A few ASTM level 3 surgical masks were tested. Worn without modification, they had a filtration efficiency of 35-78% (via particle counter).
(Side note- don’t twist the ear loops- it makes the fit worse)
Is > 20% leak well-fitting? Not in my books.
2/
With a mask brace to improve seal, the surgical masks performed better: > 92% filtration efficiency, not quite well-sealed N95 quality
To pass a formal quantitative fit test for respirators (ie N95s), one must achieve at least 99% filtration efficiency (fit factor of 100).
3/
Note the increase in pressure drop when the surgical masks were sealed with the brace.
Surgical masks are perceived as more breathable because we breath around them (>20% leak).
Surgical masks were designed to block fluid, NOT to have optimal breathability and filtration
4/
Moving on to ear-loop style respirators (KN95, KF94, 95 PFE @CanadamasQ)
These are shaped for a semi-universal fit and have superb filters. The ear loop design is more convenient, but may not fit tight to offer a perfect seal.
5/
Ear-savers or shortening the ear-loops (with knots or silicone beads) will get you closer to a perfect fit
While only a few ear-loop models would have passed a quantitative fit test without modification, all of these models achieved > 95% filtration efficiency
Clearly far superior to the so-called “well-fitting medical masks”
6/
Finally, I highlighted several NIOSH N95/FFP3 respirators (headbands). I have worn all of these models. I find the traditional cup-style the most uncomfortable. The others are very comfortable and breathable.
@masknerd would pass formal fit tests on all of them
7/
The common PH/IPAC narrative that “a non-fit tested respirator is useless at best and dangerous at worst” is clearly false.
8/
Concerned about high velocity fluid spray?
1) add a faceshield 2) choose a “surgical respirator”, which meets ASTM 3 level fluid resistance - this includes the 3M Aura and many of the Canadian made respirators, including @vitacoreinc CN99 and Eclipse Arc
9/
Of note, respirators (while not all formally tested) are fluid resistant by the nature of their filter material and most will meet ASTM 1 or 2 level fluid resistance
10/
Check out that @vitacoreinc filtration efficiency - 99.99%
This is my mask of choice
11/11
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Looking for a #BetterMask but:
✖️N95s are harder to find than TP in 2020
✖️you can’t afford N95s and your government isn’t making them accessible
✖️your workplace mandates medical masks and doesn’t allow N95s
✖️your school gives students medical masks
This 🧵‘s for you
1/
Ensure your medical mask is ASTM graded and is at least a grade 2 mask, preferably grade 3 (will ensure better filtration performance of the mask material)
Important to note, ASTM 3 does not imply or guarantee respirator-quality filtration performance.
2/
For kids and those with smaller faces, try the #KnotTuckTape
Turn that rectangle into something more face-shaped. I think taping the corners is important otherwise the tucked in edges often unfold fairly quickly.
To the experts insisting “N95s are useless if not fit-tested”
Have you ever tried to fit test a “well-fit surgical mask” or “3 layered well-fit cloth mask”?
TLDR they are inferior.
A brief case series and 🧵
1/15
There are two type of fit tests, 1) quantitative fit testing - a portacount machine measures the concentration of aerosol outside the mask versus inside the mask and 2) qualitative fit testing - a potent bitter or sweet aerosolized solution is inhaled under a hood
2/15
I underwent quantitative fit testing on a surgical mask, suboptimally fit KN95 and well fit CN99 (FFP3). The results were intuitive. The surgical mask, while still offering some protection, performed the worst.
When the science and our understanding evolves, it’s important to communicate this clearly and concisely to the public rather than fall back on nuance and shades of gray. Even when this means admitting that previous messaging was incorrect.
Side tweet - Probably could have saved some pages by omitting the giant shades of gray diagram - not a difficult concept
I wear an N95 respirator to protect myself, my patients, my colleagues and my family. Blocking inhalation and exhalation of potentially infectious particles just makes sense during a respiratory pandemic. #PerfectFit on the PortaCount #SayNoToSafetyStewardship#FreshAirWeCare
Because a fit factor of 5 (20% leak) - when quietly breathing through a surgical mask - isn’t respiratory protection. #BewareOfMaskNostrils #BYOPPE
My mask solution earlier in pandemic was a mask brace to optimize my fit. Have since switched to N95s to optimize filtration (respirator material meets higher testing standards) and function (N95 easier to put on, more comfortable, more breathable). #MacGyverYourMask
“During the great COVID pandemic of 2020, you may be shocked to learn that many international ID experts believed that respiratory viruses spread primarily through fomites and eyes, rather than the more obvious route - inhalation...”
“As the pandemic swept across the globe, and cases grew, so did the evidence supporting aerosol transmission. The increased risk in shared indoor air and poorly ventilated spaces and decreased risk outdoors was plain for all to see.”
“The paradigm shift was accepted swiftly by some. Others held firm. Some even postulated that the decreased risk outdoors was related to a mysterious germicidal substance in outdoor air, rather than the obvious answer- dilution.”