COVID19 & Mask Information from a Nurse

Question: How are surgical masks suppose to protect the public from COVID19, but are not considered protective against COVID19 to the individual wearing the mask?

TYPES OF PRECAUTIONS: Before diving in to an explanation, I’m going to present the basic infection control protocol that all health care organizations adhere to. There are different categories we have that helps us categorize the disease types with how they infect individuals, and the types of protective equipment recommended—these are the main ones:

* Universal Precautions- also known as “standard precautions”; every patient is considered this— PPE used for this are standard gloves, and hand hygiene before and after contact with the patient.* Contact precautions- PPE used for this are gloves and a protective gown as the pathogen is spread by skin to skin contact. The gown protects us because it is put on over our scrubs, and is removed after patient care. An example of this would be MRSA bacteria in a patient’s wound, or shingles lesions which are scabbed over.* Droplet precautions- PPE used for droplet precautions are gloves, a basic (surgical) mask, and (depending on disease) eye protection. This prevents large droplets from coughs and sneezes from directly entering our mouths and nose. Droplets are considered to be in the air temporarily but the weight from the droplet is too heavy to be aerosolized, so it falls towards the ground. Some diseases include influenza (flu viruses) and rhino viruses (common cold). Doors to these rooms are to remain closed.* Airborne Precautions- With this type, pathogens are in the air around the patient for an extended amount of time. They are placed in a special “negative pressure room”— where air is pulled out of their rooms continuously and diverted through filtration systems in the vents—then to outside. PPE includes gloves, a gown, hair cover, and a type of respirator—- N95 is the most basic, but we also use air purifying respirators that look like a space helmet and have a filtration component; they are battery powered. N95’s are sized for us upon hiring to ensure the size we wear is securely sealed around our mouths and nose. Diseases on this precaution include chicken pox, meningitis, tuberculosis, open sore shingles, and COVID19.* Neutropenia Precautions/ sterile bedside Procedures- used when a patient has very low white blood cells or we are preforming a sterile procedure at bedside— for this, it’s usually our cancer patients and is intermittently used with certain sterile bedside procedures to protect the patient. If it’s a sterile procedure, the patient and I both have a new surgical mask on and I have sterile gloves on. If it’s a cancer patient, I wear a mask because I’m protecting them from me.

WHAT ARE N95s AND SURGICAL MASKS MADE OF: Both N95s and surgical masks are made with “melt blown fabric”— a process in which different polymers are melted down and blown at high speeds to create a randomized “webbing” pattern. Surgical masks typically have two to three layers of this with a hydrophobic—water repelling—outer layer, while N95s have melt blown fabric layers, activated cotton layers, an activated carbon layer, and a hydrophobic outside layer. Basically, the “activated” layers are electronically charged to help “catch” super tiny charged particles and bacteria and viruses. The randomized webbing of the melt-blown fabric helps create inconsistent “holes” in the various layers. In contrast, a homemade mask out of cotton, would have a woven pattern with consistent predictable gaps even upon layering the cotton.

HOW MASKS SLOW COVID19: wearing a mask out in public is super important in helping to REDUCE the amount of virus particles you spread when you cough, sneeze, and breath.