Cloth masks better than nothing for healthcare workers?

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Of course, it is way better to wear N95. That is not the comparison we are after at this time.

Many front-line health workers, such as donor coordinators at OPOs, are having to physically go to ER. They do not have N95, and in some situations, they are not being given any masks by the hospital (due to shortage), saying that they are not showing symptoms, although security personnel and other hospital employees (who are also showing no symptoms) are in fact wearing them.

This has become a highly debated and an emotional issue on the ground right now.

 I have been receiving questions:

  1. Isn’t it better to wear a cloth mask rather than no mask when going to ER? Not perfect compared to “real masks” but not useless?
  2.  When is there a downside to wearing them? 

I asked several physicians, and here are their responses.

Great question

I have little/no expertise on the topic, but it appears that most health professionals are adopting this view: so-so mask better than no mask!

Peter A. Ubel M.D.

Duke University

Hi Sridhar, 

Scary times indeed. 

A cloth mask is probably a little better than nothing- but not as good as a surgical mask. The downside to wearing cloth masks, in my opinion, is providing false sense of security, and letting people (administration, public) believe that there is no urgent, critical need for real surgical masks. The second issue is the risk of infection when taking them off and cleaning them  (don’t know of data on how long fomites/viruses can live on cloth, and risk of contamination when washing them especially if the water temperature is not hot enough- probably need to be put in washer at high temperature, but how many people will do that every day?)

I agree that any healthcare worker should wear a surgical mask in the hospital, both for their personal protection and for the protection of all the patients and family members and other healthcare workers they will interact with. If it were me, and I didn’t have access to surgical masks, I would do as much of the work as I can virtually/remotely to reduce contact, and then write something on the cloth masks (This is not appropriate protection. I need a real surgical mask please). I’m exaggerating a little, but not completely.

Hope you and your family are well,

Ada

Ada Stefanescu, MD MSc

Clinical and Research Fellow, 

Interventional Cardiology

Massachusetts General Hospital

I suppose if it’s better than nothing, but it could be equivalent to nothing depending on the tightness of the weave in the cloth and how well they fit.

The downside is that unless they are going to throw the cloth masks out the way they would throw away a paper mask, everything and everyone the mask comes in contact with in the course of being saved, re-used, and cleaned will get contaminated with whatever is on the mask that the wearer was attempting to protect themselves from.  The downside is that cloth mask wearers get treated as if they are protected when they are not when others might be careful with them if they were not wearing anything, and their increasing presence being interpreted as an indication that the cloth masks are protective.

Heidi Yeh

Transplant Surgeon, MGH

Better than nothing. We should however not be in this situation in America.

Dinakar Golla MD, FACS

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