My favorite mask so far has been the polyester neck gaiter, not worn pulled up in a single layer bank-robber-style over the nose (it's not nearly tight enough for me to feel secure that way), but lapped into at least three layers and with the selvages over my head to create a tight seal everywhere around my nose and mouth. I showed exactly how I did it, with photos, back in May, partly in hopes to encourage the "tight-gaiter-as-mask" method of wearing it instead of the looser "bandit style."
I listed numerous advantages, and then added:
Potential disadvantages:
- Polyester knit is fairly loose-weave and its specific filtration efficacy is not known. This is the biggest caveat. It's one reason why I try to get at least three layers over my mouth and nose.
- Some brands are pricey
- Maybe it will fog your glasses and you'll have to add some wire or something
- It's a little hard to get it just right without a mirror (at least at first)
Give it a try and see what you think.
Repeated Disclaimer: I am not a professional dispenser of legal or medical advice, and I have not done an exhaustive literature search to determine if there is any other available data regarding polyester knit fabric as part of masks for source control in the community.
So! We now have a little bit---emphasis on the little---of data regarding polyester knit neck gaiters, and that little bit isn't good. In my opinion, the scrap of data is enough to make me at least temporarily uneasy about relying on the gaiters without an added filter, so I've resumed experimenting with cotton fabric.
In my opinion, it is not enough (yet) to rule out gaiters as an effective option.
We really need to know more about this, because they are a very popular face-covering right now, and for good reason. Some people believe it's the only type they can tolerate for long periods, so if it turns out that they are reasonably effective when worn in a well-fitting way, we don't want to lose them as an option.
Let's dig in to the source of this data, which is a very cool study that came out this week and which I have carefully read with some consultation assistance from my spouse, who has professional experience in particulate imaging.
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Here's a typical article's headline and excerpts, this from CBS News:
Neck gaiters may be worse than not wearing a mask at all, study shows
Using neck gaiters as a face covering might be ineffective at stopping the spread of the coronavirus, and could even spread the virus further than not wearing a covering at all, according to a new study. Researchers from Duke University found that the neck gaiter they tested was "worse than nothing."
"The neck gaiter that we tested did essentially nothing, and worse than nothing, because it appeared to make large droplets into small droplets," Isaac Henrion, the study's co-author, told CBS News. Henrion is also the coordinator of Cover Durham, a community project to distribute tens of thousands of masks to vulnerable people.The neck gaiter is a circular piece of fabric that sits around a person's neck and can be pulled up to cover their mouth and nose. The issue with the convenient cover-up is likely not with its design, but with the fabric it is typically made from.
According to Henrion, the study tested a neck gaiter made of a thin, stretchy polyester, which they are commonly made from. Instead of stopping droplets that can contain the virus from escaping into the air, the fabric appeared to turn large droplets into smaller ones known as aerosols....
Duke's study focused on droplet production while talking, as opposed to coughing or sneezing...
While the study did not set out to create a definitive ranking of masks, Henrion said that N95 and standard surgical masks released the least amount of droplets. N95s yielded the best results, and surgical masks came in second, stopping 90-95% of droplets. Simple two-layer cotton masks were effective at stopping 80% of droplets from getting out when participants spoke.
As for neck gaiters, Henrion stressed that the study was preliminary, and did not conclusively determine whether a gaiter's fabric or construction was responsible for producing smaller droplets. A neck gaiter with two layers of cotton could be more effective.
Without easy access to PPE, many people have turned to making their own masks. The study showed that homemade versions can be effective, but people should be mindful of their mask construction and fit.
"Further research is needed to investigate the performance of bandanas and neck gaiters, since our study is only a proof of concept for the experimental method," Henrion said.
Martin Fischer, an associate research professor in Duke's chemistry department who took part in the study, told WRAL-TV it wasn't meant to rate different face coverings, adding that "Not all ... neck gaiters are bad. There are plenty good ones out there. It depends so much on the material, on how many layers you wear."
So, if you read all the way through the news article, you do see some caveats. It's not an irresponsibly written news article; but I'd argue it's focused incorrectly. This study --- Fischer et al., Sci. Adv. 10.1126/sciadv.abd3083 (2020) --- is not a study of mask effectiveness at all. It appears to be a valuable and elegant study, but they did not write the paper so that they could report mask effectiveness. It is a demonstration study of their novel apparatus.
In other words:
Fischer et al. were not trying to use their apparatus to demonstrate the effectiveness of 14 masks. They were using 14 masks to demonstrate the effectiveness of their apparatus.
Along the way, though, they did produce some data, which we shouldn't ignore; but we should be aware of its limitations.
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A much better article about the study, the one that I wish had gone viral in the first place, was published in WIRED. From the very headline and sub-head, they get the focus correctly where it belongs: on the apparatus, not on the masks.
Scientists Put Masks to the Test---With A Cell Phone and a Laser
When it comes to blocking germs, not all cloth masks are created equal. A new, low-cost testing device literally illuminates which ones won't get the job done.
Three cheers for journalist Megan Molteni, who wrote the article! Three cheers for WIRED, who put all of the above in big type before the colorful illustration!
I would love for you to read the whole WIRED article, but I'll pull out a section that's especially relevant to the neck gaiter question. Emphases are mine.
The neck gaiter, made out of a lightweight, breathable fabric favored by runners and cyclists, let through even more particles than the control group—110 percent relative to wearing no mask at all.
If you’re wondering how that is even possible, you’re not alone. Fischer was similarly stumped. Then he went back and looked at the footage again of himself wearing the neck gaiter. “You can see that it’s not just that there are more particles, but that on average, the particles are much smaller,” he says. His team believes the stretchy, porous material is actually fracturing bigger, heavier droplets, splintering them into tinier particles that can more easily remain suspended in the air.
If that’s true, it would blow up the maxim that any mask is better than no mask, says Kimberly Prather, an environmental aerosol researcher at UC San Diego who was not involved in the study.
But there’s another possible explanation: Maybe the extra particles aren’t all respiratory droplets. Instead, they could be fibers shedding off the material itself. This has been shown to happen before, and would be easy enough to test—but Fischer and his coauthors didn’t. “Splintering would be bad, but we don’t know for sure that’s what’s going on,” says Prather.
She also points out that the sample size for most of the mask testing is precisely one person. The study doesn’t capture all the variability in how people’s face shapes and speaking patterns might affect the effectiveness of different kinds of masks. So, while this project’s results are in line with other, larger, more rigorous studies, one shouldn’t read too much into the performance outcomes of individual masks based on this study alone, she says.
Still, Prather is impressed that the Duke team’s technique can detect particles down to half a micron. Most laser visualization methods are sensitive only to about 20 microns. “That’s a big deal, because this captures aerosols—the particles that come out during speech—not just bigger droplets emitted during coughing or sneezing,” she says. “Keeping it in perspective, I think it’ll be a great comparison tool to look at variability between people, more conditions. There’s a lot of different things you can do with the setup they’ve developed.”
Fischer and Westman also recognize the study’s shortcomings. “This was never going to be a definitive ranking of all masks under all types of conditions,” says Fischer. Doing that would require hundreds, or even thousands, more people testing lots more masks. “What we don’t want people taking away is: ‘This mask will work. This will not.’ It’s not a guide to masks. It is a demonstration of a new, simple methodology for quickly and somewhat crudely visualizing the effect of a mask,” he says.
If you would like an article that is a little more mainstream-web than the tech-web WIRED, you could try this article by Susan Matthews in Slate. It's more of a rebuttal to the "neck gaiters are definitely worse than nothing" narrative, and mentions other reasons why it is too soon to draw that conclusion definitively. And it's written in a conversational style that might get the average person reading to the end.
And, just in -- that is, a nurse friend shared this on Facebook while I am actually writing this blog right now -- here is an article from ScienceNews that has a bad headline (it isn't a "mask study!" argh) but summarizes everything I've been trying to say. I'm being scooped in real time!
I do want to emphasize that the study is not a flawed study. It's a good study! And the paper is very responsibly written. Fischer et al. themselves are very careful to explain what their work does and does not show. It's just that media outlets don't always bother to read that far.
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I have many hot takes from all this, but as a number of them are duplicated in the news articles I've linked above, I'll restrict myself to a few in particular.
(1) A new, cheap, effective testing method.
The fundamental advance of Fischer et al. is to design and describe a low-cost mask-effectiveness-testing apparatus and data analysis method that can be assembled by any research lab and even by your higher-level citizen scientist, It is not beyond the ability of a bright high school student looking for a science fair project, or a garage tinkerer, if they can manage the data processing part or else figure out a proxy measurement.
(2) This is the first mask-tester I have seen that actually tests the mask's performance while it is being worn by breathing humans.
Other studies of mask effectiveness have looked mainly at the filtration efficiency, by (for example) stretching a sample of the fabric over an opening and pumping a mixture of air and saline droplets through the mask. But the filtration efficiency of the fabric is definitely not the only significant question, and for all we know it might be one of the least important attributes. We do not know how important the edge-seal around a mask is. We do not know how tight a mask needs to be. We do not know if the best mask-shape is different for different kinds of facial structures. We do not know how well masks perform after they become wet with sweat or respiratory fluids. We need to know these things, and the only way to find out is to test masks while they are being worn by real people.
(3) Now that an easy-to build apparatus exists, perhaps we'll soon start to see the mask studies that answer some of our questions.
What we want to see are studies that evaluate a single type of mask in many iterations on many people, while they breathe, pant, talk, sing, cough, sneeze, and shout. We want them to specifically identify the type of mask it applies to, and no, "fleece gaiter" is not good enough, nor is "two-ply cotton mask" or "poly-cotton blend." What's the proportion of polyester and cotton? What's the thread count? Is it held on by ear loops or head ties? In the case of a multipurpose face-covering such as a gaiter, is it worn tight to the face and jaw like I always have, or only pulled up over the nose? I'll just point out that this study mentions three different two-layer cotton masks, and they do not measure the same.
(4) Certain improvements that could be made will answer even more questions which are not possible with the current apparatus. Among them: how important are droplets that come away off to the side instead of dead-center in the front?
The authors of the paper explain that some very important questions literally cannot be answered with the apparatus as described in their paper, but in principle some design changes could close those gaps. I'll just quote here.
A first limitation is that our experimental implementation samples only a small part of the enclosure and hence some droplets that are transmitted through the masks might not be registered in the laser beam.... The physiology of each speaker is different, resulting in variations of the position of the mouth relative to the light sheet. Hence, the droplet count reflects only a portion of all droplets... A speaker hole that is sealed around the face would prevent the undetected escape of particles.
From looking at the diagram of the apparatus, I judge that droplets escaping around the edges of a poorly-fitted mask are the least likely to be caught at all. So if edge-leakiness is to be evaluated, the apparatus will require development.
(5) One possibility: This apparatus could be used to give a quick estimate of a particular person's particular mask on a particular day.
My spouse, who unlike me does his engineering for a corporation for actual money, immediately thought of commercializing a similar design as a screening tool. If it's vitally important that people have to have a mask that functions well on them to enter your building, you could set something like this up at the door and intercept people before they enter. You could then, in principle, get a quick estimate of how well each person's mask is working for them, relative to a standard of your choosing. If the mask they are wearing doesn't work well, you could advise the person to adjust the mask fit, or could offer the person a different type of mask.
(6) It's definitely too soon to shame people who are wearing neck gaiters.
Don't do it. I, personally, am concerned enough that I'm going to start looking for a comfortable cotton mask that fits me well (previously I had decided that the neck gaiter, twisted into a tight mask conformation, worked so well that I hadn't even bothered with cotton ones). After all, we might find out that the gaiter really is a poor choice, and I want to be ready. But we really do not know enough to abandon them, or the maxim that the best mask is the mask that you wear correctly and consistently. Save your shame for the conspiracy theorists and the people who refuse to wear any mask at all. We just don't know enough to be sure.
And I'll be frank: One of the cotton adaptations I've tried so far, and the one that I like best, is to layer the neck gaiter on top of the cotton mask. It's a little hot, but the tightness of the gaiter securely fastens the cotton mask to my face so it won't budge; destroys glasses-fogging; and spreads the pressure out all over my head. But you know what? You can't see that there's a cotton mask underneath. So if you see me on the street with my gaiter wrapped around the lower half of my face, have pity: I've got another layer under there.
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My ultimate recommendation is to watch for citations of Fischer et al. in the literature. Any paper that reproduces or improves upon their apparatus ought to be citing them, as should any paper that uses the apparatus to do a true mask study. And if my observations about media coverage of scientific results are accurate, no matter what followup studies they perform, we'll likely never see them go viral again.
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