Covid-19: Mixed medical opinion on home-made masks

Many people have been improvising masks with pieces of fabric wrapped around their faces, or in some cases sewing their own based on widely-shared patterns – but are they actually useful?

2 April 2020
By Oliver Rowland

With much talk of mask shortages in recent weeks, people have questioned if it is worth making your own to use when you go out, for example to shop.

Firstly it should be noted that the French government’s coronavirus advice does not include wearing a mask at all: it says mask supplies – which it states are now improving with millions more being made each week - should be aimed at medical professionals looking after Covid-19 patients.

Most of these are ‘surgical’ masks which were made from cloth in the past but today are made from non-woven materials include plastics and paper.

More powerfully filtering ones with the ‘FFP2’ label, of which stocks are lower, are being reserved mainly for people likely to be in close contact with Covid-19 patients and carrying out certain medical acts where they are especially at risk of a patient coughing at them.

For the public the official advice focuses instead on respecting the confinement rules, handwashing, coughing into the bent elbow etc.

French Director General of Health Jérôme Salomon said in a recent press briefing: “I see an enormous amount of masks in the street, or worn by professionals who have no reason to be exposed to infected people. These masks are worn badly, these masks are badly used, these masks are lacking for healthcare professionals…. The mask is a rare commodity and we really must reserve them for situations where they are useful – for people who are ill, in medical transport, emergency services and healthcare professionals.”

Prof Pascal Odou of the Lille teaching hospital, meanwhile has warned that using masks incorrectly can make them “worse than nothing”; notably he said they should be put on and off without touching the mask and ones’ face too much and especially without sliding the mask over other parts of the face.

What is more most experts state that masks (other than FFP2) are to protect others, not to protect yourself.

The official French government information website on the virus says the virus cannot simply hang around in the air – it is carried by droplets that that are transferred when  someone coughs or sneezes, or sometimes just while speaking, and usually when they are less than one metre away from you. The other way you can catch it is from surfaces contaminated with such droplets, which is why it is important to wash hands.

As for artisanal (home-made) masks made from cloth it states: “Studies show that in certain situations they can have a certain effectiveness and are ‘better than nothing’.

“However, home-made masks can also give a false sense of security, while the only really effective measures are using barrier measures – washing the hands, coughing into the elbow, using single-use tissues, not shaking hands and avoiding hugs) as well as social distancing.”

One high-profile doctor who was quoted recently in favour of cloth masks is GP Dr Jean-Paul Hamon, president of the Fédération des Médecins de France, a union for doctors in individual practice.

Connexion asked the FMF for comment, however Dr Hamon, their usual spokesman, is now ill with Covid-19 and no one has so far been available.

Last month he told the 20 Minutes website: “You see a lot of people with cloth masks covering up a lot of their face. If you can’t get hold of a mask from a pharmacy, it does allow nonetheless, a little bit of protection, even if the double thickness with cotton and a piece of felt means these models must be quite thick, so not very breatheable, and so quite uncomfortable.”

Asked if such masks have their place in hospital or in private practice medicine, he said: “It’s better than nothing. I’ve even tried to get knitting groups in my town to make some of these home-made ones.”

The president of another large French doctor’s union, Confédération des syndicats médicaux français, Dr Jean-Paul Ortiz, told Connexion : « Cloth masks, unfortunately are not at all effective, frankly they have zero effectiveness.

“Unless that is, they are made of an unwoven material such as felt or fleece. That is the only case where a fabric mask can a little bit stop the virus being breathed out by a patient. Apart from those cases, they are useless.”

He added: “The only mask that protects in both directions, is what we call FFP2, used in industry [eg. in conditions where there is dust or fumes] and also in medicine, that protects because it filters the air that you breath in. Otherwise, the only thing a mask can do is to filter a little bit the air that you breath out.”

A surgical mask is also only effective for protecting others, however wearing one may be useful to avoid passing on the illness, he said.

“Surgical masks must be changed every four hours; FFP2 ones, depending on the maker, last four, six or eight hours.”

The FFP2 type have a protruding round valve on the front, which helps you breathe more easily.

Home-made masks, if used, need to be machine-washed every day after use.

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