POST 122. February 1, 2021. CORONAVIRUS. Dr.Fauci endorses double-masking. Dr.Osterholm disagrees!

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“They say two heads are better than one, but can the same be said for masks?

The answer is yes, according to Dr. Anthony Fauci, the nation’s top infectious disease expert.

“So, if you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective,” Fauci told “NBC News’ TODAY” on Monday. “That’s the reason why you see people either double masking or doing a version of an N95.”…

In mid-December, Linsey Marr, a professor of civil and environmental engineering at Virginia Tech who is a leading expert in aerosol transmission of viruses, and Dr. Monica Gandhi, a professor of medicine at UCSF/San Francisco General Hospital, published a commentary calling for double masking,

“For maximal protection,” Marr and Gandhi suggested the public could “wear a cloth mask tightly on top of a surgical mask where the surgical mask acts as a filter and the cloth mask provides an additional layer of filtration while improving the fit.”

A second option, they said, could be to wear a three-layer mask made from a flexible, tightly woven fabric that conforms to the face, with an insert of a “non-woven high-efficiency filter material,” such as a vacuum bag.

Of course, the best facial coverings for protection are the N95-type respirators, made from fibers woven with an electrical charge that can trap errant particles, much like a sock that sticks to a blanket in the dryer. Similar products include the Chinese KN95, the European FFP1 and FFP2 versions, the Australia-New Zealand P2, the Korean 1st Class and the Japanese DS2.

“Consider upgrading from a cloth mask to a surgical mask, or from a surgical mask to an N95/KN95/equivalent if available. Better masks may help reduce risk from more-contagious strains,” former US Centers for Disease and Control director Dr. Tom Friedan tweeted Monday.

But the CDC isn’t currently recommending N95 masks for the general public, partly due to a shortage of the masks for health care workers, and also due to concerns that people will tolerate the masks, which can hinder breathing.

“I worry that if we suggest or require that people wear N95’s they won’t wear them all the time,” Dr. Rochelle Walensky, the new head of the CDC told CNN’s Anderson Cooper and Chief Medical Correspondent Dr. Sanjay Gupta in a town hall Wednesday.”

“They’re very hard to breathe in when you wear them properly,” Walensky said. “They’re very hard to tolerate when you wear them for long periods of time.”” (A)

“A recommendation about double-masking by White House advisor Dr. Anthony Fauci isn’t receiving any praise from one of the nation’s leading experts on COVID-19.

Dr. Michael Osterholm, who leads the Center for Infectious Disease Research and Policy at the University of Minnesota, refuted Dr. Fauci’s claim that double-layering would likely make masking “more effective.”

“I do not support the idea of two masks,” said Dr. Osterholm, who spoke to WCCO Radio’s Cory Hepola on Wednesday morning.

Osterholm explained that masks work based on how they fit and their filtration.

“Masks, as they’re defined work in two ways. The first is in regards to how that masks fits. How well does it fit around you? It’s like swimming goggles. They don’t usually leak through the lenses they leak through the seal around your eyes or face,” said Osterholm.

Dr. Osterholm pointed out the N95 respirators are so highly regarded because of how they filter out the virus.

“They have a very tight face fit and the material that’s used basically for the filters is electrostatically charged,” he said. “The pore size lets air travel through easily, but the virus is trapped as it comes through by an electrostatic charge in the respirator.”

Doubling up on masks would likely lead to more harm, than good, when it comes to cloth face masks, or even N95 respirators.

“If you put more of it on, all it does is it impedes the air coming through and it makes it blow in and out along the sides. The fit becomes even less effective,” Osterholm said. “Double masking could be a detriment to your protection.”  (B)

“The case for wearing a face mask to protect against COVID-19 is strong. According to the latest scientific brief from the Centers for Disease Control and Prevention (CDC), face coverings can reduce the risk of coronavirus infection by more than 70%. But if wearing one face mask offers solid protection, does wearing two masks at the same time work even better? Some people have started “double-masking” to increase their odds of staying COVID-free, and the trend made us wonder what the science says. Here’s what experts told us.

At this time, very little scientific data points to any benefits or drawbacks of wearing more than one face mask, Scott Segal, MD, Thomas H. Irving professor and chair of anesthesiology at Wake Forest Baptist Health in Winston-Salem, North Carolina, tells Health…

One small study directly addresses the benefit of wearing two masks simultaneously, but it hasn’t yet been peer-reviewed (which means the results shouldn’t be used to guide doctors and clinicians yet). In that study, the researchers found that a two-mask “sandwich” might prove better when a higher-functioning mask isn’t available.

“Wearing two masks might be a reasonable idea if the filtration capability of the masks isn’t very strong,” says Dr. Segal.

Most studies, including Dr. Segal’s, have found that multiple layers of cloth filter viral particles better than one single layer, and two layers of high-quality cloth with a tight weave perform best. “With poorer quality materials, more layers may perform better,” Dr. Segal says…

The issue comes down to quality vs. quantity: If a well-fitting, effective face mask isn’t available, then two lesser-quality face masks worn together might improve protection…

Double-masking or adding a filtering material might be the latest pandemic trends, but you don’t need to jump on them just because you see other people doing it. “The consensus is that an appropriate mask is either a surgical mask or a cloth mask that has two layers,” Dr. Krilov says.

Here’s a quick refresher on the best face masks: The CDC recommends choosing a mask that has two or more layers of washable, breathable fabric. It must completely cover your nose and mouth and fit snugly against the sides of your face (no gaps). Don’t wear a mask that’s made of vinyl or another fabric that makes it difficult to breathe. The CDC also advises against a mask with exhalation valves or vents, as these let virus particles escape.” (C)

But while Dr. Anthony Fauci has said it’s “common sense” for people to double-mask right now, most experts say they’re not changing how they mask.

“If you’ve got a decent mask, then the thing you need is something that’s going to make it seal around your nose and your cheeks, under your chin,” University of Maryland virologist Don Milton told Insider. “The best thing is to get one that fits.”

Insider surveyed Milton, along with a dozen other leading public health experts, including doctors, virologists, mask-makers, and environmental engineers. None of them said they are double-masking right now, but that doesn’t mean you shouldn’t. Double-masking can still be useful, especially if you don’t have a mask that filters or fits well.

Dr. Anthony Fauci, the US’ leading infectious disease expert, likes to wear two cloth masks, because he says it’s “more firm and comfortable” than just one, but he says that’s not a choice influenced by rigorous scientific evidence.

“There is no scientific study that I know of,” Fauci told the New York Press Club on Friday, clarifying that his stance on double-masking is a personal one, and not a professional recommendation.

Just because Fauci likes to double-mask doesn’t mean you have to. Many masks on the market are multi-layered, and include filters or special fabrics to trap virus particles inside, making them highly effective.

Double-masking is not always practical, either. Dr. Karen Landers, assistant state health officer at the Alabama Department of Public Health, experimented with double-masking: wearing a cotton mask on top of a surgical mask (which is the way that most experts would recommend) — but it didn’t go smoothly. 

“By the time I adjusted it, and accounted for bunching, and for the difficulty of really keeping it positioned in place, I decided that if I had trouble doing it, that perhaps this was not a good strategy to advise the general public,” Landers said.

This is why Landers stresses that wearing one mask that fits correctly is better than wearing two masks.

“If we start going into a strategy of wearing two masks, that is really not, in my opinion, better than wearing an appropriately constructed, layered mask that is correctly fitted and consistently worn.””  (D)

• A.Are two masks better than one? Double masking ‘just makes common sense’ to help prevent COVID-19 spread, Fauci says, by Adrianna Rodriguez, https://www.usatoday.com/story/news/health/2021/01/26/covid-double-masking-effective-fauci-says-makes-common-sense/4157884001/
• B.Osterholm: Double masking could lower your protection against COVID-19, By Mark Freie and Cory Hepola, https://www.radio.com/wccoradio/news/local/osterholm-raises-concerns-over-double-masking-recommendation
• C.Does Wearing 2 Masks Protect Against COVID-19 Better Than One? Here’s What Experts Say, By Claire Gillespie, https://www.health.com/condition/infectious-diseases/coronavirus/does-wearing-two-masks-prevent-covid
• D.We asked 13 public health experts whether they double-mask. None of them do., Hilary Brueck and Kelsie Sandoval, https://www.businessinsider.com/should-i-double-mask-protect-covid-19-many-experts-dont-2021-1