The World Health Organization (WHO) has once again brought the debate over face masks vs respirators back into the limelight. They are calling on health care professionals and the public to move away from ineffective surgical masks and towards better respirators post-Covid-19. Opposition to and support for face coverings have both dramatically increased. Face masks were a flashpoint during the pandemic.
Kemi Badenoch, the leader of the Conservative Party, recently expressed her own struggles with mask-wearing, stating she felt “slightly traumatised by all the mask wearing that we had to do during Covid.” This personal reflection dramatizes a universal desire to remove face masks. They represent the unfortunate cultural chasms that developed along ideological lines throughout our public health catastrophe.
In a related context, an NHS leader has emphasized that individuals displaying flu symptoms “must wear” a face mask in public settings. This declaration emphasizes the need for continued protective measures even as we move out of the Covid-19 emergency phase.
At first, the WHO was reluctant to even define Covid-19 transmission as occurring through “airborne respiratory droplets.” Today, they’re literally going back to the drawing board on their guidelines to prevent infection. A WHO spokesperson stated, “We are currently reviewing WHO’s Infection Prevention and Control guidelines for epidemic and pandemic-prone acute respiratory infections, based on the latest scientific evidence to ensure protection of health workers.”
The use and effectiveness of different kinds of masks—physiologic, cloth, surgical masks—has been a big part of this discussion. Surgical masks have been derided for their inability to protect the wearer, despite blocking about 40% of inhaled, Covid-sized particles. By comparison, UK respirators classified as FFP2 or FFP3 can filter out at least 94–98% of particles. Just as surgical masks in the EU have high filtration like N95 respirators in the US. This marked contrast in filtration effectiveness has prompted some experts to call for a move to respirators when next interacting with patients.
We’ve been fortunate to receive wisdom on this community debate from Professor Trisha Greenhalgh of the University of Oxford. As she recently put it, “An organism that never enters a person’s body cannot infect them. By creating a tight seal against the face, respirators make air flow through the respirator spacer, filtering out the germs in the air. Respirators, or filtering facepiece respirators (FFRs), are protective devices worn tightly to the face that have high filtration resistance. Medical masks, by comparison, don’t seal well and leak all over the place.”
The need for effective protective measures has been supported by former chief regulatory official at the U.S. Occupational Safety and Health Administration, Professor Adam Finkel. On Wednesday, his argument was that surgical masks are “obsolete,” comparing their use to using typewriters instead of a computer. He further explained that “surgical masks were not designed to stop airborne pathogens but invented to stop doctors and nurses from sneezing into the guts and the hearts of patients.”
Finkel’s assertions point to nothing less than a tsunami of health professional advocacy. They are finally reaching consensus that surgical masks can’t stop the spread of disease through the air. He pointed out a profound problem with all trials trying to test mask effectiveness. Participants can’t realistically wear masks 100% of the time or prevent exposure to pathogens when they are unmasked.
While these conversations are ongoing, FFP2 face masks are being tested at Moldex-Metric, a German protective workwear producer. This preliminary assessment reduces them to a ranking to help judges determine their effectiveness and applicability in different settings.