FACING UP TO IT

FACING UP TO HEALTH

BANK ROBBERS AND HIGHWAYMEN WERE THE ONLY FOLKS OTHER THAN DOCTORS OR NURSES WHO ROUTINELY WORE FACE MASKS. THAT WAS UNTIL AN INTERNATIONAL HEALTH CRISIS GRIPPED THE WORLD AND FOREVER CHANGED THE WAY PEOPLE BEHAVED.

In the early days of the Covid-19 pandemic, South Africans found it somewhat endearing when the country’s president fumbled on live television as he donned a face mask for the first time. Social media loved it and we all chuckled, praising President Cyril Ramaphosa for his humanity and ham-fistedness, knowing we’d probably also be as clumsy our first time – regardless of whether it was in the glare of live television cameras or not. Little did South Africa know on April 10 when the government decreed that mask wearing in public was compulsory, that these patches of fabric would become as much a part of everyone’s daily wardrobe as underwear!

For a nation which viewed face masks as something people wore to fancy dress parties or children for Halloween and where surgical masks were only ever seen in dentist

Science has shown that the coronavirus particles can be spread through coughing, sneezing or even talking. Virus filled particles can land on all manner of surfaces which people touch on a daily basis – one of the reasons that the simple message of hand washing and sanitising has been so important in combating the dissemination of the virus. That and social distancing.

In an article published in the Lancet, a highly regarded medical journal, Holger Schunemann wrote that by July 26 2020 more than 16 million people worldwide had been infected by the coronavirus and more than 600 000 deaths had been attributed to this disease. “Despite advances in pharmacological treatment and early vaccine development, reducing transmission of the virus with the use of facemasks (referring to medical or surgical masks, N-95 and similar respirators, cloth masks, and bandannas) by health-care workers and the public alike remains a hotly debated topic due to politicisation of discourse and decision making.”

Schunemann wrote that at the beginning of the pandemic, experts cautioned members of the public AGAINST wearing facemasks because the potential risk of transmission was deemed low and the desire was also to protect the supplies from being depleted by panic buying – and reserving them for the use of healthcare workers and frontline staff. A message that was also repeated in South Africa. Here’s a quote from Discovery Health’s head of the centre for clinical excellence, Dr Noluthando Nematswerani: “It’s important to note that medical masks are intended for healthcare workers and are therefore different from cloth face masks recommended for use by the general public.”

Dr Nematswerani went on to say: “While wearing a cloth face mask does not prevent the risk of contracting the virus, new guidelines on the use of masks released by the National Institute for Communicable Diseases (NICD) stated that these masks can play an important role in reducing the spread of the virus from infected individuals including those who are not showing symptoms. People who are not showing symptoms may not be aware that they are infected and continue to spread virus from droplets produced when they speak, cough or sneeze. It is therefore recommended that members of the general public use these cloth masks to prevent the spread of the virus. The use of cloth masks can also lower the risk of contracting the virus from contaminated surfaces by acting as a barrier to touching your face.”

But then scientists realised how useful masks were in preventing the spread.

With so much toing-and-froing about the benefits of masks, researchers at the Florida Atlantic University college of engineering and computer science decided to do what they do best – and test the theory.

or doctor’s surgeries and hospitals, they have now become an extension of everyday life. Whether attending work, shopping, exercising, commuting or walking the dog, masks are simply non-negotiable for South Africans. People might grumble and mutter be they all mask up.

Not Americans though ... It was somewhat surprising for the world to see how opposed Americans were to their adoption. Time and again, social media feeds were full of videos of Joe and Jane Average – or Karen Average ... stating that they “had a right” NOT to wear a mask! The exchange was invariably angry and aggressive, sometimes spitting was involved and there was almost always bad language and hurt feelings.

In the face of such aggression and vitriol signs went up in businesses and shops stating that patrons not wearing face coverings would be denied entry. Much of this conflict could have been avoided had there been a simple, unified message in the United States or the United Kingdom, a nationwide compulsory order such as in South Africa, that masks save lives.

A Twitter post from an American parent illustrated in the most touching way that kids are better at getting the message than supposed adults are. This was how the post went:

“Today my daughter met another little girl at the park. They spoke at a safe distance, and then my girl ran up to me and asked if she could have her mask so that her and her new friend could play. They other little girl did the same,” the father wrote.

“I was blown away. How is it that two four year old girls could have more awareness and consideration for each others’ health than most adults do in this country?

“Do you know how hard it is to get a four year old to do anything, let alone wear a mask? And yet she knew how important this one small inconvenience was in order to enjoy a quick game of chase! And they even complimented each other’s masks, which were both pink.”

This father’s parting shot was: “Be like a four year old and WEAR YOUR MASK. #MaskUp #WearAMask #InThisTogether”

Masks come in all shapes and colours. From straightforward medical masks, to N95 examples, industrial ones, homemade ones in a range of fashion fabrics, corporate branded masks and even neoprene ones with removed filters, such as those worn by the Formula 1 motoring fraternity.

The experts in fluid dynamics conducted a host of experiments using medical N95 masks, one layer cloth bandannas and then a two or three layer homemade cloth face mask. Using a mannequin, laser light sheet and a mixture of distilled water and glycerine to mimic or represent the content of a cough jet they were able to model or simulate the effect of sneezing or coughing through a mask – or without one.

As expected, the bandanna or single layer-style coverings did little to stop the aerosol projection of droplets. “Well-fitted homemade masks and off-the-shelf cone style masks proved to be the most effective in reducing droplet dispersal. These masks were able to curtail the speed and range of the respiratory jets significantly, albeit with some leakage through the mask material and from small gaps along the edges,” the report stated.

Furthermore, “uncovered emulated coughs were able to travel noticeably farther than the currently recommended 6-foot distancing guideline. Without

a mask, droplets travelled more than 8 feet (2.4m); with a bandana, they travelled 3 feet, 7 inches (1.2m); with a folded cotton handkerchief, they travelled 1 foot, 3 inches (40cm); with the stitched quilted cotton mask, they travelled 2.5 inches (6 – 7cm); and with the cone-style mask, droplets travelled about 8 inches (24cm).

“In addition to providing an initial indication of the effectiveness of protective equipment, the visuals used in our study can help convey to the general public the rationale behind social-distancing guidelines and recommendations for using facemasks,” said Siddhartha Verma, Ph.D., lead author and an assistant professor who coauthored the paper with Manhar Dhanak, Ph.D., department chair, professor, and director of SeaTech and John Frakenfeld, technical paraprofessional, all within FAU’s Department of Ocean and Mechanical Engineering. “Promoting widespread awareness of effective preventive measures is crucial at this time as we are observing significant spikes in cases of Covid-19 infections in many states, especially Florida.”

“We found that although the unobstructed turbulent jets were observed to travel up to 12 feet (3.6m), a large majority of the ejected droplets fell to the ground by this point,” said Dhanak. “Importantly, both the number and concentration of the droplets will decrease with increasing distance, which is the fundamental rationale behind social-distancing.”

The final word on the subject goes to the Lancet article by Schunemann: “No single intervention gives invulnerability to Covid-19. Facemask use should not substitute for these risk mitigation strategies, but might offer benefit.

“The current best evidence includes the possibility of important relative and absolute benefits of wearing a facemask. Depending on the pandemic situation in a given geographical setting, the desirable consequences of wearing a facemask may or may not outweigh the undesirable consequences. In highly populated areas that have high infection rates—e.g., USA, India, Brazil or South Africa—the use of masks will probably outweigh any potential downsides.”

How effective a multiple layer homemade stitched mask can be, is illustrated by this image from the Florida Atlantic University, College of Engineering and Computer Science. Just two inches – five centimetres – is the furthest that droplets travel should its wearer sneeze or cough.

HOW TO CORRECTLY WEAR A CLOTH FACE MASK

(Advice from the SA Department of Health) The face mask should cover the nose and mouth completely. Face masks should not be lowered or removed when sneezing, coughing or speaking. Face masks should not be touched, handled or fiddled with repeatedly – it should be actively discouraged. The inner side of the mask should not be touched by hands. Wash hands thoroughly after using the face mask. Wash cloth masks with warm soapy water after use and iron once dry. Each person would ideally need to have two cloth face masks so that one can be worn while the second is being cleaned.