To mask or not to mask? Can a simple face mask protect you from coronavirus?

So, Sunday is Corona Rant Day. However today it’s not so much as a rant.  I’ll give you my two Euro cents on whether to wear a face mask. After a relatively ordered, well-oiled week here in Berlin, I feel almost calm and ordered myself. And I got sewing.

While the WHO still insists to only wear face masks if looking after a sick person or when coughing and sneezing, this has been the week of the face mask here in Europe. Austria now deems them mandatory, so does the Czech Republic. In another federal state here at home, the City of Jena has also decreed people must wear them while in shops and on public transport. The Robert-Koch-Institute, in its FAQ, has now made a U-Turn two days ago that it advocates masks in public places. The Centres for Disease Control changed their advice on the same day. Looks like the mask is in!

Even the Coronavirus Guru that most people in Germany look up to, Professor Christian Drosten, has tweeted a link to this article which was published in Nature two days ago.

After the arrival of my new sewing machine, I  have taken to producing a few cloth face masks to wear outside work – mainly on my trips to and from the car, and my twice-weekly shopping trips. Not much opportunity to show them off, but hey, there’s always the gratuitous selfie. As in my hand sanitizer alternatives post, I want to give you some practical tips for face masks, even if you do not have material readily available or a sewing machine in your house.

The numbers today

World wide confirmed cases: 1 Million and 217792

Confirmed cases in Germany: 96108, of whom 27.5% are recovered and 1.5% dead

Most worrying stat: The UK managed a whopping 10.2% death rate at “only 42000 confirmed cases, placing it on a level with Spain and Italy who have about three times as many cases.

I guess if you had to pick a country to live in during all this, Germany is not such a bad choice all of a sudden, so for gods sake, no matter how nice the weather is going to be, stay at home.

Source: https://covid19info.live

So, what are the scientific grounds of wearing a face mask?

The paper mentioned above was published in Nature Medicine two days ago.

Basically, in this study from Hong Kong, researcher analysed breath samples from almost 250 individuals.  Half wore (surgical grade)  face masks and the other half didn’t. Approximately half of the study subjects had a viral upper respiratory tract infection –  but not SARS-CoV-2.  They were shedding virus by way of their respiratory tract. However… a large proportion of those shedding  did not shed by large droplet or aerosol.  This is perhaps the biggest problem with this study, as it reduced the number of subjects for a mask vs no mask comparison. Wearing a  mask, however, reduced the shedding of large droplets into the air and somewhat reduced aerosol shedding in some of the viruses examined.

There is still no right or wrong answer, but this and other publications suggest that wearing a protective face mask may not reduce your risk of a SARS-CoV-2 infection, but will protect others if you are shedding the virus. And yes, there are asymptomatic shedders, so it is common sense to wear a mask especially in situations like public transport os shops where you cannot always safely maintain a 2m distance.

Here’s another relatively recent article by David Heymann about why the jury’s out on face masks.

I’ll wear a face mask anyway

But to be honest… I will wear one now. I often touch my face, and a mask helps me not to. Now I am well aware a mask will not protect me from becoming infected, but it may reduce the virus load. Maybe. That’s good enough for me. By making my own mask, I will not take a surgical mask from where it is needed more. I have repurposed my used surgical masks before, but I’m a bit wary of the side-eye of “you are taking masks away from where they are needed”.

Which face mask patterns to use?

So, in the past two weeks, face mask patterns and tutorials have literally mushroomed out of nowhere.

For my first dip into the face mask fabrication, I used the tutorial from JoAnn, which was one of the first in the current coronavirus mask sewing frenzy, and it’s simple and well explained.

I also really like this3D Mask with filter insert tutorial – it’s in Thai, though! I really like the Thai language, even though I understand almost nothing, but the video is really lovely, self-explanatory, and strangely soothing! So far, I’ve cut  a template and will make this in the next few days. Right now I don’t have the right elastic, so with this type it is easier to replace or adjust the elastic.

Both tutorials just require simple materials – some densely woven fabric, thread, a ruler, two pieces of elastic, a needle or sewing machine.

Which fabrics for face mask?

Generally, you want a breathable fabric with a very fine weave. The ideal fabric? Probably a 600-thread count cotton in a double layer with a cotton flannel insert.

But before you cut up your Frette sheets, look if you find something that you already have int he house you can spare.

Quilting cotton is good – natural, densely woven, high-ish thread count. Who doesn’t have  a fat quarter lying around somewhere?

I first tried a Cotton Vlisco wax print fabric. Very dense, tightly woven. My basic sewing machine really struggled with a quadruple layer of it, though. The fabric might be a little dense, but I’m please with my first try.

My next try will be some thick soft cotton from some old trousers I cut up. I also “harvested” some very old boxer shorts where the cotton is tightly woven and is really tough.

I really like the idea of using a piece of Liberty Tana Lawn as I have a few smaller pieces, and well, Tana Lawn is a very classy fabric, but I find it really lightweight – perhaps too lightweight and not dense enough.

Forget T-shirt material jersey of any kind, knit fabric, or man-made fibers. Linen, my material of choice is, unfortunately usually too loosely woven.

For more detailed advice, I suggest you read this NBC article as the actual research has not yet been peer reviewed or  published.

Three other observations

Just a few bits and pieces I picked up over the week – or earlier but haven’t mentioned them here.

Read scientific publications – for free

Now is a great time to be learning about natural sciences from some reputed publications. Most publications related to COVID-19 are now open access, which means you do not need to subscribe or pay in order to read them. I’ve taken to scanning the home pages of Nature and The Lancet, and reading some articles, but all in all, it has been hard to keep track on top of my increased work load.

And I remind you there are others! Springer Nature Publishing who publish Nature is now majority German-owned, while the Lancet is owned by Elsevier, a Dutch Company not without its controversies, as they have openly lobbied against Open Access and Open Science.

Anyway… make s anice difference to Netflix.

We have really good podcast series on the COVID-19 Pandemic in Germany

Both are produced by  public regional TV Stations.

The more “famous” one is the  “Coronavirus Update” by Professor Christian Drosten, started early, on 26 February, when many weren’t really that bothered here. It is really interesting how they changed over time, from “don’t panic and still go to Italy” to more sombre. However, Professor Drosten has some track record in researching SARS-CoV and now SARS-CoV-2 and leads the lab that produced the first test for the novel coronavirus in Germany.

The second one is “Kekules Corona-Compass”, was started in 16. March 2020 and is by Professor Alexander Kekule, the lead virologist of the Martin-Luther University.  He advocated early school closures and social distancing measures for at-risk groups. He pretty openly criticises state institutions and politics where he deems appropriate, and there’s less political correctness. I slightly prefer this one.

Sadly, both are only offered in German with no subtitles. If you know Germany, they are an excellent source of information, though very Germany-centric. Do you have  asimilar source of information where you live? If you have, please let me know!

Can you get COVID-19 from touching a door handle?

Or: Will you obsessively need to clean the shopping trolley and avoid touching anything outside? No, I cannot answer that question, but another prominent German virologist has recently stated that it’s unlikely. He has just started a large-scale study in a district which was an early COVID-19 hotbed. A carnival session was thought to have caused massive local spread. HE reported in a TV show that he went into the infected people’s houses and swabbed a lot of things. Even the cats. And found no viable virus. Unfortunately, no scientific reference yet but a source from public broadcasting Station Deutschlandfunk as well as a clip to the original TV Show.

The much-discussed study of Neeltje van Doeremalen and Colleagfues from the US cites that viable virus can be found on steel surfaces for up to 72 hours, and hang around int he air for at least three hours, and the US National Institue of Health and Centres of Disease Control cite this paper in their recommendations.

The week was… okay

At work I nicely settled into my routine of catching up with then latest recommendations in the morning, then seeing patients and doing tests all day. All cases I saw were relatively mild – which is appropriate, as I run an outpatient clinic. Now we are up and running, I managed to win some colleagues, so I can go back to some elective work while working in our novel clinic on a rota.

At present, we have the Intensive Care Beds, the protective equipment, and we are once more waiting with baited breath what the next few days will bring, because, friends, it ain’t over yet!

My next level of acceleration would be to transfer to a non-COVID-19 ward. Only if we become really flooded with COVID-19 will those with no recent intensive care experience be asked to provide intensive care services. It’s reassuring there are plans in place, and we’re come to a phase where staff is briefed regularly. Still, I do not want to imagine what kind of reverberation this will have for our health service – all other services except the most urgent care on hold, thousands of office-based specialists without patients and uncertainty how the state will compensate hospitals who essentially emptied their elective beds to be ready for COVID-19.

What is next?

We have the Easter Week coming up, with splendid weather and many public holidays. I somehow fear people will blatantly break the rules of no contact and be out in droves. Already today, as we cycled round the lake by our house, we saw many cars with non-local number plates parked up, which isn’t quite what our government meant by “no contact”. Seriously, I heard the worst stories! The “Corona parties”, last minute ski trips to risk areas minutes before they closed, the flaunting of quarantine roles after being classified a “suspected case” and swabbed. Seriously, people.

Yes, we’re middle-class twits from the suburbs who have the luxury of a house and garden, but these are the rules. I take a risk every day by going out and looking for the bloody virus. I would expect people to stick to the rules and stay in – like, not go gallivant about outside your immediate ‘hood.

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