CDC & scientists: Not true: "surgical masks better than cloth masks" and here’s why
"Roger Chou, an epidemiologist at Oregon Health & Science University who tracks mask studies, said he “really has not found much evidence” on the effectiveness of cloth versus surgical masks in stopping the spread of COVID-19 in communities, even though he said that plenty of other data back up their effectiveness. The most important thing, Chou said, “is to wear a mask, whether it is a surgical mask or cloth mask.”"
A recent article from The Atlantic, “Why are Americans Still – Still! Wearing Cloth Masks?” by Yasmin Tayag triggered several follow-up reports that cloth masks are less effective than disposable surgical masks. This title is unfortunately misleading, as contradicted by other scientists and the CDC in the article itself, and outlined below. Furthermore, the author ignored the fact that not all cloth masks are the same. 2-layer 100% cotton masks have been shown by scientists to block more virus particles than surgical masks under humid conditions (2). Most studies showing the contrary were conducted in dry conditions, which does not correctly reflect real-life conditions like when we breathe in our masks.
Surgical masks are killing our planet, creating mountains of un-recyclable waste, and polluting our lands and oceans. People should choose 2-layer 100% cotton masks instead over surgical masks. There is absolutely no need for Americans to further pollute the planet with surgical masks.
The Atlantic article cited a recent study in Bangladesh (which has yet to be peer-reviewed) showing that while cloth masks where associated with a decrease in virus spread, they were less effective than surgical masks. However, the author did not pay attention to the type of cloth mask that was used. It was a mask of cotton-polyester blend, which only had filtration properties of 37%. Scientists at the National Institute of Standards and Technology (NIST) and the Smithsonian's Museum Conservation Institute showed that under 30% humidity, 2-layer 100% cotton masks performed surprisingly better than surgical masks. Masks of poly–cotton blends performed worse than surgical masks. They found that cotton fibers expanded under humidity and filtered better than surgical masks. In the Bangladeshi study, they used a cloth mask of inferior quality of poly-cotton blend. Obviously, a bad quality cloth mask will perform less well than a surgical mask.
The author also said that the fact that countries like France, Austria and Germany asked their people to use surgical masks is proof that surgical masks are better than cloth masks. This is naïve. We have seen that many countries have implemented wrong policies during this pandemic, like asking people to wear masks outdoors regardless if they are near other people. The WHO (World Health Organization) has said that discouraging the use of cloth masks by some countries was a mistake. When the correct types of cloth masks are used, they are just as effective if not more effective than surgical masks.
The author also cited that “Unless you work in health care, the CDC still recommends masks made with at least two layers of washable, breathable fabric. …A spokesperson for the CDC told me that although the agency believes that N95 masks are “better at protecting the wearer, and if available should be worn,” cloth masks have been shown to be an “effective method of source control,” according to CDC research, and are still recommended when N95s aren’t available.” The CDC’s position is clear, but the author chooses to contradict the CDC’s recommendations in her misleading title.
Michael Osterholm, an epidemiologist at the University of Minnesota, was quoted saying (although Osterholm makes it clear that he’s very pro-masking), “it’s really all about the whole hierarchy of environmental control,” he said, referring to the various methods for reducing risk within a space, a key concept in occupational safety. Vaccination is by far the most protective measure a person can take. Second is ensuring proper ventilation—replacing the air in a room at least five to six times an hour, he explained. Next is social distancing. And then there’s masking: “You keep going down in that order, and finally the lowest thing in terms of overall prevention potential is individual respiratory protection.” This is a good point that is often misunderstood, even by the author of the article. Proper ventilation is extremely important, in addition to mask use and social distancing. Making a big deal about what type of mask to use and asking people to switch to surgical masks is really missing the point.
Mask use has also been misunderstood by many to be mainly for personal protection. However, mask use is really most effective for community protection. For community protection, any good-quality mask is good; it does not have to be a surgical mask.
Another scientist quoted in the article summarizes this. “Roger Chou, an epidemiologist at Oregon Health & Science University who tracks mask studies, told me in an email that he “really has not found much evidence” on the effectiveness of cloth versus surgical masks in stopping the spread of COVID-19 in communities, even though he said that plenty of other data back up their effectiveness. The most important thing, Chou said, “is to wear a mask, whether it is a surgical mask or cloth mask.” This is the most important message, but the author again contradicted it in her misleading title.
Another recent report from McGill University further emphasizes this (3). "Mask mandates and good ventilation are critically important to curb the spread of more contagious strains of COVID-19, especially during the flu season and winter months as more people socialize indoors," says Saad Akhtar, a former doctoral student under the supervision of Professor Agus Sasmito at McGill University. While most public health guidelines recommend physical distancing of two meters for people from different households, the researchers say distancing alone is not enough to prevent the spread of COVID-19. In a study published in Building and Environment, the researchers found that when people are unmasked, more than 70 percent of airborne particles pass the two meters threshold within the 30 seconds. By contrast, less than 1 percent of particles cross the two-meter mark if masks are worn.
Because about one in three people who have COVID-19 display no symptoms at all, widespread use of masks remains important. A study (4) which reviewed the evidence on mask wearing found in favor of widespread mask use by infected people as a way to help reduce community transmission, concluding that the available evidence suggests that near-universal adoption of any face covering at all, in combination with complementary public health measures, could successfully reduce the community spread of COVID.
So please, choose 2-layer 100% cotton masks over surgical masks as your everyday mask. There is no reason to do otherwise – surgical masks are not better for everyday use, and they are destroying our planet for our children.
(1) The Atlantic, Oct 3, 2021. “Why Are Americans Still—Still!—Wearing Cloth Masks?” by Yasmin Tayag
(2) The Washington Post, Mar 27, 2021. “What’s in all those masks?” Tests conducted by the National Institute of Standards and Technology (NIST) and the Smithsonian's Museum Conservation Institute.
(3) Science Daily, October 5, 2021. “COVID-19: Without masks, two meters distancing is not enough, research finds” by McGill University. Summary: To prevent the spread of COVID-19 indoors, the two meters physical distancing guideline is not enough without masks, according to researchers. However, wearing a mask indoors can reduce the contamination range of airborne particles by about 67 percent.
(4) PNAS (Proceedings of the National Academy of Sconces of the United States of America), October 12, 2021 . “Cerebral and systemic physiological effects of wearing face masks in young adults”