At a recent medical seminar, I was approached by a doctor colleague who wanted to know why I was still wearing an N95 mask. I explained that I use a mask to reduce the risk of picking up an infection lingering in the air, and I do it depending on the risk assessment of each individual situation. For instance, the seminar was held in a small, crowded room with no windows: the chance of picking up an infection was higher than while walking on the road.
For clarity, I used the analogy of a seatbelt.
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During a high-speed collision, the human body is turned into a projectile, and is abruptly thrust forward due to the momentum of the car. A seat belt stops the person from dislodging from the seat, preventing injury, potentially saving lives.
Wearing a seatbelt is obviously of no use inside a parked car, because there is no risk of a head-on collision. It might not make any difference in a low-speed collision either.
The case with masks is similar, in that their use must be dictated by the individual situation. The following factors are worth considering while assessing individual risk.
COVID-19 is no longer the destructive force it used to be in 2020 and 2021, when millions of people died. Those who survived natural infection or underwent vaccination have acquired immune memory. Although this doesn’t stop the virus from infecting again, it reduces the chance of the disease turning severe. A cyclical viral disease like many others, COVID comes in waves spread apart by several months. Currently it is active in the United States, U.K. and Canada.
After the recent surge in April-May 2023, COVID-19 cases in India are currently at a low point. It will likely be a few months before the next wave arrives. Those at greater risk are the elderly and people who have significant underlying conditions such as chronic kidney disease. Despite being vaccinated, these individuals could sometimes have severe outcomes following COVID. They must therefore be extra cautious when cases rise again. Additionally, since at least 5% of infections can lead to Long Covid, it is a good strategy to minimise the risk of contracting the virus.
N95 masks provide protection by creating a secure seal that prevents air from leaking. Their electrostatically charged filter is able to trap particles that are even smaller than the gaps between the fibres. Viruses can’t fly on their own; they travel within tiny mucus particles, the smallest of which are called aerosols. These aerosols, generated by talking, singing, and breathing, can linger in indoor air like mist. Masks and HEPA filters trap aerosol particles, thus preventing respiratory infections. Ensuring clean indoor air is vital for health. When the air quality is poor, masks provide us with an additional opportunity to protect ourselves on an individual level.
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A special advantage of the mask is that it is variant-proof. In other words, although newer mutations help the virus escape vaccine protection, they do not diminish the protection offered by the N95 mask. Surgical masks also offer electrostatic filtering, but their fit is less secure. Cloth masks are even less effective against aerosols.
At this time, from India’s standpoint, outside of healthcare settings, there is no need for a healthy person to wear a mask outdoors or in large well-ventilated indoor spaces. However, for someone spending a long time in a crowded closed space with people talking and releasing aerosols, the protection offered by an N95 mask is worthwhile. This is particularly valuable for those who are more susceptible to severe illness or have dependents in the vulnerable category.
(Dr. Rajeev Jayadevan is co-chairman of the National IMA COVID Task Force. )
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