What we misunderstand about masks

Posted on 18 March, 2021

“What do masks actually do? Do empty middle seats actually save lives?”

By: Fahry Slatter – AIYA National Blog Editor

Translated by Gabriella Pasya – AIYA National Translator

Graphic Design by Lita  – AIYA Graphic Design Officer, oversight by Vania Djunaidi – AIYA Communications Coordinator

Bahasa Indonesia version click here.

There appears to be a lot of confusion surrounding the effectiveness of masks and how they protect us. What’s just as dangerous as the spread of the coronavirus is the spread of misinformation, specifically on masks. People have started forming their own opinions and guesswork, relying on folk wisdom and wishful thinking. Some have even ditched the idea of wearing masks and will be quick to dogpile on the first person to even bring up the topic. However, decisions cannot be made based on wishful thinking, and vague folk wisdom, but instead facts and what we’ve learned from previous diseases. Let’s dive into the world of mask wearing.

To understand masks, we first need to understand two important tangents, and then combine the pieces together in order to make any sense out of it.

When you sneeze, cough, talk, or even just breathe, the process is similar to when you shoot a water gun. You’re releasing tiny saliva droplets/particles that are trying to escape the barrel of your mouth, into the air as it propels forwards towards a target.

Take a look at the person in the picture below. You can’t see this with the naked eye, but we can see that a simple sneeze can emit a lot more than you’d think. The visual process is similar to a water gun spraying water all over the place.

Visualization of a sneeze ejecta: Scharfman, B.E., Techet, A.H., Bush, J.W.M. et al. 

Your mouth is like the muzzle of a water gun containing the ammo that is your saliva, shot through a sneeze and these droplets of saliva want to escape and hit a target. However, it gets more complicated after that. Not long after the virus became international, news got out that the coronavirus is evidently “airborne transmitted” – and from here, the situation went from confusing to even more confusing, and in some cases people started forming their own definitions as to what this means.

Airborne transmission is like the tiny splashes of water that ricochets and goes everywhere when you hit something with your water gun. These tiny splashes of water (separate from the main big splash) spread outwards and will eventually land on a surface, causing everything nearby to be wet. This could be a doorknob, handrail, buttons on an elevator, or a person, etc. We come into contact with a lot of these everyday items, most of the time subconsciously, hence why scientists and medical professionals are pushing the old, timeless saying “Wash your hands”. 

Remember: It doesn’t have to be a sneeze – even talking or just breathing propels particles from your mouth. 

This is arguably the most misunderstood and important concept of the coronavirus and what many get wrong about it. Contrary to popular belief, the coronavirus is all about viral load. How sick you get, depends on how much of the virus you catch. Growing up, we were led to believe that you either get sick or get nothing, and how sick you get depends on how many Fish oil pills you swallow in the morning i.e. how good your immune system is – but for the coronavirus, research shows otherwise. Studies tell us that how bad your symptoms are depends on how much of the virus you catch.

In the words of scientists themselves, Source: Burgess et. al (2020)

When you catch the virus, 3 things can happen: You can either get serious to fatal symptoms, or you can get mild symptoms, or you can even get no symptoms at all (hence asymptomatic). Monica Gandhi, MD, found that how severe your symptoms are depends on how much of the virus you get, i.e. the viral load. If only a tiny fraction of the virus enters your body, you will most likely not have any symptoms, and the severity increases if you catch more of the virus.

In a 2020 study with hamsters, Masakai Imai et. al (2020) further proved this concept, and the experiment showed that hamsters who were injected with less of the virus showed less severe symptoms than those who had a larger viral load. We’ve learned this to be the case since the 2012 MERS virus, by scientists in the Middle East, so Viral Loads aren’t a breakthrough.

So, now we know that your mouth and breath shoot tiny droplets into the air that splash everywhere. We also know that the less virus you get, the less sick you get. 

Now it’s time to bring those two pieces of the puzzle together and make sense out of them. 

When you put on a mask, the momentum, distance and droplets that make it into the air changes.

Observe: (Left) The unmasked man breathing/talking. (Right) The masked man doing the exact same action, but this time with a mask. Source: M.Staymates/N.Hanacik (NIST)

The change is significant. You can see that your breath along with other particles (germs, bacteria and more importantly, viruses) are greatly reduced and only surrounds the orbit of your mouth. Masks block those airborne splashes of saliva/virus from propelling outwards. Putting on a mask is the equivalent to pumping less power into your water gun. You are greatly reducing the amount that is sprayed and moreover, the distance that it travels, so the splashes of water stay within your physical space.

You’re greatly limiting the momentum and also the distance that the airborne particles travel at. So, you also have a smaller splash and are less likely to hit people around you.

“I’m not sick and have no virus to breath out, should I still wear a mask?!”

“Even with a mask, the guy is still spewing a lot of germs!”

Let’s revisit the second piece of the puzzle: The less virus you get, the less sick you get. Eventually, some of the virus will escape your mask, as they are far too small and will slip past – even if you have a good mask, inevitably, some will escape.

If you are on the receiving end, wearing a mask will filter and block most of those droplets of saliva/virus from entering your mouth and nose, like as if it were a shield. You are thus, reducing the viral load you take, leading to less severe symptoms. So, if you are on the receiving end, masks still protect you. Not feeling sick, does not free you of the duties to put on a mask, even if you don’t have any virus to project.

Thus, you fire less virus out of your mouth with less power and distance, and you also get the filtering effect by wearing a mask, reducing your viral load. Now, assuming that everyone wears a mask, repeat this cycle with everyone on Earth and you can start to see how it could save lives. 

Empty middle seats and how…..it does very little

Simulation of how germs spread after a single cough in the cabin of an airplane, Yan Chen, PhD Purdue University.

If you apply this logic in vital areas that need masks the most such as elevators, airplanes, and other claustrophobic spaces, you can see how life changing wearing a mask can be. In the simulation above by Yan Chen, PhD, a single cough combined with the air movement caused by ACs, moving arms, people walking by, etc. can spread germs. 

But If you were to wear a mask, in the words of Yan Chen himself, it would greatly help(Yan Chen, Purdue University), again because you’re not firing your splashes of saliva to people when you sneeze/cough. Even if you do sneeze or cough, the people around you have that filtering effect so they’re reducing the amount of virus they receive.

Should you sneeze into your mask, on your hands, or on your elbows or just sneeze into the open air?

As disgusting as it may sound, the safest way to sneeze is to sneeze into your mask, though try to get it as far away from others as possible. Your own saliva can’t hurt you. It can be very tempting to pull your mask down and sneeze into your hands or on your elbows and prevent contaminating that beautiful mask of yours, but sneezing into it can potentially save a life.

Understanding masks is simple – what is difficult is combating misinformation and wishful thinking. Those anti maskers and people spreading their own unverified solution have most likely been misinformed. 

Wear a mask and potentially save a life.