LETTER TO EDITOR
Importance of Mask: An Etiquette and Hygiene
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth, Chengalpettu, Tamil Nadu, India
Corresponding Author: Poornima Adde Pallin, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth, Chengalpettu, Tamil Nadu, India, e-mail: firstname.lastname@example.org
How to cite this article: Pallin PA. Importance of Mask: An Etiquette and Hygiene. J Basic Clin Appl Health Sci 2021;4(2):54–55.
Source of support: Nil
Conflict of interest: None
Keywords: COVID-19, Mask etiquette, Mask hygiene, SARS-CoV-2.
According to WHO, there have been 170,812,850 confirmed cases of coronavirus disease-2019 (COVID-19) worldwide with 3,557,586 deaths (as of June 2, 2021). It is now a well-known fact that mask plays an important role to prevent the transmission of COVID-19. Many studies conducted across the globe conclude that face masks aid in effectively controlling the spread of the virus.1 There is also a false assumption among the public that wearing a mask makes them breathless. According to research conducted by Shein et al., it was proved that in the general adult population, the risk of pathologic gas exchange impairment with cloth masks and surgical masks had no substantial negative impacts on one’s health.2 It is evident from the study done by Samannan et al. between healthy individuals and veterans with severe COPD, there was no change in oxygen or carbon dioxide levels when wearing a cloth or surgical mask during rest and even with physical activity.3 However, a face mask will prove effective only if it is worn correctly. The Centers for Disease Control and Prevention (CDC) has issued guidelines for wearing a face mask. The CDC recommends the usage of N95 masks (in healthcare settings) or surgical/ disposable masks or even cloth masks. According to the guidelines, a face mask needs to fit snugly at the bridge of the nose and against the sides of the face without gaps. The CDC also suggests to ideally wear a mask that has two or more layers of washable, breathable fabric and a feature of a pinchable nose wire to prevent air leakage and to avoid masks that have exhalation valves or vents.4
Even before recovering from the sorrows of the second wave, India is battling with increasing cases of mucormycosis and its etiology still remains a mystery. It is linked with uncontrolled diabetes, irrational use of steroids5 and use of industrial oxygen6, and another alarming reason is wearing unwashed masks for a long time.7 Though there is no clinical evidence to prove the sudden spurt of mucormycosis cases in India, we need to stress the need to maintain mask hygiene since they have become part of our normal routine.
Dear Editor, I would like to mainly emphasize the fact that as much as how important wearing a mask is for an individual, caring for a mask is also equally essential. As per the Ministry of Health and Family Welfare (MoHFW) guidelines, reusable face coverings are not suggested for healthcare professionals or anyone in close contact with COVID-19 patients, but however, they do provide effective protection to the general population for everyday usage.8 Most individuals often overlook the fact that simply using a reusable mask or face cover is not enough; they must also be cleaned and stored correctly to be effective. After all, if you use a reusable face cover once and then do not clean it before using it again, you are letting any virus or bacteria on its surface enter the human body, either directly or indirectly.8
Reusable face masks should be disinfected after each usage and not reused until the disinfection procedure is complete, and that is why, it is essential for a person to have two face masks so that they can be used alternatively and also should never be reversed and reused (without washing). The MoHFW recommends to wash such masks with soap and warm water after each usage. It is also necessary to dry them in the sunlight, which can act as a natural disinfectant for at least 5 hours. To serve its purpose, the reusable mask should also be stored in a clean and sterile place.8
With changing treatment protocols every day and the virus mutating and increasing its virulence, the face mask is one of the best non-pharmaceutical interventions in the midst of fighting the COVID-19 pandemic. As further evidence emerges that asymptomatic person can still potentially disseminate the virus,9 community-wide mask usage must be strictly enforced, especially given that we are dealing with a pandemic with few effective treatment options.
Hence, in light of various research and studies, it is advisable to always wear a mask irrespective of the nature of sickness and more importantly to follow mask etiquettes and hygiene along with other mandatory precautions such as sanitizing your hands and maintaining social distancing that can help to curb the spread of the virus.
Poornima Adde Pallin https://orcid.org/0000-0002-1520-0019
1. MacIntyre CR, Chughtai AA. A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients. Int J Nurs Stud 2020;108:103629. DOI: 10.1016/j.ijnurstu.2020.103629.
2. Shein SL, Whitticar S, Mascho KK, et al. The effects of wearing facemasks on oxygenation and ventilation at rest and during physical activity. PLoS ONE 2021;16(2):e0247414. DOI: 10.1371/journal.pone.0247414.
3. Samannan R, Holt G, Calderon-Candelario R, et al. Effect of face masks on gas exchange in healthy persons and patients with chronic obstructive pulmonary disease. Ann Am Thorac Soc 2021;18(3):541– 544. DOI: 10.1513/AnnalsATS.202007-812RL.
4. The Centers for Disease Control and Prevention (CDC), USA. Your guide to masks. 2021. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html
5. Singh AK, Singh R, Joshi SR, et al. Mucormycosis in COVID-19: a systematic review of cases reported worldwide and in India. Diabetes Metab Syndr 2021. DOI: 10.1016/j.dsx.2021.05.019.
6. Press Trust of India. Black fungus: experts to study possible causes including industrial oxygen use. India Today. 2021. Available at: https://www.indiatoday.in/coronavirus-outbreak/story/black-fungus-experts-to-study-possible-causes-including-industrial-oxygen-use-1806250-2021-05-24
7. Press Trust of India. Experts divided over unhygienic masks being contributing factor for black fungus. The Indian Express. 2021. Available at: https://indianexpress.com/article/cities/delhi/experts-divided-over-unhygienic-masks-being-contributing-factor-for-black-fungus-mucormycosis-covid-patients-7323450/
8. The Office of the Principal Scientific Advisor to the Government of India. Advisory on use of homemade protective cover for face & mouth. 2020. Available at: https://www.mohfw.gov.in/pdf/Advisory & Manualonuse of Homemade Protective Cover for Face & Mouth.pdf
9. Tan J, Liu S, Zhuang L, et al. Transmission and clinical characteristics of asymptomatic patients with SARS-CoV-2 infection. Future Virol 2020;15(6):373–380. DOI: 10.2217/fvl-2020-0087.
© The Author(s). 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.