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Efficacy of masks and face coverings in controlling outward aerosol particle emission from expiratory activities

Sima Asadi, Christopher D. Cappa, Santiago Barreda

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Anthony S. Wexler, Nicole M. Bouvier, William D. Ristenpart

2020 · Scientific Reports

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From the abstract

Abstract The COVID-19 pandemic triggered a surge in demand for facemasks to protect against disease transmission. In response to shortages, many public health authorities have recommended homemade masks as acceptable alternatives to surgical masks and N95 respirators. Although mask wearing is intended, in part, to protect others from exhaled, virus-containing particles, few studies have examined particle emission by mask-wearers into the surrounding air. Here, we measured outward emissions of micron-scale aerosol particles by healthy humans performing various expiratory activities while wearing different types of medical-grade or homemade masks. Both surgical masks and unvented KN95 respirators, even without fit-testing, reduce the outward particle emission rates by 90% and 74% on average during speaking and coughing, respectively, compared to wearing no mask, corroborating their effectiveness at reducing outward emission. These masks similarly decreased the outward particle emission of a coughing superemitter, who for unclear reasons emitted up to two orders of magnitude more expiratory particles via coughing than average. In contrast, shedding of non-expiratory micron-scale particulates from friable cellulosic fibers in homemade cotton-fabric masks confounded explicit determination of their efficacy at reducing expiratory particle emission. Audio analysis of the speech and coughing intensity confirmed that people speak more loudly, but do not cough more loudly, when wearing a mask. Further work is needed to establish the efficacy of cloth masks at blocking expiratory particles for speech and coughing at varied intensity and to assess whether virus-contaminated fabrics can generate aerosolized fomites, but the results strongly corroborate the efficacy of medical-grade masks and highlight the importance of regular washing of homemade masks.

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Original HN comments, with labels from simple text rules. A label describes the whole comment and may miss context or irony. Read the discussion to make up your own mind. About the labels

7 selected excerpts · 7 total mentions

stopping
Neutral mention · rule
There are many studies which show that surgical masks are quite good at stopping a majority of expelled particles, even those well within the aerosolized size regime: Surgical masks reduce outward aerosol-sized particles by at least 74%: https://www.nature.com/articles/s41598-020-72798-7 Surgical masks reduce outward COVID viral transmission by 73%, and viral RNA by 58%: https://journals.asm.org/doi/10.1128/msphere.00637-20 Outward filtering efficiency above 50% is certainly worth it compared to the cost of a surgeon wearing a mask. It's arguably worth it even at much lower efficiencies. If you read my comment, you'll notice I'm not disagreeing on the aerosol/droplet size boundary. I'm arguing against the apparent subtext of your comment, which seems to indicate that surgical masks aren't effective at protecting patients.
gnat
Neutral mention · rule
https://www.nature.com/articles/s41598-020-72798-7 "Here, we measured outward emissions of micron-scale aerosol particles by healthy humans performing various expiratory activities while wearing different types of medical-grade or homemade masks. Both surgical masks and unvented KN95 respirators, even without fit-testing, reduce the outward particle emission rates by 90% and 74% on average during speaking and coughing, respectively, compared to wearing no mask, corroborating their effectiveness at reducing outward emission."
davmar
Neutral mention · rule
> It started with masks. The studies that we had about masks really were not great, but they did a risk-reward calculation behind closed doors: worst case scenario, the surgical masks don't impact the spread and it changes nothing; best case scenario, we reduce community spread. The problem with this is that if they told the public that this was how they were thinking about the problem, they wouldn't get people wearing the masks, so they overstated their confidence in it when speaking to the public. A good amount of people truly believe that the science was clear. But it wasn't. Inaccurate and dangerously wrong conjecture. Research published long before COVID-19 proved…
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the efficacy of masking in blocking particulate matter. That's why terms like N95 even exist. https://www.nature.com/articles/s41598-020-72798-7 That study came out last year, but there are similar studies published many years ago. I don't have time to google for them all right now, but they are out there for those who want to find them. The science on masking was clear and your statement is irresponsible.
Aeolun
Neutral mention · rule
Got a few here: https://www.nature.com/articles/s41598-020-72798-7 It does note that non-medical (e.g. cloth) masks may be less effective, but whether those are used a lot seems to depend on environment (nobody seems to use them here). Edit: One more for cloth masks https://www.nature.com/articles/jes201642
btilly
Neutral mention · rule
First, there is active research and we demonstrably have learned something. See https://aricjournal.biomedcentral.com/articles/10.1186/s1375..., https://www.nature.com/articles/s41598-020-72798-7, and https://www.pnas.org/content/118/4/e2014564118 for several examples. Second, your simplistic analysis demonstrated that you, personally, are ignorant of the real tradeoffs involved in whether masks work. Wearing a mask reduces how much virus leaves your mouth. But when you breathe out, most of the virus is in larger droplets that quickly hit the ground. However breathing out through a mask creates perfect conditions to create an aerosol, which can allow more of the virus to…
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stay in the air for an indefinite period of time. So there is a tradeoff, and there were reasons to question whether cloth masks were better than simple social distancing. It turns out that what matters most is not that you get exposed, but rather the initial viral load that you get. You see, the virus will go on an exponential growth until the relatively fixed time it takes the immune system to figure things out and start shutting it down. If the virus gets a solid head start, the odds of serious illness go up. Therefore the lingering aerosol from a mask is (except if it accumulates in poorly ventilated indoor spaces) of less concern than an unmasked person talking directly to you. So the result is that masks work. Even crappy cloth masks work.
latch
Neutral mention · rule
An article written by an expert in biology and disease and the director of the National Institutes of Health, which summarizes an a article that was published in a peer-reviewed medical journal and written by another accomplished medical doctor, isn't scientific enough for you. Why? Because Sweden didn't mandate masks. First, Sweden had more deaths per capital than most countries. Second, even if it had very good numbers, that would not mean that masks aren't effective. Masks save lives (1) (2) (3) (4) (1) https://www.ucsf.edu/news/2020/06/417906/still-confused-abou... (2) https://www.nature.com/articles/d41586-020-02801-8 (3) https://www.nature.com/articles/s41598-020-72798-7 (4) https://directorsblog.nih.gov/author/collinsfs/
Aeolun
Neutral mention · rule
Well, that took me much less time than I actually expected. https://www.nature.com/articles/s41598-020-72798-7 It does note that non-medical (e.g. cloth) masks may be less effective, but whether those are used a lot seems to depend on environment (nobody seems to use them here). Edit: One more for cloth masks https://www.nature.com/articles/jes201642

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