PROTECTIVE MASK – Surgical mask, duck, FFP2 … Initially used by health professionals, protective face masks are now recommended for the entire population during the coronavirus epidemic. What does it really protect? Which one to wear? How to make it?
[Mis à jour le lundi 6 avril à 12h45] In full Covid-19 epidemic, the protective mask (whether a blue surgical mask or a respiratory mask) is extremely popular. If the government considers that its port is not useful in the general population and deprives people who really need it, in a press release dated April 3, the National Academy of Medicine recommends that “wearing a mask “general public”, also called “alternative” or “makeshift” (see here our tutorial with patterns and manufacturing instructions on video by Pr Daniel Garin), or made compulsory for necessary outings during confinement“. This screen placed in front of his mouth would allow “absorb potentially contaminated droplets and thus avoid contamination“. Problem: in this context of pandemic, the masks are becoming scarce and he is “complicated [de s’en faire livrer], we fight 24 hours a day “ , deplores the President of the Grand Est region Jean Rottner at the microphone of RTL, on April 1. He denounces the abuse of power shown by the Americans : “On the tarmac, the Americans take out the cash and pay three or four times for the orders we have made. Faced with these problems, I am trying to secure the goods so that they are not seized or bought by others “ he reports on RT France. In total, France has ordered “more than a billion” protective masks, especially in China, detailed the Minister of Health Olivier Véran. What mask to wear? FFP2, FFP3, surgical … How to make the difference ? How to put it on and after how long throw it away? Is it a good idea to make your own mask out of fabric? What tutorial to quickly make it? Advice.
The protective mask, also called “anti-virus”, for medical use, “surgical”, anatomical, type “duckbill” … is a medical device intended for filter bacteria and avoid getting a virus, like the flu or any other viral disease. “These masks are generally worn in the operating room to first prevent bacteria from the surgeon’s mouth from being projected onto the patient’s surgical wound, but can also be worn by the general public to protect themselves from microorganisms in a context of epidemic, like the flu for example“, says Dr. Pierre Parneix, medical officer of health and hospital practitioner in Public Health at the Bordeaux University Hospital and responsible for the Support Center for the prevention of infections associated with healthcare (CPIAS) of New Aquitaine. These masks are delivered to pharmacies from state stock via wholesalers and are delivered free of charge to patients, on medical prescription.
Some experts believe that wearing a handmade mask is “better than nothing”.
The standardized masks are now reserved for caregivers and patients (suspected or tested), many tutorials for making your mask at home are blooming on the Internet. “To be effective, the mask must be conforms to French and European standard “NF EN 14683” reminds Dr. Parneix. So homemade mask or not? Experts are divided.
- Some say that homemade masks are absolutely not effective, “falsely reassuring” and that they protect neither the wearer nor those around him. The French Society of Hospital Hygiene confirms, in a notice of March 14, that it is necessary “avoid using other types of screens instead of surgical masks (cloth masks, paper masks, cloths tied behind the typical head bandana) due to very limited scientific data concerning their effectiveness (tightness) “.
- Others believe that wearing a handmade mask is “better than nothing”.To decide, Olivier Véran, Minister of Health has “asked the competent authorities to give us opinions on the matter“. And to warn about the use of these protections homemade : they are not, according to him “not the alpha and the omega of protection“.
- What about the scarves and bandanas that you wrap around your face? We believe we are protected while not: they certainly filter large dust and pollen for example, but not viruses which are microscopic microorganisms (their size varies from 0.02 µm to 0.3 µm). They therefore do not protect from the Covid-19.
The port of medical masks is not a cultural practice in France unlike other countries such as Asia. “Instead of thanking people who wear masks because they protect us from their viruses, we tend to judge them as “dangerous”. It is a look that must really change! Wearing a mask is a very good reflex“, says Dr. Pierre Parneix.
- A person suspected of showing symptoms of respiratory infection or known to be ill may wear a surgical mask to protect others from their symptoms (at home, in public places …).
- The mask can also be used in the context of prevention of exposure to the virus. He has a “barrier effect” which will prevent the passage of bacterial and viral particles. “The mode of transmission of coronavirus is essentially the same as that of influenza, that is to say that it is transmitted from human to human during close contacts (touching or shaking hands for example) and by airway in coughing or in sneezing (saliva droplets, postillions)“Specifies the medical officer of health.
“Masks make no sense if you don’t wash your hands since you touch contaminated surfaces”
- Masks therefore have an interest in protecting themselves from them but “make no sense if you don’t wash your hands because in practice you touch contaminated surfaces “ recalled Professor Jérôme Salomon on February 26, 2020 in the Senate.
For everyone else: no need to wear a protective mask. The best way to protect yourself against coronavirus is to respect barrier gestures : wash your hands regularly and especially after each outing, use antibacterial gel if there is no water source nearby, sneeze and cough into your elbow, blow your nose with a disposable handkerchief than the we immediately throw away, maintain a safety distance with our contacts at least one meter …
Standardized masks are reserved primarily for:
- health professionals brought to take care of COVID-19 patients in town, in hospital and in medico-social structures (surgeons, medical transport, firefighters, doctors and liberal nurses, emergency or critical care services. ..)
- home help or care services
- pharmacists
- dentists
- masseurs-physiotherapists
- liberal midwives
To stop the spread of coronavirus worldwide, wearing a protective mask is now compulsory in some European countries. This is particularly the case for the Czech republic and some Slovakia who have made it mandatory to wear a mask in all public spaces. This is also the case for Slovenia, assured Prime Minister Janez Jansa, during a televised address. From March 30, 2020, Slovenians will no longer be able to go to a grocery store or other public spaces that are still open if they are not wearing a protective mask and gloves. A fine may be issued if these rules are not observed. In Austria, wearing a mask is compulsory in all supermarkets from April 1st. This obligation will certainly be extended to all public spaces. In Bulgaria, wearing a mask is “very strongly” recommended and could become compulsory for all passers-by. The United States, who have passed the 200,000 mark, are also planning to wear masks for all Americans once supplies are available again.
There are several types of mask that have variable filtration levels. “To define the level of filtration, a test is carried out with an aerosol containing strains of staphylococcus aureus“, explains Dr. Parneix. There are:
- The surgical masks (blue) type I which filters 95% of bacteria and of type II which filters over 98% of bacteria. A distinction is made between normal type 2 masks and those of type R which are more waterproof and resistant to projections. In the case of the coronavirus epidemic, these are surgical masks which are reserved for the sick or people in proven contact with a sick.
- The respiratory protection mask (shell, duck mask, FFP2 or FFP3 mask) is a safety mask with a very high level of filtration which is used in healthcare settings for infectious agents such as tuberculosis for example. This mask, which to be effective must have a shape adapted to the face of the person wearing it, no longer filters only bacteria, but also aerosols. It is reserved for health professionals throughout the chain (medical transport, firefighters, private doctors, nurses …) and is not intended for the general public. “It doesn’t make sense to wear it when you’re a citizen, to go shopping for example, underlines Professor Salomon. These are risky actions that contaminate the coronavirus: when you intubate a patient, when you examine him … “
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Disposable. The anti-projection surgical mask has a lifespan of 3 to 4 hours. “Beyond that, you have to throw it in the trash. The mask is for single use and in no case washable or reusable. After each outing, as soon as you return home, do not handle it and throw it away as it is potentially contaminated“warns Dr. Parneix. So you should not reuse a mask once it has been handled and removed from the face. The FFP type mask has a duration of 8 hours.
The protective mask is not effective that if it is well worn. Dr. Parneix’s advice for positioning it correctly:
- Wear the mask the right way round. In general, the colored side should be towards the outside and not against the mouth.
- The padded side of the nose strip should be placed over the hump of the nose to properly protect the nose.
- Prefer masks with elastic ties rather than straps: the mask will be easier to put on.
- The mask must be well enveloping and pass under the chin to protect the mouth and the nose.
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Supported by the Directorate General of Health, the Ministry of Labor authorized, Thursday, March 26, 2020, the use of expired protective mask (type FFP2), provided that the expiration date does not exceed 6 months, and that “strict instructions are observed before their use”. These expired masks must:
- “Have been stored under storage conditions in accordance with those provided by the manufacturer or distributor”.
- “Have been subjected to four successive tests” before using them. The purpose of these tests is to verify integrity of packaging, the appearance (the original color), the solidity of the elastic bands and the nasal bar holding the mask, and themask fit on face.
The surgical or anatomical mask has a lifespan of 3 hours. We throw it away.
Better to buy a surgical mask in a drugstore or pharmacy only on the Internet for two reasons: to have the guarantee that the mask conforms well to standard NF EN 14683 and to be able to benefit from the advice of the pharmacist, in particular on the wearing of the mask. “Avoid getting surgical masks online without the NF EN 14683 mention because we are never sure of their effectiveness“concludes the expert. In addition, in the event of an epidemic, some sellers take the opportunity to inflate the prices of the masks without guaranteeing their quality. We must therefore remain vigilant and favor the pharmaceutical circuit.
To note : from March 4, 2020, and as part of the coronavirus epidemic, the supply of masks in pharmacies is subject to medical prescription for the general public and otherwise reserved for healthcare professionals.
- A surgical mask costs on average between 20 and 50 cents the unit (except coronavirus pandemic)
- A FFP2 type respirator can cost up to 20 euros.
- A FFP3 type breathing mask can cost up to several tens of euros.
Caution : Unregulated prices have soared on the Internet and in some pharmacies.
Faced with the proliferation of the new coronavirus in France, a decree was published Wednesday March 4 in the Official Journal on the necessary requisitions of stocks of protective mask for health professionals and sick patients. The following are therefore requisitioned until May 31, 2020:
- Stocks of FFP2 type respiratory protection masks held by any legal person under public or private law.
- The stocks of anti-splash masks held by the companies that manufacture or distribute them.
Respiratory protection masks of type FFP2 and anti-splash masks produced between the publication of this decree and May 31, 2020 are requisitioned, for the same purposes, until this date.
Thanks to Dr Pierre Parneix, medical officer of health and hospital practitioner in Public Health at the Bordeaux University Hospital and responsible for the Support Center for the prevention of infections associated with healthcare (CPIAS) in New Aquitaine.
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