Cloth Mask or Surgical Mask? The Great Face Mask Debate

Hero blog Cloth Mask or Surgical Mask The Great Face Mask Debate
Cross Country Healthcare
November 02, 2021 03:59 AM (GMT-05:00)

While healthcare facilities have specific guidelines for face masks providers must wear at work, the question remains…what type of masks should you be wearing outside of work? What are current opinions on whether cloth masks or surgical masks are the best choice for individuals to wear in crowded situations?

In Favor of Surgical Masks

Recent reports from Becker’s, CNBC, and The Atlantic say those who are still using cloth masks should consider upgrading to surgical masks this season. Although many people continue to reach for their cloth masks on the way out the door, surgical masks may be a safer, and increasingly more available, option.

Cloth masks were initially designed as a stopgap measure. Early in the pandemic, cloth masks were a makeshift solution for widespread use among the general public. As providers know all-too-well, surgical masks and N-95 masks were in short supply and needed to be reserved for healthcare. Further, the appeal of cloth masks grew because they are convenient, reusable, and eco-friendly.

However, cloth masks do not match the protection surgical masks can provide. In a systematic review and meta-analysis published in the Journal of Education and Health Promotion, Sharma et al. conclude, “Cloth face masks show minimum efficacy in source control than the medical grade mask.” Moreover, in a study out of Bangladesh, Harvard- and Yale-affiliated researchers found surgical masks were 95% effective at filtering virus particles compared to 37% for cloth masks; even when the surgical masks were washed with soap and water 10 times, surgical masks had a filtration efficiency of 76%, much more effective than cloth masks (Innovations for Poverty Action).

With the emergence of more transmissible COVID variants, leaders of some countries are banning cloth masks. The French government has advised against wearing homemade or fabric “category 2” masks, which filter 70% of particles; only surgical masks, FFP2 masks, and “category 1” masks, which filter 95% of particles, are recommended (The BMJ). In Austria, FFP2 masks are being supplied to residents over 65 and low-income households and are mandatory in all indoor public spaces, and in Germany, medical masks are mandated on public transport and in grocery stores (The BMJ).

The Case for Cloth

Although widespread use of surgical masks may seem ideal, there are various consequences. COVID surges are unpredictable, and new variants may continue to arise. Even though surgical masks are much more available, it’s critical for providers to have uninterrupted access to PPE.

Also, advocates for cloth masks often cite the environmental implications of throwing out masks after just one use. Disposable face mask use by the general public will add to the significant volume of medical waste created during the pandemic (Case Studies in Chemical and Environmental Engineering).

The Centers for Disease Control seems to lean toward cloth masks for general use across most of its publication, but leaves recommendations relatively open in its Order, Wearing of Face Masks While on Conveyances and at Transportation Hubs:

“The following are attributes of masks needed to fulfill the requirements of the Order…

  • A properly worn mask completely covers the nose and mouth.
  • Cloth masks should be made with two or more layers of a breathable fabric that is tightly woven (i.e., fabrics that do not let light pass through when held up to a light source).
  • Mask should be secured to the head with ties, ear loops, or elastic bands that go behind the head. If gaiters are worn, they should have two layers of fabric or be folded to make two layers.
  • Mask should fit snugly but comfortably against the side of the face.
  • Mask should be a solid piece of material without slits, exhalation valves, or punctures.

The following attributes are additionally acceptable as long as masks meet the requirements above.

  • Masks can be either manufactured or homemade.
  • Masks can be reusable or disposable.
  • Masks can have inner filter pockets.
  • Clear masks or cloth masks with a clear plastic panel may be used to facilitate communication with people who are hearing impaired or others who need to see a speaker’s mouth to understand speech.
  • Medical masks and N-95 respirators fulfill the requirements of the Order.”

An Individual Decision

“Mask selection is as varied as there are masks to select from today,” says Hank Drummond, Chief Clinical Officer and Senior Vice President of Cross Country Healthcare. “Most importantly, have a conversation with your primary care provider (PCP) to determine what option is the best for you! You and your PCP will need to discuss your risk factors, comorbidities and vaccination status to best decide what is the right option for you and how to best protect you and others.”

Ultimately, the choice of whether to wear a cloth mask or a surgical mask when you’re outside of work will be a personal call – as individual as the familiar “paper or plastic?” question. You may even choose to wear different masks for different situations. Fortunately, as a healthcare provider, you’re armed with the education, experience and expertise to make a decision that’s right for you.

To discover where your specialized skills are needed most during this time, see our opportunities at Cross Country Healthcare.

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