with multiple layers of quilting fabric, and off-the-shelf cone style masks, proved to be the most effective in reducing droplet dispersal. These masks were able to curtail the speed and range of the respiratory jets significantly, albeit with some leakage through the mask material and from small gaps along the edges. Importantly, uncovered emulated coughs were able to travel notably farther than the currently recommended 6-ft distancing guideline. We outline the procedure for setting up simple visualization experiments using easily available materials, which may help healthcare professionals, medical researchers, and manufacturers in assessing the effectiveness of face masks and other personal protective equipment qualitatively.


id: cord-273565-0en2sl3q
author: Scarano, Antonio
date: 2020-06-27
url: https://doi.org/10.3390/ijerph17134624
doi: 10.3390/ijerph17134624
title:
  Facial Skin Temperature and Discomfort When Wearing Protective Face Masks: Thermal Infrared Imaging Evaluation and Hands Moving the Mask

abstract:
  Individual respiratory protective devices and face masks represent critical tools in protecting health care workers in hospitals and clinics, and play a central role in decreasing the spread of the high-risk pandemic infection of 2019, coronavirus disease (COVID-19). The aim of the present study was to compare the facial skin temperature and the heat flow when wearing medical surgical masks to the same factors when wearing N95 respirators. A total of 20 subjects were recruited and during the evaluation, each subject was invited to wear a surgical mask or respirator for 1 h. The next day in the morning at the same hour, the same subject wore a N95 mask for 1 h with the same protocol. Infrared thermal evaluation was performed to measure the facial temperature of the perioral region and the perception ratings related to the humidity, heat, breathing difficulty, and discomfort were recorded. A significant difference in heat flow and perioral region temperature was recorded between the surgical mask and the N95 respirator (p < 0.05). A statistically significant difference in humidity, heat, breathing difficulty, and discomfort was present between the groups. The study results suggest that N95 respirators are able to induce an increased facial skin temperature, greater discomfort and lower wearing adherence when compared to the medical surgical masks.


id: cord-274201-9qsqj91d
title: The history and value of face masks
author: Matuschek, Christiane
date: 2020-06-23
url: https://www.ncbi.nlm.nih.gov/pubmed/32576263/
doi: 10.1186/s40001-020-00423-4
abstract:
  In the human population, social contacts are a key for transmission of bacteria and viruses. The use of face masks seems to be critical to prevent the transmission of SARS-CoV-2 for the period, in which therapeutic interventions are lacking. In this review, we describe the history of masks from the middle age to modern times.


id: cord-275370-bt45gnqk
author: Arellano-Cotrina, Josabet Johana
date: 2020-07-17
url: https://doi.org/10.1017/dmp.2020.255
doi: 10.1017/dmp.2020.255
title:
  Effectiveness and Recommendations for the Use of Dental Masks in the Prevention of COVID-19: A Literature Review

abstract:
  The purpose of this investigation was to identify, synthesize, and compare all the current information on the efficacy of dental masks, emphasizing their use, types, and filters to prevent the spread and infection of COVID-19 and other infectious diseases. A bibliographic search of the main scientific databases was carried out using the words “masks, COVID-19, and dentistry.” Articles without language restriction up to May 31, 2020, were obtained. The types of masks, their half-life, method to use, sterilization, and proposed alternatives for dental masks were analyzed. Most of the articles refer to the use of N95 or FFP2 respirators presented as a strategy to extend the life of the masks and limited reuse. Regarding sterilization, most of the articles presented studies using ultraviolet germicidal irradiation as the sterilization method. Regarding respirator mask half-life, we recommend prolonged use, combined with a disposable surgical mask over the respirator mask. Finally, the use of N95 or FFP2 respirators are recommended as part of personal protective equipment for dental use.


id: cord-275693-ej76fsxa
author: Stanislau Affonso de Araujo, E.
date: 2020-06-28
url: https://doi.org/10.1101/2020.06.25.20139907
doi: 10.1101/2020.06.25.20139907
title:
  Teach, and teach and teach: does the average citizen use masks correctly during daily activities? Results from an observational study with more than 12,000 participants

abstract:
  COVID-19 is a new disease with no treatment and no vaccine so far. The pandemic is still growing in many areas. Among the core measures to prevent disease spread is the use of face masks. We observed 12,588 people in five Brazilian cities within the Baixada Santista metropolitan area. Even though this is densely populated region and heavily impacted by COVID-19 with a high risk population, only 45.1% of the observed population wore in face masks in a correct way, and another 15.5% simply did not use masks at all. The remainder used masks incorrectly, which is evidence of the worst scenario of people believing that they are protected when they are not. This is among the first studies, to the best of our knowledge, that measures real life compliance with face masks during this COVID-19 pandemic. It is our conclusion that it is paramount to first control the virus before allowing people back in the streets. We should not assume that people will wear masks properly. Equally important is to instruct and sensitize people on how to use face masks and why it is important.


id: cord-280220-q4aqkr0w
author: Patel, Samir N.
date: 2020-10-28
url: https://doi.org/10.1016/j.ajo.2020.10.017
doi: 10.1016/j.ajo.2020.10.017
title:
  Bacterial dispersion associated with various patient face mask designs during simulated intravitreal injections

abstract:
  PURPOSE: To investigate bacterial dispersion with patient face mask use during simulated intravitreal injections. DESIGN: Prospective cross-sectional study METHODSSETTING: Single-center STUDY POPULATION: Fifteen healthy subjects were recruited INTERVENTION: Each participant was instructed not to speak for 2-minutes, simulating a “no-talking” policy, while in an ophthalmic examination chair with an blood agar plate secured to the forehead and wearing various face masks (no mask, loose fitting surgical mask, tight-fitting surgical mask without tape, tight-fitting surgical mask with adhesive tape securing the superior portion of the mask, N95 mask, and cloth mask). Each scenario was then repeated while reading a 2-minute script, simulating a talking patient. MAIN OUTCOME MEASURES: Number of colony-forming units (CFU) and microbial species. RESULTS: During the “no-talking” scenario, subjects wearing a tight-fitting surgical mask with tape developed fewer CFUs compared to subjects wearing the same mask without tape (difference, 0.93CFU; 95%CI, 0.32–1.55; P=.003). During the speech scenarios, subjects wearing a tight-fitting surgical mask with tape had significantly fewer CFUs compared to subjects without a face mask (difference, 1.07CFU; P=.001), subjects with a loose face mask (difference, 0.67; P=.034), and subjects with a tight face mask without tape (difference, 1.13; P<.001). There was no difference between those with a tight-fitting surgical mask with tape and an N95 mask in the “no-talking” (P>.99) and “speech” (P=.831) scenarios. No oral flora was isolated in “no-talking” scenarios, but was isolated in 8/75 (11%) cultures in speech scenarios (P=.02). CONCLUSION: Addition of tape to the superior portion of a patient’s face mask reduced bacterial dispersion during simulated intravitreal injections, and had no difference in bacterial dispersion compared to wearing N95 masks.


id: cord-282879-28nhr1hv
author: Patel, Samir N.
date: 2020-09-02
url: https://www.sciencedirect.com/science/article/pii/S0002939420304384?v=s5
doi: 10.1016/j.ajo.2020.08.013
title:
  The impact of physician face mask use on endophthalmitis after intravitreal anti-vascular endothelial growth factor injections

abstract:
  PURPOSE: To evaluate the effect of physician face mask use on rates and outcomes of post-injection endophthalmitis. DESIGN: Retrospective, comparative cohort study METHODS: . SETTING: Single-center STUDY POPULATION: Eyes receiving intravitreal anti-vascular endothelial growth factor injections from 7/1/2013 to 9/1/2019. INTERVENTION: Cases were divided into “face mask group” if face masks were worn by the physician during intravitreal injections or “no talking group” if no face mask was worn but a no talking policy was observed during intravitreal injections. MAIN OUTCOME MEASURES: Rate of endophthalmitis, visual acuity, and microbial spectrum. RESULTS: Of 483,622 intravitreal injections administered, 168 out of 453,460 (0.0371%) cases of endophthalmitis occurred in the “no talking” group, and 9 out of 30,162 (0.0298%) cases occurred in the face mask group (odds ratio, 0.81; 95%CI, 0.41–1.57; p=0.527). Sixteen cases of oral flora-associated endophthalmitis were found in the “no talking” group (1 in 28,341 injections) compared to none in the face mask group (p=0.302). Mean logMAR visual acuity at presentation in cases that developed culture-positive endophthalmitis was significantly worse in the “no talking” group compared to the face mask group (17.1 lines lost from baseline acuity vs 13.4 lines lost; p=0.031), though no difference was observed at six months following treatment (p=0.479). CONCLUSION: Physician face mask use did not influence the risk of post-injection endophthalmitis compared to a no talking policy. However, no cases of oral flora-associated endophthalmitis occurred in the face mask group. Future studies are warranted to assess the role of face mask use to reduce endophthalmitis risk, particularly due to oral flora.


id: cord-283555-pgel6i3y
title: Universal masking for COVID-19: evidence, ethics and recommendations
author: Chan, Tak Kwong
date: 2020-05-26
txt: ./txt/cord-283555-pgel6i3y.txt
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extension: .txt
mime: text/plain
url: https://doi.org/10.1136/bmjgh-2020-002819
doi: 10.1136/bmjgh-2020-002819
abstract: nan
summary:
  ► There is no shortage of mechanistic evidence and observational studies that affirmed the benefits of wearing a face mask in the community, which should drive urgent public health policy while we await the results of further research. 1 There is limited clinical evidence that wearing a disposable face mask, enhancing hand hygiene practice or social distancing can reduce transmission of respiratory viral infections in the community, 2 3 although there is mechanistic basis for these measures to work. I aim to provide further clarification of the evidence and ethics on this issue (which can provide grounds alternative and/or supplementary to the precautionary principle applied by Greenhalgh et al) and make a plea to the World Health Organisation (WHO) and policy makers to reformulate current recommendations with a view to enhancing the practice of wearing a face mask in the community. While social distancing and hand washing form the main recommendations, there is no shortage of mechanistic evidence and observational studies that affirmed the benefits of wearing a face mask in the community.


id: cord-284484-oak1lfmi
author: Barratt, Ruth
date: 2019-12-04
url: https://www.sciencedirect.com/science/article/pii/S2588994X19300806
doi: 10.1016/j.auec.2019.10.002
title:
  Enablers of, and barriers to, optimal glove and mask use for routine care in the emergency department: an ethnographic study of Australian clinicians

abstract:
  BACKGROUND: The risk of healthcare-acquired infection increases during outbreaks of novel infectious diseases. Emergency department (ED) clinicians are at high risk of exposure to both these and common communicable diseases. Personal protective equipment (PPE) is recommended to protect clinicians from acquiring, or becoming vectors of, infection, yet compliance is typically sub-optimal. Little is known about factors that influence use of PPE—specifically gloves and masks—during routine care in the ED. METHODS: This was an ethnographic study, incorporating documentation review, field observations and interviews. The theoretical domains framework (TDF) was used to aid thematic analysis and identify relevant enablers of and barriers to optimal PPE use. RESULTS: Thirty-one behavioural themes were identified that influenced participants’ use of masks and gloves. There were significant differences, namely: more reported enablers of glove use vs more barriers to mask use. Reasons included more positive unit culture towards glove use, and lower perception of risk via facial contamination. CONCLUSION: Emerging infectious diseases, spread (among other routes) by respiratory droplets, have caused global outbreaks. Emergency clinicians should ensure that, as with gloves, the use of masks is incorporated into routine cares where appropriate. Further research which examines items of PPE independently is warranted.


id: cord-284925-vy2li9lz
author: Lam, Dennis Shun Chiu
date: 2020-04-29
txt: ./txt/cord-284925-vy2li9lz.txt
cache: ./cache/cord-284925-vy2li9lz.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1097/apo.0000000000000280
doi: 10.1097/apo.0000000000000280
summary:
  We also endeavor to answer the key frequently asked questions in areas of the coronaviruses, COVID-19, disease transmission, personal protection, mask selection, and special measures in ophthalmic practices. Ophthalmologists are at risk of COVID-19 infection, since routine ophthalmic examinations are usually performed in a setting with close doctor-patient contact. We have also shared the precautions and strategies that we have implemented in our ophthalmic practice, based on our previous and current successful experiences in preventing severe acute respiratory syndrome (SARS) in 2003 and the current COVID-19 outbreaks in Hong Kong. For healthcare workers, surgical masks should be worn when performing sterile procedures, or as general protection against droplets infections. The close proximity of patients and doctors during eye examination, the presence of tears and liquids for anesthesia and dilation, or the potential aerosol or droplets from "air puff" tonometry, all pose a high risk for infective transmission. Interim infection prevention and control recommendations for patients with suspected or confirmed Coronavirus Disease 2019 (COVID-19) in healthcare settings

title:
  COVID-19: Special Precautions in Ophthalmic Practice and FAQs on Personal Protection and Mask Selection

abstract:
  The Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory coronavirus-2, was first reported in December 2019. The World Health Organization declared COVID-19 a pandemic on March 11, 2020 and as of April 17, 2020, 210 countries are affected with >2,000,000 infected and 140,000 deaths. The estimated case fatality rate is around 6.7%. We need to step up our infection control measures immediately or else it may be too late to contain or control the spread of COVID-19. In case of local outbreaks, the risk of infection to healthcare workers and patients is high. Ophthalmic practice carries some unique risks and therefore high vigilance and special precautions are needed. We share our protocols and experiences in the prevention of infection in the current COVID-19 outbreak and the previous severe acute respiratory syndrome epidemic in Hong Kong. We also endeavor to answer the key frequently asked questions in areas of the coronaviruses, COVID-19, disease transmission, personal protection, mask selection, and special measures in ophthalmic practices. COVID-19 is highly infectious and could be life-threatening. Using our protocol and measures, we have achieved zero infection in our ophthalmic practices in Hong Kong and China. Preventing spread of COVID-19 is possible and achievable.


id: cord-285425-3v1bid02
title: The efficacy of medical masks and respirators against respiratory infection in healthcare workers
author: MacIntyre, Chandini Raina
date: 2017-08-30
txt: ./txt/cord-285425-3v1bid02.txt
cache: ./cache/cord-285425-3v1bid02.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1111/irv.12474
doi: 10.1111/irv.12474
summary:
  OBJECTIVE: We aimed to examine the efficacy of medical masks and respirators in protecting against respiratory infections using pooled data from two homogenous randomised control clinical trials (RCTs). There is currently a lack of consensus around the efficacy of medical masks and respirators for healthcare workers (HCWs) against influenza, with only five published randomised control trials (RCTs) in HCWs conducted to date. 3, 4 Finally, a recent study examined the efficacy of cloth masks compared to medical mask and control groups, and found that cloth masks may increase the risk of infection in HCWs. 5 Guidelines for respiratory protection have been driven by presumed transmission mode alone, and under an assumption that influenza and other pathogens are spread by one mode alone. A cluster randomized clinical trial comparing fit-tested and non-fit-tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers.

abstract:
  OBJECTIVE: We aimed to examine the efficacy of medical masks and respirators in protecting against respiratory infections using pooled data from two homogenous randomised control clinical trials (RCTs). METHODS: The data collected on 3591 subjects in two similar RCTs conducted in Beijing, China, which examined the same infection outcomes, were pooled. Four interventions were compared: (i) continuous N95 respirator use, (ii) targeted N95 respirator use, (iii) medical mask use and (iv) control arm. The outcomes were laboratory‐confirmed viral respiratory infection, influenza A or B, laboratory‐confirmed bacterial colonisation and pathogens grouped by mode of transmission. RESULTS: Rates of all outcomes were consistently lower in the continuous N95 and/or targeted N95 arms. In adjusted analysis, rates of laboratory‐confirmed bacterial colonisation (RR 0.33, 95% CI 0.21‐0.51), laboratory‐confirmed viral infections (RR 0.46, 95% CI 0.23‐0.91) and droplet‐transmitted infections (RR 0.26, 95% CI 0.16‐0.42) were significantly lower in the continuous N95 arm. Laboratory‐confirmed influenza was also lowest in the continuous N95 arm (RR 0.34, 95% CI 0.10‐1.11), but the difference was not statistically significant. Rates of laboratory‐confirmed bacterial colonisation (RR 0.54, 95% CI 0.33‐0.87) and droplet‐transmitted infections (RR 0.43, 95% CI 0.25‐0.72) were also lower in the targeted N95 arm, but not in medical mask arm. CONCLUSION: The results suggest that the classification of infections into droplet versus airborne transmission is an oversimplification. Most guidelines recommend masks for infections spread by droplets. N95 respirators, as “airborne precautions,” provide superior protection for droplet‐transmitted infections. To ensure the occupational health and safety of healthcare worker, the superiority of respirators in preventing respiratory infections should be reflected in infection control guidelines.


id: cord-288354-7ruoysxu
author: Howard, Matt C.
date: 2020-06-26
txt: ./txt/cord-288354-7ruoysxu.txt
cache: ./cache/cord-288354-7ruoysxu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32588949/
doi: 10.1111/bjhp.12453
summary:
  We argue that the current results can be broadly framed in the COM-B model (Michie et al., 2011) , but future researchers should also apply more specific theories (Arden & Chilcot, 2020; Bish & Michie, 2010; Teasdale et al., 2012) to develop interventions and encourage face mask wearing via perceptual change. The FMPS can encourage researchers to integrate face mask wearing with studies on protective behavioursespecially those focusing on the importance of perceptions as done in the current article. Such findings can provide an approach to study face mask wearing, wherein the eight dimensions identified in the current article can be incorporated into associated frameworks and the FMPS can be used as an indicator of intervention effectiveness. To ensure that an adequate scope of face mask perceptions was assessed in the FMPS while being reasonably concise, we developed items for categories with more than a 10% frequency in participants'' qualitative responses for either personal or public perceptions.

title:
  Understanding face mask use to prevent coronavirus and other illnesses: Development of a multidimensional face mask perceptions scale

abstract:
  Face masks are an avenue to curb the spread of coronavirus, but few people in Western societies wear face masks. Social scientists have rarely studied face mask wearing, leaving little guidance for methods to encourage these behaviours. In the current article, we provide an approach to address this issue by developing the 32‐item and 8‐dimension Face Mask Perceptions Scale (FMPS). We begin by developing an over‐representative item list in a qualitative study, wherein participants’ responses are used to develop items to ensure content relevance. This item list is then reduced via exploratory factor analysis in a second study, and the eight dimensions of the scale are supported. We also support the validity of the FMPS, as the scale significantly relates to both face mask wearing and health perceptions. We lastly confirm the factor structure of the FMPS in a third study via confirmatory factor analysis. From these efforts, we identify an avenue that social scientists can aid in preventing coronavirus and illness more broadly – by studying face mask perceptions and behaviours.


id: cord-288483-y9fyslgo
author: Zorko, David J.
date: 2020-07-10
url: https://www.sciencedirect.com/science/article/pii/S0195670120303376?v=s5
doi: 10.1016/j.jhin.2020.07.007
title:
  DECONTAMINATION INTERVENTIONS FOR THE REUSE OF SURGICAL MASK PERSONAL PROTECTIVE EQUIPMENT: A SYSTEMATIC REVIEW

abstract:
  BACKGROUND: The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Little is known regarding decontamination interventions to allow for surgical mask reuse. AIM: Identify and synthesize data from original research evaluating interventions to decontaminate surgical masks for the purpose of reuse. METHODS: We searched MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19 database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to April 8, 2020 for prospective original research on decontamination interventions for surgical masks. Citation screening was conducted independently in duplicate. Study characteristics, interventions, and outcomes were extracted from included studies by two independent reviewers. Outcomes of interest included impact of decontamination interventions on surgical mask performance and germicidal effects. FINDINGS: Seven studies met eligibility criteria: one evaluated the effects of heat and chemical interventions applied after mask use on mask performance, and six evaluated interventions applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask performance and germicidal effects were evaluated with heterogenous test conditions. Safety outcomes were infrequently evaluated. Mask performance was best preserved with dry heat decontamination. Good germicidal effects were observed in salt-, N-halamine-, and nanoparticle-coated masks. CONCLUSION: There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogenous methods used in studies to date, we are unable to draw conclusions on the most efficacious and safe intervention for decontaminating surgical masks.


id: cord-288569-sitxa2ul
title: Role of Mask/Respirator Protection Against SARS-CoV-2
author: Smereka, Jacek
date: 2020-04-20
txt: ./txt/cord-288569-sitxa2ul.txt
cache: ./cache/cord-288569-sitxa2ul.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1213/ane.0000000000004873
doi: 10.1213/ane.0000000000004873
abstract: nan
summary:
  1 There are currently many types of masks/respirators available, ranging from simple surgical masks designed to protect wearers from microorganism transmission and fit loosely to the user''s face, through N95 masks used to prevent users from inhaling small airborne particles. Surgical masks are designed to protect against droplets or particles with a diameter of >100 μm, whereas severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is essentially spherical, albeit slightly pleomorphic, with a diameter of 60-140 nm and 100 times smaller than the pore diameter. Long et al 5 conclude in their meta-analysis that the use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory-confirmed influenza. Wang et al 1 indicated that 10 of 213 medical professionals with no mask were infected by COVID-19 as compared with 0 of 278 wearing N95 respirators. 6 To conclude, the use of protective masks can and should be the first protection against SARS-CoV-2 transmission to medical personnel.


id: cord-289521-zun6tp2o
author: Leonard, Scott
date: 2020-05-29
url: https://www.ncbi.nlm.nih.gov/pubmed/32838373/
doi: 10.1002/emp2.12158
title:
  Reducing aerosol dispersion by High Flow Therapy in COVID‐19: High Resolution Computational Fluid Dynamics Simulations of Particle Behavior during High Velocity Nasal Insufflation with a Simple Surgical Mask

abstract:
  OBJECTIVE: All respiratory care represents some risk of becoming an Aerosol Generating Procedure (AGP) during COVID‐19 patient management. Personal Protective Equipment (PPE) and Environmental Control/Engineering is advised. High Velocity Nasal Insufflation (HVNI) and High Flow Nasal Cannula (HFNC) deliver High Flow Oxygen (HFO) therapy, established as a competent means of supporting oxygenation for acute respiratory distress patients, including that precipitated by COVID‐19. Although unlikely to present a disproportionate particle dispersal risk, AGP from HFO continues to be a concern. Previously, we published a preliminary model. Here, we present a subsequent high‐resolution simulation (higher complexity/reliability) to provide a more accurate and precise particle characterization on the effect of surgical masks on patients during HVNI, Low‐Flow Oxygen therapy (LFO2), and tidal breathing. METHODS: This in‐silico modeling study of HVNI, LFO2, and tidal breathing presents ANSYS Fluent Computational Fluid Dynamics simulations that evaluate the effect of Type I surgical mask use over patient face on particle/droplet behavior. RESULTS: This in‐silico modeling simulation study of HVNI (40L∙min(‐1)) with a simulated surgical mask suggests 88.8% capture of exhaled particulate mass in the mask, compared to 77.4% in LFO2 (6L∙min(‐1)) capture, with particle distribution escaping to the room (>1m from face) lower for HVNI+Mask versus LFO2+Mask (8.23% versus 17.2%). The overwhelming proportion of particulate escape was associated with mask‐fit designed model gaps. Particle dispersion was associated with lower velocity. CONCLUSIONS: These simulations suggest employing a surgical mask over the HVNI interface may be useful in reduction of particulate mass distribution associated with AGPs. This article is protected by copyright. All rights reserved


id: cord-291392-19vj647z
author: Poostchi, Ali
date: 2020-06-03
url: https://www.ncbi.nlm.nih.gov/pubmed/32494042/
doi: 10.1038/s41433-020-1005-y
abstract: nan
title:
  Comment on: “Controversies regarding mask usage in ophthalmic units in the United Kingdom during the COVID-19 pandemic”


id: cord-292173-95t89yee
title: COVID-19 and Dentistry: Prevention in Dental Practice, a Literature Review
author: Villani, Federico Alcide
date: 2020-06-26
url: https://www.ncbi.nlm.nih.gov/pubmed/32604906/
doi: 10.3390/ijerph17124609
abstract:
  SARS-CoV-2 is a member of the family of coronaviruses. The first cases were recorded in Wuhan, China, between December 2019 and January 2020. Italy is one of the most affected countries in Europe. COVID-19 is a new challenge in modern dentistry. New guidelines are required in dental clinics to avoid contagion caused by cross-infections. A narrative review was performed using both primary sources, such as scientific articles and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. Twelve articles were selected to develop the bibliographic review by applying pre-established inclusion and exclusion criteria. Precautionary measures should be applied to control COVID-19 in clinical practice. Several authors have highlighted the importance of telephone triage and/or clinic questionnaires, body temperature measurement, usage of personal protective equipment, surface disinfection with ethanol between 62% and 71%, high-speed instruments equipped with an anti-retraction system, four-handed work, and large-volume cannulas for aspiration. Clinically, the use of a rubber dam is essential. FFP2 (or N95) and FFP3 respirators, if compared to surgical masks, provide greater protection for health workers against viral respiratory infections. Further accurate studies are needed to confirm this.


id: cord-292201-e7k7gn9q
title: Mass masking as a way to contain COVID-19 and exit lockdown in low- and middle-income countries
author: Fodjo, Joseph Nelson Siewe
date: 2020-07-17
url: https://doi.org/10.1016/j.jinf.2020.07.015
doi: 10.1016/j.jinf.2020.07.015
abstract:
  In new guidelines published on June 5(th) 2020, the World Health Organization (WHO) recommends that in areas with ongoing COVID-19 community transmission, governments should encourage the general public to wear face masks in specific situations and settings as part of a comprehensive approach to suppress COVID-19 transmission. Recent online surveys in 206,729 persons residing in nine low- and middle-income countries showed that 32.7%-99.7% of respondents used face masks with significantly differences across age groups and sexes. Targeted health promotion strategies and government support are required to increase mask use by the general population.


id: cord-292587-hp4zd8lr
title: Respiratory Protection against Pandemic and Epidemic Diseases
author: Rubino, Ilaria
date: 2017-10-31
txt: ./txt/cord-292587-hp4zd8lr.txt
cache: ./cache/cord-292587-hp4zd8lr.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.tibtech.2017.06.005
doi: 10.1016/j.tibtech.2017.06.005
summary:
  We expect that the development of technologies that overcome the existing challenges in current respiratory protective devices will lead to a timely and effective response to the next outbreak. We expect that the development of technologies that overcome the existing challenges in current respiratory protective devices will lead to a timely and effective response to the next outbreak. While effective management and availability of control measures are crucial to an outbreak response, the pathogens [ 1 1 4 _ T D $ D I F F ] (virus/bacteria/ fungi) captured on filters are an intrinsic concern because of fear of cross-infection, new aerosol release, and contaminated waste. Hence, production of a filter that inactivates the collected pathogens would bring key improvements to current surgical masks and respirators, resulting in increased protection, reduced risk of cross[ 1 0 9 _ T D $ D I F F ] -infection, and recyclability without decontamination ( Figure 1 ).

abstract:
  Respiratory protection against airborne pathogens is crucial for pandemic/epidemic preparedness in the context of personal protection, healthcare systems, and governance. We expect that the development of technologies that overcome the existing challenges in current respiratory protective devices will lead to a timely and effective response to the next outbreak.


id: cord-295806-imuk73xa
title: Mask-associated de novo headache in healthcare workers during the Covid-19 pandemic.
author: Ramirez-Moreno, J. M.
date: 2020-08-11
url: https://doi.org/10.1101/2020.08.07.20167957
doi: 10.1101/2020.08.07.20167957
abstract:
  Introduction: The pandemic caused by the new coronavirus (COVID-19) has led to changes in the development of health care activities by health professionals. We analysed whether there is an association between the appearance of de novo headache according to the type of mask used, the related factors, as well as the impact of the headache on health professionals. Method: cross-sectional study in a tertiary hospital in Extremadura, Spain. We administered an online questionnaire to healthcare workers during the period of maximum incidence of COVID-19 in our setting. Results: n=306, 244 women (79.7%), with an average age of 43 years (range 23-65). Of the total, 129 (42.2%) were physicians, 112 (36.6%) nurses and 65 (21.2%) other health workers. 208 (79.7%) used surgical masks and 53 (20.3%) used filtering masks. Of all those surveyed, 158 (51.6%) presented de novo headache. The occurrence of headache was independently associated with the use of a filtering mask, OR 2.14 (IC95% 1.07-4.32), being a nurse OR 2.09 (IC95% 1.18-3.72) or another health worker OR 6.94 (IC95% 3.01-16.04) or having a history of asthma OR 0.29 (IC95% 0.09-0.89). Depending on the type of mask used there were differences in headache intensity. And the impact of headache in the subjects who used a filtering mask was worse in the all aspects evaluated. Conclusions: The appearance of de novo headache is associated with the use of filtering masks and is more frequent in certain health care workers, causing a greater occupational, family, personal and social impact.


id: cord-296216-odzm7lml
author: Kroo, L.
date: 2020-04-29
txt: ./txt/cord-296216-odzm7lml.txt
cache: ./cache/cord-296216-odzm7lml.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.04.24.20078907v1?rss=1
doi: 10.1101/2020.04.24.20078907
summary:
  Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The modified flow path for use as PPE (general hospital usage), is very similar to the stock configuration of the mask: all inhale breath is directed through the filter, and the majority of exhale air is directed through the chin valve. 24.20078907 doi: medRxiv preprint Figure 5 A qualitative fit test was performed by the standard University of Utah Operating Room team using the same protocol suggested by CDC and NIOSH on elastomeric respirators and N95 masks. The successful results for the fit test with the different individuals used in this study indicate that the Dolphino and Decathlon masks both form acceptable seals, showing also that the custom adapter and the chin valve do not generate significant leaks.

title:
  Pneumask: Modified Full-Face Snorkel Masks as Reusable Personal Protective Equipment for Hospital Personnel

abstract:
  Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The design (referred to as Pneumask) consists of a custom snorkel-specific adapter that couples the snorkel-port of the mask to a rated filter (either a medical-grade ventilator inline filter or an industrial filter). This design has been tested for the sealing capability of the mask, filter performance, CO2 buildup and clinical usability. These tests found the Pneumask capable of forming a seal that exceeds the standards required for half-face respirators or N95 respirators. Filter testing indicates a range of options with varying performance depending on the quality of filter selected, but with typical filter performance exceeding or comparable to the N95 standard. CO2 buildup was found to be roughly equivalent to levels found in half-face elastomeric respirators in literature. Clinical usability tests indicate sufficient visibility and, while speaking is somewhat muffled, this can be addressed via amplification (Bluetooth voice relay to cell phone speakers through an app) in noisy environments. We present guidance on the assembly, usage (donning and doffing) and decontamination protocols. The benefit of the Pneumask as PPE is that it is reusable for longer periods than typical disposable N95 respirators, as the snorkel mask can withstand rigorous decontamination protocols (that are standard to regular elastomeric respirators). With the dire worldwide shortage of PPE for medical personnel, our conclusions on the performance and efficacy of Pneumask as an N95-alternative technology are cautiously optimistic.


id: cord-297295-lsewt5t2
author: Matusiak, Łukasz
date: 2020-05-14
url: https://doi.org/10.1111/dth.13567
doi: 10.1111/dth.13567
abstract: nan
title:
  Inconveniences due to the use of face masks during the COVID‐19 pandemic: a survey study of 876 young people


id: cord-298227-av1ev8ta
title: Fundamental protective mechanisms of face masks against droplet infections
author: Kähler, Christian J.
date: 2020-06-28
txt: ./txt/cord-298227-av1ev8ta.txt
cache: ./cache/cord-298227-av1ev8ta.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0021850220301063?v=s5
doi: 10.1016/j.jaerosci.2020.105617
summary:
  Many governments have instructed the population to wear simple mouth-and-nose covers or surgical face masks to protect themselves from droplet infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in public. First of all, we show that the masks protect people in the surrounding area quite well, since the flow resistance of the face masks effectively prevents the spread of exhaled air, e.g. when breathing, speaking, singing, coughing and sneezing. Thirdly, we show that even simple mouth-and-nose covers made of good filter material cannot reliably protect against droplet infection in contaminated ambient air, since most of the air flows through gaps at the edge of the masks. However, if the distance rules cannot be observed and the risk of inhalation-based infection becomes high because many people in the vicinity are infectious and the air exchange rate is small, improved filtration efficiency masks are needed, to take full advantage of the three fundamental protective mechanisms these masks provide.

abstract:
  Many governments have instructed the population to wear simple mouth-and-nose covers or surgical face masks to protect themselves from droplet infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in public. However, the basic protection mechanisms and benefits of these masks remain controversial. Therefore, the aim of this work is to show from a fluid physics point of view under which circumstances these masks can protect against droplet infection. First of all, we show that the masks protect people in the surrounding area quite well, since the flow resistance of the face masks effectively prevents the spread of exhaled air, e.g. when breathing, speaking, singing, coughing and sneezing. Secondly, we provide visual evidence that typical household materials used by the population to make masks do not provide highly efficient protection against respirable particles and droplets with a diameter of 0.3–2 μm as they pass through the materials largely unfiltered. According to our tests, only vacuum cleaner bags with fine dust filters show a comparable or even better filtering effect than commercial particle filtering FFP2/N95/KN95 half masks. Thirdly, we show that even simple mouth-and-nose covers made of good filter material cannot reliably protect against droplet infection in contaminated ambient air, since most of the air flows through gaps at the edge of the masks. Only a close-fitting, particle-filtering respirator without an outlet valve offers good self-protection and protection against droplet infection. Nevertheless, wearing simple homemade or surgical face masks in public is highly recommended if no particle filtrating respiratory mask is available. Firstly, because they protect against habitual contact of the face with the hands and thus serve as self-protection against contact infection. Secondly, because the flow resistance of the masks ensures that the air stays close to the head when breathing, speaking, singing, coughing and sneezing, thus protecting other people if they have sufficient distance from each other. However, if the distance rules cannot be observed and the risk of inhalation-based infection becomes high because many people in the vicinity are infectious and the air exchange rate is small, improved filtration efficiency masks are needed, to take full advantage of the three fundamental protective mechanisms these masks provide.


id: cord-298433-tev33cjh
author: Mardimae, Alexandra
date: 2006-09-22
url: https://www.sciencedirect.com/science/article/pii/S0196064406009425
doi: 10.1016/j.annemergmed.2006.06.039
title:
  Modified N95 Mask Delivers High Inspired Oxygen Concentrations While Effectively Filtering Aerosolized Microparticles

abstract:
  STUDY OBJECTIVE: In a pandemic, hypoxic patients will require an effective oxygen (O(2)) delivery mask that protects them from inhaling aerosolized particles produced by others, as well as protecting the health care provider from exposure from the patient. We modified an existing N95 mask to optimize O(2) supplementation while maintaining respiratory isolation. METHODS: An N95 mask was modified to deliver O(2) by inserting a plastic manifold consisting of a 1-way inspiratory valve, an O(2) inlet and a gas reservoir. In a prospective repeated-measures study, we studied 10 healthy volunteers in each of 3 phases, investigating (1) the fractional inspiratory concentrations of O(2) (F(I)O(2)) delivered by the N95 O(2) mask, the Hi-Ox(80) O(2) mask, and the nonrebreathing mask during resting ventilation and hyperventilation, each at 3 O(2) flow rates; (2) the ability of the N95 mask, the N95 O(2) mask, and the nonrebreathing mask to filter microparticles from ambient air; and (3) to contain microparticles generated inside the mask. RESULTS: The F(I)O(2)s (median [range]) delivered by the Hi-Ox(80) O(2) mask, the N95 O(2) mask, and the nonrebreathing mask during resting ventilation, at 8 L/minute O(2) flow, were 0.90 (0.79 to 0.96), 0.68 (0.60 to 0.85), and 0.59 (0.52 to 0.68), respectively. During hyperventilation, the FiO(2)s of all 3 masks were clinically equivalent. The N95 O(2) mask, but not the nonrebreathing mask, provided the same efficiency of filtration of internal and external particles as the original N95, regardless of O(2) flow into the mask. CONCLUSION: An N95 mask can be modified to administer a clinically equivalent FiO(2) to a nonrebreathing mask while maintaining its filtration and isolation capabilities.


id: cord-298793-9vq3bogn
title: Respiratory and facial protection: a critical review of recent literature
author: Bunyan, D.
date: 2013-11-30
url: https://doi.org/10.1016/j.jhin.2013.07.011
doi: 10.1016/j.jhin.2013.07.011
abstract:
  Summary Infectious micro-organisms may be transmitted by a variety of routes. This is dependent on the particular pathogen and includes bloodborne, droplet, airborne, and contact transmission. Some micro-organisms are spread by more than one route. Respiratory and facial protection is required for those organisms which are usually transmitted via the droplet and/or airborne routes or when airborne particles have been created during ‘aerosol-generating procedures’. This article presents a critical review of the recently published literature in this area that was undertaken by Health Protection Scotland and the Healthcare Infection Society and which informed the development of guidance on the use of respiratory and facial protection equipment by healthcare workers.


id: cord-301063-kqlra788
title: Facial protection in the era of COVID‐19: a narrative review
author: Li, Dion Tik Shun
date: 2020-06-07
url: https://www.ncbi.nlm.nih.gov/pubmed/32506757/
doi: 10.1111/odi.13460
abstract:
  We live in extraordinary times, where COVID‐19 pandemic has brought the whole world to a screeching halt. Tensions and contradictions that surround the pandemic ridden world include the availability, and the lack thereof, various facial protection measures to mitigate the viral spread. Here, we comprehensively explore the different type of facial protection measures, including masks, needed both for the pubic and the health care workers (HCW). We discuss the anatomy, the critical issues of disinfection and reusability of masks, the alternative equipment available for the protection of the facial region from airborne diseases, such as face shields and powered air purifying respirators (PAPR), and the skin‐health impact of prolonged wearing of facial protection by HCW. Clearly, facial protection, either in the form of masks or alternates, appears to have mitigated the pandemic as seen from the minimal COVID‐19 spread in countries where public mask wearing is strictly enforced. On the contrary, the healthcare systems, that appear to have been unprepared for emergencies of this nature, should be appropriately geared to handle the imbalance of supply and demand of personal protective equipment including face masks. These are two crucial lessons we can learn from this tragic experience.


id: cord-303034-w72oeoxq
title: Who is wearing a mask? Gender-, age-, and location-related differences during the COVID-19 pandemic
author: Haischer, Michael H.
date: 2020-10-15
txt: ./txt/cord-303034-w72oeoxq.txt
cache: ./cache/cord-303034-w72oeoxq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33057375/
doi: 10.1371/journal.pone.0240785
summary:
  To understand the demographics of mask wearers and resistors, and the impact of mandates on mask-wearing behavior, we observed shoppers (n = 9935) entering retail stores during periods of June, July, and August 2020. Wearing a mask in public is currently a controversial and politicized issue in the United States, even with case evidence from other countries that face coverings help to control the spread of coronavirus disease 2019 (COVID-19) [1] . To facilitate greater understanding and reliable experimental data on whether gender, age, location, and the presence of mask mandates influence mask wearing in the United States, we conducted a direct observational study at retail stores in Wisconsin. It is not surprising that our June data showed that older individuals wear masks more than middle-age and young people because older adults are at higher risk for more severe cases of COVID-19.

abstract:
  Masks are an effective tool in combatting the spread of COVID-19, but some people still resist wearing them and mask-wearing behavior has not been experimentally studied in the United States. To understand the demographics of mask wearers and resistors, and the impact of mandates on mask-wearing behavior, we observed shoppers (n = 9935) entering retail stores during periods of June, July, and August 2020. Approximately 41% of the June sample wore a mask. At that time, the odds of an individual wearing a mask increased significantly with age and was also 1.5x greater for females than males. Additionally, the odds of observing a mask on an urban or suburban shopper were ~4x that for rural areas. Mask mandates enacted in late July and August increased mask-wearing compliance to over 90% in all groups, but a small percentage of resistors remained. Thus, gender, age, and location factor into whether shoppers in the United States wear a mask or face covering voluntarily. Additionally, mask mandates are necessary to increase mask wearing among the public to a level required to mitigate the spread of COVID-19.


id: cord-304170-cmeiqvnp
author: van Straten, B.
date: 2020-04-08
txt: ./txt/cord-304170-cmeiqvnp.txt
cache: ./cache/cord-304170-cmeiqvnp.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0195670120301766?v=s5
doi: 10.1016/j.jhin.2020.04.001
abstract: nan
summary:
  authors: van Straten, B.; de Man, P.; van den Dobbelsteen, J.; Koeleman, H.; van der Eijk, A.; Horeman, T. title: Sterilization of disposable face masks by means of standardized dry and steam sterilization processes; an alternative in the fight against mask shortages due to COVID-19 In preparation for that scarcity we performed a study to investigate the possibility of reprocessing disposable FFP2 face masks in order to verify their re-usability with a method that could be applied in practice using already available equipment. The results of our experiences and experiments indicate that our sterilization process did not influence the functionality of the masks tested. The sterilization process of available standard autoclaves in hospitals may have to be adjusted in order to use this sterilization method. However, our method seems to be a potentially useful way to reuse mouth masks; other hospitals facing a shortage of masks may wish to test and validate this approach to reusing masks.

title:
  Sterilization of disposable face masks by means of standardized dry and steam sterilization processes; an alternative in the fight against mask shortages due to COVID-19


id: cord-304941-yg4x7c8n
title: Recharging and rejuvenation of decontaminated N95 masks
author: Hossain, Emroj
date: 2020-09-01
url: https://www.ncbi.nlm.nih.gov/pubmed/32982134/
doi: 10.1063/5.0023940
abstract:
  N95 respirators comprise a critical part of the personal protective equipment used by frontline health-care workers and are typically meant for one-time usage. However, the recent COVID-19 pandemic has resulted in a serious shortage of these masks leading to a worldwide effort to develop decontamination and re-use procedures. A major factor contributing to the filtration efficiency of N95 masks is the presence of an intermediate layer of charged polypropylene electret fibers that trap particles through electrostatic or electrophoretic effects. This charge can degrade when the mask is used. Moreover, simple decontamination procedures (e.g., use of alcohol) can degrade any remaining charge from the polypropylene, thus severely impacting the filtration efficiency post-decontamination. In this report, we summarize our results on the development of a simple laboratory setup allowing measurement of charge and filtration efficiency in N95 masks. In particular, we propose and show that it is possible to recharge the masks post-decontamination and recover filtration efficiency.


id: cord-305282-x2zzzw43
title: Feasibility of Reusing Surgical Mask Under Different Disinfection Treatments
author: SUEN, C. Y.
date: 2020-05-20
txt: ./txt/cord-305282-x2zzzw43.txt
cache: ./cache/cord-305282-x2zzzw43.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.05.16.20102178v1?rss=1
doi: 10.1101/2020.05.16.20102178
summary:
  This investigation found that dry heat and UVC irradiance could effectively disinfect the mask material without creating significant damage to surgical mask. Methods of disinfection studied include 100 ℃ dry heat, steaming, boiling, autoclave, 75% and 95% ethanol, UVC irradiance and household detergent. In assessing the destructive level of different disinfection treatments to surgical masks, filtration efficiency and fluid repellency were the parameters being focused in this study. Bead-like droplets were observed in all the samples treated with non-fluid disinfection methods, such as dry heat and UVC irradiation. For the samples underwent other disinfection treatments, the fluid-repelling layers were concluded to be damaged as the water droplets on the mask surface could not retain bead shape. Except household detergent water, all disinfection methods were effective in eliminating S.aureus in the mask material. Non-fluid contacting disinfection methods such as UVC irradiation and dry heat retained the highest performance regarding filtration efficiency, structural consistence and surface hydrophobicity even after three cycles of treatments.

abstract:
  The possibility to extend the lifespan or even reuse one-off personal protective equipment, especially for N95 respirator and surgical mask become critical during pandemic. World Health Organization has confirmed that wearing surgical mask is effective in controlling the spread of respiratory diseases in the community, but the supply may not be able to satisfy all the demands created all over the world in a short period of time. This investigation found that dry heat and UVC irradiance could effectively disinfect the mask material without creating significant damage to surgical mask.


id: cord-305419-l68ewxar
author: Smart, Hiske
date: 2020-06-11
url: https://www.ncbi.nlm.nih.gov/pubmed/32530822/
doi: 10.1097/01.asw.0000669920.94084.c1
title:
  Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements

abstract:
  OBJECTIVE: To determine if a repurposed silicone-based dressing used underneath a N95 mask is a safe and beneficial option for facial skin injury prevention without compromising the mask’s seal. METHODS: Since February 21, 2020, staff in high risk areas such as the ED and ICU of King Hamad University Hospital have worn N95 masks when doing aerosol-generating procedures to protect against the novel coronavirus 2019. At that time, without education enablers or resources that could be directly translated into practice, the hospital’s Pressure Injury Prevention Committee explored and created a stepwise process to protect the skin under these masks. This procedure was developed over time and tested to make sure that it did not interfere with the effectiveness of the N95 mask seal. RESULTS: Skin protection was achieved by repurposing a readily available silicone border dressing cut into strips. This was tested on 10 volunteer staff members of various skin types and both sexes who became part of this evidence generation project. Oxygen saturation values taken before and after the 4-hour wear test confirmed that well-fitted facial protection did not compromise the mask seal, but rather improved it. An added advantage was increased comfort with less friction as self-reported by the staff. An educational enabler to prevent MDRPI from N95 mask wear was an important additional resource for the staff. CONCLUSIONS: This creative and novel stepwise process of developing a safe skin protection method by which staff could apply a repurposed silicone border dressing beneath an N95 mask was largely effective and aided by the creation of the enabler.


id: cord-308638-lrgvwjti
author: Chalikonda, Sricharan
date: 2020-06-11
url: https://www.ncbi.nlm.nih.gov/pubmed/32534935/
doi: 10.1016/j.jamcollsurg.2020.05.022
title:
  Implementation of an Elastomeric Mask Program as a Strategy to Eliminate Disposable N95 Mask Use and Resterilization: Results from a Large Academic Medical Center

abstract:
  BACKGROUND: The COVD-19 global pandemic has placed a large demand on personal protective equipment for healthcare workers. N-95 respirators, required to perform aerosolizing procedures, are in short supply and have increased significantly in cost. The lack of a clear end to the pandemic requires that hospitals need to create a long-term, cost effective solution to the N95 shortage. We initially used previously described methods to reuse and resterilize N95 masks however we found they did not solve the issues related to just in time fit-testing and cost. METHODS: We initiated a program with the aim to reduce our dependence on N95 masks by initiating a phased program to acquire industrial style elastomeric P100 masks as a substitute for reuse and resterilization of disposable N95s. We created an allocation strategy based on availability of the masks, as well as an operational plan to fit test, educate, and disinfect the masks. RESULTS: Within 1 month we were able to reduce the number of N95s needed by our network by 95%. We also found due that the cost was conservatively 10 times less per month than purchasing disposable N95s and the cost benefit increases the longer that they are needed. CONCLUSION: Establishing an elastomeric mask program is feasible and less expensive than programs focused on reusing and disinfecting disposable N95 masks. A well thought out elastomeric distribution and disinfection program does not pose greater operational challenges than an N95 reuse and resterilization program. In addition, elastomeric masks can be stored for future surges and should be considered an essential part of all healthcare facilities’ supply of personal protective equipment. Implementation of the program has eliminated our dependence on disposable N95s to maintain normal operations during the global pandemic.


id: cord-308857-otsrexqu
author: Goel, Saurav
date: 2020-05-28
url: https://www.sciencedirect.com/science/article/pii/S2468519420300604?v=s5
doi: 10.1016/j.mtchem.2020.100300
title:
  Resilient and Agile Engineering Solutions to Address Societal Challenges such as Coronavirus Pandemic

abstract:
  The world is witnessing tumultuous times as major economic powers including the US, UK, Russia, India, and most of Europe continue to be in a state of lockdown. The worst-hit sectors due to this lockdown are sales, production (manufacturing), transport (aerospace and automotive) and tourism. Lockdowns became necessary as a preventive measure to avoid the spread of the contagious and infectious “Coronavirus Disease 2019” (COVID-19). This newly identified disease is caused by a new strain of the virus being referred to as Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS CoV-2; formerly called 2019-nCoV). We review the current medical and manufacturing response to COVID-19, including advances in instrumentation, sensing, use of lasers, fumigation chambers and development of novel tools such as lab-on-the-chip using combinatorial additive and subtractive manufacturing techniques and use of molecular modelling and molecular docking in drug and vaccine discovery. We also offer perspectives on future considerations on climate change, outsourced versus indigenous manufacturing, automation, and antimicrobial resistance. Overall, this paper attempts to identify key areas where manufacturing can be employed to address societal challenges such as COVID-19.


id: cord-309575-7orflz20
title: COVID-19 Mask Requirements as a Workers’ Rights Issue: Parallels to Smoking Bans
author: Vuolo, Mike
date: 2020-07-16
txt: ./txt/cord-309575-7orflz20.txt
cache: ./cache/cord-309575-7orflz20.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0749379720302907?v=s5
doi: 10.1016/j.amepre.2020.07.001
abstract: nan
summary:
  Indeed, this point was summarized well by Craig Jelinek, President and CEO of Costco, who stated, "This is not simply a matter of personal choice; a face covering protects not just the wearer, but others too… and our employees are on the front lines." 9 Similar to smoking inside retail shops, restaurants, or public transportation, today''s mask-less patron impedes workers'' rights to safe and healthy occupational environments in addition to posing risks to other patrons. Although a mask refuser or smoker might argue that other patrons could simply frequent mask-wearing/smoke-free establishments, or even not go out at all, such logic neglects workplace rights and risks to workers'' health. Although smoke-free policies are not universal in restaurants and bars (contested locations for mask wearing as well), existing smoking bans offer a clear precedent-a precedent wherein worker''s rights to a healthy work environment ultimately take precedence over patrons'' preferences.


id: cord-310948-nt378esz
title: Quantifying Respiratory Airborne Particle Dispersion Control Through Improvised Reusable Masks
author: Edwards, N. J.
date: 2020-07-14
url: http://medrxiv.org/cgi/content/short/2020.07.12.20152157v1?rss=1
doi: 10.1101/2020.07.12.20152157
abstract:
  Objective: To determine the effectiveness of non-medical grade washable masks or face coverings in controlling airborne dispersion from exhalation (both droplet and aerosol), and to aid in establishing public health strategies on the wearing of masks to reduce COVID-19 transmission. Design: This comparative effectiveness study using an exhalation simulator to conduct 94 experiment runs with combinations of 8 different fabrics, 5 mask designs, and airflows for both talking and coughing. Setting: Non-airtight fume hood and multiple laser scattering particle sensors. Participants: No human participants. Exposure: 10% NaCl nebulized solution delivered by an exhalation simulator through various masks and fabrics with exhalation airflows representative of "coughing" and "talking or singing." Main Outcomes and Measures: The primary outcome was reduction in aerosol dispersion velocity, quantity of particles, and change in dispersion direction. Measurements used in this study included peak expiratory flow (PEF), aerosol velocity, concentration area under curve (AUC), and two novel metrics of expiratory flow dispersion factor (EDF) and filtration efficiency indicator (FEI). Results: Three-way multivariate analysis of variance establishes that factors of fabric, mask design, and exhalation breath level have a statistically significant effect on changing direction, reducing velocity or concentration (Fabric: P = < .001, Wilks' {Lambda} = .000; Mask design: P = < .001, Wilks' {Lambda} = .000; Breath level: P = < .001, Wilks' {Lambda} = .004). There were also statistically significant interaction effects between combinations of all primary factors. Conclusions and Relevance: The application of facial coverings or masks can significantly reduce the airborne dispersion of aerosolized particles from exhalation. The results show that wearing of non-medical grade washable masks or face coverings can help increase the effectiveness of non-pharmaceutical interventions (NPI) especially where infectious contaminants may exist in shared air spaces. However, the effectiveness varies greatly between the specific fabrics and mask designs used.


id: cord-311795-kvv3fx2n
author: Barratt, Ruth
date: 2019-08-31
url: https://doi.org/10.1016/j.idh.2019.01.003
doi: 10.1016/j.idh.2019.01.003
title:
  Clinician perceptions of respiratory infection risk; a rationale for research into mask use in routine practice

abstract:
  Abstract Outbreaks of emerging and re-emerging infectious diseases are global threats to society. Planning for, and responses to, such events must include healthcare and other measures based on current evidence. An important area of infection prevention and control (IPC) is the optimal use of personal protective equipment (PPE) by healthcare workers (HCWs), including masks for protection against respiratory pathogens. Appropriate mask use during routine care is a forerunner to best practice in the event of an outbreak. However, little is known about the influences on decisions and behaviours of HCWs with respect to protective mask use when providing routine care. In this paper we argue that there is a need for more research to provide a better understanding of the decision-making and risk-taking behaviours of HCWs in respect of their use of masks for infectious disease prevention. Our argument is based on the ongoing threat of emerging infectious diseases; a need to strengthen workforce capability, capacity and education; the financial costs of healthcare and outbreaks; and the importance of social responsibility and supportive legislation in planning for global security. Future research should examine HCWs' practices and constructs of risk to provide new information to inform policy and pandemic planning.


id: cord-314216-xx5xbjqu
author: Malik, Talia
date: 2020-04-10
url: https://www.ncbi.nlm.nih.gov/pubmed/32399354/
doi: 10.7759/cureus.7621
title:
  COVID-19 and the Efficacy of Different Types of Respiratory Protective Equipment Used by Health Care Providers in a Health Care Setting

abstract:
  Coronavirus, the virus that caused the global pandemic at the beginning of 2020 and affected millions across the globe, presented as an enormous challenge to health care providers around the world. With increasing numbers of infected patients presenting daily, health care workers are struggling to take effective measures to protect themselves from transmission against the highly contagious coronavirus. This case helps us understand the implications of coronavirus-infected patients on the health care providers directly responsible for the management of these patients and the relative efficacy of different types of respiratory protective equipment mainly N95 masks and surgical masks in preventing the spread of infection among those at the front lines providing care.


id: cord-314422-u2elzgl8
title: Retroauricular dermatitis with vehement use of ear loop face masks during COVID19 pandemic
author: Bothra, Atul
date: 2020-06-03
url: https://doi.org/10.1111/jdv.16692
doi: 10.1111/jdv.16692
abstract:
  The COVID‐19 pandemic forged theexponential use of masks of various kinds, not just by health workers but also by general population as a personal protective equipment (PPE). Although contact dermatitis due to PPE is well reported, mask induced dermatitis is a relatively unexplored phenomenon. In this article, we report a preliminary data of patients experiencing retroauricaular dermatitis due to ear loop face masks.


id: cord-316126-j51dik7f
author: Zhang, X. Sophie
date: 2020-10-28
txt: ./txt/cord-316126-j51dik7f.txt
cache: ./cache/cord-316126-j51dik7f.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1128/cmr.00184-20
doi: 10.1128/cmr.00184-20
summary:
  title: SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles Since the beginning of the COVID-19 pandemic, there has been intense debate over SARS-CoV-2''s mode of transmission and appropriate personal protective equipment for health care workers in low-risk settings. This review attempts to summarize current cumulative data on SARS-CoV-2''s modes of transmission and identify gaps in research while offering preliminary answers to the question on everyone''s mind: is the airborne route significant and should we modify our COVID-19 PPE recommendations for frontline workers in low-risk settings? Given that substantial disagreement persists on the importance of natural aerosol generation by COVID-19 patients, and consequently, the necessary level of respiratory protection in non-AGP contexts, our review will focus on transmission and PPE in low-risk health care settings.

title:
  SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles

abstract:
  Since the beginning of the COVID-19 pandemic, there has been intense debate over SARS-CoV-2’s mode of transmission and appropriate personal protective equipment for health care workers in low-risk settings. The objective of this review is to identify and appraise the available evidence (clinical trials and laboratory studies on masks and respirators, epidemiological studies, and air sampling studies), clarify key concepts and necessary conditions for airborne transmission, and shed light on knowledge gaps in the field. We find that, except for aerosol-generating procedures, the overall data in support of airborne transmission—taken in its traditional definition (long-distance and respirable aerosols)—are weak, based predominantly on indirect and experimental rather than clinical or epidemiological evidence. Consequently, we propose a revised and broader definition of “airborne,” going beyond the current droplet and aerosol dichotomy and involving short-range inhalable particles, supported by data targeting the nose as the main viral receptor site. This new model better explains clinical observations, especially in the context of close and prolonged contacts between health care workers and patients, and reconciles seemingly contradictory data in the SARS-CoV-2 literature. The model also carries important implications for personal protective equipment and environmental controls, such as ventilation, in health care settings. However, further studies, especially clinical trials, are needed to complete the picture.


id: cord-316266-6m9g3bdr
title: What proportion of healthcare worker masks carry virus? A systematic review
author: Jones, Peter
date: 2020-06-24
url: https://doi.org/10.1111/1742-6723.13581
doi: 10.1111/1742-6723.13581
abstract:
  BACKGROUND: Concerns have been raised by healthcare organisations in New Zealand that routine mask use by healthcare workers (HCW) may increase the risk of transmission of SARS‐CoV‐2 through increased face touching. Routine mask use by frontline HCW was not recommended when seeing ‘low risk’ patients. The aim of this review was to determine the carriage of respiratory viruses on facemasks used by HCW. METHODS: A systematic review was conducted with structured searches of medical and allied health databases. Two authors independently screened articles for inclusion, with substantial agreement (k=0.66, 95%CI 0.54 to 0.79). Studies that at least one author recommended for full text review were reviewed in full for inclusion. Two authors independently extracted data from included studies including the setting, method of analysis and results. There was exact agreement on the proportion of virus detected on masks. RESULTS: 1233 titles were retrieved, 47 underwent full text review and five studies reported in four articles were included. The studies were limited by small numbers and failure to test all eligible masks in some studies. The proportion in each study ranged from 0 (95% CI 0‐10) to 25% (95%CI 8‐54). No study reported clinical respiratory illness as a result of virus on the masks. CONCLUSIONS: Although limited, current evidence suggests that viral carriage on the outer surface of surgical masks worn by HCW treating patients with clinical respiratory illness is low and there was not strong evidence to support the assumption that mask use may increase the risk of viral transmission. This article is protected by copyright. All rights reserved.


id: cord-317047-86rb6hov
author: Ippolito, Mariachiara
date: 2020-04-27
url: https://api.elsevier.com/content/article/pii/S253104372030088X
doi: 10.1016/j.pulmoe.2020.04.009
title:
  Medical masks and Respirators for the Protection of Healthcare Workers from SARS-CoV-2 and other viruses

abstract:
  Abstract The use of medical masks and respirators as personal protective equipment is pivotal to reducing the level of biological hazard to which healthcare workers are exposed during the outbreak of highly diffusible pathogens, such as the recent novel coronavirus SARS-CoV-2. Unfortunately, during this pandemic, supplies are rapidly running out worldwide, with potential consequences for the rate of occupational infections. Also, knowledge about specific characteristics of respirators is of utmost importance to select the proper type according to the clinical setting. A wide variety of literature is available on the topic, but mostly based on Influenza viruses infection models. Clinical evidence on the use of respirators is poor and interest in the topic has not been constant over time. A better understanding of SARS-CoV-2 transmission is needed, together with high-quality clinical data on the use of respirators or alternative devices. Moreover, healthcare workers, regardless of their level of experience, should receive specific training. This review aims to summarize the available evidence on the use of medical masks and respirators in the context of viral infections, especially the current coronavirus disease 2019 (COVID-19).


id: cord-317915-0javg3m8
author: Kumar, Jagdesh
date: 2020-04-20
url: https://www.ncbi.nlm.nih.gov/pubmed/32455057/
doi: 10.7759/cureus.7737
title:
  Knowledge, Attitude, and Practices of Healthcare Workers Regarding the Use of Face Mask to Limit the Spread of the New Coronavirus Disease (COVID-19)

abstract:
  Introduction Many countries including Pakistan are currently using face masks in their pandemic control plans. Being highly prevalent, the correct use of these masks is particularly important, as an incorrect use and disposal may actually increase the rate of transmission. The purpose of this study was to investigate the knowledge, attitude, and practices of healthcare workers (HCWs) in wearing a surgical face mask to limit the spread of the new coronavirus disease 2019 (COVID-19). Materials and Methods This survey was conducted by interviewing HCWs using a questionnaire consisting of the basic demographic characteristics, and the knowledge, attitude, and practices regarding the use of surgical face mask to limit the new COVID-19 exposure. Each correct answer was scored 1 and each incorrect answer scored 0. The total number of questions was 16, and the final score was calculated and then labeled according to the percentage (out of 16) of correct responses as good (>80%), moderate (60-80%), and poor (<60%). Results A total of 392 participants with a mean age of 42.37 ± 13.34 years (341 males and 51 females) were included in the study. The overall final results were good in 138 (35.2%), moderate in 178 (45.4%), and poor in 76 (19.3%). Around 43.6% of participants knew about the correct method of wearing the masks, 68.9% knew that there are three layers, 53% stated that the middle layer act as a filter media barrier, and 75.5% knew the recommended maximum duration of wearing it. The majority (88.2%) of participants knew that a cloth face mask is not much effective, around 79.8% knew that used face mask cannot be re-used, and 44.8% knew about the yellow-coded bag for disposal. Conclusions Knowledge, attitude, and practice of HCWs regarding the use of face masks were found to be inadequate. Studied HCWs had a positive attitude but moderate-to-poor level of knowledge and practice regarding the use of face mask. HCWs and general public awareness campaigns regarding the proper use of face mask by utilizing all social media available resources would be helpful during this pandemic.


id: cord-318660-47dqa1dd
title: Efficacy and Use of Cloth Masks: A Scoping Review
author: Jain, Mehr
date: 2020-09-13
url: https://doi.org/10.7759/cureus.10423
doi: 10.7759/cureus.10423
abstract:
  During the coronavirus disease 2019 (COVID-19) pandemic, there has been a global shortage of personal protective equipment (PPE). In this setting, cloth masks may play an important role in limiting disease transmission; however, current literature on the use of cloth masks remains inconclusive. This review aims to integrate current studies and guidelines to determine the efficacy and use of cloth masks in healthcare settings and/or the community. Evidence-based suggestions on the most effective use of cloth masks during a pandemic are presented. Embase, MEDLINE, and Google Scholar were searched on March 31, 2020, and updated on April 6, 2020. Studies reporting on the efficacy, usability, and accessibility of cloth masks were included. Additionally, a search of guidelines and recommendations on cloth mask usage was conducted through published material by international and national public health agencies. Nine articles were included in this review after full-text screening. The clinical efficacy of a face mask is determined by the filtration efficacy of the material, fit of the mask, and compliance to wearing the mask. Household fabrics such as cotton T-shirts and towels have some filtration efficacy and therefore potential for droplet retention and protection against virus-containing particles. However, the percentage of penetration in cloth masks is higher than surgical masks or N95 respirators. Cloth masks have limited inward protection in healthcare settings where viral exposure is high but may be beneficial for outward protection in low-risk settings and use by the general public where no other alternatives to medical masks are available.


id: cord-321847-4a6eb4mr
author: Eckl, L.
date: 2020-11-13
url: https://doi.org/10.1101/2020.11.11.20224030
doi: 10.1101/2020.11.11.20224030
title:
  Gender- and age-related differences in misuse of face masks in COVID-19 prevention in central European cities

abstract:
  1 ABSTRACT Objective Correct use of face masks is required for their efficacy in preventing possible droplet infections with SARS-CoV-2. We tried to provide information about differences in the distribution of gender and age groups wearing face masks incorrectly. Design Pilot field study Methods Visual observation of mask use in public, not age- and gender-related places in central European large cities regarding incorrect mask-wearing (n=523); statistical analysis (nominal scale) in terms of gender and estimated age group using the total numbers, binomial test and chi-square test. Results There is no significant difference (binomial test: p-value = 0.43) in mask misuse between the genders (female: 271 (51.8%), male: 252 (48.2%) and 0 non-binary individuals (0%)). There is a significant difference (chi-square test: p-value < 2.2e-16) in age group distribution (170 young 10-29 years (32.5%), 261 middle-aged 30-59 years (49.9%), 92 older adults [≥]60 years (17.6%)). In total numbers, the highest counts were observed in middle-aged persons with 261 counts (49.9%). Conclusion Our study shows an uneven age-distribution of people wearing the face mask in public improperly. Keywords Coronavirus, SARS-CoV-2, COVID-19, Community, Face mask, Prevention


id: cord-322521-by0e6h7s
title: Quadrupling the N95 Supply during the COVID-19 Crisis with an Innovative 3D-Printed Mask Adaptor
author: Imbrie-Moore, Annabel M.
date: 2020-07-23
txt: ./txt/cord-322521-by0e6h7s.txt
cache: ./cache/cord-322521-by0e6h7s.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3390/healthcare8030225
doi: 10.3390/healthcare8030225
summary:
  We developed a solution for immediate use: a mask adaptor, outfitted with a quarter section of an N95 respirator that maintains the N95 seal standard, thereby quadrupling the N95 supply. Filter efficacy was quantitatively evaluated using a computerized N95 fit test machine (PortaCount Respirator Fit Tester, TSI Inc., Shoreview, MN, USA) that measures the concentration of particles leaking into the mask, either through the filter itself or through gaps around the mask components and in the face seal. To validate that it is possible to maintain the N95 filter efficacy standard with our novel mask adaptor, the final prototype was tested on six individuals using the PortaCount computerized N95 fit test machine. Filter efficacy of the mask was quantitatively evaluated using a computerized N95 fit test machine, confirming the use of this mask adaptor design as a valid means of extending the mask supply while maintaining the N95 standard.

abstract:
  The need for personal protective equipment during the COVID-19 pandemic is far outstripping our ability to manufacture and distribute these supplies to hospitals. In particular, the medical N95 mask shortage is resulting in healthcare providers reusing masks or utilizing masks with filtration properties that do not meet medical N95 standards. We developed a solution for immediate use: a mask adaptor, outfitted with a quarter section of an N95 respirator that maintains the N95 seal standard, thereby quadrupling the N95 supply. A variety of designs were 3D-printed and optimized based on the following criteria: seal efficacy, filter surface area and N95 respirator multiplicity. The final design is reusable and features a 3D-printed soft silicone base as well as a rigid 3D-printed cartridge to seal one-quarter of a 3M 1860 N95 mask. Our mask passed the computerized N95 fit test for six individuals. All files are publicly available with this publication. Our design can provide immediate support for healthcare professionals in dire need of medical N95 masks by extending the current supply by a factor of four.


id: cord-322923-zxraxgl1
author: Bayersdorfer, Jennifer
date: 2020-07-16
url: https://www.sciencedirect.com/science/article/pii/S0196655320307045?v=s5
doi: 10.1016/j.ajic.2020.07.019
title:
  Novel Manufacturing of Simple Masks in Response to International Shortages: Bacterial and Particulate Filtration Efficiency Testing

abstract:
  Many healthcare systems have been forced to outsource simple mask production due to international shortages caused by the COVID-19 pandemic. Providence created simple masks using surgical wrap and submitted samples to an environmental lab for bacterial filtration efficiency testing. Bacterial filtration efficiency (BFE) rates ranged from 83.0 – 98.1% depending on specific material and ply, and particular filtration efficiency (PFE) rates ranged from 92.3-97.7%. Based on mask configuration, specific surgical wrap selected, and ply, the recommended filtration efficiency for isolation and surgical masks of 95% and 98%, respectively can be achieved. These alternative masks can allow for similar coverage and safety when hospital-grade isolation masks are in short supply.


id: cord-324444-t697xw4y
author: Rodriguez-Palacios, Alexander
date: 2020-04-10
url: https://doi.org/10.1101/2020.04.07.20045617
doi: 10.1101/2020.04.07.20045617
title:
  Textile Masks and Surface Covers - A 'Universal Droplet Reduction Model' Against Respiratory Pandemics

abstract:
  The main form of COVID-19 transmission is via oral-respiratory droplet contamination (droplet; very small drop of liquid) produced when individuals talk, sneeze or cough. In hospitals, health-care workers wear facemasks as a minimum medical droplet precaution to protect themselves. Due to the shortage of masks during the pandemic, priority is given to hospitals for their distribution. As a result, the availability/use of medical masks is discouraged for the public. However, given that asymptomatic individuals, not wearing masks within the public, can be highly contagious for COVID-19, prevention of environmental droplet contamination (EnDC) from coughing/sneezing/speech is fundamental to reducing transmission. As an immediate solution to promote public droplet safety, we assessed household textiles to quantify their potential as effective environmental droplet barriers (EDBs). The synchronized implementation of a universal community droplet reduction solution is discussed as a model against COVID-19. Using a bacterial-suspension spray simulation model of droplet ejection (mimicking a sneeze), we quantified the extent by which widely available clothing fabrics reduce the dispersion of droplets onto surfaces within 1.8m, the minimum distance recommended for COVID-19 social distancing. All textiles reduced the number of droplets reaching surfaces, restricting their dispersion to <30cm, when used as single layers. When used as double-layers, textiles were as effective as medical mask/surgical-cloth materials, reducing droplet dispersion to <10cm, and the area of circumferential contamination to ~0.3%. The synchronized implementation of EDBs as a community droplet reduction solution (i.e., face covers/scarfs/masks & surface covers) could reduce EnDC and the risk of transmitting or acquiring infectious respiratory pathogens, including COVID-19.


id: cord-324585-2rx84imv
title: Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks
author: Konda, Abhiteja
date: 2020-04-24
url: https://doi.org/10.1021/acsnano.0c03252
doi: 10.1021/acsnano.0c03252
abstract:
  [Image: see text] The emergence of a pandemic affecting the respiratory system can result in a significant demand for face masks. This includes the use of cloth masks by large sections of the public, as can be seen during the current global spread of COVID-19. However, there is limited knowledge available on the performance of various commonly available fabrics used in cloth masks. Importantly, there is a need to evaluate filtration efficiencies as a function of aerosol particulate sizes in the 10 nm to 10 μm range, which is particularly relevant for respiratory virus transmission. We have carried out these studies for several common fabrics including cotton, silk, chiffon, flannel, various synthetics, and their combinations. Although the filtration efficiencies for various fabrics when a single layer was used ranged from 5 to 80% and 5 to 95% for particle sizes of <300 nm and >300 nm, respectively, the efficiencies improved when multiple layers were used and when using a specific combination of different fabrics. Filtration efficiencies of the hybrids (such as cotton–silk, cotton–chiffon, cotton–flannel) was >80% (for particles <300 nm) and >90% (for particles >300 nm). We speculate that the enhanced performance of the hybrids is likely due to the combined effect of mechanical and electrostatic-based filtration. Cotton, the most widely used material for cloth masks performs better at higher weave densities (i.e., thread count) and can make a significant difference in filtration efficiencies. Our studies also imply that gaps (as caused by an improper fit of the mask) can result in over a 60% decrease in the filtration efficiency, implying the need for future cloth mask design studies to take into account issues of “fit” and leakage, while allowing the exhaled air to vent efficiently. Overall, we find that combinations of various commonly available fabrics used in cloth masks can potentially provide significant protection against the transmission of aerosol particles.


id: cord-326565-s62inw07
author: Shacham, E.
date: 2020-10-30
url: http://medrxiv.org/cgi/content/short/2020.10.28.20221705v1?rss=1
doi: 10.1101/2020.10.28.20221705
title:
  Association of County-Wide Mask Ordinances with Reductions in Daily CoVID-19 Incident Case Growth in a Midwestern Region Over 12 Weeks

abstract:
  Importance: This study assessed the longitudinal impact of new COVID-19 cases when a mask ordinance was implemented in 2 of a 5-county Midwestern U.S. metropolitan region over a 3-month period of time. Reduction in case growth was significant and reduced infection inequities by race and population density. Objective: The objective of this study was to assess the impact that a mandatory mask wearing requirement had on the rate of COVID-19 infections by comparing counties with a mandatory policy with those neighboring counties without a mandatory masking policy. Design: This was a quasi-experimental longitudinal study conducted over the period of June 12-September 25, 2020. Setting: This study was a population-based study. Data were abstracted from local health department reports of COVID-19 cases. Participants: Raw cases reported to the county health departments and abstracted for this study; census-level data were synthesized to address county-level population, income and race. Intervention(s) (for clinical trials) or Exposure(s) (for observational studies): The essential features of this intervention was an instituted mask mandate that occurred in St. Louis City and St. Louis County over a 12 week period. Main Outcome(s) and Measure(s): The primary study outcome measurement was daily COVID-19 infection growth rate. The mask mandate was hypothesized to lower daily infection growth rate. Results: Over the 15-week period, the average daily percent growth of reported COVID-19 cases across all five counties was 1.81% (sd 1.62%). The average daily percent growth in incident COVID-19 cases was similar between M+ and M- counties in the 3 weeks prior to implementation of mandatory mask policies (0.90% [sd 0.68] vs. 1.27% [sd 1.23%], respectively, p=0.269). Crude modeling with a difference-in-difference indicator showed that after 3 weeks of mask mandate implementation, M+ counties had a daily percent COVID-19 growth rate that was 1.32 times lower, or a 32% decrease. At 12 weeks post-mask policy implementation, the average daily COVID-19 case growth among M- was 2.42% (sd 1.92), and was significantly higher than the average daily COVID case growth among M+ counties (1.36% (sd 0.96%)) (p<0.001). A significant negative association was identified among counties between percent growth of COVID-19 cases and percent racial minorities per county (p<0.001), as well as population density (p<0.001). Conclusions and Relevance: These data demonstrate that county-level mask mandates were associated with significantly lower incident COVID-19 case growth over time, compared to neighboring counties that did not implement a mask mandate. The results highlight the swiftness of how a mask ordinance can impact the trajectory of infection rate growth. Another notable finding was that following implementation of mask mandates, the disparity of infection rate by race and population density was no longer significant, suggesting that regional-level policies can not only slow the spread of COVID-19, but simultaneously create more equal environment.


id: cord-329945-p5hljkkm
title: Mask is the possible key for self‐isolation in COVID‐19 pandemic
author: Zhou, Zhi‐Guo
date: 2020-04-08
txt: ./txt/cord-329945-p5hljkkm.txt
cache: ./cache/cord-329945-p5hljkkm.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/jmv.25846
doi: 10.1002/jmv.25846
summary:
  States mainly adopt the method of social distance between people to reach 6 feet to prevent infection, but for the COVID-19 pandemic, it may not be effective as we supposed. First of all, the disease is highly contagious, and whether a virus with a reproduction number of more than 2 can achieve true isolation through the so-called social distance by feet is a matter of probability rather than mathematics. A recent MIT study published in JAMA found that social distance requires 27 feet to be guaranteed not to be infected, which is not operational in real life 3 . In addition, there are a large number of asymptomatic infections in this outbreak. In fact, in high-risk areas with a large number of patients, without sufficient testing to confirm clean, everyone can only be seen as potential infected, including themselves. In fact, there have been cases of concentrated infection by a large number of people in confined spaces 6 .

abstract:
  Ma's research shows N95 masks, medical masks, even homemade masks could block at least 90% of the virus in aerosols(1). This study puts the debate on whether the public wear masks back on the table. Recently Science interviewed Dr. Gao, director‐general of Chinese Center for Disease Control and Prevention (CDC). This article is protected by copyright. All rights reserved.


id: cord-332512-28utunid
author: Eikenberry, Steffen E.
date: 2020-04-11
txt: ./txt/cord-332512-28utunid.txt
cache: ./cache/cord-332512-28utunid.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.04.06.20055624
doi: 10.1101/2020.04.06.20055624
summary:
  Model simulations, using data relevant to COVID-19 dynamics in the US states of New York and Washington, suggest that broad adoption of even relatively ineffective face masks may meaningfully reduce community transmission of COVID-19 and decrease peak hospitalizations and deaths. Moreover, mask use decreases the effective transmission rate in nearly linear proportion to the product of mask effectiveness (as a fraction of potentially infectious contacts blocked) and coverage rate (as a fraction of the general population), while the impact on epidemiologic outcomes (death, hospitalizations) is highly nonlinear, indicating masks could synergize with other non-pharmaceutical measures. In summary, the benefit to routine face mask use by the general public during the COVID-19 pandemic remains uncertain, but our initial mathematical modeling work suggests a possible strong potential benefit to near universal adoption of even weakly effective homemade masks that may synergize with, not replace, other control and mitigation measures.

title:
  To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic

abstract:
  Face mask use by the general public for limiting the spread of the COVID-19 pandemic is controversial, though increasingly recommended, and the potential of this intervention is not well understood. We develop a compartmental model for assessing the community-wide impact of mask use by the general, asymptomatic public, a portion of which may be asymptomatically infectious. Model simulations, using data relevant to COVID-19 dynamics in the US states of New York and Washington, suggest that broad adoption of even relatively ineffective face masks may meaningfully reduce community transmission of COVID-19 and decrease peak hospitalizations and deaths. Moreover, mask use decreases the effective transmission rate in nearly linear proportion to the product of mask effectiveness (as a fraction of potentially infectious contacts blocked) and coverage rate (as a fraction of the general population), while the impact on epidemiologic outcomes (death, hospitalizations) is highly nonlinear, indicating masks could synergize with other non-pharmaceutical measures. Notably, masks are found to be useful with respect to both preventing illness in healthy persons and preventing asymptomatic transmission. Hypothetical mask adoption scenarios, for Washington and New York state, suggest that immediate near universal (80%) adoption of moderately (50%) effective masks could prevent on the order of 17--45% of projected deaths over two months in New York, while decreasing the peak daily death rate by 34--58%, absent other changes in epidemic dynamics. Even very weak masks (20% effective) can still be useful if the underlying transmission rate is relatively low or decreasing: In Washington, where baseline transmission is much less intense, 80% adoption of such masks could reduce mortality by 24--65% (and peak deaths 15--69%), compared to 2--9% mortality reduction in New York (peak death reduction 9--18%). Our results suggest use of face masks by the general public is potentially of high value in curtailing community transmission and the burden of the pandemic. The community-wide benefits are likely to be greatest when face masks are used in conjunction with other non-pharmaceutical practices (such as social-distancing), and when adoption is nearly universal (nation-wide) and compliance is high.


id: cord-332577-2z5pchyq
title: Governor partisanship explains the adoption of statewide mandates to wear face coverings
author: Adolph, C.
date: 2020-09-02
url: https://doi.org/10.1101/2020.08.31.20185371
doi: 10.1101/2020.08.31.20185371
abstract:
  Public mask use has emerged as a key tool in response to COVID-19. We develop and document a classification of statewide mask mandates that reveals variation in their scope and timing. Some U.S. states quickly mandated the wearing of face coverings in most public spaces, whereas others issued narrow mandates or no mandate at all. We consider how differences in COVID-19 epidemiological indicators, state capacity, and partisan politics affect when states adopted broad mask mandates. The most important predictor is whether a state is led by a Republican governor. These states were much slower to adopt mandates, if they did so at all. COVID-19 indicators such as confirmed cases or deaths per million are much less important predictors of statewide mask mandates. This finding highlights a key challenge to public efforts to increase mask-wearing, widely believed to be one of the most effective tools for preventing the spread of SARS-CoV-2 while restoring economic activity.


id: cord-333379-wtdhdcjz
author: Rajagopaian, Sanjay
date: 2020-05-11
url: https://doi.org/10.1136/heartjnl-2020-317104
doi: 10.1136/heartjnl-2020-317104
abstract: nan
title:
  Flattening the curve in COVID-19 using personalised protective equipment: lessons from air pollution


id: cord-334166-vll4s0xq
title: Reducing Aerosolised Particles and Droplet Spread in Endoscopic Sinus Surgery during COVID‐19
author: Jones, Huw AS
date: 2020-08-15
url: https://www.ncbi.nlm.nih.gov/pubmed/32798323/
doi: 10.1002/lary.29065
abstract:
  OBJECTIVES: The presence of high SARS‐Cov‐2 viral loads in the upper airway, including the potential for aerosolised transmission of viral particles, has generated significant concern amongst Otolaryngologists worldwide, particularly those performing Endoscopic Sinus Surgery (ESS). We evaluated a simple negative pressure mask technique to reduce viral exposure. METHODS: Two models simulating respiratory droplets >5‐10 μm and fine respiratory nuclei <5 μm using fluorescein dye and wood smoke respectively were utilised in a fixed cadaveric study in a controlled environment. Using Ultra‐Violet light, fluorescein droplet spread was assessed during simulated ESS with powered microdebrider and powered drilling. Wood smoke ejection was used to evaluate fine particulate escape from a negative pressure mask using digital subtraction image processing. RESULTS: The use of a negative pressure mask technique resulted in a 98% reduction in the fine particulate aerosol simulation, and eliminated larger respiratory droplet spread during simulated ESS, including during external drill activation. CONCLUSIONS: As global ENT services resume routine elective operating, we demonstrate the potential use of a simple negative pressure mask technique to reduce the risk of viral exposure for the operator and theatre staff during ESS.


id: cord-337372-y43prnko
author: bin‐Reza, Faisal
date: 2011-12-21
txt: ./txt/cord-337372-y43prnko.txt
cache: ./cache/cord-337372-y43prnko.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/22188875/
doi: 10.1111/j.1750-2659.2011.00307.x
summary:
  A limited effort was made to identify additional studies: reference lists of review articles were examined; the European Centre for Disease Prevention and Control''s (ECDC) Antimicrobial Resistance and Health Care Associated Infection Programme was consulted; and MEC''s and AN''s hardcopy literature files were hand-searched. [7] [8] [9] [10] [11] Two of these studies compared N95 respirators (designed to seal tightly to the wearer''s face and filter out very small particles or aerosols that may contain viruses) and surgical masks (used to block large droplets from coming into contact with the wearer''s mouth or nose) amongst healthcare workers; one trial found a lower rate of clinical respiratory illness associated with the use of non-fit-tested N95 respirators compared with medical masks, 6 whilst a non-inferiority trial found that masks and respirators offered similar protection to nurses against laboratory-confirmed influenza infection.

title:
  The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence

abstract:
  Please cite this paper as: bin‐Reza et al. (2012) The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence. Influenza and Other Respiratory Viruses 6(4), 257–267. There are limited data on the use of masks and respirators to reduce transmission of influenza. A systematic review was undertaken to help inform pandemic influenza guidance in the United Kingdom. The initial review was performed in November 2009 and updated in June 2010 and January 2011. Inclusion criteria included randomised controlled trials and quasi‐experimental and observational studies of humans published in English with an outcome of laboratory‐confirmed or clinically‐diagnosed influenza and other viral respiratory infections. There were 17 eligible studies. Six of eight randomised controlled trials found no significant differences between control and intervention groups (masks with or without hand hygiene; N95/P2 respirators). One household trial found that mask wearing coupled with hand sanitiser use reduced secondary transmission of upper respiratory infection/influenza‐like illness/laboratory‐confirmed influenza compared with education; hand sanitiser alone resulted in no reduction. One hospital‐based trial found a lower rate of clinical respiratory illness associated with non‐fit‐tested N95 respirator use compared with medical masks. Eight of nine retrospective observational studies found that mask and/or respirator use was independently associated with a reduced risk of severe acute respiratory syndrome (SARS). Findings, however, may not be applicable to influenza and many studies were suboptimal. None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection. Some evidence suggests that mask use is best undertaken as part of a package of personal protection especially hand hygiene. The effectiveness of masks and respirators is likely linked to early, consistent and correct usage.


id: cord-341695-9l2lmzyr
author: He, W.
date: 2020-11-04
txt: ./txt/cord-341695-9l2lmzyr.txt
cache: ./cache/cord-341695-9l2lmzyr.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.11.01.20223982
doi: 10.1101/2020.11.01.20223982
summary:
  Both the filtration efficiencies and electrostatic potential of the cotton mask had no change after 5 times of common hand disinfection ( Figure 2 and is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint ; https://doi.org/10.1101/2020.11.01.20223982 doi: medRxiv preprint For a type of selected surgical masks (brand 1), the average electrostatic potential decreased as the number of common hand disinfection increased (Figure 3a) . The electrostatic potential of all tested N95 respirators had no statistically significant difference after common hand disinfection up to 10 times, which indicated that using alcohol-based is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint ; https://doi.org/10.1101/2020.11.01.20223982 doi: medRxiv preprint filtration efficiencies of the surgical masks decreased as the number of common hand disinfection increased (Figure 3b ).

title:
  Filtration Performance Degradation of In-Use Masks by Vapors from Alcohol-Based Hand Sanitizers and the Mitigation Solutions

abstract:
  How often does one perform hand disinfection while wearing a mask? In the current COVID-19 pandemic, wearing masks and hand disinfection are widely adopted hygiene practices. However, our study indicated that exposure to the vapors from alcohol-based sanitizers during hand disinfection might degrade the filtration performance of the in-use masks, and the degradation worsened with the increasing number of hand disinfection. After five times of hand disinfection, the filtration efficiencies of surgical masks decreased by >8% for 400 and 500nm particles and by 3.68{+/-}1.83% for 1m particles. This was attributed to the dissipation of electrostatic charges on the masks when exposed to the alcohol vapor generated during hand disinfection. Simple practice of vapor-avoiding hand disinfection could mitigate the effects of alcohol vapor, which was demonstrated on two brands of surgical masks. The vapor-avoiding hand disinfection is recommended to be included in the hygiene guide to maintain the mask performance.


id: cord-342357-g8m57t67
title: Management and use of filter masks in the “none-medical” population during the Covid-19 period
author: Cumbo, Enzo
date: 2020-09-21
txt: ./txt/cord-342357-g8m57t67.txt
cache: ./cache/cord-342357-g8m57t67.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0925753520303945?v=s5
doi: 10.1016/j.ssci.2020.104997
summary:
  SARS-CoV-2 has become a pandemic disease declared by the World Health Organization, consequently each nation has taken a series of actions managed by the government in order to prevent the spread of this dangerous virus. Those masks are medical devices that should be handled properly; unfortunately in our study, observation of the population during the so-called "phase 2" has very often shown an inappropriate use of any type of mask which reduces its effectiveness. The data collected show important results that indicate how citizens'' behavior may not be perfectly correct; the use of a medical device, such as a mask, which has an extremely important role in preventing the spread of infections in the air, must comply with very precise principles. Public health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto

abstract:
  SARS-CoV-2 has become a pandemic disease declared by the World Health Organization, consequently each nation has taken a series of actions managed by the government in order to prevent the spread of this dangerous virus. The most common countermeasure is the use of a mask that should cover the mouth and nose to filter the inhaled and exhaled air. Those masks are medical devices that should be handled properly; unfortunately in our study, observation of the population during the so-called “phase 2” has very often shown an inappropriate use of any type of mask which reduces its effectiveness. The correct dissemination of adequate information on how to use the mask and the strict control by the government not only on staying on the street wearing masks but above all on how they should be worn, could have further reduced the spread of Covid-19.


id: cord-342666-7el8o6qq
author: Mahmood, Syed Uzair
date: 2020-05-23
url: https://www.ncbi.nlm.nih.gov/pubmed/32596068/
doi: 10.7759/cureus.8248
title:
  Strategies for Rational Use of Personal Protective Equipment (PPE) Among Healthcare Providers During the COVID-19 Crisis

abstract:
  As the coronavirus 2019 (COVID-19) began spreading globally with no clear treatment in sight, prevention became a major part of controlling the disease and its effects. COVID-19 spreads from the aerosols of an infected individual whether they are showing any symptoms or not. Therefore, it becomes nearly impossible to point exactly where the patient is. This is where personal protective equipment (PPE) comes in. These are masks, respirators, gloves, and in hospitals where the contact with the infected and confirmed patient is direct, also gowns or body covers. The PPEs play a major role in the prevention and control of the COVID-19. The PPE is able to prevent any invasion of the virus particles into the system of an individual which is why it is an essential item to have for healthcare workers. Due to the high demand for PPEs all around the world, it is important to optimize the use of protective gear and ration the supplies so that the demand are met. However, there are guidelines recommended by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) to maintain the supply in the wake of this increased demand of PPE, how the manufacturers should track their supplies, and how the recipients should manage them. Various strategies can be used to increase the re-use of PPEs during the COVID-19 pandemic that has modified the donning and doffing procedure.


id: cord-343535-r8rsbfs3
title: Prospect of biobased antiviral face mask to limit the coronavirus outbreak
author: Chowdhury, Mohammad Asaduzzaman
date: 2020-10-03
txt: ./txt/cord-343535-r8rsbfs3.txt
cache: ./cache/cord-343535-r8rsbfs3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33022215/
doi: 10.1016/j.envres.2020.110294
summary:
  This is the first study that has endeavoured to explore the design and fabrication of an antiviral face mask using licorice root extract, which has antimicrobial properties due to glycyrrhetinic acid (GA) and glycyrrhizin (GL). Theoretical estimation signifies that an 85 L/min rate of airflow through the face mask is possible which ensures good breathability over an extensive range of pressure drops and pore sizes. Finally, it can be concluded that licorice root membrane may be used to produce a biobased face mask to control COVID-19 spread. No study on the development of biobased face masks using licorice root membrane was found in the literature. In this paper, we have proposed the potential of the licorice root membrane as a nanofiber that can be used in the production of a face mask.

abstract:
  The rapid spread of COVID-19 has led to nationwide lockdowns in many countries. The COVID-19 pandemic has played serious havoc on economic activities throughout the world. Researchers are immensely curious about how to give the best protection to people before a vaccine becomes available. The coronavirus spreads principally through saliva droplets. Thus, it would be a great opportunity if the virus spread could be controlled at an early stage. The face mask can limit virus spread from both inside and outside the mask. This is the first study that has endeavoured to explore the design and fabrication of an antiviral face mask using licorice root extract, which has antimicrobial properties due to glycyrrhetinic acid (GA) and glycyrrhizin (GL). An electrospinning process was utilized to fabricate nanofibrous membrane and virus deactivation mechanisms discussed. The nanofiber mask material was characterized by SEM and airflow rate testing. SEM results indicated that the nanofibers from electrospinning are about 15-30 μm in diameter with random porosity and orientation which have the potential to capture and kill the virus. Theoretical estimation signifies that an 85 L/min rate of airflow through the face mask is possible which ensures good breathability over an extensive range of pressure drops and pore sizes. Finally, it can be concluded that licorice root membrane may be used to produce a biobased face mask to control COVID-19 spread.


id: cord-345883-ncot7tvn
title: Exploring motivations behind pollution-mask use in a sample of young adults in urban China
author: Hansstein, Francesca Valeria
date: 2018-12-04
txt: ./txt/cord-345883-ncot7tvn.txt
cache: ./cache/cord-345883-ncot7tvn.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/30514342/
doi: 10.1186/s12992-018-0441-y
summary:
  Using the Theory of Planned Behaviour (TPB) as conceptual framework, this study explores the role of socio-cognitive factors that affect the decision of wearing a pollution mask in the context of young educated people. To conduct the empirical investigation, the Theory of Planned Behaviour (TPB) was applied to determine the role that socio-cognitive factors play on the decision of wearing a pollution mask among a sample of Chinese students. Previous research had proven the validity of the theory-based psychological models in explaining the intention to take preventive measure for limiting the health effects of air pollution [18, 19] . Attitude, social norm, self-efficacy, and past behaviour were all positively related to the intention of wearing a pollution mask and also highly significant (specifically, β A = 0.23, p < 0.01, β SN = 0.37, p < 0.01, β SN = 0.32, p < 0.01, β PB = 0.12, p < 0.01).

abstract:
  BACKGROUND: Wearing a pollution mask is an effective, practical, and economic way to prevent the inhalation of dangerous particulate matter (PM). However, it is not uncommon to observe negligence in adopting such behaviour, and this especially among young segments of the population. Using the Theory of Planned Behaviour (TPB) as conceptual framework, this study explores the role of socio-cognitive factors that affect the decision of wearing a pollution mask in the context of young educated people. This is done by selecting a sample of college students in urban China, a country that has seen air quality as one of the major challenges in the last decades. While young urban college students might be expected to be receptive to standard attempts to be influenced through reason-based cognitive stimuli, it is often found that this is not the case. The empirical analysis was articulated it in two steps. Structural Equation Modelling (SEM) was first used to examine the relationships among the conceptual constructs derived from the TPB conceptual model, and second Step-Wise Ordinary Least Squares Regressions (SWOLS) were employed to observe the partial effect played by each item on the decision to wear a mask. RESULTS: Results show that, while reason-based stimuli play a role, attitude, social norm, and self-efficacy were the most important predictors of the behavioural intention (p < 0.01). The role of past behaviour was also acknowledged as strongly associated with the dependent variable (p < 0.01). Overall, the likelihood of wearing a pollution mask increases with the importance of others socio-cognitive and psychological factors, which could help understand behavioural biases, and explain the relative role of several mechanisms behind the decision to wear a mask. CONCLUSIONS: While tackling pollution requires multiple and synergic approaches, encouraging self-prevention using pollution mask is a simple and effective action, implementable at negligible costs. Resistance among younger, well-educated cohorts to wear masks can be overcome by stressing the social desirability of action and the sense of empowerment derived from its usage. This study has the potential to inform policies aimed at changing suboptimal behavioural attitudes by identifying triggers for change, and it could serve in improving the tailoring of health promotion messages aimed at nudging healthy behaviour. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12992-018-0441-y) contains supplementary material, which is available to authorized users.


id: cord-347390-xz5a99cr
author: Ray, Saikat Sinha
date: 2020-08-07
txt: ./txt/cord-347390-xz5a99cr.txt
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url: https://www.sciencedirect.com/science/article/pii/S2352186420313936?v=s5
doi: 10.1016/j.eti.2020.101093
summary:
  With the emergence of the coronavirus disease (COVID-19), it is essential that face masks demonstrating significant anti-droplet and hydrophobic characteristics are developed and distributed. In this study, a commercial compressed-polyurethane (C-PU) mask was modified by applying a hydrophobic and anti-droplet coating using a silica sol, which was formed by the hydrolysis of tetraethoxysilane (TEOS) under alkaline conditions and hydrolyzed hexadecyltrimethoxysilane (HDTMS) to achieve hydrophobization. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 The methodology for fabricating a stable hydrophobic coating on a mask surface utilizing silica 202 sol as well as HDTMS is discussed in materials and methods section and summarized in 203 Scheme 1.

title:
  Surface innovation to enhance anti-droplet and hydrophobic behavior of breathable compressed-polyurethane masks

abstract:
  With the emergence of the coronavirus disease (COVID-19), it is essential that face masks demonstrating significant anti-droplet and hydrophobic characteristics are developed and distributed. In this study, a commercial compressed-polyurethane (C-PU) mask was modified by applying a hydrophobic and anti-droplet coating using a silica sol, which was formed by the hydrolysis of tetraethoxysilane (TEOS) under alkaline conditions and hydrolyzed hexadecyltrimethoxysilane (HDTMS) to achieve hydrophobization. The modified mask (C-PU/Si/HDTMS) demonstrated good water repellency resulting in high water contact angle (132°) and low sliding angle (17°). Unmodified and modified masks were characterized using attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray photoelectron spectroscopy (XPS). A drainage test confirmed the strong interaction between the mask surface and coating. Moreover, the coating had negligible effect on the average pore size of the C-PU mask, which retained its high breathability after modification. The application of this coating is a facile approach to impart anti-droplet, hydrophobic, and self-cleaning characteristics to C-PU masks.


id: cord-351506-ubaoxxg0
title: “Masking” our emotions: Botulinum toxin, facial expression, and well‐being in the age of COVID‐19
author: Nestor, Mark S.
date: 2020-07-12
txt: ./txt/cord-351506-ubaoxxg0.txt
cache: ./cache/cord-351506-ubaoxxg0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32592268/
doi: 10.1111/jocd.13569
summary:
  CONCLUSIONS: Mask‐wearing in the wake of COVID‐19 brings new challenges to our ability to communicate and perceive emotion through full facial expression, our most effective and universally shared form of communication, and BTX may offer a positive solution to decrease negative emotions and promote well‐being for both the mask‐wearer and all who come in contact with that individual. 5 With these restrictions now being slowly lifted, patients are once again receiving this most common and valued aesthetic procedure for its desired effect of facial muscle paralysis to diminish or eliminate unwanted frown lines and "crow''s feet." 6 Today however, these effects are now complemented by a mask that hides the lower half of the face, interfering with emotional processing and our ability to interpret each other''s emotions through facial expression.

abstract:
  BACKGROUND: The globally devastating effects of COVID‐19 breach not only the realm of public health, but of psychosocial interaction and communication as well, particularly with the advent of mask‐wearing. METHODS: A review of the literature and understanding of facial anatomy and expressions as well as the effect of botulinum toxin on emotions and nonverbal communication. RESULTS: Today, the mask has become a semi‐permanent accessory to the face, blocking our ability to express and perceive each other’s facial expressions by dividing it into a visible top half and invisible bottom half. This significantly restricts our ability to accurately interpret emotions based on facial expressions and strengthens our perceptions of negative emotions produced by frowning. The addition of botulinum toxin (BTX)–induced facial muscle paralysis to target the muscles of the top (visible) half of the face, especially the corrugator and procerus muscles, may act as a therapeutic solution by its suppression of glabellar lines and our ability to frown. The treatment of the glabella complex not only has been shown to inhibit the negative emotions of the treated individual but also can reduce the negative emotions in those who come in contact with the treated individual. CONCLUSIONS: Mask‐wearing in the wake of COVID‐19 brings new challenges to our ability to communicate and perceive emotion through full facial expression, our most effective and universally shared form of communication, and BTX may offer a positive solution to decrease negative emotions and promote well‐being for both the mask‐wearer and all who come in contact with that individual.


id: cord-354111-rj6te7fz
author: Stone, Teresa E.
date: 2020-04-12
txt: ./txt/cord-354111-rj6te7fz.txt
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url: https://doi.org/10.1111/nhs.12724
doi: 10.1111/nhs.12724
abstract: nan
summary:
  The World Health Organization''s director general, Dr. Tedros Adhanom Ghebreyesus, said that, as a result of the COVID-19 outbreak, demand for personal protective equipment was 100 times higher than average, and prices had risen to 20 times higher resulting in global stocks of masks and respirators being insufficient to meet supply (Boseley, 2020) . Authors of a recent systematic review of ten randomized control trials found limited evidence for face mask effectiveness in preventing influenza virus transmission either when worn by the infected person to avoid transmission or when worn by uninfected people to reduce exposure (Xiao et al., 2020) Summing up evidence Pawlowski (2020) notes that surgical masks are designed for surgeons to wear to prevent the transmission of pathogens from their nose and mouth to the surgical field; they are not intended to avoid viruses being inhaled through the mask.

title:
  Editorial: Facemasks and the Covid 19 pandemic: What advice should health professionals be giving the general public about the wearing of facemasks?


id: cord-354127-sb8tovy2
author: de Abreu, Andrea Pio
date: 2020-08-26
txt: ./txt/cord-354127-sb8tovy2.txt
cache: ./cache/cord-354127-sb8tovy2.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32877491/
doi: 10.1590/2175-8239-jbn-2020-s103
summary:
  title: Recommendations from the Brazilian Society of Nephrology regarding the use of cloth face coverings, by chronic kidney patients in dialysis, during the new coronavirus pandemic (Covid-19) Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. Considering the scarcity of Personal Protective Equipment (PPE), the SBN recommends that all asymptomatic chronic renal patients, as well as the general population, should wear protection masks, based on recommendations from the Ministry of Health (MH), through Informative Note 3/2020-CGGAP/DESF/ SAPS/MS1.

title:
  Recommendations from the Brazilian Society of Nephrology regarding the use of cloth face coverings, by chronic kidney patients in dialysis, during the new coronavirus pandemic (Covid-19)

abstract:
  These recommendations were created after the publication of informative note 3/2020- CGGAP/DESF/SAPS/MS, of April 4, 2020, in which the Brazilian Ministry of Health recommended the use of a cloth mask by the population, in public places. Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. The present recommendations have eleven items, related to this rationale, the procedures, indications, contraindications, as well as appropriate fabrics for the mask, and hygiene care to be adopted. These recommendations may change, at any time, in the light of new evidence.


