As COVID-19 sweeps across the globe (click here for the latest numbers from the WHO), there is a sudden spike in interest in the use of face masks and respirators for personal use and as personal protective equipment (PPE). Masks/respirators are specifically designed for different tasks, and like most safety gear, they are only effective if you know what to use, when to use them, and how to use them. In this post I share info about:
- Masks/respirators: COVID-19 (click here for WHO guidance (pdf): Rational use of personal protective equipment for COVID-19)
- Masks/respirators: Personal Use and Backpacking (including a review of the Vogmask N99 that I carried on my CDT thru-hike)
Quick back story: “You have a choice,” my pulmonologist (lung doctor) told me, “you can keep breathing or you can keep your job” I thought he was joking. He wasn’t. I thought he was wrong. He wasn’t. [sigh] There’s a long story there (including leaving my job to do my AT thru-hike), but the short version is that I was diagnosed with occupational asthma in the early 2010s, and knowing when, where, and how to use masks/respirators correctly got very personal, very fast. I’ve been using N-95 respirators and other masks in personal and professional contexts ever since (e.g. as an asthmatic, as a researcher, as a certified First Responder, as a backpacker, and as a traveler).
1. Masks & Respirators: COVID-19
Should I trust information I find on random blogs about COVID-19? NO! I recommend checking information from both the CDC and the WHO for information about protection and prevention:
- CDC: COVID-19: Prevention and Treatment
- WHO: COVID-19 technical guidance: Infection prevention and control / WASH
- WHO(pdf): Rational use of personal protective equipment for COVID-19
Should I buy a mask/respirator for personal use? No, not until the global shortage has ended. We need to make sure that the folks that need them to do their jobs safely (First Responders, Health Care Workers, et al.) have access to them. According to the World Health Organization (WHO), as of March 2, 2020:
“The current global stockpile of PPE is insufficient, particularly for medical masks and respirators… Surging global demand − driven not only by the number of COVID-19 cases but also by misinformation, panic buying and stockpiling − will result in further shortages of PPE globally… especially if the widespread, inappropriate use of PPE continues” [REF: WHO March 3, 2020][REF: WHO Guidance].
Do I need a mask/respirator to protect myself from COVID-19? Probably not. According to the WHO and the US Centers for Disease Control and Prevention (CDC), you don’t need to wear a mask unless you are taking care of somebody with a suspected SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. I’ve quoted their guidance (as of March 3, 2020) for your convenience:
- WHO: If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection. Wear a mask if you are coughing or sneezing. Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water. If you wear a mask, then you must know how to use it and dispose of it properly.
- CDC: does not recommend the routine use of respirators outside of workplace settings (in the community). Most often, spread of respiratory viruses from person-to-person happens among close contacts (within 6 feet). CDC recommends everyday preventive actions to prevent the spread of respiratory viruses, such as avoiding people who are sick, avoiding touching your eyes or nose, and covering your cough or sneeze with a tissue. People who are sick should stay home and not go into crowded public places or visit people in hospitals. Workers who are sick should follow CDC guidelines and stay home when they are sick.
- FDA: The CDC does not generally recommend facemasks and respirators for use in home or community settings. However, they may be appropriate for persons at increased risk of severe illness from influenza or other respiratory diseases.
For those of you looking for a fun/easy to read article, check out this one: Despite COVID-19 Coronavirus, Here Is Why You Should Stop Buying Face Masks.
2. Masks and Respirators: My Experience
[Disclaimer: Refer to WHO, CDC, FDA, or other official sources for information about masks and/or respirators for infection control (ie COVID-19); This section includes my individual experiences with masks for respiratory health in non-infectious, personal settings. Although the masks I use, and carry, may filter viruses and bacteria, I would classify them as Dust Masks].
Despite the fact that I’ve rarely discussed it here on the blog, I’ve carried a face mask/respirator with me on every backpacking trip I’ve taken since 2015, and consider my mask an indispensable piece of hiking gear. This is especially true in areas where dust, fires, pack animals, and/or high altitudes are common (I’m looking at you: PCT, CDT, Utah, Peru, Colorado et al). Without my mask/respirator, I wouldn’t have been able to complete my CDT thru-hike in 2018 to finish the triple crown.
Vogmask (reusable N-95): My Favorite for Backpacking & Travel.
The mask I carry with me on all my backpacking adventures nowadays is my Vogmask N95-Respirator. It is a re-usable dust mask that I find to be effective, fun and comfortable. It is the dust mask that I recommend for backpackers and thru-hikers. When I retired my last one, I bought 2 new Vogmasks (VMCV L). Now I have one dedicated for hiking (a bumblebee Vogmask), and one dedicated for sleeping (a unicorn Vogmask). I use these masks for dust, allergen, smoke, etc protection while traveling and backpacking. As COVID-19 began to spread, I chose to bring (and wear) my bumblebee mask in the airport and on the plane for my respiratory health. Not necessarily to prevent COVID-19, more to keep my lungs moist and to minimize particulate irritation that might make me more susceptible to infection.
- Cost (3/5): $33
- Weight (5/5): 0.7 oz
- Comfort (4/5): In general, I’ve found my Vogmasks to be incredibly comfortable. Comfortable enough to sleep in, which is impressive to me. However, when it is hot out, and I’m engaged in rigorous physical activity, they can feel uncomfortably hot… For heavy activity (but lesser filtering capacity, I use my Respro Mask).
- Durability (4/5): The mask itself will live forever, but the filter isn’t replaceable, and eventually it gets gummed up. For occasional use, I’ve found my masks to be effective for up to a year or two (the one I had before the CDT lasted 2 yrs). However, the mask I used on my CDT thru-hike in 2018 stopped being effective after 2 – 3 months of heavy use (backpacking 20+ miles a day through wildfire smoke).
- For backpacking (4/5). The Vogmask is hands down my favorite reusable mask for N-95 level protection for backpacking, travel, and occasional use for protecting sensitive lungs from airborne particulate including smoke, dust, pollen, perfumes etc, especially on the PCT, CDT, as well as areas with pack animals (Peru) that kick up dust and/or are prone to fires/pollution.
- Infection Control (1/5): not recommended. Vogmask is NOT classified as Masks to prevent disease. However, Vogmask claims that “the filter class provides >99.9% viral and bacterial filtering efficiency and no inward valve leakage.” NOTE: a re-usable mask is a bad idea if an infectious agent is likely present
- Certifications (3/5): NOT approved by NIOSH in the US, but “conforms to NIOSH N99 filtering efficiency as stated in 42 CFR Part 84.181.” The CDC specifically calls out Vogmask for Misrepresentation of NIOSH-Approval. My take is that the filter is effective (they have certifications in Europe, Korea, and China) but they’re approach to the US regulatory process was not.
- Vogmask Availability: Limited (Currently SOLD OUT)
- March 4, 2020: Noir (black) Masks available at 8 am (PST); [Edit: they sold out in under 10 minutes]
- March 11: Printed designs
- March 18: Printed designs
- March 25: Printed designs and organics
Re-Usable Masks/Respirators: What I use and when
Ever since I developed occupational asthma, I’ve got much better and being kind and considerate to my lungs. Here are some of the tasks I use masks/respirators for, as well as my preferred mask choices:
Backpacking: Re-usable Dust/Pollution
- Vogmask: preferred for wildfire smoke and cool climates, my mask stays where I put it and creates a good fit. Comfortable for day and night-time use. I trust the filter, and found it to be consistent with my experience with other N-95s, but much more comfortable than the occupational masks I’ve used.
- Respro: bulkier (less convenient), but easier to breath through (did not feel like an N-95 filter) and more comfortable when it is really hot. Greater initial expense, but replaceable filters. While backpacking I had trouble adjusting it to keep an N-95 level seal, and felt the filter efficiency was reduced relative to the Vogmask.
- Currently Sold out: Website is down until March 6, 2020
- Respro Knock Off from China: 1/2 the cost of the Respro, better (and cheaper) replaceable filter options. Not as comfortable as the original… functional as a backup, but not my preferred option.
Sleeping: Re-usable Dust/Pollution Masks I use for sleeping; separate from masks used in other situations if/when possible.
- Vogmask: preferred for wildfire smoke & high airborne particulate; will use in lieu of separate small cotton mask for self-humidification as described below
- Re-usable cotton mouth mask: preferred to wear at night when humidity is low, or I’m stuffed up and forced to breath through my mouth; cotton mask traps the humidity from my exhaled breath, acting as a self-humidifier for the air I inhale. NOTE: I do not consider these masks to be filters, not at all.
Anytime I’m engaged in activities I consider “high risk” for my lungs, and/or any time I’m dealing with potentially allergenic, infectious, or toxic particles I use disposable masks if available. For these tasks I typically use NIOSH approved respirators. These masks are the same kinds of masks people need to safely perform their jobs, “approximately 5% of all U.S. workers in about 20% of all work establishments wear respirators at least some of the time while performing their job functions.” Unfortunately, COVID-19 panic has caused a world-wide shortage of these types of masks and respirators, threatening the health and livelihoods of people throughout all the industries that rely on them.
Please join me in abstaining from buying NIOSH approved respirators for personal use for the next month or two (or until otherwise advised by the CDC and WHO). For me, this will mean restricting some of the activities and chores I do around the house and barn (less sweeping, dusting, chimney cleaning etc) and prioritizing the use of the masks/respirators I currently have.
Additional Links and Information
My Previous Asthma-Related Blog Posts
- Prologue: Why I decided to hike the Appalachian Trail – April 2013
- Asthma Update (500 miles) – June 2013
- Inhaler Physics (AT Days 64 & 65) – July 2013
- Confessions of an Asthmatic (PCT Days 63-65) – June 2014
- Patches the Asthma Girl! (Asthma Ditty) – August 2014
- Goat Rocks (PCT Days 144-147) – September 2014
- Blizzard of 2015: A Vignette – November 2015
- Thirsting for Adventure (Trekking in Peru: Day 2) – November 2016
References & Additional COVID-19 Links:
- Timeline: 2002 – 2003 Timeline for SARS and 2019-2020 Timeline for COVID-19 (published February 24, 2020 in JAMA: Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648]”>
News & Interest
- National issues supporting the Face Mask Market in China (Feb. 7, 2020)
- This article has useful insights. http://infomullet.com/2020/03/02/covid19mentalmodel/
World Health Organization (WHO) Links:
- WHO: Coronavirus disease (COVID-19) advice for the public
- WHO: COVID-19 Confirmed Cases GIS Map (daily updates)
US Centers for Disease Control and Prevention
- CDC: COVID-19 Guidance
CDC: Strategies for Optimizing the Supply of N95 Respirators (February 29, 2020)
For Healthcare Providers:
- CDC Slidedeck: Strategies for Ensuring Healthcare Systems Preparedness and Optimizing N95 Supplies
[Edit: March 5, 2020] The CDC has specific guidance for health care facilities experiencing shortages of N95 respirators. From an infection control standpoint I found them to be sobering.
- CDC: Checklist for Healthcare Facilities: Strategies for Optimizing the Supply of N95 Respirators during the COVID-19 Response
- CDC: Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States
- CDC: Preventing COVID-19 Spread in Communities