December 12, 2020 By Off

Coronavirus Masks: N95 Mask vs KN95 vs Surgical Mask vs Cloth Mask

by Waverly Yang, The University of Texas at Austin College of Pharmacy

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The Centers for Disease Control and Prevention (CDC) recommended that all Americans wear cloth face masks in public places, stating that there was increasing evidence that up to 25% of carriers who don’t show symptoms themselves are spreading coronavirus to others.  If everyone wears a mask in public, it will reduce the risk that asymptomatic carriers who don’t realize they are infected will spread the virus to others. Wearing a mask may also reduce your risk of getting infected with coronavirus.

A properly fitted mask provides two-fold protection for the wearer and those around them. For the wearer, it can protect the face from large droplets released by someone’s cough, sneeze, or breath, and it can also help block the wearer from exposing others to infectious droplets through the same means. However, the level of protection a mask provides depends on its material and proper usage by the wearer.

The masks that provide the best protection against coronavirus are N95 masks and certain surgical masks:

  • A N95 mask is a tight-fitting respirator mask that is properly fitted to the face and is able to block out small particle aerosols and large droplets (roughly 95% of airborne particles) through which the virus is typically transmitted.
  • A KN95 mask is a respirator mask that is similar to the N95 mask. These masks also block out roughly 95% of airborne particles and carry about the same level of protection as an N95 mask. As they are made in China, they follow the standards set by the Chinese government. Due to overall mask shortages, the US CDC has approved use of KN95 masks in place of N95 masks. Shop KN95 masks here.
  • A surgical mask, which is made from a more porous material and has a looser fit than an N95 mask, is more effective at limiting the spread of droplets from coughs and sneezes coming from the wearer.  Because it is highly permeable, it does not provide much protection against small virus particles.

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N95, KN95, and surgical masks are considered critical medical supplies, which should be reserved for healthcare workers and medical first responders who need the masks as they come in direct contact with coronavirus patients.

For non-healthcare workers, the CDC currently recommends wearing cloth face masks if you must leave the home. Many online retailers now offer a variety of cloth face masks for purchase. You can make your own mask by repurposing old t-shirts, fabrics, or blankets around your home. The CDC has provided a step-by-step, illustrated tutorial with sew and no-sew instructions for homemade masks. U.S. Surgeon General Dr. Jerome Adams also has a tutorial on YouTube on how to make a no-sew face mask.

Since hospitals are seeing a shortage of N95 masks, there has been a rise in KN95 mask usage. The main difference is that N95 masks must meet requirements set by the US National Institute for Occupational Safety and Health, while KN95 masks meet manufacturing standards set by the Chinese government. The key differences between American and Chinese respirator mask requirements are that KN95 masks are required to be fit tested on humans while N95 masks have additional requirements for breathability. However, KN95 masks are generally viewed as “equivalent” to N95 masks and both have very similar levels of protection. Due to recent shortages of masks, the CDC has approved the use of KN95 masks for healthcare workers in place of N95 masks.

The ideal type of fabric for a homemade cloth mask will have a thicker, high thread count and a tighter weave (e.g., quilting fabric).  To see how effective your fabric might be at filtering the air, try holding a piece of cloth up to a bright light or sunlight. The more the fabric blocks out light, the better it should be for filtration.  The CDC recommends layering at least two layers of fabric is key to maximize your mask’s filtration capabilities, especially with thinner fabrics.  

Remember that the fabric must be breathable since it will cover your nose and mouth, and it should not get damaged or change shape from frequent washing and drying.  Once you’ve picked out your fabric for your cloth mask, wash and dry it on the warmest settings to make sure they don’t shrink later.

Scientists have been testing the filtration capabilities of various household materials, such as vacuum bags and HEPA filters, suggesting that these materials can be considered for use in homemade masks. Putting a filter in your mask may not offer complete coverage against airborne particles, but will improve your homemade cloth mask’s effectiveness and protection. 

A recent NY Times article reported the initial findings of Professor Yang Wang, who has been recognized internationally for his aerosol research.  Professor Wang and his graduate students found that an allergy-reduction HVAC filter captured 89 percent of particles with one layer and 94 percent with two layers.  By comparison, an N95 mask captures at least 95 percent of particles as small as 0.3 microns, while a typical surgical mask filters about 60 to 80 percent of particles.

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When choosing a filter for your cloth mask, here are a few options that are often used:

  • PM2.5 filters are becoming increasingly common face mask filters and may also be included with face masks purchased online. Although they aren’t perfect, using a filter still offers a higher degree of protection than a cloth mask can on its own.
  • Activated charcoal filters are already used in vacuum cleaners, air purifiers, and more. They are effective in trapping particles in the air and may also be integrated into some PM2.5 filters.
  • HEPA filters are often used in air purifiers and central air systems, but its effectiveness has not been studied in masks. Despite not offering full protection, they may help to improve your mask’s defense to some degree. Make sure the HEPA filters you buy are true HEPA filters and not “HEPA-like” or “HEPA-type.”
  • Additional pieces of fabric will add more layers to your mask and increase the level of protection against airborne particles. 

Before using any household items for filter materials, confirm that they do not contain any substances that could be harmful to breathe.  Some household air or furnace filters, for example, contain fiberglass, which could damage your lungs.  

When using a filter in a cloth mask, make sure to change out the filter at least once a week (or more often if you use it daily). You should not wash your filters unless specified by the manufacturer or if the filter is a reusable piece of fabric. Many filters will degrade over time, so changing them regularly will help to maintain their effectiveness.

At this time, there are no cloth masks that meet the qualifications of an N95 mask. N95 masks should capture at least 95% of 0.3 micron particles and form a tight seal around the nose and mouth. N95 masks must be manufactured and tested according to standards set by the US government, so homemade cloth masks are not considered N95 masks and are unlikely to offer the same level of protection.

When putting on your face mask, make sure that the mask fits snugly against the sides of your face to create as much of a seal as possible. The mask should be tightly but comfortably secured behind your ears or your head and neck. Don’t forget to adjust your mask to completely cover your nose, mouth, and chin. 

It’s important to take off your mask properly so that you minimize contamination of your face. You should start by carefully removing the mask starting at the ears or head and neck. Avoid touching your nose, mouth, or eyes when taking off your mask and make sure to wash your hands immediately after removal.

Cloth face masks can be reused and should be washed routinely, depending on the frequency and duration of use. Although we don’t know how long coronavirus can survive on fabric, one recent study showed that the virus can survive on cardboard for up to 24 hours. Therefore, it is recommended that you machine wash and dry your cloth mask after each use, if at all possible.

Surgical masks, N95, and KN95 masks should not be washed. Washing these masks will likely damage them and make them ineffective. Instead, the CDC recommends changing these masks when they are soiled, damaged, or difficult to breathe through. It may also be a good idea to dispose of the mask after a couple of uses and to avoid touching the outside of your mask when removing or reusing them.

Just like with adults, the CDC recommends wearing cloth face masks for children ages 2 and up.  Such children should wear a mask over the nose and mouth in public unless they already have difficulty breathing without a mask or cannot remove the mask themselves.  Babies under the age of 2 should not wear a mask because of their inability to remove the mask or express distress if they are having trouble breathing. Fabrics have the potential to suffocate if they are accidentally pressed too tightly against the nose and mouth and block those airways.

Young children may find it difficult to wear a mask properly, so it’s important to explain that wearing a mask is critical to protecting themselves and others from invisible germs. Your child may also be more inclined to wear their mask if the design features their interests, such as a cartoon character or a favorite color. Wearing a mask can be stressful for your child, so be creative when familiarizing them with mask-wearing and offer ample rewards and encouragement. Some experts suggest that having children practice putting masks on stuffed animals may reduce their anxiety about wearing a mask. If your child has trouble keeping her mask on for an extended period of time, make sure she can maintain a 6-foot distance from others and, at a minimum, is able to wear a mask in crowded areas or situations where social distancing is harder to maintain.

It’s important to find a securely-fitting mask for your child to reduce the frequency that they touch or readjust their mask, so here are some quick tips: 

  • The American Academy of Pediatrics recommends pleated face masks with elastic ear loops for younger children as they may be easier to wear. 
  • The child’s mask should cover the nose and mouth with minimal gaps around the cheeks, nose, and chin. 
  • Some adult masks may be too large for small children, so purchase or make masks designed specially for children. 
  • You can adjust a loose mask by tying a small knot in the ear loops to reduce their length so that the mask sits snug against the face.
  • Demonstrate to children the correct way to wear a mask so they can model your behavior.
  • Like most habits, children will only grow accustomed to wearing a mask if you practice it as frequently as tolerable.

With many school districts opening up in the fall, it’s crucial that children wear masks when attending in-person classes at school, ensure that masks fit correctly, and have enough clean masks to wear during the week. The CDC recommends that face coverings be washed after each use, so prepare enough cloth masks for each day of the week that your child attends class in person.

Yes. A healthy person can get infected by coronavirus by exposure to respiratory droplets released by an infected person’s cough, sneeze, or breath. While the CDC’s recommendation to practice six feet of social distancing is designed to help you avoid contact with the largest of these respiratory droplets, smaller particles (known as aerosols) can travel much farther than 6 feet. In fact, researchers at MIT have observed that aerosols released from a cough or sneeze can travel up to 16 and 26 feet, respectively.  

Although face masks help to reduce the spread of the coronavirus, it is still very important to practice current recommendations of social distancing, home quarantine, and proper hygiene and handwashing. To learn more about proper cleaning, check out our blog Spring Cleaning: Coronavirus Edition. Combining all of these precautions will help to minimize the spread of the virus.

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