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Why wear a mask?
COVID-19 isn’t over. The disease continues to circulate widely in Nova Scotia, causing more death and disability than at nearly any other stage of the pandemic. You can get infected regardless of your vaccination status. Infection doesn’t confer lasting immunity, which means you could be reinfected every few months. Each infection increases your risk of long-term disease.
The list of short-term and long-term health problems attributable to COVID-19 is shockingly long and includes debilitating fatigue, cognitive decline, immune system dysfunction, respiratory problems, cardiovascular disease, and more.
A COVID-19 infection could change your life. It could affect your ability to do the things you love and shorten your lifespan. You could pass on the disease to others, thereby putting loved ones at risk.
Masks are part of a suite of proven measures that we can employ to make spaces safer and reduce COVID-19 transmission. Such precautionary measures support inclusion and accessibility. The greater the proportion of people in a space that wear masks, the safer the space is for everyone – especially those who are medically vulnerable. By wearing a mask, you are not only protecting your own health – you are caring for your community and helping to make it more inclusive.
Summary
Since most Nova Scotians no longer wear masks, you need a more effective mask to protect yourself (and others) from COVID-19 whenever you share air with people outside your household. We suggest choosing a well-fitted respirator, since they provide much more protection than either surgical or cloth masks.
The degree of protection provided by a respirator mask largely depends on the quality and integrity of its face seal. KF94, KN95, and other ear loop respirators, while better than surgical masks, may not provide adequate seals. You should also watch out for counterfeits, which claim higher levels of protection that they actually offer.
You can reuse disposable N95 respirators with proper care and storage, but you should dispose of any mask that is damaged or creased.
A well-fitted reusable elastomeric respirator is a good alternative to disposable masks, and may provide a better and more comfortable seal. Be sure to choose a reputable manufacturer.
Below is a more detailed discussion of the masks most commonly used in Nova Scotia and the value and risks of each.
Contents
1. Surgical masks
Surgical masks help to reduce COVID-19 transmission by limiting the dispersion of infectious particles exhaled by a mask-wearer (e.g. an asymptomatic carrier of COVID-19). This is called source control. When worn by everyone, surgical masks confer helpful levels of protection.1 However, in situations where most people aren’t masking, surgical masks are of limited value to those who wear them because they offer limited respiratory protection. Unlike respirators, they aren’t designed to seal to the face, so wearers remain exposed to airborne viruses entering via gaps around the edges of their masks.
2. KF94 and KN95 respirators
Unlike surgical masks, disposable respirators are designed to offer respiratory protection to wearers. There are many types of disposable respirator. KF94 and KN95 respirators, commonly sold in Canada, are designed to adhere to South Korean ("KF" prefix) and Chinese ("KN" prefix) standards, respectively.
Some KF94 and KN95 models have been found to fail filtration standards. Respirators of all types have also been subject to counterfeiting. Using a fake or deficient respirator can endanger the wearer. There are guides online (example) to help you establish whether a given respirator or manufacturer is legitimate.
Most KF94 and KN95 masks use ear loops, as opposed to headband straps, to stay attached to the wearer's face. Research suggests ear loops masks may not provide a seal that is tight enough to adequately protect wearers. For this reason, some international workplace safety regulators advise against the use of ear loop masks.2 The National Institute for Occupational Safety and Health (NIOSH), the government agency that certifies respirators in the United States, has not approved any ear loop mask.3
3. Disposable N95 respirators
Respirators are designed and tested in accordance with various international standards. In Canada, one of the most common types is N95, a certification issued by the National Institute of Occupational Safety and Health (NIOSH), a United States government agency. There are many different manufacturers of N95 respirators, which come in several different styles.
Unlike surgical masks, N95 respirators are designed to provide a tight seal to a wearer's face. N95 respirators provide respiratory protection to the wearer by removing particles from inhaled air. Most also provide source control, protecting others from an infected wearer. (The exceptions are models equipped with one-way exhalation valves.) In order to provide a tight seal, N95 respirators use around-the-head straps (also known as headband straps). NIOSH has not approved any ear loop-type mask.3
Beware of counterfeits and manufacturers that falsely claim NIOSH certification. NIOSH provides lists of approved respirator models for easy reference. The United States CDC has published a guide for those looking to confirm that a respirator is NIOSH approved as well as a guide to spotting counterfeits. The 3M Company, a reputable manufacturer of N95 respirators, is a common target of counterfeiters and has an anti-fraud webpage with useful resources, including lists of counterfeit 3M respirators.
Disposable N95 respirators can be worn multiple times, but you should dispose of any respirator that is dirty or damaged.4 Over time the strap may loosen, such that it is no longer able to pull the respirator close to the face. Disposable respirators should not be cleaned, washed, or sprayed with disinfectant.5
4. Reusable elastomeric respirators
Several manufacturers produce respirators that can be cleaned and reused. These normally feature an elastomeric (rubber-like) gasket between the body of the respirator and the face, which is intended to provide a better seal and improved comfort, with replaceable filters.
Reusable elastomeric respirators are favoured by many for a variety of reasons:
Comfort – many find the elastomeric gasket more comfortable
Environmental – less waste
Safety – the elastomeric gasket may provide a better seal. Some models (e.g. 3M HF-800 series) provide simple "seal check" capabilities to help the wearer detect leaks. Different types of filters are offered by manufacturers. Some offer P100 filters which have higher filtration capability than N95 filters.
Cost – although the upfront cost is higher, it may be more cost-effective to wear a reusable respirator instead of purchasing many disposable respirators.
Some models common in industrial and healthcare settings look much more conspicuous than other respirators, but at this stage of the pandemic those who continue to mask are likely used to standing out! Some other reusable elastomerics are designed with aesthetics in mind.
Like disposable respirators, reusable elastomeric respirators are available in a variety of styles and sizes. There are models for children and adults. Some manufacturers (e.g. Flo Mask) offer "low nose bridge" and "high nose bridge" models. You may have to try a couple different models to find the perfect fit.
Clean Air Crew has a resource page listing several popular types of reusable elastomeric respirator.
The Flo Mask, one popular model of elastomeric respirator (head straps not shown).
(Image: Flo Mask)
5. Cloth masks
Though used extensively early in the pandemic, cloth masks are no longer recommended, as they provide very little protection against transmission of airborne viruses such as COVID-19.
Tips and additional resources
Eye protection
It is believed that COVID-19 is sometimes transmitted through the deposition of virus-laden droplets on the eyes. You may consider pairing a respirator with some form of eye protection, particularly in risky or crowded settings (such as a hospital or aircraft). This could take the form of safety glasses, which provide more protective coverage than regular glasses, or safety goggles that have an elastomeric gasket between the face and the eyepiece. Safety glasses are available with prescription lenses. Safety goggles (such as the 3M GoggleGear 500 Series) are widely available online or at retailers such as Canadian Tire.
Long hair
A Twitter user has created a short video demonstrating how people with long hair can wear N95 respirators with headband straps.
Sample packs and fit testing
The Donate a Mask Canada online charity store offers several N95 sampler packs to help you choose a respirator that fits best.
There are ways to perform simple, low-cost, at-home fit testing to help ensure your respirator provides a good seal. Clean Air Crew provides an overview of some methods.
Notes
1. Masks for Source Control in Non-Healthcare Workers. (2022). Public Health Ontario.
2. Ear loop respirators/masks do not provide protection as tight fitting RPE. (2022). Health and Safety Executive (United Kingdom).
3. Counterfeit Respirators / Misrepresentation of NIOSH Approval. (2022). Centres for Disease Control and Prevention (United States).
4. Information about our most popular models of 3M N95 Respirators. (2023). 3M. "N95 filtering facepiece respirators can be reused until they are dirty, damaged, or difficult to breathe through. You should inspect your N95 respirator before each time you put it on. If the straps or noseclip are broken, it’s torn, dirty, or otherwise damaged, then you should dispose of it. You should always wash your hands before and after handling your respirator."
5. Parker-Pope, Tara. (27 January 2022). How Long Can I Keep Wearing the Same Respirator Mask? The New York Times.
Originally published 2 May 2023. Last updated 4 January 2024.
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