As local schools ready for reopening and a fair number of Newtown’s college students return to campuses across the country and beyond, it remains clear that face coverings will play a critical role in keeping COVID-19 transmission rates low.

Recently, misinterpretation about a Duke University study had students and parents expressing concern about gaiters, a lightweight and trendy face covering. But in the end, Duke took the time to clarify their findings, which initially had media sites across the nation reporting that gaiters might amplify the transmission of droplets. The experts agree that the idea of a fabric gaiter creating more airborne particles is unlikely.

Face shields and vented masks are also less of an option as more information emerges, like a new study in the journal Physics of Fluids that reinforces CDC recommendations regarding those two protective devices.

Newtown school district student health services Supervisor Anne Dalton told The Newtown Bee that while the state updated face covering guidance September 1, local schools are maintaining policies already in place.

“We have not changed from requiring anyone who comes into a school building to be wearing a mask,” Dalton said. “We have advised that the masks should be at least 2 ply and should cover the nose and mouth. We are not allowing masks with valves for exhaled air. Gators can be appropriate if they are 2 or 3 layers thick. Thin, stretchy fabric is not recommended.”

A web search turned up numerous credible sources offering information to consider when weighing the options, especially for the type of masks that might be worn by students returning to school — or anyone looking to better protect against transmission of COVID-19.

Rachel Nania and Peter Urban at AARP tapped a survey initially published by Science Advances that ranked some of the most reliable face coverings: fitted N95 (no exhalation valve), three-layer surgical masks, cotton-polypropylene-cotton masks, two-layer polypropylene masks, and two-layer cotton pleated-style masks came out on top.

The AARP article reiterated longstanding advice from public health experts who have stressed the importance of wearing face masks as a way to curb the spread of the coronavirus, especially by asymptomatic carriers, or people who do not know they have the virus because they never develop symptoms.

The AARP team tapped Eric Westman, MD, an associate professor of medicine at Duke University School of Medicine and a coauthor of the study that also tested a number of other types of masks for their effectiveness.

If a standard three-layer surgical mask is available to you — and some are now showing up on store shelves — go for it, Westman says. But know that your double-layer DIY cotton mask is also fine in the community setting. Just be sure not to wear an N95 mask with a valve, as these masks release exhaled air, which defeats the purpose of wearing the mask to protect others, he added.

Another drawback of the N95 masks according to Dr Teresa Amato, director of geriatric emergency medicine at Northwell Health, is the requirement for a perfect fit to ensure maximum effectiveness. She told Healthline.com that they aren’t exactly a one-size-fits-all option.

“N95 masks need to be fitted, and the wearer needs to be fit-tested to make sure that it’s on there appropriately,” she said. “Otherwise, wearing one is actually not very useful.”

Studying Coughs & Sneezes

A late June 2020 study from Physics of Fluid, a subsidiary of the American Institute of Physics (AIP), used qualitative visualizations of emulated coughs and sneezes to examine how material and design choices affect the extent to which droplet-laden respiratory jets are blocked.

Researchers at AIP found that loosely folded face masks and bandana-style coverings provide minimal stopping-capability for the smallest aerosolized respiratory droplets. Well-fitted homemade masks with multiple layers of quilting fabric and off-the-shelf cone-style masks proved to be the most effective in reducing droplet dispersal.

These masks were able to curtail the speed and range of the respiratory jets significantly, albeit with some leakage through the mask material and from small gaps along the edges. Importantly, uncovered emulated coughs were able to travel notably farther than the currently recommended six-foot distancing guideline.

Siddhartha Verma, PhD, the AIP study’s lead author, told Healthline that the simplest masks — either a bandanna or handkerchief — were virtually ineffective.

“I was a bit surprised to see how much leakage could occur through the bandannas and folded handkerchief masks we tested, even through multiple folds of the cotton fabric,” he said. Ultimately, Verma and his colleagues determined that the most effective homemade masks were those that were well-fitted with multiple layers of quilting fabric.

Healthline also reported that cone-style masks also worked well.

“Quilting cotton, with two layers stitched together, turned out to be the best in terms of stopping capability,” said Verma. “For minimizing the chances of transmission, it is important to use masks made of good-quality, tightly woven fabric, as well as mask designs that provide a good seal along the edges without being uncomfortable.”

Amato says another useful mask option, for those who can obtain them, are simple surgical masks.

“In the beginning, we were kind of holding onto those for healthcare workers, but now we have a good supply of them,” she said. “They’re probably the most comfortable to wear. They’re very lightweight and they afford good protection.”

Stanford University experts say in early June the World Health Organization updated its advice on masks. The new guidelines recommend that everyone who comes in close contact with others in crowded or close quarters, such as on a bus or in a store, wear a cloth mask composed of at least three different layers of material.

People 60 or older, or those with underlying health conditions, should wear medical masks, such as surgical masks, in public, Stanford Health writer Krista Conger related.

About Mask Misconceptions

Amy Price, PhD, a senior research scientist at Stanford’s Anesthesia Informatics and Media Laboratory also addressed misconceptions about any harm that could result from wearing masks.

“I’ve heard so many misconceptions about cloth masks,” Price said. “Some people think that if you wear a mask for long periods of time you will trap and breathe in excess amounts of carbon dioxide, which could lead to brain damage. That’s just not true.”

Price says a properly constructed mask provides more than enough ventilation. In fact, one way to test if your mask is well made is to try to blow out a candle through the mask from about one foot away. If you can’t do so, your mask might be too tightly woven.

“Other people feel that wearing a mask encourages people to touch their face and to loosen their adherence to other safety precautions like social distancing and hand washing,” Price observed. “We’ve found the opposite. Wearing a mask reminds people to continue to be cautious. With a mask on, you actually touch your face less.”

Price said people who experience skin irritation should ensure their mask has a layer of wicking fabric, like cotton, against the face, and everyone should change the mask if it becomes wet or dirty.

“Finally, it’s been suggested that mask-wearing may increase the concentration of viral particles around an infected person’s mouth and could increase the severity of the illness,” Price said. “While it’s true that some studies of health care workers have suggested that the viral dose is an important determinant of infection, it’s different for someone who is already infected. If you are sick, you already have the virus in your lungs; it’s not going to get any worse.”

19 Studies Reviewed

In 2015, the CDC reportedly examined the filtration ability of cloth masks by reviewing 19 studies, and found that the filtration effectiveness of cloth masks was generally lower than that of medical masks and respirators. The CDC found that filtration effectiveness of cloth masks varied widely.

The filtration effectiveness of cloth masks depended on many factors, such as thread count, number of layers, type of fabric, and water resistance.

One study tested medical masks and several household materials for the ability to block bacterial and viral aerosols. Participants made masks from different materials, and all masks tested showed some ability to block the microbial aerosol challenges although less than that of medical masks.

Another study found that homemade cloth masks may also reduce aerosol exposure although less so than medical masks and respirators.

The CDC said masks made of cotton and towel provide better protection than masks made of gauze. And although cloth masks are often not designed to fit around the face, some materials may fit snugly against the face.

Another study even found that the use of nylon stockings around the mask improved filtration, and another stated that filtration effectiveness of wet masks was reportedly lower than that of dry masks.

The CDC appreciated the fact that cloth masks could be made in large quantities in a short time, and that they can be reused after being decontaminated by various techniques, ideally washing in hot water with soap.

Other methods or products for mask cleaning included using bleach, isopropyl alcohol, or hydrogen peroxide; autoclaving or microwaving; and application of ultraviolet radiation or dry heat. Unlike disposable medical masks and respirators, the material of cloth masks is unlikely to degrade from standard decontamination procedures.

Tips On Masks For Kids Returning To School

If your child is heading back to in-person classroom environments, Melissa Tenhet, director and instructor at the Mississippi State University Child Development and Family Studies Center, offers these tips:

*Make wearing a mask fun. Let them choose from two appropriate options when they pick out their clothes. This helps the child feel in control, and the adult also will be happy.

*Pack an extra mask in a zip-top bag in case the one they are wearing gets wet or soiled.

*Washable masks must be cleaned in the washing machine. Have enough to get through the week.

*Wear one mask per day unless it becomes contaminated. Wash washable masks after each day of use. Throw away disposable masks daily.

*Wear the mask correctly at all times. It should cover the nose and mouth. Do not remove it to talk to others.

*Touch only the ear loops, ties or elastic to put on and take off the mask. If the front of the mask is touched, wash hands afterward.

*Be a role model. Practice with your children, and wear a mask when appropriate.

*Watch a kid-friendly video that explains the process and why we should all wear masks. It can help start the conversation.