Most of us are aware that the right type of mask can offer more protection against the new coronavirus, but your mask choice can also impact both the economy and the environment. To understand how, we must first understand why we need masks.

Unlike other viruses, this current coronavirus allows people to be contagious for a full five days before any symptoms occur. Pre-symptomatic people are spreading the virus and walking around for days before they even know they need to self-isolate.

What’s worse, people shed more of the virus and are much more contagious during this pre-symptomatic stage than when they actively show symptoms. Pre-symptomatic transmissions occurred in at least half of all transmissions in Asia, according to the European Centre for Disease Prevention and Control (ECDC).

Also, a high viral load (the amount of virus you inhale) is connected to the severity of symptoms. A study from Amoy Gardens in 2003 showed that viral load had worse outcomes for SARS patients. This is important as SARS is about 80% genetically identical to this new coronavirus.

This may explain a great deal about why health care workers have a higher mortality rate, as they are more exposed to the virus.

In addition, this virus is much more contagious than other viruses. The R0 value (the average number of people a single person transmits a virus to others) of the flu is 1.2. According to the Center for Disease Control and Prevention (CDC), this new coronavirus started with an infection rate of 5.7. However, it has now been found from the researchers at The Scripps Research Institute that the viral strain currently in Europe and America has mutated to be “about ten times more infectious than the original strain.” That means one person, on average, infects 57 other people. The most contagious virus we know of is the measles, which has a R value of 18.

According to the World Health Organisation in July, this virus is likely more contagious due to the “possibility” of it being transmitted through aerosols. Forget about someone coughing near you, they only need to ‘talk’ near you to potentially transmit it. Italian scientists from Bergamo found viable viral particles in air pollution, meaning the virus may even travel through the air through air pollution. Also, the Society for Healthcare Epidemiology of America recently found in studies that “faeces may form high concentrations of viral aerosols that travel through the air to cause infection,” which makes public toilets one of the most dangerous places for viral transmission.

The need for masks

There is something that could significantly decrease viral load, lower the rate of infection and protect others from contagious pre- symptomatic people: masks. Studies have shown a 55% weekly increase in coronavirus deaths per capita after their first case was reported in countries where masks weren’t recommended, compared to 7% where masks were required.

What type of mask?

The type of mask used changes how effective it is against the new coronavirus. Michael Osterholm, regents professor and director of the Center for Infectious Disease Research has recently stated in an interview on The Joe Rogan Experience that wearing the right type of mask does makes a difference, and the N95 (FFP2) or N99 masks (FFP3) provide the most protection. These masks are medical-grade and filter out 95% or 99% of particles in the air, respectively.

These masks tend to be tight-fitting (avoid having long beards) to provide greater protection, but they may also be uncomfortable to wear for long periods of time. Avoid masks with valved masks, as they do not filter the wearer’s exhaled air.

Surgical masks are looser fitting and more comfortable. They are much more effective than homemade masks, but not quite as effective as the N95 or N99 masks. In 2013, Cambridge University found surgical masks were three times more effective than any type of homemade masks. Viruses are very tiny, and their particles can go right through many homemade masks. However, any type of mask still significantly reduced the number of microorganisms (at least 50%).

Avoid buying disposable N95 masks, as these are the same masks that most healthcare workers use. Purchasing them could risk a shortage.

‘Green’ masks are important for our environment

Surgical masks need to be changed every four hours of use. This is needed for healthcare workers, as they see multiple patients in a day and do not want to risk cross- infection. However, for the rest of us, there is no need to use disposable masks. Any single use, disposable mask wreaks havoc on the environment. Most disposable masks end up in landfills or oceans. In late February, Oceans Asia reported finding “masses of surgical masks washing up on the shoreline.”

There’s an issue with non-disposable masks as well. They are typically made from petroleum-derived plastic, contributing to plastic pollution, contaminating rivers and act as choking hazards to wildlife. According to the World Wildlife Fund, “If just one percent of the masks were disposed of incorrectly and dispersed in nature, this would result in as many as ten million masks per month polluting the environment…forty-thousand kilograms of plastic in nature.”

Wearing a mask will not seriously harm you

For the general public who are able to wear masks without respiratory or other health conditions, masks have no serious side-effects. It’s true, some masks can fog up your glasses, make you feel more light-headed on a hot day or slightly limit your oxygen intake temporarily. They can also increase your urge to rub your eyes or touch your mask after it has been collecting germs, which can transmit the virus.

However, claims that wearing a mask creates hypercapnia or hypoxia are likely untrue. Sarah Stanley, an associate professor of Infectious Disease and Vaccinology at the University of California in Berkeley School of Public Health states, “Many people have routinely worn masks for long periods of time without clear adverse effects…we would know if hypercapnia was a problem.” Surgeons have been wearing surgical masks while performing surgeries that last for hours without getting hypercapnia.

Masks are just the start of our protection

No matter what mask you use, they are not the only tools we can use for protection. If this virus is truly airbourne, we may want to also consider wearing goggles or face shields. We can also wear masks anytime we are in a situation where we are more exposed to the virus, not just when the laws tell us to do so.

Using masks when needed will likely slow the progression of this virus enough to boost our economy. New research from Goldman Sachs suggests a national mask mandate may lower the growth of infection rates enough to prevent a 5% GDP loss caused by additional lockdown measures, which is over 14 billion pounds in England.

What can we do?

Washable, reusable and recyclable N99 masks offer maximum protection against this virus. If a N99 mask is too uncomfortable or tight-fitting, an eco-friendly surgical mask can provide short-term protection.

We are still learning more about the most effective ways of controlling this mutating virus each day. In the meantime, our mask choice, hand hygiene and social distancing can still greatly help control the current impact of this virus, and prevent a potential second wave.

Dr Persephone is a fully licensed herbalist and acupuncturist, Nutritional Therapist, Integrative Medicine Practitioner and Diplomat of Oriental Medicine.