How We Screwed the Pooch with Masks

I must first disclose that I’m not a COVID conspiracy believer, I’m not an anti-vaxxer (I am fully vaccinated) and I am not an anti-masker. I even transformed some of our manufacturing capacity into making surgical N95 respirators. I hold two engineering degrees in aeronautical/aerospace engineering, worked at NASA 14 years, did a few startups in the software space and have now been CEO designing and manufacturing FDA Class II medical devices in the U.S. for over 10 years. Why do I have to throw my beliefs and credentials up before I write an article? Because I’ll probably get hate mail and get cancelled for what I’m about to say and I am going down screaming.

The History

First, I’ll ignore all the stupid going on at the beginning of the pandemic. Those are things like the government telling people they don’t need to wear masks to the surgeon general getting on TV showing how to fold a towel to make a mask (it really looked like an instrument you would stuff in someone’s mouth in a horror movie). I am ignoring all that.

What the government then settled on was telling people to wear masks, not to protect themselves, but to protect everyone else. That’s right.  It’s the patriotic thing to do. To point out the lunacy of this approach, I’ll use a winter coat analogy. Can you imagine the only way you could stay warm standing out in the cold is if EVERYONE ELSE had to put a winter coat on? You would be running around going “I’m cold!!  Put your damn winter coat on!!” There would be slug fests in the streets as we would all be in the winter-coat-policing business with half the country (especially in Florida) screaming “BURN the winter coats!” And it gets better. People would only put on a wind breaker… They might even put on short pants to spite you.

That’s where we are with masks. We have pitted people against each other to be hall monitors with the belief they need to find and rat out every person not wearing a mask and do a citizen’s arrest. How did we do this? By telling everyone that the other person not wearing a mask is causing you to get sick. All the people showing up in hospitals with COVID are victims of the non-mask wearing population. The new mode of operation is to politicize everything and pit people against each other to get any policy through. Thank goodness we already accepted the wearing of underwear before now. One thing is very clear though: We will NEVER convince everyone to voluntarily wear a mask so the premise of everyone protecting everyone else fails. We now have people wearing “any mask” and most are as useless as seat belts on an airplane.

The State of the Union

So why didn’t we work towards a plan to provide proper masks and education that protect the wearer? Masks have two basic requirements: Appropriate filtration material and a good 360-degree seal on your face. What I am referring to are N95 or N95-like masks that seal to a person’s face and don’t leak on the edges and fog up your glasses. I get it that in the early days of the pandemic this was not possible but here we are over a year later and people are still wearing 4x9 procedure masks with ear loops (but now we can smash it to our face with a second mask to get it to work better) and Chinese made KN95s that are many times poor quality and don’t seal well on your face. If we are lucky, people keep their nose in the mask – but it’s rare. 

Also, here’s the dirty little secret most people don’t know: The material used to make 4x9 surgical procedure masks with ear loops is the SAME material used to make N95 respirators! They are both made with polypropylene fabrics called melt blown and spun bond. Putting those fabrics through an origami-like folding and welding process gives you either a flat mask that doesn’t seal to your face or an N95 mask that does. The issue is it is much harder to perform the N95 manufacturing and regulatory burden than flat mask manufacturing.

Let's Change This

So where do we look for guidance? Hospitals have had to deal with health care workers walking into highly infectious spaces since the beginning of time. The occupational safety and infectious control people have this stuff well figured out. They fit test many brands of masks with different designs and have heaps of data of what works and what doesn’t. For example, they may know that a KN95 style mask will only pass fit testing on 23% of their employees (I’m just making these numbers up to prove a point) whereas a horizontally folded and pleated design will pass fit testing 87% of the time. Some of these hospital systems have literally fit tested tens of thousands of people over the years. So this is where the inspiration comes from to develop more generic sizing (like underwear) and specific designs (like briefs or boxers or boxer-briefs) to solve the fit-testing problem for the masses. Yes, it’s better to get my shirts custom sized and made (never done it actually) or I can just buy an XL from L.L. Bean. 

This is why hospitals will not buy certain designs of N95 respirators. In my discussions with hospitals, the vertical fold style N95’s that look like KN95s with head straps just have a low fit testing success rate whereas boat-style and horizontally folded designs have much higher fit testing success. It’s also why hospitals pre-pandemic didn’t allow doctors and nurses to wear cloth masks smashed over a surgical mask (remember…. Same material could have been used to make an N95). 

So what should our government have done or do now? I love this part as I get to play Monday morning quarterback with all the luxuries of knowing what didn’t work. The scary thing is, nothing has worked all that well for the masses. A lot of people are still getting sick and a lot of people are wearing masks. So now we have many people saying “masks don’t work.” It’s like saying coats don’t work because you once tried a light spring jacket in the depths of a Minnesota winter. Improper mask wearing does not work. Proper masking with better masks and respirators does.

The government should have worked with hospitals and industry and came out with 3-4 respirator style mask designs, made them open source, and told industry “Make these and we’ll buy and distribute them.” Instead, we have this wild west garbage going on with China flooding our markets with fake 3M products and inferior KN95 designs. It is sheer madness. To top it all off, the big online media and shopping sites won’t allow American-made N95s to sell or advertise. I have no idea what that is about. Go to Google and search on “N95” and click “Shopping.”  BAM! Blocked! Search on “KN95” and the screen fills with China certified products.  I digress though.

Protect Yourself with Better Masks

The point of this article is to say the time has come for people that want to protect themselves to wear a face-sealing respirator style mask because the reality is the person sitting next to you on an airplane or train probably doesn’t care about you. In a perfect world, I would love to see everyone on an airplane wearing an N95. It will NEVER happen. So, I’ll wear my N95 knowing it provides great protection for ME and the hell with the guy in the middle seat wearing his flat mask below his nose. In fact, I would prefer he just took the damn thing off and be happier. A bunch of angry people wearing bad masks improperly doesn’t help anyone. Let’s focus on the people that want to protect themselves and provide better masks and education.

Do I need to mask everywhere to protect myself?  I don’t think so but that’s my opinion. In high-risk situations like on an airplane, public transportation, stuck in a classroom all day or going to the grocery store during flu season?  I’m going to put on an N95. I’ve participated in the H1N1 pandemic two times both resulting in hospital time. I’m pretty sure coast-to-coast flying caused it for me. One thing I can say for certain is I am out of the mask policing business. I am just going to put on my own winter coat if I’m cold. 

One last thing is I do have to put a plug in for ivWatch and our wonderful mask and respirator collection at https://blox.ivwatch.com/ : Put one on and protect yourself.