Folks at higher risk may be able to participate in public life safely even with unilateral self-protective measures. See below:
… on Monday [April 18th], COVID-19 experts took to Twitter to reassure uneasy travelers that they still have the power to protect themselves — even when everyone else on board is going gleefully maskless.
“One-way masking works, if you wear the right mask,” tweeted Dr. Scott Gottlieb, former commissioner of the U.S. Food and Drug Administration. “KN95, KF94 or better. For those at risk from Covid, or who want added safety even as those around them unmask, a high quality mask worn properly can afford a measurable degree of added protection.”
“Remember that even if masks aren’t required, people who choose to can wear them (as I will continue to, on planes/trains),” added Dr. Leana Wen, former Baltimore health commissioner. “If you wear one, please opt for an N95 or equivalent (KN95 or KF94) for optimal protection.”
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The idea of one-way masking isn’t new. Indoor mask mandates have been falling for months, and high-profile voices such as Wen and Gottlieb have responded by insisting that individual masking can still serve as an adequate shield for Americans (especially if they’re fully vaccinated and boosted) who want to minimize their risk of infection during a concert or a trip to the grocery store.
But the sudden toppling of the federal travel mandate — which is unlikely to return — may mark a turning point in the conversation about solo masking. Before, cautious individuals could largely decide not to spend time in places where face coverings were scarce. Many Americans, however, do not have a choice about taking a plane, train, bus or subway to get somewhere. They will now be forced to share air with the great unmasked masses for extended periods — and they’ll want to know whether covering just their own face can really keep the virus at bay.
So what does the latest science say?
Bad news first: Indoor spaces would undoubtedly be safer if every single person were wearing an N95, a KN95 or a KF94 respirator. When properly fitted, these masks prevent about 95% of airborne particles (such as the SARS-CoV-2 virus) from passing through. But because such particles have to breach the mask material twice when everyone is masked up — once after someone breathes them out, then again before someone else breathes them in — universal masking actually doubles the filtration power. As a result, a room, or cabin, of N95s can reduce overall exposure by 99% compared to zero masking.
For anyone who is immunocompromised, ineligible for vaccination or otherwise vulnerable or concerned, that would be the ideal scenario.
The problem, of course, is that it isn’t a realistic scenario, and it wasn’t a realistic scenario even before this week. Travelers on planes, for instance, have long been allowed to remove their masks while eating and drinking. Many, if not most, wear cloth or surgical masks instead of N95s. And even those who do opt for N95-grade respirators tend not to know how to achieve the optimal seal required in, say, laboratories, where professionals undergo a rigorous fit-testing process to minimize leakage.
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The question, then, is not how one-way masking compares to perfect and universal N95-grade masking, but rather how one-way masking compares to the patchwork alternative previously in place.
And that’s where the good news comes in. According to Joseph Allen, an associate professor and director of the Healthy Buildings program at Harvard University’s T.H. Chan School of Public Health, a standard cloth mask filters out roughly 50% of virus particles. So “when two people wear this level mask,” Allen explains, “the combined efficacy is 75%.” Meanwhile, a single surgical mask — which uses electrostatically charged, particle-trapping material, like an N95, but doesn’t fit nearly as well — boasts a 70% filtration rate, meaning the combined efficacy of multiple surgical masks is 91%. That’s good enough for hospitals.
Before the travel mandate was lifted this week, mask filtration on planes, trains, buses and subways probably would have fallen somewhere on the lower end of this 75% to 91% range, given how many people were wearing cloth or surgical masks and removing them to eat and drink — or letting them drop under their noses for the entire flight.
But here’s the heartening thing: One well-fitted N95-style respirator is able to filter out 95% of airborne particles all by itself, no matter what anyone else is wearing (or not wearing). Some can perform even better. That means it’s possible for a consistent one-way masker to be even safer in a space where nobody else is masking than a bunch of people wearing a mixture of masks in a space where they’re frequently removing them to snack and sip.