{"id":3612,"date":"2020-09-07T15:46:06","date_gmt":"2020-09-07T15:46:06","guid":{"rendered":"https:\/\/www.editage.com\/insights\/the-history-and-science-of-mask-wearing\/"},"modified":"2025-01-15T06:29:45","modified_gmt":"2025-01-15T06:29:45","slug":"the-history-and-science-of-mask-wearing","status":"publish","type":"post","link":"https:\/\/www.editage.com\/insights\/the-history-and-science-of-mask-wearing","title":{"rendered":"The history and science of mask-wearing"},"content":{"rendered":"

Note:\u00a0<\/em><\/strong>This content was originally published on\u00a0IndiaBioscience<\/a>\u00a0on June 8, 2020, and has been republished here with permission.\u00a0<\/em><\/p>\n

If previous pandemics have offered the world a\u00a0lesson or two, then it is the use of masks. The practice of wearing face-masks to prevent disease\u00a0can be dated back to<\/a>\u00a0the\u00a01910-11\u00a0Manchurian epidemic in China. It was\u00a0Wu Lien-teh, a\u00a0Cambridge educated Chinese doctor<\/a>\u00a0who described the mask as a\u00a0\u200b\u2018prophylactic apparatus\u2019 that could be worn by all to protect themselves from the plague. An entire century later, masks have remained a\u00a0humble yet effective tool that can be easily mass-produced and utilized in our battle against infectious disease.<\/span><\/span><\/span><\/p>\n

In the same decade as the Manchurian epidemic, over\u00a040\u00a0million people around the world lost their lives to the Spanish flu of\u00a01918. This number is greater than the total casualties from World War I. The same outbreak, when it reached India, arrived as the Bombay fever and took\u00a017\u00a0million lives,\u00a040% of the total deaths worldwide. The practice of covering one\u2019s face with scarves and veils with the intention to ward off disease originated during this period and remained until it faded towards the end of\u00a01919.<\/span><\/span><\/span><\/p>\n

In\u00a01923, the Great Kanto earthquake in Japan was followed by a\u00a0firestorm that wrecked over half a\u00a0million homes. Damage to the Fukushima reactors leaked radiation and left the sky filled with residual ash for months. Facemask production surged and it became an accessory for the inhabitants of Tokyo and Yokohama. The influ<\/b>enza epidemic in\u00a01934\u00a0triggered a\u00a0different relationship with masks for the Japanese, that of social courtesy. Infected people were conscientious about not passing on germs to others, and masks were no longer only worn by healthy individuals trying to avoid illness.<\/span><\/span><\/span><\/p>\n

This early, occasional mask-wearing transformed into a\u00a0year-long habit as industrialisation from World War\u00a0II\u00a0and pollen emitted by the Japanese cedar polluted the air. Today, this practice is deep-rooted in the historical framework of East Asian culture. It symbolises more than just protection from infection and represents cooperation and solidarity that allows a\u00a0society to function during a\u00a0pandemic. It reinforces civic duty and helps us deal with the fear that conquers the healthy and sick\u00a0alike.<\/span><\/span><\/span><\/p>\n

Mask wearing is not new,\u00a0COVID-19\u00a0is<\/b><\/span><\/span><\/span><\/p>\n

Today, the most affordable protection available against the novel coronavirus which causes\u00a0COVID-19, is in front of our faces, literally. There is an extremely good reason to wear a\u00a0mask: wearing one decreases the probability and the number of people who can be infected by a\u00a0person who carries the disease. Masks are designed to prevent the escape of a\u00a0significant number of droplets (also known as aerosols) expelled from our nose and mouth. A\u00a0cough can produce as many as\u00a03000\u00a0droplets and I\u00a0may spray thousands of microscopic droplets as I\u00a0utter the phrase\u2009\u2014\u2009\u200b\u201cWear a\u00a0mask!\u201d<\/span><\/span><\/span><\/p>\n

The\u00a0N95\u00a0mask, for instance, can block particles that are as small as\u00a00.3\u00a0microns with\u00a095% efficiency, while surgical masks can do the same with\u00a0an efficiency of\u00a075\u2009\u2013\u200980%<\/a>. Although not all masks offer complete protection against the entry of viral particles, they still aid the immune system by effectively reducing the overall quantity of viruses that the immune system might have been exposed to otherwise.<\/span><\/span><\/span><\/p>\n

This becomes relevant when it comes to barricading virus-containing droplet nuclei using masks. Droplet nuclei consist of tiny amounts of fluid, carrying the virus that remain suspended in the air for several hours. They are usually less than\u00a05\u00a0\u00b5m in diameter \u2013 twenty times smaller than the width of a\u00a0human hair. As a\u00a0result, these droplets can travel by virtue of air currents and can be breathed in, as opposed to larger droplets that usually fall to the ground or a\u00a0surface due to gravity. Thus, these small droplet nuclei can act as a\u00a0vehicle for airborne diseases. Droplet nuclei can be formed by the natural drying of respiratory droplets that are generated naturally as a\u00a0result of talking, breathing, coughing etc.<\/span><\/span><\/span><\/p>\n

The\u00a0principal route for the transmission<\/a>\u00a0of the novel coronavirus is through respiratory droplets from pre-symptomatic as well as asymptomatic individuals. Although the viral droplets were\u00a0earlier thought to remain actively suspended in air<\/a>\u00a0for only\u00a03\u00a0hours,\u00a0a\u00a0new preprint suggests<\/a>\u00a0that the viruses in the droplets can survive for over\u00a016\u00a0hours.<\/span><\/span><\/span><\/p>\n

Some of the measures that can prevent the spread of the virus are limiting interpersonal contact through physical distancing and tracing infected individuals. Wearing masks in public has been established as effective in reducing the incidence of transmission per contact. As one would expect, this is most effective when mask-wearing is adopted as a\u00a0consistent practice by the public.<\/span><\/span><\/span><\/p>\n

Respiratory protection for respiratory transmission\u00a0<\/b><\/span><\/span><\/span><\/p>\n

A research team led by Jeremy Howard, data scientist and faculty member at the University of San Francisco, proposed a\u00a0mathematical model of\u00a0COVID-19\u00a0transmission. The model estimates the successful outcome of wearing masks considering three aspects: efficacy of the mask in offering protection against the virus, the proportion of the people who practise mask-wearing, and the rate of transmission of the virus. The model suggests that if most people wear a\u00a0mask in public, the transmission rate is at its lowest, effectively slowing down and eventually stopping the spread of the disease. A\u00a0rudimentary\u00a0DIY\u00a0(do-it-yourself) mask will not block every single viral particle but it lowers the transmission rate.<\/span><\/span><\/span><\/p>\n

As asymptomatic, infectious carriers contribute to a\u00a0significant proportion of the infections and masks do an effective job of blocking the infection at the source,\u00a0\u200b\u201cmasks for all\u201d may be the best option for preventing disease spread.<\/span><\/span><\/span><\/p>\n

In a\u00a02015\u00a0study, a\u00a0team of Indian scientists\u00a0studied the dispersion of particles<\/a>\u00a0expelled during coughing\/\u200bsneezing using aerodynamic simulation techniques. The study was led by Guruswamy Kumaraswamy, Indian Institute of Technology (IIT) Bombay; Prem Andrade, Ansys Software; and Pankaj Doshi, Pfizer Inc. The researchers observed that larger droplets emitted from coughing\/\u200bsneezing can be blocked by a\u00a0mask. A\u00a0mask reduced the distance travelled by smaller droplets from nearly\u00a02\u00a0metres to less than\u00a030\u00a0cm. At the same time, maintaining a\u00a0physical distance of at least\u00a02\u00a0metres is greatly beneficial as even the particles that escaped the mask in the study could carry the virus no farther than\u00a01.5\u00a0metres.<\/span><\/span><\/span><\/p>\n

A Cambridge University study published in\u00a02013\u00a0compared homemade masks made out of a\u00a0variety of household materials with surgical masks on their efficacy in offering protection during an influenza pandemic. All the masks studied in the report reduced the number of microorganisms expelled into the air by volunteers, at least to an extent. Masks from dish\/\u200bcleaning towels or cotton blend t\u2011shirts turned out to be considerably effective in capturing small particles (stopping\u00a083% and\u00a074% of the particles, respectively).<\/span><\/span><\/span><\/p>\n

Cloth masks, when worn by infected individuals, can play a\u00a0role in protecting people in their immediate surroundings from the infection even if they are not as effective as an\u00a0N95\u00a0respirator tailored for medical personnel. Cloth masks offer source control\u2009\u2014\u2009they reduce the possibility of transmission of infection from an infectious mask wearer. This is the single most important reason for the public to wear\u00a0masks.<\/span><\/span><\/span><\/p>\n

In order to rightly prioritise the medical and clinical community\u2019s access to respirators and surgical masks, the Indian government is encouraging the use of cloth masks. Taiwan, Thailand and the Czech Republic are other governments who have encouraged the use of\u00a0DIY\u00a0or cloth masks by the public. Cloth masks, as an alternative to surgical or\u00a0N95\u00a0masks, offer reduced blockage of viral particles and yet a\u00a0higher degree of protection against transmission when a\u00a0large proportion of the public wear\u00a0them.<\/span><\/span><\/span><\/p>\n

Mask-wearing is an enduring and powerful form of protection, even beyond the biological context of disease spread, as it fosters a\u00a0sense of social responsibility and unity, which is necessary to face a\u00a0challenge like the present pandemic.<\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Note:\u00a0This content was originally published on\u00a0IndiaBioscience\u00a0on June 8, 2020, and has been republished here with permission.\u00a0 If previous pandemics have offered the world a\u00a0lesson or two, then it is the use of masks. The practice of wearing face-masks to prevent disease\u00a0can be dated back to\u00a0the\u00a01910-11\u00a0Manchurian epidemic in China. It was\u00a0Wu Lien-teh, a\u00a0Cambridge educated Chinese doctor\u00a0who […]<\/p>\n","protected":false},"author":2162,"featured_media":33313,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[2445],"tags":[2711],"new_categories":[],"new_tags":[],"series":[],"class_list":["post-3612","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid-19","tag-covid-19"],"acf":[],"yoast_head":"\nThe history and science of mask-wearing | Editage Insights<\/title>\n<meta name=\"description\" content=\"The history and science of mask-wearing: Preventing COVID-19 with scientific guidance\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.editage.com\/insights\/the-history-and-science-of-mask-wearing\" \/>\n<meta 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